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There are a number of tools that can help clinicians more effectively treat their clients and support improved mental health. And one of those tools that is becoming increasingly popular—thanks to advances in genetics—is pharmacogenetic counseling.
Genetic tests can help medical professionals understand how an individual's genes may affect how they metabolize, respond, and react to certain drugs—which, in turn, can help them make better, more effective prescribing decisions.
Currently, genetic testing can only be ordered and evaluated by a licensed healthcare professional with prescribing privileges—for example, a psychiatrist, primary care physician, or psychiatric nurse practitioner. But as a therapist, these tests may play a role in your client’s overall treatment plan, so it’s important to understand what they are, how to speak to clients about them, and how to incorporate them (if needed) into your work with clients.
Let’s take a look at everything you need to know about genetic testing in mental health, including what tests are most useful, when to recommend testing, how to explain to clients what these tests mean, and how to integrate findings into their overall treatment plan.
What is pharmacogenetic counseling—and what is the role of genetic testing in mental health?
“Pharmacogenetic testing is a cheek-swab DNA test that looks at how someone's genes may affect the way their body processes certain medications,” says Alex Thorpe, MSN, RN, PMHNP-BC, board-certified psychiatric mental health nurse practitioner at LiveWell Behavioral Health in Melbourne, Florida.
In the mental health space, “the primary purpose of pharmacogenetic counseling is to provide patients with information regarding how…[their] genetic profile affects the way in which their body metabolizes selected psychiatric drugs,” says Bonnie Lambert, PMHNP-BC, LPC, board-certified Psychiatric Mental Health Nurse Practitioner and Licensed Professional Counselor at Portland, OR-based Crestview Recovery.
Once a client undergoes pharmacogenetic testing, the clinician will review their results and may use that information to help determine the best course of action for that client—including determining which psychiatric drugs may be a potential fit for that client’s treatment plan.
It’s important to note that, while pharmacogenetic counseling can be a helpful evaluation tool, it doesn’t offer any definitive answers about which drugs or treatments would be effective for a specific client.
“Pharmacogenetic testing does not identify a single drug as ‘the correct’ drug,” says Lambert. “Rather, it provides insight into the reason(s) why some individuals experience unwanted side effects from a standard prescribed dose whereas others require a greater dose to achieve the desired therapeutic effect.”
It’s also important to note that while genetic testing in mental health may provide clinicians with insights into the client’s genetic makeup, genes are only a small part of an individual’s mental health—and, as such, these tests should always be used as one part of a larger, more comprehensive approach to mental health treatment.
“A genetic test can't replace a psychiatric evaluation or tell us exactly which medication will work,” says Thorpe. “We consider it alongside the patient's symptoms, medication history, therapy progress, and input from the rest of their care team.”
“A genetic report will never replace an entire assessment of a person’s mental health,” Lambert agrees. “Instead, it is part of the many components of the overall picture, including symptoms, prior treatment experiences, physical illnesses, and the individual’s own objectives.”
Bottom line? “The purpose [of pharmacogenetic counseling] in mental health is not to identify the perfect drug for each individual—that is unrealistic,” says Dr. Max Doshay, PsyD, Clinical Psychologist and Co-Founder and CEO of KMN Psych in San Diego, CA. “Rather, [it is] to offer additional information that can assist in guiding decision-making regarding treatment options.”
What tests are the most useful for mental health?
When it comes to genetic testing for mental health, not all tests are created equal.
“The best clinically applicable genetic testing for psychiatric conditions is through pharmacogenetic panels to assess the patient’s genetic background as it pertains to the metabolization of psychiatric medication,” says Doshay. “These panels will specifically test the genes related to the patient's ability to metabolize antidepressant medications and other psychiatric medications.”
In addition, “testing panels provide the highest value when they have been supported with clinical studies that support their application, and are interpreted by a licensed healthcare professional,” says Doshay. “This way, the interpretation of the results can be applied to the treatment of the individual.”
On the other hand, “I'm less interested in broad reports that make claims about personality or diagnosis,” says Thorpe. “The information should be clinically useful and interpreted by someone who understands the patient's complete history.”
To summarize, “I recommend that physicians limit their ordering to commercially available panels that have established scientific evidence of their clinical utility—rather than ordering a broad-based panel of tests, where each test does not have equal clinical relevance,” says Lambert.
When to recommend genetic testing
Now that you understand what pharmacogenetic counseling is, let’s jump into when to recommend testing. Because while only licensed health professionals can order genetic tests, it may make sense for other clinicians—including therapists—to recommend them as part of a client’s treatment plan.
There are a few different scenarios where it may make sense to recommend genetic testing for mental health, including:
When a client has tried multiple psychiatric drugs: It can be frustrating for clients to try one psychiatric drug after another and not find relief. “Because many antidepressants and other psychiatric medications require several weeks before therapeutic benefits become apparent, many unsuccessful medication trials can become really discouraging for patients and their families,” says Thorpe. “Pharmacogenetic testing can provide additional information that may help guide future medication selection”—so, if you have a client that has tried multiple psychiatric drugs without success, it may make sense to recommend genetic testing as a next step.
When a client is hesitant about psychiatric drugs: Another use case for genetic testing in mental health is for clients who are hesitant to explore psychiatric drugs as a treatment option—for example, clients who are worried about side effects or how they’ll react to a medication. “I often recommend testing for families who are understandably hesitant or cautious about starting psychiatric medications for their child…[or] for adults who are nervous about treatment,” says Thorpe. “Having additional, objective information can help provide reassurance throughout the treatment process.”
When a client has a complex history: It can also make sense to recommend genetic testing for clients with a complex medical/psychiatric history. “I frequently consider pharmacogenetic testing for individuals with a complicated treatment history or more complex psychiatric conditions, such as bipolar disorder or schizophrenia, particularly when medication selection is challenging or previous treatments have been unsuccessful,” says Thorpe. “While genetic testing can't determine which medication might be best, it may identify medications that could need dose adjustments or closer monitoring because of differences in drug metabolism.”
If you have a client that you think could benefit from genetic testing for mental health, make sure to do your research and identify a reputable healthcare professional who offers pharmacogenetic counseling and testing before you make a recommendation.
How to explain genetic testing for mental health to clients
If you do decide to recommend genetic testing, it’s important to understand how to explain it to clients.
Here are a few tips on how to talk about mental health genetic testing with clients:
Be clear: When explaining genetic tests for mental health—and what role they play in a client’s treatment—it’s important to talk to them in a clear, easy-to-understand way. “I tell patients it's a simple test that may help us understand why they process certain medications differently,” says Thorpe. “I explain what the test measures, why I believe it may be helpful, and how the results can support medication decisions.”
Frame it as a tool—not a solution: It’s also important to explain to clients that genetic testing is just a tool—and while it can offer helpful information about how their body processes medications, it’s just one part of a much larger approach to how to determine the best treatment plan for them. “I'm also clear that [genetic testing] isn't a diagnosis or crystal ball,” says Thorpe. “It doesn't replace a thorough psychiatric assessment, medication history, or ongoing monitoring. It's simply one more tool that may help us make a better-informed medication decision together.”
Don’t oversell it: As mentioned, genetic testing in mental health can provide helpful insights that support a client’s treatment plan. But they’re not a definitive solution for how to move forward on a mental health journey—and so, when you talk to clients about these tests, it’s important to set proper expectations. “Our role as practitioners is to educate patients about both the benefits and limitations of pharmacogenetic testing,” says Thorpe.
“Typically, I encourage my patients to consider a genetic test as a roadmap—a way for both me and them to navigate the best ways of prescribing medications that are most likely to be processed by their bodies with success, while also identifying those that should be used with caution,” says Lambert.
How to integrate findings
When it comes to genetic testing in mental health, knowing how to interpret results—and which (if any) psychiatric medication should be prescribed—will fall to the ordering healthcare professional. But how to integrate those findings into the client’s overall treatment plan may be a more collaborative process.
“The test may help us refine a medication choice, but the strongest outcomes usually come from matching the full care plan to the individual, not relying on any single tool,” says Thorpe.
If you have a client that’s undergone genetic testing for their mental health—and they’ve given you permission to connect with their healthcare provider—consider working with that provider to come up with a larger treatment plan that best supports the client. If you can, share information (again, only with the client’s consent) that may be helpful—for example, session notes or previous psychiatric assessments. These additional assets can help the healthcare provider better understand the client’s mental health as a whole—which, in turn, can help them make better, more informed decisions about how to move forward with medication.
“A genetic report needs to be viewed within the context of the patient's symptoms, their diagnosis, their medical history, how they live their life, and all the medications they've been on before.” says Lambert. “If used thoughtfully, this information can enable us to feel more confident when prescribing, decrease our need to make unnecessary medication adjustments, and assist us in having a much better conversation with patients regarding why we are choosing one treatment over another.”
Does insurance cover pharmacogenetic testing for mental health?
Another question many clinicians (and clients) may have about genetic testing in mental health is: What about insurance coverage?
And the answer is: it varies.
When it comes to insurance coverage for mental health-related genetic testing, “coverage depends upon the patient's insurance plan,” says Thorpe.
“Some patients will be able to get at least part or all of the cost covered by their insurance company—some patients will incur out-of-pocket expenses,” says Doshay.
For example, “while some insurance companies do provide coverage for testing that has a medical basis—i.e., at least one trial of two different medications; experiencing significant medication side effects—other insurance companies won't,” says Lambert.
Because there’s so much variation in insurance coverage, “all patients [should] check their plan's benefits before they undergo testing to help them make a better-informed financial choice, rather than be shocked by the cost,” says Lambert.
Sources
Bishop, J. (2022). Pharmacogenomic testing. National Alliance on Mental Illness.
Doshay, M. (2026). Personal interview.
Lambert, B. (2026). Personal interview.
Sperber, N., Roberts, M., Gonzales, S., Bendz, L., Cragun, D., et al. (2024). Pharmacogenetic testing in primary care could bolster depression treatment: A value proposition. Clinical and Translational Science.
Thorpe, A. (2026). Personal interview.
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