ROBERT M. NEWELL, PH.D.
FORENSIC AND CLINICAL PSYCHOLOGY
Specializing in Behavioral Healthcare for Children &
Adolescents, Families, Couples, and Adults.
FREQUENTLY ASKED QUESTIONS
What Is Psychotherapy?
Psychotherapy is a process in which a trained and licensed psychotherapist enters into a professional relationship with a patient for the purpose of helping the patient with symptoms of a psychiatric disorder, behavioral problems, and/or personal growth. The process of therapy involves the patient and psychotherapist sitting in a room talking, which is why psychotherapy it is often referred to as “talk therapy” or “the talking cure”.
There are a variety of therapeutic approaches such as psychodynamic therapy, cognitive behavioral therapy, behavioral therapy, and interpersonal therapy, to name a few. There are also different therapeutic modalities such as individual therapy, couples therapy, family therapy, and group therapy. Cognitive-behavioral therapy (CBT) is the most popular and commonly used therapy for the treatment of depression and anxiety disorders. Hundreds of research studies have been conducted which verify its safety and effectiveness. CBT consists of simple techniques which focus on an individual’s negative thought patterns, called “cognitive distortions”, which the depressed person may habitually use.
Therapy begins by establishing a supportive environment for the patient. Educating the patient about how depression may be caused by cognitive distortions is the next step. The types of faulty thinking are discussed (e.g., "all or nothing thinking," "misattribution of blame," "overgeneralization," etc.) and the patient is encouraged to begin noting his or her thoughts as they occur throughout the day. This is done so that the individual may understand how common and often these thoughts are occurring.
In cognitive-behavioral therapy emphasis is placed on discussing the thoughts and the behaviors associated with depression rather than the emotions themselves. The rationale for this is that it is believed that by changing thoughts and behaviors the emotions will also change. Because of this approach, cognitive-behavioral therapy is short-term and works best for people experiencing quite a bit of distress. Individuals who are able to approach a problem from a unique perspective and who are more cognitively-oriented will to do best with this approach.
Interpersonal therapy is another short-term therapy used in the treatment of depression. The focus of this approach is on improving an individual's social relationships. It is thought that good, stable social support is essential to a person's overall well-being. This therapy seeks to improve a person's relationship skills, communication skills, expression of emotions, and assertiveness. It is usually conducted on an individual basis, but can also be used in a group therapy setting.
Most individual approaches will emphasize the importance of the patient being actively involved in his own recovery. Patients are usually encouraged to do homework assignments between sessions. If the patient is not yet able to participate actively in therapy, then the therapist may provide a supportive environment until medication begins to improve the patient's state of mind.
What Is the Difference Between Counseling and Psychotherapy?
"Psychotherapy" and "counseling" are terms that are often used interchangeably. Although they are very similar, there are some important differences as well. Technically speaking, "counselor" means "advisor". It involves two people working together to solve a problem. It is a term that is used in conjunction with many types of advice giving. For example, financial planning and spiritual guidance are both types of counseling. Just about anyone at all may claim to be a counselor if they are in the role of giving advice. The term counseling may also properly be used to refer to what occurs in a relationship with a psychotherapist. In the context of mental health, "counseling" is generally used to denote a relatively brief treatment that is focused upon specific behavior. It often targets a particular symptom or problematic situation and offers practical suggestions and advice for dealing with it.
"Psychotherapy" is generally a longer-term treatment which focuses more on gaining insight into chronic physical and emotional problems. It's focus is on the patient's thought processes and way of being in the world rather than specific problems. In actual practice there may be quite a bit of overlap between the two. A therapist may provide counseling with specific situations and a counselor may function in a psychotherapeutic manner. Generally speaking, however, psychotherapy requires more skill than simple counseling. It is conducted by professionals trained to practice psychotherapy such as a psychiatrist, a trained counselor, social worker or psychologist. While a psychotherapist is qualified to provide counseling, a counselor may or may not possess the necessary training and skills to provide psychotherapy.
What Do All Those Initials After the Psychotherapist’s Name Mean?
As I already mentioned, psychotherapy is conducted by a professional with specialized training at the post-graduate level who is a licensed by the state of Washington as a mental healthcare provider. However, there are a number of different types of training and degree programs which allow an individual to become licensed to provide psychotherapy. How is one to make understand and make sense of a mental healthcare professionals credentials? What are the qualifications of the person treating you?
Doctoral Degrees: Although it's common to associate the title "Doctor" with a physician (i.e., someone with a M.D.), this title also applies who other types of advanced degrees. Also, just because someone uses the title "Doctor", does not mean that he or she is qualified to provide psychotherapy. For example, an individual who is an OB-GYN goes by the title “Doctor”, as does an individual who a professor of economics at a state university. If in doubt, ask to see their full credentials.
Some professional titles you may run into are:
· Ph.D. stands for Doctor of Philosophy. Ph.D. programs may offer degrees in many diverse areas ranging anywhere from Agriculture to Urban Economic Development. Psychologists often have this degree as well. Psychologists with Ph.D.'s may have degrees in Clinical Psychology (focused upon research and practice), Counseling Psychology (focused upon counseling people with day-to-day problems), School Psychology or just Psychology. In general, psychologists cannot prescribe medication, although several states now allow them to do so under specific conditions.
· M.D. stands for Medical Doctor. Psychiatrists are usually M.D.'s. Because they possess a medical degree. They can prescribe medications and may also provide psychotherapy, although most psychiatrists limit their practice to medication management.
· Psy.D. stands for Doctor of Psychology. This type of degree focuses more upon the practice of psychology than research.
· D.Min. stands for Doctor of Ministry and is a degree held by a minister. Ministers may offer Pastoral Counseling.
Masters Degrees: Whereas someone with a doctorate may have three to four years education plus and internship or residency beyond a Bachelor's degree, Masters programs are generally closer to 2 years. Some degrees you may encounter:
· M.S.W. stands for Masters in Social Work. This is the degree that social workers generally possess.
· M.Ed. stands for Masters in Education. Many counselors have this degree. It may be given in any field of education.
· M.S.Ed. is similar to a M.Ed.
· M.S. or M.A. stand for Masters of Science and Masters of Arts, respectively. These are the traditional degrees given by Colleges of Arts and Sciences In the United States. Generally a Masters degree is not sufficient to be licensed as a psychologist, although some states and Canadian provinces do allow it.
· M.Div. stands for Masters of Divinity. Ministers who are Pastoral Counselors may have this degree.
Licenses: Some states required counselors to be licensed, conferring the titles L.P.C. (Licensed Professional Counselor) or M.F.C.C. (Marriage, Family and Child Counselor). In some states the title L.S.C.W., for Licensed Clinical Social Worker, may be used for social workers.
Special Certifications: Certifications are similar to licenses, but with a more limited scope of practice. Some certifications you may see:
· C.S.A.C. stands for Certified Substance Abuse Counselor. This person usually has at least a Bachelors degree and some additional training in substance abuse.
· C.A.C. stands for Certified Alcoholism Counselor. Similar to a C.S.A.C., but with an emphasis in alcohol abuse.
Board Certifications: Physicians generally pass "specialty boards" to become "board certified" in their chosen specialty.
· A.B.P.P is a board certification credential available through the American Board of Professional Psychology. Any psychologist who passes their exam may use these initials. Many psychologists do not get this certification, however.
· F.A.C.P. stand for Fellow, American College of Physicians.
How Do I Choose a Therapist?
Psychotherapy can be a time-consuming, expensive process. You don't want to waste money and effort on a therapist who won't help you achieve results. The following tips will help you select a therapist who best meets your needs. Find someone with whom you are comfortable. Although the therapy relationship is not a friendship, you will still get the best results if you trust your therapist and feel comfortable with him or her. You should feel able to open up and be honest with your therapist. If you withhold information, you cheat yourself out of making real progress. Just like with any relationship, you and your therapist may not "click". If not, you owe it to yourself to seek another therapist.
What Are the Minimum Qualifications to Look For?
Look for at least a Masters degree. A therapist should be licensed in the state in which he or she practices. Avoid counselors who have little or no formal training. If in doubt, ask about the therapists credentials. An ethical therapist should have no problem providing you with the requested information.
Where Can I Find a Recommendation for a Therapist?
The best source for recommendations are trusted friends. Alternatively, ask your family doctor or psychiatrist--if you have one--for recommendations of colleagues. There are also several databases on the Internet which provide listings. Many patients have reported good success by simply choosing a name from the phone directory. Be aware that your insurance provider may limit who you may see.
Important Questions You Should Always Ask
Here are some important questions you should ask when looking for a psychologist. Use this list as a check list of the questions you should ask when talking to a prospective therapist. Remember, don’t be afraid to ask any questions you may have.
· What is your academic and training been to prepare you to practice as a therapist?
· What specialized training and/or experience have you had in working with the issue I am dealing with?
· What professional associations do you belong to?
· What are your fees? How will my insurance claim be handled? (preferably fees and potential insurance coverage should be discussed on the phone prior to making the first appointment)
· What type of therapy do you do? (e.g., cognitive-behavioral, psychodynamic, hypnosis, etc.)
· What are your office protocols? (e.g., booking appointments, payment for missed appointments, emergencies, building access after hours, etc.)
· I would like a brief explanation as to what I can expect to happen in my sessions.
· How long will each session last?
· How many sessions will it take to resolve my issue?
· How will my confidentiality be assured?
DR. ROBERT M. NEWELL
Copyright © 2004-2007 Robert M. Newell, Ph.D. All rights reserved.