Many people do not realize the importance of the setting for the treatment they are receiving.  Different settings (hospitals, clinics and private practices) are designed for different types of treatment and to work with different types of problems.  Sometimes when people are looking for a therapist they are told that the setting they have chosen is not "appropriate."  This of course is not helpful because they do not know how to make a better choice in treatment provider.  Very generally, these are the different types of treatment settings and what they are designed to treat:

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Private Practice:  This is usually the setting that people have in mind when they first decide they should look for a therapist.  Private practices provide a level of comfort and intimacy that the other treatment settings often do not offer.  Private practice therapists may or may not accept insurance.  Therapists in private practice are probably also the most guilty of telling people that they are not "appropriate" to be seen in their office.  Usually what this means is that that particular therapist does not have training in the specialty that your treatment would require (See below to determine whether or not you should see a specialist.) or that you should be seen in another treatment setting altogether.  While it can feel personal when a therapist says they cannot treat you, they are actually making a decision based on their ethical responsibility to direct you to the best treatment option.

 

Outpatient Mental Health Clinics (OMHCs): These clinics are a good choice if you want something like a private practice but do not have an insurance that is widely accepted by private practices or need to pay a lower fee.  These clinics also offer an advantage in that your therapist is more likely to work in-office with a psychiatrist which is helpful if you are taking medications. This allows for a more collaborative relationship between your therapist and psychiatrist. Private practice providers can still collaborate with your medication provider, but this close and frequent interaction with psychiatrists is one advantage of Outpatient Mental Health treatment. Lastly, OMHCs are well connected to a number of other services and typically have case managers to help you with a wide variety of problems that cannot be addressed in therapy.

 

Intensive Outpatient Programs: These programs come under a number of labels but they all involve multiple visits each week and sometimes ask people to be present for most of the day, every day.  They are a good option for individuals who are just coming out of the hospital or who find that they have been hospitalized multiple times without making sustainable gains in their recovery.  There are some specialized programs that offer intensive treatment for specific diagnoses such as schizophrenia, bipolar disorder, addiction, eating disorders or personality disorders.

 

Hospitals: Hospitals have inpatient units which are used to help people stabilize when they have a crisis severe enough to put themselves or others at risk. Many people do not know that hospitals also have outpatient units to provide regular mental health services.  These outpatient clinics accept the widest variety of insurances and offer access to affordable treatment.  They are also ideal for anyone who has had to be in the hospital within the past year or two because each therapist is connected to an interdisciplinary team and can quickly connect you to any service that you might need (including the emergency room or inpatient service).