By Erin Buell
People often call St. Luke's Center for Community Health to request information on mental-health issues and for a referral to a professional counselor. It can be a big, sometimes daunting process for people to make the decision to seek out counseling and then find a suitable provider.
Professional mental-health assessment and treatment can come from counseling, also referred to as therapy or psychotherapy, or from a medical doctor. Counseling is a treatment modality with a wide range of approaches for helping someone resolve issues and work toward optimal mental health. A psychiatrist is a physician who specializes in psychiatry and mental disorders. A psychologist is not a medical doctor, but may have a doctorate degree in psychology. Additionally, many medical doctors have expertise and training in treating mental illness and disorders.
A look in the Yellow Pages under "counseling" will show lots of different letters after the counselors' names. These represent educational degrees, certifications and licensing. Masters-level degrees related to counseling are generally MA, MS and MED. A nonmedical doctoral degree requires more education and is a Ph.D. LCPC means licensed clinical professional counselor; LMFT means licensed marriage and family therapist; LCSW means licensed clinical social worker; and CADC means certified alcohol and drug counselor.
Some people may have an advanced degree, but not have a license. A therapist may become licensed when he or she has completed a determined level of education to practice in his or her field with competence, has passed appropriate exams and has completed supervised training. Most states require continuing education to maintain licensure.
But education is only part of the equation in choosing a therapist. One of the most important predictors for success with professional mental-health care is a positive relationship between the client and the therapist. Comfort, trust and open communication are key elements in the success of treatment.
Someone seeking counseling can make phone calls to several therapists based on referrals from doctors, community resources, family or friends, or simply by looking in the Yellow Pages. Prior to setting up a first appointment, it is appropriate to ask questions about training, treatment modalities, licensure and expertise. Though a counselor may not be able to answer the phone during regular appointment hours, he or she should follow up and return these phone calls as soon as possible. This initial phone call should only be five or 10 minutes, but can give a person a sense of whether there is a positive connection. If a person has a specific concern such as marital problems or an eating disorder, it would be important to determine if that counselor has specific training to address that issue.
Finding out what the therapist charges per session, how long each session lasts and if he or she is taking new clients should also be covered in this initial conversation. Employers or insurance may help cover the cost of therapy, and some therapists offer a sliding scale fee for people who qualify based on financial factors.
Like physical health-care providers, mental health-care professionals can assess whether a person is dealing with a chronic, acute or emergency situation. Chronic conditions develop slowly and may continue to worsen over an extended period of time. Acute conditions come on suddenly and severely, and may quickly worsen. Emergencies, often also acute conditions, are of course best met with immediate professional attention.
Sometimes medication is appropriate. A person may benefit from counseling or medication or a combination of both.
Our health in general will be better if we take care of issues while they are small. Recognizing when we are unable to resolve feelings of sadness, anxiety, stress, etc., and getting help at the onset will make it easier to develop and incorporate skills to bring mental and emotional upheaval back into balance.
Erin Buell is outreach coordinator at St. Luke's Center for Community Health in Hailey.
