How does therapy actually work, how do you find a good one, and what’s the difference between counseling/therapy/psychiatrists/psychologists/etc.?
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People used to talk to me about therapy work when I was studying psychology and doing PhD. I never had any training in therapy during 6 years of psychology study. We were just doing experiments. We would touch on mental health and other issues, but usually it was through the lens of what does someone’s issues tell us about how mind actually works? So a psychologist is not always a trained therapist. I would be terrible at that too, I get social anxiety around someone in need. All psychologists from my uni who wanted to be therapists had to go to clinical psychology training and masters route, for actual application of knowledge and therapy skills.
Really simply, psychiatrists can prescribe medication and conduct therapy. Many choose to do brief sessions focused on medication and maintenance. Counselors and psychologists both conduct therapy but cannot prescribe. Counselors tend to get more training surrounding conducting therapy, but little on testing and research. Psychologists (PhD) are trained more heavily and conduct more testing and research than counselors. A psyD psychologist will likely have more therapy training than their phd cohorts but less research. Finding a good one is very specific to you. A different tool for every job. For instance, an individual who has strong insight and meta cognitive Skills could greatly benefit from straight forward CBT or ACT, whereas someone with more difficulty in this area might benefit more from say DBT or talk therapy. Even those examples are not catch all’s as every Person is different.
There’s already a lot of conversation on degrees and education, so I won’t focus on that much here. All I’ll say is that degree mostly tells you 1. how much research experience the person has (PhDs are research-heavy), which frankly has little to do with you in therapy, and 2. some insight into the therapist’s background (social workers look at social factors impacting mental health, marriage/family therapists use the whole family system in treatment, etc.)
Honestly speaking, your relationship with the therapist is the biggest driving factor for change. So, don’t focus too much on degree when looking for a therapist.
Finding a “good” therapist is all about finding a good fit for you. Some people scoff at the idea of Christian or religious therapy, but others would only feel comfortable with a therapist who shares their spiritual beliefs. Therapists with a strong background in research may be a good fit for clients with specialized and complicated problems (like multiple severe mental disorders), but typically wouldn’t serve diverse populations as well as social workers. So, your search should mostly focus on the therapist’s personality, with a little consideration for specialization.
Personality is basically random. It’s normal to “shop around” and see a few therapists before finding someone who you mesh with. Please remember to ask plenty of questions when you do this! Therapists understand that shopping around is a part of the process, and they don’t get offended by it. They want to help you find a good fit, too.
Specialization is easier to recognize. What’s important to note here is that certifications and trainings have nothing to do with the therapist’s degree, as they are acquired after graduation. The degree is foundational knowledge; the certification/training is specialization.
While not every problem needs a specialist, that information can be helpful to know. Psychology Today’s website is actually a great resource for looking up therapists in your area, and you can filter results by many things including the issue you want treated and the type of therapy used to treat it.
As a general rule, most therapists are experienced in Cognitive Behavioral Therapy (CBT) and Solution Focused Brief Therapy (SFBT). Trauma specialists are often trained in Eye Movement Desensitization and Reprocessing (EMDR) and, for youth, Trauma-Focused Cognitive Behavioral Therapy (TF-CBT). Marriage Therapists typically pursue training in the Gottman Method and Emotionally Focused Therapy (EFT)/Emotionally Focused Couples Therapy (EFCT). Child therapists usually have training in things like Sandplay and other play-oriented methods. However, this barely scratches the surface of certifications so there are certainly other models that are useful with these problems.
Again, it’s the therapist’s individual personality/skills and their relationship with the client that makes therapy successful – the method that the therapist uses is pretty much secondary. And, honestly, very few therapists are “purists” – most would call their approach “integrative” which means that they pull skills and theories from multiple models (called “common factors”) into their work. Just focus on how you feel in the therapy room with them and they’ll figure out a treatment that works for you. That’s their job, after all.
Psychiatrist: a medical doctor (or nurse practitioner)–someone who can prescribes medication.
Psychologist: has a doctoral degree in psychology, provides talk therapy.
Therapist: provides talk therapy. Depending on your location, this term is not strictly legally regulated. In my experience, but almost all have some kind of license like “licensed clinical social worker (LCSW),” “licensed professional counselor (LPC),” etc. Those qualifications do have specific legal requirements, probably including a master’s degree and supervised work experience. I’d be reluctant to see a therapist who wasn’t certified or licensed in some way, partly because the certification implies that they have experience and partly because it requires them to follow a variety of ethical rules.
In my experience, people who are using medication don’t just see a psychiatrist–they’ll see a therapist or psychologist regularly for talk therapy, and see a psychiatrist less frequently when they need to adjust their meds or get new prescriptions.
Suggestions for finding a good one:
– Read up on some common treatment approaches (cognitive behavioral therapy, psychodynamic therapy, etc). If one sounds like a good fit for you, you can look for therapists who use that approach.
– Use listings on psychologytoday.com, your health insurance website, or similar sites to find local therapists (i like psychology today because it has more filtering options you can use to narrow down the options). Read the profile info to see if they specialize in the type of issue you’re trying to address or treatment approach you’re interested in.
– It can take a while to find a therapist who is a good fit for you. Don’t be afraid to try several. In my experience, maybe 30% of the therapists I’ve seen were (IMO) bad people (ethical issues, judgemental/not respectful, etc). Another 40% seem like they’re probably good therapists for other people, but their methods and personalities didn’t really click for me. The remaining ones were a good fit, and they were really helpful.
Where are you? Where you live will affect these answers. A lot.
HEADS UP LONG COMMENT!
There are a lot of different kinds of therapy. I’ll try to give the best description and advice I can based on personal experience.
-CBT aka cognitive behavioural therapy. This is usually a group based therapy, that focuses on teaching you how to identify problems, learn how to fight problematic feelings and thoughts, and it teaches you a lot about taking a step back to see how your thoughts affect your actions. It’s really good and it really helps with coping. CBT is a short term therapy following several modules for a few weeks or months.
-DBT aka dialectical behavioural therapy. This therapy is often group based as well and also follows several modules as a short term therapy. It builds off of CBT but focuses more on validation, social aspects, and relationships. DBT helps correct destructive behaviour and negative thinking patterns and teaches you how to recognize and identify these problems.
-One on one therapy. This is exactly what it sounds like. You privately meet with a therapist, usually for around an hour, and you talk about your, stresses, feelings, problems with a professional who went to school to help you find solutions and offer knowledgeable advice on these things. This therapy is long term and very helpful in finding helping you with any problem or stress that you approach your therapist with. If you want to vent and cry or have a more serious discussion that’s what they are there for. They will validate your feelings in the right situations and still offer advice on what to do or how to manage in the problem. If you have some trauma or heavy experiences, they will help you open up and help you recover as it is mostly affecting your life in small ways in the present. Your therapist is someone that you go to who you can talk to about anything, even stuff you don’t feel comfortable talking to your friends or family about. Any conversation that happens with your therapist is confidential unless you want to hurt yourself or someone else.
Now to answer the next part. Counselling is usually short term and is used for more general issues. Therapy is long term and focuses on a broader spectrum of issues. Psychologists usually take on people with more severe mental health issues. They can diagnose disorder based on studying behaviour and can help treat the issue. Psychology is a PHD while a therapist is a Masters. Psychologists sometimes work with psychiatrists to provide proper treatment. A psychiatrist is the only one of those who can prescribe you with medication. Their main focus is figuring out what medication you need and what specific variant of medication is best suited for you. A psychiatrist will often recommend seeing a psychologist while you are getting help to get the best results for long term treatment.
Lastly, finding a good therapist can take some time. It’s important to find someone you actually feel comfortable talking to. Sometimes it can take a couple sessions to feel comfortable opening up, but if you still aren’t feeling too great about it, don’t be afraid to look for a different therapist. If you feel like you can talk to them about anything, and also think the advice and solutions they offer you are helpful, you’ve found someone good. Personally I found that looking for my own therapist online gave me better results than one recommended by my school or family doctor. Where I live they offer “sliding scale therapy” in some places. These are students who’s are finishing their masters or returning to do their PHDs. Not only is it cheaper, I’ve found it so much easier to click with someone who speaks to me the same way I speak to them while still being professional (it may have also helped that I felt more comfortable because the were closer to my age). I’ve found that I like behavioural one on one therapy the best, because while it’s still a normal session your therapist will pick up on small physical behaviours that you do while talking about specific issues and figures out how it’s subconsciously related to a problem. ex, sitting with your arms and legs close to your body or holding a pillow when talking about a certain issue can be a boundary problem. You are putting an object between you and the other individual or staying compact subconsciously. It’s a habit you probably developed from negative a serious of negative past events and your body is showing hints of that in ways that you don’t usually notice. They help you open up about those events and lower the walls you put up to help you heal.
Personally, I know I’ve found a good therapist when they aren’t treating my as “just another patient” and are actually engaging and attentive when I am talking. It’s important not to get discouraged when trying to find the right fit for you and it’s always good to ask someone who likes their therapist how they found them.
*this is only personal knowledge and understanding, it’s always good to do your own research to get the best understanding and most accurate results*
A lot of misinformation in this thread. Clinical psychologist here. Sometimes these terms depend on state and date of license issuance, but generally:
A therapist is someone who does therapy, this can be done by individuals with masters or doctorates. It is a catch all term.
Psychologist is a legal term for someone with a doctoral degree in psychology. This could be in a research field (ex cognitive psychologist) or a clinical field (ex clinical psychologist, neuropsychologist).
Psychiatrist is an individual who went to medical school and then chose to specialize in psychiatry, a blend of medicine and therapeutic skills. Some psychiatrist do therapy, some do more therapy (edit: provide medication), many do both.
A general difference between psychologists and psychiatrists is that psychiatrists can prescribe medication and deliver psychotherapy. Clinical psychologists can do psychological testing (IQ, personality, etc) and deliver psychotherapy.
Counseling and therapy are essentially synonymous, though sometimes counseling is used to refer to therapy for individuals without a severe mental health diagnosis.
One way to find a psychologist is to call your insurance and ask them to recommend providers in network to you. You can also use a resource like Psychologytoday.com to search in your area. You can also just google the above terms in google maps.
Very briefly, therapy/counseling works by using psychological principles like insight, behavior, and relationships in order to help a person change both their intrapsychic and interpsychic behavior.
There are exceptions to the above, and obviously a lot more detail. Please feel free to ask more.
In most cases, therapy works because it helps people figure out why they have certain feelings and reactions to situation. Once they understand that, they can learn how to change unhealthy patterns of thinking and acting.
Counseling is not a really define role, it’s an umbrella term for anyone that could help someone by talking with them. There is no legal requirement to be a counsellor, unless a specific organisation demand it. In general they are less qualified and can only help you so far. They are often the first person someone will get help with, trying to figure out what is wrong and getting recommended to a specialist that could better help you.
Therapy is where you meet with a legally bound specialist. So anyone with a license and a title protected by the law. This include psychologist, Social workers, Marriage/Family Therapist and some specific type of counsellors. Basically if you specific requirement for you role defined by the law, you are a therapist, if not you are a counsellors. A Therapist can call himself a counsellor, but a counsellor can’t always call themselves a therapist.
Psychologist are there to talk to you and help you figure out what is wrong and how you can fit it. They are a type of therapist that studied psychology and is licensed.
Psychiatrists are something completely different, they are medical doctor specialist in brain chemistry. They gonna identify what mental problems you could have and with the help of medicine try to balance the chemistry of your brain to either fix the problem or more likely fix the symptoms.
There’re many type of mental illness as well as therapy for them but for example, therapy can teach you control your emotions better, reform the way of your thinking, exercise that reduce stress or unwanted behavior,…
Counseling: you ask a professional for advice
Therapy: you work on your therapist’s plan to resolve your problem.
Psychiatrist: Psychology Doctor that can give prescription. (usually for really grave disorder that can’t be helped with therapy or need monitoring ex: schizophrenia)
Psychologist: Psychology expert, can’t give prescription. Can do therapy. (for thing like stress, depression, phobia)
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