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January 13, 2023

1/13/2023

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LICSW, LMHC, or Psychologist? The Differences Between Mental Health Professionals 

By  Lauren Chapin, LICSW
​

It can feel daunting when you are searching for a therapist and aren’t sure what all of those letters mean following a person’s name. Is there a difference? Will I get better care with one or the other? How do I know who is right for me? This post outlines the major similarities and differences between the licensure options you’ll find at Castlebrook Counseling Services. Please note that educational and licensure requirements vary by state. 

Education and Training
    LMHCs: To become a Licensed Mental Health Counselor, one must first complete a master’s degree in mental health counseling (~2 years). Common courses include theories of personality, psychological testing, psychopathology, foundations of counseling, and ethics. Many counseling programs also incorporate diversity courses and emphasize socio-cultural issues as they pertain to treating individuals and groups. Role play is often used in order to practice counseling skills among peers. After graduation, Mental Health Counselors must have at least two years of clinical supervision in order to sit for the examination to become Licensed. 

    LICSWs: For this level of licensure, a master’s degree in social work is required (~2 years). Social work coursework varies slightly from counseling in that students are required to take more courses that focus on “macro” topics such as issues of diversity, oppression, and privilege, public health policy, program evaluation, and social welfare systems. In addition to these courses, clinical social workers also take classes geared towards providing therapy to individuals, couples, children, and families. Social Workers are first Licensed Clinical Social Workers (LCSW) shortly after graduation, which means that they have passed regulatory exams and can practice under the supervision of a Licensed Independent Clinical Social Worker (LICSW) or other licensed clinician. After at least two years of clinical supervision, LCSWs are eligible to sit for another examination in order to demonstrate advanced clinical knowledge, and achieve LICSW licensure. 

    PsyD: To earn a PsyD (Doctor of Psychology), students must complete a doctorate degree in clinical psychology (~4-6 years). Like in masters level programs, coursework can be tailored toward specific interests or populations. Prospective PsyD’s can also opt to focus on the administration and interpretation of psychological assessments. These programs offer similar coursework to master’s degree programs, but are more intensive and, due to length, offer increased opportunity for practical application of skills. The PsyD differs from the PhD in that it emphasizes clinical experience rather than academic or lab-based research. Several years of clinical supervision are necessary in order to achieve licensure as a Psychologist.

EdD: Instead of a PsyD, some may choose to pursue a doctorate of education in psychology (~3-5 years) in order to obtain licensure as a psychologist. You may find EdDs working as school psychologists or elsewhere in the education field, but they can also work as clinical psychologists in any setting depending on the coursework chosen. These programs are also often heavy in research, offering courses in research methods and advanced statistics. As with PsyD’s and PhDs, several years of clinical supervision are necessary in order to achieve licensure as a Psychologist.  

Supplementary Requirements
    Each degree option also requires students to complete additional requirements in order to graduate such as internships, field practicums, and dissertations. However, this does vary widely by program. Most degree programs will require students to complete field work where they receive supervised experience treating clients in a real-world setting. These settings will vary by interest area and program, but some examples include school counseling, youth and family services, community mental health, hospitals, and the prison system. In some doctorate programs, students are required to complete supervised hours in the university counseling center. For EdD programs, students also need to complete a dissertation which summarizes the research project they have completed during their studies. 

Licensure
    In Massachusetts, all psychotherapists need to be licensed by the state regulatory board corresponding to their education. In order to obtain licensure, all clinicians must pass licensing exams. Each licensure option also requires a specified number of hours of continuing education in order to maintain/renew their license periodically. This ensures that clinicians are kept up to date on emerging research findings, evidenced based practice, and social issues. 

So Who Do I Choose?
    With all of these options, it can be overwhelming to choose. Thankfully, there is no licensure type that is better than another. The best fit for you will depend on the individual clinician’s expertise, interest areas, specific training, and overall personality. Many clinicians with differing licenses are also trained in the same approaches. For example, if you’re interested in receiving Dialectical Behavioral Therapy (DBT), you will find that someone from each licensure option is trained in this modality at Castlebrook. 

    Although each licensure type has a different road to becoming clinicians, many end up in the same settings working side by side as a team to achieve similar goals. Whether they have a social work, counseling, education, or psychology background, clinicians are all able to learn from each other’s unique perspectives. Next time you find yourself in search of a therapist, fear not the alphabet soup; there are excellent clinicians in every category. 

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December 27th, 2022

12/27/2022

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4 Mental Health Metaphors to Get You Thinking Differently

Lauren Chapin, LICSW

Thoughts are our daily companions. They are with us when we wake up, as we go about our day, and oh so often when we are trying to fall asleep at night. It is natural for humans to seek pleasure and avoid pain, so when we have a thought that feels uncomfortable or upsetting, we might try to get rid of it by pushing it down or trying not to think about it. Other times, we get wrapped up in these thoughts and let them guide our lives. Below are four metaphors to help interact with and respond to these distressing thoughts a bit differently.  

1. The Beach Ball


Thoughts are like a beach ball. What happens when you try to hold a beach ball underwater? Chances are, you can keep it down for a bit as the water pressure squeezes in, but as soon as you release your grip, the ball pops into the air. The same can be said for thoughts. For example, have you ever tried not to think about something only to have it pop up later when you’re trying to fall asleep? Pushing thoughts away is like trying to hold a beach ball underwater all day, it’s going to get tiring and it’ll come back up anyway. 


So what can you do instead? You could throw the beach ball further from you, but chances are it will just keep on floating nearby anyway. The best option is to let go and allow the beach ball to float freely. Although we might not want to keep our difficult thoughts around, the more we struggle with them the more caught up we get.

2. Purple Elephants 


Try not to think about purple elephants for the next 10 seconds. Ready? Go! 


How did you do? My  guess is that a purple elephant or two might have crossed your mind. This classic metaphor symbolizes an important lesson: you can’t force yourself not to think about something. The very act of trying not to think about something causes you to have to remember what not to think about. Instead, practice noticing when a thought pops into your head, acknowledge its presence, and then try to re-engage in whatever you were doing (repeat as necessary). 


3. Backseat Driving

Have you ever been annoyed by a pesky passenger telling you how to drive your car? Do you always do what they say? Probably not. Thoughts can be like passengers in your car chirping their input from the back seat. For example, “You shouldn’t go to that party, nobody likes you anyway” or “Don’t leave your house, it’s dangerous out there.” Whatever the passengers are saying, we have a choice to listen to them or not because we are the ones driving the car. Next time your brain is telling you something unhelpful, imagine the thought as one of those passengers; thank them for their input and keep on driving! 

4. Junkmail


​Like junkmail that crowds our inbox, not all thoughts are important enough to read into and analyze. This is quite easy to take care of in your mailbox as you weed through and delete promotional emails you didn’t sign up for. However, when it comes to thoughts, it’s easy to assign meaning to our “junkmail” and save it to the folder marked “priority” instead. For example, someone may have a thought about steering their car into traffic even if they have no desire to do so. While some people will write this thought off as strange or silly, other people may find it distressing and feel fearful that it could mean something about them. Remember that sometimes thoughts are just thoughts and humans are great storytellers, there is no limit to what our brains can come up with. Like junkmail, we don’t have to read (or read into) all of it. 



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December 08th, 2022

12/8/2022

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Managing Holiday Stress: Tips for Setting and Maintaining Healthy Boundaries

​Lauren Chapin, LICSW

“No” is one of the first words we learn to say as children. As we grow older, though,  it often becomes more difficult to deny what is requested of us. We say yes to staying later at work, yes to a favor for a friend, and yes to last minute weekend plans. While none of these examples are necessarily negative, sometimes we find ourselves overcommitted which can lead to feelings of resentment and exhaustion.

Why is it so difficult to say no?

A study published in the Journal of Experimental Psychology found that people who reject a request overestimate the negative consequences of doing so. For example, somebody may believe that they will sour a relationship by declining an invitation to a party, when on average, the reaction would actually be much less severe. Fear of rejection or abandonment also come into play when considering declining an invitation, request, or favor. If you think that somebody might be angry and not want to associate with you anymore, it's much more difficult to say no. 

Two additional reasons we may find ourselves drowning in commitments are guilt and the fear of missing out (colloquially known as FOMO). We may not want to say no to a favor because it comes from a person who we feel indebted to in some way. Further, if your friends are all getting together, it could be difficult to exclude yourself from the festivities only to hear later about what a great time everybody had. 


What are boundaries and why should I set them?


Boundaries are the metaphorical line that we draw in the sand to signal to others what we are and are not willing to accept, how we wish to be treated, our physical space, our values, and our desires. As it pertains to time or favors, boundaries are a helpful way to exhibit and model self-care around respecting your own time, limitations, and schedule. 


Setting boundaries around your time also allows you to make space for the people and things that mean the most to you and to foster these connections with deliberate focus. When we are more discerning about where our time goes, we are less likely to feel burnt out or resentful. Boundaries also help us to separate our own needs and desires from those around us and to communicate this separation in a healthy way. Although your family member might want you to do something, if you are unable to or don’t want to, saying no communicates both to you and to them that their desire is not your responsibility.
 


How do I set healthy boundaries?


Begin with an honest inventory of why you have difficulty saying no in the first place. Knowing where the problem originates will help you to work through it. Second, identify your values to provide a frame for the tough decisions you have to make when thinking about how to spend your time. For example, if you know that you value family, you can fall back on this value when trying to decide whether to stay late at work or go home for dinner. 


Once you have a better understanding of what is important to you, the next step is to practice. It takes a lot of effort to change ingrained habits and it will be uncomfortable at first! However, the more consistent you can be with your boundaries, the better the outcome will be as those around you learn what they can expect from you and what you expect from them in return. 


​Sample script for rejecting a request


“
I appreciate [the invitation, you reaching out, you thinking of me], that sounds like [a good time, something I’d enjoy, fun]. [Unfortunately, Regrettably, Sadly] I [won’t be able to attend/make it, have other commitments, am not available]. I hope [you have a good time, it goes well, we can see each other soon].” If you desire to make plans with this person in the future, you can add “let’s plan something for [insert time here].” If you do not desire to make plans with this person in the future, you do not have to leave the door open. This is part of setting solid boundaries! 




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CASTLEBROOK COUNSELING SERVICES, INC.
24 Lyman St. Suite 200
Westborough, MA 01581
(508) 475-9110

Mission Statement

​Castlebrook Counseling Services, Inc. is a group of private practice clinicians with a shared goal of strengthening our community by providing therapy and clinical support designed for children, adults, and families to successfully meet life’s challenges.
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