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July 23, 2019

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How to find the right therapist for you

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While 2018 saw a slew of celebrities speaking openly about their struggles with mental health—Ariana Grande spoke of her anxiety and PTSD on her song “Sweetener;” Chrissy Teigen took to Twitter to discuss her postpartum depression; and Jon Hamm talked of his therapy and antidepressants—there’s still a stigma attached to seeking professional help.

Types of therapists

There are two categories of mental health providers—those who have a master’s degree (i.e. licensed clinical social workers and licensed social workers) and those who have a doctorate’s degree (psychologists and psychiatrists), Glover said. There are also those who provide emotional support without having a master’s or doctorate degree and include pastoral support, certified peer specialists and social workers.

However, struggling with mental health is far more common than we realize. About a fifth of U.S. adults struggle with mental illness, but only 41 percent of that group received services in the past year, according to the National Alliance on Mental Illness.

“The two most common mental health issues in America are anxiety and depression,” said Stephanie Glover, director of employee assistance and work/life services at Behavioral Healthcare Options. “Most people are pretty aware of their symptoms. They are aware they’re feeling bad, but they may not know why. That’s where [a therapist] helps them figure out what’s going on, what might be the cause of it, and most importantly, what might be the solution to it.”

What’s the difference between a psychologist and a psychiatrist?

• Psychologists receive their doctorate degree in psychology and focus heavily on psychotherapy. While they can diagnose mental health conditions, generally they can’t prescribe medicine.

• Psychiatrists are practicing doctors who can prescribe medicine, create medical plans with their patients, diagnose mental illnesses and perform medical testing. They often work in tandem with psychologists to ensure the overall health of the patient.

Glover offered several tips for selecting a therapist to help you deal with whatever issues you’re battling.

First, find a therapist that’s in your insurance network by checking the back of your insurance card for the behavioral or mental health number. This helps ensure that you won’t pay an exuberant amount for each session, and customer service can direct you to the best therapy in-network plan for your needs.

If you don’t have insurance, look at therapists who offer a sliding-scale—where the cost in based on income—or free options. Sites such as findahealthcenter.hrsa.gov, findtreatment.samhsa.gov or psychologytoday.com/us/ therapists are all great for hunting down affordable options. If you’re recovering from addiction, attend group sessions at Alcoholics Anonymous or Narcotics Anonymous meetings, Glover said; findtreatment.samhsa.gov also offers substance abuse disorder-related options. 

Make your first appointment, but think of this as a first date.

Above all during the first session, consider how comfortable you feel in the environment and in the company of your therapist, Glover said. If you don’t feel comfortable, don’t go back and begin to look for a different therapist. It may take a few tries to find an individual you like, but it’s worth the extra legwork.

After your first session, which is generally an intake process for the therapist to understand your psychological history, you should start to ask yourself if this therapist best fits your needs.

Some questions to ask yourself include: Do you prefer to have someone just listen to you as you sort out the problem on your own, or do you prefer someone to be more engaged? Do you prefer a therapist who gives you homework outside the session or someone who keeps the progress confined to the office? Do you prefer an individual who asks provocative and digging questions or someone with a softer touch?

A few questions to ask your therapist include: How long have you been practicing? Do you specialize in specific issues such as depression, divorce or anxiety? Do you have a bias that could conflict with my progress? Do you set up goals for your patients to meet? How long do you anticipate the sessions continuing?

Decide what level of care you need. Most seek aid for a short period of time when navigating a crisis, Glover said. If that’s the case, a master level therapist and talk therapy should be enough. However, if you struggle with more severe mental health challenges such as bipolar disorder, clinical depression or psychotic disorders that require medication, look for a therapist at a doctorate level. In this instance, Glover also suggests combining talk therapy and medication. Your healthcare provider can help you navigate the level of care you need. — Camalot Todd

Low-cost clinics and programs help fill Southern Nevada's mental health care gap

There’s no spinning Mental Health America’s 2018 report: Nevada is the worst. Out of 50 states and the District of Columbia, the Silver State ranks last in the mental well-being of Americans. It’s shocking—and it isn’t, given the state’s low prioritization and funding of social services and Nevada’s regular placement at the bottom of the survey.

Born This Way

Lady Gaga’s foundation, Born This Way, conducted a survey of 401 youths in Las Vegas about their mental health. The report has a margin of error of plus or minus 4.8 percent, with a confidence level of 95 percent. Some highlights of the report include:

• 50 percent of high school age youths rate their mental health highly

• 33 percent of college-age youths rate their mental health highly

• 46 percent of those surveyed reported feeling anxious

• 41 percent reported feeling sad for a “good bit of time” or more during the past month

• 9 out of 10 individuals see mental health as a priority

• 50% said that they rarely talk about mental health

When the youths surveyed do talk about mental health …

• 65% are more likely to talk to a friend

• 48% are more likely to talk to a parent/guardian

• 15% are more likely to talk to a mental health professional

• 1 in 4 said young people rarely or never have access to the resources needed to address their mental health

If there’s one aspect that local mental health and psychology experts bemoan the most, it’s access to care. From the state’s small and overburdened pool of mental health care providers to the troublesome nature of health care coverage for behavioral treatment, it’s no wonder so many Nevadans endure recurring or untreated mental illness. Fortunately, for those who lack insurance or who have given up on their insurance’s in-network providers but still require help, viable, low-cost alternatives exist.

UNLV is leading the way with two community clinics. The first is called The PRACTICE, which stands for The Partnership for Research, Assessment, Counseling, Therapy and Innovative Clinical Education. During the last recession, stimulus money was awarded to the university’s colleges of education and liberal arts to establish an innovation-geared mental health clinic so psychology students could provide supervised counseling to the community. “Out of crisis came this idea to pull out of our respective training silos in an interdisciplinary way and increase access to mental health care and improve training of the mental health workforce at UNLV,” says associate professor and PRACTICE director Michelle Paul.

Clinicians at the PRACTICE are graduate students in psychology and postgraduate fellows, and therapy/counseling sessions are supervised unobtrusively. Fees are based on a sliding scale—“We are cheaper than most copays,” says Paul—though there’s one downside: The clinic has had a waiting list since its 2012 launch. For those who require quicker treatment, The PRACTICE offers group therapy sessions, which Paul says not only enable more care to more people, but are highly effective. “We’re lucky to have one of two or three nationally certified group psychotherapy professionals. [And] ours is the flagship training program.”

UNLV’s second community clinic, while on the main campus, is part of the new School of Medicine on Shadow Lane: The Center for Individual, Couple and Family Counseling. Sara Jordan, an associate professor who oversees the program and university’s couple and family therapy master’s program, stresses that everyone is welcome. “People think, ‘I’m not [part of] a couple or have a family.’ That’s why we call it the Individual, Couple and Family Clinic—about half of our cases are individual,” Jordan says.

Similar to The PRACTICE—and just about any other mental health care facility in the country—depression and anxiety are the two most common problems addressed by CICFC’s clients. And also similar to The PRACTICE, graduate students of the couple and family therapy program amass clinical experience by conducting supervised sessions with clients. Besides the goal of helping those with few to no treatment options—those with insurance are referred elsewhere—Jordan says the program strives to further populate the Valley with mental health care providers. “We’re trying to keep our graduates in state as much as possible because of the need,” she says.

Predating both UNLV clinics is the Community Counseling Center of Southern Nevada, established in 1990 to assist those living with HIV/AIDS who were being denied services. Since then, the program has been expanded to include general mental health issues and substance abuse. “There’s always been a need,” says executive director Patrick Bozarth, who cites Vegas’ 24-hour lifestyle, rising housing costs and trauma (especially related to the October 1 shooting) as some environmental triggers for adverse psychological conditions and substance abuse.

CCC accepts everyone, regardless of insurance or Medicaid status, and employs a sliding fee scale payment system and a streamlined registration process that goes from receptionist to case manager to counselor. “We make it a point to get clients as quickly as possible—even that day—and enroll them in whatever treatment is needed, either individual or group,” Bozarth says. Every CCC counselor is at master’s level or above, and is certified with the state’s mental health and substance abuse licensing boards.

Other programs that serve those with unmet mental and behavioral health needs include Volunteers in Medicine of Southern Nevada, Nevada Health Centers, Southern Nevada Adult Mental Health Services, Mojave Counseling and Open Path Psychotherapy Collective.

All programs aim to break down the barriers to mental health care and the stigma of treatment itself. “There’s always talk about how it’s acceptable to go to your cardiologist or your general practitioner, but it’s shameful if you’re depressed or bipolar,” CCC deputy director Aaronell Matta says. “As a society, we need to rally against that. You don’t want to know someone has a mental health issue when it’s too late.” — Mike Prevatt

This story originally appeared in the Las Vegas Weekly.