help people use their processes of cognition, emotion and behavior to cope better with their lives. They are also trained in psychological testing which is sometimes used to help evaluate these processes. Some psychologists would like to have limited prescription privileges so they could also prescribe psychotropic medication. A few psychologists have been trained to do this, but, so far, no state licenses psychologists to prescribe. There has been a small project in the military in which a very few specially trained psychologists have been allowed to prescribe. A doctorate in psychology takes four to six years, and includes at least one year of internship or traineeship. The differences between the letters Ph.D., Ed.D., and Psy.D. after a name are relatively minor. In my case, the most significant difference was that I had to take fifteen more academic points than the Ph.D. candidates while they had to pass examinations to show they had a reading knowledge of two foreign languages. Some psychologists serve residencies after earning their doctorate in which they receive further training while working in a mental health setting.

A masters degree in social work (MSW) takes two years, and includes field work assignments in which the student works in an agency under supervision.. In New York State, most health insurance will only reimburse for the work of social workers after they have an “R Number”. To get the “R Number” they have to have six years of supervised experience. Many professionals seek further training beyond their basic degrees. Ask your new therapist what training and experience s/he has had since graduate school. As in many other things, experience is the best teacher! Psychologists often have other specialties, e.g., neurological psychology or ADHD. For most therapeutic issues, however, there is little difference between seeing a psychologist or a social worker, especially after they have had some years of experience.

Therapy can be looked at in at least two ways: Some people see it as a quasi-medical procedure designed to “cure” certain psychological/psychiatric defects. Others see it as an educational process designed to develop human potential, and enhance the clients ability to cope with and enjoy life. Clearly it has aspects of both. Those who emphasize the first view tend to look for specific techniques that have demonstrated effectiveness and can be prescribed for specific problems. For example, Desensitization is the therapy of choice for simple phobias. Unfortunately, many phobias are not simple, they are embedded in extensive personality problems. Desensitization might still help, but only in combination with more comprehensive approaches. Using desensitization alone would be like treating tuberculosis with a cough suppressant. Those who view therapy primarily from the second perspective tend to look for general approaches that promote psychological growth.

You may be told about Evidence Based Therapy (EBT). Most therapists who talk about EBT take the first approach mentioned above. They look for techniques that have been “proven” in Random Controlled Trials (RCT), studies with carefully selected subjects who have a “pure” diagnosis and are treated by therapists using a manual to insure uniformity of treatment. The subjects are randomly assigned to treatment and non -treatment groups. (Note that such studies compare the treatment being studied to no treatment at all. They do not compare one treatment to another. Many approaches are too complex to be easily put in a manual.) Unfortunately, such pure diagnoses are rarely found in practice. Much research of this kind has been done with Cognitive Behavioral Therapy (CBT). It has been shown to equal medication in relieving depression. (The combination of CBT and medication is better than either alone.) CBT has NOT, however, been demonstrated to be more effective than any other approach in promoting general emotional and psychological growth, or even in relieving depression. Studies and surveys have indicated that psychotherapy is generally effective at promoting growth, but no approach has been shown to be significantly more effective than any other. That, of course, is an average. A particular approach may be more effective with YOU than any other even if it is not more effective on the average. Some therapists are generally more effective than others! Furthermore, a therapist that was effective with someone else, may not be as effective with you, and visa versa. It may well be that different approaches work best with different people, or even with the same people at different times. Therapists gravitate toward approaches that fit their personalities. You should too. Look for a therapist whose primary approach suits you, but who can muster techniques from other approaches when appropriate. Rigidity in a therapist is not a good sign.

The following descriptions of some of the major approaches to psychotherapy may help you decide what to look for, and what you’d rather avoid.   Note that there are institutes that teach one or another of these approaches to graduate mental health professionals, however, many professionals focus on one or more approaches without being certified by such an institute.