Clinic or Private Practice?

Choosing between seeing a therapist at a mental health clinic or a private practice is an individual issue. Each setting has pros and cons, depending on the type of services your child needs. When making your decision, what is most important is how you and your child feel about the person and the services being provided.

Private Practice

In order for a therapist to work privately, and charge your insurance company for the visit, she must be licensed by the state she works in. Some psychologists in private practice do not take insurance at all, or only work with a select few insurance companies. Always ask what the fee is. Sometimes it can be more than in a clinic setting. Often with a private clinic or practitioner, you will pay the full cost of the services, less the amount paid by your insurer. If you need medication, group, or other services, you might be referred out to another provider. Some therapists in private practice run their own groups, but they are usually specialized. Examples include groups for eating disorders, anger, anxiety, or depression.

Services Offered by a Private Practice

Many private offices have specific times when the office is open and when the therapist will be available to return phone calls. When you see someone in a private practice, he may or may not be more accessible than a provider in a clinic setting. Some private practitioners answer the phone themselves and schedule their own appointments, and others use answering services. Some private offices have an after-hours answering service or offer emergency services. Sometimes you can get an appointment within a week or two of your first phone call, and can be seen regularly right away, but it may take weeks before you can get in for an appointment if the therapist is good. Many offer early morning, day, and evening hours, and sometimes see clients on Saturdays. Some offer a sliding fee based on your income. Often psychologists in private practice have an office and waiting room that is specially designed with the client in mind. They will create a space that feels comforting, warm, and relaxing, very much like a living room.

A Clinic

Unless you are calling for a specific person you might be given to the therapist who is next in line for a referral. However, many clinics use triage systems to determine the best fit between a client's needs and therapist availability. Always ask about the therapist you are scheduled with if someone has not given you a specific name. Therapists might be right out of school, be licensed or not, be receiving supervision or not, or be degreed in psychology or not. Often you can wait weeks to get an appointment, similar to private practice, and if the clinic is busy, your child might not be able to be seen again, by the same person, for another month. It can take awhile to get on a therapist's schedule with frequency. Often clinics offer a sliding fee scale and many try to become a provider for every insurance company possible, including medical assistance/Medicaid and Medicare. There are some clinics that have a psychiatrist and vocational counselor on staff, or can provide testing and assessment as well, providing you convenient access under one roof.

Services Offered at a Clinic

Usually you will find a multitude of options at a mental health clinic because of the number of counselors or mental health workers on staff. Most offer psychological and psychiatric evaluations, medication and medication management, psychological testing, individual, group, and family therapy, play or art therapy, crisis intervention, and twenty-four-hour emergency services. Most clinics have a larger waiting room, similar to a doctor's office, where you will sit with a number of people waiting for your appointment. A clinic will usually have a business office, several people who do your scheduling, and an office manager. A clinic normally offers evening hours for appointments and may also have weekend hours.

Things to Consider

Pay attention to the surroundings and the staff, noticing if they feel comfortable in the space and are respectful and warm to one another. Check to make sure client confidentiality is protected. Use your own instincts; knowing your child best, you can make a good determination of what would be a comfortable setting for him.

Essential

If when you first meet the counselor she does not greet you warmly, with eye contact, seems distracted, rushed, or not able to find a sense of ease with your child, you might need to look for another therapist.

When you do choose a therapist or psychiatrist, find out who covers for her when she is not working, or is on vacation. Always ask who does the billing for insurance and how co-pays or the fee is collected.

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