How to Find a Psychologist
Maybe you have wavered, questioning, “do I or don’t I need professional help for my mental health concerns?” Maybe you have been in “talk” therapy for a while, but you are feeling like there is stagnation or less progress than you expected; now, you want to try therapy that may be more targeted to your specific needs and helps you build skills. Maybe you want to know if you have a mental health disorder and you want to understand what type of treatment or supports could likely help.
You have decided you want to work with a clinician, but there are so many different types of practitioners out there. How do you know who to see? The answer is complex: It depends on what your concerns and goals are.
I may be biased, but often I recommend seeing a psychologist if
you have tried therapy before but felt your symptoms did not improve or felt like your difficulties worsened.
you have been struggling but you are not sure what might be causing your challenges (if you want diagnostic clarity and specific recommendations for help)
you have severe symptoms or a combination of challenges
Psychologists are mental health experts with advanced training in assessment and treatment. You are now needing to sort through a sea of psychology practitioners to find the “right” one. How do you know if they will be the right one for you? What is important in determining who to contact?
Therapy and assessment are not one size fits all. Every client brings a lifetime of experiences that shape who they are going to work with best. Some people want a more directive psychologist, others may be better with someone who guides but does not tell them what to do. And still others may want something in-between.
Finding the right psychologist for you can, unfortunately, involve a little trial and error. But because services are so expensive and often private insurance coverage is limited, and because it can take time to even get a first appointment, it would be nice to minimize the error.
What Makes a Good “Fit” with a Psychologist
and Why is it Important?
There are lots of factors that play a role in what we call “goodness of fit”—the idea that the client and the therapist have a good “therapeutic alliance” (a good relationship or bond). When there is not a good alliance with your psychologist, you are less likely to reap the benefits of services. Poor alliance predicts:
withholding deeply personal information
dismissing or not buying in to strategies or ideas to try outside of therapy
not sharing about pitfalls, barriers, or when strategies are not useful
stagnation or worsening of symptoms
missing appointments
You Won’t Hurt My Feelings: Some clients continue with a practitioner, even though they know it is not going well—they are not getting what they need (goals are not aligned) or they just generally do not like something about the provider. I know I am not every potential client’s cup of tea, and that is okay: My ego can handle it when a client opts out of working with me—in fact, I welcome clients to share those insights because I want to see people find a good fit and get the full benefit of services.
What are the Differences Between
Other Mental Health Practitioners and Psychologists?
It can be quite complex to navigate all the different types of clinicians. Programs that train clinicians can emphasize different skills and knowledge. Some programs have very high, strict standards for applicants, with very low acceptance rates; often those programs also have strict standards for graduating from the programs. This is not true of all educational pathways. Accreditation of the graduate school a practitioner attends is also an indicator of the quality of training. Programs that are accredited must adhere to a high standard, providing both breadth and depth of education and training that meets a national standard.
Some practitioners are limited to providing psychotherapy.
Other practitioners may provide psychotherapy and diagnostic assessments.
Therapy: There are a range of practitioners with various types of degrees and training experiences who can provide psychotherapy. Certain degree programs train clinicians to work with clients who may have more complex or severe concerns; typically, this is characteristic of accredited clinical psychology programs.
Assessment & Diagnosis: Physicians, nurse practitioners, psychiatrists, and psychologists can diagnose mental health conditions. In Ontario, nonmedical practitioners or mental health practitioners who are not registered with the CPBAO cannot assess and diagnose. Communicating a mental health diagnosis is a controlled act that requires substantial training and experience. Those without the licensing to permit them to communicate a diagnosis can be fined up to 25k per offence.
A Sea of Credentials:
What Does the Alphabet Soup After a Practitioner’s Name Mean?
Most of the initials refer to degrees and some refer to college registration/licensing. Some also refer to additional certifications that recognize advanced training and peer-reviewed competence.
M.S.W. = Master’s of Social Work
B.S.W. = Bachelor’s of Social Work
M.Div = Master’s of Divinity
M.A. = Master’s of Art (with specialization in Counselling or Clinical Psychology)
M.Sc. = Master’s of Science (in Clinical Psychology)
Ph.D. = Doctor of Philosophy (in Counselling or Clinical Psychology; these programs are scientist-practitioner models that emphasize clinical training and research training)
Psy.D. = Doctor of Psychology (these programs are more clinically focused and require less research training than Ph.D. programs)
Ed.D. = Doctor of Education (in Counselling Psychology)
M.Ed. = Master’s of Education (in Counselling Psychology)
M.D. = Doctor of Medicine
Additional Designations:
“C.Psych.” = Clinical Psychologist, registered with the College of Psychologists and Behaviour Analysts of Ontario
“R.S.W.” = Social Worker, registered with the Ontario College of Social Workers and Social Service Workers
“R.P.” = Psychotherapist, registered with the College of Registered Psychotherapists of Ontario
“CAPDA” = Canadian Academy of Psychologists in Disability Assessment
“CBPP” = Canadian Board of Professional Psychology
“FRCPC” = Fellow of the Royal College of Physicians of Canada
Are There Differences Between Psychologists?
There is no short answer for this. For decades, most clinical psychologists practicing in Ontario were those who completed rigorous doctoral training (Ph.D., Psy.D, or Ed.D.). Few were permitted to register at the master’s level. Traditionally, clinical psychologists were required to complete a level of training on par with physicians - an undergraduate degree plus several years of post-undergraduate education as well as hands on, well supervised training in multiple practicum placements and a year-long residency.
But this is likely changing. Soon, many in Ontario will be able to register as a psychologist at the master’s level. The title of psychologist will no longer automatically convey the same high level of training and rigour Ontarians have come to expect from psychologists for the last several decades. I discuss these changes in another blog on “modernization” of psychology. Ultimately, what these changes mean is the public will have to become more savvy shoppers when seeking psychological services.
These changes to the credentials and experience required to be a psychologist are important because experience and education can also be quite relevant factors related to services.
It is important to be a
careful consumer
of psychological services
What to Look for When Shopping for a Mental Health Provider
1) Therapeutic Relationship (Alliance). One of the most important factors in predicting change is whether you actually like your practitioner. As much as 50% of change can be attributable to the professional relationship you have with your practitioner. This can be more important than any other single factor. Even if you might respect their expertise, if you don’t like them, you’re not likely to benefit as much and you are not as likely to act on the courses of action you discuss with them.
Read their website (and blogs).
Do they seem knowledgable about your concerns?
A clinician who has experience with a particular form of therapy and/or your particular set of concerns, can generally speak to those experiences.
i. Ask your practitioner what their training is in that specific therapy or with your specific concerns.
ii. If their training/experience is limited to a half or full day training session with no supervised experiencing engaging in that service with real clients, then their claimed expertise is questionable.
Do you like the tone and content of what is written?
Are they aligned with you in areas that matter to you? Sometimes there are personal or cultural factors you are looking for in a practitioner. While all psychologists are trained to work with clients regardless of background characteristics, values, religiosity, etc., you may feel more comfortable if certain factors are aligned.
Does the practitioner acknowledge limits of their competence?
Expertise is built on experience and education. It is not possible, even with decades of education and experience, to become an expert in all aspects of mental health assessment and treatment.
Caution is likely warranted whenever a clinician claims to have expertise across the entire lifespan (e.g., someone who sees toddlers through seniors) and for every possible mental health concern.
Consider Obstacles.
What are their fees? What is your insurance limit?
Is the practitioner in-person only, online only, or able to offer either if particular needs arise?
Small inconveniences can become major hurdles.
If working in person, are there concerns about location, accessibility, parking that need to be considered?
What is the practitioner’s schedule and can it align with yours?
Arrange a session (or a few).
Comfort can take a bit of time to build. Keep in mind that sometimes the discomfort of treatment itself in the initial stages might be at play. After a few sessions, if you do not feel you connect with or like your practitioner, it is probably beneficial to work with someone else.
The professional designation of clinical psychologist (C. Psych.) will be changing to apply to a much wider range of people, who will have very different training and education experiences moving forward. I encourage you to make an informed decision about what practitioner is going to best meet your needs. I also encourage you to ask any practitioner you may want to work with for a consult call to discuss their experience and education and get a sense of their approach to working with clients.
Keep in mind, you are in the position to interview psychologists for the privilege of working with you to help you achieve your goals; that is a job you don’t want to hire just anyone to fill.
Lastly, don’t be afraid to change it up if it does not feel like a good fit. More gains happen when you find the right fit.
About the Author, Dr. Ava, in Light of the Above:
I believe I am exactly who you read about on my website.
I am doctorally trained. I attended a program that equally emphasized assessment and therapy (some programs and training placements are not as heavily assessment focused). I base my work on science, using evidence-based approaches to assessment and intervention. My experience and education allows me to work with adolescents and adults. I offer a wider range of assessment than treatment services, focusing on areas of care where I have the requisite knowledge and experience—and I am happy to discuss that experience with you.
Interpersonally, I tend to be empathic and also direct. I will help you with the change you seek by supporting you to do what is hard and uncomfortable but also achievable.
I believe the best interests of people at heart. If my approach is not a match with your needs and we are not a good fit, I will try to provide referral options to help you connect with someone who is a better fit.
