Guide to Starting Counseling

Finding a counselor can be stressful. This is a little guide to finding a counselor and what to expect when starting counseling.

What you should know

Nearly everyone will experience a mental health struggle at least once in their life. Most of these issues are easily remedied with education on mental health, guidance in developing coping skills, and a little processing. Counseling does not have to be forever, and it doesn’t mean there is anything wrong with you. The point of counseling is to improve quality of life and counselors are trained in helping you find that improvement.

Tips and advice

1. You are not required to stay with a counselor if you don’t click
2. Counseling should be collaborative, if you don’t like the direction the session is going, say something.
3. Counselors are not supposed to judge. Be honest with them.
4. Unless the counselor is concerned about harm, they are legally required to keep all information discussed confidential.
5. Alternative services, such as coaching, are available for those needing a lower level of care.

Finding a counselor

There are two basic types of counseling offices.

1. Community groups

These are groups that offer low cost to free counseling based on financial need and usually take Medical. The biggest pro of these groups is that they are affordable due to government assistance and the use of more interns. Another pro is that these groups are community founded, meaning they are usually able to provide many resources such as legal help, family support, and work assistance. The cons of these groups are that the client usually has less control over the counselor they see. Clients are usually assigned in a rotation meaning you see the one next of the list. The groups that use government types of funding can also come with restrictions such as session caps and restrictions on types of issues served. Most groups are skilled at navigating these restrictions but can be problematic for some.

2. Private practice

These counselors operate independently, although many will group up, sharing office space and resources. The benefit here is that when you choose to go to a counselor you choose the actual counselor you will be seeing. Most will offer free consultations which will allow you to get to know each other before making a commitment. The con with these counselors usually comes down to cost. Since they don’t receive government assistance and must provide their own office space they need to charge more for services. There are 2 types of payment types.

1. Private pay – This means fees are paid directly to the counselor without the use of insurance or other payments. Fees can range from $50 a session to $200 per session based on the counselor, appointment time, Client need, and counselor experience. For example, a newer counselor may have lower costs and appointments on nights and weekends may be more expensive. However, this is not always the case, so it is important to discuss sliding fees with a counselor.
2. Insurance –The insurance provider a counselor will take is based on a few things. First, in order to accept insurance, a counselor must be accepted by the insurance board which can be very difficult. Next, many insurance companies don’t provide adequate payout per session to allow the counselor to cover operating costs. Finally, insurance can come with restrictions such as session caps and diagnosis requirements. A counselor must be picky when choosing what if any, insurance providers they work with. If a counselor takes your insurance, you can expect to pay between $20 – $50 a session based on your co-pay.

Coaching Alternative

Coaching services are not a replacement for therapy or traditional counseling but may be useful for those undergoing temporary or mild issues. Coaches do not offer treatment or diagnosis of mental health conditions. Some common areas of coaching include:

1. Life changes (career change, starting or finishing education, family transitions)
2. Grief support
3. Managing stress and anxiety (mild, non-diagnosable conditions)
4. Lifestyle changes (fitness goals, improve relationships, self-improvement)
5. Self Help (organization and improve time management, parenting classes)
6. Self Care training

Coaches do not accept insurance and will always be private pay. Coaches will be able to refer out for services that are beyond their scope of practice.

Starting counseling

1. Contact, consultation, set up an appointment – This is everything in finding a counselor area. Psychology today and web searches can be very useful. Tip: have some questions you want to ask written down before the first contact.

2. Paperwork – You will be provided paperwork outlining confidentiality, HIPPA, fees, and consent to treat. Sometimes these forms will be provided ahead of time, other times it may be dealt with in the first session. Therapy cannot begin until this is complete. Nothing about these forms is anything to be afraid of if there are any questions or concerns ask.

3. Intake and assessment – In the first few sessions expect a lot of questions. This will help a counselor to get to know you. This may include family and personal history as well as symptoms you are experiencing and likes and interests. Sometimes a counselor will provide a questioner before the first session to help the process.

*Coaching will not include step 4. Clients in need of treatment and diagnosis will be referred to a licensed counselor or therapist.

4. Diagnosis and treatment – This is the scariest part for most clients, but there is nothing to be afraid of. It may sound clinical, but it is only meant to give the sessions a focus and ensures you are working on what you need to. You should be part of this process to, to provide feedback and ask questions.

5. Discharge – The point of counseling is to make you no longer need the counselor. This doesn’t mean you won’t need help again, only that, for now, you are ready to do it on your own!