What's the difference between a psychiatrist and a psychologist?
About a $100 an hour. Seriously, for the consumer the practical difference is that a psychiatrist can prescribe psychoactive medications (for example, an antidepressant) and a psychologist cannot. That's because psychiatrists and psychologists have different training and licensing requirements.
A psychiatrist has an M.D. degree and has completed a psychiatric residency which these days focuses on psycho-pharmacology rather than talk therapy.
A psychologist has a Ph.D. degree and has completed an internship in a clinical setting A psychologist's training focuses primarily on talk therapy and these days usually includes education about psychoactive medications. By the way, I received my license in psychology in 1988.
(In some states psychologists can receive specialized training in psychopharmacology in order to be licensed to prescribe certain psychoactive medications. California does not currently allow this type of licensure for psychologists.)
About a $100 an hour. Seriously, for the consumer the practical difference is that a psychiatrist can prescribe psychoactive medications (for example, an antidepressant) and a psychologist cannot. That's because psychiatrists and psychologists have different training and licensing requirements.
A psychiatrist has an M.D. degree and has completed a psychiatric residency which these days focuses on psycho-pharmacology rather than talk therapy.
A psychologist has a Ph.D. degree and has completed an internship in a clinical setting A psychologist's training focuses primarily on talk therapy and these days usually includes education about psychoactive medications. By the way, I received my license in psychology in 1988.
(In some states psychologists can receive specialized training in psychopharmacology in order to be licensed to prescribe certain psychoactive medications. California does not currently allow this type of licensure for psychologists.)
So what's the difference between a psychologist and a counselor? Or a therapist and a counselor? Or a psychotherapist and a shrink?
Let me say that I, too, think the terminology is confusing. Therapist, counselor, shrink, psychotherapist: these are all generic terms used loosely to refer to a person who helps others deal with emotional and psychological problems. What any of these terms means depends on who's using them. One way to eliminate some of the
Let me say that I, too, think the terminology is confusing. Therapist, counselor, shrink, psychotherapist: these are all generic terms used loosely to refer to a person who helps others deal with emotional and psychological problems. What any of these terms means depends on who's using them. One way to eliminate some of the
With so many different kinds of therapists, what kind is the best for me to see?
Personally I would not choose a therapist based on his or her professional discipline. Throughout my graduate training and career I have worked with professionals from each discipline whom I respected greatly and to whom I would confidently refer a family member or friend.
On the other hand, I've worked with some highly trained professionals in each discipline to whom I would hesitate to refer someone. In my opinion, what's far more important than a therapist's professional discipline or techniques is how you feel about the relationship you develop with him or her. However, a psychiatrist's services cost much more than those of other licensed therapists and that is primarily because psychiatrists prescribe medication. Usually a psychiatrist's training now focuses more on psycho pharmacology than psychotherapy. Please see Choosing a Therapist for more ideas about finding a therapist.
Personally I would not choose a therapist based on his or her professional discipline. Throughout my graduate training and career I have worked with professionals from each discipline whom I respected greatly and to whom I would confidently refer a family member or friend.
On the other hand, I've worked with some highly trained professionals in each discipline to whom I would hesitate to refer someone. In my opinion, what's far more important than a therapist's professional discipline or techniques is how you feel about the relationship you develop with him or her. However, a psychiatrist's services cost much more than those of other licensed therapists and that is primarily because psychiatrists prescribe medication. Usually a psychiatrist's training now focuses more on psycho pharmacology than psychotherapy. Please see Choosing a Therapist for more ideas about finding a therapist.
Do you have a specialty?
The mental health professions do not have a system of certified specialties as does the medical profession. An M.D. may have board certification in surgery or obstetrics, but no parallel system exists in the mental health professions.
Psychotherapists' specialties are usually self-selected based on interest, training and/or experience. With a few exceptions, no licensing board or professional association certifies a therapist's competence in a specialty area. (One exception is that some professional associations certify special competency in treating chemical dependence or substance abuse.)
People often wonder if they should see someone who specializes in the treatment of particular symptoms, such as anxiety or depression. My view is that there are an infinite ways that a person can end up depressed or anxious. How a person resolves that depression or anxiety will be a unique blend of his or her life experiences, strengths and goals. The symptom doesn't determine what that unique blend will be. Rather, that unique blend evolves (in the context of therapy) as a person and their therapist work together to make sense of the person's experiences.
That said, I feel comfortable to say that my specialty is helping people to understand and accept themselves so they can better enjoy their lives, reduce avoidable emotional suffering and cope better with emotional pain that is an unavoidable part of life. I see individual adults, couples and families.
The mental health professions do not have a system of certified specialties as does the medical profession. An M.D. may have board certification in surgery or obstetrics, but no parallel system exists in the mental health professions.
Psychotherapists' specialties are usually self-selected based on interest, training and/or experience. With a few exceptions, no licensing board or professional association certifies a therapist's competence in a specialty area. (One exception is that some professional associations certify special competency in treating chemical dependence or substance abuse.)
People often wonder if they should see someone who specializes in the treatment of particular symptoms, such as anxiety or depression. My view is that there are an infinite ways that a person can end up depressed or anxious. How a person resolves that depression or anxiety will be a unique blend of his or her life experiences, strengths and goals. The symptom doesn't determine what that unique blend will be. Rather, that unique blend evolves (in the context of therapy) as a person and their therapist work together to make sense of the person's experiences.
That said, I feel comfortable to say that my specialty is helping people to understand and accept themselves so they can better enjoy their lives, reduce avoidable emotional suffering and cope better with emotional pain that is an unavoidable part of life. I see individual adults, couples and families.
Are you going to tell me everything that's wrong with me?
No. Perhaps you've heard call-in "therapists" on the radio who aggressively confront callers' behavior or ways of thinking. Or maybe you've seen television programs or movies in which an all-knowing therapist plays tough and confronts someone with the error of their ways. In my opinion, that's not therapy. And I would steer clear of a therapist who assumes they can be an expert and an authority about you and your experience.
Therapy isn't about pointing out someone's "deficiencies" in order for them to "correct" themselves. In my experience, people usually seek therapy because they already recognize to some degree their patterns of thinking and behaving that harm themselves and their relationships.
What helps more than confrontation is exploring why they feel the need to react in these ways. Such exploration not only deepens self-understanding; it also fosters receptiveness to new and more adaptive ways of thinking and behaving. (In those instances in which a person does not see how their reactions are harmful to themselves and their relationships, aggressive confrontation usually lowers a persons' self-regard and their openness to change.)
Very often people actually don't recognize their strengths and positive qualities; indeed, they may even view them as weaknesses or as part of the problem. One of the consistent outcomes of successful therapy is deeper self-understanding and, consequently, enhanced self-esteem. One of the rewards for me of doing this work is seeing a person learning to like and appreciate themselves.
No. Perhaps you've heard call-in "therapists" on the radio who aggressively confront callers' behavior or ways of thinking. Or maybe you've seen television programs or movies in which an all-knowing therapist plays tough and confronts someone with the error of their ways. In my opinion, that's not therapy. And I would steer clear of a therapist who assumes they can be an expert and an authority about you and your experience.
Therapy isn't about pointing out someone's "deficiencies" in order for them to "correct" themselves. In my experience, people usually seek therapy because they already recognize to some degree their patterns of thinking and behaving that harm themselves and their relationships.
What helps more than confrontation is exploring why they feel the need to react in these ways. Such exploration not only deepens self-understanding; it also fosters receptiveness to new and more adaptive ways of thinking and behaving. (In those instances in which a person does not see how their reactions are harmful to themselves and their relationships, aggressive confrontation usually lowers a persons' self-regard and their openness to change.)
Very often people actually don't recognize their strengths and positive qualities; indeed, they may even view them as weaknesses or as part of the problem. One of the consistent outcomes of successful therapy is deeper self-understanding and, consequently, enhanced self-esteem. One of the rewards for me of doing this work is seeing a person learning to like and appreciate themselves.
How long will therapy take?
In my experience, it takes as long as it takes. It's impossible to specify a length of time that would apply accurately to every person.
The reasons that a person begins therapy are unique to that individual (regardless of the symptoms they may have). Let's say someone seeks therapy because they're experiencing depression. Here are just a few of the many factors that influence how long therapy might last: how long the person has been depressed, how severe the symptoms are, what life events triggered the depression (for example, loss of a job vs. death of a loved one), whether the person abuses substances, whether physical health problems contribute, how much social support the person receives from others, the presence of a family history of depression (possible hereditary predisposition to biological depression).
Now, take all those factors and add in the well-established research finding that the outcome of therapy is determined largely by the therapeutic alliance - an academic term for how well two people establish a relationship of trust, openness and colloboration.
In my experience, it takes as long as it takes. It's impossible to specify a length of time that would apply accurately to every person.
The reasons that a person begins therapy are unique to that individual (regardless of the symptoms they may have). Let's say someone seeks therapy because they're experiencing depression. Here are just a few of the many factors that influence how long therapy might last: how long the person has been depressed, how severe the symptoms are, what life events triggered the depression (for example, loss of a job vs. death of a loved one), whether the person abuses substances, whether physical health problems contribute, how much social support the person receives from others, the presence of a family history of depression (possible hereditary predisposition to biological depression).
Now, take all those factors and add in the well-established research finding that the outcome of therapy is determined largely by the therapeutic alliance - an academic term for how well two people establish a relationship of trust, openness and colloboration.
Will I have to spend months or even years dredging up childhood problems or analyzing my relationship with my parents?
Not necessarily; there's no set agenda of topics that you'll need to discuss in order to resolve your problems. Media stereotypes about therapy give the incorrect idea that therapy follows a set pattern of uncovering forgotten memories, particularly about one's parents. I've worked with people who spent little or no time discussing the past; they made very significant changes in their lives. I've worked with others who initially didn't plan to talk about family relationships; but as we explored their problems they realized they wanted to talk about family relationships, both past and present. Ideally, you'll feel free to set the pace and direction of what you talk about with your therapist. If therapy is going well, you'll likely become curious about things you'd always taken for granted about yourself and your relationships.
Not necessarily; there's no set agenda of topics that you'll need to discuss in order to resolve your problems. Media stereotypes about therapy give the incorrect idea that therapy follows a set pattern of uncovering forgotten memories, particularly about one's parents. I've worked with people who spent little or no time discussing the past; they made very significant changes in their lives. I've worked with others who initially didn't plan to talk about family relationships; but as we explored their problems they realized they wanted to talk about family relationships, both past and present. Ideally, you'll feel free to set the pace and direction of what you talk about with your therapist. If therapy is going well, you'll likely become curious about things you'd always taken for granted about yourself and your relationships.
confusion about terminology is to think in terms of a therapist's license. Here in California a person who has fulfilled specific training requirements may be licensed in one of several mental health disciplines: psychology (Ph.D.), psychiatry (M.D.), social work (LCSW) or marriage and family therapy (MFT).
If someone says he or she is a therapist (or a counselor or a psychotherapist), that doesn't tell you what license he or she has received.
If someone says he or she is a therapist (or a counselor or a psychotherapist), that doesn't tell you what license he or she has received.
In fact, that person may not have a license yet because he or she is still in training. Or, he or she may not have and may not intend to seek a license. Be sure to ask a person about their license if their advertising or business card doesn't indicate what it is.
First, it depends a lot on what you hope to get from therapy. In your first few meetings you'd probably clarify what you want to accomplish. But the only way to find out whether therapy will work is to try it. I know of no tests or questionnaires or personality characteristics that can accurately predict whether therapy will work. So much depends on the collaborative relationship that develops between you and your therapist. Again, I think the Consumer Reports study ("Mental Health: Does Therapy Work?") mentioned above offers very useful ideas if you're unsure whether therapy will work for you.
If you've been in therapy once before (or even more than once) and you felt it didn't work for you, it's still quite possible that it could work for you now. You and/or your life circumstances may have changed since then in ways that would enable you to get a lot more out of therapy. It's also possible that you and your previous therapist weren't the best fit. In fact, trying a few sessions with a new therapist could include discussion of what did and didn't for you in therapy before - and that could make just the difference for you to have a better experience.
Do you accept insurance?
After many years of dealing with multiple insurance companies' paperwork systems, unneeded and sometimes harmful meddling by "managed care" overseers and long delays in receiving payment, I decided to not participate in insurance, preferred provider or managed care programs.
Your insurance company most likely has an "out-of-network" benefit. That means you could receive services from me and also be re-imbursed partially by your insurance company for payments you've made to me. You would simply submit to the insurance company the billing statement you receive from me. That statement would contain the date and type of service along with a diagnosis code (required, unfortunately, for coverage).
Keep in mind that, in the opinion of many mental health professionals, the benefit offered by many insurance companies is barely adequate at best. Yes, your benefit may include 10 sessions per year within your network, but it may cover only $25 of the total cost of each session. One way to address the cost of therapy is to use, if your employer offers one, a medical spending account. With such accounts (they go by many names) you can set aside pre-tax dollars that are designated for medical expenses, including psychotherapy. Also, your company may offer an Employee Assistance Program (EAP) that includes confidential short-term counseling. Earlier in my career I worked for an EAP sponsored by El Camino Hospital in Mountain View. For some types of problems EAP services can be just right.
After many years of dealing with multiple insurance companies' paperwork systems, unneeded and sometimes harmful meddling by "managed care" overseers and long delays in receiving payment, I decided to not participate in insurance, preferred provider or managed care programs.
Your insurance company most likely has an "out-of-network" benefit. That means you could receive services from me and also be re-imbursed partially by your insurance company for payments you've made to me. You would simply submit to the insurance company the billing statement you receive from me. That statement would contain the date and type of service along with a diagnosis code (required, unfortunately, for coverage).
Keep in mind that, in the opinion of many mental health professionals, the benefit offered by many insurance companies is barely adequate at best. Yes, your benefit may include 10 sessions per year within your network, but it may cover only $25 of the total cost of each session. One way to address the cost of therapy is to use, if your employer offers one, a medical spending account. With such accounts (they go by many names) you can set aside pre-tax dollars that are designated for medical expenses, including psychotherapy. Also, your company may offer an Employee Assistance Program (EAP) that includes confidential short-term counseling. Earlier in my career I worked for an EAP sponsored by El Camino Hospital in Mountain View. For some types of problems EAP services can be just right.
What's the difference between a psychologist and a psychiatrist?
So what's the difference between a psychologist and a counselor? Or a therapist and a counselor? Or a psychotherapist and a shrink?
With so many different kinds of therapists, what kind is best for me to see?
Do you have a specialty?
Are you going to tell me everything that's wrong with me?
How long will therapy take?
How can I know whether therapy will work for me?
Will I have to spend months or even years dredging up childhood problems or analyzing my relationship with my parents?
Do you accept insurance?
So what's the difference between a psychologist and a counselor? Or a therapist and a counselor? Or a psychotherapist and a shrink?
With so many different kinds of therapists, what kind is best for me to see?
Do you have a specialty?
Are you going to tell me everything that's wrong with me?
How long will therapy take?
How can I know whether therapy will work for me?
Will I have to spend months or even years dredging up childhood problems or analyzing my relationship with my parents?
Do you accept insurance?
© 2008, Dr. Eric Olsen, all rights reserved