LCSW vs. Clinical Psychologist: practical differences?
March 6, 2012 10:13 AM   Subscribe

Transitioning into long-term depression treatment, I got a referral to both a Licensed Clinical Social Worker and a Clinical Psychologist. It's not clear to me how they would differ in their abilities/attitudes towards treatment.

I have been going to an Employee Assistance Program counseling center since a depressive crisis last autumn (not while on the job -- this was a voluntary entry to the program and my coworkers mostly don't even know about it). My established number of visits have been exhausted and at this point I'm planning on transitioning to long-term treatment. I was given a referral to two different therapists, a licensed clinical social worker and a clinical psychologist. As of yet I haven't followed either up. I read this question which gave me a better idea of the credentialing but not a good view of how treatment would be different under these two different types of therapists. Specifics of my isssues/treatment to date in the next paragraph.

My crises and day-to-day concerns are mostly activated by job stress, which is coming to a bit of a head in this year. The main symptoms are inability to focus day-to-day and, in the throes of the infrequent crises, a complete cessation of useful activity. Early in my counseling I was referred to a psychiatrist, who diagnosed me with disthymia and sporadic moderate depression. I am still under his care and have bee prescribed a dosage of 37.5mg daily (recently increased from 25mg) of sertraline. My other treatment has been largely self-directed thus far but in a cognitive-therapy mold at the advice of my counselor: my (currently imperfect) practices are centered around scheduling and parceling up tasks to create discrete, completable accomplishments. I'm still given to backsliding on it rather badly.

So coming from this specific background (light medication, disthymia, focus issues, self-directed half-assed CBT), I'm wondering how my treatment would be likely to differ between a psychologist and LCSW.
posted by anonymous to Health & Fitness (4 answers total) 1 user marked this as a favorite
The treatment approaches will have less to do with each therapist's credentials and more to do with their personal style and philosophy. The best advice I can give you is to schedule a quick phone consultation with each of them and ask them about their treatment philosophy. Then go with whichever one feels the best to you.

Studies have shown that, regardless of treatment modality, the single most influential factor in therapy is the relationship between the client and the therapist. So it's most important that you feel like your therapist is someone you can connect with, open up to and engage with honestly.

Beyond that, CBT is a great treatment approach because its focused on giving you tools to deal with irrational thought patterns RIGHT now, rather than delving into past issues and asking all the "why?" questions. But no matter what their approach, a good therapist is one who listens to what you say, points out irrational patterns of thought and behavior, and helps you find ways to reframe and change those patterns.
posted by missjenny at 10:19 AM on March 6, 2012 [5 favorites]

It really depends on the individual and their therapy modality than it does on their credentials in this case (it would be different if one sounded like they were a meds person). They'd both be doing talk therapy, so I'd call, or email, or check their Psychology Today pages, or just go "interview" each of them at a first appointment to see which person is a better fit for you.
posted by ldthomps at 10:20 AM on March 6, 2012 [1 favorite]

I think the answers given are accurate/agree with my experiences.

Also, you might know this already, but there's a compilation of depression- and therapist-related questions over on the MeFi Wiki.


I was over there looking up info myself, then remembered I saw your question earlier. Hope it helps.
posted by ArgyleMarionette at 2:22 PM on March 6, 2012

Like others said, it all depends on what techniques and approaches they use in their practice. The psychologist has a PhD and probably is involved in research along with practicing (not saying they will do research on YOU, but it's part of the PhD training) and can give advanced psych tests. The social worker doesn't have a PhD (unless he/she has PhD or EdD behind their name). Most social work programs focus on how the individual functions in family or group settings, but a lot of social workers will find their calling in various areas and focus their work on one particular area of mental health. Both psychologists and social workers could have an interest in how people function in the work/employment setting, so the level of education won't necessarily come into play in your decision.

You can always call the office and find out what each one specializes in, and at the first appointment talk about what you need help with and how they would approach your issues. If you sign a records release the EAP can send your records to the new therapist so they can see what you have been working on.

One other caveat (if this applies)...check your insurance coverage. A lot of insurances will cover at different levels based on the level of training of the therapist. Some may only cover a clinical psychologist for testing services and not counseling. If cost is an issue, ask the offices to verify your insurance benefits (they will ask for your insurance information and then call the insurance to find out if they are in network, how much the copay is, how many sessions are covered, etc.) and find out what your cost would be. That may factor into your decision, or it may not, but it's something quite a few people don't realize.
posted by MultiFaceted at 2:33 PM on March 6, 2012

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