For instance, Michael Sherman, chief medical officer for Harvard Pilgrim Health Care, said his company, as a general rule, pays for treatment administered by state-licensed mental health clinicians with advanced degrees who can practice without supervision. By that standard, over the past decade, Harvard Pilgrim began reimbursing licensed independent social workers, mental health counselors, and marriage and family therapists.
According to many mental health specialists, anyone seeking therapy services should first see a primary care doctor (or a pediatrician in the case of a child) to rule out any physical ailment to explain the emotional distress. For instance, some hormonal or neurological problems can explain depression or mood issues. Once a physical problem is ruled out, then a doctor can often help advise the patient about what type of therapist is best suited for their specific issue — such as a psychiatrist who can prescribe medications if bipolar illness is a possibility, a social worker if school troubles loom large, or a marriage and family therapist if divorce is on the horizon.
Eisman, of the Massachusetts Psychological Association, said there is also the intangible of chemistry between a patient and clinician — no matter if they have a MD, PhD, or LICSW after their name. She said any good clinician has had his or her share of therapeutic relationships that just didn’t work, and often can facilitate a better referral if necessary.
“Therapy works best when you can talk honestly,” she said.
Patricia Wen can be reached at firstname.lastname@example.org.