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Finding a Therapist for Your College Student

More-than-you-wanted-to-know summer edition.

 Nitin Dhumal/Pexels
Source: Nitin Dhumal/Pexels

Somehow, your college student made it through the fall and spring semesters. They even made it back home safely! But your parental sixth-sense is screaming "something is not right." Maybe they've been acting different from their normal chipper self. You may have gotten that vibe over the phone or when you visited during the semester, but now that they're home, it's pretty clear they're not doing well. They may have less energy. They may be less engaging. They may even seem hyper-vigilant and worried a lot more but without a good reason. It's time to reach out to a professional — but who should you call?

Home or School?

Let's start with a tricky dilemma: Do you try to find a therapist around home or for back at school?

If your college student’s semester ended in mid-May and they are heading back for the fall semester at the end of August, they’ll have 15 weeks to work with a therapist at home. That’s a decent amount of time if they are available immediately and your college kid’s challenges don't require more intensive intervention. Getting weekly counseling for that chunk of time could make a big difference and set your college student up for a positive transition back to campus in the fall.

Here are some obstacles to consider when looking for a local therapist: Is the therapist going on vacation or unavailable for a few weeks? Will there be any substantial disruptions during the summer or can they meet most weeks? Do they have any openings immediately or will you get waitlisted? Will they agree to work with someone for just the summer? Does your family have a vacation time planned that would get in the way of seeing the therapist?

The benefits and considerations of finding a therapist around college look a lot different but may not be as immediately satisfying. Establishing a relationship with a therapist before the start of a semester means you are likely to not get wait-listed. Most students leave spring semester with their fall class schedule already nailed down, which means you could possibly not only get on the therapist’s schedule, but know the dates/times for each session. Therapists generally appreciate this sort of predictability, especially if they specialize in college student counseling. In my practice, I am typically full before the fall semester even starts. This sort of planning also helps your child anticipate and plan accordingly if they wanted to join any clubs or if they will likely have a busy Greek-life schedule.

Some students may even have their syllabi for the fall and know that certain big assignments, projects, or tests will make specific dates and times for sessions really challenging, which means they can already move those sessions around to avoid those scheduling conflicts. I had one student do this last year — they were at the business school and had massive projects listed on their syllabi that they knew from other students would eat up big chunks of time. They contacted me two months in advance to move our fall appointments for those weeks. Wow.

What if your college student needs help ASAP but you’ve found a great therapist back at school? Some therapists will do virtual or phone sessions for the interim, depending upon their licensing requirements and state laws. If your college kid had been previously working with a therapist, the new therapist may encourage that relationship to continue and then have a transition at the end of the summer or beginning of fall. Basically, therapists should be able to be creative in finding a solution to the limitations and timing issues that are often associated with summer break.

The Search Begins

Now, how the heck does someone find a therapist? Regardless of whether you’re looking for a local therapist or someone near campus, I’ll go through some gritty details now on how to do it. Even if you’ve found one in the past, you may have simply googled "therapist" and your zip code and found a list of random providers that have offices in your zip code. They probably showed up on Psychology Today (the big daddy of mental health providers in the country).

Ok...I see the list

Ok...I see their pretty head shots

Ok...I’m reading through their ‘about me’ blurps. But wait! They all seem to be the same or at least have marginal differences. How does someone actually figure out not only who is good or not-so-good, but which ones specialize or treat the symptoms my college student is describing?

One thing to start off considering is that it’s difficult for many reasons to verify a provider’s expertise. For instance, you will find therapists that claim to treat all ages, all diagnoses (eg. Depression, Anxiety, Substance Abuse, Eating Disorders) and have expertise in all modalities (eg. DBT, CBT, Motivational Interviewing). I can assure you, they may have a basic understanding of those diagnoses and modalities, but they are far from deep experts.

Online databases are really good for two things:

  • Finding a therapist within your zip code
  • Finding a therapist that accepts your insurance

Another good (OK, somewhat good) resource is the database kept by your insurance company. Most insurers have client/patient portals where you can look up all the therapists within a geographic area and, obviously, accept your insurance. They rarely have much detail about the therapist but at least you can confirm they are in-network.

Alphabet Soup

While searching you will likely see a whole bunch of letters after someone’s name. That’s not just egomania about how smart they are – many licensing bodies require clinicians to list their degree (Masters, Doctorate or Medical Doctorate) as well as their license.

Here is a list of other credentials you may see after someone’s name and what they mean:

LPA – Licensed Psychological Associate

LCSW – Licensed Clinical Social Worker

LCAS – Licensed Clinical Addiction Specialist

LMHC – Licensed Mental Health Counselor

LPCA – Licensed Professional Counselor Associate

LMFT – Licensed Marriage and Family Therapist

NCC – National Certified Counselor

RN – Registered Nurse

MS – Masters of Science

MA – Masters of Arts

MSW – Masters of Social Work

DSW – Doctorate of Social Work

Ph.D. – Doctorate of Philosophy

Psy.D – Doctorate of Psychology

Ed.D – Doctorate of Education

MD – Medical Doctor

DO – Doctor of Osteopathic Medicine

Now for a bit more detail on the most common types of mental health professional, you’ll run into on Psychology Today and other databases.

Psychiatrist. A psychiatrist is a physician (doctor of medicine [M.D.] or doctor of osteopathic medicine [D.O.]) who specializes in mental health. This type of doctor may further specialize in areas such as child and adolescent, geriatric, or addiction psychiatry. A psychiatrist can perform the following though they primarily prescribe medication:

  • Diagnose and treat mental health disorders
  • Provide counseling
  • Prescribe medication

Psychologist. A psychologist is trained in psychology — a science that deals with thoughts, emotions and behaviors. Typically, a psychologist holds a doctoral degree (Ph.D., Psy.D., Ed.D.). A psychologist:

  • Can diagnose and treat a number of mental health disorders, providing counseling, in one-on-one or group settings
  • Cannot prescribe medication unless he or she is licensed to do so
  • May work with another provider who can prescribe medication if needed

Licensed Clinical Social Worker. If you prefer a social worker, look for a licensed clinical social worker (L.C.S.W.) with training and experience specifically in mental health. A licensed clinical social worker must have a master’s degree in social work (M.S.W.), a Master of Science in social work (M.S.S.W.) or a doctorate in social work (D.S.W. or Ph.D.). These social workers:

  • Provide assessment, counseling and a range of other services, depending on their licensing and training
  • Does not prescribe medication
  • May work with another provider who can prescribe medication if needed

Licensed Professional Counselor or Mental Health Counselor. Training required for a licensed professional counselor (L.P.C.) and (L.M.H.C.) varies slightly by state, but most have at least a master’s degree with clinical experience. These counselors:

  • Provide diagnosis and counseling for a range of concerns
  • Does not prescribe medication
  • May work with another provider who can prescribe medication if needed

Background Checks

When I encourage folks to conduct background checks, I’m not talking about running their info through the FBI to find out if they are criminals. When considering whether to work with a therapist, google their name, look up their info on the state licensing board’s website (if the state has one), and ask for clients or colleagues that could provide a referral. Asking for a referral is a bit unorthodox and most therapists wouldn’t know how to respond but it doesn’t hurt to ask. When prospective clients ask for referrals, I explain that because of HIPAA rules, I can’t just hand over a previous client’s contact info. What I can do is contact previous clients and ask if they would be willing to provide feedback to the prospective client. It’s tricky since I want to protect privacy and not put any sort of burden on the client.

Questions to Ask

Real simply put, when you are looking for a therapist, think of it like interviewing someone for a job (counseling). Treat it like a hiring interview and have a plan. Here is the list of questions you need to ask when considering whether or not to work with a therapist (print this off if needed):

  • What training do you have to treat the issues I described?
  • Please give me an example of how you would work with me on the issues I described?
  • What are your communication policies between sessions?
  • Have you ever had your license suspended or removed in this or another state?
  • How do you use technology in your practice? Is your agency able to provide weekly and 24 hr reminders prior to sessions?
  • If I need a different type of care or different level of care, what’s your experience in working with referral sources?
  • Are you in-network, out-of-network with my insurance? Do you have someone in your practice that files claims and works with insurance?

First Session

Show up early and come with any additional questions, concerns, goals or obstacles regarding your issues. I love it when parents show up with a page or more of thoughts, questions and random ideas. It not only helps me zero-in on a diagnostic impression but also helps me understand how the family operates and what their values are. If this is a session set up for your college kid, be confident and let the therapist know you want to sit in on the first 30 min to download some history and concerns from your perspective. It’s also a great time to sign a release of information so the therapist can legally speak with you between sessions. If the therapist is working remotely near campus in preparation for your kid to head back for the coming semester, make it clear you need to be kept in the loop and your son/daughter will be signing the release of information asap.

Final Notes

One of the best uses of a therapist for summer break is helping parents understand what's going on with their college student and what the most effective treatment/intervention is. Developmentally appropriate emotions and behaviors can often look similar to mental health challenges. For example, when is smoking weed just 'normal college kid behavior' and when is it a clinical issue? Your college student's therapist can help differentiate between the two. Consistently working with a good therapist over summer break can help your college student feel supported and stabilized, set them up for a great fall semester while also helping parents feel more confident their kiddo is on a healthy path.

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