The many faces of psychotherapy…

Given what is going on with legislation on a state level in NY state, (see my earlier post about signing the petition), it seems timely to clarify terms for people less familiar with the field of psychology and psychotherapy. I hope this will be helpful information about the different types of healers , doctors, and therapists out there and the kind of choices you have, as well as how these separate paths to becoming a healer are viewed by American society…
People of course often ask me what I do and what is art therapy.
Some of this blog has involved giving people an idea of the scope of the work of an art therapist in private practice, but the blog has also provided an opportunity for me to write about all kinds of topics ranging from psychology  and related issues to cultural diversity and rituals. I even posted on here about Facebook and other random topics like the healing power of companion animals and ways lawyers sometimes occupy therapeutic roles…
As I said, I will focus on New York state also because the treatment you find varies from state to state as does health insurance. I actually think that licensing and credentialing should be on a national level, so as to avoid the kinds of conflicts between different kinds of psychotherapists that are going on right now with this Proposition issue that I just posted about…
Psychiatrists and Psychopharmacologists are usually the only therapists with an MD. It used to be that only a psychiatrist, nurse practitioner or primary care physician could prescribe “psychotropic medications.” However that has changed since just recently. I think at the moment, only in New Mexico can psychologists with a doctoral degree also prescribe medications. See this article on the NAMI website:
Whether it’s a good idea or not for doctoral psychologists to prescribe medication is a very controversial topic…
Anyway, back to the point about psychiatrists and nurse practitioners. Many people prefer to have a psychiatrist just as a “Psychopharmacologists” to prescribe their medication and check in with him or her once a month or every 2 months once that know what medications are helping them and working. An appointment with a psychiatrist in this role could range from 15 minutes to 45 minutes depending in the doctor. Many psychiatrists also have patients that they see weekly or twice a week for therapy. Some psychiatrists also have formal training in psychoanalysis and/or other fields. This leads to the term, “primary therapist” when there is a clinical team involved (mostly at clinics and other outpatient services.) In private practice it is usually that you see your primary therapist once or twice a week and your psychiatrist monthly. Also nurse practitioners sometimes specialize in psychiatry and also prescribe medications. I know a nurse practitioner who is also a psychoanalyst and works in private practice. In fact, many clinicians have more than one kind of training or license…
So thus as a licensed Creative Arts Therapist, I have some patients who also see a psychiatrist or nurse practitioner but consider me to be their “primary therapist.”
Many people who seek treatment through some form of psychotherapy or other kind of therapy do not take any medications at all. They have a wide range of choices in terms of the type of therapist they want to work with. Ultimately, people often choose their therapist based on how they feel about the person rather than his or her training. Students will often choose a therapist trained in the field they are studying.
In New York state, most kinds of therapists cannot now practice without a license. Licensed Social workers actually have two licenses. The first one they receive after grad school in social work when they pass the first of two licensing exams. The first one makes you an LMSW, Licensed Masters Social Worker, and the second one involves many supervised hours of work and another exam to become an LCSW, Licensed Clinical Social Worker. To be in private practice social workers have to have a certain amount of experience and an LCSW.
Most people put a whole bunch of letters after their name. Usually for masters level clinicians (those whose highest degree is a masters degree, the first is their masters degree, such as MA or MPS, Master of Art or Master of Professional Studies, and the next is either other credentials or the kind of license they have. For art therapists, for example, the first credentialing post masters degree is the “ATR”, which stands for Registered Art Therapist and then if the person is Board Certified it is ATR-BC. LCAT is the term for Licensed Creative Arts Therapist and includes a variety of kinds of therapists, including art therapists, dance therapists, poetry therapists, music therapists and drama therapists. I am not certain whether “expressive arts therapists” are included. Anyway, if you just see “LCAT” after someone’s name, you will not know which is their “modality” in which they work.
Dance therapists: “There are two different credentials offered by the Dance Movement Therapy Certification Board, Inc: the Registered Dance/Movement Therapist (R-DMT) credential and the more advanced Certified Dance/Movement Therapist (BC-DMT). A BC-DMT can provide training and work in private practice, while an R-DMT can work only in a clinical or educational setting and cannot provide training. To earn the BC-DMT, several thousands of hours of clinical experience are required.”
A drama therapist will have the initials RDT, LCAT, meaning Registered Drama Therapist. A music therapist will have MT-BC, which means s/he is Music Therapist-Board Certified. Poetry therapists are “Certified Poetry Therapist (CPT) or Registered Poetry Therapist (RPT).” The difference between these two credentials is that I think the RPT has more advanced training than the CPT…
There is another term called “psychodrama” therapy, which is not the same thing as drama therapy! Psychodrama is usually a group modality involving a lot of intense role play. It seems the credentials are “national certification offered at two levels: Certified Practitioner (CP) or Trainer, Educator, Practitioner (TEP).” It appears that Psychodramatists are included with Creative Arts Therapists: The New York Coalition of Creative Arts Therapists (NYCCAT) is an association made up of professionals from the field of Creative Arts Therapy including Art Therapists, Dance/Movement Therapists, Drama Therapists, Music Therapists, Poetry Therapists, and Psychodramatists.,but I am not sure if there is a separate License for psychodramatists, as usually they are trained in another field and have another license, which makes figuring out credentials confusing…
Licensed Psychoanalyst, (LP). New York State also now recognizes Psychoanalysts as being capable of being licensed practitioners without need of any other license. Psychoanalysis is difficult to describe as it varies so much depending on the training program the clinician completed. Examples include the Jungian Institute, NPAP, IEA (Institute for Expressive Analysis), the White Institute and many others. Most of these programs are very rigorous and the students often have extensive training in other areas: many are social workers, mental health counselors, creative arts therapists, even psychiatrists. Psychoanalysts have many years of post graduate study and usually an oral and written presentation of a case study as well as years of supervision and required analysis 2 or more times per week. So if you find an institute where the fee is low to work with a student, do not dismiss the person as too inexperienced as for example, I have a colleague who has an LCSW and an LCAT who is training to be a psychoanalyst.
For more specifics on the history of psychoanalysis and what they actually do, see this link:
Then there are psychologists who are either PhD or PsyD, which are two types of doctoral programs, the first placing more emphasis on research and the PsyD on other aspects of the discipline, but I’m not too clear on this and am myself confused as I see coleagues who are getting one or the other for various reasons. Well it seems I do have the general idea as those with a PsyD focus more on clinical work whereas a big component of the PhD involves resarch, however lots of psychologists who are PhD focus on clinical work in private practice. A psychologist with either degree has what’s called a doctoral degree, which is much more advanced than just a master’s degree. Also, you may see them referred to as Dr. Jane Smith, PhD. This does not mean they are a medical doctor but that they have a doctorate.
More to say… to be continued.
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