Frequently Asked Questions
- How do I choose a therapist?
- What type of Professional is right for me?
- How Long do I Have to See A Psychotherapist?
- Is Therapy Really Confidential?
First, you want to be sure your therapist is qualified. Ask the therapist if he/she is licensed. Although the state of North Carolina requires licensing of a number of mental health professionals, anyone can "hang up a shingle" and offer therapeutic help. An active license means the therapist has met the educational, ongoing training and practice requirements of the profession.
Ask the therapist if they are affiliated with a national organization. This means the therapist follows the guidelines and is accountable to the ethical standards of their profession.
In addition, when you meet the therapist, judge for yourself if you find the therapist to be a "good fit" - if they are easy to talk to, offer hope, and seem confident about their ability to offer help. Ask the therapist if he/she has experience with your particular concern or problem. Other questions like flexibility of scheduling appointments, or if there is a waiting list may be important to you.
There are three major types of professionals in North Carolina that offer licensed treatment for mental health and emotional/relational difficulties. They are Psychiatrists, Psychologists and Clinical Social Workers. Marriage and Family Counselors are not yet licensed in NC, but are also available for their specialization.
Psychiatrists are medical doctors (MDs) trained in the medical management of symptoms, primarily with the use of medications. Although some psychiatrists also offer psychotherapy, the majority of psychiatrists prescribe and monitor medication, and refer their patients elsewhere for psychotherapy.
Psychologists may have a degree of PhD or PsyD, are trained to provide psychological testing, and may also be trained in providing treatment. Some psychologists may have a masters degree and are certified in North Carolina, providing the full range of psychological services with additional requirements for supervision.
Clinical Social Workers (MSWs or ACSWs) make up the majority, about 80%, of all licensed psychotherapists in the country. They also work in collaboration with psychiatry and psychology to provide comprehensive treatment for those in need of a combination of medical, testing and therapy services. A Social Worker must have a masters degree and 3,000 hours of supervised post graduate training to receive a North Carolina State license. (LCSW). To maintain the LCSW, they must have a least 40 hours of education in treatments skills and ethics, every two years. They also must abide by the National Association of Social Workers code of ethics.
Clinical Social Workers are trained in a broad range of psycho-therapeutic skills, and may treat specific problems, or more broad populations and age groups. They provide diagnostic assessment, treatment, consultation, psycho-education and other specialized services.
This depends on the problem or concern. The therapist will initially evaluate your problem by seeking information about how long it has lasted, how it has affected your functioning and your relationships, etc. They will also ask information about your history and family history to determine the most appropriate plan for treatment. The therapist should discuss their plan with you at the beginning of treatment. As treatment progresses, the progress and direction of treatment should be reviewed.
Some people benefit from brief therapy, and these are often goal oriented or solution-based interventions. Adjustment problems, interpersonal conflict, unwanted behaviors are examples of difficulties that are often helped with shorter term therapies. Those with longer term, or more complex difficulties, may benefit from a longer term process of treatment. This may include people who have repeated patterns of relationship difficulties, problems maintaining stability in work or school, those who have faced devastating trauma or abuse, or those in search of personality changes, emotional growth, or self enhancement.
Confidentiality is an important part of the therapy relationship. It means the therapist cannot discuss information about you without signed permission by you. Therapists usually discuss their cases with other colleagues for supervision, but they cannot reveal identifying information about you in these discussions.
There are a couple of exceptions to client confidentiality. If the client is involved in a legal issue such as a custody case or violent criminal act, a judge may order the release of records or sign an order for a therapist to testify in court. The amount of information shared in court, if any, depends on what information is relevant. The client's right to a confidential relationship with their therapist is an important factor to many judges.
Insurance companies also may require information about a client and their treatment. In fact, the amount of information required by insurance companies varies immensely. In many cases, this information will determine if the insurance will pay for services, as well decide the duration of treatment. Some insurance companies simply require diagnosis and dates of service. Others, in particular managed care organizations, may require progress notes, detailed monthly treatment plans and a regular conferences by phone with the therapist, in order to approve or reject the need for treatment.