Therapists and Modalities

Let’s be honest—figuring out how to get help for yourself or someone you love can feel like entering a maze. Between the different kinds of therapists, therapy types and all the acronyms, it can be confusing knowing where to start.

There are several types of professionals in the mental health world, and they all have different training and strengths. Here’s a quick breakdown:

Psychiatrists are medical doctors who specialize in mental health. They can diagnose, prescribe medications and sometimes offer therapy. If you’re dealing with a diagnosis such as bipolar disorder, major depression or psychosis, a psychiatrist is a key piece to improving and healing.

Psychiatric nurse practitioners are advanced practice nurses who specialize in mental health. They provide medication management under the supervision of a physician.

Primary care doctors can prescribe medications, but if the situation is complex, they’ll usually refer you to someone who specializes in mental health.

Psychologists (Ph.D. or Psy.D.) don’t prescribe medication, but they’re trained in diagnostic assessment and therapy, and some perform psychological testing. They have expertise in various different therapeutic modalities, and often specialize in a specific modality—cognitive behavioral therapy (CBT), interpersonal psychotherapy (IPT) or psychodynamic therapy are some examples.

Licensed clinical social workers (LCSWs) have a master of social work and are trained therapists, too. They also look at the bigger picture—family, finances, community—because all those things affect our mental health. They can offer great tools for life transitions, parenting stress, substance use and more.

Licensed professional counselors (LPCs) and marriage and family therapists (LMFTs) are trained to help with emotional and relational challenges. They often work with individuals, couples or families—think stress, relationship tension or personal growth.

What Kind of Therapy Do You Actually Need?

Different therapy modalities work best for different issues, diagnoses, circumstances and people. A good therapist won’t be offended if you ask about their training, approach or what therapy with them usually looks like. It can also be helpful to understand how you’ll both know that therapy will be “successful.” In other words, what are the goals and how will you know if you have achieved them?

CBT (Cognitive Behavioral Therapy): Super practical, structured and skills-based. Great for anxiety, depression and OCD.

DBT (Dialectical Behavior Therapy): Helps people who feel overwhelmed by their emotions or struggle with things like frequent thoughts of self-harm or intense, difficult relationships.

EMDR (Eye Movement Desensitization and Reprocessing): Can be effective for trauma or PTSD.

Psychodynamic Therapy: More insight-based. You explore patterns, your past and how it all connects to what’s happening now. This usually can be a longer-term treatment.

Mindfulness-Based Therapies: Focuses on staying present, reducing stress and accepting thoughts without judgment. Great for anxiety and preventing depression relapses.

Couples or Family Therapy: Helps with communication, confiict or relationship dynamics.

Group Therapy: For people who want support and connection with others going through similar things—can be really helpful with grief, addiction or skill-building.

How Do You Know What’s Right for You?

Here’s a way to think about it:

For symptoms like moderate-severe depression or anxiety, mania, suicidal thoughts or hallucinations, it’s best to start with a psychiatrist or psychiatric nurse practitioner. You can also consult with your primary care provider to help guide and sometimes initiate treatment, or help escalate a referral if symptoms are more urgent or pressing.

Need both meds and talk therapy? Many mental health disorders respond best to a combination of medication and therapy. You might work with a psychiatrist or psych NP and a therapist (like a psychologist or LCSW).

Struggling with anxiety or depression? Again, bring it up with your PCP, but either CBT, medication or both can be great first-line options.

Past trauma getting in your way? Trauma can lead to lots of different mental health challenges, and there’s no “one size fits all” treatment. A full diagnostic evaluation by a qualified mental health professional is essential to help figure out what treatment is most likely to be helpful for you. In some cases, EMDR or trauma-focused CBT can be an important part of treatment.

Feeling emotionally all over the place or stuck in unhealthy patterns in your
relationships? DBT can be life-changing.

Trouble with relationships or family dynamics? A marriage and family therapist or a counselor trained in that area can help.

Going through a tough life change (divorce, job loss, grief)? A social worker or counselor can be a great guide.

Therapy will look different for everyone. It might be one-on-one, with your family or even in a group. Thankfully, virtual therapy is here to stay. So if you need fiexibility, feel comfortable in a virtual setting or have limited access to transportation, consider if teletherapy is feasible for you.

There’s no “perfect” therapist, but the right fit matters. If something doesn’t feel right after a few sessions, that’s okay! It can be extremely helpful to discuss your concerns about treatment directly with your therapist—people often avoid doing this because they are concerned about offending them, but your relationship with your therapist is really different from relationships with family and friends. Therapists are trained to have these difficult conversations and often welcome them, as they can facilitate mutual understanding and an improved therapeutic relationship. If you still feel uncomfortable with your relationship, you can move on to a different therapist. What’s most important is finding someone you feel safe with, who listens well and who helps you move forward with concrete tools for continued improvement.

Dr. Jennie Berkovich is the JOWMA director of education.

Dr. Tal Weinberger is the co-chair of the JOWMA Mental Health Committee and director of psychiatry and behavioral health, CHEMED Health Center.

‍