A short course in understanding what mental health professionals do

Sometimes you can almost have too much of a good thing.

That seems to be the case when it comes to mental health professionals. There are so many different disciplines involved, with so many different approaches and with such a variety of titles and credentials, that it almost takes a graduate degree to sort it all out.

Even as a mental health professional myself, I must confess I'm not always totally sure who is doing what and how. Yet, if we're going to get the help we need when we need it, we'll want at least some understanding of the who, what and how of such programs.

With that in mind, this week I'd like to try to sort things out a bit. Following are some very brief descriptions of a number of the mental health disciplines and titles that you'll find in the field (they're arranged alphabetically).

• Chaplain - usually a minister (or a trained lay worker) who has specialized in providing mental health services to individuals and families in a hospital setting. Most have at least one graduate degree and have extensive training in Clinical Pastoral Education. They are normally certified by the College of Chaplains, which has very rigorous standards.

• Counselor - a frequently used, but almost meaningless, term. Anyway, all kinds of people call themselves counselors. In fact, I recently heard a carpet company call their sales staff "counselors" in their advertising. There are also a number of less-than-reputable people who offer mental health services as counselors, yet have little if any training to deliver what they offer.

On the other hand, there are people who use this title who have graduate degrees in counseling and are well qualified to provide mental health services.

So, when you see the title "counselor," check for other, more specific, credentials. In Illinois, a state license - Licensed Clinical Professional Counselor - is required to provide mental health services using the title "counselor."

• Marriage and family therapist - a professional who has specialized training in understanding and helping troubled relationships.

Such people are usually trained to work with individuals as well. The largest national certifying body is the American Association for Marriage and Family Therapy, which requires that its clinical members have earned at least one specialized graduate degree in marriage and family therapy.

Members also must have received extensive supervision of their work for a number of years. Illinois also requires such practitioners be licensed as Licensed Marriage and Family Therapists.

• Pastoral counselor - a minister who has specialized in mental health. At least one graduate degree is required; many have two (in both a theological and psychological discipline).

The largest national certifying organization is the American Association of Pastoral Counselors, which grants membership only after exhaustive training and supervision.

• Psychiatric nurse - a registered nurse who has specialized in mental health. Psychiatric nurses generally have a bachelor's degree in nursing and additional training and experience working with troubled individuals and families. Many have also gone on to earn an additional graduate degree in one of the mental health disciplines.

Psychiatric nurses work in both hospital and outpatient settings. Those with advanced training often provide psychotherapy. Certification for psychiatric nurses is granted by The American Nurses Association.

• Psychiatrist - a licensed medical doctor who has done additional training in mental health, most often "psychopharmacology" (the use of drugs to treat certain, usually more severe, emotional or cognitive disorders).

Psychiatrists may or may not have training to provide psychotherapy. Psychiatrists are generally accredited by the American Psychiatric Association, which monitors their training and practice.

• Psychoanalyst - a person, usually a psychiatrist, who has specialized in a particular school of psychotherapy - Freudian. Analysis is usually longer in duration than other approaches and involves only one person.

• Psychologist - an individual with a graduate degree in psychology. Some psychologists do only testing (I.Q. tests), while others specialize in research and teaching. Clinical psychologists have specialized in assessment and psychotherapy, are usually licensed by the state, and generally belong to the American Psychological Association, which sets standards for training and practice.

• Psychotherapist - a generic term that can encompass the work of any person in the field. Though less misused than the term "counselor," it is still a good idea to check for additional credentials.

• Social worker - generally a person who has received a master's degree in social work (though some persons have received a bachelor's degree in social work, or a graduate degree in a related field, and can call themselves social workers if they meet certain standards).

Though social workers are trained in a number of areas (child welfare, public aid, school social work), many have specialized in counseling and psychotherapy (often called clinical social work).

Certified social workers have practiced for a set number of years and passed a state exam. The Academy of Certified Social Workers is the national organization that credentials such advanced social workers. Illinois offers a Licensed Clinical Social Worker for this professional focus.

Confused? It can be more than a bit difficult to sort all these titles and credentials out. In choosing a mental health professional to work with, however, the guidelines are a bit simpler.

1. Start by asking people you know who they would recommend (you'd be surprised how many people have used or are using the services of a psychotherapist). This might include asking a minister or priest you trust, or asking your family physician.

2. Check out training and credentials. Generally, look for someone with graduate education and clinical training and supervision. Also, look for certification by a national certifying body.

3. Schedule a few initial sessions (three or four is often sufficient) to get to know a therapist. Therapy is a relationship; it is important that you are comfortable with and trust the person you are working with. And don't be hesitant to try another therapist if the "fit" doesn't seem right.

It has been suggested that, during the course of a lifetime, almost all of us will seek out the services of a mental health professional. I hope that this "short course" in the field will help you when that time comes for you.

• Dr. Ken Potts is on the staff of Samaritan Counseling Center in Naperville and Downers Grove. He is the author of "Mix Don't Blend, A Guide to Dating, Engagement and Remarriage With Children."