[Editor’s Note: Everyone has mental health experiences on the spectrum between thriving and struggling. Perhaps you (or a friend) are in a season where you need extra mental, social, emotional, spiritual, and physical support. In this #mentalhealth series we want to balance personal experience/story with input from mental health and medical professionals. We want to also explore, “How does our faith in Jesus relate to our mental health?” Our desire is to support you as you work towards mental well-being. 

If you are considering hurting yourself or someone else, or you know someone who is, please contact a mental health emergency hotline. If you need urgent counselling support, Kids Help Phone is also available for young adults up to age 29 for phone calls, Facebook Messenger, or texting conversations.

Esther Allison is a Registered Psychotherapist with a private practice in Elora, Ontario. A staff member of Power to Change – Students recorded this interview.] 

  1. What’s the difference between a counsellor, a psychotherapist, a psychologist, and a psychiatrist? How do I know which one I need? 

A counsellor is a title that anyone can use if they are in a role of offering advice and support. It is not regulated by a professional college. A psychotherapist (a “therapist”) is a regulated profession, which means that psychotherapists are required to have training and ongoing professional development to safely engage in client-therapist relationships. In addition to providing therapy, a psychologist is able to diagnose mental health problems. A psychiatrist is a doctor, and is able to diagnose mental health problems as well as prescribe medications. If you are unsure which one is the right fit for you, visiting your family doctor is a good place to begin. 

  1. If I am a Christian, how important is it to go to a counsellor who is also a Christian? What are the drawbacks or benefits of seeing someone who has a different worldview?

This is a very personal decision. The benefits of seeing someone with a different worldview might include: that they could ask questions you hadn’t thought of or challenge some thinking patterns in ways you may not have otherwise. If a therapist is a professional, they won’t insert or push their worldview on to you in the process. However, having a therapist who is a Christian may help some Christian clients trust their therapist more easily, and may provide an opportunity to explore faith-related questions or concerns in the context of some mutual understanding.

  1. What can or can’t I talk about with a counsellor? Can I talk about God, my faith, or my Christian community, even if they aren’t a Christian? 

You can talk about anything you want in counselling. The process will look different, depending on whether or not you are speaking with a counsellor or a psychotherapist. In Biblical counselling, you may receive guidance and direction from a biblical worldview. If you are working with a psychotherapist, they will provide space for you to explore your questions in a safe place, and may offer resources or suggestions of where to find the answers you are seeking, supporting you in finding your own conclusions. 

  1. How do I find a counsellor? Where can I start looking for a counsellor?

A great way to find a counsellor is to look on psychologytoday.com. It is a website with a network of therapists across North America. You can use the filtered search to find a counsellor who works specifically with the type of concern you may have. Another great way to find a counsellor is to talk with your friends, family, pastor, or your doctor to see if there is a counsellor who comes recommended by people you know. 

  1. What questions should I ask when I’m looking around for a counsellor? What are some things I should take into consideration when deciding who to meet with? 

I would suggest looking online at a few therapist profiles and/or websites. Usually, you can get a sense of what the therapist specializes in by how they word their profile. See if their profile sounds like a good fit for the concern you have. Look to see what level of training and certification the counsellor has. Therapists should have at least a Master’s level education.

  1. Does it matter if my counsellor is the same gender as me? 

This is a very personal choice, and I believe it comes down to your comfort level.

  1. How much does culture and ethnicity matter in counselling? Any advice if your counsellor’s cultural background is different from yours?   

This is a very good question. Most counsellors who have recently graduated would have some training in cultural sensitivity. All professional therapists should be aware that culture influences the worldviews of both the therapist and the client. However, not all counsellors may be aware of your unique cultural experience. If you find a counsellor who does not share your cultural identity, and if you are comfortable doing so, you may wish to educate your therapist about your culture and how it shapes your presenting concern. This can help your therapist better help you. 

  1. What can I do to prepare well for my first appointment? 

You will normally be asked to complete an intake questionnaire, which will provide your therapist with some of your background information and concerns. In addition to this, I would encourage you to ask your therapist any questions you have. 

  1. How can I get the most out of counselling sessions in general?

I think you’ll need to find a counsellor you trust and feel comfortable with. Research indicates that one of the most important factors for effective change is a strong therapeutic relationship between client and therapist. 

  1. How is online counselling different from being in person? Will being online be less effective? 

I think face to face appointments will always be the gold standard of care. However, if you have a good internet connection and a private place to meet, I believe online counselling can be equally as effective. In fact, I am finding many people are beginning to see the convenience of not having to take time to drive in to their appointments which can still happen when the weather and road conditions are not great.

  1. How often do people normally go to counselling? 

It depends on the intensity of distress someone is in. Frequency of appointments should be an open discussion with your therapist, tailored to best suit your needs. If someone is experiencing an acute crisis, they may want to be seen twice a week. Other clients may wish to begin with weekly appointments to kickstart their progress and then space their appointments from there. Some people book monthly appointments if they are feeling well overall and just want to maintain good mental health. Sometimes people schedule their appointments farther apart to make counselling more feasible. 

  1. When is it okay to skip a session if I’m not doing well? Counselling can be hard. 

Counselling can be difficult, and sometimes we feel a little worse before we feel better. However, if you start noticing that you are struggling with regulating your emotions or extreme fatigue, etc. after an appointment, it is a good idea to let your therapist know, as it may be an indication that the therapist needs to slow the pace of the sessions. Therapy is a collaboration between the client and therapist, so keeping an open dialogue with your therapist about concerns will help them help you. If you feel apprehensive or overwhelmed and need to cancel or reschedule, that is always okay too.

  1. How much should I expect to pay for a counselling session? What are some options if I can’t afford the cost of counselling right now?

Therapists in private practice tend to be the most expensive, simply because they have a lot of overhead costs and do not usually receive private funding from charities or the government.  Therapists in private practice are usually between $100-$200 per hour. However, there are lots of more feasible alternatives to consider. If you are a post-secondary student in Ontario or Nova Scotia, you can check out good2talk.ca for a free assessment and directions to community resources most suitable for you. Many individual universities also offer support through various programs. Alternatively, many family doctors have therapists who work with their family health team who are covered by provincial health insurance, so asking your doctor about this can be a good place to start. Some communities will have affordable local options run by the municipality or non-profits. For example, Family Counselling and Support Services in Guelph, ON and Shalem Mental Health Network in Hamilton, ON, have a sliding scale of fees based on income. And check with your church: some churches have started to create partnerships with local therapists to provide free counselling appointments. 

  1. How do I know if my counsellor and I are a good fit for each other? What’s the best way to “break up” with a counsellor if things don’t seem to be going well?

Counselling is a collaborative process between you and your counsellor. It’s good to let your counsellor know what is or is not working for you, as it can help your counsellor help you better. But just as in friendship, we more easily connect with some therapists’ personalities than others. This is natural, and a professional therapist will not take it personally if you simply decide to cancel and search for another therapist. 

  1. What if my counsellor suggests doing something I feel uncomfortable with? 

You can let them know about your discomfort. If you continue feeling uncomfortable with your counsellor, you can cancel anytime and find someone who is a better fit for you.

  1. How do I know when I’m well enough to stop seeing a counsellor regularly? 

Usually, when you are in therapy there is a goal that you and your therapist are working towards. When you notice improvements in your area of concern, an attuned therapist will likely notice this as well. Together, you can decide to either stop counselling and/or set up a follow up appointment for a later date to check in and ensure you are able to maintain your progress. 

Did you enjoy this article? We encourage you to check out more articles in our #mentalhealth series. 

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