Finding a Counselor

As a therapist, I'm asked often what the difference is between a therapist and a counselor. I also hear other questions, regardless of the issues clients bring to session, that may be important to address. For example, "If someone is expensive, are they a better counselor. Or, if they don't take my insurance will they still be able to see me? For many therapists these questions are heard a lot, and I hope to provide some answers for those asking the questions.

What is a therapist?

This may be one of the most common questions I hear around the community. Similarly, people ask what the difference is between a therapist, psychologist, or psychiatrist. Among the profession, there are various titles that someone offering mental health services may be called. Some of the various titles you may hear are counselor, therapist, psychotherapist, psychologist, psychiatrist, social worker, or case manager. Some are similar but carry different credentials; others are very different in the types of services they provide.

Counselors, therapists, and psychotherapist are similar, and in some circumstances it's just a matter of semantics. In most cases, a psychotherapist is an individual who has had extensive training in traditional psychotherapy. The title counselor or therapist is given based on the state license that individual has. An LPC (licensed professional counselor) would traditionally call themselves counselors. While this may be consistent in most circumstances it can also be a personal preference for the professional to chose the title counselor or therapist.

For the title psychologist and psychiatrist the distinction is great. A psychologist has a PhD in some form of psychology, with the exception of school psychologists who can have only a master's degree and hold the title. A psychiatrist has an MD and has prescriptive authority.

Sliding Scale

Some therapists who offer sliding fee scales for services rendered. Clients financial situations are considered when determining sliding fee scale eligibility. Not all therapist use sliding fee scales, and those who do often have limited openings for new clients utilizing the scale. The best thing to do, if you're looking for a therapist using a sliding scale is to call ahead and just talk to them about it. Most are open to discussing financial concerns and may provide assistance.

Cost vs. Experience

When looking for a therapist I hear the question asked frequently, "if the therapist is expensive are they better at what they do?" While is some instances the credential, experience, or training validates an increase session fee, it's not always the case. The rage for session fees exists anywhere from $50-$200 for a 50 minute session. From what I can tell, most charging higher fees typically hold credentials at the doctoral level, or have been in practice for 15 plus years. Although it's a good idea to consider experience when you're looking for a therapist, I often encourage people to consider the 'fit' of a therapist before his or her years of experience. By this I mean the dynamics between you and the therapist. Therapy is part treatment for different conditions, a part relationship to foster change within the client. Some issues hindering the healing relationship may be a poor fit between you and the therapist.

Using Insurance

Finally, when considering a therapist you're likely to be faced with the question about whether or not to use insurance. Or, will they accept your insurance. This is a complicated issue for many people, and also for some therapists. Each insurance provider has different policies and procedures for reimbursing mental health services. For example, while some waive the deductible for out patient mental health, others require you meet your deductable first. So if you have a $500 deductable, and your insurance provider doesn't waive the $500 for mental health services, plan on paying full fee for counseling sessions until you've met that $500.

The next step is finding a therapist that takes your insurance. Previously we talked about finding a therapist that is a good 'fit'. So, to make things a bit more complicated, now you need to find a therapist that is a good 'fit' and takes your insurance. A good way to narrow down the search is to call your insurance provider and ask for a list of local therapists that are currently accepting your insurance. Most insurance providers will also have a list on their website you can search through.

Tying it all together

While I'd like to say this is a complete and whole guide to finding a good therapist, there is so much more information I could provide on this topic. I do hope, however that it has provided you with some information to point you in the right direction. It can feel overwhelming at times, when you're trying to find support, but we therapists are hear to help, and I hope that's what you find when you see your therapist.


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Mary is a Mental Health Therapist and PhD candidate in Clinical Psychology. For more great information on how to find a good Spokane Counselor, visit http://www.laynestoops.com