When You Don't Know Where to Turn / A Self-Diagnosing Guide to Counseling and Therapy

by Steven J. Bartlett

Clinical psychologists generally have a Ph.D. and complete a lengthy internship in a clinical setting. Most clinical psychologists develop competence in both diagnostics and intervention. The area of diagnostics includes individual interviews, psychological testing, and personality assessment (psychological evaluation to determine what a client's difficulties are). Intervention (the actual approach used to help a person) includes individual psychotherapy, group therapy, and marriage and family therapy.

The objective of counseling psychology is to encourage growth in the three major life areas of family, work, and education and to prevent excessive psychological stress in them. Like clinical psychologists, counseling psychologists receive training in individual, group, and marriage and family counseling as well as in vocational counseling, assessment, and rehabilitation.

Often, you will find clinical psychologists in private practice, while many counseling psychologists hold positions in organizations, schools, and social service agencies. Counseling psychologists generally have a master's degree or Ph.D. and also are required to complete internships in supervised counseling.

Psychometrists are specifically trained to give and to evaluate psychological tests. They are, so to speak, the "radiologists" of the fields of counseling and psychotherapy. Clients may be referred to a psychometrist in order to take one or more psychological tests; the psychometrist's interpretation of the results is then forwarded to the client's therapist or counselor. Increasingly, psychologists are being trained to do much of this work themselves, so it has become less common to refer clients to psychometrists unless an extensive amount of testing is desired.

If you are advised to take one or more psychological tests, you may be interested in knowing what to expect. Many psychological tests are multiple-choice. You are given a printed list of questions and an answer sheet. There are no "right" answers. You answer such questions as "Would you rather go to a party or stay home and read a good book?" Tests like this attempt to provide insight into a client's outlook, personality, concerns, values, and interests. Some tests help to assess concentration, coordination, and problem-solving ability. Results of psychological tests can be helpful to a counselor in deciding how best to treat a client's problems. Testing can be a great time- and money-saver in therapy: the results of a twenty-minute test can give a counselor information about a client that might otherwise be gained only through a number of sessions.

FEES

Because of their more advanced training, clinical psychologists can be expected to charge fees that are somewhat higher than what social workers in private practice receive. Charges for the services of a clinical psychologist are made on an hourly basis; counseling sessions usually last forty-five to fifty minutes, although some psychologists will see clients for shorter periods.

Rates vary considerably according to geographical area. An approximate range of $50 to $80 per private session is normal at this time. Group session rates tend to be significantly lower.

If you consult a clinical or counseling psychologist who works through an agency, you will often find that a sliding scale is used to determine charges, as in social work. If you have limited or no health insurance, and financial concerns are a problem, you can telephone counseling agencies in your area to ask whether a sliding scale is used and, if so, what charges correspond to your monthly income. Later, we will look at how to locate counseling agencies, as well as professionals in private practice.