What to expect in couples therapy and how it actually works. Too often, couples don’t get the support that could help their relationship because they don’t know enough about couples counseling. Rivkah Krumholz, LMFT and Rabbi Simcha Feuerman, LCSW-R DHL  address questions people have about couples counseling. 


Rivka Krumholz, LMFT Private practice in Marriage and Family Therapy.  Many decades of serving the Jewish community to improve mental health and family relationships.  Individual and couples psychotherapy.

 Rabbi Simcha Feuerman, LCSW-R DHL Director of Operations and Strategic Development for Ohel Bais Ezra / Lifetime Care Foundation. Clinician in private practice, specializing in high-conflict couples and families and male sexual health.



Choosing a mental health professional

adapted from Getting the Help You Need: Who Can Provide Treatment by Hindie M. Klein, PsyD (2015)


Whichever mental health professional you end up working with, it is integral that the therapist be licensed in their field. It is also highly recommended that the therapist receives advanced certification in their specialty, i.e. family and marital therapy. Although this is important, and certainly adds to the expertise of the therapist, it does not take the place of licensure in their particular profession. Licensure signified the person has attended a program accredited by the Department of Education, has complied with all requirements, placements internships, and has passed the licensing exam of that state (or any state where the therapist wishes to practice). These days it is easy to check if a person is licensed via each state’s Department of Education and Licensing website.

The road to recovery via psychotherapy can be exhilarating, painful, difficult and enlightening. Most often, psychotherapy evokes all of those feelings, as well as a myriad of others. What is most important is that the treatment be provided by someone who is well-trained, competent, experienced and licensed in their profession.
Although this is not a fool proof system, it certainly ensures a greater probability hat you will be treated with dignity and respect in a highly confidential emotionally safe environment. In addition, when a person is licensed, they have to agree to a professional code of ethics and can be censured by their licensing board if they stray from their profession’s guidelines.

!  Licensure regulations vary from state to state, so it is important that the therapist be licensed in the state where they are providing treatment.

Types of practitioners


Social worker (MSW, LCSW, DSW) Social workers are Master’s level clinicians who have completed a 2 year post-graduate course in Social Work from an accredited university. A social worker will become a LCSW after they have completed at least 3,000 hours of supervised experience in diagnosis, psychotherapy and assessment based treatment. This is followed by a second licensing exam. A MSW is not yet licensed.   [Master Social Work, Licensed Clinical Social Worker, Doctor of Social Work)

Psychologist (Phd, PsyD)
Psychologists are doctoral level clinicians who have completed 4-5 years of postgraduate training in Psychology from an accredited university. In addition to coursework, psychologists must complete several pre-doctoral externships and a full year of internship. Psychologists are qualified to provide comprehensive psychological evaluations hat can include tests of cognitive ability, social/emotional functioning, personality assessment and academic functioning. Psychologists are also trained to provide various forms of psychotherapy. In order to sit for licensure as a psychologist, psychologists have to complete 1,750 hours of post-doctoral experience.

Mental Health Counselor (MHC, LMHC)
Mental health counselors are Master’s level clinicians who can provide psychotherapy and counseling. They are also trained in psychological evaluation, but to a much more limited degree than psychologists. What distinguishes MHCs from social workers or psychologists is their emphasis on prevention via psycho-education and a holistic approach to treatment. Mental health counselors receive training via a 2-3 year post-graduate program which involves coursework and 600 hours of pre-Master’s supervised experience at various externships. Upon graduation, they are awarded a degree in mental health counseling (MHC). However, they can only sit for licensure after they have completed 3,000 hours of post-Master’s supervised clinical experience.

Licensed Marital and Family Therapist (LMFT)
A LMFT may be trained specifically in this area, without first receiving a pre-specialty degree in social work, psychology, etc. They have completed Master’s level training and a certain number of hours of supervision posts Master’s. Their practice is limited to marriage and family.

Psychiatrists are medical doctors who have completed 4 years of medical school and a post-medical school residency training program in psychiatry. Psychiatrists are qualified to evaluate for medical treatment and can dispense psychiatric medication such as anti-depressants or anti-anxiety agent. Although psychiatrists are most often utilized for medication evaluation and treatment, some will engage patients in psychotherapeutic treatment, in addition to dispensing medication.  To that end, some psychiatrists receive further clinical training in many of the sub-specialty treatments listed above.

Coaches and Pastoral Counselors
Coaches and pastoral counselors are an unlicensed and unregulated field. There are various training institutes that offer training and certification in these disciplines. Some are quite professional and thorough, while others may be no more than a diploma mill. Certifications are sort of like semicha  – they are not regulated by the state and are only as good as the reputation of the institution that gave it. In a general sense, some of these practitioners can be helpful, insightful and supportive, while others could be dangerous. There is no way to know. In addition, if the problems being treated are of a serious psychiatric nature, and not ‘merely problem’, one should only see a professional who is licensed to provide treatment.


Additional training

Psychologists, social workers and mental health counselors often receive further training in clinical sub-specialties, such as Cognitive Behavior Therapy (CBT), hypnosis, Dialectical Behavior Therapy (DBT), Eye Movement Desensitization and Reprocessing (EMDR) for trauma, EFT, marital therapy, group psychotherapy, psychodynamic
psychotherapy and psychoanalysis, the treatment of eating disorders or substance abuse disorders, to name a few.

Mental health professionals can work in different modalities. Individual therapy, family therapy, couples therapy, and group therapy are the most common.  Other modalities include art therapy, music therapy, and sex therapy.  There are many more.




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