Looking for a therapist with a master's? PhD?

November 26, 2014 12:19 PM

Does it make much difference whether my therapist has a PhD or just a master's?

I have had some unexceptional experiences with therapists years ago, but I want to start going again. The purpose is to work on anxiety, depression, and other issues. Does it make sense to limit myself to someone who has a PhD?

Obviously there are other questions to consider: psychoanalytic vs CBT, personality/individual chemistry, or price, for example. (And price is an issue, which makes me think it's probably more likely a master's level therapist would be cheaper). However, given that the problems I will be bringing up are relatively longstanding and therefore perhaps more challenging, should I only look at psychologists with a PhD (or PsyD)?

Or is it really all about the individual person and very little correlation between a therapist's education and their ability to help patients solve problems?

posted by lewedswiver to Human Relations (11 answers total)

"psychoanalytic vs CBT, personality/individual chemistry" are way more important than whether the person has a master's or PhD. make sure your insurance covers whomever you are checking out and go see them in person to see if you get along with them and are willing to work within the modalities they use. if you don't have insurance ask about sliding scales for uninsured patients or consider a hospital program. you could also try to find a school where PhD candidates offer clinical services as part of their training.

ymmv, but i have had both unexceptional and great experiences with people who have the phD and the same range of experience with people who had master's. it depends so much on the person and whether you feel you can open up to them. for reference, i went to therapy as a kid, later as an adolescent, and most recently about a year ago as an adult.
posted by zdravo at 12:56 PM on November 26, 2014 [2 favorites]

All of this is very individual so YMMV, but I think as a general rule, years of experience are much more important than the degree.* Of course, you want someone accredited, but if you're deciding between PhD vs PsyD vs MSW/LICSW, I would say the individual therapist's expertise and fit with you is far more important.

And yes, if cost is a factor (will this be out of pocket?), then as a general rule someone with a masters will probably be cheaper.

You should sit down and decide on what you're looking for in a therapist: sliding scale vs insurance, CBT vs psychodynamic, male vs female, and any other special interests like LGBT-friendly, or whatever. Then go shop around. You may be able to do a short phone consult beforehand for free so that you don't have to waste time and money on someone who is obviously not a good fit.

*This isn't to say that you shouldn't work with someone who has relatively little experience. I've had good luck with someone who only had a few years experience when we started. I'm just pointing out that years of experience are probably more useful than a couple extra years of education, as a general rule.
posted by litera scripta manet at 1:01 PM on November 26, 2014 [1 favorite]

I'm a doctoral-level therapist (Doctor of Marriage and Family Therapy, though I'm not your therapist), and while I'd love to tell you that education matters, the research on therapeutic effectiveness doesn't really bear this out.

Scott D. Miller, one of the first to really look at what made therapy successful (outcomes) found three factors that accounted for the majority of therapeutic success:
1. "Alliance" - the relationship between the therapist and client, or "fit"
2. "Allegiance" - how strongly the therapist feels aligned to her/his way of doing therapy (modality)
3. "Model/Technique" - the actual therapeutic methods the therapist used

The thing Scott Miller found is that 60% of successful outcomes were due to Alliance, and another 30% to Allegiance. Only 8% of what resulted in a successful therapeutic outcome could be attributed to the actual interventions the therapist used.

Long story short, it really is about therapist-client fit: finding someone who you get along with, can build rapport with, and who will challenge you when appropriate. That's not to say that advanced training won't impact a therapist's ability to connect a little bit, but in my mind, not enough to make that be the deciding factor in choosing a therapist.
posted by cheeken at 1:27 PM on November 26, 2014 [23 favorites]

Second cheeken's post - it is really more about how much you like and trust your therapist (and to a lesser extent, vice versa) than pedigree or education. The only practical difference is that doctoral degree therapists are qualified to administer and evaluate psychological assessments, and often many in private practice just do one or the other (therapy vs assessment) - this doesn't sound like it would impact your decision either way.

Re: price, IME master's level isn't necessarily going to be much cheaper vs. doctorate level. This varies more based on setting I think.
posted by obliterati at 2:03 PM on November 26, 2014

Yeah, the only reason I'd seek out therapists with advanced degrees is when it serves to increase patient/therapist fit. For all the anxious and depressed grad students out there on Metafilter, seeing someone who's been through a graduate program and knows what it's like can actually be pretty helpful, anecdotally speaking.
posted by deludingmyself at 2:22 PM on November 26, 2014 [3 favorites]

I think it depends on your level of need and the therapists specialty. I need someone trained in complex trauma and disassociative disorders. Both my therapists have Ph.D's (group therapist and individual therapist) but my issues are somewhat more unique than those of the general population.

But I've had very competent masters level therapists too.
posted by AlexiaSky at 2:45 PM on November 26, 2014

Seconding deludingmyself. I've been around the therapy block a few times, and the only time I've ever found it to matter whether my therapist had a PhD/PsyD or not was when I really needed them to understand what late-stage grad school is like without a lot of explanations.
posted by dorque at 3:28 PM on November 26, 2014 [1 favorite]

If you anticipate needing obscure, tremendously expensive or somehow 'controversial' treatment, your insurance company may insist on you having seen someone with a PhD. In that case, it's obviously more convenient for your therapist to have a PhD than for you to have to find someone to have one session with for the sake of insurance.

I'll third the "if you are doing a PhD, you want someone with a PhD" but that's about the therapist having a frame of reference for your life not their academic qualifications.
posted by hoyland at 3:37 PM on November 26, 2014

FWIW, my best therapist had an MA and my worst had a PhD.

One way to increase your odds of a good fit: try someplace with a bunch of therapists and an intake person. That way you can tell the intake person what sort of personality you prefer to work with (e.g., it drives me crazy when therapists are all cooing and sympathetic), and they can guide you to a decent match.
posted by feral_goldfish at 3:55 PM on November 26, 2014

Thirding Cheedens post. This is a consistently repeated finding about the personal fit. Sorry I'm crap with remembering sources, but it's been hammered home in a lot of related training days.
posted by tanktop at 2:15 AM on November 27, 2014

Fit is so important. I have a PhD (in another field), and confess that I was initially a little skeptical about working with someone with a master's-level qualification. (I'm not proud of my snobbery, just not denying it.) But my current therapist, whom I adore, is not only an MA but also in the process of obtaining her certification. And yet, she is fantastic, smart, really good at both empathizing and calling me out on my BS, and helping me figure out how to work productively toward my goals. I've been with her for over a year and would hate to have to switch, regardless of the other person's qualifications.
posted by Superplin at 2:42 PM on November 30, 2014