Choosing the
right therapist is an important part of the treatment process. Many
questions people have about therapy include:
Finding
the right Psychologist
Psychologist or Psychiatrist: what's the
difference?
Is this confidential, and what does
that mean?
What kind of therapy do you do: do you have experience
with my problem?
Is this treatment researched for its effectiveness
in therapy?
How long will therapy take?
Would I be more comfortable seeing a woman or
male Psychologist?
How much is this going to cost?
Is the cost covered under my extended health
care (e.g., Blue Cross, employee benefits)?
Finding the
right Psychologist
Finding the right Psychologist is sometimes stressful in and of itself.
With access to the Internet, people are finding that they have more
choices and greater information before they walk into the Psychologist's
office. Often, people seeking counselling are tired, confused, or
feeling overwhelmed. They are often nervous about talking about their
problems to a stranger. What is important to understand is that you
have a right to feel comfortable and confident in a counselling environment.
Therefore, you have the right to interview the therapist about her
or his treatment approach; if they have experience in treating the
area of your concern; identify goals for therapy; as well as ask questions
openly about the cost of therapy.
Psychologists
are people just like you, and sometimes personalities do not match.
Therefore, you are entitled to find a therapist with whom you feel
comfortable and get along with. This goes both ways, as Psychologists
are to refer clients to other health care professionals if their own
feelings are in conflict with the best needs of the client. Each Profession
has a code of conduct (Psychiatry, Psychology, Social work, and Medicine,
for example) and they differ somewhat in their content. So it's important
to feel safe and understood as you start the counseling process.
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What is the
difference between a Psychologist and Psychiatrist?
A Psychiatrist has a medical degree (MD). She or he has the privilege
of prescribing medication for psychiatric conditions and has special
training (a residency) in the field of Psychiatry. Some Psychiatrists
offer psychotherapy, or counselling services, to their patients, and
some are more restricted in their services. Some Psychiatrists offer
almost exclusive medication management for the treatment of psychological
or psychiatric disorders (for example, depression, panic attacks,
and schizophrenia). Psychiatrists can bill your Medical Services Plan
(MSP) directly for their sessions at no additional user cost to the
patient. Treatment models, such as medication management, and types
of therapy offered, vary according to the training background of the
Psychiatrist.
A Psychologist
in B.C., has a Ph.D. (or Ed.D, or Psy.D.) in the discipline of Psychology
and is registered to practice Psychology by the governing body of
the College of Psychologists of British Columbia (CPBC). She
or he does not prescribe medication. However, on occasion, a Psychologist
will consult with a Psychiatrist or a General Practitioner
to assist in medication management with the client (for example, arranging
a consult for the use of antidepressant medication to assist treating
a severe depression). Some Psychologists have a Masters degree in
Psychology, and were Registered in B.C. before the CPBC instituted
the Ph.D. level of registration. They are entitled to use the term
Psychologist with the permission of the CPBC. Each Psychologist must
pass a written test of competency and have an oral exam in each province
in which they practice to call themselves a Psychologist. The term
Psychologist is a legally protected term and a person using this title
must be registered by the CPBC to legally use this name. Derivations
of the term Psychologist, (e.g., Psychological Services) are protected
in the same manner. Psychologists are entitled to practice in areas
in which they are competent, but are not to practice outside their
area of expertise. For example, some Psychologists are trained and
have demonstrated competence to perform Legal Assessments of Children,
and some do not have this training. Psychologists also vary in the
specific professional areas in which they practice, for example, Clinical
Psychology, Counseling Psychology, Child Psychology, Adult Psychology,
Couples Counselling, Health Psychology, Disability Management, etc.
Therefore, it is good to ask your Psychologist up front if she or
he can work with you in your area of concern.
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Confidentiality
A Psychologist is ethically bound to keep your file information confidential.
He or she will not release any information to anyone without your
written permission. Confidentiality is not the same as the Privilege
that Lawyers have, and has its limits. Exceptions include the following:
(e.g., if a Psychologist is subpoenaed to testify in court, if a child
or senior is in need of protection, or if someone is in immediate
physical danger). Sometimes an insurance carrier is paying for the
service and requests progress reports. These limits need to be discussed
during the initial session.
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What kind
of therapy do you do?
Psychologists can be Generalists in some areas, and have more specific
expertise in others. If you have questions about the type of therapy
you are receiving, please feel confident to ask. Counseling is a professional
activity, and a personal experience. Sometimes counselors and clients
don't "click" because of a poor mix of personalities or approaches.
A good fit is required between the client and the type of therapy
being used, as not everyone is amenable, for example, to insight-oriented
therapies, but might do better with a behavioral approach. Most Psychologists
will ask you to do "homework" of some type, or ask you to practice
new ways to manage your problem. It is always good to ask your Psychologist
if she or he has experience working with your specific problem. If
not, you are likely better served with someone who has experience
and competence working with your concerns (e.g., depression, child
and parenting problems, panic attacks, pain management, or job burnout).
Even if the first Psychologist you see cannot help you with your specific
area of concern, he or she can likely help you with a referral to
the appropriate resource to provide you with assistance.
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Is this treatment
researched for its effectiveness in therapy?
The type of therapy you are to receive should be well researched and
tested for effectiveness with your problem. Many books and Psychological
organizations like the American and Canadian Psychology Associations
publish lists of validated treatments for psychological problems.
Feel confident to ask about whether the Psychological approach being
used is well researched to assist you in achieving your goals. If
the answer is "I don't know," then walk out the door and find someone
else who does. Although alternative treatments have gained interest
over the years, there is no research to indicate that "smiling at
the moon" or "lighting incense" will help resolve your depression.
If you are in any way "uncomfortable" with a treatment, you are entitled
to stop treatment and discuss alternatives, or seek a second opinion.
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How long will
therapy take?
This is usually discussed at the initial assessment, or very soon
after. After the problem area has been identified, then a goal and
plan for treatment should follow. For most conditions, the therapist
can give you a "ball park" idea of how many sessions will likely be
required. Some problems require a longer counseling approach or simultaneous
access to specialized services. Each person is different and responds
to therapy differently, however, if results are lacking, it is good
to re-evaluate goals and progress sooner than later. Areas such as
couples counseling, bereavement issues, and individual differences,
are usually the areas that typically require ongoing revision of time
lines. Some types of therapy are by definition long-term, and should
be discussed between you and your Psychologist at the beginning of
therapy. Always be sure to have goals established at the beginning
of therapy.
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Would I be
more comfortable seeing a female or male Psychologist?
This is a choice that is entirely up to you. Before or after you meet
with a Psychologist, you might feel more comfortable seeing either
a female or a male therapist. If you are seeing already seeing a Psychologist,
she or he can help you find a Psychologist, female or male, with whom
you feel comfortable.
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How much is
this going to cost?
The cost of seeing a Psychologist is not currently covered under the
Medical Services Plan (MSP) of B.C. Costs for Individual therapy sessions
can vary widely with some Psychologists charging $150.00 an hour to
$200.00, or more. The fee usually depends on the type of services
being offered. For example, group sessions are usually less expensive
per person, whereas, Couples counseling, Individual therapy, or Family
therapy might have different fee structures because of the professional
experience required, length of sessions, or how many people are involved.
Fees for Psychological Assessments, or extensive assessments for insurance
companies are based on the service requested, the nature of the referral
question, and the experience required to perform the evaluation. Payment
is typically made at the end of each session. Often, if you miss an
appointment without giving the Psychologist 24-hours notice, you will
likely be billed for the missed session. A missed session means someone
else could have used that spot. Therefore, it is good to keep track
of your appointments. Sometimes, Psychologists will use a sliding
fee scale based on a person's income and ability to pay. Fees are
discussed in the first session, or at the point of first contact.
You should always feel comfortable asking about fees and payment.
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Is the cost
covered under my extended health care (e.g., Blue Cross, employee
benefits)?
The cost of seeing a Psychologist is not currently covered under the
Medical Services Plan of B.C. It is good to find out if you have any
extended benefits under either Blue Cross, or your employee benefits,
to help pay for your sessions. You should always feel comfortable
asking about fees and payment.
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