Does being in counseling mean I’m crazy?

Many people going through an extremely stressful time in their lives experience anger, depression and other troubling emotions. By seeking out a counselor to work with, you recognize that you’re having significant challenges in your life and need some help. It also indicates that you want to find new ways to deal with the stress and ultimately to improve your life. There is no need to be embarrassed to ask for help from a trained professional. There comes a time for each of us when we just can’t cope without someone else’s help. You shouldn’t be criticizing yourself for getting help. You should be congratulating yourself.

What can I expect from counseling?

Each person has their own experience when going to a counselor. The sessions are a way to learn about yourself, about your thought process and emotions, and about your relationships. The way to get the most out of the sessions is to attend them regularly, be active and participate, and do any actions assigned. The most important thing to remember is to be open and honest with your counselor. When you and the counselor are working with the truth, that’s when you can gain the most benefit from the work you put into the sessions.

You may feel an increased anxiety during the counseling process. This is natural as you will be looking at and working on feelings and beliefs that you’ve had for a long time. You may even feel some anger toward your counselor. This is natural and the best approach is to speak with the counselor about your feelings so you both can discuss them.

Please know that everything you say in any counseling session will be held confidential. All information will be confidential and stay between you and the counselor. The only exception may be if you appear to be a danger to yourself or to other people. In that case, the counselor may seek additional outside help for you.

My symptoms aren’t that severe. Can I still benefit from counseling?

Most people find that counseling can improve their lives. Even mild anxiety can keep you from fully enjoying your life. Counseling can help you to identify those areas in your life that you could improve to have a more fulfilling life.

How much does therapy cost?

Each psychotherapist sets his own fees, and many use a sliding scale. A limited number of clients are offered a lower rate depending on what they can afford.

Often patients use their Health Insurance to pay for sessions, and only have to pay a co-pay after meeting their deductible. Insurance coverage varies and they often have restrictions such as to the number of session they will cover, or they may require cost-sharing. Contact your insurance company for your specific coverage.

These questions will be useful when talking to your Insurance Company before starting:

▪Do I have mental health insurance benefits?

▪What is my deductible and has it been met?

▪How many sessions per year does my health insurance cover?

▪What is the coverage amount per therapy session?  Is there a co-payment, and of what amount?

▪Is a referral required from my primary care physician? 

Also see my section on Services and Payment Plans.

How long will treatment take? How will I know it is completed?

Therapy is a very individualized process and there is no standard answer to this question. The length of treatment depends on the severity and type of challenges presented. In general, you and your therapist will work out treatment goals (which can change through the course of treatment). Treatment is complete when you’ve reached your goals to your satisfaction.

Ultimately, it is your decision when to terminate.

Will what I say to you remain private?  The law protects the communication between a therapist and patient. In most situations, a therapist can only release information about your treatment to others if you sign a written authorization form, or for the purposes of Insurance payments.

The following represents situations in which therapists are required to disclose information without your consent:

▪When a patient threatens to harm himself/herself or is otherwise unable to care for him/herself, a therapist may be obligated to seek hospitalization for the patient, or contact others who may help ensure safety.

▪When there is reason to suspect that a child is the victim of abuse or neglect, a therapist may be required to file a report with the appropriate agency.

▪When there is reason to suspect physical or monetary abuse of an elder or dependent adult, abandonment or abduction, the therapist must report the suspected abuse.

▪When a patient or family member communicates a threat of violence against someone, a therapist must take protective actions including warning the potential victim and contacting law enforcement or any other person/agency deemed important for protecting the safety and well-being of the identified person.

▪Clinical records are occasionally subject to legal subpoena. In those unusual instances a therapist is not obligated to release the records and may claim confidentiality. If however a legitimate Order of the Court is issued, release of records or summary of records may be required even without consent.

Please be aware that the above circumstances are rare and that disclosures without your consent only take place in extreme situations, and usually only to protect you or others.

For MINORS: 

If you are under 18 years of age, your parents or guardians generally have the right to ask and know what goes on in therapy. However, I always ask that parents/guardians respect the privacy of the therapy (except for safety issues like those listed above) and realize that trust can be particularly difficult with teens, so the treatment should remain private. I also ask parents to discuss treatment with the child/teen present, so the communication is transparent to the teen. Usually parents will go along with this request. 

 

 

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