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Ask the Mental Health Expert Archives 2001-2004

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Mental Health Profesionals

Q. Can you give a brief synopsis of the different types of mental health professionals and their qualifications (by category)? Specifically, can you compare psychiatrists, clinical psychologists, psychologists, LCSW, LCSW-C, counselors, etc.? I am stymied to find a resource that details this. Also, I'm wondering if you can recommend a web site that lists all medical degrees (nationally and possibly internationally) and what they stand for, the training they go through, etc. Thanks!

A. I go into this question in some detail, in my book "A Consumer's Guide to Choosing the Right Psychotherapist" (Jason Aronson, 1997). Essentially, here's the story: Psychiatrists are medical doctors who have had four years of college, four years of medical school training, and a four-year residency in psychiatry. (Some psychiatrists are graduates of osteopathic training programs, and have the initials D.O. after their names, instead of M.D. Their training is virtually equivalent to that of the MDs. Some physicians trained in Britain may have the initials "M.B." after their names.)

Of all the mental health professionals, only psychiatrists are qualified both to diagnose medical illness and to treat it independently, as well as to provide psychotherapy. (This statement must be qualified somewhat nowadays, since nurse clinicians or clinical nurse specialists do provide similar services independently in a few states; in most states, however, they must work collaboratively with a physician).

Clinical psychologists generally have had four years of college, four years of graduate school, and a one-year internship culminating in a Ph.D. or Psy.D. degree. Although a subgroup of psychologists is fighting hard for prescription privileges, this is not yet permitted outside some parts of the military, and psychologists do not have medical expertise comparable to that of physicians. The terms psychoanalyst and psychotherapist are not uniformly regulated by law, and thus may not be precisely defined; e.g., not all psychoanalysts are physicians, nor are all psychotherapists are Ph.D.'s.

The term social worker is quite broad, and may apply to those entry-level workers with a Bachelor of Social Work (BSW); a master's degree (MSW), or even a doctorate (DSW) in social work. About half the states license or regulate clinical social workers (e.g., a licensed clinical social worker has an LCSW designation). Certification by the Academy of Certified Social Workers (ACSW) requires a master's or doctoral level degree; two years or 3000 hours of postgraduate experience, and passage of a written examination.

Specialists in psychiatric nursing usually hold a master's degree from a program that lasts up to 2 years. The American Nurses Association certifies psychiatric nurses on several levels, and, as I noted above, clinical nurse specialists (CNS) have had additional, specialized training in psychopharmacology that permit them limited prescribing privileges.

Finally, Certified Clinic Mental Health Counselors must have an appropriate master's degree (or the equivalent), plus two years of counseling experience. I'm afraid I don't know of the type of web site you are interested in. You may want to write to the American Psychiatric Association, the American Psychological Association, and the Academy of Certified Social Workers for more information about training, credentials, etc. You may also be interested in the book, "Training Behavioral Healthcare Professionals: Higher Learning in the Era of Managed Care", by JM Schuster et al (1997).

August 2001

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