Need someone to talk to? Or someone who’ll listen? You’re not alone.
According to the Mental Health Commission of Canada, mental health problems and illnesses account for 30% of short- and long-term workplace disability claims in Canada. And that’s only people who are actively seeking treatment and who have the health insurance benefits to help pay for it. While virtual and online portals have made mental healthcare more accessible, many Canadians continue to spend their days in various states of depression, anxiety or trauma without any therapeutic help or attention.
“It’s not always easy for someone to take that first step and meet with a therapist or counsellor,” says Meredith Henry, the New Brunswick Anglophone Director for the Canadian Counselling and Psychotherapy Association. “People sometimes have trouble talking to their loved ones about what they’re going through. So, by comparison, talking to a complete stranger can seem even more challenging.”
As a licensed counselling therapist, Henry hopes to normalize mental healthcare by making people feel more comfortable talking to a therapist. “It’s easier if people know what they’re getting into ahead of time,” she says.
So, if you’re feeling uncertain or nervous about seeing a therapist, here are some answers to common first-timer questions and concerns that may put you at ease:
How do you know what type of mental health professional to see?
Psychotherapist. Psychiatrist. Psychologist. They all mean the same thing, right? “That’s not true,” Henry says. “Even within the field, a lot of people don’t know the difference, which only adds to the general public’s misperception.”
To clear up the confusion, Henry breaks it down:
What is a psychotherapist? Often referred to as therapists or counsellors, these healthcare professionals are trained to help people with everyday mental challenges such as anxiety, depression or grief. Their fees aren’t covered by provincial health insurance, but may be included in workplace health benefits.
What is a psychologist? Psychologists typically hold a doctorate (PhD) in clinical psychology. They’re skilled in diagnosing and treating certain mental illnesses and learning disabilities. Their fees aren’t covered by provincial health insurance, either.
What is a psychiatrist? They’re medical doctors who often work with people with severe mental illnesses, like schizophrenia or bipolar disorder. Unlike psychologists or psychotherapists, psychiatrists’ medical background allows them to prescribe medication to their patients. Some psychiatrists may also practise psychotherapy or work with a therapist to help treat their patients. Psychiatrists ARE covered by provincial health insurance.
As a profession, psychotherapy is statutorily regulated in four provinces.
Registered Psychotherapist (RP)
No specific title, but therapists require a Psychotherapy Permit
Licensed Counselling Therapist (LCT)
Registered Counselling Therapist (RCT)
Whatever you may call a therapist, it’s important to choose one who is licensed to treat you. To do this, Henry suggests doing a bit of online research and finding out if the therapist you’re considering is registered with any legitimate mental health or psychotherapy associations.
What if you can’t afford a therapist?
It isn’t just apprehension holding someone back from seeing a therapist. In some cases, it comes down to cost. What do you do if you can’t afford a therapist? You have options:
- Non-profit organizations and associations. Look into non-profits in your local region to see if any can help. “A lot of non-profit organizations realize that mental health can be financially difficult to access at times,” says Henry. “That’s why some non-profit counselling service agencies will offer three to five sessions for free or at a sliding scale fee.”
- Government-funded programs. “You should also find out or ask a medical professional if there are any mental health programs or services in your area that are funded by the provincial or federal government,” suggests Henry. For instance, Big White Wall is backed by the Ontario government and offers free, 24-hour online support, self-help tools, assessments and guided courses to help residents manage everything from depression and anxiety to weight-management and smoking cessation.
- Employee assistance programs. Reach out to your HR department to see if your workplace benefits include an employee assistance program (EAP). “These programs usually provide 24-hour support to employees who need to resolve mental or physical health issues that may affect their performance at work,” says Henry. Depending on the terms of your EAP, you could receive a set amount of e-counselling, video counselling or in-person counselling sessions.
- Search online for e-therapy discounts. “Nowadays, you’ll see so many mental health clinics, programs and hotlines that provide e-services or phone services,” says Henry. For example, trained crisis volunteers at Kids Help Phone offer mental health support through a free bilingual texting service. Meanwhile, online mental health platforms like Inkblot and Wellpoint Connect deliver video counselling sessions with licensed therapists or counsellors at a reduced rate. So whether you’re intimidated by an in-person interview or don’t have the time to meet someone face-to-face, e-therapy can help you from anywhere, any time.
What happens before the therapy session?
If you’ve found a therapist to meet in-person or virtually, there are two steps to take before the actual session:
- Paperwork or registration. The amount of paperwork or online registration you have to go through often depends on the setting. “In private practice, we ask for demographic info like your name, address, number, emergency contact, whether or not you’re currently on any meds,” Henry explains. However, if it’s a clinical setting like a hospital, there may be additional forms concerning your health history and background.
- Confidentiality. “Your therapist will explain their confidentiality agreement to you and ask you to sign an ‘Informed consent paper’ stating that they’ve talked it over with you before your session,” says Henry. In e-therapy, you may be asked to check off a box stating you agree to the terms and regulations concerning confidentiality.
Will everything you say to your therapist stay confidential?
Since many people are worried about being judged or shamed for their mental-health issues, it’s understandable that confidentiality is such a huge concern. “Anything you say in therapy is private and not allowed to be shared or talked about with anyone else unless there’s an issue of violence, harm or abuse that needs to be reported,” says Henry.
And, don’t fret about running into your therapist outside of your session. “They aren’t allowed to say they know their clients if they run into them anywhere, like in the street or the grocery store, because that’s considered a breach of confidentiality,” Henry adds.
What kind of questions will your therapist ask you on a first meeting?
“Therapists are trained to build a trusting relationship with their clients, but that trust takes time to develop,” says Henry. “That’s why the first meeting is usually just taking the time to get to know the person and make them feel at ease.”
In an effort to get to know you better, your therapist may ask questions like:
- Can you tell me a little bit about yourself?
- What are your hobbies?
- What kind of job do you have?
- Do you enjoy your job?
- Do you have a family? A partner?
After the two of you have gotten more comfortable chatting, your therapist may ask what brought you to therapy and explore the history of why you’re here. “If someone’s going to therapy, then they’re dealing with some type of problem. Perhaps they don’t feel right or they feel like something’s missing,” says Henry. “I would ask them, ‘If all of that were fixed, what would things look like for you? And how would you like it to be?’ Their answer gives me an idea of what they hope to achieve through therapy and how I can help them.”
What are people surprised to discover during their first therapy session?
Henry notices that many of her clients express how good it feels to have someone to hear them out. “A lot of times we feel like we’re not being heard. So to have someone whose job is to listen to you is a novel experience,” she says. “They feel accepted as they are and don’t feel as though they have to wear a mask or pretend to be happy all the time. They can just be themselves. A lot of people are surprised by that, because it’s not something you might find in other parts of society.”