Lcsw vs Psychologist?? Is There a Big Difference

Updated on February 08, 2014
L.O. asks from Sterling Heights, MI
5 answers

for those who have had experience with these mental health professionals or those that work in the field... Is there a big difference in these 2 degrees? should I choose 1 over the other? or are they basically equal?

this is for a 6year old boy.. with a bit of anxiety.

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J.B.

answers from Boston on

We deal with mental health professionals on a regular basis (my husband "has issues" LOL). We've worked with all levels, from an unlicensed pastor of a church that we didn't belong to - who was AMAZING - to a highly credentialed psycho-pharmacologist (who was also quite good). Some have been great, some we only saw a few times before deciding that the fit wasn't right. In no case was there a correlation between the letters after their name and the quality of their work.

If you're not comfortable asking your friends for recommendations, ask the school counselor. If we need someone to see one of our kids, my husband usually schedules a meeting in advance without the child present to make sure that we like the person first. So much of child psychology succeeding relies on the parents making recommended changes at home that if you find someone who you don't agree with or whose ideas you're not open to, it's a waste of time and money. Oh and do make sure that whoever you choose is on your insurance plan. Mental health should be a covered benefit.

ETA: regarding someone's comment below about psychiatrists only wanting to prescribe medication...not necessarily true. They are the only providers who CAN prescribe medication but that doesn't mean it's all they do or want to do. We worked with a psychiatrist who did a year of marriage counseling with us and also did some counseling with one of my sons for ADHD. We chose him because of his deep understanding of my husband's mood disorder and his guidance helped a lot even when my husband decided to not use medication. Because they do treat with medication they can jump to that as a first approach and not a last one, but not all are like that.

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S.S.

answers from Chicago on

What do the initials stand for? A psychiatrist can prescribe needs. A social worker or psychologist can not. When you say a bit of anxiety do you mean he worries or that he vibrates out of his shoes? Most schools these days have social worker on staff. If it's the first I would start there before going full steam into the others

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A.M.

answers from Washington DC on

I agree with the suggestion that you begin with the school's staff. Also what does your pediatrician recommend.

Anxiety is a strong word. It doesn't mean worries a lot, It means that the worry impairs one or more major life functions. Examples:
the pre-schooler who begins withholding his bowels and develops chronic constipation.
the middle schooler who is so worried about attending school that he or she vomits in the morning.
the teenager who is so stressed over interacting with peers that she has begun pulling out her hair and can't stop.
the college freshman who is sleeping only 2-3 hours a night for months because he is redoing minor assignments until they are perfect.

There are different types of anxiety. Children may have generalized anxiety, social anxiety academic anxiety (and that can be math-specific) anxiety provoked by OCD, etc.

About 3 years ago, I saw a huge spike in my community in the number of kids being diagnosed with generalized anxiety and coded as having an "other" disability for an IEP. Almost without exception, these students are given additional time to complete assignments and sometimes a "flash pass" to see a counselor if they are having a panic attack. These accommodations can help a child while they are being treated through therapy (and medication if needed). All too often, though, the parents make no other arrangements for the child. Which is unfortunate because most children with anxiety have it due to a specific trigger and their condition can be greatly improved if not entirely resolved.

You're going the correct route by looking for a professional and asking questions about who is best for your child. Continue to ask specific questions and demand options throughout the entire process.

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P.G.

answers from Topeka on

In part, it depends on your state's licensing requirements. In some states, a psychologist may prescribe medication. I would hope that is an option explored much further down the line if necessary. A psychologist has more academic training, and some of this is in doing formal psychological testing to determine what is going on. Formal psych testing is not necessarily part of a counseling process unless the situation is unclear/complicated presentation of symptoms, etc.

I'm a clinically licensed SW in Kansas and a clinically trained clergy who used to work at the Menninger Clinic (now in Houston, own by Baylor). I agree with the comments about it is not about the letters. I think it is true that a parent should check out a professional to determine her/his sense of connection with the person. That doesn't necessarily mean it will work for your boy. Gender may or may not be important depending upon what the underlying issues are.

While I'm not Freudian in my approach, I don't think he got it all wrong (smiley face), and know this is an important time in the development for boys in relationship to their mothers. I say that to say this, gender may make a difference, and I don't know if he is more comfortable with one or another. He may not have had any male teachers or coaches of sports to allow you to have a feel for that, but if so ask.

I think getting suggestions from any number of sources may be helpful. I used to do clinical training of clergy (most of whom intended to be pastors). Part of what I encouraged them to learn was who are the best mental health referrals in your area, and to find out sooner as opposed to later once you get to a new town.

So, even if you aren't part of any congregation (church or temple), if you know a clergy with whom you have any connection, they are happy to be helpful. As the risk of offending some, it is generally the clergy from more "liberal" traditions who would have this information.

I would pay attention to how long someone has been in practice as well. Even if one is using psychological testing there often comes a point in which the professional makes a judgment as to whether she/he thinks this or that about someone's problems. Seasoned professions develop a "feel" for certain situations/issues what have you, and can be more adept in responding. Often, the quicker someone catches a feel for something, the sooner some sort of resolution or treatment can be had.

If you are at a point of thinking your boy needs help, I am sorry. I know it is painful to see your child suffer. What is so difficult with mental health issues - anxiety what have you, is that a child is often less able to put what is troubling them into words than an adult.

And, we adults always, always can clearly identify whatever is at the root of whatever is bothering us with pinpoint accuracy in every moment of time, right? Maybe not.

Sometimes I have to talk to think. I forgot about two other important avenues to explore:

1) Those trained and/or certified in child attachment theory. As many children's issues can be related to his/her sense of connection/disconnection with parents or other key people in their lives, it has to do with her/his sense of attachment. While most professional have training in this area, it is a relatively new focal point for care and treatment and a blossoming field with much research being done in it.

2) those certified or trained in child therapy. This is a relatively new field so some of the best most seasoned professionals may not have these credentials, but often the play therapy certifying organizations have lists of their folk and can tell you if anyone is nearby.

I wish you and your boy well.

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G.B.

answers from Oklahoma City on

An LPC is a professional counselor that only has a Master's degree. They can accept 3rd party payments and often, depending on the state regulations, have to be supervised by a licensed Ph.D. psychologist. Some states do not see them as professionals and some do. They do counseling just as anyone that does counseling does. They do not usually do anything different.

The main thing to understand is this:

A Psychologist, Therapist, LPC, MSW, etc...are therapists. They will sit you down and want to talk. To use up your hour and help you gain insight into what is going on and help you get fixed. These docs do NOT write prescriptions. They can suggest you visit with your Psychiatrist about a particular med but it's likely they won't talk to you about meds very often.

A therapist of any sort has these different names because some can take your insurance and some can't. That's about what it comes down to. If they can get paid through insurance or they have to be paid cash. So check with your insurance company first off and see who they have a contract for services with. If they don't have a payment option for a particular person then it's up to you to pay cash or go to a different person for help.

A Psychiatrist is a medical doctor who has their medical degree then specialized in treating mental health issues. They DO NOT want to visit with you, they do NOT want to sit and talk, they MIGHT have 5 minutes scheduled for you but then they want you gone.

A Psychiatrist only writes prescriptions for you. They don't treat you for anything else.

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