1. How does therapy work?

Therapy is interpersonal treatment for problems in living. It involves talking with a trained professional about conditions ranging from depression and anxiety to relationship conflicts and career frustrations. Therapy provides ways to express feelings, understand patterns of thinking, gain perspective on past events and current relationships, set goals, and clarify dreams for the future. Therapy can both alleviate pain and suffering and add meaning and richness to life. Therapists employ a range of techniques and methods, some suited to particular mental health issues and some that can be applied to clients dealing with a variety of issues. All therapists seek to increase their clients’ mental health and to act as a confidential and careful listener.

Today many therapists use a combination of approaches, but among the most common methods are psychodynamic therapy and cognitive-behavioral therapy. Psychodynamic therapy focuses on patterns of behavior and the relationship between the therapist and patient. Cognitive behavioral focuses on challenging the patients’ beliefs and thoughts to transform emotions and behavior.

2. What is an LPC (licensed professional counselor)?

Licensed professional counselors (or in some states, “licensed clinical professional counselors” or “licensed mental health counselors”) provide mental health and substance abuse care to millions of Americans. LPC’s are at least master’s level mental health service providers, trained to work with individuals, families, and groups in treating mental, behavioral, and emotional problems and disorders.

The practice of professional counseling includes, but is not limited to, the diagnosis and treatment of mental and emotional disorders, including addictions; psychoeducational techniques aimed at the prevention of such disorders; consultation to individuals, couples, families, groups, and organizations; and research into more effective therapeutic treatment modalities. LPC’s training in providing therapy includes the origin of mental illness and substance abuse disorders, and the provision of the established, research-based “talk therapies” of cognitive-behavioral, interpersonal, and psychodynamic therapy. LPC’s and members of the other non-physician mental health professions of psychology, clinical social work, marriage and family therapy, and psychiatric nurses provide the majority of mental health services in the U.S.

3. What is an LMFT (licensed marriage and family therapist)?

Marriage and Family Therapists (MFTs) are mental health professionals trained in psychotherapy and family systems, and licensed to diagnose and treat mental and emotional disorders within the context of marriage, couples and family systems.
MFT’s are a highly experienced group of practitioners, who average 13 years of clinical practice in the field of marriage and family therapy. They evaluate and treat mental and emotional disorders, other health and behavioral problems, and address a wide array of relationship issues within the context of the family system.

MFT’s broaden the traditional emphasis on the individual to attend to the nature and role of individuals in primary relationship networks such as marriage and the family. MFTs take a holistic perspective to health care; they are concerned with the overall, long-term well-being of individuals and their families.

MFTs have graduate training (a Master’s or Doctoral degree) in marriage and family therapy and at least two years of clinical experience. MFT’s are recognized as a “core” mental health profession, along with psychiatry, psychology, social work and psychiatric nursing. At any given time they are treating over 1.8 million people in America.

4. What is an NCC (national certified counselor)?

The National Board for Certified Counselors, Inc. and Affiliates (NBCC), an independent not-for-profit credentialing body for counselors, was incorporated in 1982 to establish and monitor a national certification system, to identify those counselors who have voluntarily sought and obtained certification, and to maintain a register of those counselors.

NBCC’s certification program recognizes counselors who have met predetermined standards in their training, experience, and performance on the National Counselor Examination for Licensure and Certification (NCE), the most portable credentialing examination in counseling. NBCC has approximately 42,000 certified counselors. These counselors live and work in the US and over 50 countries. The NBCC examinations are used by more than 48 states, the District of Columbia, and Guam to credential counselors on a state level. NBCC’s flagship credential is the National Certified Counselor (NCC).

5. How is a psychiatrist different than a professional counselor?

A psychiatrist is a medical doctor who can order medical tests and prescribes medication. It takes many years of education and training to become a psychiatrist. After earning a bachelor’s degree, he or she must graduate from medical school and go on to complete four years of residency training in the field of psychiatry. Most, but not all psychiatrists, will see a patient for medication evaluation and diagnosis but not do the “talk therapy” part of therapy or will do only a limited amount. They will continue to follow up with their patient to insure that prescribed medication is working properly and their patients are receiving the proper dosage.

6. Is medication really necessary?

Consultation with a psychiatrist is often an effective way of determining if medication is necessary. The decision as to whether to take medication such as an antidepressant or an antianxiety drug is a decision that is best made in dialogue between the client, doctor, and therapist (and parents if the client is a minor).

If the problem that brings someone into therapy has been chronic and/or persists even after therapy begins, then medication may be a necessary component of the total treatment plan. Once medication has been taken for awhile, it is also best to never discontinue medication without first consulting your psychiatrist.

7. How do I know if I need therapy?

If you have been trying for some time to change your way of thinking or a behavior that is creating problems for you but simply cannot achieve any lasting results, then it may be time to seek help. If your life changes dramatically due to a painful loss such as the loss of a job or a significant relationship, and you realize you are unable to recover like you wish to, then it may be time to seek therapy.

Therapy can help you understand and reframe your problems and concerns. It can teach you specific emotional and social skills, and can help you reap more satisfaction from your work and your relationships. A therapist’s office can be a sanctuary where you are free to express private thoughts and struggles. Friends and family members can provide excellent emotional support, but a therapist can give you a trained, and more impartial, perspective on your life. Because subjective feelings and thoughts are involved, therapy’s effectiveness is harder to measure than, say, a cure for a medical ailment. But many studies have shown the effectiveness of therapy in improving quality of life. A landmark 1995 Consumer Reports study concluded that patients benefited very substantially from psychotherapy. The key to successful therapy is a connected, trusting relationship between client and therapist.

8. How much does therapy usually cost?

Most psychotherapy is paid for by the “session” — usually 45-50 minutes. The per-session cost to the client varies widely. It can be zero in a public agency setting, where the practitioner is paid a salary by the agency to counsel its clients.

On the other side the cost can be somewhere between $100-$150 per session, according to the therapist’s degree and licensure. If you are willing to be seen by someone who is a licensed associate (someone who has graduated from graduate school but has not yet met all of the licensure requirements) and not a fully licensed therapist, the fee may average $60-$90 per session.

Fees vary based on several criteria. In general:

• If the practitioner is very well known and/or very busy, his or her fees go up. On the other hand, practitioners who are working to build a practice often keep their fees low to attract more clients.
• The more time and expense the practitioner has invested in obtaining professional credentials, the higher his or her fee. Practitioners who are interested in serving a particular population — or a diverse population — often work on a sliding fee scale.
• Psychotherapy is often paid for in several ways:
•    Some psychotherapy is provided as a service by a mental health agency. The agency pays the therapist, and the client is not involved in any financial transaction.
•    Employee Assistance Programs contract with independent practitioners to provide short-term counseling service to the employees or members of their client organizations. The individual client is not normally asked to pay any part of the cost. The client organization pays a fee based on the number of covered employees.
•    Many health-insurance programs provide “mental health” coverage that includes psychotherapy and/or counseling. Because this coverage is based on the assumption that the therapy is required in order to “cure” an “illness,” the practitioner is usually asked to begin “treatment” on the basis of a formal diagnosis and to justify continued therapy on the basis of progress reports. The client is usually expected to choose a psychotherapist from a panel of practitioners who have agreed to the insurance provider’s fee schedule. The client is also usually asked to make a co-payment toward the cost of each session.
•    Some health-insurance programs allow the use of “out-of-network” providers. In that situation, the client can choose any provider who is licensed to perform the desired service, however the client may have to pay a larger percentage of the provider’s fee than if he or she saw one of the insurance company’s preferred providers. Often when using an “out-of-network” provider insurance companies will pay 50-60% of the therapist’s fee; some will not pay for any “out-of-network” providers. Check with your insurance company by calling the “800” phone number on the back of your insurance card.
•    The client can initiate and pay for the cost of psychotherapy without intermediaries. The disadvantage is that he or she bears the entire cost of each session. The advantages are that the client can choose any psychotherapist, pay their fee, and be confident that no other parties (such as a managed care or EAP representative) are involved in the therapeutic process.