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Dr. Worthen's Newsletter, September 9, 2010 Issue
September 09, 2010

For this first issue of Dr. Worthen's Newsletter, I'm going to reprint an excellent article by Dr. John Grohol, titled "Distinctions Between Therapist Degrees". Dr. Grohol publishes a superb website,, which I highly recommend that you visit for abundant information about psychology and mental health.

Here is the article:

by John Grohol, Psy.D.

An Introduction
As managed care continues to make substantial changes in the field of behavioral healthcare, it is important to understand what you are paying for with your healthcare monies. There is a great degree of differences between professional's degrees in this field, and those differences may impact on the effectiveness and quality of your psychotherapy work.

In nearly every state in the U.S., therapists must be licensed to practice (e.g., receive a fee for services) under specific, protected titles. For instance, the terms "psychologist" and "psychiatrist" are protected legal terms in every state and, when referring to providing clinical services, can only be used by properly licensed professionals.

Ideally, such licensure helps to ensure that the professional has passed a minimum set of qualifications via a written examination and that if a problem arises with their provision of professional services, the authorities of that state have some recourse. In the real world, however, bad therapists obtain licensure all the time and the redress procedures for filing a complaint against a therapist nearly always favor the therapist. Nevertheless, when shopping for a therapist, make sure the professional is licensed whenever possible.

And yes, you should shop and compare therapists, just like you would in making any important life decision. You will spend a fair amount of your hard-earned money to pay for the therapist's services (whether it's done out of pocket or via your insurance/HMO premiums). You deserve to know basic information about the professional you are about to trust your innermost feelings and thoughts to, including their professional background, their educational background, how many years they've been practicing, and how much experience they've had in helping people with problems similar to your own. The more experience they've had and the longer they've been in practice are usually two of the best indicators to look for in finding a suitable clinician. A professional, regardless of their educational background, who has had 20 years of therapy experience and has worked with dozens of individuals presenting with problems similar to your own is much more likely to be of help to you than someone with 2 years of experience and you're the first person they've seen with your particular mental health concern. (It makes sense, doesn't it? The research backs up this view.)

Keep in mind that if you find your first choice in a therapist isn't working out, give the therapist a pink slip and ask for a referral to one of his or her colleagues. Remember, the therapist works for you. If you don't feel like you're clicking after a few sessions, or the therapist isn't listening to your concerns or providing you with enough feedback in your sessions, let them know. Don't be afraid to change therapists if your concerns aren't adequately addressed to your satisfaction.

There are a number of degrees which I didn't cover in my original writings, but which are included in the other people's comments section. These degrees/clinicians include licensed professional counselors, marriage and family counselors, and psychiatric nurses, to name a few.

Psychologist (Ph.D.)
Doctorate of Philosophy (Research degree)
General description: Doctoral degree in either clinical or counseling psychology

This is the traditional degree of practicing, academic, and research psychologists. Training includes courses in psychological assessment, theories and practice of different types of psychotherapy, research and statistics, as well as diagnosis and ethics. A dissertation is required which must be defended. The emphasis of this degree is on research and theory, much more so than any other degree discussed here. A pre-internship experience (called a practicum) is usually an integral part of the program. Some programs require multiple practicums. The average length of a Ph.D. program is 6 to 7 years. Ph.D. psychologists most often pursue careers in academia or practice. The differences between a Ph.D. psychologist who graduated from a clinical program as opposed to a counseling program are minimal. Clinical programs, which are more widespread, tend to focus more on serious mental illness (e.g., depression, schizophrenia, anxiety, etc.) its assessment and treatment. Counseling programs tend to focus more on change-of-life issues (e.g., divorce, relationship problems, academic problems, etc.) and assessment of those problems. However, this is a broad generalization and the actual experiences of the clinician will vary according to the program they graduated from. As an interesting side-note, psychologists are now trying to gain prescription privileges. Given their lack of medical training and education, where is the wisdom in such a misguided attempt to gain ground on psychiatrists?

Psychologist (Psy.D.)
Doctorate of Psychology (Professional degree)
General description: Doctoral degree in clinical psychology.

This is a newer (circa. 1968) degree offered to those individuals interested exclusively in the practice of psychology. Its focus tends to be more clinically-oriented than the traditional Ph.D., offering more pre-internship experience and practical coursework, in lieu of courses on research and statistics (although most Psy.D. programs also require a dissertation). Some programs require up to three practicum experiences before internship. These practicums typically are 15-25 hours per week, for an entire year. Therefore, some graduate students in these programs will graduate with over 1,500 - 2,500 pre-internship clinical hours, and gain another 1,000 - 2,000 hours while on internship. This amount of direct clinical training experience is equaled by no other profession today (nor do any come close). These clinical experiences cover all aspects of treatment, modalities, and settings in mental health, from community mental health centers and day treatment programs, to geriatric and university counseling centers.

If the Psy.D. program doesn't require a dissertation (which generally includes the authoring of original research), it will have a requirement for a research paper with less of an emphasis on creating original research. The research paper can be a literature review or some other similar type of contribution to the field. The average length of a Psy.D. program is 5 to 6 years. Most Psy.D. psychologists pursue careers in practice, although some also enter into research and academia. As with the above doctoral degree, psychologists aren't eligible to become licensed in a state (a legal distinction, not an educational one) until at least one year after receiving their degree. Licensure typically involves a certain amount of additional supervised clinical hours, and receiving a certain minimum score on a national and state psychology licensing examination.

To read the rest of the article--and to check out the Comments others have made--please click here to go directly to Dr. Grohol's website.

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