Understanding The Qualifications And Differences Between Professionals
Patients and clients enter counseling or psychotherapy with a number of questions. The following is a list of informational topics that can help you select a therapist or counselor.
Degree(s). The type of degree or number of degrees a professional has attained indicates their exposure to academic education, their ability to assimilate that body of knowledge and their ability to perform successfully in a academic or research setting. A degree in psychology, counseling, social work or medicine is not by itself a good indicator of professional skill, competence or compassion. An individual with a doctoral degree has been formally exposed to a more advanced and demanding knowledge base than a person with a master's degree. They may have been exposed to a rigorous clinical training internship and residency. However, academic programs vary significantly in terms of the quality of students they graduate. A doctoral degree is not better than a masters degree. The are many people with doctoral degrees that are not related to the area in which they practice. For instance, there are professionals who refer to themselves as Doctor and tell you they are licensed but in truth they may be a licensed masters level counselor and they have a Ph.D in English. There is also a difference between a Ph.D and a Psy.D. A Psy.D is a doctorate in professional psychology and is based on a the practice of psychology. Nearly all Ph.D programs have a training focus that emphases research and skills necessary for an academic career in psychology. These distinctions alone are insufficient to differentiate the competence of a licensed counselor or therapist. Some programs in counseling, psychology and social work are outstanding. Others can be abusive, model callous attitudes, and will actually "weed out" caring and competent people and retain students purely on the basis of academic performance or the ability to publish research. The level of fame or notoriety achieved by a university may be associated with successful research programs, success in the distant past, and may not necessarily b related to training for clinicians that will benefit you as a consumer.
License(s). In Oregon, practitioners must be licensed or be supervised by a licensed professional in order to practice psychotherapy, provide consultation or make a diagnosis. However, there are people who call themselves a counselor or a therapist and practice without a license. They may or may not have training and they are not licensed. Having a license is the first indicator that a professional has demonstrated competence to practice. However licensure alone is not a reliable predictor that the person is a good practitioner or the right person for you. Licenses are issued by a Licensing Board designated by States where a professional wishes to practice. The fact that a person has a license does not mean the professional is truly competent. It does mean they met the required educational and training requirements, passed a licensing examination, have met the necessary supervision requirement for licensure, and that they are meeting the required continuing education requirements.
The fact that a person has lost their license, has been suspended, or sanctioned by their licensing board is a good indictor that the professional's competence and judgment has been questionable. Licensing serves to protect the public by denying licensure to people who lack required knowledge and skill, but also by dealing with those professionals who have complaints filled against them which are sustained through licensing board investigations. Practicing without a license is not a problem when the person is supervised by a licensed professional. In fact it could be to your advantage. Your records and relationship with your therapist are not confidential if you seek counseling or psychotherapy from an unlicensed person who is not supervised by a licensed professional. This means that your records can be released by your therapist or subpoena during legal or administrative proceedings despite your objection.
Training & Certifications. A professional's training or certifications can provide evidence of competence and knowledge within a particular area of practice. Unfortunately, many certifications are little more than marketing tools that create the appearance of competence or special ability. In most cases, only another professional can discern whether or not particular trainings or certifications are meaningful. Many professionals will state they are certified in a certain treatment method, but if you call the particular training institute, you may discover they provide training, but do not give certification. For the most part, specific certifications are necessary to conduct court ordered or forensic evaluations. Beyond that, a certification is usually no substitute for credible experience and the recommendations of past clients or patients.
Availability. There are four categories of a professional's availability. Routine means the professional is generally available on a weekly basis. Urgent indicates the professional is generally available within 72 hours. Crisis means the professional or their backup is available to see you within 24 hours. Emergency means you will be seen right away or as soon as reasonably possible. An emergency would generally be seen immediately or within 1 to 8 hours.
Affiliations. Affiliations reflect what organizations or institutes a professional has joined or is involved with. Affiliations alone are not good indictors of professional competence, but can help you to identify those professionals who support and participate in activities that demonstrate their professional interests. While many professionals find it offensive as well as an unkind observation about their profession as a whole, there are practitioners who simply join organizations to enhance their resume and to help market their practice. It may help you to feel better about a professional if you ask questions about their interest, involvement and activities within organizations they are affiliated.
Fees & Costs. The fees set by a professional in no way indicates their level of competence or the actual demand for their services. It is a fairly common practice for professionals to charge fees that support a very small practice of 5 or 6 clients. Likewise, low fees do not necessarily indicate a professional is not as competent as a professional who charges a much higher fee. Psychotherapy fees can range from $45 per hour to $125 per hour. Evaluation and expert witness fees generally exceed $100 per hour and can exceed $150 per hour. There has been considerable debate among consumers and within managed health care as to whether or not psychotherapy services warrant fees in excess of $90 per hour. Keep in mind that a professional who sees 8 patients per day at $90 per hour is billing $720 per day, $3600 a week and approximately $172,000 a year. Business overhead and taxes range from approximately 30 to 50%. You have right to expect that people who command such fees to be trained, professional, licensed, ethical, effective and come recommended.
Specializations. Many counselors and psychotherapists are in general practice. More and more professionals attempt to specialize in certain areas practice and have acquired skills from a program of education and training. To claim a specialization, the professional should have some evidence in the form of a certification or record of continuing education training on file with their licensing Board. A professional who claims a specialization should be able to readily describe a program of training that demonstrates special skill and experience. It is quite rare that any professional can claim specialization in more than four areas. Specialization is a higher standard than a professional's Focus of Practice & Interest.
For example, working is a hospital does not make a professional a specialist in medical psychology, medical social work, etc.. Having a deep spiritual belief system or spiritual practice does not make them a specialist in spirituality. Keep in mind that professionals with less than 10 years of experience will rarely have 4 documented areas of specialization. Specializations that are not reflected in a professionals licensing continuing education record must be defined, discussed and approved by the Guild on an individual basis before they can be published on this web site. Keep in mind that a specialization to be a level of skill that one could reasonably defend to a Professional Licensing Board or to a jury in a court of law if they were involved in a court proceeding.
Focus of Practice & Interests. While many professionals may have one or two specialties, they often have experience and training regarding several areas of practice and interests. This information tells you about what a professional does and what kind of work they find interesting. Having a therapist or counselor who is curious and interested in the kind of service you may need can be important. A therapist can be interested in many aspects of mental health and have only a few specializations.
Background & Experience. Knowing where a professional has worked, their background and their experience can help you understand their skills and what talents they bring as an therapist, evaluator or expert. In general, the more rich a professional's background the greater will be his or her ability to recognize a range of problems and potential solutions. Dealing with complex problems, especially crises and emergencies, usually requires the involvement of professionals with credible experience in these areas.
Patient & Client Populations Served. Not all professionals are qualified to treat all populations. In fact, very few professionals are truly able to treat children, teenagers, adults and elders. The circumstances in which a professional will work with children depends on a number of criteria that you should ask about before you enter treatment. For instance, a professional may choose to not work with a child unless the entire family is involved. Others may only work with a child if the family is not involved. This depends on the problem and the professionals therapeutic orientation.
Therapeutic Orientation & Approach. To some extent, the manner in which a professional will approach a problem can provide information that can help determine whether or not you may benefit from therapy. While there are approaches to treatment that are stereotypic, good therapy does not necessarily belong to any discipline, orientation or approach. If you have benefited from a particular approach in the past, you might consider staying with that approach. And while a different approach may be indicated after a failure to respond, there is still a possibility that you would benefit from another trial of the same approach.
In some cases, psychotherapy techniques are becoming trendier that MTV and less therapeutic. Beware of therapy techniques that are revolutionary, miraculous, easy or promise quick cures for problems that have existed for a long time.