ARE THERE DIFFERENT KINDS OF PSYCHOTHERAPISTS? 

Yes. Licensed psychotherapists may be psychologists (LP), counselors (LPC/LPCC), clinical social workers (LICSW), or marriage and family therapists (LMFT). Psychoanalysts are specialists working under one of the above licenses. Some psychotherapists are psychiatrists (MD), psychiatric nurses (APRN/ARNP/CNP/PMHNP), or physician assistants (PA-C) and they are able to prescribe medications. (If curious about these distinctions, more detailed information is provided below.)

Psychotherapists, Degrees and Professional Licenses

WHAT DO ALL OF THESE DIFFERENT PSYCHOTHERAPY DEGREES AND CREDENTIALS MEAN?

Psychotherapy is such a vast field that I think it is oftentimes difficult to find good information about the basic meaning of the various terms related to it. Many people find themselves overwhelmed by the multitude of academic degrees, professional licenses and philosophical approaches associated with the practice of psychotherapy. But without an initial framework to address the topic, it can be challenging to determine what questions they may even want to ask. The following, then, is a very brief overview to help address that dilemma.

WHAT ACADEMIC DEGREES DO PSYCHOTHERAPISTS HAVE?

MD: Psychiatrists are medical doctors who have completed a residency in psychiatry, and therefore can prescribe medicine. They are usually seen in conjunction with a regular psychotherapist because most psychiatrists these days only offer 15-minute sessions for medication management, rather than 50-minute sessions of psychotherapy. (Psychiatric Nurses and Physician Assistants may also be certified to prescribe medicine.)

PhD: A doctorate degree generally attained at public universities and which is oftentimes more oriented towards careers in research and academia than the PsyD.

PsyD: A doctorate degree generally attained at private universities and which is more oriented towards practice than the PhD. The degree was developed in the late 1960s to address the need for practitioners. In the last few decades, the PsyD has become increasingly popular.

MS, MA, MSW: Master degrees are earned in generally two to four years as opposed to the four to six years required for most doctorates. Masters degrees are oriented almost entirely towards the theory and practice of psychotherapy; there is less emphasis on research, statistics and data gathering; and there is less training in proprietary assessment testing instruments. 

WHAT ARE SOME COMMON THEORETICAL APPROACHES THAT PSYCHOTHERAPISTS USE IN PRACTICE?

Acceptance Commitment Therapy (ACT)
Accelerated Experiential Dynamic Psychotherapy (AEDP)
Adlerian
Choice Theory / Reality Therapy
Cognitive-Behavioral Therapy (CBT) 
Dialectical-Behavioral Therapy (DBT)
Existential Therapy
Eye Movement Desensitization and Reprocessing (EMDR)
Family Systems Therapy
Feminist Therapy
Gestalt Therapy
Humanist (Rogerian)
Internal Family Systems (IFS)
Jungian Analytical Psychology
Narrative Therapy
Psycho-Education
Psychodynamic (Neo-Freudian) 
Psychoanalytically-Oriented Psychotherapy
     (e.g., Classical, Ego-Psychology, Self-Psychology, Interpersonal, Object-Relations, Relational, Lacanian) 
Psychoanalysis (Analyst certificate) 
Rational Emotive Behavioral Therapy (REBT)
Somatic Experiencing
Systems Theory

Note About Specialities: It is important to understand that any psychotherapist can work within any of the theoretical models listed above or within any one of many dozens of other common approaches. There is no way to tell from an academic degree or professional license which modality a psychotherapist is likely to use. Most therapists graduate as “generalists” and begin to specialize through their selection of which post-graduate Continuing Education Workshops to attend. 

Moreover, most therapists specialize in at least a couple of different modalities, and use whichever model they feel works best with the needs and temperament of each given client. The only way to know what kind of therapy a therapist offers is to ask. That said, there are some general trends (see below).

WHAT ARE SOME OF THE GENERAL TRENDS THAT DISTINGUISH VARIOUS TYPES OF PSYCHOTHERAPISTS?

P S Y C H O L O G I S T S   &   C O U N S E L O R S : The difference is primarily historical. Psychology began as an offshoot of medicine, and was oriented towards the remedy of “abnormal psychology.” In contrast, counseling began as an offshoot of education, and evolved from studying what contributes to “healthy psychology.” The historical distinctions between psychology and counseling are collapsing in many training programs today. It is not uncommon now, in fact, to see programs in “Counseling Psychology.” 

C O U N S E L O R S are often trained in Rogerian/Humanist therapy as their primary modality, which places an emphasis on human relationships, and to acquiring an awareness of one’s emotional and physical bearing.

C L I N I C A L   S O C I A L   W O R K E R S are oftentimes trained in “systems theory” which places an emphasis on how members of a group function together to impact the functionality of the whole. Power dynamics and cultural/environmental factors that impact mental health are carefully considered—which may include considerations of race, class, sex, gender, and sexual orientation.

M A R R I A G E   &   F A M I L Y   T H E R A P I S T S specialize in family group work, but can see individuals. When seeing individuals they are likely to focus on family dynamics.

P S Y C H O A N A L Y S T S are unique among psychotherapists in that the title itself signifies that they practice a specific modality: psychoanalysis. They are specialists who, after attaining one of the above academic degrees and licenses, undergo years of additional post-graduate training in psychoanalytic psychotherapy. The psychoanalytic approach is explicitly oriented towards “depth-work” achieved through long-term psychotherapy with multiple sessions per week. 

HOW DO I KNOW WHETHER A THERAPIST IS A GOOD FIT FOR ME?  

The good news is that in most cases a client does not need to understand the distinctions detailed above in “Are there different types of psychotherapists?” to pick a therapist that is right for them, or for their therapy to be successful. The most important criterion for a successful outcome in therapy, studies have shown, is the degree to which a client feels comfortable with their therapist. Part of this rapport is determined by whether a practitioner’s theoretical orientation and worldview is compatible with the client’s own outlook. However, clients do not necessarily need to articulate what this worldview is to be able to identify whether the therapist shares it. Rather, this knowledge usually comes from feeling as though they resonate with what is being said in the room. 

HOW DO I CHOOSE A THERAPIST?  

We would suggest that you ask around for referrals from people you trust. If you can't ask a friend for referrals, call various therapists and ask them who to talk to given your interests. The insurance company’s Providers List may list specialty areas (e.g., CBT, REBT, existential, feminist, etc.), and it's likely that the insurance agent is prohibited from providing recommendations beyond that.

I'd also like to suggest that you consider meeting for one session with perhaps three different therapists before making a decision about who to stay with. I'm oftentimes surprised by the fact that many people spend more time shopping for a pair of shoes than for the therapist they are trusting to help them sort through some of their most painful or difficult life experiences. At first glance, it might feel like a "waste" to spend money on relationships you don't intend to continue. However, you will learn a lot about yourself and how you want to be helped from these initial meetings. You will also begin to get a feel for how different therapies emphasize different aspects of the human experience, and how different therapists approach their practice. If nothing else, it will make you feel more comfortable with the person you eventually do choose to work with. 

Finally, trust your instincts. If something doesn't feel right, do not doubt yourself. It does not matter if you cannot articulate why you don't feel settled. While it is true that you may need to push yourself to share difficult content in therapy; you should not need to push yourself to feel comfortable in the therapeutic relationship itself.

Please let me know if you have any other questions, or if we can be of any other help. We look forward to speaking with you.