THE OTHER SIDE OF THERAPY
Things You Might Not Know
A licensed mental health therapist or counselor may have one or more titles. They may be a psychiatrist, psychologist, clinical social worker, licensed professional counselor, licensed marriage and family therapist, or a nurse practitioner with a specialty in mental health care. The ways therapy is conducted overlaps among the profession, yet differs in others.
Psychiatrist and nurse practitioners are the only ones who can prescribe medication, except in a few states where psychologist with additional training can also prescribe certain drugs for mental health care. Mississippi does not allow psychologist to prescribe medication.
A psychiatrist has a medical degree in addition to the additional training in psychiatry. A nurse practioner holds a masters in nursing, with additional training in mental health.
In order to use the term "psychologist", one must earn a doctorate in psychology, do an internship, and sit for national and state license exams. This process takes at least eight years, but usually several more past high school. Psychologist often have additional training in psychological testing.
Clinical social workers, licensed marriage and family therapist, and licensed professional counselors can become licensed for practice after completing a master's degree and an internship. This can take six to eight years, post high school. Some with these license go on to complete a doctorate in their field, adding time to their training.
Once one becomes licensed, the education is not over. Each professional must continue their training by doing continuing education to stay current with treatment techniques and ethical concerns. And, each must follow the standards set by their board. This is one reason to always seek out a licensed professional.
In this state, Mississippi, in addition to traditional licensed therapists, mental health centers and the state hospitals have their own "license". This is for those who may not meet the requirements for the traditional boards. And, in some cases in such agencies, therapists are allowed to practice with a lesser degree or no license, but under the supervision of a licensed therapist
Building a practice requires dedication and persistence. While we would like to think that we can "build it and they will come", it is not that simple. After renting office space and furnishing it, marketing becomes a major part of what a therapist does until people learn who they are and what they do. Building a practice, for some, may take years before they can have a comfortable income. Many "new" therapist do private practice in additon to a salaried job until they build up enough to turn loose of the security of a salary.
If a psychologist does testing, it is not uncommon to spend five to ten thousand dollars on materials to do the tests to start, then update when new versions come out. Each test booklet adds an expense, as does some of the scoring for these tests.
Therapist often talk about the "ebb and flow" of practice because the phone might not ring for days, then suddenly "ring off the wall". Also, holidays, inclement weather, and illness plays a role in whether the therapy calendar will be full. Vacations, sick days, bad weather, conferences, etc. are unpaid days for the therapist.
If you have seen a therapist in the past, you might have been asked to provide a credit card number or other method of payment for missed appointments. Now, you may ask why this is necessary. It is because when you make that appointment, you "rent" that block of time. It is held only for you, unlike some medical clinics who overbook and make you sit and wait for hours in the waiting room. If you cancel on short notice or don't show up, there is no income for the therapist for that time period, yet the expenses they incur continues.
Also, by not keeping an appointment, you are denying someone else the opportunity to be seen in your time slot, or the therapist might not have to make the trip to the office at that time of day. Think of it this way: If you were expecting someone to come to your house, you would probably make preparation for them, and be there when they arrived. I dare say that you would be upset if you didn't hear a word from them, and they were a no show. You might even call them "rude" or "inconsiderate". And, you can bet some therapist see it this way too!
Insurance will pay for therapy in some cases. Before calling to make an appointment, it is important to know whether this service is covered, as well as what part you will be responsible for. The deductible amount that you must meet before insurance pays, as well as whether you have a co-pay each week should be determined. And, be aware that if the insurance denies the claim you are responsible for the balance.
You will find some therapist who accept your insurance, then others who work in what is called "out of network". If the therapist is out of network, you will be expected to pay the full fee at the time of service, then submit a receipt to your insurance company for reimbursement. If "in network", you pay the co-pay at the time of service. There are several reasons that therapist may choose to not accept insurance. If you have questions, most will discuss this with you.
And, speaking of insurance, it is important to know that when you use your insurance for mental health care, a diagnosis is given. And, your insurance company may require that your clinical notes be reviewed by them. You give up some of your privacy when you use insurance, thus, many prefer to forgo using it.
Often people ask how long therapy will last. Sessions are usually from 45 to 60 minutes. New standards, set in place at the national level set these times at the beginning of 2013. Thereapist are now finding that some insurance companies will only pay for the 45 minute time. Sessions are usually held weekly. As to the number of sessions one will need, that depends on several things, including nature of problem and how the person responds to therapy.
A therapist work is not done when the list of people to be seen is finished for the day. A treatment plan is developed when therapy begins, and this is followed by notes following each session. Reports and test scoring can take hours to do. It is fair to say that an additional 20 to 25 per cent of a therapist work is done after clinic hours with "paperwork" chores and phone calls.
Some come to therapy with reservation, while others come eager to resolve issues of concern. If you are hesitant to make that call, just remember that, if you seek out a licensed thereapis they are well trained to help you, and they understand your reluctance. If you are nervous to make that call, don't be because you will find a well qualified, caring person at the other end of the line.
If I can help you, just give me a call. I choose to work afternoons to allow those who are in school or work an opportunity to be seen after normal clinic hours.
Dr. Nona Owens
580 Springridge Rd.
Clinton, Mississippi, 39056