HOW TO FIND THE RIGHT THERAPIST FOR YOU

Finding a therapist is a vulnerable and confusing process if you don’t understand the terms. Here’s a guide to help you understand what you need to know to choose a therapist that is right for you. 

COUNSELOR VS. THERAPIST VS. PSYCHOTHERAPIST: WHAT ARE THEY CALLED?

There are many different names for a therapist including counselor, therapist, and psychotherapist. Broadly speaking, all these terms mean the same thing: someone who provides mental health therapy. 

COUNSELOR VS. SOCIAL WORKER VS. FAMILY THERAPIST VS. PSYCHOLOGIST: WHAT’S THE DIFFERENCE?

Many people get confused on what’s the difference between the various letters following the therapists’ names and which one is right for you. In the state of Illinois, we have LPC/LCPC, LSW/LCSW, AMFT/LMFT, and PhD/PsyD. Different states might use different titles, but they all fall into the same categories. You can find highly qualified, great therapists from all these groups. You will often see more differences when you compare how someone does therapy vs. what type of degree they have. 

• LPC/LCPC: These are clinicians who have completed a master’s degree in counseling. An LPC is a provisional license for new clinicians working under the supervision of a fully licensed clinician. An LCPC is a fully licensed clinician who can work independently. Counseling programs generally focus on training clinicians to be a counselor/therapist. 

• LSW/LCSW: These are clinicians who have completed a master’s degree in social work. An LSW is a provisional license for new clinicians working under the supervision of a fully licensed clinician. An LCSW is a fully licensed clinician who can work independently. Social work programs generally include training on policy and advocacy as well as doing therapy. 

• ALMFT/LMFT: These are clinicians who have completed a master’s degree in Marriage and Family Therapy. An ALMFT is a provisional license for new clinicians working under the supervision of a fully licensed clinician. An LMFT is a fully licensed clinician who can work independently. Marriage and Family therapists generally are trained in and focus on couples (or marriage) therapy, family therapy, and therapy with any other small group of people (friends, coparents, etc.), and do see some clients as individuals. 

• PhD/PsyD: These are clinicians who have completed a doctorate degree; once they have completed all licensing requirements they are considered a Psychologist. Psychologist programs generally include training on mental health testing, also called neuropsych testing (like for ADHD or intelligence) as well as doing therapy. 

Should you only look at fully licensed clinicians? Not necessarily. Fully licensed clinicians have more experience; however, you can find very good provisionally licensed clinicians as well. Sometimes you’ll find that provisionally licensed clinicians have more enthusiasm and are generally up to date on some of the latest advances in the field. 

And if what you are really looking for is someone who can prescribe you medications, you want a Psychiatrist, Psychiatric Nurse Practitioner, or a psychiatric focused Physician’s Assistant. These are folks with a medical degree; a psychiatrist is an M.D. Generally, most modern prescribers don’t also do therapy, just medication management. You can also ask your PCP for medication, as a place to start. 

THEORETICAL ORIENTATION? WHAT IS THAT?

The way a therapist practices therapy and the type of training they have will result in more differences than what degree they have. A theoretical orientation is similar to thinking about what kind of philosophy the therapist has, or, in other words, what they believe makes people behave the way they do and what can best help them change. Often searching for therapists based on their theoretical orientation can be helpful; however, people without experience with therapy generally have little to no knowledge about the different orientations. Here are some common ones with very basic descriptions. 

• Trauma Therapists: Present Awakenings focuses on trauma therapy. Trauma therapists are therapists who believe that what has happened to you in the past can cause difficulties and symptoms in your present, and gaining understanding about that, as well as processing through past traumas can provide present relief. There are many specialized types of training among trauma therapists, and if you're looking for a trauma therapist, it can be helpful to find someone who has specialized training. 

  • Eye Movement Desensitization and Reprocessing (EMDR): Present Awakenings focuses on EMDR therapy. It is a specialized type of therapy that allows for quicker processing of traumatic events through the use of Bilateral Stimulation (moving your eyes back and forth, listening to sounds alternating between each ear, or alternating tapping on both sides of the body). See more about EMDR here. 

  • Internal Family Systems (IFS) and Ego State Therapy: Both IFS and Ego State Therapy are “parts work” therapies. Present Awakenings’ therapists include parts work with some clients. Parts work recognizes that everyone has various parts of themself; at a simple level this could be the part of you that is your work persona that is different from the part of you that parents your child or goes out with your friends. By gaining understanding of your various internal parts, you can often reduce inner conflict, negative self-talk, and other mental health symptoms. 

  • Somatic Experiencing or Sensorimotor Psychotherapy: Somatic based therapies like Somatic Experiencing and Sensorimotor Psychotherapy focus on the body’s experience of past trauma. Present Awakenings’ therapists include somatic work with some clients. Releasing the body’s memory of an experience can reduce present pain and discomfort and other mental health symptoms. Somatic therapies are known as a more gentle, but can be a slower approach, than other approaches. 

  • Prolonged Exposure (P.E.), Cognitive Processing Therapy (CPT), and Narrative Therapies: Prolonged Exposure, Cognitive Processing Therapy, and Narrative Therapies have have protocols that include clients creating a narrative of their trauma experience and going through it multiple times to reduce reactivity to the experience.  

• Behavioral-Based and/or Skills-Based Therapists: Behavior based therapies focus on the present and work on changing a client’s behavior through various means. Present Awakenings’ therapists incorporate techniques from these therapies. 

  • Cognitive Behavioral Therapy (CBT): CBT focuses on changing a client's thought patterns to change their behavior. 

  • Dialectical Behavior Therapy (DBT): DBT focuses on the dialectical principle that two seemingly opposing things can be true at the same time, especially that you have to acknowledge and accept a problem (give attention to it and acknowledge what it is even if you don’t like it) to be able to change it. DBT includes a full skills manual with mindfulness skills, distress tolerance skills, emotion regulation skills, and interpersonal effectiveness skills. 

  • Mindfulness: Mindfulness based therapies focus on being able to observe and notice the present, including present thoughts, emotions, and body sensations. 

  • Acceptance and Commitment Therapy (ACT): ACT focuses on helping the client find acceptance (not necessarily approval, more of “it is what it is” acceptance) for their present and learning to observe it without judgment. 

  • Exposure Therapies: Exposure therapists help the clients identify “exposures” or experiences that cause them anxiety in the present and then methodically face those exposures to reduce anxiety and/or learn that you can manage it. 

  • Strengths Based Therapy: Strength based therapies help clients identify their strengths and how they can use those strengths to overcome and/or manage distress and problems. 

• Humanistic: Humanistic therapies focus on the client being the only expert on themself, and work to nonjudgmentally view the client through the client’s experiences, beliefs, and values. Present Awakenings’ therapists incorporate techniques from these therapies.

  • Client-Centered: Client-centered therapy focuses on the client’s experience and includes the therapist working to be empathically present with the client and truly hear and see their world as they experience it. 

  • Existential: Existential therapy understands that human existence in itself is anxiety provoking and helps clients face their anxiety that stems from connection (or lack there of), finding meaning and purpose, making choices, and facing their own mortality. 

• Feminist and Culturally Focused Therapies: Feminist and other culturally focused therapies look at the client as part of their environment and see how their unique lived experience, which includes discrimination and systemic oppression, impacts them. 

• Art Therapy, Dance Movement Therapy, Music Therapy, and Psychodrama: These therapies help the client express themself and process their experiences through means other than talking. 

• Relational Therapy: Relational therapy focuses on how a client experiences other people and how other people experience them and includes significant feedback and disclosure from the therapist about their experience of the client. 

• Psychodynamic/Psychoanalytic: Psychoanalytic therapy is the therapy originally developed by Freud. Psychoanalysis generally includes multiple sessions a week over several years and focuses on the therapist helping the client find insight. Psychodynamic therapy is the more modern version where clients are generally seen once a week. 

This is by no means an exhaustive list. If you’re curious about another type of therapy, please feel free to ask us (or you can also ask Google). 

SCIENCE, PLUS ART: WHETHER OR NOT YOU “CLICK” IS IMPORTANT TOO

While the therapist’s education and training are important, so is how you experience them as a human. While your therapist will never be your friend (for very sound ethical reasons that help get you the best possible therapeutic outcomes), it is important that you feel comfortable with them and feel like you can open up. Some practices, including Present Awakenings, offer a free 10-15 minute consultation phone call to allow you to get a feel for the therapist and ask questions about their background and training to help you see if it potentially could be a good fit. Past that, a general rule of thumb is that after 3-4 sessions with a therapist (so past the initial intake assessment and treatment planning and into therapy), if it doesn’t feel like a fit to you, you may want to consider trying a different therapist. Finding the right therapist is key to helping you achieve your therapy goals. 

WHAT ELSE DO I NEED TO CONSIDER? 

Many factors go into a person’s choice of therapist. Some people have a preference for the therapist’s gender, race, ethnicity, and lived experiences. While it is not necessary for your therapist to share parts of your identity or experience, your preferences are definitely part of the process. 

Since the pandemic, we now widely have both in-person and telehealth options for therapy. Which is right for you will depend on many factors, including your symptoms and preferences. Present Awakenings encourages clients to consider in-person therapy since the therapist has access to your entire body’s nonverbal communication. However, we understand that commutes, health factors, and more make telehealth the right choice for some people, and so we also see clients via telehealth. If you are looking for in-person therapy, then the location of the office needs to be factored into your choice. With telehealth, you just need to make sure you will be located within the state the therapist is licensed in during therapy sessions. (Present Awakenings’ therapists are all licensed in Illinois.) 

AND WHAT ABOUT INSURANCE?

Most major health insurance plans have some coverage for mental health therapy, if what you are experiencing meets their criteria (such as your symptoms impact your ability to work at your job or engage in your life in meaningful ways). At Present Awakenings (and many other therapy practices in Chicagoland) if your therapist is considered “in-network” with your insurance, we will bill your insurance directly and you will only be responsible for any copays, coinsurance, or deductible. If your insurance is “out-of-network” with your therapist, at Present Awakenings and most Chicagoland practices, you will be responsible for the therapist’s fee on the day of service and then you’ll get a “superbill” (which is a special kind of receipt) that you can submit to your insurance for reimbursement based on their out-of-network reimbursement rates. Each insurance plan is different, so you’ll need to call the number on the back of your card or use the plan’s app to find out what your financial responsibilities are. 

OKAY, I’VE GOT A GOOD IDEA OF WHAT TO LOOK FOR, BUT WHERE DO I LOOK?

There are several ways to find a therapist. One place NOT to look is your best friend’s therapist, even if they rave about how good the therapist is. Therapists work to ensure they are not engaging in dual-relationships so that they get all their information about you from the only expert on you (which is you!). If that best friend and their therapist are willing, however, that therapist might be able to provide you with referrals to other therapists at their practice or that they know. You can also ask primary care doctors, school counselors, other treatment providers, and search through your insurance plan. However, most people nowadays find their therapist via internet search. There are several different sites that therapists put profiles on that you can do filtered searches by things like location, insurance, type of therapy, etc. 

Here are a couple to try out:

• Psychology Today: Many therapists use Psychology Today to post profiles, so you can find a wide variety: https://www.psychologytoday.com/us

• EMDRIA’s Find An EMDR Therapist: The EMDR International Association (EMDRIA) has a Find A Therapist search where you can search specifically for EMDR therapists: https://www.emdria.org/find-an-emdr-therapist/. Other theoretical orientations also have therapist finders for therapists who specialize in that specific orientation. 

One thing to note, there are several sites out there that use therapists’ profiles they take from other sites and use them to get people to use their online services; some of these might have good therapists, but be warned if you see disclaimers on a therapist's profile page.

NOW, TAKE A DEEP BREATHE, AND REACH OUT

It can be daunting signing up to tell a stranger some of the most vulnerable details about your life, and that first step can be hard. However, your mental health is important and having a therapist’s help can really benefit you. Once you reach out, the therapist should be able to answer any questions you may have and guide you through the process from there. 

If you are interested in starting therapy with Present Awakenings, reach out, and we’ll happily answer any questions and help you get connected to a great therapist.