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.

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.

What are the different types of therapist?

“Psychotherapist” is a broad category, covering a number of specific designations. Each of these professions comes with its own set of skills and certifications.

The following designations apply to Ontario, Canada. Some designations may differ province to province.

Registered Psychotherapists and Registered Social Workers

Registered Psychotherapists (RPs) and Registered Social Workers (RSWs) both provide counselling. However, they are not able to diagnose mental illnesses or prescribe medication.

Registered Psychotherapists must be members of the College of Registered Psychotherapists of Ontario (CRPO). To qualify, they must complete at least 1000 hours of direct contact with clients, and 150 hours of clinical supervision.

Registered Social Workers must be registered with the Ontario College of Social Workers and Social Service Workers (OCSWSSW).In order to qualify, they must complete a Bachelor of Social Work at an accredited institution.

COST: Rates for RPs and RSWs range from $50 – $200 per session.

COVERAGE: RPs and RSWs are typically covered by private health insurance plans. However, since the designation RP is fairly recent (2015), they may not yet be covered by your healthcare plan.

Psychologists

Psychologists have advanced training in psychotherapy and the science of behavioural change. They can diagnose illnesses, sometimes by conducting tests—such as IQ and personality tests. They are not able to prescribe medication.

In order to practice, a psychologist must be registered with The College of Psychologists of Ontario. In order to do that, they need either a Master’s or a Doctorate in Psychology from an accredited institution.

COST: Rates to see a psychologist range from $200 – $350 per session.

COVERAGE: Perhaps the most widely covered mental health practitioner, psychologists are covered by most private healthcare plans.

Psychiatrists

A psychiatrist is a medical doctor who specializes in treating psychological disorders. Psychiatrists can diagnose illnesses, as well as prescribe medication. In order to see a psychiatrist, you need a referral from your general practitioner (GP) or family doctor.

Psychiatrists don’t typically offer regular, recurring therapy sessions. Their job is diagnosis and prescription. You may have a regular therapist who you see often, and a psychiatrist in charge of managing your prescriptions.

In Ontario, psychiatrists are required to earn a medical degree, and qualify for membership in the Ontario Psychiatrist Association (OPA).

COST: Covered by OHIP

COVERAGE: While psychiatrists are covered by OHIP, wait times to see one are typically longer than they are to see a privately practicing mental health professional.

General Practitioners and Registered Nurses

Family doctors, GPs, and registered nurses (RNs) may be trained to provide rudimentary counselling. A doctor can diagnose illness and prescribe medication. 

An RN who has the judgement, skill, and knowledge to practice therapy is allowed to do so. They can use the title “psychotherapist,” but are not required to register with the College of Registered Psychotherapists of Ontario (CRPO). 

However, RNs who practice therapy are not the same as Registered Psychotherapists (RPs) and cannot use the title of Registered Psychotherapist without proper credentials.

Both doctors or RNs can refer you to a registered therapist, psychologist, or psychiatrist.

COST: While GPs are covered under OHIP, RNs can range from $100-$250 per session.

COVERAGE: It is very challenging to find a GP in Ontario who will offer multiple therapy sessions. RNs are only covered if they are working through a publicly funded clinic.

Where should you see a therapist?

Your choice of therapist will depend on accessibility. For instance, do you live in a major city, or somewhere more remote? How long are you willing to commute? Are you comfortable visiting a hospital or doctor's office, or would you prefer a more "homey" setting? Therapists practice from a range of locations.

Private Practices

Therapists who work at private practices may work out of their home, or rent space in a building shared with other therapists. You can expect to have your therapy session in a comfortable, private space.

WAIT TIME: Wait time to see a Registered Psychotherapist (RP), Registered Social Worker (RSW), or psychologist at their private practice can be as short as one day if they are accepting new patients.

Psychiatrists’ Practices

In order to see a psychiatrist, you need to make an appointment with your general practitioner or family doctor, and get a referral.

Some psychiatrists work out of their home, while others work out of hospitals or doctors’ offices. 

WAIT TIME: The waitlist to see a psychiatrist can be months long. Your GP may prescribe medication and therapy in the interim, before a psychiatrist offers a more specific diagnosis and prescription.

Online

Especially in the wake of COVID-19, online therapy has become a popular choice for people of all ages. Video conferencing with your therapist lets you get help without leaving your home. It also gives you a broader selection of professionals to choose from. You can access online therapy through your laptop, desktop, or mobile devices.

If you use an app designed to connect you with a therapist, you may see the same therapist every time, or talk to a different one each session. Therapists who work through these apps vary in terms of experience and qualifications. They’re often paid significantly less than private practice therapists, so you may not end up with the same quality of therapy.

You may also choose to connect with a therapist who operates independently from any apps or online services. In this case, you can reach them privately with apps like FaceTime, Skype, Zoom, or Google Hangouts. It’s up to your therapist to ensure the app they use is secure and private.

WAIT TIMES: Using a therapy app, you may be able to chat with a therapist instantly. Qualified independent therapists typically have a longer wait time, but you may be able to schedule a consultation sooner with them online than you would in person.

Walk-In Therapy and Low-Cost Clinics 

If you need mental health support but face financial barriers, walk-in therapy and low-cost clinics offer therapy sessions by accredited and qualified therapists at a lower cost.

Typically, low-cost clinics offer support for specific groups of people—for example, youth and young adults, women, people dealing with addiction, or people experiencing homelessness.

That’s not to say that there aren’t low-cost clinics that are accessible to a broader range of clients. Clinics such as the Toronto Institute for Relational Psychotherapy (TIRP) and Woodgreen Walk-in Counselling provide therapy for anyone in need of a low-cost solution.

Finally, free hotlines such as Telehealth are accessible 24/7. Telehealth will connect you with an RN who can provide talk therapy or offer resources to help you find further help. Phone calls are completely confidential, and talking with an RN is free.

WAIT TIMES: Low-cost clinics have varying wait times depending on demand. For walk-in counselling, you may need to stay in a waiting room until you can see a therapist.

How do you 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 OHIP
• 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?

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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