February 21, 2023

What you need to know before you see a therapist

By Farhana Uddin and Andrée-Anne Guénette

Thinking of therapy? It could be the first step to improving your mental health. Here’s what you need to know before booking that first appointment.

Need to talk to someone? Someone who’ll really listen? You’re not alone. 

A 2021 Sun Life survey found that 60% of Canadians have a mental health issue. Issues like anxiety, stress, depression and addiction are topping the list. And over half of those experiencing mental health issues have not gotten the help they need.

Thankfully, virtual sessions and online portals have made mental healthcare more accessible. There are more and more options out there to find the help you may need.

“It’s not always easy for someone to take that first step and meet with a therapist or counsellor,” says Meredith Henry. Henry is 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. Talking to a complete stranger can seem even more challenging.” 

As a licensed counselling therapist, Henry hopes to normalize mental healthcare. Her hope is to make people feel more comfortable talking to a therapist. “It’s easier if people know what they’re getting into ahead of time,” she says.

Are you 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:

What are the types of mental health professionals? 

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.” 

To clear up the confusion, Henry breaks it down: 

What is a psychotherapist or mental health counsellor? These trained healthcare professionals help people with mental challenges such as anxiety, depression or grief. Only some provinces regulate psychotherapists and counsellors (see the table below). Provincial health insurance doesn’t cover their fees, but your workplace health benefits may.

What is a psychologist? Psychologists often hold a doctorate (PhD) in clinical psychology. They’re skilled in diagnosing and treating certain mental illnesses and learning disabilities. Provincial health insurance doesn’t cover their fees either. Like psychotherapists, your workplace health benefits may cover their fees.

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. Provincial health insurance covers costs for Psychiatrists.

There’s statutory regulation for psychotherapy, as a profession, in four provinces: 

Province Title
Ontario Registered Psychotherapist (RP)
Quebec No specific title, but therapists require a Psychotherapy Permit
New Brunswick Licensed Counselling Therapist (LCT)
Nova Scotia Registered Counselling Therapist (RCT)

It’s important to choose a licensed therapist to treat you. To do this, Henry suggests doing a bit of online research. Find out if the therapist you’re considering is registered with a legitimate mental health or psychotherapy association. 

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: 

1. Non-profit organizations and associations. Look into non-profits in your area to see if any can help. “A lot of non-profit organizations realize that mental healthcare can be expensive,” says Henry. “Some non-profit agencies will offer three to five sessions for free or at a sliding scale fee.”

2. Government-funded programs. “Check online resources," suggests Henry. "There, you can find mental health programs or services in your area that the provincial or federal government funds.”

3. 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," says Henry. "They’re available to employees who need help with mental or physical health issues that may affect their work performance.”

Depending on the terms of your EAP, you could receive a set amount of:

  • e-counselling,  
  • video counselling or  
  • in-person counselling sessions. 

4. Search online for e-therapy options. “Many mental health clinics, programs and hotlines now 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. Online mental health platforms like Inkblot deliver video counselling sessions with licensed therapists or counsellors at a reduced rate.

Maybe an in-person interview feels intimidating or you 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, there are two steps that take before the session:

1. Paperwork or registration. This may vary depending on the setting. “In private practice, we ask for info like your name, address, phone number, emergency contact. We also ask if you’re taking medications,” Henry explains. In a clinical setting like a hospital, there may be additional forms concerning your health history and background.

2. Confidentiality. “Your therapist will explain their confidentiality agreement to you. They’ll ask you to sign an ‘Informed consent paper.’ This states that they’ve talked it over with you before your session,” says Henry. In e-therapy, you may need to check off a box stating you agree to the terms and regulations. If sessions are happening virtually, you can ask about secure connections and any other concerns you may have.  

Will everything you say to your therapist stay confidential? 

Confidentiality is often a huge concern. Many people worry about judgement or shame for their mental-health issues. “Anything you say in therapy is private. The only exceptions are reporting issues of violence, harm or abuse,” says Henry.

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. That would a breach of confidentiality,” Henry adds.

What kind of questions will your therapist ask you on a first meeting? 

“Therapists receive training to build a trusting relationship with their clients. That trust takes time to develop,” says Henry. “That’s why the first meeting centers on getting to know the person and making them feel at ease.” 

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? 

Your therapist may also ask what brought you to therapy. “If someone’s going to therapy, perhaps they don’t feel right or they feel like something’s missing,” says Henry. “I would ask them, ‘If you fixed all of that, 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.” 

Can you see benefits from the very first therapy session? 

Many clients express how good it feels to have someone to hear them out. “To have someone whose job is to listen to you is a novel experience,” she says. “They feel accepted as they are. They don’t feel as though they have to pretend to be happy all the time. They can just be themselves.”

How can you find a therapist to work with? 

Ready to find someone to talk with? You can use Lumino Health to find a mental health-care provider. Lumino’s provider search is available to everyone and offers a hub of health resources, including:  

  • a stress and anxiety explorer, and  
  • a library of mental health articles. 


Read more: 

This article is meant to provide general information only. It’s not professional medical advice, or a substitute for that advice. 

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