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The short answer?
Make sure your child's therapist is a licensed clinical child psychologist with a Ph.D. degree (ABPP Board Certification is a plus!), who is trained in the most current, scientifically-based approaches to psychotherapy, such as cognitive-behavioral therapy. Other mental health providers, such as school psychologists, social workers, psychiatrists, or psychologists with other educational degrees (Psy.D., MD, MSW, MA, or MS degrees) may also be good options, but be sure to do your homework on what type of therapy they will offer. Read below for more information.
Do they have a license to offer mental health treatment?
Be careful! In most 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 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" or a "licensed social worker."
Licenses are regulated by the state government (usually called the Office of Professional Regulation). A very thorough and careful review is conducted by the 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 gets ongoing training (i.e., "continuing education") to help them kept up-to-date of the latest developments in the field. By the way, if you feel that your mental health provider has acted inappropriately, then you want to make sure that you inform the Office of Professional Regulation in your state immediately.
Are they a psychologist, a psychiatrist, or a social worker?
Licenses are given to members of three types of mental health professionals: psychologists, psychiatrists, and social workers.
Psychiatrists attend medical school and receive a MD degree. They may receive some training in medical health issues during their four years of medical school, and then they may select a psychiatry internship/residency for some years after medical school. Psychiatrists are trained to regard mental health difficulties as a medical disorder that can primarily be addressed with the use of psychotropic medications (i.e., pharmacotherapy). Some psychiatrists also receive training in how to conduct psychotherapy. In most all cases, training in pharmacotherapy is far more thorough than training in psychotherapy. Thus, appointments with psychiatrists often last about 15 minutes to monitor children's reactions to psychotropic medications. If you would like to receive a prescription for psychotropic medication to give to your child, you should see a psychiatrist. In some cases, psychiatrists will conduct more traditional "talk" therapy during hour-long sessions. If you select a psychiatrist for your child's mental health needs, be sure to ask very direct questions regarding the type of treatment s/he will provide.
Social workers may receive a license to provide mental health services once they have received a Masters degree (a MSW degree). This type of training typically lasts about two years followed by a 1 year internship. Social workers receive some training in psychotherapy, however, this is sometimes not the focus of their training. If you need to connect with social services to help your family obtain specific resources or connect with community agencies, you should see a social worker. Note that some social workers do have excellent training in psychotherapy and could be very good therapists. Make sure you thoroughly investigate the training and experience of any mental health provider before you ask them to work with your child.
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 internship, and then an additional 1-2 years of "postdoctoral" clinical experience, a licensed psychologist receives intensive training in how to conduct psychotherapy. Psychologists who receive a Ph.D. degree also 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. Although in some states, some psychologists are allowed to prescribe medications, psychologists generally receive more intensive and thorough 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.
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 growing fields, however, and may be relevant for your child's difficulties.
Counseling psychologists are trained to deal with issues that are common to most people's lives (i.e., career planning, relationship disputes, stress and coping). If your child is experiencing some general adjustment difficulties, you may be interested in seeing a counseling psychologist.
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.
Clinical child psychologists are trained to treat children who are experiencing significant psychological symptoms that are interfering 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 psychologists. (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").
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 something called a Psy.D. degree. These are both doctoral degrees, but they are very different, and this can have important implications for the type of therapy your child will receive.
Ph.Ds are trained at colleges and universities, and most all of these doctoral programs emphasize the importance of both the science and the practice of clinical psychology. Most parents would like their child to receive the most current, scientifically-based treatment based on the knowledge of what has been proven to be effective. Incidentally, clinical psychology Ph.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. programs accept only 1-8% of all applicants to their programs!
Psy.D.s are a bit of a mixed bag. Some Psy.Ds are trained at colleges and universities just like Ph.Ds. Also, some Psy.D.s are given excellent training and can provide very good psychotherapy.
However, the majority of clinical psychologists with Psy.D. degrees have been trained at for-profit institutions. In other words, these "schools of professional psychology" (some are even called, 'universities") accept a tremendous proportion of their applicants and charge them large tuition bills to attend. These types of programs are designed to make money and turn a profit for business-type investors.
The type of training offered to Psy.D students in these programs is very different from what most people realize. Whereas most Ph.D. programs accept less than 10 students per year so that they can offer individualized training, many Psy.D. programs accept 50-100 students each year who do not have the same opportunities to work with faculty and receive thorough supervision.
Most Psy.D programs are much less focused on the science of clinical psychology. Rather than being trained in the most current, scientifically-based techniques, many Psy.D. programs teach students psychotherapy in ways that are very outdated (some even still use old fashioned Freudian techniques!) and can even be potentially harmful.
These important differences between Psy.D.s and Ph.Ds in clinical psychologists are supported by published statistics. The academic credentials (e.g., standardized test scores) of students who enter Psy.D. programs are substantially lower than students in Ph.D. programs. Psy.D students are much less successfully passing the national licensing exam for psychologists than are Ph.D. students.
Are they board certified?
After providing psychotherapy as a licensed psychologist for a few years, clinical child psychologists may apply for Board Certification (ABPP). You will know who's 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 Academy of Clinical Child and Adolescent Psychology. Board Certification in clinical child psychology is relatively new, so you won't find too many people who are Board Certified yet. But if you do, then this is the person who you want to be your child's therapist!
Be careful for 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 the criteria that licensing board and the American Psychological Association recognizes. Some of the other "certifications" out there are just created to try and get innocent psychologists to surrender their money to add meaningless letters to the end of their professional signatures.
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 have been trained on how to do these specific types of treatments. Among psychologists, some refer to their approach to treatment as their "theoretical orientation." You should ask a potential therapist for your child about their theoretical orientation and their familiarity with the treatments listed on this site. If they mention an orientation that is listed as evidence-based on this site (e.g., "cognitive-behavioral"), then you they should be trained in the well-established therapeutic approaches listed on this site. If they mention a different theoretical orientation not mentioned on this site, then they may not be familiar with these treatments, and your child may not get treatments that are known to work.
Psychologists are not allowed to provide therapy in an area that they are not trained. If you ask them whether they are trained in treatment X, they are not allowed to lie, 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."
Remember, your expectations should be the same as they would be for your child's pediatrician. They should be able to tell you what they believe 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?
Ask your child's potential therapist where they received their doctoral training, their internship training, and their postdoctoral training. You may not recognize the names of some of the schools you hear (not all of the popular undergraduate schools have clinical psychology doctoral programs), but you can do a little research to learn more about high quality clinical psychology training programs. For instance, if you visit www.socialpsychology.org, you will see various ranking systems of clinical programs. You will probably want your child to see a therapist who trained at a well-regarded institution.
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