Finding a Therapist for Your College Student 2.0

The last time I published a post on this subject, way back in 2019, we could go to Starbucks, hug a stranger, and go grocery shopping without looking like we’re about to rob the place. Since then, a lot has changed thanks to COVID-19.

Anxiety and depression are way up, especially among students. Access to counseling services is super limited—most therapists are only seeing clients via phone or video conferencing. Even as states loosen restrictions, many providers are likely to maintain minimal in-person sessions. When students head back to campus in the Fall university counseling centers (CAPS) will likely have reduced availability and will likely use virtual sessions. Most CAPS centers can't work with students virtually if they are physically in another state.

Home or school?

Is it best to find a therapist at home or near school? As of right now, nearly all counseling is virtual or phone which means, technically, it doesn’t really matter where the therapist (or your son or daughter) is located, they theoretically just need a device and internet. But, like the dilemma mentioned above with CAPS and providing service to out-of-state students, many providers are not permitted to provide counseling services out of the state in which they are licensed.

Benefits of a home (virtual) therapist?

Though most counselors have the same type of training (e.g., graduate school) there are unique benefits from working with a counselor from your geographical area.

Cultural considerations, colloquialisms, and personality traits may provide a stronger rapport between the counselor and the student, even if the counseling is over the phone or virtual.

School counselor

One really important consideration to working with someone around school is that you are likely to not get wait-listed. Most students leave spring semester with their fall class schedule nailed down, which means you could conceivably get all of the counseling sessions scheduled through till the end of the semester. 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 starts. This sort of planning also helps your son or daughter anticipate and plan accordingly if they want 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 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.

The search begins

So how does a student or parent find a therapist? Regardless of whether you’re looking for a local therapist, someone near campus or someone virtual, Even if you’ve found one in the past, you may have simply googled "anxiety" or "depression" or "therapist" or “counselor” and your zip code and found a list of random providers. They probably showed up on Psychology Today.

The first thing to consider is that it’s difficult to verify a provider’s expertise. For instance, you will find therapists that claim to treat all ages, all diagnoses (e.g., depression, anxiety, substance abuse, eating disorders) and have expertise in all modalities (e.g., DBT, CBT, motivational interviewing). They may have a basic understanding of those diagnoses and modalities, but they are far from deep experts.

Another thing to consider is that online databases are blunt tools and really good for two things: Finding a therapist within your zip code and Finding a therapist that accepts your insurance.

And lastly, check with your insurance company. Insurers have patient portals where they keep a database of providers within a geographic area and, obviously, accept your insurance. They rarely have much detail about the therapist but at least you can confirm they're in-network.

Alphabet soup

You're likely see a whole bunch of letters after providers’ names. Most licensing boards require clinicians to list their degree as well as their license to the public.

Here's 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
• M.D.: Medical Doctor
• D.O.: Doctor of Osteopathic Medicine

Here are some details on what the most common credentials and what they can and can't do.

Psychiatrist. A psychiatrist is a physician who specializes in mental health and may further specialize in a specific area. A psychiatrist can do the following though they mostly prescribe medication:

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

Psychologist. Typically, a psychologist holds a doctoral degree (Ph.D., Psy.D., Ed.D.) and can provides the following:

• Conduct psychological testing
• Diagnose and treat mental health disorders
• Cannot prescribe medication (though there are rare exceptions)

Licensed Clinical Social Worker. Make sure to 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 at least 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.). Social workers can:

• Provide assessment, counseling and case management
• Cannot prescribe medication

Licensed Professional Counselor. Training required for a counselor (L.P.C., L.M.H.C., LCMHC) varies slightly by state, but most have at least a master’s degree with clinical experience. Counselors can:

• Conduct testing, diagnosis and counseling for a range of concerns
• Cannot prescribe medication

Background checks

I think it's important to google providers to look up their info to make sure there isn't any crazy media stuff or off-the-wall reviews. It's also a good idea to to go directly to the provider's licensing board and verify they are in good standing and don't have any formal complaints against them.

Questions to ask

When you're looking for a therapist and have an initial call or consult, think of it like you are interviewing them for a job.

Treat it like a hiring interview and have a plan. Here is the list of questions to ask when considering whether or not to work with someone:

• 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?
• 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?
• And for virtual and phone counseling, do you work from a professional office or home office? If you have a home office, how do you maintain professionalism and confidentiality?

First session

First, complete all the necessary intake and payment forms before the first session. Next, for the first (and all) virtual and phone sessions, check apps/settings/login stuff 30 minutes prior to sessions. For in-person sessions, show up early and come prepared with questions, concerns, goals or obstacles regarding your issues. I find it helpful if parents or clients email me prior to the first session so I have more context than just my online intake form. 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, let the therapist know you want to sit in on the first 30 minutes to download some history and concerns you have. It’s also a great time to sign a release of information so the therapist can legally speak with you between sessions.

Final notes

Working with a therapist over summer break can help parents understand what's going on with their college student and what's most effective. Developmentally appropriate emotions and behaviors can often look similar to mental health challenges. A good therapist can also help your college student feel supported and stabilized, set them up for a great fall semester while also helping parents feel more confident their college-aged kid heading in the right direction.

To search for a therapist near you, visit the Psychology Today Therapy Directory.