Congratulations! You’ve made one of the best decisions you can make: asking for help. Whether you’ve decided to get help to control or moderate your use of alcohol or substances, or whether you’ve decided you want to be entirely abstinent, or whether you just want to explore the role that addiction might play in connection to an underlying depression, anxiety, stress, or self-esteem issue, you are being proactive in trying to find someone who can help you. Acknowledging that you need help is never easy, but it’s one of the best things you can do for yourself. Finding the right addiction therapist is just as important as making the decision to get help.
Before determining whether the treatment provider is “expert” enough, you have to decide what type of practitioner you would like to consult. Addiction treatment often involves working with a combination of professionals. Probably the most comprehensive place to start would be to meet with an addiction psychologist for a complete evaluation. However, there are several other types of therapists with the necessary and sufficient experience to get you on your way. It is important to know the differences between these sorts of treatment providers.
People often will begin their search for addiction treatment by consulting an “addiction psychiatrist” or “addiction psychologist.” In actuality, these are two very different kinds of professionals. Knowing the difference is essential. Furthermore, the professions of psychotherapist, social worker, and counselor all have different specialties, and their focus and breadth of treatment can vary considerably. In most instances, their credentials are much less important compared to their experience and the connection you can establish with them. Most therapists would likely agree that the most curative factor in the psychotherapeutic relationship is the rapport that develops between therapist and person in therapy. So while you’re looking for someone you can afford, you are also looking for someone with whom you can connect.
What Is an Addiction Psychiatrist?
An addiction psychiatrist is a medical doctor who specializes in treating people with addictive and mental health issues primarily with medicines such as antidepressants, antipsychotics, and medications that help to treat underlying mental health conditions and comorbid issues. While there are many psychiatrists who don’t prescribe medications much and focus primarily on therapy instead, most psychiatrists manage medications and work closely with psychologists and other therapists who will provide the talk therapy treatment. Subsequent psychiatric appointments following an evaluation tend to be short, about 20- to 25-minute med checks; they are mostly concerned with how a person is adjusting to a drug regimen, minimizing side effects, and gauging effectiveness.
Most importantly, an addiction psychiatrist has special training in prescribing medications to help individuals who are struggling with their substance use. It is important to work with an addiction psychiatrist and not just a general psychiatrist when you are trying to determine the nature of your relationship with drugs and alcohol and considering making behavioral changes. An addiction psychiatrist can prescribe medications to help you detox or withdraw from drug and alcohol use, and they can also prescribe medications to help you with cravings, which could avert relapse.
What Is an Addiction Psychologist?
An addiction psychologist, on the other hand, is a doctor but not a medical doctor. Addiction psychologists are trained mental health professionals who can help you explore the role that addiction plays in your life. An addiction psychologist can help you become more aware of your thoughts, feelings, and behaviors, and teach you different ways of dealing with problems through therapeutic approaches such as cognitive behavioral therapy, motivational interviewing, mindfulness-based relapse prevention, 12-step facilitation treatment, and community reinforcement and family training.
Additionally, addiction psychologists let you talk your way through a problem and help you get to the heart of the issue so you can make the necessary changes that will improve your life for the long haul, and not just put a bandage on a major wound. A typical appointment with a psychologist is 50 to 55 minutes.
Other Professionals Who Can Help
There are other types of addiction therapists in addition to psychologists who might be helpful, including social workers and licensed professional counselors. Social workers may have their master’s or doctorate, while licensed professional counselors may have only a master’s-level education, though both are trained in mental health issues to varying degrees. Social workers in particular are trained in obtaining the best social agency support services, and they tend to take a social and networking approach to the treatment of mental health issues.
Psychotherapists may have any of the above degrees or none at all. A psychotherapist is sometimes a catch-all for someone who practices talk therapy, but the therapist may or may not be adequately trained according to the standards of another professional degree or certificate. For example, a psychiatrist or psychologist may describe themselves as a psychotherapist, but so too can a recovery coach or Joe Shmoe because he’s been a “spiritual advisor” ever since he was electrocuted while trying to repair his garage door. That said, many psychotherapists do receive comprehensive training, but it is important that you vet their experience, training, and credentials, as you should with any other therapist. (GoodTherapy.org does this work on your behalf as it has strict educational and training requirements for membership.)
Certified addiction counselors and certified alcohol and drug counselors are just a few of the titles bestowed to professionals who are counselors but not at the educational or academic level of psychiatrists, psychologists, or social workers. Often, these titles vary slightly according to state board guidelines, which can be somewhat less standardized from state to state. They may be no less qualified to treat you, but it is important to see someone who is licensed in his or her professional field. Ideally, your clinician would be qualified as both an addiction counselor and as a licensed mental health professional.
Finding the Right Addiction Therapist
Now that you know the differences between professionals, let’s talk about how to find the right addiction therapist for you. There are two common ways to find a psychiatrist and/or psychologist: (1) research local addiction professionals online, or (2) identify an addiction therapist who is recommended to you by another professional, friend, or family member. Both are perfectly legitimate ways to begin your search for the best match.
Once you think you have found someone, follow these steps to determine if they are competent, credible, and a good match for you. First and foremost, check their credentials to see if they are who they say they are. Make sure they have the associated degree of the professional discipline you personally are looking for. The professional you go to should be licensed, and the license should be up to date and clearly indicated on his or her website or profile listing.
If you think you found someone but they end up not being the right match for you, do not give up hope. It may be important to explain very clearly to this person what it is that you feel you are not getting.
Secondly, whether you want to see an addiction psychologist, psychiatrist, counselor, or psychotherapist, you should determine what expertise the person has in the field of addiction. This can be daunting because, across disciplines, there is no standardized way of determining one’s expertise in addiction. For example, while psychiatrists can be board certified in addiction medicine, addiction psychologists might obtain their proficiency by having (1) additional certification as a certified alcohol and drug counselor, (2) by being a member of the American Psychological Association Division 50 Society of Addiction Psychology, or (3) by having conducted research and published articles on addiction. Moreover, addiction counselors may have a certification through a state board, yet they may lack the background and training that a psychologist receives in mental health issues. This is important because half of all individuals who are diagnosed with a lifetime prevalence of addiction will also be diagnosed with a lifetime prevalence of another comorbid mental health diagnosis. Furthermore, one might not want to see a psychiatrist who specializes in medication management and may not have as much training and experience in the various treatments involving the talk therapies.
Third, check reviews online. There are excellent therapists who don’t yet have reviews online, perhaps because they haven’t had an online presence or because it’s just not ethical to ask for reviews. Many psychotherapists will have colleagues write reviews for them, which is a helpful way of getting recommendations. One bad review can affect someone’s listing significantly, so look carefully at all the reviews to be fair.
Fourth, review the professional’s website and other sites where their practice might be listed to see that they offer “evidenced-based” or “best practices” treatment. While these buzzwords have quite frankly become passé and obsolete as they have been co-opted by marketers, you want to be sure that your therapist at least knows about the most up-to-date evidenced-based treatment approaches. Ask what treatment the professional uses that is evidenced-based, or ask for an opinion on something you’ve learned about, like harm reduction, 12-step facilitation, motivational interviewing, or mindfulness-based stress reduction or relapse prevention.
Fifth, have a phone conversation to see if you feel some sort of connection to your addiction therapist. This may be a feeling of confidence or an inexplicable bond of initial trust, but in either case, feeling secure with your addiction therapist is crucial. It is completely appropriate to say you are shopping for a therapist and that you’d like to speak on the phone to ask some questions or let the person know what is going on to see if it even makes sense to set up an appointment. This also allows the therapist to gauge whether you’re a good fit for him or her, and if not, to offer a referral.
Sixth, make a follow-up appointment where you can meet the person face-to-face and see if your initial instinct was correct. It is also reasonable to meet once or twice before you decide whether to commit to working with the person while you develop a treatment plan together. Remember, most importantly, you are looking for someone you connect with. You and the professional should both believe that the therapist can help. You are looking for someone you can afford, someone with whom you can feel comfortable, and someone you believe can help you.
If you’re lucky, you may get all these steps right on the first try, but many people do not. If you think you found someone, but they end up not being the right match for you, do not give up hope. It may be important to explain very clearly to this person what it is that you feel you are not getting. Often, the difficult experience you are having with the therapist is related to the reason you are in therapy to begin with. In other words, the conflict or problems you are having with your therapist may be the sorts of problems you have in other relationships and could be driving addictive or compulsive behaviors, and now you have an opportunity to work through those issues with a therapist who is trained to help you see your role in the relationship and in other, more important relationships. This is a wonderful opportunity to learn about yourself.
If your therapist shies away from this sort of dialogue, they will not be helpful to you. Sometimes, the match is just not right and you have to find another therapist. The right person is out there; you just might have to work a little harder to find that person.
In summary, because addiction treatment is a unique field, it is essential that your addiction therapist have a solid background in mental health and not just expertise in addiction. Since many of those with a substance use issue in their lifetime will also meet the criteria for another mental health condition, it is clear that these comorbid conditions are interrelated and may fuel each other. This is why it is so important that your therapist be an expert in both domains. When you seek help for addiction, you may experience issues such as depression, anxiety, trauma, attention-deficit hyperactivity, and relationship problems. Addiction therapists who are not licensed, such as recovery coaches and interventionists, can have an important role, but only when mental health professionals who are licensed are supervising and quarterbacking the treatment.
Once you’ve found an addiction therapist who is a good fit and you begin to understand your addiction issues—medical, psychological, and otherwise—you may feel as if a big weight has been lifted off of your shoulders. While most individuals considering stopping or reducing their drug or alcohol use are loath to imagine their lives without the use of alcohol or drugs, many recovering individuals report that their lives are vastly improved and that that their worst days in recovery are far better than their best days using.
© Copyright 2015 GoodTherapy.org. All rights reserved. Permission to publish granted by Jeremy Frank, PhD, CAC, Drug and Alcohol Addiction Topic Expert Contributor
The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by GoodTherapy.org. Questions or concerns about the preceding article can be directed to the author or posted as a comment below.