Understanding Your Therapist’s Scope of Practice and Its Impact on Your Care

Dr. Amy Marschall, an autistic clinical psychologist with ADHD, specializes in supporting children and adolescents who share similar neurodiverse identities. She holds certifications in Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) and telemental health services.

In mental health care, a therapist’s "scope of practice" defines the specific areas of specialization they are trained and experienced in. This encompasses the knowledge, skills, and clinical expertise necessary to provide effective therapy and counseling tailored to various mental health diagnoses and client needs.

While graduate programs offer broad foundational training, therapists often develop preferences for certain therapeutic approaches and feel more confident addressing particular diagnoses. Recognizing the boundaries of their scope ensures clients receive the most appropriate and high-quality care.

How Do Therapists Define Their Scope of Practice?

Therapists’ individual strengths and personal connections often guide their choice of specialization. For instance, a therapist with a reserved demeanor might find it challenging to engage young children through play therapy, whereas a more playful therapist might resonate better with younger clients.

Similarly, adult clients may prefer therapists whose style aligns with their own personality and needs.

Many therapists choose to specialize in areas reflecting their own lived experiences, such as specific mental health conditions, which allows them to offer deeper empathy and understanding.

Demographic similarities also influence scope choices; for example, LGBTQ+ clients often seek therapists who share or deeply understand their identity.

Some therapists identify underserved populations within their communities and dedicate their practice to meeting those specific needs.

The professional setting also shapes scope; a therapist working in correctional facilities will focus on issues pertinent to incarcerated individuals.

Common Types of Therapy Scopes

A therapist’s scope includes the mental health issues they treat, the age groups they serve, and the therapeutic techniques they employ. Expanding one’s scope often involves additional training and clinical experience.

Certain modalities, like Eye Movement Desensitization and Reprocessing (EMDR), require specialized certification and are frequently used for trauma survivors. Therapists certified in EMDR typically concentrate their practice on clients benefiting from this treatment.

Others may focus on specific diagnoses, such as eating disorders, where specialized expertise is often limited but critically needed.

Some therapists maintain broad scopes, especially in rural areas where mental health providers are scarce. These therapists must be versatile in addressing a wide range of conditions common to their communities.

Throughout their careers, therapists may refine or broaden their scope based on evolving interests, skills, and community needs.

Why Is It Crucial to Understand a Therapist’s Scope of Practice?

Just as you wouldn’t consult a dermatologist for kidney issues, it’s essential to work with a therapist trained to address your specific mental health concerns.

Engaging with a therapist outside their expertise can lead to ineffective treatment or even harm. Therapists lacking current knowledge on best practices for your diagnosis may not provide the quality care you deserve.

Therapists also consider their personal wellbeing when defining their scope; for example, a therapist managing their own trauma may avoid treating clients with similar experiences to maintain professional boundaries.

The scope of practice is designed to protect clients and ensure they receive competent, ethical care.

What Happens If Your Needs Fall Outside a Therapist’s Scope?

Therapists have an ethical obligation to refer clients to more suitable professionals when a client’s issues exceed their scope. This practice safeguards clients from inadequate treatment and is mandated by professional ethical codes.

Therapists maintain networks of colleagues and resources to connect clients with specialists better equipped to meet their needs.

In some cases, therapists may pursue additional education or supervision to expand their competencies, especially when limited referral options exist, such as in remote areas.

Tips for Finding the Right Therapist

Taking the initial step to seek therapy can be challenging, and it’s important to remember that referrals to other providers are made with your best interest in mind.

Many therapists clearly list their specialties on their websites, making it easier to identify those suited to your needs. Online directories allow filtering by diagnosis and treatment methods to find the best match.

Your primary care physician can also be a valuable resource, often providing referrals to local therapists with relevant expertise.

Ultimately, partnering with a therapist who understands your unique concerns and has the appropriate training is key to effective treatment.

Explore more about choosing the best therapy type for you and getting started on your mental health journey.

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Sources: Verywell Mind relies on peer-reviewed research and authoritative guidelines to ensure accurate, trustworthy information.

1. Terrell PA, Osborne C. Teaching Competence in Counseling: A Focus on the Supervisory Process. Semin Speech Lang. 2020 Aug;41(4):325-336. doi:10.1055/s-0040-1713783.
2. Grus CL, Skillings JL. Scope of practice considerations related to master’s training and psychological practice. Professional Psychology: Research and Practice. 2018;49(5-6):311-313. doi:10.1037/pro0000198
3. American Psychological Association. Ethical Principles of Psychologists and Codes of Conduct.
4. American Counselors Association. 2014 ACA Code of Ethics.
5. National Association of Social Workers. Code of Ethics.
6. American Association for Marriage and Family Therapy. Code of Ethics.

Authored by Amy Marschall, PsyD
Dr. Amy Marschall is an autistic clinical psychologist with ADHD, specializing in working with neurodiverse children and adolescents. She is certified in TF-CBT and telemental health.

Updated by Hannah Owens, LMSW

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