There are multiple types of mental health practitioners out there and knowing the difference between each type helps make the search for your prospective mental health provider less daunting. (Please note that coaches do not provide mental health counseling/treatment).
The following list (in alphabetical order) includes the general categories that you will find in our directory.
Only individuals with a license in good standing are allowed to practice in their state. Ethically and legally, mental health providers must be transparent when listing their credentials and education. Please know you can verify the status of the license of your prospective mental health provider by looking up their license through the license verification search option on your respective state’s website.
1) Advanced Practice Psychiatric Nurse (APRN)
Advanced Practice Psychiatric Nurses have years of experience and training along with a BA in nursing, a MA in psychiatric-mental health nursing and a license as a Registered Nurse. APRNs are authorized across all 50 states in the US to prescribe medications and conduct comprehensive mental status/psychiatric evaluations. APRNs can work with individuals across the age spectrum, provided focused training is received. Some APRNs may provide individual, couples and group therapy. APRNs are licensed through their state board and must continue to obtain re-certification and training to uphold their license.
2) Applied Behavioral Analyst (ABA)
Applied Behavior Analysis (ABA) is a type of treatment that focuses on using learning behavior and applying it to help individuals with psychological disorders, specifically across the autism spectrum, learn specific skills. Specific skills of focus range from social skills, reading, academic, hygiene and job competence, amongst others. ABA can be provided by practitioners at schools, homes, office settings and residential treatment centers. Research shows the effectiveness of ABA for individuals with special needs.
The certification levels for behavioral analysts depends upon the education level. The certification levels are listed below:
3) Art Therapist
Art therapy focuses on using active art-making via multiple mediums (drawing, sculpting, painting, etc.) to help understand underlying issues to help facilitate growth, emotional resilience and enhance mental wellness.
Art therapists need to have an MA at minimum. They must also obtain supervised hours for a few years, the number of hours and years depending upon each state. Art therapists cannot prescribe medications. Art therapists work with individuals of all ages, family groups and communities. Art therapists are licensed through their state and are required to obtain continuing education in order to uphold their license. At this time, not every state has recognized art therapy and the American Art Therapy Association is advocating that states change their status.
The main license title designation for art therapists varies by state:
In other states, art therapists hold a license in another field (LCSW or LPC) and obtain an art therapy concentration certification.
4) Counselor
As counseling is a collaborative effort between the counselor and the client, professional counselors help clients identify goals and potential solutions to problems that are causing emotional stress. Counselors focus on helping their clients reach the optimal level of wellness — a key feature of the counseling field.
Most counselors have an MA in mental health counseling or community clinical counseling. In order to be licensed, counselors must be supervised for three to four years of full-time work in a clinical setting. Counselors can provide individual, group, couples and family therapy –provided they have experience and training in the last three. Counselors cannot prescribe medications. Counselors are licensed through their state and are expected to obtain continuing education to keep their license.
There are multiple license title designations for counselors (the designation depends upon the state). Below are most of the license title designations:
5) Drug and Alcohol Counselor
Drug and alcohol counselors focus on drug and alcohol addictions. Addictions are viewed as diseases with additional factors playing a role in the person’s development of the addiction. Drug and alcohol counselors can either have a BA or MA. Individuals with a high school diploma, GED or BA degree can only become a certified drug and alcohol counselor (CADC). They must be under the supervision of an MA level (or higher) licensed and certified drug and alcohol counselor (LCADC). Neither a CADC or LCADC can prescribe medication. Often, it is advised to see a dual-licensed therapist (therapist with LPC or LCSW) who can work with both your presenting mental health concerns and addiction diagnosis. LCADCs are licensed through their state and are required to obtain continuing education in order to uphold their license.
The main license title designations for drug and alcohol counselors is listed below:
LCADC- Licensed Drug and Alcohol Counselor
6) Marriage and Family Therapist
Marriage and family therapists focus on the person’s set of relationships. Marriage and family therapists focus on how family dynamics affects a person’s mental health.
Marriage and family therapists must have an MA at minimum. They must also obtain supervised hours for a few years, the number of hours and years depending upon each state. Marriage and family therapists can provide individual, group, couples and family therapy. Marriage and family therapists cannot prescribe medications. Marriage and Family therapists are licensed through their state and are required to obtain continuing education in order to uphold their license.
The main license title designations for marriage and family therapists are listed below:
Can practice independently:
Must be supervised by a fully licensed LMFT:
7) Pastoral Counselor
Pastoral counselors are counselors trained to include a spiritual framework when working with clients to help them achieve spiritual wellness. According to the Association for Pastoral Counseling Education, the role of pastoral counselors is changing and efforts are being made to train pastoral counselors on using more evidence-based techniques.
8) Play Therapist
Play therapy is therapy that uses play, considered as children’s “language,” to help them better express themselves, address and resolve their issues. Play therapists need to have an MA at minimum to practice. Their MA can be in social work or counseling, but they must be licensed in their respective fields (counseling, social work, Ph.D. in psychology, etc.). They must also obtain supervised hours, with the exact number depending upon each state. Play therapists cannot prescribe medication. They work primarily with children, most often from ages 3 to 12.
Play therapists have the following certification levels:
9) Psychiatrist
As psychiatry views mental health and mental health disorders primarily from a medical model. Psychiatrists have a medical degree (MD, DO). Psychiatry focuses on the biological and neurochemical basis of mental health disorders, which is why psychiatrists are trained to prescribe medications, given that they have an active medical license. Although most psychiatrists usually focus on medication management and brief supportive therapy, some psychiatrists may also offer more in-depth therapy. Psychiatrists can work with adults, and with additional training, with children and adolescents. Psychiatrists are licensed through their state board and must continue to obtain re-certification and training to uphold their license.
10) Psychologist
Psychologists focus on providing behavioral and related interventions and are also trained extensively in administering different types of assessments. Psychologists have a doctorate in psychology (Ph.D.: Doctorate of Philosophy in psychology, Psy.D: Doctorate of Psychology with a more clinical emphasis or Ed.D: Doctorate of Education in Counseling Psychology). Very few states allow those with an MA in psychology to be referred to as a psychologist.
Psychologists cannot prescribe medications, although very few states do allow them to, but only if the psychologist has received extensive additional training. Psychologists can work with individuals across the age spectrum and provide individual, couples, family and group counseling. Psychologists are licensed through their state and are expected to obtain continuing education to keep their license.
11) Social Worker
Social Work as a field focuses on systemic issues, such as human rights, legal issues and socioeconomic concerns and their impact on a person’s functioning. Licensed social workers with no clinical training help individuals secure housing, maintain financial stability and keep necessary medical appoints.
Social workers need a minimum of an MA in social worker with a few years of supervised experience in a clinical setting in order to become licensed and provide therapy. Licensed clinical social workers can provide individual, group, couples and family therapy–provided they are trained in the last three. Social workers cannot prescribe medications. Social workers are licensed through their state and are expected to obtain continuing education to uphold their license.
There are different license title designations for social workers such as those listed below:
Are coaches mental health professionals?
Coaches are not mental health professionals in that they are not trained to diagnose and treat mental health disorders and illnesses. Coaches cannot treat anxiety, depression, PTSD, trauma, eating disorders, etc. According to the International Coach Federation (ICF), the main coaching certification body, per the ethical guidelines for coaches, they must refer out someone who needs therapy as they are not trained mental health therapists.
If you are seeing a coach while meeting with a mental health provider, please let all parties know that you are in treatment with the other in order to ensure that no contradictory recommendations or suggestions are being made.
UNDERSTANDING HOW YOUR INSURANCE WORKS
Using your health insurance in Canada
Because Canada has a single payer system, your province has a healthcare plan that covers you and other residents for medical treatment. If you are interested in making an appointment with a psychiatrist or other mental health care provider, speak to your primary care physician and ask for a referral so you can get started on the process.
Using your health insurance in the US
Healthcare in the US is, unfortunately, very expensive. Until we make healthcare, especially mental health care, accessible and affordable to everyone, understanding how to use your insurance benefits is necessary. Prior to finding a mental health provider and then setting up an appointment with them, it helps to know which plan you have and what your benefits are. Most providers will call themselves anyways, so they are aware for billing purposes.
Follow the steps listed below to find out about your insurance benefits:
Locate the “Members Services” or “Behavioral Health” phone number on the back of your insurance card
Here are key definitions. Please follow up with your insurance company to confirm your plan requirements within the context of your plan.
HMO plans (aka managed care): these plans do not have out-of-network benefits. You therefore need to see a provider who is in-network.
PPO plans (Traditional/Commercial plans): these plans have out-of-network benefits. You have more leeway as to whom you can see.
In-Network: In-Network refers to a mental health provider who is credentialed/paneled within your network and therefore, takes your insurance.
Out-of-Network: Out-of-Network (OON) refers to individuals who are not credentialed/paneled with your specific health plan. Generally, if you have a plan with OON benefits, you can see any provider you wish, provided they take insurance.
Deductible: The amount you have to pay out-of-pocket before your insurance benefits begin.
Co-pay: The amount of money you pay per session, while insurance will cover the remainder of the amount.
Out-of-Pocket Maximum: Once you reach your out-of-pocket max, you no longer have to pay your co-pay (this depends upon each specific plan- please verify the amount and if this applies to your plan).
HSA Benefits: You may have the opportunity to enroll in a Health Savings Account (HSA) through your employer. It is like a personal savings account, but it’s considered pre-tax dollars and can be used to pay off your deductible and co-pay for each session.
Sliding Scale: Some mental health providers may use an income-based scale to determined your rate for each session, provided you do not have insurance and are unable to pay the full rate. This usually requires you to bring income verification to your therapist. Most private practice mental health providers do not offer a sliding scale, but instead may offer reduced fees.
Reduced Fee: Some mental health providers will offer a reduced fee, which is not necessarily based on income. You can discuss this further when you have your initial phone consultation.
DO I HAVE TO USE MY INSURANCE?
No, you do not have to use your insurance as it is your right to choose how you pay. Some individuals decide not to use insurance for multiple reasons. The ones listed below are a few of the most common ones:
Marriage and couples counseling is not technically covered by insurance companies due to not having a specific code for billing. Usually, this means the therapist will diagnose one partner with the other partner being regarded as needed for the treatment of the other partner.
Ultimately, it is your choice to use your insurance or not. Whichever you decide, please be aware that if you are paying a co-pay or simply out-of-pocket, therapists cannot legally charge you for credit card transaction fees.
WHAT TO LOOK FOR IN A MENTAL HEALTH PROVIDER
Once you figure out your insurance benefits and decide whether you want to use your insurance, your next step is to find a mental health provider. You can either ask your insurance company for a list of providers that take your insurance, or you can search on our directory. Because research has shown that the relationship and rapport between a person and their mental health provider is one of the key ingredients for change, it’s important to find a practitioner you connect with, feel comfortable with and feel understood by. It’s important to remember that trust takes time to build, but that doesn’t mean that your mental health provider shouldn’t exhibit the qualities of a good mental health therapist from the beginning.
Listed below are some qualities that make a good therapist:
Exhibits cultural competence and/or cultural humility: Your therapist takes the time to understand you, your cultural background and its role in your life. Your provider does not look to you to be the representative of your culture and answer all their questions about your culture, but is willing to do the research themselves, acknowledge their limited awareness and not engage in stereotypical and hurtful comments about cultural backgrounds. Your therapist accepts your spirituality and religious background without judgment and incorporates spirituality, only if you want to, in your treatment. Your therapist refers you to get additional support from a chaplain or religious leader instead of trying to answer your spiritual questions (see point 2).
Works within their expertise: Your therapist is working within their scope of expertise. If your therapist is helping you with an eating disorder, but does not have any training in working with individuals with eating disorders, or is not in the process of obtaining training and supervision for working with eating disorders, then your therapist is operating outside of their scope of practice. If a therapist realizes that they cannot help you and you need someone with more experience and a more focused approach, they should refer you out.
Is willing to work with you in the process: Your therapist is engaged with you in the process, challenges you appropriately, supports you, helps you learn new behavioral skills and works towards achieving optimal wellness. Your therapist does not talk so much in session that you can’t, nor so little that you are the only one talking in a session.
Treats you non-judgmentally and with unconditional positive regard: Your therapist is not judgemental of you, your lifestyle or your behavior. Your therapist does not impose their personal values, including spiritual ones, or their spiritual views of your actions on you. Your therapist treats you with “unconditional positive regard –the idea that you are worthy and to be accepted completely for how and who you are.
Develops a treatment plan with you- Your therapist is interested in your goals for therapy, and the changes you want for yourself. Your therapist works with you on developing your treatment plan. Your therapist explains to you that the treatment plan is there to guide treatment, but can also be changed and modified with the inclusion of new goals if needed.
Maintains high ethical standards- Your therapist follows their code of ethics and maintains high ethical standards. They do not initiate physical contact without your permission, and even then it is limited (shaking hands, hugging, a tap on your knee). They do not initiate friendship during or outside of session, nor do they rely on you for their emotional needs. They do not talk about their personal issues with you and if they self-disclose, they do so only with the intention of it helping you therapeutically. They do not barter with you, offering their counseling for services for what you can do for them (whatever skills you have). They do not initiate a sexual relationship with you. They maintain your privacy and do not give away your information without your consent or signed release, nor do they tell you the identities of their other clients.
Empowers you- Your therapist teaches you new skills and techniques so you can, at some point, terminate therapy and implement the skills you learned from your work together. Your therapist challenges you (in a gentle, supportive, helpful manner) and doesn’t blame or encourage you to blame others for your struggles and issues.
Is open-minded and flexible: Your therapist doesn’t ridicule other approaches you might prefer, your therapist is open to hearing about your experiences with other treatment modalities without ridiculing or judging your experiences (unless clarifying how it may have been unethical, damaging or misguided). Your therapist is willing to work with you on modifying your treatment plan if you feel it needs to be modified.
Expresses hope and optimism– Your therapist expresses hope and optimism that with hard work and therapy, you can make changes, but does not give you any guarantees or promises.
Is actively engaged: During your time together, your therapist is listening to you and engaged with you. They remember your name, recall past conversations and are able to remember themes. They are not spending time on their phone, or being distracted by other things as you are talking.
Is non-defensive: Your therapist creates an atmosphere and relationship with you where you can address any complaints or concerns you might have about counseling, their techniques, something they may have said or any other concerns you might have. When you do share your concern, your therapist does not take it personally, acknowledges when mistakes are made and processes your feelings around your concerns with you. Finally, if you determine that you prefer being referred out and working with someone else, your therapist may help with referrals and does not try to force you to stay in treatment with them.
Works on establishing a therapeutic alliance: Your therapist is authentic and genuine with you. Your counselor doesn’t miss sessions often or show up late or cancel on you multiple times. Your counselor makes sure you understand what your diagnosis is and what techniques they will be working on with you instead of using dense mental health jargon. Your therapist shows empathy– not so much that they are triggered by your emotions and you need to comfort them, and not so little that you feel unheard and hurt after being vulnerable.
Informs you of your rights and reviews important information: Your therapist reviews important information as you begin counseling: confidentiality and its limits, HIPAA and privacy policy, financial policies, information about themselves (training and approach), and other important documents. Your therapist confirms that your signature indicates your consent to treatment. (Please note the requirement for what a therapist must share with their client at the beginning of treatment varies by state, but the documents listed above are the minimum required by states).
Is aware of nuances in treatment: Your therapist doesn’t push you to explore heavy, vulnerable and difficult experiences, feelings and memories until you are ready. Your therapist balances helping you with learning new coping skills to address the current, pressing issue as you work on understanding the underlying reasons for your concerns. Your therapist doesn’t just focus on thoughts, or behaviors, or feelings only, but instead acknowledges the roles each plays. Your therapist doesn’t give you unsolicited advice, act as if they know all the answers, or tells you what to do.
Continues professional development: Your therapist makes sure to stay abreast of new techniques and continues their professional development and education. They seek consultation with other therapists.
As you search for a mental health provider, you can ask them any questions you think may be helpful for you to understand them and ultimately assist you in deciding whom to work with.
Some suggested questions to ask in your initial phone call to help you make your decision are listed below:
QUESTIONS TO ASK YOURSELF AFTER YOUR FIRST MEETING
After your first meeting with your mental health provider, thinking about how the meeting was can help you decide if you want to go forward. Of course, it is important to keep in mind that it takes time to develop a relationship of deep trust with your therapist or psychiatrist. However, there are a few questions you can ask yourself after the first meeting to gauge how you feel. The questions are listed below:
ETHICAL GUIDELINES FOR MENTAL HEALTH PROVIDERS
Every mental health practitioner has codes of ethics they must follow. You can find the links to their code of ethics below.
The key guidelines that mental health providers must follow:
Mental health practitioners must follow the rules of confidentiality and HIPAA. You can read more about confidentiality guidelines and HIPAA in the section about confidentiality. Also, your mental health provider will review the guidelines for confidentiality with you so please ask them about specifics for your state, especially confidentiality limits when working with children.
The general rules of confidentiality are:
Each type of mental health provider has a code of ethics, formulated by their respective professional organization, that they must follow.
Click on the organization name below to get access to their code of ethics:
QUESTIONS AND CONCERNS AROUND YOUR THERAPIST’S ETHICAL BEHAVIOR
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