FAQs

 Adapted from the Canadian Psychological Association Website (www.cpa.ca)

WHY WOULD I SEE A THERAPIST?     Making a decision to see a psychologist or other mental health practitioner can be difficult. Many people feel uncomfortable about the prospect of talking about things that are distressing or embarrassing. Talking to friends and loved ones can be very supportive but sometimes it is difficult for people we know well to be objective and honest because of their feelings for us and due to their roles in our lives. In addition, our family and friends may not recognize the nature or seriousness of a psychological problem or the expertise to help us cope with it.

WHO DO I SEE?   Once you make a decision to seek help, you need to decide who to choose. Many people claim to treat mental health problems. Not all of them are well-trained professionals in the mental health field. Regardless of who you consult, it is important to ask if they are regulated – in other words, do they have a license to practice and are they accountable to a regulatory body?

HOW DO I CHOOSE A THERAPIST?   It is very important that you have a trusting, positive and constructive relationship with any psychologist or counsellor you choose to work with. As is the case with any other kind of professional, one practitioner might be a good fit for one person, but not a good fit for someone else. The therapist you choose should have the training and experience that fits the issues you are dealing with. Once you have established the practitioner’s credentials, the best way to determine if he or she is right for you is to rely on your feelings: Does this person appear kind, understanding and non-judgmental? Do you feel listened to? If not, perhaps you need to try someone else who might be a better fit.

 HOW ARE COUNSELLING SERVICES PAID?   In Canada, the services provided by a psychologist are covered by provincial health insurance only if the psychologist is employed by, for example, a hospital, correctional facility, community clinic, social agency or school. The services provided by a psychologist or registered counsellor in private practice are not covered by provincial health insurance plans and the psychologist/counsellor bills the patient directly. Many people have extended health benefits through their employers that cover some amount of psychological or counselling service annually.

WHAT HAPPENS ON MY FIRST VISIT?  Once you have the name of a practitioner and make a first appointment, it is usual for him or her to ask you to describe your problem and to ask for details about your personal history. These questions will include such things as when did your problem start, what makes it better or worse, and how does the problem affect your work or social life. Questions about your personal history can include details about your experiences growing up, your education and work history, your marital status and interpersonal relationships, and whether you use medication, alcohol or drugs. This information-gathering phase can take one or more sessions.

WHAT HAPPENS DURING INITIAL TREATMENT?   Early on in the treatment, the therapist will help you make goals to work towards and identify the ways therapy will help you achieve them. Goals can include feeling less depressed, feeling more comfortable in social situations, improving pain management, changing your behaviour, or increasing self-esteem, for example. In addition, the therapist will review your progress in meeting these goals at certain intervals and may have you fill out questionnaires designed to help monitor progress.  An important thing to remember about therapy is that it can be hard work to change feelings, thoughts and behaviours – attending sessions regularly and following through on recommendations are important. One thing that cannot be changed is what happened in the past – but you can change how it affects you. It is also difficult to change the behaviour of other people. Therapy is primarily focused on helping you make personal changes to improve your life. You are entitled to be an informed consumer and active participant in the  treatment process – if you have questions or concerns, let your therapist know!  

WHAT HAPPENS TO THE PERSONAL INFORMATION I DISCUSS WITH MY PSYCHOLOGIST OR COUNSELLOR?   Information disclosed to a therapist is confidential and cannot be disclosed without the client’s consent except under certain specific conditions. These conditions are referred to as the “limits of confidentiality,” These limits typically involve situations where the client gives the psychologist information that leads him or her to suspect that harm might come to someone. If a therapist suspects that a client is going to harm himself or someone else, that a child is being abused or neglected, or that another health care practitioner has sexually abused a patient in some way, then he or she has an obligation to report this information to the appropriate authority. The courts also have the power to subpoena a therapist’s files.  Therapists must retain records of their contacts with clients. These records typically include details about the clients presenting problem and history, psychological test data and any diagnoses made, as well as details about sessions attended. In BC, a therapist’s records are kept for 7 years after the end of treatment and, if the client was a minor, for at least seven years after the client reaches the age of majority.

WHAT IS THE DIFFERENCE BETWEEN A PSYCHOLOGIST AND A PSYCHIATRIST?   A psychologist typically holds a doctoral degree in psychology and has a total of ten or more years of university study into how people think, feel and behave.  Psychologists typically will have completed their graduate university training in clinical psychology, counselling psychology, clinical neuropsychology or educational/school psychology and those with a doctorate degree may use the title “Dr.”. A practicing psychologist is trained to assess and diagnose problems in thinking, feeling and behaviour as well as to help people overcome or manage these problems. A psychologist is uniquely trained to use psychological tests to help with assessment and diagnosis. Psychologists help people to overcome or manage their problems using a variety of treatments or psychotherapies. Psychiatrists are medical doctors who go on to specialize in mental health and mental illness. Psychiatrists often use medication to help their clients manage their mental illness. There are some mental illnesses for which medications are very necessary (such as schizophrenia, and some depressions, for example). Some psychiatrists also do psychotherapy much like psychologists do. Sometimes a client might consult his or her family physician about medication while seeing a psychologist for psychotherapy. Some family physicians have an interest and some training in treating psychological problems.  In some cases, an individual might be followed by a psychiatrist for his or her medications, while seeing a psychologist for therapy.

DO MEDICATIONS WORK?  Research indicates that medications most often manage, but do not cure, psychological problems or mental illness. This is also the case for some types of physical problems. For example, if you have diabetes, you may need to take insulin for the rest of your life. This is different from, for example, having an infection and taking an antibiotic, with the goal of curing the infection. Most medications for psychological problems or mental illness do not cure the illness but relieve it and make it easier for the person to manage, often with the help of psychotherapy. As noted above, there are some mental illnesses for which medications are very necessary. Research tells us that medication and psychotherapy together work better than either medication or psychotherapy alone in managing some types of psychological problems. Finally, some types of problems are better managed with psychotherapy alone. 

WHAT ARE PSYCHOLOGICAL TESTS?  Psychological tests are used to gain a better understanding of the kind of problem in thinking, feeling or behaviour a person presents. If a psychologist plans to use a test, he or she should explain why it is being used and what it is used to assess. For example, some tests are used to assess and help diagnose mood, some are used to assess problems in memory or concentration, and some might be used to better understand personality characteristics. Some are pencil and paper tests that pose questions to which you must answer true or false, and others might require you to manipulate objects or remember numbers or phrases. Testing is used to help the psychologist arrive at a diagnosis of your particular problem.