Finding Help

Often the process of seeking mental health care begins with your primary care physician. Your primary care physician may recommend that you see a mental health professional or may prescribe medications until you’re able to get an appointment with a mental health professional.

What Do I Do When It Seems That Something Is Wrong?

If you think that something just isn’t right, it can be a good idea to start by asking yourself these questions:

• Are there signs that something might be wrong? What are they?
• Is it becoming harder to keep my emotions under control?
• Am I or is a loved one at risk for self-harm or suicide?
• Am I or is a loved one at risk for violence toward others?
• Would it be helpful to consult a healthcare professional?

If the answer to these questions is yes, this may be a sign that you would benefit from consulting a professional.

Where Can I Find Help?

Once you decide to seek professional help, there are many types of providers who can assess and treat your condition. It’s important to determine what kind of mental health care professional is best suited for you or your loved one. You may want to consider different types of providers before settling on one.

As an initial step, it's a good idea to begin with an evaluation with a general psychiatrist or psychologist. These individuals will usually conduct a thorough diagnostic interview. They may offer you treatment or they may refer you to another mental health professional.

• Learn more about the treatment programs offered in the Department of Psychiatry at Mass General.
• Learn more about making an appointment in the Department of Psychiatry.

Things to Consider When Selecting a Provider

When searching for a provider, there are a number of things you may want to consider:

• Does the provider accept your insurance? Many providers in private (independent) practice accept limited or no insurances
• Group practices and community clinics can be great options, as they frequently accept many types of insurance and may be easier to access
• What is the provider’s area of expertise? For example, different providers may specialize in a specific age group, psychological disorder, etc.
• What is the provider’s treatment approach? For example, you may benefit from a particular type of treatment such as cognitive behavioral therapy (CBT), dialectical behavioral therapy (DBT) or mindfulness based interventions
• Are there characteristics of the provider that may be important to you? (e.g., gender, racial or cultural background, sexual orientation if known, etc.)
• If you want to receive both medication management and psychotherapy from the same provider, you will need to find a psychiatrist or psychiatric nurse practitioner who also practices psychotherapy. In general, so-called “combined treatment” is not available in most health systems, including in our department, but it may sometimes be offered in private practice settings

Types of Care Providers

There are many types of mental health professionals offering a broad variety of treatment approaches. Licensing and certification requirements for these professionals vary by state, province or country.

Psychiatrist

Credentials: MD

A psychiatrist is a medical doctor who specializes in the diagnosis, treatment and prevention of mental health conditions. Training requires a medical degree, followed by an internship, usually in general medicine, and then residency training in psychiatry. Some psychiatrists specialize in treating certain age groups, while others specialize in a particular condition or type of treatment.

Psychiatrists may prescribe medications, provide talk therapy or both to their patients.

Psychologist

Credentials: PhD, PsyD, EdD, MS

A psychologist assesses and treats emotional, behavioral and learning problems. A psychologist has typically earned a doctoral degree (usually a PhD) in psychology, although some have a master's degree in psychology. Some psychologists provide talk therapy and may specialize in certain types of therapies such as cognitive behavioral therapy (CBT) or interpersonal therapy (IPT). Others specialize in evaluating learning and behavioral issues that can affect academic and work performance.

In most US states, psychologists are not authorized to prescribe medications.

Social Worker

Credentials: MSW, LCSW, LICSW, ACSW, LCS, DSW, PhD, CCSW

A social worker helps individuals, families and communities to overcome challenges and improve emotional health and daily functioning by providing counseling. Social workers also help identify appropriate community resources and support systems. A social worker has an advanced degree in social work and may have received additional clinical training in mental health care. A licensed clinical social worker (LCSW or LICSW) has completed additional training and is qualified to conduct psychotherapy and diagnose mental health disorders.

Social workers cannot prescribe medication.

Psychoanalyst

Credentials: MD, PhD, MSW, LICSW

A psychoanalyst may be a psychiatrist, psychologist, social worker or, in certain states, even a lay individual. Psychoanalysts complete specialized training in addition to their medical, psychological or social work studies. Psychoanalysts focus on helping individuals understand and address the unconscious factors that may create unhappiness or difficulties in work or relationships. Treatment is typically intensive with psychoanalysis sessions four to five times a week.

Licensed Mental Health Counselor

Credentials: LMHC, LPC, LCPC

Licensed mental health counselors have a master's degree in counseling or a closely related discipline, plus post-master's clinical work under the supervision of a licensed or certified mental health professional. Counselors offer a variety of services to individuals, couples and families, including assessment and diagnosis, psychotherapy, treatment planning, crisis management and prevention programs.

Advanced Practice Registered Nurse

Credentials: APRN, APN, ARNPP, MHN

Advanced practice registered nurses (APRN) have a master's degree in mental health nursing and are eligible to be licensed as therapists. APRNs may perform the function of a psychotherapist, educator or advanced case manager.

These nurses are authorized to prescribe medication in certain states, usually under the supervision of a medical doctor.

Substance Use Counselor

Credentials: NCAC, MAC

Substance use counselors are trained to prevent and treat problems relating to drug or alcohol use disorders. They have typically received training in a certified training program, and a master's degree is required in most states. Some substance use counselors are themselves recovered substance users and may share their personal experiences with their clients. This practice differs from that of other mental health professionals, who typically do not disclose detailed information about their personal lives.

Other mental health professionals such as psychologists and psychiatrists may also work in the substance use disorder field, either as therapists or (in the case of psychiatrists) as psychopharmacologists who prescribe medications.

Marriage and Family Therapist

Credentials: LMFT, MFCC

These professionals specialize in working with families and couples to provide psychotherapy. Marriage and family therapists evaluate and treat emotional and behavioral disorders. They can also address relationship issues within the context of the family system. They have a graduate degree (either a master's degree or doctoral degree) and clinical work experience.

Other Care Providers

In addition to conventional therapy approaches, many other choices for alternative approaches exist, including:

• Art or music therapy
• Osteopathy
• Homeopathy
• Neurofeedback
• Acupuncture or massage
• Reiki

Some of these alternative practitioners are subject to licensing and some are not. Likewise, some of these practices have specific degree programs associated with the discipline and others do not. It's generally a good idea to research alternative care providers carefully before embarking on a lengthy course of treatment, particularly as alternative treatments are often not covered by insurance.