Where to Start

Issues with mental health, especially if they’re chronic (persistent or recurring often), can be debilitating. Your body can respond physically to depression or anxiety much like it does to physical illness. And sometimes, mental problems can actually be caused by a physical condition. So the first person to see if you think you are having a mental problem is your primary care doctor.

Your doctor will ask about your symptoms, how long you’ve been having them, and whether they’re constant or come and go. Your doctor will check for physical problems that could be causing your symptoms and help you decide what type of mental health professional and what kind of therapy might be best for you.

Types of Mental Health Professionals

Your doctor might refer you to any of the following mental health professionals:

Psychiatrist. A psychiatrist is a medical doctor (M.D. or D.O.) who specializes in preventing, diagnosing, and treating mental illness. A psychiatrist’s training starts with four years of medical school and is followed by a one-year internship and at least three years of specialized training as a psychiatric resident. A psychiatrist is trained to differentiate mental health problems from other underlying medical conditions that could present with psychiatric symptoms. They also monitor the effects of mental illness on other physical conditions (such as problems with the heart or high blood pressure), and the effects of medicines on the body (such as weight, blood sugar, blood pressure, sleep, and kidney or liver functioning).

Psychologist. A psychologist has a doctoral degree (PhD, PsyD, or EdD) in psychology, which is the study of the mind and behaviors. Graduate school provides a psychologist an education in evaluating and treating mental and emotional disorders. After completing graduate school, a clinical psychologist completes an internship that lasts two to three years and provides further training in treatment methods, psychological theory, and behavioral therapy.

Licensed psychologists are qualified to do counseling and psychotherapy, perform psychological testing, and provide treatment for mental disorders. They are not, though, medical doctors. That means that, with the exception of a few states, psychologists cannot write prescriptions or perform medical procedures. Often a psychologist will work in association with a psychiatrist or other medical doctor who provides the medical treatment for mental illness while the psychologist provides the psychotherapy.

Licensed Mental Health Counselor. A psychological counselor is a mental health professional who has a master’s degree (MA) in psychology, counseling, or a related field. In order to be licensed, the professional counselor also needs two additional years’ experience working with a qualified mental health professional after graduate school. A mental health counselor is qualified to evaluate and treat mental problems by providing counseling or psychotherapy.

Clinical Social Worker. A clinical social worker has at least a master’s degree in social work and training to be able to evaluate and treat mental illnesses. In addition to psychotherapy, social workers can provide case management and hospital discharge planning as well as work as an advocate for patients and their family.

Psychiatric or Mental Health Nurse. Some nurses have had special training in providing mental health services. Depending on their level of training and certification, they can evaluate patients for mental illness and provide treatment in the form of psychotherapy. In some states, they are also licensed to prescribe and monitor medications, sometimes independently and sometimes under the supervision of a medical doctor. Nurses also provide case-management services and serve as patient advocates.

The Difference Between Counseling and Psychotherapy

Although the terms counseling and therapy are often used interchangeably, there is a difference between psychotherapy and psychological counseling. Counseling focuses on specific issues and is designed to help a person address a particular problem, such as addiction or stress management. The focus may be on problem solving or on learning specific techniques for coping with or avoiding problem areas. Counseling is also usually more short-term than therapy.

Psychotherapy is more long-term than counseling and focuses on a broader range of issues. The underlying principle is that a person’s patterns of thinking and behavior affect the way that person interacts with the world. Depending on the specific type of psychotherapy that is being used, the goal is to help people feel better equipped to manage stresses, understand patterns in their behavior that may interfere with reaching personal goals, have more satisfying relationships, and better regulate their thinking and emotional responses to stressful situations. If someone has a form of mental illness such as depression, bipolar disorder, schizophrenia, or an anxiety disorder, psychotherapy also addresses ways in which the illnesses affects their daily life, focuses on how to best understand the illness and manage its symptoms and follow medical recommendations.

Types of Psychotherapy

There are numerous approaches to psychotherapy, also called talk therapy, from which mental health professionals draw their treatment practices. Different types of psychotherapies are often better-suited to specific types of problems. For example, some psychotherapies are designed mainly to treat disorders like depression or anxiety, while others focus more on helping people overcome problems with relationships or obstacles to greater life satisfaction. Some forms of psychotherapy are one-on-one with a therapist, while others are group-based or family-based. According to the American Psychological Association, those approaches fall into five broad categories.

Psychoanalytic or psychodynamic therapies. The idea behind this kind of therapy is that people’s lives are affected by unconscious issues and conflicts. The goal of the therapist is to help the person bring those issues to a conscious level where they can be understood and dealt with. This may involve analyzing dreams or exploring a person’s personal history.

Humanistic Therapy. This approach to therapy is based on the idea that people are capable of making rational choices and developing their maximum potential. This approach to therapy is often client centered, with the client being seen as the authority on what is going on inside.

Integrative or Holistic Therapy. This approach relies on integrating multiple approaches to therapy based on the client’s individual needs. For instance, cognitive behavioral therapy is a combination of the two individual therapies and focuses on both thought and behavior.

Getting Started With a Mental Health Professional

Finding the right mental health professional and the right approach to therapy is as important as finding the right medical doctor. Whether you are planning to see a psychologist or a psychiatrist or another type of mental health professional, you should start with a phone call to the professional. Ask about the professional’s approach to dealing with mental issues and how they generally work with clients. Ask about whether or not they accept insurance and how payments are handled. You might describe your reason for wanting to make an appointment and ask if they are experienced in dealing with such issues. If you are comfortable talking with them, the next step is to make an appointment.