Choosing a Mental Health Professional

Mental health professional post

How do you choose a mental health professional? There are so many names, waiting lists, initials and varying approaches. Especially without a referral choosing a mental health professional can feel like a shot in the dark at best! While this post cannot choose someone for you hopefully it can inform you a little more on what you're looking at. 

Who's qualified to do what (not an exhaustive list but a list of the most common licensures for mental health services)

Listed in parenthesis are some common initials that people list to signify their education and licensure. For a full list of these things check out this link: 

Medical Doctors (MD). In the mental health world this usually is associated with a psychiatrist. You will need an MD in order to be prescribed medication. Psychiatrists are better to consult for medication than say your general practitioner because they specialize in mental health medication and will likely be better at dialing in what is needed for you. In the old days MD's also often practiced psychotherapy and psychoanalysis (forms of talk therapy). You can still find some practicing that today but often it is more about medication and general assessments. 

Psychologists (PhD, PsyD, EdD, MA, MS, LP). Psychologists can assess for things like ADHD, learning disabilities and other disorders as well as for intelligence, personality and things like depression and anxiety, etc. They also generally practice talk therapy, some practice from a more eclectic model (using various tools like mindfulness, talk therapy, psychoanalytic theory, EMDR, cognitive behavioral therapy, etc.) and some use specific forms only (like psychoanalysis, psychotherapy, cognitive behavioral therapy, etc.).

Social Workers (MSW, PhD, LSW, LCSW). Social Workers have a long history of helping people with a variety of social and mental health issues. Social workers are qualified and licensed to practice various forms of therapy (again some use an eclectic model and some use specific models). They too can perform assessments as well but not as many as psychologists.

Marriage and Family Therapists (MA, MS, PhD, LMFT, LCMFT). Marriage and Family Therapists are trained in a variety of mental health needs. They are trained to work from a systems view. Meaning they look to how people are affecting each other. Again, they too can formally assess in a limited function.

Counselors (PhD, MA, MS, LPC, LCPC). Counselors are trained to help people with a variety of needs ranging from career planning to serious mental health issues. They too can assess formally, but again, are not licensed to assess as much as psychologists are. Again, they can practice various mental health therapies ranging from an eclectic model to specific strains of therapy expertise. 

Addictions Counselor (CAC, CADAC, CADC). Addiction Counselors are certified to help people specifically with addictions. Some have more specificity in their expertise (i.e. alcohol addiction, etc.). These counselors are trained to help people specifically change their behavior around addictions but are not generally trained to help with more complicated underlying issues that can cause addiction. 

What Will A Mental Health Professional Cost?

When choosing a mental health professional a big question also is usually concerning cost. Why do people charge what they do and why do some take insurance while others do not? And what does it mean to have someone be "out of network" only?

What will it cost?

It's important to ask about costs when deciding who to work with. In private practice people range from somewhere between $50 a session to $200+ a session. Generally an area will have an average range of cost. In Kansas City the general range goes between $80 and $150. Of course their are outliers on either side of that. Sometimes it depends on the service (some people charge more for couples and family work than individual work). Sometimes people have a sliding scale as well. This generally means that you will pay based on your income and number of dependents. Sometimes people have initial consult rates that are lower or higher as well. Finally, some people have interns working with them and often offer their services at lower rates.

Why mental health professionals often choose to not accept insurance

Managed care has changed the mental health field a lot. On the surface managed care is about helping people receive high quality care in an efficient way. In reality, it seems managed care is really about keeping profits high and costs low for insurance companies despite what might be best for the care of a patient. Often managed care requires loads of paper work that is both intrusive into the patient's privacy as well as a burden for the mental health professional. The mental health professional is not getting paid to do the hours of additional paper work and sometimes insurance companies can threaten to demand money back if notes are not set in a certain format to verify information that they deem important (despite the fact that often the mental health professional might deem different information as more important). Finally, insurance companies do not pay very good wages usually and they pay various wages dependent on the licensure level. Often this can be up to half or more than half of what the mental health professional's out of pocket fee may be. 

Why are the fees high?

It's easy to assume that mental health professionals are simply getting the hourly rates you are paying. That is not the case though. There is a lot of overhead behind the scenes ranging from education costs, to rent, to employee salaries, to record keeping software, to licensure and insurance costs, etc. A private practice practitioner usually sets their fee at a place that helps them reach the bottom line and then slowly over time raises their rates to adjust for both inflation and their growing expertise and experience. 

Serious Mental Illness Vs. Less Serious Mental Health Issues

Another factor in choosing is what is bringing you into to see a mental health professional. In general, mental health professionals know what they can do and what they cannot do. So they will able to refer you to the right professional for your issues. Often there is a team approach. For example someone might seek a counselor who might, after assessing, refer them to a psychiatrist for medication and a psychologist for a personality assessment but continue to see them for regular talk therapy. 

In general, if you are seeking treatment for depression or anxiety all of the listed people except addictions counselors will be good places to go. If the depression or anxiety is symptomatic of something else that the person you're seeing is not qualified to treat they will refer you to where you need to go.