Once you have decided to attend therapy, it is time to pick a therapist. But what is the best way to go about this? What makes one therapist better than another? What do all of these letters behind their names mean? How do I know when I have found the right therapist for me?
One of the best places to start is word of mouth. As a practitioner, I take pride in the fact that my clients are one of my main referral sources. The best compliment a client can give me is to recommend my services to others. If there is someone you know that seems to be doing better after attending therapy, ask them who their therapist is and what they are like. If you have another healthcare provider that you trust, ask them for a referral. If you are a full-time college student, you likely have access to a counseling center on campus. If you work outside the home, your employer may have a list of resources in the community. If you are part of a community group, religious group, or other group of people with shared values, they may have suggestions for you as well.
Once you have recommendations from people in your life, it’s time to go online and do your homework. Most therapists will have a website or at least an online profile that gives you an introduction to their expertise and style. It is important to find a therapist who is competent to work with you. This means they need to have a graduate degree in psychology, counseling, social work, or related field. They also need to be licensed in your state. You will likely find most therapists have a lot of letters after their names and this can be confusing. Below is a list of common credentials you may see and a brief explanation to help decipher the alphabet soup:
Degrees – These abbreviations describe the type of education the person received.
Ph.D. – Doctor of philosophy. This person is not a physician, but they have completed the highest degree in their field and can be addressed as Dr. This is a research-based degree that can apply to many different fields. Usually, if it is a therapist, this degree will be accompanied by the phrase Licensed Psychologist (see below).
Psy.D. – Doctor of psychology. This is also a doctorate degree, but it is specific to psychology. This person is a psychologist (not a physician) and can be addressed as Dr.
M.D. – Medical doctor. This person is a physician and can be addressed as Dr. If they work in the mental health field, it is likely that they are a psychiatrist (not a psychologist, described above) and have prescription privileges. Typically, psychiatrists focus more on medication management than talk therapy.
M.A./M.S.– These stand for “master of arts” and “master of science” respectively. Like a Ph.D., these degrees can apply to any number of fields, so knowing the persons degree does not tell you their specific field. Usually, a therapist with this degree will also have LPC or LPA (see below) after their degree.
MSW – Master of social work. This is a master’s degree specific to social work. It is often accompanied by LCSW (see below).
Licenses – The following abbreviations represent the license the person holds. After completing graduate school, therapists must complete the licensure process within their field.
Licensed Psychologist – This person has completed a doctoral program in psychology, including multiple practicum experiences and a 2,000 hour internship. In most states, including North Carolina, this person has been required to complete 1,000 hours of supervised post-doctoral work. They have passed the national Examination for Professional Practice in Psychology (EPPP) as well as their state licensing exam.
LPA – Licensed psychological associate. In some states, such as North Carolina, the psychology licensing board will credential master’s level psychologists. In North Carolina, this person has a master’s degree in psychology and is being supervised by a doctoral-level licensed psychologist. They have also passed the EPPP (there is typically a lower score requirement than for doctoral level psychologists) as well as the state licensing exam.
LPC – Licensed professional counselor. This person typically has a master’s degree in counseling, psychology or related field. They have completed 3,000 hours of supervised professional practice and have passed the Jurisprudence exam.
LPCA – Licensed professional counselor associate.This is a restricted license for individuals working toward their LPC (see above) and are in the process of completing their 3,000 hours of supervised professional practice.
LPCS – Licensed professional counselor. This license is for LPCs who have been in practice at least 5 years and who are qualified to supervise LPCAs.
LCSW – Licensed clinical social worker. This person has a master’s degree or Ph.D. in social work. They have been in practice at least two years and have completed 3,000 hours of supervised practice. They have passed the ASWB clinical level exam.
LCSWA– Licensed clinical social worker associate. This is a restricted license for someone working toward their LCSW (see above). They are in the process of completing their 3,000 hours of experience and passing the ASWB.
Now that you are an expert in credentials, it is important to find someone who specializes in your particular issue. You can learn this through reading their profile or asking them directly. Most therapists are happy to answer a few basic questions via email or 15-minute phone call. Depending on what your presenting concern is, it may be more or less important to find a specialist. More mild and common symptoms (e.g., occasional sadness or worry) can be treated by a larger number of therapists, whereas more severe and unique symptoms (e.g., intrusive hallucinations or severe substance use) need more specialized attention and expertise.
One of the main concerns for people trying to find a therapist is how to pay for it. If you plan on filing your insurance, the most reliable way to verify what therapists are in-network and what your co-pay will be is to call the number on the back of your insurance card. If you have a therapist in mind, ask your insurance company if that person is in-network and ask them what your co-pay is for mental health services. Some insurance companies have a list of providers on their website as well. If you have found a therapist you really like, but they are out-of-network, you can call and ask your insurance company what their reimbursement rate is for out-of-network mental health services. My clients that I see out-of-network pay me directly and I give them a monthly invoice. They submit the invoice to their insurance carrier and receive a percentage of my fee directly from their insurance carrier.
One of the most difficult parts of attending therapy is finding the right therapist. It can be confusing, frustrating, and scary to make and attend that initial appointment. I hope this information will help you in your search for the best therapist for you and in moving toward the life you want for yourself.