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Taking Depression Seriously: Selecting a mental health care provider

In the sixth post in the Taking Depression Seriously series, Sophia Xiao and physician Randall Stafford clarify the different types of care providers.

Finding the right health care provider can be critical to treating depression. Different types of practitioners are licensed to provide distinct forms of support based on their training and experience. Although there is some variation between states, requirements such as the level of education are generally consistent nationwide.

Here's a look at the most common types of mental health providers and what they each can offer. 

Psychiatrist

A psychiatrist is a physician (has an M.D. or a D.O. degree) who specializes in mental health. Psychiatrists generally focus on understanding and treating depression from a biological standpoint and often further specialize in different areas of mental health, such as child and adolescent, geriatric, depression, or addiction psychiatry. Psychiatrists can diagnose and treat mental health conditions. Some provide talk therapy while most prescribe medication.

Psychologist

A psychologist generally holds a doctoral degree (usually a Ph.D.) and is trained in psychology, the science of the mind. Psychologists primarily deal with thoughts, emotions, and behaviors and focus on helping patients overcome the mental barriers involved with their depression.

Psychologists can diagnose and treat mental health disorders and provide counseling. Many have training in specific types of therapy, like cognitive behavioral therapy or other interventions. Psychologists cannot prescribe medication, but often work with other providers who can.

Social worker

Clinical social workers are trained to evaluate a person's mental health and use therapeutic techniques based on their specific training. A licensed clinical social worker must have at least a master's degree (M.S.W.) in social work. They often help people meet their basic needs, including food, housing, health care, and social support and they are skilled at assisting individuals who are not able to fulfill these basic needs on their own.

Social workers' counseling regarding depression often focuses on problem solving. Depending on training level, social workers can provide assessment, diagnosis, therapy and a range of other services, but cannot prescribe medications.

Licensed professional counselor

Licensed professional counselors can operate under many different titles depending on the state, including LPC (licensed professional counselor), LMFT (licensed marriage and family therapist), and licensed clinical alcohol and drug abuse counselor. Most are required to have at least a master's degree and have clinical experience. These providers counsel clients on a range of issues, but they are not licensed to prescribe medication.

Other health providers

Other health care professionals can also provide some services. Primary care physicians can diagnose and prescribe medications and may be especially important for those with both mental health and physical health issues. They can also provide referrals to more specialized mental health professionals. Physician assistants and psychiatric/mental health nurse practitioners can also diagnose and prescribe medication.

Online providers

The internet has created new mental health treatment options, including online cognitive behavioral therapy (CBT). More accessible and lower cost than in-person treatment, online CBT can be either automated or involve a remote human provider. Online CBT programs often offer educational modules and tools to help track mood and behavior. They can provide structured homework assignments similar to those given in a traditional CBT setting. Despite their promise, however, online CBT programs' effectiveness is not well studied.  

When it comes to depression or other mental health conditions, a first step is to find the type of provider who fits your needs. A provider's ability to prescribe medications and skills in specific types of counseling or therapy are key criteria. Other important considerations include the provider's experience, their areas of specialization, their price range and coverage by insurance, and how you get along with them. Some providers may offer a short introductory phone call that can help you decide whether they are a good fit for you.

This is the sixth in a series of blog posts, Taking Depression Seriously, that aims to help patients and family members better understand depression as a chronic disease and more successfully navigate the health care system. The next blog will address health behavior changes that can improve symptoms of depression.

Sophia Xiao is a masters degree student in Community Health and Prevention Research at Stanford University. She studies barriers to health care and the role of public health education in improving access to care. Stanford professor and primary care physician Randall Stafford, MD, PhD, studies strategies to improve chronic disease treatment, including increasing the role of patients in their health care.

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