If you’ve ever tried to get help from a mental health professional, you have already encountered the dizzying array of choices, degrees, certifications and qualifications among people working in this field. It can be bewildering to figure it all out:
- Who does what?
- How do I know if I am going to find the right help?
- Is this person good at what they do? How can I tell?
- How do I use my health insurance?
- What if I don’t want to use my health insurance?
- What if my insurance doesn’t cover this kind of treatment?
- Yikes! Where in the world do I begin?
What’s the Difference Between a Psychiatrist, a Psychologist and a Therapist?
While there are challenges facing anyone on this journey, a few basics may help provide some direction and clarity. First, the professional titles. A psychiatrist is a physician who has graduated from medical school, just like a pediatrician, surgeon, pathologist, or medical specialist. Psychiatrists earn the degree of Doctor of Medicine (MD) or Doctor of Osteopathy (DO) (a topic for another blog). Training after medical school determines what kind type of medicine the graduate intends to practice. A psychiatrist generally has four years of training after medical school, and then may choose to become “board certified”—originally an optional designation, but now required or highly recommended for certain kinds of physician employment.
The training to be a psychologist is actually quite different from medical training. Graduate school studies involve both academic work and clinical training, culminating in a doctoral degree, either a Doctor of Philosophy in Psychology (PhD) or a Doctor of Psychology (PsyD). A psychologist may find work in a very wide variety of settings, from working with patients and treating mental illness to doing research, teaching or providing many kinds of services to individuals, groups or businesses.
What, then, is a therapist? A therapist, or psychotherapist, is a person who has received specific training to offer help to those dealing with any number of psychological or emotional concerns. Training can range from a few to a great many years and can be undertaken by people with many different kinds of academic and experience backgrounds. Many therapists first earn a Master of Social Work (MSW) and then go on to more intensive training in psychotherapy. However, many psychiatrists and psychologists also engage in psychotherapy, having gained classroom and experiential training to become therapists. They usually are referred to as psychiatrists or psychologists as a professional distinction; nevertheless they, too, treat patients using psychotherapy.
And while there are even more types of professionals working in the mental health field, this covers the most frequently observed role titles and their essential differences and similarities.
How Does Insurance Coverage Affect My Choice of Mental Health Professional?
We all understand that using our health insurance benefits can be a complicated journey. Many people don’t really know what kinds of services are covered, or what “coverage” even means. Most plans require you to check in advance with a potential provider to determine if he or she is included in your plan before you make a visit, or you will be charged the full fee. Even if the provider is covered, almost always these plans include a deductible, a co-pay, limitations on the number of sessions or even on the kind of professional whose services are eligible for coverage.
Finding a professional through an insurance website can be a challenge. While in some areas appointments are easily obtained, other practices may have long waiting lists or are not accepting new patients at all. Your primary care physician can be a source of recommendations; however it is rare for one to break the rules and assist you in getting an otherwise unavailable appointment.
Your provider directory will likely include providers from corporate medical organizations that employ hundreds, even thousands of physicians and other health care professionals. It may also include independent practitioners who often are more flexible, more available and are relatively free to operate outside of institutional parameters. These individuals accept (meaning they accept the “assigned fee” for a particular service) health insurance.
Where Else Can I Look for Help?
If you would rather base your choice on something other than membership in your insurance panel, Psychology Today is a great resource for lists of well-organized, well-described practitioners from all fields of mental health. It has an excellent search engine and provides an overview of each professional—their specialty, style, the kinds of treatment they provide and other information. The site also includes listings of those in a particular profession, such as marriage counselors, addiction specialists or treatment facilities, as well as naturopathic or holistic healers.
You may discover physicians in other ways, too, through employee assistance programs, school guidance centers, health fairs or various rating websites such as Yelp. And although treatment for mental distress is rarely a topic of conversation, you might be surprised what you discover by asking a trusted friend or relative about their experience with the mental health world.
How Do I Pick the Right Mental Health Professional for Me?
So, now that you are thoroughly overwhelmed with options to consider and various paths to follow, what to do? No doubt, this is a very difficult, potentially awkward or frustrating journey. Here are a few tips:
- Check with your insurer so you know what is available. November is usually the “re-up” month for choosing your plan for next year. Find out about mental health coverage and about out-of-network (OON) coverage. Policies with OON benefits can give you more flexibility and a wider range of options, even if there is some increase in your monthly payment.
- Start with familiar sources of information. Ask trusted family, friends or colleagues for suggestions. A connection of any kind can cut through much of the uncertainty and ambiguity you face in this process.
- Trust your gut. Instincts may not align with what you see or hear, but that small voice inside possesses wisdom about you and your desires that no one else knows. Allow yourself to wonder, to be curious and to take a chance if you are drawn in a certain direction.
- Don’t get discouraged if your first choice doesn’t work out. Of course we all hope the first choice will be “the one” and we won’t have to look any further because we will feel a “click” soon in the initial visit. However, that might not happen. Don’t get discouraged. It’s okay to allow yourself time to think. It’s okay to compare, and it’s okay not to be sure right away. Commencing this journey is an act of faith; a need you have come to understand that will not be met without help from someone. It’s important to take the time to find the right partner. Remember that this is a choice about creating the life you want to live. This journey is worth sticking to, even as you may have to navigate some bumps in the road. Walk forward in hope.
Dr. Donald Schiermer, MD, PhD, MPH, is a family physician and clinical psychologist with decades of experience in clinical practice and psychopharmacology. He provides compassionate counseling and comprehensive medication oversight to help you reclaim a hopeful, fulfilling life. Contact Dr. Schiermer today to schedule your appointment.
Image Credit: William Bout