How do I find the best counselor or therapist for me?

The terms counselor and therapist are often used interchangeably to describe a variety of mental health providers with different licenses and training backgrounds. Here’s a brief guide to decoding who’s who:  

Psychiatrist: Psychiatrists are the only providers in this list who have attended medical school and can prescribe psychotropic medication. They’ve specialized in psychiatry just as another doctor may have specialized in orthopedic surgery. While some psychiatrists also provide therapy services, they typically focus on medication management and diagnosis.

Licensed Clinical Mental Health Counselor (LCMHC): In the state of North Carolina, this is the official title for someone who has completed a master’s degree with specialized focus on providing counseling services and is licensed by the NC Board of Licensed Clinical Mental Health Counselors. Informally, LCMHCs are often referred to as counselors or therapists. Their training focuses on developing supportive relationships with clients to create a space for self-understanding and problem-solving. (Previously, this title was Licensed Professional Counselor, and there’s a nationwide shift to use the term “clinical mental health counselor” for providers across different states who’ve met the same educational and licensing requirements).

Licensed Marriage and Family Therapist (LMFT): While they have similar training to LCMHCs, their masters programs include a focus on understanding and treating marriage and family dynamics. They can provide individual counseling as well as couples and family counseling. LCMHCs, LCSWs and Psychologists can also provide couples and family therapy if they have completed additional training and certification for this type of work. 

Psychologist (Ph.D. or Psy.D.): Psychologists have completed doctoral programs, which include training in providing counseling services, in addition to training in conducting research and psychological assessments. Some psychologists specialize in school, sports, or health psychology. Psychologists are the primary providers for psychological testing (for example, providing testing for school admissions or to diagnose ADHD). Some psychologists provide testing services exclusively or counseling services exclusively, or a combination of the two. 

Licensed Clinical Social Worker (LCSW): Clinical social workers have completed masters or doctoral degrees in social work, in addition to meeting state licensing requirements for clinical practice. Social workers holding a clinical license in the state of North Carolina can provide counseling services. In addition to training in counseling services, social workers have been trained to provide support at both the individual and community level, addressing systemic issues that are impacting the well-being of a person, family or community.

There are many different “flavors” of therapy. It can be daunting to sort through buzzwords and alphabet soup while trying to find treatment. Trauma-informed, CBT, DBT, ACT, EMDR, ERP, IFS, etc, the list goes on. In the Mind The Gap Glossary of Terms, we’ve taken time to define different treatment approaches and the types of concerns they can treat. 

Considering your goals for therapy, as mentioned above, can be helpful to determine which treatment approach is a fit for you. This can be difficult to decide on your own–especially if you’re wondering if you have a potential diagnosis–so an initial meeting with a therapist can be helpful to identify your primary concerns and narrow down what type of support you need. That’s why it’s important to ask in your first session about the types of treatment the provider offers and if those treatments are a good fit for your goals. If you’re able, research some treatment approaches before your first session and bring your questions. 

Some conditions need a specific treatment and others can be addressed by several treatment approaches. For example, Dialectical Behavior Therapy (DBT), Cognitive Behavior Therapy (CBT), and Acceptance and Commitment Therapy (ACT) are all effective in treating anxiety and depression. However, a specific treatment is needed for Obsessive Compulsive Disorder (OCD)–Exposure and Response Prevention (ERP)–which is a form of Cognitive Behavior Therapy (CBT), but not all therapists trained in CBT are also trained in ERP.

Confusing? Yes. Additionally, many people who go to therapy don’t have a diagnosis. They may be seeking support related to life changes, loneliness, decisions, friendships or grief. A certain treatment approach might not be needed, but it’s helpful to know a provider has experience guiding clients through specific situations or if they’ve received unique training in those areas. 

It could take some trial and error to know if you prefer a certain approach or find one more helpful. It’s okay to give your therapist feedback about what is working or not working for you. Ultimately, a strong connection with your therapist will maximize the benefits of any treatment approach.