Will Meek PhD
Client’s Guide to Counseling

Client’s Guide to Counseling

If you are just getting started in your search for a therapist, or are looking to deepen your understanding of the options, please check out the Client’s Guide to Counseling. In general, mental health services are filled with different titles and technical jargon, and those things can make the search daunting, whether you are in Rhode Island or anywhere else. TL:DR at the bottom. 

Types of Providers

There are a number of different professions that can offer counseling (also referred to as psychotherapy, but the terms are basically interchangeable). The most common you will find are clinical psychologists and counseling psychologists (PhD, clinical social workers (LICSW), licensed mental health counselors (LMHC), marriage and family therapists (LMFT), and psychiatrists (MD, DO). In general, these distinctions are unimportant for most clients. All of them can be helpful, and these differences are really just about level of education (PhD or MA) and training approach (like how much they learned about diagnosis and research). The biggest difference to know is that a psychiatrist is mostly focused on providing medication, whereas all of the others offer mental health counseling. 

I’m a counseling psychologist, so I have a doctorate (PhD), and the training I received was a balance of practical skills and understanding research to help people build on their strengths, while not overly focusing on specific diagnoses. 

Different Counseling Approaches

You’ll see therapists of all sorts describe the approach they take by saying which types of therapy they provide. Some common examples are Cognitive-Behavioral Therapy (CBT), interpersonal and relational therapy, Emotion-Focused Therapy (EFT), Dialectical Behavior Therapy (DBT), Psychodynamic / Psychoanalysis, Acceptance and Commitment Therapy (ACT), and countless others. In general, these just indicate a difference in how much the person is going to focus on thoughts vs feelings, listening vs being active, and past vs present issues. 

Others will write about being “eclectic” or integrative. This basically means they will sample from a range of approaches and mix things together depending on who they are working with. This is how I practice. Just like the previous section, much of his stuff may not matter much for you, unless you are looking for a very specific type of therapist. It is important to note that research has shown over and over that none of these approaches is better than any others; basically all of them work. The effectiveness depends on other things like how much you actually like the therapist, how frequently you attend sessions, and how motivated you are to improve. 

Telehealth vs Office

The coronavirus pandemic really opened up the option of getting mental health help through remote video sessions (e.g. Zoom). Sometimes this is called “online therapy”, “teletherapy”, or “telepsych”. The benefits are that you can do it from anywhere, you don’t need to add extra time in your day for travel, and the number of providers available to people is higher since you can find anyone in your state to work with rather than just who is in driving distance. Traditional office visits are still the most common way people work with a counselor, but research shows that both are effective and that neither is better than the other.

My practice is all online, and although I’m based in Providence, I see people from all over Rhode Island (Pawtucket, North Kingstown, East Greenwich, Barrington, Bristol, Westerly, Warwick, Cranston, Middletown, Portsmouth, Newport, Woonsocket, Smithfield, etc). 

Traditional Therapist vs BetterHelp

It’s almost impossible to not see an add for BetterHelp or TalkSpace at the moment. These are giant online counseling groups that offer a mix of asynchronous messaging and brief live sessions with a therapist. These platforms have become very popular because they have taken a lot of the challenge in finding a therapist out of the equation, made the payment easy (usually just a flat monthly fee), and create a different level of daily accessibility. The drawback for a lot of people is the cost because BetterHelp and TalkSpace do not take insurance, so nearly everyone ends up paying significantly more for them than if they found a traditional therapist.

Generalist vs Specialist

A generalist in mental health counseling is going to be someone that can work with a wide range of people, and it’s so common that most people don’t even refer to themselves that way. There are also many self-identified specialists that work with people that have depression, anxiety (like generalized anxiety disorder), substance use issues (alcohol, marijuana, etc), relationship problems, communication, parenting, work and career development, OCD, anger, trauma, etc. Other therapists may say they specialize in certain populations like college students, small business owners, artists, parents, doctors, caregivers, etc.

Like many of the things above, this part likely doesn’t make a difference in outcomes for most people. If you are really looking for a certain type of specialist, it would also be worth seeing what demonstrates that, like extra training or a certification, rather than just be marketing.

Insurance vs Self-Pay

Many people use insurance to pay for counseling. The big insurance carriers in Rhode Island are Blue Cross of Rhode Island, United Healthcare, Tufts, Harvard Pilgrim, Rhode Island Neighborhood Health Plan, and Cigna, although there are many others. Your ‘copay’ is the amount you pay for each session, although it’s slightly more complicated than just that. Sometimes you may have a ‘deductible’ that applies, which is an amount of money you have to pay first before the copay is allowed. For most plans you get a lower copay for providers “in network” (who are contracted with your insurance company), and the deductible is sometimes waived for those counselors. Additionally, most plans also let you work with people “out of network” (who are not contracted with your insurance company) for a slightly higher fee. The benefits of self-pay are that you can operate outside of all of the restrictions and issues with insurance, but for a lot of people the cost is prohibitive. Insurance does not cover coaching. 

At the moment I am contracted with United, and am in process of adding others. I can also help you work with me as an out of network provider. I am happy to call the insurance company for you and get the plan details and help make sense of it. 

How To Find A Therapist

The most common ways people find mental health counselors are either word of mouth, searching Google for terms like “counselor near me” or “mental health counselor in Providence”, or using one of the major therapist databases like PsychologyToday or ZenCare (my fav). I’d suggest using all of these tools to see who is available, since each of them may bring different results. 

TL;DR / What Actually Matters

OK, so what actually matters? First off, it’s impossible to determine who is the “best therapist” in Rhode Island (or anywhere else really) because it is totally an individual preference. Rather than looking for a specific therapy approach or credentials, I’d prioritize how much you are likely to have a positive experience with the therapist, regardless of the other stuff.

So as you do your search, I’d suggest reading the websites from a bunch of counselors, seeing who looks friendly or makes you feel hopeful (like they could understand you or your concerns), who you feel like you could trust and connect with, or who may have something to offer you. I’d also suggest not getting focused on just one person to start, but meet a few and pick the best fit after that. Research has shown over and over that the connection with the therapist is the most important variable for counseling success. After you get going, if you don’t feel like you’re progressing, tell the counselor. And if things don’t get better after that, then find another person who can help.

I certainly hope I may be that person for you, and if so, then contact me today so we can set up a time to meet as soon as tomorrow. If not, I hope you found this helpful and I wish you the best in your search.