What is psychotherapy?

Don’t let the prefix “psycho” throw you off. “Psycho” means “of the mind.” A physiotherapist improves their patients’ physical wellbeing. A psychotherapist improves their mental wellbeing.

You don’t need to suffer from debilitating mental health issues in order to see a psychotherapist. Many people you might consider “normal” have benefited from one.

Alex Cameron is a Registered Social Worker and Psychotherapist in Toronto

What does a therapist do?

A therapist is a trained professional. Their job is to listen to you without judgement. Your time with a therapist is a protected space, where you can talk about problems without fear of being judged or hurting anyone’s feelings.

When you talk to a therapist, they’ll offer insights into the problems you face and the goals you aim to achieve. Even better, they’ll prompt you to come up with your own insights.

How does therapy work?

Your therapist can help you change distressing or negative thought patterns and behaviour on a deep level. They’ll also help you better understand yourself—your past, and any trauma you may have faced. Their aim is to give you the ability to heal and create meaning in your life, while having the freedom to reach your full potential.

They may do this using a variety of techniques—from talk therapy, to art therapy, somatic (body-focused) therapies, and other approaches. A prospective therapist should be able to explain which techniques they use, and adapt them to suit your needs.

Therapists vs. counsellors

Some professionals in the field try to distinguish between the two terms. However, for the purposes of this guide, “therapists” and “counsellors” are identical.

Types of counsellors in BC

Legally, anyone in BC can call themselves a counsellor or therapist. With that in mind, it’s important to understand the different therapy credentials out there, and what each one means.

To make the job easier, and to better understand what all those letters after counsellors’ names mean, it’s important to know the difference between colleges and associations.

Colleges regulate and govern the members of a certain profession; they work in the public interest. Associations represent their professions to the public, and advocate on their behalf; they work in the interest of their members.

You can think of a counsellor’s college as designating their job title. The association(s) they belong to are a bonus, proving that they’ve met extra requirements that allow them to use the association’s title.

 For instance, for counselling you may go to someone who is a Registered Social Worker (RSW)—their job—who happens also to be a Canadian Certified Counsellor (CCC)—their accredited association.

Types of counsellors by college

Psychiatrists

A psychiatrist in BC is a medical doctor with additional training in psychotherapy. Psychiatrists can diagnose mental health issues. And they’re the only mental health professionals able to prescribe medication. That being said, other medical doctors, such as general practitioners, can write prescriptions.

Typically, if you visit a psychiatrist, it will be for no more than a few sessions. Their job is to diagnose your condition and prescribe or adjust the right medication. After that, you’d see a different counsellor on an ongoing basis.

Since they’re in high demand, you typically won’t be able to see a psychiatrist unless you get a referral from a doctor.

COST: Covered by MSP

COVERAGE: Covered by MSP

Registered Psychologists (R.Psych)

In BC, Registered Psychologists are able to diagnose mental health issues, but can’t prescribe medication. In order to register with the College of Psychologists of British Columbia, they need to complete an accredited doctoral program, as well as meet other stringent requirements.

You can get a referral from a doctor to see a psychologist. In that case, if the psychologist is part of a provincial program, costs covered by MSP. You can also get in touch with a psychologist through their private practice. In that case, costs aren’t covered by MSP, although some employee health plans cover them.

Depending on your circumstances, you may also be able to get funding through the Crime Victims Assistance Program (CVAP), ICBC, or the Employee and Family Assistance Program (EFAP).

COST: As low as $175 per hour for reduced cost counselling, $225+ for standard counselling

COVERAGE: MSP if through doctor’s referral

Registered Social Workers (RSW) and Registered Clinical Social Workers (RCSW)

A Registered Social Worker in BC has, at minimum, a bachelor’s degree in social work from an accredited institution. Many also have master’s and doctorate degrees. In order to become a Registered Social Worker, they have to pass a licensure examination.

While some social workers offer clinical counselling, those who wish to specialize can pursue extra credentials and pass additional, rigorous examinations. This allows them to use the Diagnostic and Statistical Manual (DSM-5) to diagnose and treat mental disorders.

COST: Starting at around $90 per hour

COVERAGE: Not covered by MSP, may be covered by extended plans

Associations for counsellors

Counsellors in BC belong to a variety of professional organizations. 

A note on self-regulating bodies

BC has no professional College for counsellors Meaning, anyone can label themselves a counsellor and charge customers by the hour. This situation is less than ideal, and counsellors have been working for more than a decade to fix it. But, for the time being, counselling in BC has no official, regulating College.

Instead, BC counsellors may join one or more self-regulating bodies. These organizations set minimum levels of education—and, by extension, clinical experience—for their members. As a result, clients have a set of standards to go by when choosing a counsellor. 

The main designations to look for are:

• Certified Canadian Counsellor (CCC): Administered by the Canadian Counselling and Psychotherapy Association (CCPA)
• Registered Clinical Counsellor (RCC): Administered by the BC Association of Clinical Counsellors (BCACC)
• Registered Marriage and Family Therapist (RMFT): Administered by the British Columbia Association for Marriage and Family Therapy (BCAMFT)
  

Each of these designations is marked with a an asterisk below.

Canadian Certified Counsellor (CCC)*

Canadian Certified Counsellors (CCC) are certified by the Canadian Counselling and Psychotherapy Association (CCPA). In order to do that, they need a graduate degree in a related field. They also have to pass a CCPA evaluation and abide by its code of ethics. In order to keep their designation, CCCs must maintain ongoing training in their field.

Registered Clinical Counsellor (RCC)*

All Registered Clinical Counsellors (RCCs) in BC belong to the BC Association of Clinical Counsellors. To qualify, they need, at minimum, a Master’s Degree in a field like psychology, counselling, or social work. BCACC also needs to supervise them in a clinical setting before approving them for membership.

Registered Marriage and Family counsellor (RMFT)*

Overseen by the Canadian Association for Marriage and Family Therapy, the RMFT designation is typically used by professionals who refer to themselves as marriage counsellors, couples counsellors, or family counsellors. To qualify, they need to complete 1000 hours of therapy while supervised by an RMFT Approved Supervisor. They must also have graduate level training in couples and family therapy.

Registered Professional Counsellor (RPC)

Individuals usually pursue the RPC designation with the Canadian Professional Counsellors Association (CPCA) while completing a program in counselling at university. They need to complete 600 hours of work under clinical supervision by a mental health professional.

Registered Therapeutic Counsellor (RTC) 

RTCs are registered with the Association of Cooperative Counselling Therapists of Canada (ACCT). They are required to abide by the ACCT's code of ethics and standards of practice. In addition to the RTC designation, members may also be certified as a Master Therapeutic Counsellor (MTC) or a Registered Counselling Supervisor (RCS).

Low-cost counselling in BC

Many counsellors offer sliding scale fees for clients who struggle to pay fees. 

Also, you may want to get in touch with the nearest university that offers a counselling program. Often these programs provide free counselling as a way to help graduate students log hours of clinical experience.

You can use tools like eMentalHealth.ca to find counselling services, and customize your search to find free and publicly funded options. Or check out the lists of affordable counselling for these areas: 

• Metro Vancouver
• Victoria 
• Vancouver Island
• Kamloops and area

Erica Berman is a Registered Psychotherapist in Toronto

How to choose a therapist

Beyond making sure a prospective therapist has the proper credentials, choosing one is all about finding the right fit and fostering a healthy therapeutic alliance.

The therapeutic alliance is the relationship between a therapist and their client, where the intention is a beneficial and positive relationship in order to inspire improvement and healing.

Research studies have proven that the therapeutic alliance—the strength of the relationship between the client and the therapists—has a direct correlation to how successful therapy will be; it’s the most important factor when determining a positive outcome.

Some items to keep in mind when shopping around for a therapist:

• Budget. There’s a wide range of costs for therapy. What can you realistically afford on a regular basis?
• Coverage. Do you need to ensure a prospective therapist is covered by your private health insurance? Or is it essential they’re covered by MSP?
• Location. Is it easy to get to your therapist on a regular basis? Will their location be a barrier to seeing them regularly?‍
• Availability. When do you need to see a therapist? How often?

Juliann Rasanayagam is a Registered Psychotherapist in Toronto

How to tell if a therapist is right for you

Choosing the right fit when selecting a therapist often comes down to your intuition. It’s a subjective assessment, unique to you. In this instance, it’s completely acceptable to have a preference around gender, ethnicity, religious background, or even the way a prospect sounds. 

Getting results and meeting your goals should be your main priority. Checking out a potential therapist’s First Session interview is a great way to get a feeling for their personality, and learn more about how they approach their practice.

Once you’ve chosen a potential therapist, you can book a consultation with them. The consultation is their chance to learn more about your needs and goals, and your chance to see if they’re the right fit. It’s totally acceptable to have a consultation, and choose not to book further sessions. This is part of the process of choosing the right therapist for you, and taking the next steps in your mental health journey.
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Feeling intimidated by your first consultation with a therapist? Don’t sweat it. Registered psychotherapist Christina Simonetti explains why it’s okay to take your time and find the right fit.

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