Helping Your Patients Understand the Types of Military Mental Health Providers

A smiling service member sitting across from a clinical provider
U.S. Air Force photo by Senior Airman Ian Dudley
By Christina Schendel, Ph.D.
May 7, 2018

The good news for service members seeking mental health care in the Military Health System is there are many options for care. But it can be difficult to understand the many types of mental health care providers and the kinds of services they offer. Here is a list of common types of providers found in military treatment facilities. Providers can use this overview with service member and veteran patients, particularly new patients, to help them find the right provider for their specific needs.

Clinical Providers

Psychologist

A psychologist holds a doctoral degree in psychology (a Ph.D. or Psy.D). Psychologists are employed in specialty care (outpatient mental health clinics), inpatient hospital psychiatric units, primary care (as described below), and may be embedded into military commands. Psychologists assess and diagnose mental health conditions; provide therapy; administer and interpret psychological testing; and provide psychological evaluations. Some psychologists in the military are trained and credentialed to prescribe psychotropic medications to their patients.

Psychiatrist

A psychiatrist holds a medical degree (doctor of medicine (MD) or doctor of osteopathy (DO)) and has medical and psychiatric training. Psychiatrists work in specialty care (outpatient mental health clinics), inpatient hospital psychiatric units, and may be embedded into military commands. Psychiatrists diagnose mental health conditions; prescribe and monitor medications; and provide specialty psychiatric evaluations.  

Clinical Social Worker

A clinical social worker holds at least a master’s degree (MS) in social work. Similar to psychologists, clinical social workers commonly work in mental health clinics, hospitals, inpatient psychiatric units, and primary care. They’re also used in family advocacy and family programs to conduct risk assessments and psychosocial assessments of children, adults and families; collaborate with community resources regarding abuse cases; and provide psychoeducation for families and parents. Social workers can diagnose and provide individual and group counseling, case management and advocacy services.

Behavioral Health Technician

A behavioral health technician, also called a mental health technician, psychiatric technician, or behavioral health specialist, supports mental health services across several settings including psychiatry, psychology, social work, and substance abuse prevention and rehabilitation. Behavioral health technicians are enlisted service members who are trained through the military at the Medical Education and Training Campus in San Antonio. These technicians assist in both inpatient and outpatient mental health clinics by performing intake assessments, assisting with individual and group therapy, providing patient education, and increasing the efficiency and efficacy of a clinic.

Embedded Behavioral Health Provider

Embedded behavioral health providers are embedded into expeditionary military units for the purpose of recognizing signs of problems early, fostering prevention and early intervention efforts, increasing access to care, and making military units more comfortable with the idea of seeking mental health care. They administer advanced evaluations and community-level treatment to improve service members’ well-being, decrease behavioral health symptoms, and strengthen positive unit climates.

Psychiatric Nurse Practitioner

Psychiatric nurse practitioners have a master’s degree in nursing. They practice in inpatient psychiatric units (including partial programs), outpatient mental health clinics, alcohol/drug rehabilitation programs, and combat stress units. Psychiatric nurse practitioners can provide crisis interventions, patient counseling, and critical incident debriefings and can prescribe medications.

Clinical Providers in Primary Care

Not everyone with a mental health concern needs specialty care. Since 2013, the Defense Department aims to provide adult behavioral health services in primary care as a means of increasing access to care, identifying problems early, reducing stigma associated with seeking care, and reducing costs. Common issues that can be treated in primary care include mild depression, anxiety, chronic medical issues, relationship issues, stress, anger, sleep, diet, and alcohol misuse.

Internal Behavioral Health Consultant

An internal behavioral health consultant is a specially-trained psychologist or social worker (see descriptions above) who provides assessments of behavioral health symptoms and care in the primary care setting. These consultants provide focused interventions and skills training with the aim of behavioral change to optimize health.

External Behavioral Health Consultant

An external behavioral health consultant is a psychiatrist, psychiatric nurse practitioner (a registered nurse with postgraduate training in mental health), or prescribing psychologist who provides consultation to the primary care providers regarding psychotropic medication decisions, switching medications, and managing side effects.

Behavioral Health Care Facilitator

A behavioral health care facilitator is a registered nurse who is trained to provide mental health care for such disorders as mild depression and anxiety. They interact frequently with the patient to answer questions about care, ensure adherence to the treatment plan, and monitor the patient’s response to treatment. A primary function of the behavioral health care facilitator is ensuring an individual’s clinical care team is collaborating with one another to manage a patient’s symptoms and recovery.

Non-clinical Providers

Chaplain

A chaplain has an advanced degree in religion or theology and provides confidential assistance regarding spiritual and mental health concerns, often by means of short-term counseling to individuals regarding a range of concerns such as spirituality, work-related stress, grief, and marriage and family relationship troubles. Chaplains also collaborate with mental health providers and work to improve service members’ attitudes and knowledge regarding mental health concerns such as suicide, combat stress and depression.

Military and Family Life Counselor

Military family life counselors hold a master’s or doctoral degree in a mental health-related field (often social workers or psychologists) and provide support services to service members and their spouses and families. They offer non-medical, short-term counseling to address concerns related to family life, parenting, relationship and emotional issues. When situations require additional psychological health treatment, these life counselors make referrals to appropriate behavioral health agencies. Counselors are often embedded within military units to allow service members immediate access to counseling.

Community Providers

Learn more about the community providers mentioned below through TRICARE and other community resources.

Counselor (Licensed Professional Counselor, Licensed Clinical Professional Counselor, Licensed Mental Health Counselor, Licensed Professional Clinical Counselor, Licensed Clinical Alcohol and Drug Abuse Counselor)

Counselors have a master’s degree (M.S. or M.A.) in counseling with many providers having specialized degrees in such topics as:

  • rehabilitation counseling

  • school counseling

  • addiction counseling

  • career counseling

  • college counseling and student affairs

  • marriage, couple and family counseling

Counselors can be found in a variety of community treatment settings including schools/colleges, alcohol and drug treatment centers, outpatient and inpatient mental health centers, rehabilitation centers, career centers, and several other social service/counseling/support service organizations. They assess, diagnose and treat a variety of mental health conditions and career, school, and psychosocial concerns. They provide therapy and similar to clinical social workers, they provide risk assessments, collaborate with community resources, and provide psychoeducation to children, adults and families.

Licensed Marriage and Family Therapist

Licensed marriage and family therapists have a master’s degree (M.S. or M.A) and specialize in treating couples and families. Similar to other community providers, marriage and family therapists can assess, diagnose and treat in a variety of clinical settings and can diagnose and treat mental health and relationship concerns.

For information on how to connect with a mental health provider and other support resources, visit the Real Warriors Campaign Seek Help, Get Care webpage or call the Psychological Health Resource Center.

Schendel is a contracted psychologist and psychological health subject matter expert at the Psychological Health Center of Excellence. She has a doctorate in counseling psychology and a master’s in clinical psychology.


The views expressed in Clinician's Corner blogs are solely those of the author and do not necessarily reflect the opinion of the Psychological Health Center of Excellence or Department of Defense.


Comments

  • Your blog is incomplete. You have totally neglected Marriage and Family Therapists (LMFT) and Licensed Professional Counselors (LPC). These two professions are better trained and have more stringent credentialing requirements for counseling than any of the professions you sited in your Blog. I am assuming the over sight is just a mistake. Please be Complete. I am A Disabled Combat Veteran and an LMFT I specialize in treating Combat Veterans as do many of my Veteran LMFT's and LPC's. However, we are totally pushed aside by the DoD yet they complain of a shortage of therapists?

  • Military members are also able to see qualified mental health counselors. Mental Health counselors have at least a masters degree and are licensed in the state they practice in. They provide therapy, coping skills, career counseling, and marital therapy.

  • Hi Dr. Christina Schendel,
    I am sure the License Mental Health Counselor (LPC) was not meant to be missed on your list of Mental Health providers. I am a resent graduate from a CACREP accredited school and working as a veteran in the VA health administration to advance my career in that direction. LPC's have counseling specific education and require a Masters degree, treatment skills include Cognitive Behavioral Therapy, family counseling, and career counseling to name a few. I have been studying Moral Injury it increase my skill set within the VA. It is important for counselors of any discipline to know and understand the military culture to build the therapeutic relationship. Any military personnel seeking help should find a provider they are comfortable talking to.
    Thank You for the Article,
    Laura Harris

  • I am very upset that Licensed Professional Counselors, Clinical Mental Health Counselors and Marriage and Family Therapists are not included as providers. This article is a further escalation of ostracizing of credentialed professionals who are trained, competent, and effective in care and treatment. I find this article ill-informed and egregious against my profession. I believe this article is a means of the continual practice to restrict the practice of Licensed Professional Counselors, Clinical Mental Health Counselors and Marriage and Family Therapists. These professionals are currently employed by DoD and being mistreated by clinical psychologist and social workers who are subject matter experts for their own profession. There is no SME for these professionals. There is no evidenced based or empirical research to support the continual exclusion of these professional from military behavioral health. It appears that this a means of psychologists and social workers to marginalize care to service members and veterans, including retirees. Where was the term of non-clinical derived when these professional utilize the same diagnostic tools, i.e. DSM, ICD, and various psychological testing dependent upon training. The distribution of the information is one-sided and does not provide patients with the best options for improvement as it negates an entire group of clinically trained providers. I look forward to a response to my comment.

  • This article leaves out some important providers who also care for military members and their families: licensed professional counselors (LPC) and licensed marriage and family therapists (LMFT). It is confusing for consumers to decipher the various types of behavioral health providers available to them. In trying to clarify credentials for the reader, the author actually creates more confusion by telling only part of the story.

  • Does this include the Clinical Mental Health Counselor as a part of military care, and if so, is this area of care intertwined with the growing fields of care.

  • We appreciate the comments above related to service members' and veterans' mental health care options. This blog specifically referenced types of mental health providers in the Military Health System at military treatment facilities. But we've revised it to include the settings where LPCs and LMFTs provide valuable mental health care services to service members, veterans and their families.

    -- Dr. Christina Schendel

  • I am not sure why LMFT, Marriage and Family therapist is not listed as a clinical professional. When you have to be clinical license and in training you earn way more hours - clinical, then social workers. LPCs are just left off the list as if they do not work with the military in many capacities. LPCs and LMFTS are very valuable and as a provider I appreciate all that they both do to serve the military. Representation and recognition is important. Disappointing and misinformation.

  • As a LMFT, I am very disappointed we are listed as community. When we are in fact well trained clinical providers. Trained in system theories and the military is a system. A family. We do way more then given credit for.

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