Individual Counseling

Sharing problems with friends or family is difficult enough, so it’s no surprise that many people are apprehensive about sharing those problems with total strangers. To complicate matters further, there seems to be hundreds of available counselors, each with some combination of letters after their name, but not much information about what those letters mean and how to go about choosing. Hopefully this page can shed some light on the subject.

Psychiatrists and Psychologists. 

In a very basic sense, psychiatrists are licensed medical doctors (M.D.) and can prescribe medications. With training specific to diagnosis and treatment of mental disorders, they focus on the medical side of psychopathology. There is a common misconception that psychiatrists will also provide psychotherapy, but for most consumers this is not the case. A psychiatrist will arrive at a diagnosis relatively quickly, and will address the issue through medication management. Some psychiatrists will automatically make a referral for counseling, some will ask if the patient would like a referral, and some will make a referral if requested.

Clinical and counseling psychologists are also doctoral level providers, and will carry a designation of Doctor of Psychology (Psy.D) or Doctor of Philosophy (Ph.D). The designation of, “doctor,”  however, should not be confused with the more recognized meaning of doctor associated with medical providers. Psychologists cannot currently prescribe medication, though the idea has been proposed.  With psychologists, the designation of doctor signifies a doctoral level of academic achievement.

The difference between a psychologist and a psychiatrist (again in a very basic sense) is in the way each approaches mental health issues. A psychologist will not visualize the disorder from the medical perspective of a psychiatrist. Rather than conceptualizing from a physiological perspective, psychologists will approach presenting problems from a psychological (i. e. behavioral, emotional, contextual, cognitive) standpoint. A psychologist is also trained extensively in psychological assessment and will utilize specific measures to arrive at a diagnosis. In many cases, the first 3 or 4 sessions may be diagnostic. This training, in addition to doctoral education and training in psychotherapy, means that psychologists are uniquely suited to cases involving the diagnosis and treatment of developmental disorders, many forms of psychosis, or differentiating a diagnosis (or diagnoses) when multiple symptom clusters are present.

In many cases, a master’s level provider will refer a client for psychological assessment in order to specify diagnosis, then the client will either return to the original provider for treatment, or will remain with the psychologist. The decision regarding which professional will provide treatment will rest upon many factors, which will be discussed with the client when a recommendation is made. Also, psychologists typically focus specifically on severe mental illness. While master’s level providers will also see clients with severe mental illness, some clients seek counseling for life issues, or health and wellness issues that don’t involve psychopathology.

Master’s Level Providers

It is likely, due to the number of providers, that master’s level mental health practitioners provide the majority of psychotherapy and counseling in Georgia. This is due to several factors, some of which can be accounted for in the various professional designations. In Georgia, master’s level providers encompass 3 distinct but often overlapping fields: professional counselors (LAPC or LPC), marriage and family therapists (LAMFT or LMFT), and social workers (MSW or LCSW). Each field shares many commonalities, but each is distinct in the way in which it conceptualizes client issues.

Professional counselors are trained specifically in theoretical orientations, psychopathology, assessment and appraisal, and counseling systems and interventions, and the issue will likely be conceptualized within the individual himself. In most programs, marriage and family therapists receive the same education as professional counselors, with additional coursework in family systems theory and theoretical orientations specific to couples and family therapy.  Marriage and family therapists conceptualize issues from a systemic perspective. There is significant overlap in the work performed by professional counselors and marriage and family therapists, and much of that overlap is due to the specific nature of the work. Although conceptualizing problems differently, both fields, in education and training, specifically focus on psychotherapy.

This differs somewhat from a licensed social worker, who operates within a much broader field. Social workers can be found in schools, hospitals, mental health clinics, human service agencies, and within family and children services. Many work in a private practice setting providing psychotherapy, and many social workers never practice psychotherapy.  Sometimes, the primary difference is the effort that social workers give to linking the client to adjunctive services like social assistance, housing, medical or dental care, and advocacating for the client within occupational or educational settings.

Personally, I believe that a good therapist will posses elements from each of the areas discussed above. For example, it is not uncommon for a client to present with a personality disorder that is negatively affecting family, marriage and the ability to sustain employment. Many people today still don’t have insurance, and lack of consistent work often means lack of consistent food along with difficulty meeting immediate needs. Issues like this have usually been going on for years prior to seeking counseling and problems exist on many levels. There would be many considerations to process, but a likely path would be individual therapy for the personality disorder, along with family therapy to address the systemic manner in which the family system has both been affected by, and perpetuates, the issue itself. Referrals for job assistance or training, food, and/or health care may also be appropriate.

Regardless of the type of provider you choose, remember that there is no shortage of providers, so do some research and find a good fit. Psychology Today has a great feature that allows providers to be searched for by location, specialty, prices, licensure, etc. It is also ok to call a provider prior to making a decision. Some providers are more than happy to answer any questions you have.  When making your final decision, remember that you’re a consumer and make sure that you’re happy with the services provided.  If not, find another provider.