What is the difference between a psychological problem and a psychological diagnosis or disorder?

The short answer - there is no difference. The words diagnosis and disorder are medical terms, based on an illness concept of describing psychological problems. There is some value in using the medical model to describe psychological problems. But, it also creates confusion about how to properly treat psychological problems, because it implies that they are medical problems, rather than psychological problems. That leads to a conclusion that medical treatment, such as drugs, must be better than psychological treatment, such as psychotherapy. That conclusion is simply is not true. In fact, many research studies have found psychological treatment to be superior to drug therapy, and without the dangers present in all drug treatments.

The word diagnosis refers to the process of determining the cause of a disease, malfunction or problem. A disorder is a mental or physical disturbance, or a disease. A problem is a difficult matter to be settled, or a question set forth for solution or discussion. Some psychological problems might fit the medical model to some extent, but many do not. Most therapists prefer to use the problem model to describe and explain psychological issues. However, in order to consider whether the remediation of psychological problems should be covered by medical health insurance, insurance companies require a medical diagnosis. As a result, the medical model will probably always be a part of psychological services.

How to Select a Therapist?

Selecting a therapist is similar to selecting any other professional. You should assess the therpist's credentials, including both training and experience. Discuss the fees before you begin treatment, and verify your insurance coverage for psychological treatment. Ask questions about the services that will be provided, so you will not get something different from what you expected. Finally, spend enough time talking to the therapist prior to the initial meeting to determine how comfortable you feel when interacting with the therapist.

Here are some important questions to ask:
• Is the therapist licensed to practice in your state?
• Does the therapist have experience treating your specific problem?
• What other experience does the therapist have?
• Does the therapist have a specialty?
• What kind of treatment will be used for your problem?
• What is the cost of treatment?
• What are the billing policies? Is insurance coverage accepted?
• Is there a sliding fee, if you can't afford the full cost of treatment?
• Is the office conveniently located?
• What are the office hours? Is an appointment available within a few days?
• If you have health problems, will the therapist consult with your physician?
• If you are taking medication, will the therapist work with your physician?

After gathering the above information, briefly state what your problem or issue is, and ask how the therapist would proceed in working with you. This conversation will be an important measure of your comfort level with the therapist. Does the therapist listen to you? Do you feel comfortable talking to him/her? Do the ideas presented sound like a good place to start working on your problem? If you can't discuss your problems on the telephone, then set a date and time for the first appointment, and see what happens. But remember, you can always switch to another therapist if you decide that treatment is not working for you.

If you have a managed care health plan, you may be encouraged, by the insurance plan or your employer, to first obtain the names of other therapists on their panel, and choose from among them. If you follow this procedure, you will eliminate many qualified therapist who may be better able to help you resolve your problem. Most importantly, some managed care plans will first refer you to therapists with less training and experience, because they are paid lower fees by the plan.

Currently, most managed care plans also have an out-of-network option. This option allows you to choose any therapist, and gives you much greater choice. Additionally, an out-of-network choice eliminates the need for constant oversight by the managed care plan, which requires your therapist to provide the plan with confidential information about your problem and your treatment. You might prefer that this information remain confidential. It makes better sense to first select the therapist you feel is best suited to your needs, and then assess the costs of treatment. If the therapist you select is not covered by your plan, you can negotiate the fee with the therapist, if the costs are beyond your means.