FAQ About Mental Health Services
What's the difference among a psychologist, psychiatrist, social worker, and counselor?
The title "Counselor" is a fairly loose title often used in a general sense to describe any professional at any educational level who provides guidance and assistance to people in many aspects of their lives. The general "counselor" title can apply to psychologists, social workers, guidance counselors, life coaches, case managers, and psychiatrists. A license is not required to call oneself a counselor. The title "Psychotherapist" is also a general (e.g., not official) title that typically describes a counselor who has at least a master's degree and a license to practice. You should always seek a licensed mental health professional for your mental health care.
In North Carolina, a Licensed Psychologist has a doctoral degree, such as a Ph.D. or Psy.D. A doctoral degree involves four years of undergraduate study and then four to six or more years of graduate study. A Ph.D. requires a dissertation, which is an original piece of research in the field of study. Not all people with doctorate degrees in a mental health field are qualified to pursue a license as a psychologist. To become a licensed psychologist, one must have completed an approved doctoral program with specific coursework and training, an internship and postdoctoral residency, and successful completion of state and national board examinations. The title "Licensed Psychologist" in North Carolina is a protected term that describes only individuals with that specific state-issued license.
Licensed Psychologists are qualified to conduct psychotherapy, psychological evaluations, and psychological testing, although. It is common for Licensed Psychologists to specialize in one or more areas, such as child psychology, neuropsychology, or forensic psychology. Although psychologists have training in psychotropic medications, they do not have prescribing privileges in NC. They can, however, conduct psychological testing, diagnose mental illness, and treat mental illnesses through psychotherapy. Perhaps the main factors that separate psychologists from other mental health professionals is that they have more training in psychology, have conducted original research (i.e. a doctoral dissertation), and are heavily trained in psychological testing and assessment.
A Licensed Professional Counselor (LPC) is a mental health professional who has attained at least a Master's degree in Mental Health Counseling or a closely related field, has completed many hours of supervised clinical practice pre- and post-degree, and who has passed an examination. The title "Licensed Professional Counselor" in North Carolina is a protected title describing only individuals who hold a license as an LPC. LPCs are well-trained in providing psychotherapy from a variety of theoretical perspectives. They work in many different settings providing much needed services to a variety of people.
A psychiatrist is a medical doctor (M.D.) whose specialty is in mental health. Psychiatrists complete four years of undergraduate study, usually in biology or chemistry, four years (typically) of medical school, an internship, and residency. Psychiatrists diagnose mental disorders and prescribe medication when needed. They are heavily trained in the medical model of psychology. Although not as heavily trained in psychotherapy, some psychiatrists do provide psychotherapy.
North Carolina recognizes other types of professionals through a state-issued license. A Licensed Psychological Associate (LPA) is similar to an LPC but requires supervision from a Licensed Psychologist to practice psychotherapy. A Licensed Clinical Social Worker (LCSW) has a master's degree in social work and is also adept at psychotherapy.
At Etheridge Psychology, all of our clinicians provide counseling and psychotherapy, and our licensed psychologists provide psychological testing/evaluation and other services such as forensic examinations and consultation.
Why do people seek therapy?
People seek therapy for any number of reasons. We see clients with many presenting problems, such as sadness or depression, stress, anxiety, obsessive thoughts, compulsive behaviors, relationship issues, grief, trauma, divorce, work issues, and social problems. Some clients may not even know exactly what they need to change; they just know they are unhappy and want to explore the cause. You don't need to have a mental illness to benefit from counseling.
What will my first therapy session be like?
The first therapy session is generally part assessment, part counseling, and part just getting to know each other. Some clients are in crisis and need to spend much of the session working through their immediate feelings and formulating an initial plan of action. Others are not in emotional crisis, and their first session is spent describing the issue that brought them to counseling and providing background information. We generally spend a couple of minutes in the first session going over the initial paperwork and answering any questions about policies, fees, and confidentiality, and then inquire about the issue at hand. The session continues from there based upon your needs.
What happens after the first session? How long does therapy take?
Depending upon your needs, we generally recommend weekly sessions at first. The frequency of sessions eventually tapers to every two weeks, then one or more monthly check-ins until the end of therapy is mutually agreed upon. Some clients feel better after just one session and do not feel the need to return. Others attend therapy for a few weeks, while still others continue their appointments for months. Our goal is to help you develop the tools you need to make positive changes. Once that occurs, therapy may no longer be needed. Once therapy has ended, you are always welcome to return should the need arise again in the future.
Will my sessions be confidential?
The law protects the relationship between a client and a psychologist or other licensed mental health professional, and information cannot be disclosed without your written permission. There are certain exceptions to this, and although they are listed them below, please discuss confidentiality concerns with your clinician.
Suspected child abuse or dependent adult or elder abuse, for which we are required by law to report to the appropriate authorities immediately.
If a client is threatening serious bodily harm to another person/s, we must notify the police and inform the intended victim.
If a client intends to harm himself or herself, we will make every effort to enlist their cooperation in insuring their safety. If they do not cooperate, we will take further measures without their permission in order to ensure their safety. This may include involuntary admission to a crisis stabilization unit.
When an evaluation is ordered by the court, confidentiality can be limited. The purpose of the evaluation, limits of confidentiality, the results of the evaluation, and to whom the results will be shared is disclosed prior to the evaluation taking place, to the extent possible. We will make every effort to maintain confidentiality regarding any information that does not bear directly upon the legal purpose of the evaluation.
Even in non-forensic evaluations and psychotherapy, a judge can order us to testify or turn over your records to the court.
Minors have limited rights to confidentiality in that their parent or legal guardian may have access to their records.
Why do people get psychological evaluations?
People seek psychological evaluations or assessments for any number of reasons. They may wonder if they have a depressive disorder, an anxiety disorder, Attention-Deficit/Hyperactivity Disorder (ADHD), Autism Spectrum Disorder, Obsessive-Compulsive Disorder, or another mental illness. We test children and adults for learning disabilities, IQ tests to determine giftedness, and we test for early entry to kindergarten. We can also assess the grade level at which a child is performing. We provide pre-surgery evaluations to ensure that patients are emotionally and behaviorally ready for surgery. Finally, we also conduct psychological evaluations in civil and criminal legal situations.
What is a forensic evaluation?
A forensic evaluation is done to answer questions raised by the court, or to assist in a legal proceeding. We are often contacted by attorneys who feel that a psychological evaluation of their client might be helpful in their defense of the client. Our forensic evaluations are legal services, not clinical or medical services, so a typical doctor-patient relationship is not established. This type of evaluation is not covered by health insurance. The work product, typically a forensic report, is delivered to the attorney or court, not the individual being evaluated.