Choosing a Therapist

If you do a Google search for therapist or counsellor you will come up with pages upon pages of search results. There are some directories such as Psychology Today who help organize by discipline, focus, etc. but it can still be overwhelming to try and figure out where to begin!

So how do you choose one?

1. Relationship/rapport. Research has shown that the therapuetic alliance between client and counsellor is the most important factor in determining outcomes in therapy. Take advantage of those free 15 minute consultation calls and make sure you vibe with the therapist! If you don’t feel it, keep searching. I remember finishing a game of tennis with a youth on a very hot day (we were working on comfort being in public doing something vulnerable and we both suck at tennis) and afterwards I offered her an ice cream bar. She declined saying she is vegan. I am also vegan and of course the ice cream bars were non dairy. Instant rapport! We ended up working together quite well for several months and her mom was surprised she kept returning after she had refused to go back to the 8 previous therapists. We are human beings and connection is important. You don’t have to play tennis and eat ice cream with your therapist, but they do need to be someone you feel you can be authentic and vulnerable with.

2. Professional designation. I’m not even sure how to unpack this one in a short blog but in British Columbia, the terms “therapist” and “counsellor” are unregulated. This means anyone (literally anyone) could call themselves a therapist. Yikes right? Start by checking out credentials. I know I just said the therapuetic alliance is most important but you also want to ensure the person you’re unpacking your deepest darkest stuff with has some kind of training in how to manage it. Although not provincially regulated, I personally recommend finding a therapist with a minimum of a Masters level education. Within that level of training are a variety of disciplines, most common being RCC, Registered Clinical Counsellor, and RSW, Registered Social Worker (Pro tip: if they don’t have that “R” meaning Registered, keep looking. You want to ensure your therapist is accountable to a regulatory body).

What is the difference between an RCC and RSW? This is a blog so these are strictly my opinions but I’d say social workers are more solution focused (think make a plan and get shit done) and clinical counsellors may be more invested in unpacking the journey. Again, just my opinion.

What about psychiatrists? They’re the ones with the prescription pads. Psychiatrists are very important medical specialists who often work in collaboration with therapists but rarely provide talk therapy. Psychiatry is a medical service covered under MSP in BC and if you would like to discuss medications or other medical interventions with a psychiatrist, speak to your family doctor for a referral. In some very rare situations psychiatrists do provide talk therapy as well.

What if I found someone who seems like a great counsellor but doesn’t have any formal training? There are things you can inquire about that those of us with professional licenses have to honour such as our privacy policies, confidentiality, reporting, record keeping, etc. The sketchy part of this unregulated profession is that without a regulatory body (for example, I am accountable to the BC College of Social Workers) your personal information could be at risk, as well as your personal safety if the “counsellor” isn’t trained in handling complex issues. Another piece to inquire about is insurance. This is to protect the therapist, but can be an indicator of how legit they are.

3. Style and approach to counselling. Every therapist is going to have their own unique approach. My approach often involves incorporating movement, either into our sessions, and/or in the treatment plan as I strongly believe in the body/mind connection and the healing power of movement. This may not resonate with everyone so finding out which framework or approach your potential counsellor works from can be helpful before investing too much into the relationship. You may also want to explore their values as they relate to your experience. If you’re wanting to process and integrate following a spiritual awakening with plant medicines, somebody who doesn’t believe in the healing powers of these plants may not be a fit.

4. The practical bits. So you’ve found someone with a Masters level education whose approach resonates with you and you feel connected with right away. Great right!? Well… not quite. Therapy is expensive af. One of the first things you may want to consider is what your extended health benefits cover. Some extended health plans (or ICBC, victims assistance, WCB, etc.) only cover certain designations (RSW or RCC) Checking this ahead of time can save you quite a bit of time (and money!)

Unfortunately counselling is not covered under MSP in BC (it should be – surely there are petitions out there you can sign) and if you don’t have extended health benefits, you may be looking for some cost effective ways to get help. Below are a few options:

a. Student clinics. If you’re looking for a therapist in the lower mainland, SFU, UBC, City University and Adler University all have free or low cost counselling services by masters level interns. Those interns are supervised by more experienced professors. Don’t let their inexperience scare you away, interns can be some of the most caring and invested people in your wellness!

b. EAP – employee assistance plans. Some workplaces have these plans as an option and they are significantly underutilized. They will set you up with a counsellor depending on what you need and despite being a resource through your employer, confidentiality is still honoured.

c. Specialized clinics – there are far too many to list but there are all types of great organizations with specializations depending on the issue you want to work through. One of my very first counselling jobs was actually providing support to people affected by HIV (usually family members of people who were HIV positive) which is one example of a specialized free counselling service. Other specialized counselling services may be included under larger organizations such as Fraser Health or MCFD’s child and youth mental health clinics. There are far too many to list so I encourage you to use Google here.

Did I miss anything here? If you have any questions about how to go about finding a therapist, please don’t hesitate to shoot me a message.

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