What is the difference between a psychologist and psychiatrist?
A licensed psychologist has completed an average of five years of graduate training beyond the four-year degree. This includes advanced training in issues specific to mental health and treatment and several years of supervised training at the pre-doctoral level to include a year-long internship. A licensed psychologist in North Carolina also requires a year of full-time practice under supervision at the post-doctoral level. Degrees earned can include Ph.D., Psy.D., or Ed.D. In this state, psychologists typically focus on providing therapy, psychological evaluations, and/or consultations and are unable to prescribe medication.
Psychiatrists, on the other hand, are prescribing physicians who have attended four years of medical school following the four-year degree. They are then required to complete a year-long general residency prior to completing at least three additional years of residency specific to mental illness and its treatment. Some psychiatrists conduct psychotherapy, but most primarily see individuals for psychiatric evaluations and medication management.
How do I know if I need therapy?
Many people choose to begin psychotherapy to address any number of personal goals or to gain insight into behavioral patterns and may not necessarily “need” therapy in that they can continue to function day-to-day. Other people require treatment in that their work, school, and/or relationships become negatively affected. Friends or family may voice being concerned or one may not be able to cope with a recent life event or change. Certainly if you have seriously considered suicide, this is an indicator you need to reach out for professional help.
Can’t I just talk to a friend?
It can be comforting to talk to a friend about one’s problems. While that friend may offer reassurance or advice, he or she likely lacks the professional training and education of a psychologist or other mental health provider and is most likely biased. This individual may also be hesitant to say certain things for fear of it negatively impacting the friendship. The professional, therapeutic relationship and accompanying confidentiality, on the other hand, is oftentimes viewed as offering safety. With a few exceptions (i.e. threat of danger to you or someone else), you can rest in knowing your information is safe and respected.
What can I expect?
It’s natural to want to know what psychotherapy might look like before starting the process. Truly each psychologist and client relationship is unique. For some, sessions are structured, topics agreed upon at the beginning of the therapy hour and certain goals addressed or skills taught. Others may benefit from a less structured, more person-centered approach which, while drawing upon a variety of techniques, may look similar to certain conversations you may have with others. Still for other clients, significant portions of sessions may be spent exploring the past in order to gain insight, including the ability to make different choices in the here and now.
Whichever approach might be taken (and there are many), know that I take seriously the therapeutic relationship and each individual client. You will have a say in what treatment might look like as I believe you are the one who knows your needs best. That being said, I have found that those persons who are helped the most are those who are actively involved in their treatment, complete homework assignments, and think about the work in between sessions.
How long will therapy take?
The length of treatment will vary greatly, dependent on a number of factors including the presenting problem, motivation, and modality or type of treatment used. There are occasionally individuals who find what they are looking for in one or two sessions, but this is rare. Most clients meet at least some of their therapeutic goals within a few months. For others, they consider psychotherapy to be preventive in nature and/or work on issues pertaining to personal growth and may attend psychotherapy (either regularly or intermittingly) for years.
How will I know which provider can best help me?
There are numerous types of providers who have a variety of educational and training backgrounds. It may feel overwhelming to find the right clinician. Know it may help to ask specific questions. For instance, is the provider licensed? What is the therapist’s education level and how long has he or she been practicing? Does the provider have experience and/or training specific to the problem area you want to address? If so, what is the success rate?
While the answers to these questions are important, it is significant that research has pointed to the therapeutic relationship as being the best predictor of change. Once you feel your questions are sufficiently addressed, it is important to listen to your gut instinct. The first couple of appointments, although typically focused on intake, can be valuable in determining your comfort level with the provider. Note how well he or she listens to you and addresses your questions. At a minimum, it is hoped that you feel validated and respected, ideally with a newfound understanding of the problem you are facing and also with a measure of hope.