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How to Choose a Child Therapist

This website offers free information to help educate families how to obtain scientifically-based therapy that has the best chance of working to reduce youths’ symptoms.  This site is a free public service.  We do not offer any specific program of therapy, or a specific group of therapists.  However, we have information below to help you make decisions on how to select a therapist who will be most likely to use treatments that have been proven to work scientifically.    

Many professionals claim to offer psychotherapy, but it is up to you to pick a therapist who is best for your child.  It is critical that you read the information below and “interview” your potential therapist accordingly.  Below, we have provided a list of directories that may help you locate a therapist in your area.

Short Answer?

Make sure your child's therapist is trained in the most current, scientifically-based approaches to psychotherapy, such as cognitive-behavioral therapy and interpersonal psychotherapy. In addition to psychologists from traditional training programs (PhD), psychologists from other programs (PsyD—see a description of differences below), and various other mental health providers, such as school psychologists (Ed.D or M.Ed.), social workers (MSW, LCSW), psychiatrists (MD or DO), licensed professional counselors (LPCC/LPC) or marital-family therapists (MFT) may also be good options depending on their experience with scientifically-based approaches. Do your homework on what type of therapy a provider will offer before establishing an evaluation appointment. Read below for more information.

What to Look For in a Therapist

Do they have a license to offer mental health treatment?

Be careful! In many states, almost anyone can call themselves a "child therapist" or a "child counselor," even without any type of relevant training. But only some are licensed to provide mental health treatment, and it is critical that you and your child get treated by someone with a license to do so. Make sure that the person you choose has the official credential of a "licensed psychologist," a "licensed psychiatrist," a "licensed social worker," a “licensed counselor” or a “licensed marital and family therapist.” Note that a license, although important, does not guarantee the person will have a background in the most evidence-based  approach for your child. A license can be thought of as a necessary but not sufficient credential.

Licenses are regulated by the state government (e.g., the Office of Professional Regulation). A very thorough and careful review is conducted by the state government to make sure that someone applying for a license has appropriate training in higher education, follows the ethical code of their profession as well as state law, and in many, but not all states, gets ongoing training (i.e., "continuing education") to encourage them to keep up-to-date with the latest developments in the field. By the way, if you feel that your mental health provider has acted inappropriately, then you should inform the relevant state licensing board immediately.

Are they a psychologist, a psychiatrist, social worker, marriage and family therapist or something else?

Licenses are given to members of several types of mental health professionals: psychologists, psychiatrists, social workers, counselors and marital/family therapists. Here is some information on the training differences of therapists working in these different professions.

Psychiatrists attend medical school and receive a medical doctor (MD) or doctor of osteopathy (DO) degree. They receive some training in mental health issues during their four years of medical school, then complete a psychiatry residency for four years after medical school. Child and adolescent psychiatrists either complete an additional two-year fellowship working with children or complete a combined five-year adult/child-adolescent training program. Psychiatrists are trained primarily in the biological bases of mental disorders, as well as in their biologic treatments (usually medications, but also often includes phototherapy, electroconvulsive therapy, and other brain stimulation strategies). Some training in psychotherapy is provided, but training in pharmacotherapy is more extensive. Appointments with psychiatrists may be brief (15 to 30 minutes) and often focus on monitoring children's reactions to psychotropic medications. If you believe your child would benefit from medication, seeing a child and adolescent psychiatrist is recommended. Of note, many primary care physicians (e.g., pediatricians, family practice doctors) routinely treat ADHD as well as uncomplicated cases of depression, anxiety and developmental disorders. Developmental-behavioral pediatricians (pediatricians who have completed a fellowship in developmental disabilities) often see children with autism spectrum disorders and other developmental disorders, particularly when the child has a co-occurring psychiatric problem (i.e., comorbidity - more than one diagnosis).

Social workers, counselors and marital/family therapists typically have a master’s degree (obtained in a 1 to 2 year training program) and must have additional supervised experience to become licensed.  Training programs vary widely in their focus; it is important that you find a therapist who has experience working with the types of problems your child is experiencing. Just like PhD-level psychologists, some masters-level clinicians have significant training in scientifically-based approaches, whereas others have virtually none.  

Psychologists attend graduate school training programs to obtain a doctoral degree (a Ph.D. or Psy.D. degree; see below for a discussion of the differences between these two options). Throughout all four or more years of graduate training, a one year full-time pre-doctoral internship, and usually an additional 1-2 years of post-doctoral clinical experience, a licensed psychologist receives extensive training in how to conduct psychotherapy. In some limited settings, psychologists might prescribe medications, however, psychologists generally receive more intensive training in conducting psychotherapy (and conducting psychological evaluations) than any other mental health professionals. For these reasons, many parents choose a clinical child psychologist as their child's psychotherapist. It is important to note that psychologists vary extensively in their use of scientifically-based approaches. Just as with other types of therapists, it is important to ask about the type of approaches a given psychologist uses.

What's the difference between a clinical child psychologist, a counseling psychologist, and a school psychologist?

The vast majority of psychologists who work with children are clinical child psychologists. Counseling and school psychology are related fields, however, and may be relevant for your child's difficulties.

Counseling psychologists are typically trained to deal with issues that are common to most people's lives (i.e., career planning, relationship disputes and family issues, stress and coping). If your child is experiencing some general adjustment difficulties, you might be interested in seeing a counseling psychologist. In some cases, counseling psychologists may have additional training in scientifically-based approaches for psychological problems in children.

School psychologists typically work in school systems, and provide an essential role in conducting psychological evaluations for children in need of special school services (note: clinical child and counseling psychologists also are trained similarly to conduct such psychological evaluations). Some school psychologists also may conduct psychotherapy with children who are experiencing difficulties at school, or work with teachers to implement behavioral programs (for children with ADHD or ASD, for example) in the classroom.

Clinical child psychologists are trained to treat children who are experiencing significant psychological symptoms that interfere with their ability to lead happy, successful lives. If your child experiences some of the symptoms that are listed on this website, then you likely want to see a clinical child psychologist. (Note: children who experience medical health issues as well as mental health issues may benefit from seeing a specific type of clinical child psychologist, referred to as a "pediatric psychologist" or "child health psychologist"). As with other types of therapists, it is always important to ask a child psychologist to what degree he/she uses scientifically-based approaches because this varies across practitioners.

What type of degree do they have: Ph.D. or Psy.D.?

If you are looking for a clinical child psychologist, you will notice that some have a Ph.D. degree, and others have a Psy.D. degree. These are both doctoral degrees, but the training for each can be quite different.

Psychologists who receive a Ph.D. or Psy.D. from a traditional University often receive thorough training in the most current scientific findings regarding 1) the factors that cause and maintain psychological symptoms; and 2) the most effective treatments to help reduce children's psychological symptoms. Ph.D.s and University-based Psy.D.s are trained in programs that usually emphasize the importance of both the science and practice of clinical psychology.

Incidentally, clinical psychology Ph.D. and University-based Psy.D. programs have the most competitive admissions processes of any type of graduate programs in any field. It's harder to get into a clinical psychology graduate program than it is to get into medical school, law school, or any other type of higher education profession. Ph.D. and University-based Psy.D. programs typically accept a small percentage of all applicants to their programs and focus on individualized training.

Some psychologists are trained at Psy.D. programs housed in “for profit” institutions, which generally do not emphasize the connection between science and practice seen in Ph.D. and University-based Psy.D. programs. Many of these "schools of professional psychology" have a different admission and training process, and accept upwards of 50-100 students each year. The academic credentials (e.g., standardized test scores and GPAs) of these admitted students are, on average, significantly lower. In summary, not all therapists with doctoral degrees are trained in the same way or with the same rigor. This is true for professionals in Ph.D. and Psy.D. programs. Thus, as with master’s level clinicians, consider a degree a starting place for your assessment of a given therapist not the end point.

Are they board certified?

Some clinical child psychologists are board certified. After providing psychotherapy as a licensed psychologist for a few years, clinical child psychologists may apply for Board Certification from the American Board of Professional Psychology (ABPP). You will know who is Board Certified by the letters after their name. "ABPP" means that they are Board Certified, for example, Jane Smith, Ph.D. ABPP. A Board Certified psychologist has met extremely rigorous criteria establishing their expertise in the specialty area of clinical child and adolescent psychology, as determined by the American Board of Clinical Child and Adolescent Psychology (ABCCAP). Board Certification in clinical child and adolescent psychology is relatively new, so you won't find too many people who are Board Certified yet. But if you do, then this person should be well trained, and may be an excellent match for you and your child.

Be careful, as there are some unofficial "board certifications" out there. Some people will say that they are Board Certified by a different board of professional credentialing. However, only the ABPP meets criteria that state licensing boards and the American Psychological Association recognize. Other “vanity certifications" are confusing to the consumer—so don’t be afraid to ask!

What is their approach to treatment (i.e., theoretical orientation)?

This site outlines the types of treatment that are supported by scientific evidence (i.e., evidence-base treatments) for many different types of psychological symptoms that children and adolescents may experience. However, not all psychologists (or other mental health professionals) have been trained on how to provide these specific types of treatments. Therapists often refer to their approach to treatment as their "theoretical orientation." You should ask a potential therapist for your child about his/her theoretical orientation and familiarity with the treatments listed on this site related to your child’s difficulties. If they mention an orientation listed as evidence-based on this site (e.g., "cognitive-behavioral," “interpersonal psychotherapy’), this suggests they will be familiar with the well-established therapeutic approaches listed on this site. If they mention a theoretical orientation not mentioned on this site, then they might not be familiar with these treatments, and your child may not receive  treatment that has been shown  to work.

Due to their ethical standards, psychologists are not allowed to provide therapy in an area in which they are not trained. If you ask them whether they are trained in a specific type of treatment, they must be truthful according to the Ethical Guidelines for Professional Psychology. So, feel free to be direct in your questions, and don't accept wishy-washy answers! If a therapist tells you that they are 'familiar with some aspects of the treatment,' or that they use 'an eclectic, integrative approach that uses features of different treatments," then they might be really saying, "No, I don't know that treatment or how to provide it."

Use the same expectations you have for your child's pediatrician. The psychologist should be able to tell you what your child's diagnosis is, what the treatment options are, why they are recommending a specific treatment, how they think that treatment will reduce your child's symptoms, and what the plan is for determining whether the treatment is working. If you don't like what you hear - get a second opinion!

Where did they train?

Check on where your child's potential therapist received her or his  doctoral, internship and postdoctoral training. You may not recognize the names of some of the schools you hear, but you can do a little research to learn more about high quality  training programs. For instance, if you visit www.appic.org, you can learn the acceptance rate into APA-approved clinical internships for various doctoral programs. You will probably want your child to see a therapist who trained at a well-regarded institution.

Additional Suggestions for Finding a Therapist

  1. Ask other parents you trust, or your child’s teacher, for referral suggestions, but then follow the guidelines also listed above. You can also check www.abct.org for practitioners in your area.
  2. Be leary of prices that seem out-of-keeping with what others in your area charge.
  3. If you hear claims of “cure,” be sure to check into the credibility of the claim (e.g., ask how many people have been treated, what s/he means by ‘cure,’ and check whether the treatment is listed on this site. Extreme claims about treatments not listed on this site should be viewed with caution).

Where can I find a therapist in my area?

There are several directories available to find therapists who may offer evidence-based practice.  

The Association of Behavioral and Cognitive Therapies is dedicated specifically to scientific approaches to treatment.

The American Board of Professional Psychology includes child and adolescent therapists with Board certification.

What if my first choice therapist is unavailable, or I cannot find many choices?

If you cannot find a therapist in your area, or if the person you have identified is not able to accept you as a client, be sure to ask them for their recommendations for someone who practices one of the approaches listed on this website.  Most therapists will be able to offer you several phone numbers readily.   
 

 
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