Mental health professionals include a wide variety of experts – such as psychiatrists, psychologists, social workers, nurses, counselors and others – who help diagnose and treat patients with mental health disorders.
All mental health professionals receive extensive training and education in their field. These experts may specialize in treating specific disorders or specific demographic groups. Some also help people find services in the community, such as financial aid, jobs or housing. Mental health professionals may employ different methods of therapy, such as medication treatment, group therapy or cognitive behavior therapy (CBT), depending on the patients they treat. Mental health professionals are bound by an ethical vow to keep a patient’s information confidential.
Choosing the proper mental health professional is crucial if treatment is to be effective. Patients are urged to seek advice from friends, family and others about reputable mental health providers in the community. Factors that may influence a choice of mental health professional include the nature and severity of a patient’s symptoms, the patient’s health insurance coverage limitations, the potential need for medication and the provider’s experience and expertise levels.
Once a provider has been chosen, an initial appointment will be scheduled. Patients who do not feel comfortable talking with their provider should always feel free to choose another provider. A patient’s comfort level with a mental health professional is an important factor in whether or not treatment will be successful.
About mental health professionals
Mental health professionals are experts who help diagnose and treat patients with mental health disorders. People who work in this field come from various backgrounds and have specialties in different aspects of mental health care.
Some mental health professionals specialize in treating specific disorders. Others may specialize in treating specific demographic groups (such as psychotherapists who work with children or with couples). Some professionals also help people find services in the community, such as financial aid, jobs and housing. In addition to these specializations, some mental health professionals may use specific types of therapy. These include group therapy, cognitive behavior therapy (CBT) and play therapy.
All mental health professionals receive extensive training in their field. This usually involves education at the graduate level or beyond, as well as a period of supervised work experience that in some cases lasts for several years. States usually license mental health professionals, although the qualifications for achieving such licensure vary from state to state and depend on the type of mental health professional receiving licensure. Finally, mental health professionals often receive accreditation from national associations devoted to their field of treatment and research.
All reputable mental health professionals share the same vow to keep a patient’s information confidential. However, these therapists are bound by law to report certain behavior to the proper authorities, including patients’ threats to injure themselves or others, or some illegal acts (e.g., child abuse, pedophilia).
Acknowledging the need for mental health treatment is an important first step to improving one’s mental health. However, it is just the beginning of the process. Patients are urged to carefully consider the type of mental health professional who might serve their needs best. The more comfortable a patient is with a therapist, the more successful treatment is likely to be.
Types and differences
Therapist is the general term used to describe all mental health professionals. These professionals can be further subdivided according to their type of training and expertise. Patients are urged to carefully screen potential providers, because some people advertise themselves as therapists or psychotherapists without completing a formal training, certification or licensure process.
Types of mental health professionals include:
- Psychiatrist. A licensed doctor of medicine (M.D.) or doctor of osteopathic medicine (D.O.) who has specialized training in the diagnosis, treatment and prevention of mental illnesses and substance use disorders. After finishing medical school, psychiatrists must complete four years of residency training in the field of psychiatry. Many psychiatrists undergo additional training so that they can further specialize in such areas as child and adolescent psychiatry, geriatric psychiatry, forensic psychiatry or addiction psychiatry. This extensive medical training enables the psychiatrist to understand the body’s functions and the complex relationship between emotional illness and other medical illnesses.
Because they are medical doctors, psychiatrists can prescribe psychiatric medications to patients. “Board certified” psychiatrists have passed the American Board of Psychiatry and Neurology’s national examination, and all psychiatrists should have a state license to practice. Since the treatment of mental disorders requires teamwork, psychiatrists collaborate with other mental health professionals on the treatment of the same patient. While the other professionals provide some form of talk therapy or psychosocial interventions, the psychiatrist typically concentrates on managing the patient’s psychiatric medications.
- Psychologist. A mental health professional with specialized training in psychology, which focuses on the functions of mind, including behavior and cognition. Psychologists have earned a Doctor of Philosophy (Ph.D ) or Doctor of Psychology (Psy.D.), degree, and has also met state or provincial licensing criteria. They have supervised work experience in psychological research, testing, evaluation and therapy. They may specialize in certain areas of study, and those who diagnose and treat mental illnesses are usually known as clinical or counseling psychologists. Some receive additional training and specialize in treating certain demographic groups (such as children or adults) or conditions (such as personality disorders).
Clinical psychologists often work in clinics, counseling centers, hospitals and private practices and diagnose and evaluate mental and emotional disorders. Psychologists use tools such as cognitive-behavioral and interpersonal psychotherapy and hypnosis to treat patients. They conduct interviews and psychological tests, and may implement complex treatment programs, often in conjunction with psychiatrists and other mental health specialists. Psychologists are not physicians and, with the exception of some states, they are not qualified to prescribe medication to patients.
- Licensed clinical social worker. Social workers have a broad range of responsibilities. They are trained to diagnose mental disorders and to provide individual and group counseling. They also help patients address problems related to social skills or health concerns, and may specialize in areas such as domestic violence or chronic illness. Social workers have master’s degrees in social work from an accredited graduate program and are licensed to practice in the state in which they reside. Many are members of the Academy of Certified Social Workers. In some states, people can achieve social worker status without advanced training. However, they are not allowed to provide mental health counseling under such circumstances.
- Psychiatric/mental health nurse. Also known as a nurse psychotherapist, they are licensed registered nurses (R.N.s) trained to practice mental health nursing, to promote and foster mental health, assist clients in regaining or improving their coping skills or abilities, and prevent further disability. Psychiatric nurses assist patients with self care, administer and monitor treatment regimens and teach about mental health in individual or group counseling. Some nurses may receive a master’s degree in psychiatric-mental health nursing, which qualifies them as advanced practice registered nurses (APRNs), meaning they can diagnose and treat mental illness. In some states, they can also prescribe medications and practice under a physician’s supervision.
- Licensed professional counselor. A counselor trained to diagnose mental disorders and provide patients with individual and group counseling. Licensed professional counselors have master’s degrees in counseling, psychology or a related field and are licensed to practice in the state in which they reside.
- Mental health counselor. A mental health professional specially trained to diagnose mental disorders and provide patients with individual and group counseling. Mental health counselors usually have master’s degrees in mental health counseling and several years of supervised clinical work experience. Mental health counselors often specialize in certain areas, such as career counseling or substance abuse. They are certified by the National Academy of Certified Clinical Mental Health Counselors.
- Certified alcohol and drug abuse counselor. Counselors who are specially trained to diagnose substance abuse and provide patients with individual and group counseling. They are licensed by the state in which they reside.
- Marriage and family therapist. Counselor trained to diagnose problems and provide individual and group therapy related to marriage and familial issues. These therapists may treat problems such as conflicts between parents and children, or the depression of a family member. These therapists have master’s or doctoral degrees with special education in their field, and most states require licensure. They may be certified by the American Association for Marriage and Family Therapy.
- Pastoral counselor. People who have a background in religious or theological training and provide counseling services for mental disorders in individual and group settings. Their counseling usually has a spiritual component. Individual clergy members without training still counsel their congregants, but may refer them to pastoral counselors for further treatment. Pastoral counselors may be certified by the American Association of Pastoral Counselors.
- Psychoanalysts. Counselors who use a form of psychotherapy called psychoanalysis. Developed by Sigmund Freud, this approach focuses on the unconscious factors that influence a patient’s thoughts and behaviors. The term “psychoanalyst” does not have a legal definition, meaning that anyone can describe himself or herself as providing the service. However, many psychoanalysts undergo training or certification.
- Case manager. Someone who advocates on behalf of and coordinates various services for patients with mental health disorders. These may include services related to mental health, education, health, vocational training, transportation, respite care and recreational activities.
Choosing the right mental health professional
It is crucial that patients choose the right mental health professional. Patients are urged to seek advice from friends, family and others about reputable mental health providers in the community. For example, the mental health division of a patient’s local health department can offer suggestions about local mental health providers. A patient’s family physician, employee assistance program and health insurance company can also be good resources for this information.
Other resources include members of the clergy, family service agencies, school counselors, psychiatric hospitals and other mental health organizations. If emergency mental health care is needed, patients and their loved ones can receive rapid help by calling hotlines, crisis centers and hospital emergency rooms.
Factors that may influence a choice of mental health professional include the nature and severity of a patient’s symptoms, the patient’s health insurance coverage limitations, the potential need for medication and the provider’s experience and expertise levels. Patients may also prefer therapists of a certain age, gender, religion, language or cultural background.
Patients are urged to spend some time screening potential providers. It is important that patients feel comfortable with their providers, so patients are urged to ask about approaches to treatment and the professional’s areas of specialty or expertise. Patients should also inquire if the professional has treated people with similar conditions and if they have particular ideas about treatment. It is often a good idea for patients to write down any questions they may have ahead of time and bring them to the appointment. This helps ensure that the patient does not forget to address any important topics with the mental health professional.
In many cases, patients who are seeking help may feel too overwhelmed by their emotional problems to undertake the effort necessary to ensure a good fit between the patient and the provider. Turning to family, friends, clergy and other trusted allies could help make the process easier.
Prior to the treatment, the patient will undergo a structured interview called a psychiatric interview. The purpose of the psychiatric interview is to obtain information from the patient about the presenting problem and the factors that lead to it. The psychiatric interview also focuses on the patient’s previous disorders, predisposition, biopsychosocial strengths and limitations, insight into the problem and desire for assistance. The psychiatric history covers topics that range from identifying data to coping mechanisms.
Patients may be asked several questions, including:
- What do you think is the problem?
- What are some of the important details surrounding the problem?
- Where do you live?
- What is your job?
The provider will also ask questions about the primary relationships in the patient’s life. It is normal for some people to feel a bit uncomfortable about having to reveal intimate details regarding their lives. It is also common for patients to feel better initially and then feel somewhat worse as treatment continues. Patients may struggle with their feelings when confronting troublesome issues from the past or present.
Following the initial visit and the psychiatric interview, providers will discuss their thoughts about the diagnosis and treatment plan with the patients. They will also inform patients about the methods, frequency, duration and cost of the treatment.
However, some patients may experience discomfort that goes beyond what is acceptable for the patient-provider relationship to function effectively. Patients who do not feel comfortable talking with their provider – for whatever reason – should always feel free to choose another provider. This is true even if the discomfort does not emerge until after several sessions have been completed.
Questions for your mental health professional
Preparing questions in advance can help patients to have more meaningful discussions with their mental health provider regarding their conditions. Patients and their families may wish to ask a mental health provider the following questions:
- What is your educational background, training, licensure, etc.?
- How many years have you been practicing in this field?
- What are your office hours and fees?
- Do you accept my insurance, or Medicare or Medicaid?
- How long do sessions typically last?
- How often will we meet?
- What is your general treatment approach?
- How will I know if I’m making progress?
- What are your specialties?
- Can you refer me to someone who specializes in my disorder?
- Have you treated patients with my particular problem?
- Do you recommend medications in addition to therapy?