Important Topics

The Team: Understanding who does what on the Treatment Team

When you enroll your young adult in treatment, you’re suddenly part of a rather large team of people trying to help your child thrive.  All the titles and roles on this treatment team can be a bit hard to navigate if you’re new to the therapeutic world.  Following is a quick lexicon to help you understand who’s who and who does what on the treatment team.

• Psychologist: A psychologist is generally a Ph.D. or Psy.D.-level, licensed clinician.  Psychologists may specialize in assessments or may practice psychotherapy.  Often the psychologist’s role is to provide clinical supervision and training for the clinical team, broad case management, and program management.  A psychologist is not licensed to manage medication.
• Psychiatrist:  The psychiatrist is a medically trained (MD) mental health professional who is trained in psychotherapy (with a medical and psychodynamic orientation) and licensed to manage medication.  The role of a psychiatrist in treatment is usually limited to questions of medication management (including prescribing, monitoring, and adjusting), complex psychiatric and medical assessments, and psychiatric-crisis management.
• Direct Care Staff:  Direct-care employees are generally the people who will spend the most time with your child during treatment.  These are usually program-trained, but unlicensed, employees charged with supervision, activities and recreation, safety management, and mentoring/counseling. Some have bachelor’s or master’s degrees and certifications in recreational therapy or other direct-care specialties.  A direct-care team may include dorm staff, activities staff, night staff, and etcetera.
• Advanced Nurse Practitioner: An advanced nurse practitioner has medical and often psychiatric training.  An advanced nurse practitioner with psychiatric training and can offer traditional nursing services as well as certain psychotropic-medication management and psychotherapy.  ANP’s and other nurses may also monitor the health aspects of treatment including those related to eating disorders, self-harm, medication interactions and reactions, and physical/mental health interplay.
• Psychotherapist: Psychotherapists are clinicians who specialize in delivering individual, group, and family therapy directly to clients.  Training for psychotherapists varies widely and may include a master’s degree and one of a variety of licenses (e.g. LMFT, LPC, LCSW, etc.).  Clinical training for psychotherapists may involve specialization in areas such as social work, family systems, or addictions. In a program setting, psychotherapists are in charge of case management, delivery of therapy, and family/professional communication.
• Addictions Counselor: Addictions counselors focus on providing support, counseling, and resources for clients struggling with drugs, alcohol, and other addictive things or activities.  Training varies widely from certification (E.G. CDAC) to graduate studies with a variety of orientations including more traditional approaches such as 12-step recovery, and newer approaches such as SMART Recovery.   Depending on the program’s emphasis, addictions counselors may serve either a primary or supportive therapeutic role.