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Note: Responses to the following questions are my own opinion and should not be construed as representative of all mental health professionals.

1. What's the difference between a psychologist and other mental health providers?

While there are caring and competent providers in every field of mental health, significant differences exist in the level of their education and training. This table summarizes the basic differences in training between mental health providers.

Licensed Clinical Psychologists Psychologists hold a doctoral degree such as a Ph.D. or Psy. D. and have completed a pre-doctoral residency and post-doctoral fellowship/supervision hours. They have passed a national and state board exam and have been granted a license from the State Board of Psychology allowing them to practice independently. Health psychologists also have specialized training in psychological factors related to medical conditions. Psychologists provide psychological testing and evaluation, psychotherapy, and in some states prescribe psychotropic medications.
Psychological Associates Psychological Associates hold a masters degree in psychology. They do not complete residencies or fellowships. They must pass a national board exam to obtain a license. They must practice under the active supervision of a doctoral level licensed psychologist and may not practice independently.
Psychiatrists Psychiatrists hold a doctorate in medicine or osteopathy ( M.D. or D.O.). They are physicians who completed residency training in mental health. They must pass national and state board exams to receive their license to practice independently. Sometimes psychiatrists provide psychotherapy, but most often they focus on pharmacological treatment of emotional and mental disorders (e.g. prescribing medication).
Psychiatric Nurses Psychiatric Nurses hold either a bachelors or a masters degree in nursing and have completed some coursework and training in mental health. They must pass a national board exam in order to receive their certification. Registered nurses, nurse practitioners, and clinical nurse specialists must practice under the supervision of a licensed physician.
Licensed Professional Counselors Licensed Professional Counselors hold a masters degree in a counseling related field. They have completed two years of post-masters supervised clinical experience and must pass a national board exam before receiving licenses to practice independently.
Licensed Clinical Social Workers Licensed Clinical Social Workers hold a masters degree in social work and have completed two years of post-masters supervised clinical experience. They must pass a national board exam prior to receiving a license to practice independently.
Licensed Marriage & Family Therapists Licensed Marriage and Family Therapists hold a masters degree in marriage and family therapy or an equivalent course of study and have completed two years of post-masters supervised clinical experience. They must pass a national board exam before receiving a license to practice independently.
School Psychologists School Psychologists are credentialed by the State Board of Education. They may provide services independently only within the school setting. They are not equivalent to Clinical Psychologists and legislation is pending set forth by the American Psychological Association that may result in their inability to use the term �psychologist� at all.
Guidance Counselors Guidance Counselors are teachers who have been certified by the State Board of Education to use this term. Guidance Counselors may provide services only within the school setting.
�Psychotherapists� or �Therapists� The terms �Psychotherapist� or �Therapist� are not legally protected. Therefore, individuals sometimes refer to themselves by these titles when they do not have a license from a state board authorizing them to provide mental health services. They may have little or no training in mental health.

2. How do I know if my child needs mental health treatment?

It is common for children to experience occasional problems as they grow and mature. They experience conflicts at home over such issues as toilet training, bedtime and homework. They encounter problems with parents and peers as they attempt to establish a personal identity and practice relating to others. They experience conflict with teachers as academic and behavioral demands increase. As a child is faced with new situations, demands and expectations, it is common for the child to experience emotional ups and downs characterized by feelings of sadness, fear and anger. These reactions tend to be short-lived, however, and usually do not significantly interfere with the child's life. However, occasionally a child's response to life's pressures may become severe, and the parents' attempts to help their child may be unsuccessful. At times such as these, professional assistance may be warranted.

3. So how does a parent know when it is time to seek professional assistance for their child?

In my practice, I look at a number of factors in determining the appropriateness of treatment. First, I evaluate if the observed emotional distress is disrupting daily functioning, threatens to overwhelm the child or interferes with the achievement of age-appropriate developmental milestones. For example, parental divorce is an emotionally upsetting experience that children react to in a variety of ways. If a child's reaction includes uncharacteristic school failure, fear of sleeping alone or heightened anxiety when separating from a parent, it indicates that normal functioning has become disrupted, and referral for psychological treatment is indicated.

Similarly, psychological treatment may be warranted when a child's difficulties interfere with normal family functioning, even though the child is not upset by this circumstance. I see this situation frequently with children who have unrealistic or exaggerated fears about going to school. These children become frantic when faced with separation from the parents. The child may be content to remain at home but the parents are often very distressed and inconvenienced by their child's unreasonable refusal to go to school. The child's inability or unwillingness to separate from the parents may make them late for work or miss work altogether, and they may feel frustrated and helpless to effectively deal with the situation.

Children may also benefit from psychological treatment when the problems they face are complicated and beyond the range of normal daily experience. For example, children who suffer from serious or life-threatening medical problems often derive benefit from the assistance provided by a knowledgeable psychologist. The psychologist focuses on helping these children develop coping skills to deal with their unique situation and advises parents regarding how best to support their child.

The least common but most serious indication that psychological treatment is needed is when a child's symptoms are severe or the behavior is extreme and potentially life threatening. This would include situations in which a child is experiencing false auditory or visual sensations, setting fires, assaulting others, or is severely depressed and making remarks about committing suicide.

Child psychologists possess specialized knowledge and skills that enable them to identify problem behaviors and formulate appropriate interventions. As a psychologist trained to work with children and families, I can develop individualized treatment plans appropriate to each child's specific needs. Children's reactions to stressful life circumstances range from mild and short-lived to severe and long lasting. When a child's problems do not resolve within a reasonable time-frame psychological intervention is recommended. Therapy offers children the opportunity to identify, discuss and understand problems and to develop necessary coping skills. Therapy also provides the opportunity to address parental concerns, educate parents regarding their child's unique needs, and assist them in meeting these needs in an appropriate, effective fashion. Finally, it is important to recognize that without appropriate and timely treatment a child's problems may become severe and lead to more serious, long-lasting difficulties.

4. How long will my child be in treatment?

In general, a circumscribed issue with a short history will probably be dealt with fairly quickly, for example in 6-10 sessions. Short-term/focused therapy is definitely the current trend in treatment. However, a non-specific issue with a long history like, "I've never really been a happy person," will probably need a much longer time period to be dealt with.

5. Am I a failure as a parent if my child needs to go see a psychologist?

Absolutely not! I suggest that consulting a psychologist be viewed the same as when one visits another profesional, for example, a physician. When you are struggling with your health or the health of your child�be it physical or emotional, I believe it is wise to seek professional help. Most parents can and should attempt to help their child cope with problems before consulting a psychologist. However, as with all areas of life, there are some situations where outside help is warranted. The average parent is not reluctant to consult a physician for their child's medical needs. In fact, parents who do not obtain appropriate medical care for their children are considered negligent. I believe the informed parent also recognizes when their child may need or benefit from psychological treatment and understands that such intervention is not in any way a sign of failure. Parenting is the hardest job we will ever do in our lifetime. Seeking help is a sign of courage and says you love your child enough to recognize when you can�t do it alone.

6. Can't I just read a book, attend a parenting class, etc. and get the help I need?

You certainly can try that, but you may have already tried several of those methods. From my experience, most of my clients have already tried several avenues to deal with their problem by the time they come in for psychotherapy. In fact, the problem I hear over and over is that the self-help book, seminar, parenting class, etc. that was utilized was not specific enough to the client's particular situation. In psychotherapy, problems and the application of solutions to those problems can be discussed in great detail.

7. Can't we just put the problems behind us, move on, and hope for the best next time?

You can certainly try that but it often doesn't work if we are honest with ourselves. And in fact, the more we deal with life in that manner the more difficult it usually becomes to move on after each successive disappointment, frustration, or conflict. I think this is because each issue or situation that isn't dealt with appropriately accumulates with other prior unresolved issues. Then when too many issues accumulate, the overflow comes out in the form of symptoms like stress, anxiety, depression, irritability, lack of focus, stomach upset, headaches, muscle tightness, and the like. It is akin to a container that becomes too full and spills over if not monitored.

8. What can I expect in the first session?

In the first session, I will be asking a lot of questions in order to gain a clear understanding of what issues concern you about your child, how and to what extent those issues impact your child and family, what factors may have led to the development of the issue, and how, together, we can address the issue in terms of working toward a solution. I will give you time to ask any questions you may have, and if we are both in agreement that we will continue working together, we will set the day and time of your next appointment and discuss how long it may take for you all to reach your goals.

9. Will what I say in therapy sessions be kept private and confidential?

Generally, what you say in therapy sessions will be kept confidential. However, there are circumstances under which exceptions do exist. The following is not a complete list of exceptions to confidentiality but it does contain a few of the more common ones: 1) you or your child are in danger of harming yourself or someone else; 2) child abuse or neglect is suspected; 3) your treatment records are requested by subpoena.

10. How will I know when it is time to end treatment?

A simple answer is, when your goals for treatment have been met. (If for some reason you want to stop treatment before that point, you may do so at any time and for any reason.) However, a termination session that brings closure to our work together is recommended before you leave. Once you do leave treatment, I hope you will think of therapy as you do medicine or dentistry; that is, coming for "checkups" as needed (before too much stress builds up) is a very appropriate way to utilize therapy once you have completed an initial course of treatment. On a related note, if I believe that psychotherapy is not the best method for treating your particular issue, then I will refer you to the appropriate resource in your community. My goal is to get you the help you need.

11. What is teletherapy?

Teletherapy is a form of therapy provided via internet technology, which can include consultation, treatment, and/or education using interactive audio and video. Teletherapy has the same purpose or intention as psychotherapy or psychological treatment sessions that are conducted in person, and is subject to the same laws of privacy and confidentiality under HIPPA. I use a secure, HIPPA compliant portal for teletherapy sessions, and if an initial evaluation appointment is scheduled, I will provide you with a teletherapy consent form which outlines the information about telehealth in more detail.