Labor Day, which is always the first Monday in September, came as late as it ever can this year — on the 7th of the month. It was a welcome extension of summer.
But when September 8th came, so did the start of the new school year. Suddenly all the things that could wait were urgent problems and folks were in hyperdrive.
Along with this change came an increase in requests for help from mental health professionals. Some of the questions that come up repeatedly are:
- "What kind of a clinician should I see?"
- "What's the difference between a psychiatrist and a psychologist?"
This month I will answer these questions — and more.
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Good Qualities In Any Professional
Behavioral health professionals, also called mental health professionals, vary in their training. Some provide highly specialized treatment. But there is also a lot of overlap in terms of the types of problems these various professionals treat.
Regardless of specialty, here are some of the qualities you'll want to look for in any mental health professional:
- Good training
- An ability to tune in to your problems and be practical about solutions
- An awareness of their own limits as professionals
- A willingness to refer you to someone else if you need something they can't provide
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Different Training for Different Professional
There are four major types of mental health professionals: psychiatrists, psychologists, social workers and psychiatric nurses.
Psychiatrists
Psychiatrists have the same medical school training as other physicians. This includes training in the biological bases of medicine. They receive either an M.D. or D.O. degree. After medical school, psychiatrists do four years of specialized training before they are eligible to be certified by a specialty board. Read more about the significance of board certification.
Psychiatrists diagnose and treat mental health problems. Unlike psychologists and social workers, they can prescribe medicines. Many psychiatrists, but not all, provide talk therapy. You can find more information about psychiatry and psychiatrists at www.psych.org.
Clinical Psychologists
A clinical psychologist goes to graduate school for either a doctoral (Ph.D., Psy.D., or Ed.D.) or master's degree (M.A. or M.S.) in psychology. A doctoral degree takes several years to complete and is much more demanding than a master's degree (two years). A clinical psychologist should be licensed to practice in your state.
Psychologists are experts in human emotion, thinking and behavior. Although psychology training may not emphasize biology in great detail, some clinical psychologists have strong training in neuroscience (the study of the brain). Clinical psychologists learn how to evaluate and treat patients through internships in clinics and hospitals.
Psychologists cannot prescribe medication, but doctoral-level psychologists are usually well trained in evaluating mental problems and providing psychotherapy.
Psychologists are the only mental health professionals who can perform psychological testing. Psychological tests are standardized tools (like intelligence tests or the famous inkblot test) for evaluating mental abilities, personal qualities or behaviors. More information on psychology and psychologists can be found at http://www.apa.org/.
Social Workers
Clinical social workers complete at least a two-year graduate program and receive a master's degree (M.S.W.). Some go on to receive a doctoral degree (D.S.W. or Ph.D.). As part of their training, they do clinical internships.
Clinical social workers are licensed in the state where they practice (L.C.S.W.). The Academy of Certified Social Workers (A.C.S.W.) may also certify them. Since social workers work in many settings, it is important to consult one who has been trained to evaluate mental problems and provide psychotherapy.
The primary distinction between social workers and other mental health professionals is that social workers specialize in understanding patients in the context of a "system," such as the family or the community. You can read more about professional social work at the National Association of Social Workers website.
Psychiatric Nurses
A psychiatric nurse is a registered nurse (R.N.) who has specialty training and usually a master's degree (M.S.N.) beyond basic nursing training. All registered nurses assess mental health needs as part of their work with patients and their families.
Psychiatric nurses may have additional training to work as clinical nurse specialists (C.N.S.) or nurse practitioners (N.P.). In these roles, they can assess, diagnose and treat individuals or families with psychiatric problems or disorders. The licensing of nurse practitioners varies from state to state. In some states, they may prescribe medications, often under the supervision of a psychiatrist. Many provide psychotherapy.
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Other Types of Mental Health Professionals
You may find mental health professionals in your community who have other types of training. They may come from counseling traditions, such as pastoral counseling or expressive therapy. Ask about their training and clinical experience.
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Getting Specific
Usually it is not enough to know a mental health professional's degree. Even with the same training on paper, no two professionals are alike. So you may find it helpful to find out more about the individual's approach to treating mental distress.
Here are some questions you might ask:
- How long have you been in practice?
- What kinds of treatments do you provide?
- What kind of treatment or therapy do you recommend to me? Why?
- How does treatment work?
- What are the advantages and disadvantages of the different kinds of treatment, even the ones you are not able to provide?
- How soon should I start feeling better; how will we assess my progress?
- What are the options if this treatment doesn't work?
There is no one right answer to each question. The goal is not to put the professional on the spot. Rather, these are questions to help you have a meaningful discussion about the value of treatment and what you can expect along the way. The key is to pay attention not just to the answers, but also to your reactions to the person answering your questions.
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Getting Comfortable
Finally, make sure you feel comfortable with the professional you choose to work with. People do best when they sense a good match and feel a personal connection to the person treating them.
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Professional Degrees and Credentials
Profession | Initials | Credential | Psychiatry | M.D. | Doctor of Medicine | | D.O. | Doctor of Osteopathic Medicine | Psychology | Ph.D. | Doctor of Philosophy in Psychology | | Psy.D. | Doctor in Clinical Psychology | | Ed.D. | Doctor of Education | | M.A. | Master of Arts (in psychology) | | M.S. | Master of Science (in psychology) | Social Work | M.S.W. | Master of Social Work | | D.S.W. | Doctor of Social Work | | L.C.S.W. | Licensed Clinical Social Worker | | A.C.S.W. | Academy of Certified Social Workers | Nursing | R.N. | Registered Nurse | | B.S.N. | Bachelor of Science in Nursing | | M.S.N. | Master of Science in Nursing | | C.N.S. | Clinical Nurse Specialist | | N.P. | Nurse Practitioner | |
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Michael Craig Miller, M.D. is editor-in-chief of the Harvard Mental Health Letter and an assistant professor of psychiatry at Harvard Medical School. Dr. Miller has an active clinical practice and has been on staff at Beth Israel Deaconess Medical Center for more than 25 years.
