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What is counselling?

Counselling is a professional relationship with the goal of assisting people in gaining a mastery for dealing with stressful life experiences/circumstances and making use of personal and environmental resources to make desired changes in their life.

Counselling is a collaborative effort between the counsellor and client. Professional counsellors help clients identify goals and potential solutions to problems that cause emotional turmoil. They seek to improve communication and coping skills, strengthen self-esteem, and promote behaviuor change and optimal mental health and well-being. Through counselling, you examine the behaviours, thoughts and feelings that are causing difficulties in your life. You have an opportunity to learn effective ways of dealing with your problems by building upon personal strengths. A skilled professional counsellor will encourage your personal growth and development in ways that work for you, foster your interest and enhance your well-being.

In summary, counselling is a helping relationship between a person seeking assistance with a particular issue (client) and a person offering professional assistance (counsellor) in resolving a presented issue. I believe that the main prerequisite for effective counselling is a therapeutic relationship between client and counsellor. Additional factors that may decide how effective counselling might be are: an ongoing assessment, the client’s goal setting, the choice of helping strategies, and the willingness to implement new behaviours and/or views. Effective counselling practice is done not to but with clients.

Who are Registered Clinical Counsellors (RCC)?

Registered Clinical Counsellors (RCC) work to enhance mental health by providing accountable and skilled professional services to individuals, couples, families, groups, and organizations.  A designation of Registered Clinical Counsellors (RCC) is reserved to counselling professionals who have met rigorous academic training (Masters-levels), clinical experience and supervision requirements that are an integral part of the BC Association of Clinical Counsellor’s criteria.  RCC professional practice is guided by the Code of Ethical Practice and Guidelines for Registered Clinical Counsellors that protects the confidentiality of the counselling relationship; prohibits discrimination and requires understanding of and respect for diverse cultural backgrounds; and mandates that professional counsellors put the needs and well-being of clients before all others in their practice.

Professional counsellors offer help in addressing many situations that cause emotional stress, including, but not limited to:

  • anxiety, depression, and other mental and emotional problems and disorders
  • stress and anger management
  • panic and obsessive/compulsive behaviour
  • family and relationship issues
  • psych education
  • substance abuse and other addictions
  • sexual abuse, domestic violence – violence in relationship
  • eating disorders
  • career change and job stress
  • work-place bullying
  • conflict resolution
  • communication skills/assertiveness
  • gender and sexuality issues
  • social and emotional difficulties related to disability and illness
  • feeling of isolation and lack of belonging to your living/social environment
  • attachment issues
  • adopting to life transitions
  • the death of a loved one

When should you seek counselling?

From childhood through late adulthood, there are certain times when we may need help addressing problems and issues that cause us emotional distress or make us feel overwhelmed. When you are experiencing these types of difficulties, you may benefit from the assistance of an experienced, trained professional. Professional counsellors offer the caring, expert assistance that we often need during these stressful times. A counsellor can help you identify your problems and assist you in finding the best ways to cope with the situation by changing behaviours that contribute to the problem or by finding constructive ways to deal with a situation that is beyond your personal control.

“Good indicators of when you should seek counselling are when you’re having difficulties at work, your ability to concentrate is diminished or when your level of pain becomes uncomfortable,” says Dr. Gail Robinson, past president of the American Counselling Association. “However, you don’t want to wait until the pain becomes unbearable or you’re at the end of your rope.”

“If someone is questioning if they should go into counselling, that is probably the best indicator that they should,” says Dr. William King, a mental health counsellor in private practice in Indianapolis, Indiana. “You should trust your instincts.”

Joyce Breasure, past president of the American Counselling Association and a professional counsellor who has been in private practice for more than 20 years, recommends counselling when you:

  • Spend 5 out of 7 days feeling unhappy
  • Regularly cannot sleep at night
  • Are taking care of a parent or a child and the idea crosses your mind that you may want to hit that person
  • Place an elder in a nursing home or in alternative care
  • Have lost someone or something (such as a job)
  • Have a chronic or acute medical illness
  • Can no longer prioritize what is most important in your life
  • Feel that you can no longer manage your stress

“If you’re not playing some, working some, and learning some, then you’re out of balance. There’s a potential for some problems,” Breasure says.

Robinson points out you don’t have to be “sick” to benefit from counselling. “Counselling is more than a treatment of mental illness,” she says. “Some difficult issues we face in life are part of normal development. Sometimes it’s helpful to see what you’re going through is quite normal.”

Questions I may want to ask during my first counselling session?

Some of the questions below may be addressed during your initial phone conversation with the counsellor and others may be more appropriately discussed in your first face-to-face meeting. Some of these questions may not be relevant to you (e.g. in-home counselling, sliding scale etc.) so you may skip them.

  • Are you a registered certified counsellor and if yes, with what professional organization?
  • What is your educational background?
  • What is your personal counselling philosophy?
  • How long have you been practicing counselling?
  • What are your areas of specialization (such as family therapy, women’s issues, substance abuse counselling, etc.)?
  • Would you be open to providing in-home counselling (e.g. when applying family therapy) and if yes, how would that look like?
  • What are your fees?
  • Do you accept my insurance?
  • How is billing handled?
  • Do you offer a sliding fee scale or a payment plan if I do not have insurance for mental health services?
  • How can you help me with my problems?
  • What type of treatment do you use? Can I decide on the treatment modality used in the sessions? If not, why not?
  • How long do you think counselling will last?

After you have had these questions answered by the counsellor to your satisfaction, reflect on how comfortable you feel with the individual, since you will be working closely together during your counselling sessions.

Once in counselling, what are my rights?

Your rights are NOT limited to only one listed below:

  • to be treated with respect and dignity
  • respect of your culture, ethnicity and beliefs
  • to withdraw your consent at any time
  • to terminate your counselling at any time
  • to request further referral
  • to discuss and decide on the therapeutic approach used in counselling
  • to refuse particular therapeutic modalities offered to you
  • to be informed what are potential risks as well as potential benefits of clinical counselling
  • that your information is handled with utmost confidentiality and protection
  • to have access to counsellor’s written notes in all times
  • to be aware of limitation of the privacy protection
  • to file written complaint to BCACC Registry
  • to be aware of counselling fees, lengths of counselling sessions, cancellation policy

How many counselling sessions are recommended?

In ideal circumstances counselling is terminated when the problem that you pursued counselling for becomes more manageable or is resolved. For some people, a few counselling sessions may be sufficient and for others, several (long term) sessions may be necessary. For treatment to be completed, a number of sessions may also depend on the therapeutic approach-modality used in the sessions. However, some insurance companies may limit the number of sessions for which they pay for. You should check with your medical health plan to find out more about any limitations in your coverage. During the first few counselling sessions, your counsellor should also discuss the length of treatment that may be needed to achieve your goals.

How will you know that counselling is working for you?

Counselling can help you maximize your potential and make positive changes in your life.

Together you and your counsellor will set goals, you will work toward achieving them, and you and your counsellor will assess how well you are actually meeting them. A good counsellor will make ongoing assessments and recommendations and they will ask you for feedback. Changes are not always so obvious, some are more clearly measured and others are more saddled and harder to notice. Please don’t forget that counselling may be hard work at times but change and progress do happen.

How would you know that you picked the right counsellor for yourself?

It is difficult to open up and share your problems with a stranger and you may feel awkward or anxious during your initial sessions. However, it is also important that you have a “chemistry” or rapport with the counsellor. I suggest you trust your instinct and go from there. This should not preclude you from making an educated judgement. Instead, by following your instinct it speaks of your personal strength to recognize and accept what your body (senses) are telling you.

Counsellors have different styles, personalities, worldviews and approaches. Some (like myself) have different accents and they come from different cultural/ethnic backgrounds. A sensitive inquiry is always welcome and depending on your needs/preferences, it may be even required. Most importantly, take time to evaluate how you are feeling when interacting with the counsellor and whether you believe that the two of you can work effectively together. If you do not feel at ease with a certain counsellor, do not get discouraged. Instead, look for a different individual with whom you would feel more comfortable working with.

How long is a counselling session and how is it paid for?

Your first session is in the length of 90 minutes ($105). Consequent counselling sessions are 55 minutes long if no prior agreement is made. Individual sessions cost $105 (55 min). Family sessions (parents/children/other) are in length of 90 minutes and they cost $125 per session. Payment for all sessions are due at the end of each session and may be paid in the form of cash, cheque, and/or direct/credit card payment (depending of the session’s location). The cost of home and/or collateral visits/phone calls will be discussed and/or charged separately.  The cancellation of any session needs to be done 24 hours in advance. Multiple missed appointments may result in termination of the service by the counsellor.

Although counselling fees are not covered under the BC Medical Services Plan, many workplace health benefit plans (like those of Great West Life, Manulife, and Pacific Blue Cross) do include counselling coverage that reimburse you for visits to a Registered Clinical Counsellor (RCC). Your insurance company or Human Resources department will be able to advise you on this. Some Extended Health Plans will also cover some of the cost of counselling. It is important to refer to your plan manual for details.

How to fit counselling into my busy schedule?

We all live busy lives and as much as we recognize our need for counselling, we may have difficulty fitting it into our busy schedule. My experience suggests that some people prefer to attend counselling sessions during the workweek and others prefer to attend and reflect on their counselling when they are most relaxed such as weekend or evenings. At this time, my hours are highly flexible. Thus, my preference is during Friday & Saturday day-time, and the occasional Sundays (from noon to 3 pm).

How is my privacy protected?

All members of the BC Association of Clinical Counsellors subscribe to the Code of Ethics and Standards of Practice which require counsellors to protect the confidentiality of their communications with clients. As a client, you are guaranteed the protection of confidentiality within the boundaries of the client/counsellor relationship. Any disclosure will be made with your fully written, informed consent and will be limited to a specific period of time. The only limitations to confidentiality occur when a counsellor feels that there is clear and imminent danger to you or to others, or when legal requirements demand that confidential information be disclosed such as a court case. Whenever possible, you will be informed before confidential information is revealed. Confidentiality continues after the end of the counselling relationship.

In summary: confidentiality does not apply when:

A/ If a child is or may be at risk of abuse or neglect, or in need of protection;

B/ If a counsellor believes that you or another person is at clear risk of imminent harm;

C/ For the purposes of complying with a legal order such as a subpoena, or if the disclosure is otherwise required or authorized by law.

Do I have to sign something before I engage in counselling?

Yes. Individual, couple and family counselling are based on consensus. During your first counselling session with me, I will ask you to sign a Consent for Clinical Counselling Treatment & Written Disclosure Form. This document is designed to protect your privacy and to ensure professional service you have requested. Please read this document before signing it. You will be given a copy of the document for your records.

What can I do if my counsellor was less than professional?

RCC are required to provide accountable and professional service based on the Code of Ethics and Professional Standards. It is always recommended that you address your concerns with the counsellor first. If you find it to be impossible or unsafe, or if your concern is not resolved through collaborative discussion process, you may wish to contact the Register of the BC Association of Clinical Counsellors at 1-800-909-6303. Your concern (in writing) will be responded to in a timely manner and with the highest priority.

Photo by AlicePopkorn