Therapy FAQ

I have this idea for a blog. It would be called "Ask A Shrink," and the point would be to demystify psychology and psychotherapy. No one knows what happens in therapy except people already in therapy. Here's my beginning FAQ about therapy.

1. What's the difference between psychiatrists and psychologists?
Psychiatrists are M.D.s - medical doctors - who specialize in psychiatry, like others specialize in surgery or internal medicine. They can prescribe medicine. Some, but not all, also do psychotherapy. Most manage medications and send patients to someone else to do the therapy.
Psychologists have Ph.D.s., not M.D.s - they can't prescribe meds (yet - there's a move to get prescription privileges). If they're Clinical Psychologists or Licensed Psychologists, they also have a state license to practice. Some of the experience requirements vary from state to state, but the test they take to get licensed is a national test.
Each state also has its own brand of masters-level clinicians. Licensed Clinical Social Workers (LCSW), Licensed Professional Counselors (LPC) and Marriage and Family Therapists (MFT) all do psychotherapy, too. The requirements vary from state to state although LCSWs are pretty standard, and MFTs are trying to standardize across the nation.
BTW, as far as I know (will be googling this soon, I suppose), all states have some sort of master's license, but in some states you don't actually need a license to practice psychotherapy.


2. Does going to therapy mean I'm crazy?
No. In the field, "crazy" means psychotic. Psychotic means someone has broken with reality - they're either seriously delusional or having hallucinations. Many of us in private practice don't see those with serious psychoses.

3. What do people do in therapy?
In a nutshell: They talk about what's bothering them. They get almost an hour to focus on themselves, and they get someone else to listen carefully and reflect back and ask questions. This process helps people think through whatever's bothering them.

4. Why is it so expensive?
Because just like you, we have to make a living. Personally, I wish I could charge depending on how difficult the case/client is. Some would be over $200, some would just be $50, maybe. But given the time I take on each case and the paperwork involved, I probably average about $30/hour.

5. Why are you guys so guarded about it?
Because the last thing we want to tell people in a social setting is what we do for a living. Want to make a group of people at a party nervous? Tell them you're a psychotherapist.

6. Do therapists really sleep with their clients?
Not the ethical ones who want to keep their license. It's very much against the ethical code. In a big way. Unfortunately, it does happen, as evidenced by the disciplinary action listings in my professional magazines. Makes me crazy that it's as prevalent in the movies as it is.

7. How do you sit and listen to people's problems all day long?
I'm not just listening to their problems, I'm listening to their stories. Everyone has a story. And fortunately, I think the human mind and how it works is fascinating. Also, not everyone is in crisis at once. That helps.

OK. Those are the general ones I can think of right off the top of my head. Can anyone think of any more? Shoot.