It can be hard choosing. LPCC? Psychiatrist? MFT? Life
Coach?
Therapists: First of all, the distinguishing feature of any
licensed therapist is that they are legally allowed to diagnose and treat
mental disorders, as defined by the Diagnostic and Statistical Manual (DSM). Approaches to treatment vary a great deal, as
there is no requirement for any therapist to work in any particular way, as
long as they are working in a professionally recognized treatment method, but
there are many.
Unfortunately, the license
type does not tell you what method(s) the therapist works with, or how effective
they are. In general, however, here are
some distinctions: MFT’s are trained as relationship specialists, LPCC’s counsel individuals, LCSW have training in social work,
psychologists often do testing and frequently are involved in research, and
psychiatrists (MD’s) are the only professional group in California who
prescribe medication. Often, that's all they do.
What’s a Coach? While many therapists include coaching (guidance and support in attaining future goals) as part of what they offer, coaches do
not do therapy….that is, they do not (legally) treat mental disorders. (One wonders, however, that since they are not trained to diagnose, how they know a person doesn't have a mental disorder?) While
therapists can treat mental disorders as well as helping people with personal
growth, or working toward excellence, coaches claim only to work with personal
future growth. Life coaches often distinguish themselves as focused on the future, vs.
healing the past.
What “consumer protection” is there? The purpose of
a license is consumer protection. Earning a license requires fulfilling many very specific
educational requirements, qualified training, many supervised hours of pre-licensed
practice, and on-going accredited continuing education, as defined by California legal code, all for the purpose of
increasing the likelihood that therapists will be safe for people in a
vulnerable position. The law
is not fool-proof. Unfortunately, some disturbed or manipulative or
unscrupulous people occasionally get through the screening process. But, at
least there is some training and screening to ensure that the overwhelming
majority of therapists are trustworthy.
On the other hand, there
is NO screening whatsoever, for Life Coaches and NO regulation. Try googling “Life Coach training” and you’ll
get pages of training “institutes” who grant certificates. It is a huge
business right now, and basically, anyone can get certified with no tested skill or
knowledge. Some of these schools ("for
profit" businesses) offer a certificate for as little as 3 on-line hours. Most
importantly, there is NO “screening” for safety.
Safety As a consumer of therapy or coaching, you are
in a vulnerable position. You want to be sure the person you are working with has
been trained not to take advantage of that, or make mistakes out of ignorance
or self-interest.
So, how to choose?
Carefully review your potential therapist’s or coach’s background, training and
experience. Is he/she just a great salesperson (as many coaches are), or does
his/her track record indicate he is both good at what he does and safe.
Most importantly, if after
a few sessions, things don’t feel right, he/she should be willing to talk with
you about what doesn’t feel right. If it feels like he/she is again trying to “sell”
or pressure you, as opposed to addressing and making well your concerns, it
might be time to move on.
A word about Insurance Most insurance companies specify that their
benefits are for “medically necessary” treatment, as defined by the DSM. Therefore, if you want insurance coverage,
you will receive a mental disorder diagnosis. This did not happen before the
inception of “managed care” in the 1980’s, and is a huge factor in the misconception that therapists only work
with mentally ill people. The burgeoning
growth of the Life Coaching industry, in large part, is due to their encouragement
of this misconception. What is true, is that if you want to work with a licensed
therapist who offers personal growth work, and you do not have a diagnosis, you
will have to pay out-of-pocket (as you will with a coach).
