We have discussed the different disciplines in the mental health field in the first two articles (What is the Difference Between a Counsellor, Social Worker, Psychologist and Psychiatrist, Parts 1 and 2) So, what is a consumer to do? It’s all a bit overwhelming.
First, coverage. If you have a national Employee Family Assistance Program (EFAP), keep in mind that most Psychologists and veteran therapists do not work for the lower paying national EFAP. As well, you are generally not able to choose a specific therapist or a specific discipline with these EFAP’s, and you may only have access to sessions by telephone or email.
Alternatively, if you have access to insurance or extended health benefits (where you may have to pay up front and be reimbursed), many of these plans will only cover a Registered Psychologist. While insurance companies are slowly becoming more inclusive to disciplines other than Psychology, check your plan first. Remember, the actual registering body of the professional is the key here. Registered Psychologist or Registered Social Worker are often the only two mental health disciplines covered. However, some employers have taken steps to include Certified Counsellors as well. Every individual policy will have their own definition of what will be covered. As well, some require a doctor’s referral to be submitted along with your receipt, and others do not. Again, refer to your policy details.
Getting a word of mouth therapist recommendation is a very good idea. Personally, I would be reluctant to see a therapist without a recommendation by a trusted friend. Most therapists don’t mind a brief telephone interview. Tell the therapist what you are doing and ask them questions suiting your concerns and values, beyond their profile on a website.
Remember, the purpose of your first appointment is to tell your story and further rate them. I tell my clients they need to give me at least an 80% satisfactory rating before returning. If I am seeing a couple, they each need to give an 80% grade. Couple’s counselling will fail if one gives 50% and the other gives 100%.
You will need to establish whether you are looking for a “process-” or “outcome-” based therapist. Process-based therapists are nice, kind, warm and interested in the relationship where your self-evolved insight will be helpful. Outcome-based therapists on the other hand, may have these characteristics as well, but more importantly focus on the outcome – the goal. They focus on fewer sessions with maximum outcome. Generally, it is the veteran therapists that practice the more direct approach.
Costs vary amongst disciplines. Psychiatrists and Psychiatric nurses are generally covered under medical care (as are all other public practitioners). Those of us in private practice have wide ranging rates, from under $80 per hour to $180+ per hour. The costs are generally based on 1) the therapist’s qualifications (a PhD for example, generally demands a higher hourly rate), 2) the therapist’s experience (therapists with less than 5 years’ experience generally charges a lower rate), 3) the location (therapists operating out of their homes have no little to no expenses. An interview question for these therapists might be, where will my file be securely and safely stored until it is destroyed) and 4) the size of the practicing group (sole practitioners with no Administrative staff or overhead charge the lowest hourly rates).
You can always discontinue with a therapist if you find the relationship match (which is the most important factor of all) is not working. Admittedly, if you have seen 3 or 4 therapists and were dissatisfied with all of them, you may be looking in the wrong direction.
Best of luck with your search!