Questions about Counseling/Psychotherapy
- What to look for in a counselor?
- Confidentiality?
- Frequency of Sessions?
- How long will it take?
- Termination?
- Billing Practices and Client Records?
- Washington State Brochure: What to Expect from a Licensed Mental Health Counselor
What to look for in a counselor
Licensed counselors act in accordance with state law and Department of Health rules, as well as the Codes of Ethics of their national professional organizations. Reading through the Washington State Brochure: What to Expect from a Licensed Mental Health Counselor will give you a good sense of competent, professional counseling practices. I encourage you to read it to be well informed. You want to consider a counselor’s education and training, whether they have the professional qualification and expertise for counseling your particular needs.
Research evidence shows a number of counseling approaches are beneficial, however the most discriminating factor of importance is the client/counselor relationship. So you want to find a counselor with whom you feel comfortable. This may come by a friend’s recommendation, a doctor’s referral, or your own on-line or phone book search.
In your initial contact with a counselor, do you feel respected as a person? Do you feel the counselor really listens and seeks to understand you? Or does the counselor seem judgmental and too ready to “label” you with a diagnosis? Does she or he consider the whole person, assessing possible physical causes for which you should see a medical doctor, rather than just psychological causes? Is he or she spiritually abusive with simplistic “if your only had faith” solutions? Does the counselor look for your strengths and look for signs of health? Is the counselor attuned to your need—as you share your pain, does the counselor naturally express empathy? Do you feel validated as a person? Trust your senses. You will know when you find a counselor who is a “good fit” for you.
As my client, you have the right to discuss any concerns you have about matters of confidentiality, privacy, and release of information, as well as limitations on confidentiality. State law guarantees confidentiality between counselors and their clients. This means that you seeing me as a client and whatever you tell me are private, and I make every attempt to protect information about you from possible misuse. In many cases, your written permission is required before I can release records. However, there are a few exceptions. .
- Insurance If used, the insurance company has the right to know certain things about you. This information includes a diagnosis, type of treatment, dates, and sometimes a justification for treatment. While most insurance companies keep medical information confidential, I cannot guarantee confidentiality once information leaves my office. If the insurance company asks for more detailed information than usual, I will speak to you about it and let you decide what you want them to know. However, if you choose not to provide them with information, you may be assuming financial responsibility for treatment costs yourself.
- Lawsuits You need to be aware that if you decide to sue someone for a personal injury that is the focus of your treatment, you may be signing away your right to confidentiality. In the legal process, the defendant may be able to gain access to your treatment records to help in their defense. A judge could order that your file be turned over to the court.
- Abuse If you make statements that lead me to believe a child or vulnerable adult has been abused or neglected, my personal ethic and the requirement of the law necessitate a report to appropriate authorities.
- Harm If you make statements that indicate you intend to harm yourself or others, my personal ethic and the requirement of the law necessitate a report to appropriate authorities.
My usual preference is to meet with clients on a weekly basis with 50 min. sessions. I find weekly sessions more conducive to reducing symptoms and making progress in therapy. However, each client has differing needs, so I am open to working out what works best for my clients. If a client will read recommended books, listen to CD’s, or actively journal the progress of therapy is supported to where every other week could work.
If a person is in crisis, twice weekly may be necessary until he or she is more stable. Toward the end of therapy, sessions are sometimes spread out. After termination, clients are always welcome to come back for a “tune-up.”
The number of sessions varies greatly depending on the type and severity of the problem and the expressed needs and desires of the client. I wish I could give you an idea of precisely how long, but it is difficult to say. Some depends upon how long your problem has been going on. Symptom relief for a single incident trauma could resolve in just a few sessions with EMDR. Other client issues resolve fairly quickly with a Solution Focus treatment approach. But some clients have issues that need on-going, deep therapy, especially in cases of early trauma or neglect, and long standing depression or anxiety.
This is understandable. Change does not happen overnight. There are no “quick fixes.” Habits take time to change. Each individual learns and progresses at her or his own pace. Sometimes life circumstances add complexity. Working through deep psychological wounds or complex relationship issues takes time. Changing long-held, negative beliefs or behavioral patterns is understandably worth the time for adequate therapy. A good therapist is motivated toward your healing and recovery and ability to get on with your life as quickly as possible.
As with the commitment and investment for a college degree, I hope clients begin to think of personal growth and healing as a wise choice. For child therapy, I usually encourage parents to plan for 12 sessions. Many children get the benefit they need within that time. If more time is needed, we can extend things.
I will inform you of options regarding your counseling, and will respect your needs and desires regarding frequency of sessions and length of counseling. Clients have the right to discontinue or terminate therapy when they wish. It is good, however, when a final session for closure is scheduled.
If you wish to call me and let me know why you are seeking therapy at this time, maybe I can give you a clearer idea of how many sessions to plan on. Sometimes things can be worked on in stages, taking one step at a time.
While every client has the right to choose when to end therapy, I hope termination is something we discuss and decide together. I encourage you to talk with me before making that decision. If you chose to begin therapy, I want you to make a commitment to it. You will be involved for a while and sometimes it will seem like hard work. Personal growth is a commitment and an investment.
My goal is to get you feeling better about your situation, yourself, and your ability to cope in the future. I take my job seriously. I appreciate open communication from my clients so I know clearly what they want and need. If ever a client felt that I couldn’t meet those needs, I hope they would let me know so I could give them some good referrals. Since the effectiveness of therapy depends so much upon the client/counselor relationship, “Goodbye” times are important for closure.
Session fees can be paid by cash or check at the beginning of each session. At the first session, we can discuss the option of paying by the month. If your insurance will cover my services as an out-of-network provider, I will be happy to send the bill directly to them. We’ll discuss the frequency of payment for your co-pay amount.
Client Records
Both the law and the standards of my profession require that I keep appropriate counseling/treatment records. I keep client records and progress notes in locked file cabinets. You have the right to have access to your records. It is my policy to review your records with you. I am willing to release your records to another mental health professional with your written permission, once you know what they contain.
What to Expect from a Licensed Mental Health Counselor
Washington State Brochure