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FAQs (Frequently

Asked Questions)

Answers provided by OPS

Clinic Director, Dr. Lisa Hardebeck​


Psychologists, psychiatrists, therapists, counselors: What’s the difference?

For the lay consumer, I know there can be some confusion about all of the different titles used by mental health practitioners. Below, I have made a chart to define some of the confusing terms and initials. One good way around the confusion is to ask your family physician for a referral when you need mental health assessment or care.

In any case, do not be afraid to ask mental health practitioners about their education and training; most of us are used to fielding these types of questions.


Advanced Registered Nurse Practitioner. Nurse practitioners sometimes work in the mental health field, and often prescribe medications.

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Basically a generic term for anyone who "counsels." No specific education or license is required to use this title.

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Licensed Social Worker. Social workers sometimes work in the mental health field. They must have at least a master's degree. There are three levels of licensing for social workers in Washington 
State. You can read the requirements for all levels here.

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Marriage and Family Therapist. May mean that they are a L.M.F.T., or it could mean that they are a member of the A.A.M.F.T. or the W.A.M.F.T.

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A medical doctor who specializes in mental health, and can prescribe medications and/or conduct therapy. Must be a licensed physician. Typically will be "board certified" in psychiatry, although 
any physician who specializes in mental health might legally be able to call themselves a "psychiatrist."

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A title that was discontinued by Washington State some years ago. The title simply meant that the counselor had registered with the state, but had no specialized training.

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Chemical Dependency Professional. Must have at least an AA degree, and the state requires specific training for this title. See the full licensing requirements here.

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A person with this title has a doctorate degree in education.

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Licenced Mental Health 
Counselor. Must have a master's or doctoral degree and supervised 
training. See complete licensing requirements here. An "L.M.H.C. Associate" is someone who has completed their academic degree, but is still working on their training hours.

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(M.A. or M.S.)

A master's degree is designated by the initials M.A. (Master of Arts) or M.S. (Master of Science). Specialized master's degrees include a Master of Arts in Counseling (M.A.C.), a Master's in Education (M.Ed.), and a Master's in Social Work (M.S.W.). A person with a master's degree probably has extensive education and training in mental health issues, unless, of course, their master's is in an unrelated field. A person may also have a master's degree, but may not have met the licensing requirements to be a L.M.F.T., L.M.H.C., or L.I.C.S.W.

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A person who practices psychoanalysis, which is a branch of psychology. Typically a "psychoanalyst" will have a Ph.D. or Psy.D., although it may be legally possible to call oneself a psychoanalyst without any specialized education or training.

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School psychologists administer some academic and cognitive assessments, and conduct therapy. However, they are not licensed psychologists and are not required to have a doctoral degree. They must have at least a master's degree and training in assessment. Other requirements can be seen here.

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The term "clinical" before or after a title simply indicates that the person works with people in a clinical setting, rather than, say, working in a research or academic setting. No specific education or license is required to use this term.

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Must have a master's or doctoral degree and supervised training. See complete licensing requirements here. An "L.M.F.T. Associate" is someone who has completed their academic degree, but is still working on their training hours.

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Life Coach

A generic term for anyone who gives advice on life's 

difficulties or changes. No specific education or license is required to use this title.

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(Ph.D. or Psy.D.)

A doctor of psychology who is licensed by the state to perform psychological assessments and conduct therapy. See complete licensing requirements here, and read more detailed information from the state here. All psychologists have a doctoral degree (Ph.D. or Psy.D.), however sometimes a person may have earned the academic degree, but may not be a "licensed psychologist" because they have not met the licensing requirements of the state.

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A person who practices psychotherapy, which is a type of mental health therapy. Typically a psychotherapist will have a master's or doctoral degree, although it is legally possible to call oneself a psychotherapist with no specialized education or training.

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Basically a generic term for anyone who conducts therapy. No specialized education or license is required to use this title, or other forms of "therapist," such as "hypno-therapist," "equine-therapist," etc.

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Will my insurance cover mental health services?

Most health insurance plans will cover visits to a psychologist for therapy or psychological assessments. However, coverage can vary a great deal depending on your specific plan, so it is important that you are familiar with your coverage, or call your insurance company and ask. Insurance companies typically do not cover couples or marital counseling.

For more specific information about the insurance companies that Olympic Psychology Services contracts with, visit the fees page HERE.

In the event that Olympic Psychology Services does not contract with your health insurance company, you may be able to use your "out-of-network" benefits. To do so, you must initially pay out-of-pocket, and then we will submit a claim to your insurance company for reimbursement at out-of-network rates. Insurance companies will typically reimburse you for 60%-80% of the costs for an out-of-network provider, although this varies by plan.

In some situations, OPS also accepts payment from third-party payees, such as law firms, school districts or other government agencies.

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Why do I need a psychologist? People should be able to make behavioral changes for themselves, or for their families.

True, most of the time, people can change their own undesired behavior, or can help their children change negative behaviors. When individuals and families are able to function healthily, they do not need the services of a mental health professional.


But sometimes people need help because a situation becomes unmanageable. Mental health care is similar to physical health care in this way: most of us can manage everyday cuts and bruises, but we certainly wouldn't think of conducting surgery at home. Helping someone who is “having a bad day,” or teaching children to behave properly are certainly manageable within most families. But conditions such as clinical anxiety and depression, autism spectrum, eating disorders, phobias, psychosis, and many, many others are indeed serious. People who have these conditions are not just “looking for attention,” and are not able to “just stop acting like that” on their own.


In addition, there are sometimes difficult situations that might ultimately be manageable on your own, but a mental health professional can help to direct your efforts and get better, faster results. These situations might include child behavior concerns, relationship problems, adjustment to life changes, and self-esteem difficulties.


Sometimes families and individuals need the help of a mental health provider. It is not a sign of weakness any more than seeking the help of a physician.

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Isn't it kind of weird or strange to talk about my personal issues with someone I don't know? 

Talking to a psychologist might feel awkward at first. But part of our job is to establish trust and a good working relationship with every client. We are trained in how to do this.


It's important to remember that talking with a psychologist is not the same as talking with a friend (or family member) about problems. A friend might care about you in a different way than a psychologist. But if you think about it, that caring and history between the two of you might inadvertently get in the way, or cloud the issues at hand. Talking with a psychologist will usually bring much more clarity to the situation, because a friendship is a personal relationship rather than a professional relationship. A psychologist will work with you in achieving specific goals, and will devise treatment plans to meet those goals. A psychologist has many years of education and training in knowing how to do these things.

When your mental health is not in balance, it's good to have friends to talk to, and it's good to have a therapist. But they are not the same.

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What is a visit to a psychologist like?

Usually, a first appointment is what we call an "intake interview." At this time we would discuss your reasons for coming to us, and we would collaborate on a plan to meet your needs.

Therapy appointments are scheduled regularly, typically once a week or once every two weeks. There are many different types of therapy, depending on the age of the client and the specific issues involved. For young children, "play therapy" is often used to address their needs. Most other types of therapy are classified as "talk therapy." Talk therapy can include a number of approaches, in which the client verbally works through his or her issues with the guidance of the psychologist. Some talk therapy approaches are more focused on identifying and changing specific thought patterns and behaviors, while other approaches focus on processing thoughts and feelings related to personal relationships and 

As your goals for therapy are achieved and/or as you begin to feel more at ease in your life, you and your therapist will begin to discuss tapering appointments further apart. When you feel ready to discontinue therapy, it is generally useful to schedule an ending session or two with the therapist, in which the two of you will review your progress and discuss a plan to help you maintain and strengthen your gains on your own. 


Psychological assessments vary greatly. For children, psychological assessments often seem like playing a game, drawing pictures, or solving a puzzle. For adolescents and adults, there are often many questions to answer, and sometimes problem solving activities. Most assessments are designed to seem relatively simplistic on the surface. You will get the most benefit from a psychological assessment if you simply relax and be as open and honest as possible. Children should not be "prepped" for an assessment; this often produces only anxiety, which is usually  counterproductive. It is best for parents to simply give some very minimal information to the child about the visit, and then adopt a relaxed, pleasant attitude.

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How can I talk a family member into going to therapy?

First of all, it is not advisable to try to force someone into therapy; a willing (if somewhat skeptical) participant generally leads to a more successful outcome. Except in extreme situations, it's generally best for all forms of mental health care to be a choice. But even if a loved one refuses help, it is still possible for you to respectfully and lovingly tell the person that if they will not participate in therapy, it can still be your choice (and your right) to go on your own, so that you can find better peace of mind.


That being said, there are some good strategies for helping a loved one to see that therapy might benefit them:

  • Find a good time and place to have an extended conversation about therapy. Do not approach the topic in anger or frustration, instead stress how much you care about the person and reassure them that you are suggesting therapy out of your love and concern for them.

  • De-stigmatize mental health care. Maybe the person knows someone else who has benefitted from therapy. Maybe someone famous whom they admire has benefitted from therapy. (Here's a great video about an NFL player working to normalize mental health care.) Talking about these therapy "role models" could be used as a lead-in to your conversation.

  • Offer your support. Offer to go with them to the appointment, either into the therapy room or to wait in the waiting area. Tell them that they do not have to divulge what happens in therapy. Give them every reassurance and every bit of support that you can.

  • Remind them that they do not have to continue if therapy does not seem to be helping. If there is a chance that therapy might make life better, why not give it a try?

  • For more thoughts on encouraging a loved one to see a therapist, check out these links:

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