MENTAL HEALTHCARE INFORMATION

WHAT IS MENTAL HEALTH?

"Mental health includes our emotional, psychological, and social well-being. It affects how we think, feel, and act. It also helps determine how we handle stress, relate to others, and make healthy choices. Mental health is important at every stage of life, from childhood and adolescence through adulthood. 

Although the terms are often used interchangeably, poor mental health and mental illness are not the same. A person can experience poor mental health and not be diagnosed with a mental illness. Likewise, a person diagnosed with a mental illness can experience periods of physical, mental, and social well-being." (Centers for Disease Control & Prevention, 2021)

WHY IS MENTAL HEALTH IMPORTANT?

"Mental and physical health are equally important components of overall health. For example, depression increases the risk for many types of physical health problems, particularly long-lasting conditions like diabetes, heart disease, and stroke. Similarly, the presence of chronic conditions can increase the risk for mental illness." (Centers for Disease Control & Prevention, 2021)

WHAT CAUSES MENTAL ILLNESS?

There is not a singlar cause for mental illness to develop. A variety of factors can contribute to heightened risk for developing a mental illness, such as

• "Early adverse life experiences, such as trauma or a history of abuse (for example, child abuse, sexual assault, witnessing violence, etc.)
• Experiences related to other ongoing (chronic) medical conditions, such as cancer or diabetes
• Biological factors or chemical imbalances in the brain
• Use of alcohol or drugs
• Having feelings of loneliness or isolation." (Centers for Disease Control and Prevention, 2021)

WHAT IS MENTAL HEALTHCARE?

"Services devoted to the treatment of mental illnesses and the improvement of mental health in people with mental disorders or problems" (Collins English Dictionary, n.d.).

"Mental health services integrated into primary care include the identification and treatment of mental disorders, referral to other levels where required, attention to the mental health needs of people with physical health problems, and mental health promotion and prevention" (World Health Organization, 2009).

References

Centers for Disease Control and Prevention. (2021). About mental health. https://www.cdc.gov/mentalhealth/learn/index.htm 

Collins English Dictionary. (n.d.). Mental health care. https://www.collinsdictionary.com/us/dictionary/english/mental-health-care

World Health Organization. (2009). Improving health systems and services for mental health. https://apps.who.int/iris/bitstream/handle/10665/44219/9789241598774_eng.pdf

LEVELS OF CARE (from highest to lowest level)

• Residential: 24/7 care with nurses, therapists, and a psychiatrist for 1+ months; can be used for longer-term stabilization of mood dysregulation
• Inpatient Hospitalization (IP): 24/7 care with nurses, therapists, and a psychiatrist for 1 day+ depending upon a psychiatrist’s view of progress and whether a patient discharges against medical advice (AMA); can be used for stabilization of crises and strengthening coping skills 
• Detox: this can be in a hospital, designated detox center, or psychiatric hospital; a patient is detoxed from substance intoxication with the help of nurses and/or doctors
• Partial Hospitalization Program (PHP): group therapy that occurs for 20 hours per week
• Intensive Outpatient Program (IOP): group therapy that occurs for 9-15 hours per week
• Outpatient Therapy: individual, family, or couples therapy that is 1-4 hours per week (depending upon therapist availability) that is often supplemented with self-help/support group attendance; can get access to an individual therapist and potentially an entire treatment team involving a psychiatrist depending upon the setting

TYPES OF THERAPY 

• Couples/Marriage: for pre-marital counseling, to address marital issues, to address parenting issues, to address divorce issues, and any other issues affecting a coupleship
• Family: members of a family come to counseling to work on family dynamics, e.g. improving communication and trust, overcoming changes; can provide opportunity to heal broken or dysfunctional family dynamics and communication 
• Group: a grouping of individuals that do not know each other gathering together to get counsel on particular topics (e.g. depression, addiction, anxiety); can provide needed structure, psychoeducation, and a place to fit in
• Individual: therapy on one’s own; if an adolescent, parents may join at different points; if an adult, individuals may bring loved ones for support or to address an issue at times; can provide opportunity for deeper processing of issues
• Medication-Assisted Treatment: working with a medication prescriber (e.g., doctor, psychiatrist, nurse practitioner, physician's assistant), medications can be prescribed to potentially help soothe hyperarousal and other unpleasant symptoms caused by an imbalance in the brain and/or body; research has shown that a number of medications are most effective when coupled with therapy

While this is not a comprehensive list of all therapy approaches that exist and can be applied during counseling, here is a list of those therapies I use in my counseling practice:

• Acceptance and Commitment Therapy (ACT)
• Art Therapy 
• Behavior Therapy 
• Brainspotting 
• Brief Solution-Focused Therapy (BSFT)
• Career Counseling 
• Cognitive Behavioral Therapy (CBT)
• Cognitive Therapy (CT)
• Dialectical Behavior Therapy (DBT)
• Emotion Focused Therapy (EFT)
• Existential Therapy 
• Eye Movement Desensitization and Reprocessing (EMDR)
• Gestalt Therapy
• Humanistic Therapy
• Hypnotherapy 
• Jungian Therapy 
• Logotherapy 
• Mindfulness-Based Cognitive Therapy (MBCT)
• Motivational Interviewing
• Parts & Memory Therapy
• Person-Centered Therapy 
• Psychoanalytic Therapy 
• Rational Emotive Behavior Therapy (REBT)
• Reality Therapy 
• Revisioning
• Sex Therapy 
• Solution-Focused Brief Therapy (SFBT)
• Systemic Family Therapy
• Trauma Focused-Cognitive Behavioral Therapy (TF-CBT)

DEGREES / TITLES YOU MAY SEE IN THIS FIELD

• Counselor Education & Supervision Ph.D.: Ph.D. in learning how to educate counseling students in masters programs (what I’m doing)
• Doctor of Professional Counseling (D.P.C.): have completed a master’s degree in counseling and have also acquired LPC and/or LMFT credentials from the state where they practice, acquire a deepened specialization in counseling; will conduct individual, couples, and family therapy
• Master of Arts  (M.A.) in Counseling, Counseling Psychology, or Psychology: 2-2.5 year degree if a full-time student
• Master of Science (M.S.) in Counseling or Psychology: 2-2.5 year degree if a full-time student
• Master of Education (M.Ed.) in Counseling, Clinical Mental Health Counseling, or School Counseling: 2-2.5 year degree if a full-time student
• Physician’s Assistant (P.A.): PAs have a master’s degree and may diagnose illnesses, develop and manage treatment plans, prescribe medications, and serve as a principal healthcare provider; PAs are required in many states to have a direct agreement with a physician
• Psychiatrist, M.D.: goes to medical school, sometimes will do therapy, main focus as a medical doctor is prescribing medications for mental health management 
• Psychology Ph.D.: clinical psychologist, will do therapy but trained primarily in doing psychological assessments 
• Psychology Psy.D.: clinical psychologist, trained in assessments but typically more focused on doing clinical therapy

LICENSURE FOR TREATMENT AVAILABLE IN TEXAS

• LPC (with masters or Ph.D.): a Licensed Professional Counselor - they often specialize in working with individuals and will see couples or families; requires a masters degree
  • A LPC-Associate is still under supervision to acquire hours for full licensure, often a recent graduate 
  • A LPC-Supervisor (LPC-S) is a person with a Licensed Professional Counselor license that has been licensed for at least 5 years and that completed a 40-hour course on supervision to supervise counselors without full licensure

• LMFT (with masters or Ph.D.): a Licensed Marriage and Family Therapist - they specialize in couples and families and will see individuals, couples, and families; requires a masters degree 
  • A LMFT-Associate is still under supervision to acquire hours for full licensure, often a recent graduate
  • A LMFT-Supervisor (LMFT-S) is a person with a Licensed Marriage and Family Therapist license that has been licensed for at least 3 years and that completed a 40-hour course on supervision to supervise counselors without full licensure

• LCDC: a Licensed Chemical Dependency Counselor - they specialize in substance addiction issues and will work with individuals, couples, and families; does not require a masters degree, only a high school degree
  • A LCDC-Intern is still under supervision to acquire hours for full licensure
  • A LCDC-Supervisor (LCDC-S) is a person with a Licensed Chemical Dependency Counselor license that has been licensed for at least 3 years and that completed a course on supervision to supervise counselors without full licensure

• LMSW: a Licensed Master Social Worker; this license requires ongoing supervision by a LCSW and they are not allowed to practice independently; requires a masters degree
  • LCSW: a Licensed Clinical Social Worker; the LCSW is the “terminal” license for Social Workers and indicates that they can practice independently without the need for supervision (LMSW cannot), and have completed additional minimal requirements of clinical supervision and training that demonstrates competency in clinical interventions including but not limited to Mental Healthcare. LCSW licensure is required to qualify the practitioner to seek credentialing with insurance panels, including Medicare. LCSW licensees work with individuals, couples and families; requires a masters degree
  • LCSW-Supervisor: a Licensed Clinical Social Worker that has been licensed for at least 2 years and that completed a 40-hour course on supervision to supervise counselors without full licensure

• LPA: a Licensed Psychological Associate; this license requires completion of a doctorate in psychology of some kind and passing the Examination for Professional Practice in Psychology (EPPP); these professionals are in ongoing supervision by a Licensed Psychologist for two years and they are not allowed to practice independently; offerings of clinical assessments and therapy can vary from LPA to LPA
  • LP: a Licensed Psychologist; this professional has completed internship or formal training as a LPA; offerings of clinical assessments and therapy can vary from LP to LP

SOME ACRONYMS YOU MAY SEE

• ASCH = American Society of Clinical Hypnosis 
• BSP = Brainspotting
• CMAT = Certified Multiple Addiction Therapist
• CCPS = Certified Clinical Partner Specialist; has been specially trained to treat partners of sex addicts who have been traumatized by betrayal
• CCTP = Certified Clinical Trauma Professional
• CSAT = Certified Sexual Addiction Therapist
• CST = Certified Sex Therapist
• EMDR = Eye Movement Desensitization and Reprocessing
• ICST/CST = Internationally Credentialed Sandtray Therapist/ Certified Sandtray Therapist
• RPT = Registered Play Therapist
• SEP = Somatic Experiencing Practitioner
• SP = Sensorimotor Psychotherapy

Question: How do I know what therapy approach is best for me or what I need?

• Answer: It is not necessary for you to "know what you need" before starting therapy. Just show up to an appointment and be yourself. Your therapist will help guide you to what is right for you! But if you are interested in learning about different treatment approaches, you can use the list of therapy approaches provided above as a starting place, or you can research different approaches through studies on Google Scholar (scholar.google.com). Then, if you have found a particular approach you would like to try, you can seek out a therapist that offers what you are looking for through platforms like Headway, Psychology Today, Sondermind, Therapy Appointment, and Therapy Den. 

Question: What if I don't like my therapist? Do I have to stay with that therapist?

• Answer: No, you do not have to stay with that therapist, but it is best practice to only work with one at a time unless different therapists are providing different services that one or the other cannot provide, for example, hypnosis. If you decide that you no longer want to work with a therapist, it is appreciated that you communicate that via phone or email rather than no longer showing up to appointments.

Question: How do I find a therapist?

• Answer: You can call your insurance and ask for a list of covered providers meeting your criteria that are in your area. You can also do special searches through platforms like Headway, Psychology Today, Sondermind,  Therapy Appointment, and Therapy Den. Lastly, another suggestion is asking for therapist recommendations from a doctor, friends, or loved ones. If you are enrolled at a college or university, oftentimes there is a student counseling center where free or reduced cost counseling is available. 

Question: How do I find a doctor to prescribe me medications to help my mood? 

• Answer: You can either use a doctor (primary care physician (PCP) or psychiatrist (who specializes in psychological medications)  or a nurse practitioner for prescribing mood-altering and other types of medications for one's health.
• Find a Psychiatrist (American Psychiatric Association)

Question: How do I get testing to figure out if I meet criteria for a particular diagnosis? 

• Answer: You can see a licensed counselor that has training in conducting assessments or see a licensed psychologist who offers testing. 
• Psychologist Locator (American Psychological Association)

Question: How do you find a psychiatrist or psychologist? 

• Answer: Call your Insurance and ask for covered providers in your area or you can search for one on PsychologyToday.com with specific search criteria. Also, you can ask a therapist you are working with for some referrals. 
• Find a Psychiatrist (American Psychiatric Association)
• Psychologist Locator (American Psychological Association)