Navigating the Therapist Maze

Probably the most frustrating thing for me as a counselor is when I talk with a vet who says he’s getting counseling and then says it’s not working.  Often he’ll say, “all my counselor does is push meds on me.” Well, that’s probably because the “counselor” is not a counselor, but a psychiatrist and that’s what most psychiatrists do. They prescribe meds and most do very little counseling, except for quick check-ins with their patients. To get counseling, the vet has to see a “counselor.”

Humor me for a few minutes as I try to unravel the counseling/therapist/psychiatrist maze and bring a little clarity to the confusion. This is important for you to know in order to manage your own mental health care so you get the counseling you need.  Disclaimer here…To add to the confusion, there are lots of different kinds of counselors, degrees, and certifications, so I’m going to keep this article to the two basic types, psychiatrists and counselors.

It’s important to know that in most states the only people in the psychiatric community who can prescribe meds are those who go by the title doctor. For the most part, these are licensed psychiatrists, who are also MDs. They charge a lot of money for their services and rarely do the standard 45-50 minute counseling session. The doc may talk with you briefly to understand your symptoms, but this is only to help him prescribe the right meds. So if you’re seeing someone for 15 minutes and they give you a prescription at the end, it’s most likely a psychiatrist. If you’re at the VA and all you come away with is a prescription, you’ve most likely seen a psychiatrist.

To really get counseling for your issues, you need to see a counselor, also called therapists, and sometimes clinical social workers. We’re the ones doing most of the heavy lifting when it comes to counseling, and often specialize in certain areas of counseling, such as trauma counseling, marriage work, family counseling, etc. For example, if you’ve been diagnosed with  PTSD, it’s good to get a counselor who is experienced in trauma work. This person understand trauma and how to treat it. Also, most counselors have Master’s degrees, and we are often called by our first names in session.

Don’t be afraid to interview your counselor to learn more about him or her before you start counseling. Here are some questions to ask of your counselor.

  1. What is the educational degree? Ask for the person’s title, i.e., doctor.
  2. Is the person licensed, and what is the license? Every state allows you to check to see if the person is still licensed in the state or if sanctions have been placed against the person for violations, usually ethics violations. You should get a disclosure statement from your therapist that tells you about your therapist’s degrees, licensing information, etc. It’s required by law.
  3. What other degrees and training does the counselor have? For example, for a person to practice EMDR therapy, he or she must have training in EMDR through a certified training organization and adhere to the professional standards of the certifying organization.
  4. How often will the counselor see you? Once a week? Twice a month? For therapy to be effective, especially in the beginning, once a week is preferable.
  5. Does the counselor talk to you about your treatment goals? How does he or she assess your psychiatric health? Does the counselor write and follow treatment plans and do they share those plans with you? You should know the plan for your treatment.
  6. Will this counselor consult with other professionals, such as psychiatrists, or medical doctors? Note that you must sign a release in order for your counselor to talk with anyone else.

Stay tuned for the next part of this blog when I address the question of how to work with your therapist to get the most out of your therapy.











I bring the Air Force perspective into this group, though as life would have it, my daughter enlisted in the Army. My family has a long history of military service, in the Air Force, Marines, and the Army. I earned my commission into the Air Force in 1981 and served in Public Affairs while on active duty and then continued in the public relations career field as a civilian. A few years ago, I began to work with other service members, journeying with them through some tough times, and seeing life through their eyes. It was at this time I felt called to do more and found myself in a Master of Arts in Counseling program. I am finishing my internship year, working with clients struggling with a whole host of issues, including PTSD, sexual trauma, suicide, and marital and family problems. I am also trained in EMDR and use this in my practice.

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This blog is for information only. It is not intended as a replacement for therapy. If you need additional help, please see a qualified therapist.