Choosing a Psychotherapist

Psychotherapy can be a life-changing experience. Finding a therapist with whom you feel comfortable is very important. One of the reasons psychotherapy is successful is the rapport that develops between therapist and client. Taking the time to have a brief conversation over the phone with potential therapists can help you make an informed decision. You may want to know how long they have been in practice, and if they specialize in any particular areas. This can include asking them about their views on topics of importance to you. If you have a preference for a particular type of therapy, ask if he or she has had training and experience in that therapeutic intervention. But also trust your intuition. Does the therapist sound warm and inviting? Is he or she willing to take the time to answer your questions? Does he or she express confidence in being able to help you?

There are five types of mental health practitioners licensed by the New Hampshire Board of Mental Health Practice, and two by the NH Medical Board. Here is a brief description of each:

Clinical Psychologist: A Clinical Psychologist has a PhD or PsyD in psychology, which includes 4-5 years of course work and a major research project. He or she has completed an Internship and at least two years (3,000 hours) of working with clients under supervision, and has passed a written exam. The license of Clinical Psychologist has the widest scope of practice for psychotherapists, including assessment, prevention and treatment of emotional and mental disorders with individuals, children, adolescents, couples, families and groups with personal, social, emotional or behavioral problems. They are licensed to do psychological testing and interpretation. Psychologists cannot prescribe medications.

Pastoral Counselor: These are members of the clergy who have specialized training in psychology and counseling. They have a Doctorate degree, Clinical Pastoral Education, and postdoctoral supervised experience. In New Hampshire they are licensed at the same level as psychologists. Most do not provide counseling solely from a religious framework, but it's important to ask about their religious orientation. Many have a special interest in marriage counseling.

Clinical Social Worker: A Licensed Social Worker has a Master's Degree in Social Work plus 1,000 hours of clinical placement and 3,000 hours of post-Masters clinical supervision. They are required to pass a national written exam. Their training focuses on social work, such as family intervention and the welfare of children. They provide individual, group, family, child, marital, and adolescent therapy. They often practice in family service agencies, hospitals, employee assistance programs, and mental health clinics.

Marriage and Family Counselor: A Marriage and Family Counselor holds a Master's degree in counseling and has completed 3,000 hours of supervised experience. They must also pass a written exam. Their license allows them to counsel individuals, couples, children, adolescents and groups with relationship problems.

Mental Health Counselor: A Licensed Mental Health Counselor also has a Master's Degree in Counseling, and 3,000 hours of supervised experience, and has passed a written exam. Their license allows them to provide general counseling, but their experience is often focused on a particular problem or group of clients. They most often work in mental health centers.

These groups are licensed by the NH Board of Mental Health Practice. They are required to have 20 hours of Continuing Education a year, and to document peer supervision and/or collaboration with other mental health professionals. They are the only professionals licensed in NH to provide psychotherapy. If someone advertises as a psychotherapist and is not licensed they are breaking the law.

Psychiatrist: A Psychiatrist is an M.D. who has had 3 years of specialty training in mental disorders. A board-certified psychiatrist has, in addition, practiced for 2 years and passed the written and oral examinations of the American Board of Psychiatry and Neurology. Most psychiatrists only handle evaluations and medication prescriptions for patients. Some psychiatrists have taken further training to conduct psychotherapy, and of those, most have been trained in psychoanalysis. Medical continuing education is required to maintain their licenses.

Psychiatric Nurse Practitioner: ARNPs are registered professional nurses who have specialized training at the Master's level or above. They conduct individual, family and group consultation and education, and prescribe medication. A few are in private practice, but most practice in hospitals, community mental health centers and other agencies.