Looking for a clinical counsellor can be an intimidating process, especially with the abundance of information floating around. Here are some tips for making sure your clinical counsellor is a good fit for you.
The Mental Health Landscape in British Columbia
Currently in BC, mental health services are unregulated- what this means for you as a client is that, providers for mental health are not considered health care practitioners. As it stands, BC has registering bodies for mental health providers, however they are not regulated under the Provincial Health Care Act. This includes psychologists, registered counsellors and social workers.
What does this mean for you as a client?
As a client, it is extremely important to understand that mental health providers do not need to prove credentials to provide services in BC at this time. From an ethical stand-point this is absolutely not okay. Most working professionals have supporting education and credentials behind their practices and services, however, client's should make sure to do their diligence to ensure they are receiving the best standard of care.
Knowing the Differences between the different mental health providers.
There are subtle differences between the different mental health providers in BC. Registered Clinical Counsellors (RCC's) are individuals who have completed a Master's level university degree and have registered with the British Columbia Association of Clinical Counsellors (BCACC). This allows the registrant to have a licensing number and ensures a standard of education and experience has been met. RCC's are known as clinical counsellors because they provide treatment and therapy to clients ( BCACC, Scope of Practice, 2020).
Also in the mental health landscape in BC is Registered Psychologists (RP). These individuals have also completed a Master's level university degree and have gained registration with British Columbia Psychological Association (BCPA). This too provides assurance that the clinician has a standard of education and experience before providing services. RP's can also provide therapy to client's as well as provide diagnosis and assessments to clients (BCPA, Laws & Regulations, 2020).
Lastly, Registered Social Worker's (RSW) are within the mental health scope in BC. They too have a Master's level of education in Social Work and hold registration with the British Columbia College of Social Workers (BCCSW). RSW's can provide therapeutic programs, diagnosis and assessments for a client as well as facilitate human services programs (BCCSW, Scope of Practice, 2020).
Other differences for the client to consider are; fees, insurance, additional training of their provider. Fees are different for each of the service providers. It is recommended that RCC's standard fee's for individual sessions fall between 120-150$/50 minute session (BCACC Fee Schedule, 2020). As of 2013, the recommended rate for RP's in BC was 200$/50 minute individual session (Alter, 2013). Fee's charged by RSW's are dependent on the RSW as many times they are employees rather than private practice. There is no accessible fee schedule for private practice. When it comes to insurance, client's need to check with their individual providers, as each plan is unique and some carriers will cover only one or two providers, some cover all providers. When evaluating which provider you will choose incorporating financial needs is extremely important. I always remind clients to be aware that they also need to evaluate the clinicians fees once they have exhausted their benefit program. Often times client's come forward saying they were seeing someone else because they had insurance but couldn't afford to continue seeing them when paying out of pocket. Although they have the right to do that, client's should be informed that, switching therapeutic providers after treatment has started and therapeutic rapport has been developed, can be very taxing and hard for the client. It can also be detrimental in that every practitioner has their own unique approach, adjusting to this change may work for some clients but for many others, it can be confusing and contradictory to their previous program.
And lastly, additional training. Each provider is responsible for their own continuing education and has the choice in what courses they take (if any). Client's want to look at what their clinician provides in terms of therapeutic orientations, styles, and approaches. This is really vital for client's to understand because this ultimately speaks to how the clinician can help you. If you have borderline personality disorder or complex post traumatic stress disorder for example, understanding that your clinician has an approach that fits to work with that condition is important as not all orientations fit with every condition. Therapeutic approaches like EMDR, Gottman's Level I and II for couples therapy, DBT, CBT, etc. are individual approaches that clinicians get additional training in after they graduate. These courses are not offered in the standard level of education but are post graduate workshops that clinicians choose to take to build their skills. Knowing what areas (if any) the clinician has completed additional training is important to consider when evaluating who you want to see and how they can help you.
Important Questions To Ask:
I always advise client's to bring paper and a pen to their first session and/or in their phone consultation, because often times they receive an abundance of information from their potential clinician regarding fees, insurance, therapeutic approaches, treatment planning, scheduling, goals, etc. This can be overwhelming and hard to remember for the client. Client's often struggle with knowing what questions they should ask, or forget what they wanted to ask. Some questions I recommend you explore with your clinician are:
Qualifications:
What are their qualifications? Are they an RCC, RP or RSW? You will need to know this for your own insurance as you will have to check this.
Areas of Practice or Interest:
What areas do they work in/have experience in? Or more specifically do they work with xx (your specific need)? Do they work with trauma?
Approaches:
Once you clarify what areas they practice in, knowing their approach can be helpful. For example, if your clinician practices in the area of trauma, they should be able to speak to the trauma-informed approach they use. Not every approach fits with every issue (for example, cognitive behavioral therapy is not considered a treatment for trauma).
Fees and Insurance:
What are their fees? If you need financial assistance with fees, do they offer sliding fee scales? Do they direct bill your provider? Do they belong to any organization as a provider (eg. Crime and Victims Assistance Program, ICBC, WorkSafe)?
Scheduling and Waitlists:
What does their scheduling look like? Do they offer morning spots if that is ideal for your schedule? Weekends? Do they have a waitlist?
** Information and/or opinions in this blog is not intended to substitute medical advice, diagnosis or treatment provided to you by a doctor, mental health professional or any other medical health professional. The purpose of this blog is to provide education only, it is not intended to provide treatment or diagnosis to any individual. If you are need of urgent care, please contact your local mental health crisis center, call your national or local crisis line(s), or call 911. Those numbers and other resources can be found on our Resources Page.**
References:
Alter, T. (2013). BC Psychologist (2):2. Pg 4.
BCACC Fee Schedule. (2020). BCACC https://bc-counsellors.org/find-a-counsellor/fee-schedule/
Laws and Regulations. (2020). BCPA. https://collegeofpsychologists.bc.ca/about-the-college/laws-legislation/
Scope of Practice. (2020). BCACC https://bc-counsellors.org/code-of-ethical-conduct-and-standards-of-clinical-practice/
Scope of Practice. (2020). BCCSW. https://bccsw.ca/registrants/scope-of-practice/