There’s no one specific time to seek counselling. Some people seek counselling:

• following a traumatic experience
• when they recognize they’re caught in patterns that are unworkable
• when anxiety and/or low mood are taking over their lives
• when they want to identify their values and goals and make changes
• when they want to process their past so it doesn’t negatively impact the present
• to learn coping skills
• to gain new insights and perspectives to further understand themselves
• When they feel apathetic or lack a sense of purpose 
• When they’re feeling deep hopelessness and/or suicidality 
• When you’re seeking validation, empathy, understanding, and connection

The list goes on. To figure out whether or not the time is right for you to see a Counsellor, you can reflect on the above and ask yourself if you have the capacity to effectively cope with what’s going on in your life currently. If the answer is “no”, now may be the time to try or return to counselling. 

Isn’t our mental health system confusing! I am both annoyed and deeply disturbed by how convoluted and confusing it is for those who are trying to navigate the mental health system. There is significant overlap and important differences between various mental health care providers. For now, I’m just going to speak to Registered Clinical Counsellors (RCC’s), Social Workers, Psychologists, and Psychiatrists. Each of these professional categories aims to help people, couples, and families. When trying to figure out who can support you best, you can reflect on the following:

• What do I need?
• What might this provider offer me?

Let’s start with Registered Clinical Counsellors (RCC’s) – that’s me! A RCC is a professional who has completed masters- level counselling education/training and has met the necessary standard requirements to receive the classification as a Registered Clinical Counsellor from the B.C. Association of Clinical Counsellors (BCACC). Depending on their area of practice, RCC’s support clients experiencing a wide range of emotional and psychological difficulties to help them bring about effective change and/or enhance their wellbeing. Please be aware that the term “Counsellor” is not protected in BC which means that anyone (including someone without masters-level education) can call themself a Counsellor. This is why it’s important to connect with those who are RCC’s (and have a registration #). 

Social Workers can either have an undergraduate degree or an undergraduate degree and a masters degree in social work. Social Workers can work in a variety of settings from healthcare, to education, to private practice, and more. Some Social Workers take specific training in Counselling and work as Counsellors. When Social Workers provide counselling services, they can be similar to the services offered by RCC’s. Keep in mind that different training, education, and experience will inform how Social Workers and RCC’s practice. 

Okay, how about Psychologists? Registered psychologists provide services to manage and enhance the cognitive, behavioural, emotional, interpersonal and physical functioning of individuals or groups of individuals, primarily by applying and using psychological assessment and intervention strategies. As part of this work, Psychologists also assess and diagnose behavioural, emotional, cognitive and mental disorders. One of the key defining features between a Psychologist a RCC/Social Worker is that Psychologists are able to formally assess and diagnose disorders. And to confuse things even more… Some psychologists also offer counselling although they typically charge $200+ per session. 

Are you still reading? If so, well done! Okay, last but not least – Psychiatrists. 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. Some psychiatrists also offer therapy although this is more rare. In order to see a Psychiatrist you will need a referral from a Doctor such as your Family Doctor or Nurse Practitioner or a GP at a walk-in clinic. 

After reading all this, let’s loop back to the two questions offered at the beginning so that you can figure out which provider is going to be the best fit for you:

• • What do I need?
  • What might this provider offer me?

Let’s peel back the curtain on what actually goes on in a counselling session shall we! First off, it depends on what kind of session it is. In an initial session, we are just getting to know each other and start to build our relationship. In an initial session, I give you the option of where you’d like to start and we’ll cover:

• What’s bringing you in for counselling and why now?
• What are your goals for counselling?
• A brief overview of any previous counselling experience (what worked well and what didn’t)
• Why did you choose me to work with/is there anything specific about me as a person or as a Counsellor that you’re looking to connect with?
• Who are you? ( Big question right?) This one takes time, I’ll get to know you and we’ll get to know each other over several sessions. 

In subsequent sessions I start off with seeing whether or not you’d like a brief recap/summary of the last session, including touching base on any homework that was identified in the previous session, or if you’d like to jump right in. I’ve been told by clients that they find it helpful to hear a recap/summary from the previous session which usually includes my clinical thinking. Sometimes clients are ready to talk and get into things and other times clients ask for more direction from me – I always work to be client centred in this way (which means what works best for you). 

Another factor that determines what goes on in a session is which type of therapy or modality we are using. For talk therapy, we’ll be discussing the topics you bring up and I will be offering various perspectives from Acceptance & Commitment Therapy, to intersectional-feminism, to queer theory, to mindful self-compassion, and other therapies. We’ll also be connecting in to your emotions because despite our desire to avoid difficult emotions, they usually have important information for us to tune into. We may also engage in practices and exercises together where I walk you through a mindfulness practice for example or a grounding or containment exercise. I often find it helpful to practice tools/strategies together before you try them on your own because then we can troubleshoot any difficulties or make modifications. With EMDR, we will be identifying targets and going through a standard protocol that involves assessing the targets, using bilateral visual stimulation (either following my hand for in-person sessions or a ball on a screen for virtual sessions), check-ins, body scans, and reorienting negative beliefs .

From time to time, I will check in with you about what’s working well in our sessions and what isn’t working well and we will make adjustments based on your feedback. You’re also welcome to give me feedback anytime! Afterall, success in counselling is determined by you. 

A note on terminology – sometimes called “employer benefits,” “group benefits,” “health benefits,” “student benefits”, “extended benefits”, or “health insurance,” these plans cover a variety of health services including mental health support. You may have these benefits from your employer, through a family member, or from your education institution.  

Many plans now include coverage for Registered Clinical Counsellors (RCC’s). If your plan specifically states that it covers RCC’s – that’s great news! The typical range of coverage for mental health services in Canada (for both employees and students) is between $500 and $3,000 per year. Plans vary in the % of each session they cover from 50-100% often to a maximum dollar amount. In order to apply your benefits coverage to our counselling sessions, you pay upfront with your credit card and after the session has been completed, you will receive an email with a receipt that has all the necessary information to submit your claim to your benefits provider and then you will be reimbursed as per your plan allotment. 

If your plan does not specifically state that it covers RCC’s (it may for example state that it covers Psychologists and/or Social Workers) then you may need to do some inquiring and advocacy. This can be tricky depending on how comfortable you are discussing the topic of mental health and support services with your employer or academic institution. If you’d like some support demonstrating the education, ethics, standards, and professionalism of RCC’s, please get in touch with me and I would be happy to share a template letter I have that outlines the similarities in education & professional requirements for Social Workers (who are usually covered in benefits packages) & Registered Clinical Counsellors (who are newly being included in benefits packages). I have had a couple of clients who were successful in having RCC’s included in their benefits packages after sending my letter to their employer who then forwarded it onto the insurance provider. 

First off, it’s up to you! I’m happy to support both options including a combination of virtual and in-person depending on what works best for you and our scheduling alignment. 

Before the pandemic, I rarely conducted virtual counselling sessions and had the misconception that counselling was much more effective in-person. And then we all know what happened…. The pandemic hit and our worlds were turned upside down. I went from having conducted the odd virtual session to delivering exclusively virtual sessions. I noticed that many of my clients transitioned well from in-person to virtual and rarely had negative things to say about virtual counselling. Because of the video component of virtual counselling, I too found sessions to be effective and did not notice negative impacts on clients or their therapy goals. Research shows that online therapy can be just as effective as in-person therapy for various mental health conditions.(1) 

Here’s what you can consider when determining whether or not virtual, in-person, or a combination of both 

• Accessibility 

There’s no doubt that virtual sessions are more accessible than in-person sessions. Virtual sessions provide accessibility to individuals who are disabled or housebound as well as offer access to those who live outside of downtown Vancouver where my office is located. With that said, please note that my office is accessible for those with impaired or limited mobility and/or other disabilities. 

• Convenience

There’s nothing more convenient than being able to access virtual therapy from the comfort of your own home. No need to commute, pay for transit or parking, and put on real pants! Accessing virtual counselling sessions may work particularly well if you are working from home. 

With that said, some of you may be back in the office in downtown Vancouver or live close by thereby making in-person sessions more convenient. 

• Privacy 

It’s important to consider the level of privacy you have when accessing virtual counselling sessions. Let’s be honest, most of us are living in small spaces in Vancouver and having family members or room-mates at home may impact our privacy. When considering booking a virtual session, it’s imperative that you have access to a private space where you can feel comfortable talking, sharing, and emoting. It’s ideal to be in a room or space by yourself that’s relatively quiet and not distracting. Having headphones/earbuds accessible is important too in case there’s any distracting background noise. If you do have other family members or room-mates in the home you can ask them to respect your privacy by leaving you undisturbed for the duration of your session. You can also get creative and plan your virtual sessions around knowing when people will be out of the house or simply asking them to be out of the house for the duration of your session. 

In-person sessions will always guarantee privacy – my office is a private space in a quiet building and I use a white noise machine and fan to further block out noise carryover. 

• Technology 

I recommend using a laptop or tablet for virtual sessions that can stand on its own or be propped up so that you can minimize distractions and be comfortable. You can use an iPhone or Android if need be but due to the device size, it’s not ideal. Whatever device you are using needs to be able to access Jane which is the fully integrated practice management system I use. There are several ways to join your virtual session through Jane – click here to learn more about how to access your virtual session through Jane from a desktop or laptop. If you are accessing your virtual sessions from an iPhone or iPad click here Please note that Jane’s virtual sessions are PIPEDA compliant in Canada – if you’d like to read more about Jane’s privacy compliance click here.

Because virtual sessions include video for both you as the client and me as your Counsellor, you will need an integrated or external camera and a strong password protected internet connection. The good news is that most devices these days have an integrated camera. On my end, whether I’m delivering virtual sessions from my office or at home I only use password protected wifi and rarely experience connectivity issues on my end. 

When it comes to in-person sessions, technology isn’t required. I’m old school – I take written notes during our session and then input those into your digital Jane chart. 

• Tangibility 

Okay now bear with me on this word… I was trying to think of how to describe the notion that we are doing so much virtually and online these days that connecting in person can be particularly meaningful and important. Tangibility can refer to the advantages of being able to physically interact with someone in-real-life (IRL for those in the know). Some clients prefer in-person sessions because they have limited in-person interactions during the day. In-person sessions can be a great way to get yourself out of your home if you struggle with low mood and/or anxiety. However, if you experience more extreme mood challenges then virtual sessions may be a more accessible way to start off your counselling journey. When in doubt – experiment! Try both virtual and in-person and see what works best for you!