Choosing the Right Therapist, Counselor, or Shrink

This guide is intended to help you understand the differences between the kinds of help available and assist you by showing you what qualities a good therapist, counselor, or shrink should have.

My expertise is helping people find the right person to talk to. I supervise the work of 16 different psychologists, social workers, and counselors, or as you may call them - “therapists”. This includes over 6,000 different outpatient visits each year and ranges from play therapy for kids, psychotherapy for adults, family counseling, couples counseling, psych testing, neuropsych testing, and every other kind of outpatient mental health service available. I make my living connecting clients with the appropriate type of help.

When I use the terms therapist, counselor, social worker, psychologist, or psychotherapist, I mean the same thing. Yes, all of these words mean basically the same. I will explain a few differences but as you will see, there is little difference between any of them.

Therapist is the general term for someone who provides a psychotherapy service – so these two are easily interchangeable. The word therapist does sometimes refer to other kinds of therapy such as massage therapy. Mental health treatment is called psychotherapy specifically but we usually just shorten the term and call it therapy.

Psychotherapy is the term we use to refer to the treatment of a mental health disorder. This can mean anything from depression, anxiety, post traumatic stress disorder, family problems, relationship issues, or any range of other symptoms. Bottom line here is that if you are not feeling well emotionally, psychotherapy can help.

If you are looking for medications, this is a different story. Most therapists will communicate with your physician, if necessary, to help them decide what kinds of medications might help you. A therapist works with words and education, but never with medications.

To seek the help of medications you need to visit your primary care doctor, who may refer you to a psychiatrist. Psychiatrists are markedly different than the services you would receive from a therapist.

Psychiatrists treat mental illness using medications. They do not provide psychotherapy or talk therapy. The visits with a psychiatrist are for the sole purpose of finding a medication that will reduce your symptoms. Your psychiatrist is not there to listen to your problems and help you find solutions, that would be psychotherapy.

To provide psychotherapy there are three major areas of study that one can specialize in, these are counseling, social work, and psychology. A professional therapist requires a masters degree in any of these three fields of study. It is not a requirement for them to go on and get their doctorate degree, but some professionals do choose to do so. When we use the three terms counseling, psychology and social work, we are usually referring to someone who provides psychotherapy. In an outpatient facility such as mine, the professional that you work with can be any of these three degrees. In fact, most patients don't know the exact degree of the therapist they are working with.

It is surprising to most people that you can be a therapist with a degree in so many different areas. Truth is I think it's strange also. Three different degrees but all training for the same purpose...mostly. There are a few subtle differences. One example is that psychologists study organizational psychology but social workers study macro level social work, which is the study of organizations and communities...basically 6 of one and half dozen of the other.

The point I am trying to make is that in terms of who can better help you- a therapist, psychotherapist, psychologist, social worker or counselor? They are all the same.

As long as your therapist holds a masters degree in one of the three already discussed fields of study, I recommend ignoring which degree they actually have. Instead, choose your therapist by a different set of standards.

What makes for great treatment isn't the difference between what kind of degree your therapist has. What makes a great therapist is their ability to connect or to “click” with you. If you feel comfortable with them and after having had your first few visits with them you feel like they get you and understand you and your needs, I strongly encourage you to keep them.

Great therapists are able to make you feel comfortable, relaxed, and confident in their ability. These are what I call relationship building skills. They are the number one most important skill a therapist can have. I will never hire a therapist that does not have extremely strong skills in this area. I don't care how educated the therapist is or how great they may be at providing therapy - if clients don't feel comfortable, relaxed, and confident - forget it. They will not be successful in this field.

Relationship skills can not be taught in school. This is something that your future therapist either has or doesn't have. The only way for you to find out is to give them a shot. If after you first few visits you are not feeling “it”, don't waste more of your time. Move onto a new therapist until you find one that clicks.

When you do find one that clicks tho, make sure you stick it out. Don't therapist hop, this can be dangerous and unhelpful for your well-being. If you made it past the beginning stages because you liked your counselor but now they are pressing you into areas that are uncomfortable, don't just drop them. Talk to them! Explain how you are feeling and see if there is a way that it can be resolved so that you can both continue to move forward. If your therapist is doing something that makes you feel uncomfortable there is probably a reason.

One last note on finding the right therapist for you. I often get clients who want to know if their therapist has certain qualities such as “what is the therapists religion?” or race, family background, etc. Most recently I had a gentleman interested in working with only a counselor that is vegan. While I understand the logic behind wanting to know personal information about your therapist, I assure you it is irrelevant. A therapists ability to help you through your personal issues has nothing do to with their own choices.

Therapists are trained to help you reach your goals by understanding the human mind and what makes it work. When a professional understands these underlying principles, it doesn't matter what the specific issue is, they will know how to help.

Long story short, don't judge a therapist by their degree and try to not get thrown off by all of the different professional terms used. Find someone who has a degree in counseling, social work, or psychology, and try until you find one that clicks.