Finding a good therapist can seem daunting, but it is important that you persevere and find one that can help. There are many factors that differentiate therapists, and here are a few differences that may be helpful when choosing a therapist.
A. The Degree
Therapists differ in terms of their education and acquired therapeutic techniques, and this can be reflected in the degree they obtain. Generally, here are some differences to expect when choosing a therapist to work with:
Differences between Master’s and Doctoral degrees
The main difference between master’s and doctoral degrees is the years of education required for the degree. Most master’s degrees require 1-3 years of course and clinical work, while a doctoral degree requires 4-7 years of work. Within the shorter master’s program, students focus on therapeutic technique and practical considerations of being a therapist. Doctoral students also study therapeutic techniques, but additionally they develop a richer understanding of the historical and theoretical explanations of disorders and the experimentation that supports these theories.
This difference may not simply translate into a “better” therapist (i.e. more education = better therapist), as there are additional factors that influence the skill of the therapist. Also, there is much learning after the degree has been obtained through active practicing and subsequent training seminars. It does generally translate into the cost of their services as people with doctoral degrees are often able to ask for a higher hourly rate as compared to a people with master’s degrees.
Differences in Master’s degrees
Master’s programs related to therapy can be very specific in terms of their training/educational goals, and this specificity is reflected in the title of the degree. For instance, while a Master’s in Counseling program trains students in therapeutic techniques to help the individuals mental state, a Master’s in Social Work program will additionally train students in the community resources available to help change the situation the individual or family exists (e.g. hospice, welfare, employment). Similarly, a Master’s in school psychology program specifically trains students for clinical situations related to learning and the school environment. In selecting a therapist, one should consider the degree specificity in relation to your own situation.
Differences in Doctoral degrees
There are a few types of doctoral degrees related to therapy. Two are the Doctorate of Philosophy in Clinical Psychology (Ph. D.) and the Doctorate of Psychology (Psy. D.). While both require extensive amounts of training (4-7 years), they differ in emphasis. The Ph. D. program emphasizes training in research, experimentation, and theory development (in addition to therapeutic technique training), sometimes referred to the scientist-practitioner model. The Psy. D. program de-emphasizes training in how to be a scientist and focuses on extensive training in therapeutic techniques (sometimes referred to as the practitioner-scholar model).
As with differences between Master’s and Doctoral training, the difference between those with a Psy. D. and a Ph. D. does not easily indicate which will be the better therapist. Years of active therapeutic practice will often erase any difference in the degree training.
A third is a Doctorate in Medicine (M.D.). An M.D. can practice psychological therapy as a psychiatrist. In this regard, psychiatrists are fully able to prescribe medicinal treatments for psychological disorders, and In some cases, a psychiatrist will also engage in verbal therapy as well. While therapists without a M.D. cannot prescribe medicine as a treatment, they will often partner with a psychiatrist if the condition of the patient is best treated pharmacologically.
You may have seen a therapist advertise themselves as a licensed therapist (e.g. “Licensed Marriage and Family therapist”). Most states require a therapist to become licensed before practicing. The awarded license simply indicates that the state has validated that the person has the appropriate education/training and has passed a state sponsored test of their knowledge. While the license indicates that certain training requirements have been completed, it serves more as a legal permission to advertise yourself. That is, while many can provide therapy related to a marriage or family situation, a therapist can only call themselves a “Marriage and Family Therapist” if they have obtained a license. For someone seeking an appropriate therapist, it is enough to know that licensure simply indicates that the state has verified that the therapist has a specific training and knowledge base.
Each state has their own rules concerning licensure (click here for some information). If your are interested in learning more about licensure for Oregon, or researching the licensure of a specific therapist, you can access this information via the following websites:
The Board of Psychological Examiners
The Oregon Board of Licensed Professional Counselors and Therapists
The Oregon Board of Clinical Social Workers
As the state has the ability to award a license, they also have the ability to revoke a license as well. Information about the license suspension of a specific therapist can be found at these websites as well.
C. Appropriate Fit For You
Remember, when looking for a good therapist, you are looking for a therapist that is good for YOU! Even if a therapist has an excellent education and training background, and they has worked successfully with other people, this does not mean they will be good for you.
First, their training and background must fit your specific psychological situation. A therapist with years of successful experience with depressed patients, may not be helpful with a problem related to a family situation. There are many different types of therapeutic techniques (behavioral, cognitive and pharmacological), and some work well with certain disorders while others work better with different disorders. There is not a single “best” therapy. The techniques known and used by the therapist need to be useful for your specific condition. Generally speaking, you will not know what your condition is, or the best treatment for it. A good therapist will be able to accurate identify your condition and the best treatment for it. If they do not have the optimal training to treat your condition, they should refer you to someone who better able to help.
Second, while training and education are very important (as are years of practice), another important quality is the trust that develops between the therapist and the patient. Trust is influenced by many factors and as one meets with the therapist, they should consider if the therapist is someone that they could develop a trusting relationship.
D. It’s OK To Change Your Therapist!
Just like one pair of shoes does not fit every pair of feet, not every therapist is right for every client. After some time, you may realize your therapist’s approach does not match your personal values or goals. This would be a good time to ask for a referral to a new therapist. A good interpersonal fit with a mental health provider is just as important as their degree, title, and licensure. Keep in mind, though, that while the therapist is there to support you, they are also there to help you focus on issues that are stressful and create anxiety. Not enjoying the therapeutic process is not the same thing as having a poor fitting therapist.