White Forest Guide - How to Find a Counselor or Mental Health Therapist

This guide is designed to support anyone in their search for an in-person Counselor or other mental health practitioner. It is important to note that while much of this information may be generally applicable, individual state laws may vary and be in conflict with some of the information presented here, which is based upon the laws of our home state of Oregon. Included are important questions to have in mind before and as you begin your search. Each question is followed by some important points to consider provided by White Forest.

Practitioners will typically advertise or explain what types of issues they work with.

Specialists prefer to focus on very specific populations. Some examples might be a practitioner who works with children who have been diagnosed with Asperger Syndrome, or one who works with recovering abuse victims. If you are seeking help with an issue which is uncommon, or if you are feeling that you may benefit from more specialized help, then you may want to seek the help of a specialist. Specialists tend to have a lot of education, training and/or experience in their specialty, so they may be of particular help to you. Specialists typically don’t have a unique label or title, but rather they often advertise their specialty in any marketing you receive, or in your initial contact with them.

Generalists work with a wide range of issues. If you are seeking help with an issue that is more common, or if you are simply looking for more generalized therapeutic support, then you may wish to seek out a generalist. Several examples of relatively common issues might include depression, relationship or marital challenges, stress and anxiety, etc.

Therapists often provide some sort of consultation prior to the start of therapy. It is the ethical responsibility of all therapists to inform you if the issues you seek to address are beyond their scope of training and practice, in which case they will often refer you to a practitioner who can meet you needs.

Doctoral practitioners typically graduate from programs which are more specialized than master’s level programs. For this reason, you will typically find more specialists among the doctoral ranks. This largely arises from the 1-2 years of additional schooling which doctoral students largely spend researching and writing a dissertation on a specific topic. It is not uncommon that doctoral practitioners translate their graduate research into a specialty. Also, in many states doctoral students are the only practitioners who can provide formal psychological testing. If you have a need or desire to have formal psychological testing and evaluation performed, a doctoral practitioner is likely to be a good choice.

Master’s level practitioners may be less likely to come from a specialized program. For this reason, master's level practitioners tend to be more generalized in practice. In most master's programs there is no focus on research, so graduate emphasis is entirely on the practice of psychotherapy. Instead of specializing through a dissertation, masters level practitioners often become specialized from years of working within a specialty. Practitioners also tend to be more affordable, due to the fewer number of years spent in graduate school.

Agencies often take the form of larger organizations which serve local communities. Agencies have some advantages and disadvantages compared to psychotherapists in private practice. Here are a few advantages to working with an agency:

Community services, such as supplementary therapeutic groups, are more likely to be accessible when working with an agency.

Supervision is very common in agency settings. It is likely that practitioners in agency settings are receiving some form of regular clinical supervision.

Affordability is another reason why an agency might be a good choice. They often have sliding scales and/or lower service fees due to their public and grant funding, as well as their large client volume.

Confidentiality may be lower in agency settings. Various offices may be close together so there can be less privacy. Agencies typically have a significant amount of required paperwork which is kept for years in office files and can be accessed by non-clinical staff for billing, etc.

Individual attention may be lower in agency settings. Practitioners often have case load requirements which can exceed a reasonable amount. In addition, when paired with excessive paperwork demands, practitioners can be under a significant amount of stress. This can lead to poor case management and/or less effective therapeutic work.

Skill levels of practitioners may span a wide range. Often times agencies employ graduate student interns who are working on accruing hours to become professional counselors. Employing student interns is, in part, what allows agencies to be more affordable.

If you are interested in going to an agency, we encourage you to ask around in the community to find out more about the clinical reputation of the practitioners within the agency.

Private practitioners are individuals or groups of individuals who work independently in the field. Typically you may find them listed under their name, or as part of professional groups, wellness centers, etc. Going to see a therapist in private practice can also have advantages and disadvantages, which are often opposite of those listed above regarding agencies. Some advantages might include:

Confidentiality is typically highest in a private practice setting. This may be for a variety of reasons. If payments are made out-of-pocket, practitioners may have no record requirements. In other words, there may be no client files, or if they are kept, clinical notes are typically short and vague. Commonly there are much fewer non-clinical staff members with access to personal information.

Individual attention may be higher in private practice settings. Unlike many agencies, there are no case load requirements, far less paperwork and very few additional pressures. This typically translates into practitioners who are less stressed, and better able to focus on their clients.

Skill Levels of private practitioners are typically high. While this is not always the case, private practitioners have usually spent many years working in other settings (such as agencies) before they have the financial means to start a private practice. For this reason they often have more years of experience.

Community services, such as supplementary therapeutic groups, are less likely to be components of private practices.

Supervision may be underutilized in private practices. While at White Forest we believe in the importance of regular supervision, some practitioners do not continue to receive supervision to support their in-person practice.

Cost is one reason why some people may not choose private practitioners. Typically private practitioners do not receive public funding or grants. They also typically have a smaller client volume, so they may not be able to compete with lower agency fees. However, some practitioners utilize sliding scales and/or offer low income slots which can make them more affordable. White Forest offers online and distance services at lower fees to address this.

Maybe you have been in therapy before and found that you liked a specific approach, or maybe from doing your own research you found something that drew your interest. Many practitioners specialize in certain theories or approaches. Simply ask practitioners if they have experience working within the specific theory or approach. Be mindful, however, that just because you are interested in a specific approach, does not necessarily mean that it will be appropriate for you or your situation. We encourage you to be open to feedback that practitioners give you.

I know what type of practitioner I want to work with, but how do I narrow down my list of available practitioners?

Talking to and getting input from others can be a great way to narrow down your options, as long as you feel safe and comfortable openly discussing your plans to seek counseling.

A great place to start is by tapping into your peer network. It may be that one or more of your friends have had good or bad experiences with a mental health practitioner. Depending on their experience, the sharing of this information will hopefully shorten your list.

Another good place to start is by getting recommendations from local medical professionals whom you trust. Generally speaking, helping professionals care about your health, so they are happy to refer you to someone who they believe can help you in a way that they can’t. So don’t hesitate to ask your primary care physician, chiropractor or acupuncturist, for example, if they know of any good mental health practitioners.

Does the practitioner have the appropriate educational background and degree?

When looking for a counselor/therapist, it is important to know that the person has actually obtained a graduate degree in the field. If a practitioner doesn’t provide you with this information, don’t hesitate to ask them. Find out what degree they received; inquire about their program of study; ask which institution they graduated from. Hopefully you feel comfortable with their responses. If you feel any uncertainty, or if you have never heard of their graduating institution, then simply use the information they provided you and look up the institution’s website. If you want to perform a thorough investigation, you may even contact the institution to verify that the practitioner graduated from their program.

All of the following are abbreviations of appropriate graduate degrees which a mental health practitioner may possess and list following their name:

For an explanation of these various degrees, see our terms and definitions section. We recommend that you avoid any practitioner who claims that they are providing mental health services without a master's or doctoral degree in a relevant field.

Many practitioners received their graduate education from an accredited graduate program. For example, Lesley University (where White Forest practitioners received their degrees), is accredited by the New England Association of Schools and Colleges (NEASC). Most programs will be accredited by a similar regional accrediting body. According to NEASC, accreditation is

“a system of accountability that is ongoing, voluntary, and comprehensive in scope. It respects differences in institutional populations, missions, and cultures, and fosters institutional change grounded in the judgment of practicing educators. It is based on standards which are developed and regularly reviewed by the members and which define the characteristics of good schools and colleges. Commission Standards are high and focus on virtually every aspect of a school or higher education institution’s operation. These standards often are accepted in substitution for standards set by state departments of education. Standards are reviewed periodically by the commissions and the membership, reflecting the voluntary, independent nature of accreditation combined with recognition of pertinent state and federal regulations.”

If you would like to learn more about the accreditation process, we encourage you to visit the accrediting body in your region. We have included links below for your convenience. If you are considering going to see a psychologist, you may want to investigate if they earned their degree from a program that is accredited by the American Psychological Association (APA). The APA link is also included below.

Northwest Commission on Colleges and Universities (NWCCU) - Alaska, Idaho, Montana, Nevada, Oregon, Utah, and Washington http://www.nwccu.org/

Western Association of Schools and Colleges (WASC) - California, Hawaii, Guam, the Commonwealth of the Northern Marianas, American Samoa, the Federated States of Micronesia, the Republic of the Marshall Islands, and East Asia http://www.acswasc.org/index.htm

New England Association of Schools and Colleges (NEASC) - Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, Vermont, and American/international schools in more than 60 nations worldwide http://www.neasc.org/

North Central Association of Colleges and Schools (NCACS) - Arizona, Arkansas, Colorado, Illinois, Indiana, Iowa, Kansas, Michigan, Minnesota, Missouri, Nebraska, New Mexico, North Dakota, Ohio, Oklahoma, South Dakota, West Virginia, Wisconsin, and Wyoming, including schools of the Navaho Nation http://www.ncahlc.org/

Middle States Commission on Higher Education (MSCHE) - Delaware, the District of Columbia, Maryland, New Jersey, New York, Pennsylvania, Puerto Rico, the U.S. Virgin Islands, and several locations internationally http://www.msche.org/

Southern Association of Colleges and Schools (SACS) - Alabama, Florida, Georgia, Kentucky, Louisiana, Mississippi, North Carolina, South Carolina, Tennessee, Texas, Virginia and Latin America and other international sites http://www.sacs.org

American Psychological Association (APA) - Accredits doctoral level psychology programs www.apa.org

There exist a variety of mental health programs that are not accredited by the governing accreditation board in their region (or by the APA for doctoral programs). This may be for a variety of reasons, such as a program being fairly “young,” and not institutionalized long enough to receive such accreditation. Another reason might be that a program provides an “alternative” style education, which teaches outside of the guidelines established by the accrediting body. Because accreditation is voluntary, in some cases an institution may meet or exceed accreditation standards, but choose not do spend the money or time becoming accredited. Whenever you meet with a practitioner from a non-accredited program, you simply want to use caution. Such practitioners may be quite skilled, and may, in fact, be more skilled than graduates from an accredited program. However, there may also be a greater risk that the practitioner is under-skilled, as compared to a practitioner from an accredited program.

Licensure is the process by which mental health practitioners get licensed either at the state or national level. A license can mean different things depending upon your state laws, but in general, a license allows practitioners to accept insurance, and it also permits practitioners to provide services without clinical supervision (explained further below). A practitioner does not need to be licensed to practice, as paradoxical as this may sound. In some cases practitioners may spend their entire careers unlicensed. Once students graduate, they are considered practitioners. The only caveat is that in order to provide unlicensed services mental health practitioners must be registered with their state of practice and receiving regular clinical supervision.

It may be easy to assume that a licensed practitioner is a better practitioner, but this is not necessarily true. There are countless factors that impact the effectiveness of therapy and the therapist, and many of these factors have nothing to do with whether a practitioner is licensed or not.

Clinical supervision is the process by which practitioners meet with a licensed clinical supervisor to discuss their work in a confidential manner and get professional feedback to help improve their service to clients. In some cases supervision may take the form of meeting with fellow professionals. At White Forest we believe that regular clinical supervision is fundamental to effective and successful in-person mental health practice. We believe that all in-person practitioners should be engaged in some form of ongoing clinical supervision, and we believe that this is a much more important factor than looking at whether or not a practitioner is licensed. State laws permit licensed practitioners to practice without supervision. Some licensed practitioners continue clinical supervision despite this freedom, but others do not. We believe that unsupervised practice regardless of licensure status is not in the client's best interest. We encourage you to ask therapists if they are engaged in ongoing supervision, and to consider this information as part of your selection process.

It is important to find out what rates therapists charge because there is a wide range, and therapy can be quite expensive. There is no set rule about what therapists can charge. As a very general rule of thumb, the more years of schooling received the higher the rates. However, there are many exceptions to this. Therapists may charge higher rates because of special education they received, extensive years of experience, they are good at what they do and are in high demand, or for any other number of reasons. Rates may be important to consider, particularly if you will be paying out of pocket, or if your insurance only covers a percentage of each session.

If you don’t have insurance and will be paying out of pocket, one way to narrow your therapist list is to ask who provides either pro-bono work or a sliding scale. Pro-bono is the provision of free services, typically to people who do not have the resources to cover their mental health care. Sliding scales are lower rates which may be provided for the client to choose from, or therapists may require some sort of documentation to verify that you cannot afford to pay for services. Even if you have insurance, your deductible or co-pays might require a fair amount of out of pocket expenses. Some therapists may be willing to work with you to make special financial arrangements. So be sure to ask about this if it is an issue.

Did you find this guide helpful? Do you have ideas on how to make it better? Send us an email and let us know!