Answers to Common Questions about Counseling
When should you seek counseling?
From childhood through late adulthood, there are certain times when we
may need help addressing problems and issues that cause us emotional distress
or make us feel overwhelmed. When you are experiencing these types of difficulties,
you may benefit from the assistance of an experienced, trained professional.
Professional counselors offer the caring, expert assistance that we often
need during these stressful times. A counselor can help you identify your
problems and assist you in finding the best ways to cope with the situation
by changing behaviors that contribute to the problem or by finding constructive
ways to deal with a situation that is beyond your personal control. Professional
counselors offer help in addressing many situations that cause emotional
stress, including, but not limited to:
"Good indicators of when you should seek counseling are when youíre
having difficulties at work, your ability to concentrate is diminished or
when your level of pain becomes uncomfortable," says Dr. Gail Robinson,
past president of the American Counseling Association. "However, you
donít want to wait until the pain becomes unbearable or youíre
at the end of your rope."
- anxiety, depression, and other mental and emotional problems and disorders
- family and relationship issues
- substance abuse and other addictions
- sexual abuse and domestic violence
- eating disorders
- career change and job stress
- social and emotional difficulties related to disability and illness
- adopting to life transitions
- the death of a loved one
"If someone is questioning if they should go into counseling that
is probably the best indicator that they should," says Dr. William
King, a mental health counselor in private practice in Indianapolis, Indiana.
"You should trust your instincts."
Joyce Breasure, past president of the American Counseling Association
and a professional counselor who has been in private practice for more than
20 years, recommends counseling when you:
"If you're not playing some, working some, and learning some, then
youíre out of balance. There's a potential for some problems,"
- Spend 5 out of 7 days feeling unhappy
- Regularly cannot sleep at night
- Are taking care of a parent or a child and the idea crosses your mind
that you may want to hit that person
- Place an elder in a nursing home or in alternative care
- Have lost someone or something (such as a job)
- Have a chronic or acute medical illness
- Can no longer prioritize what is most important in your life
- Feel that you can no longer manage your stress
Robinson points out you donít have to be "sick" to benefit
from counseling. "Counseling is more than a treatment of mental illness,"
she says. "Some difficult issues we face in life are part of normal
development. Sometimes itís helpful to see what youíre going
through is quite normal."
What is professional counseling?
Professional counselors work with individuals, families, groups and organizations.
Counseling is a collaborative effort between the counselor and client.
Professional counselors help clients identify goals and potential solutions
to problems which cause emotional turmoil; seek to improve communication
and coping skills; strengthen self-esteem; and promote behavior change and
optimal mental health. Through counseling you examine the behaviors, thoughts
and feelings that are causing difficulties in your life. You learn effective
ways to deal with your problems by building upon personal strengths. A professional
counselor will encourage your personal growth and development in ways that
foster your interest and welfare.
Who are professional counselors?
Licensed professional counselors provide quality mental health and substance
abuse care to millions of Americans. Professional counselors have a master's
or doctoral degree in counseling or a related field which included an internship
and coursework in human behavior and development, effective counseling strategies,
ethical practice, and other core knowledge areas.
Over 80,000 professional counselors are licensed or certified in 44 states
and the District of Columbia. State licensure typically requires a master's
or doctoral degree, two to three years of supervised clinical experience,
and the passage of an examination. In states without licensure or certification
laws, professional counselors are certified by the National Board for Certified
Counselors (NBCC). Participation in continuing education is often required
for the renewal of a license or certification.
Professional counselors adhere to a code of ethics that protects the
confidentiality of the counseling relationship; prohibits discrimination
and requires understanding of and respect for diverse cultural backgrounds;
and mandates that professional counselors put the needs and welfare of clients
before all others in their practice.
Will my health insurance cover counseling?
Many insurance and coverage plans cover mental health services by a licensed
professional counselor including some Medicaid programs, CHAMPUS, and other
government-sponsored health coverage programs. If you do not have health
insurance, or if your coverage does not include mental health care or the
services of a professional counselor, many professional counselors will
work with clients on a sliding-fee scale or will offer a payment plan.
Talk to your counselor about your options.
How much does counseling cost?
The cost of counseling can vary greatly depending on your geographic
location and whether counseling is being provided by a community mental
health center or similar agency or by a counselor in private practice.
In general, the average paid fee for individual counseling sessions is about
$65. Fees for group counseling are generally lower, about $35 per group
session. For clients with health insurance that does not cover mental health
care and others who cannot afford the counselorís standard fee, some
counselors will lower their fee on a sliding scale basis or will work out
a payment plan. Your counselor should explain to you, prior to beginning
the counseling relationship, all financial arrangements related to professional
How long does counseling take?
Ideally, counseling is terminated when the problem that you pursued counseling
for becomes more manageable or is resolved. However, some insurance companies
and managed care plans may limit the number of sessions for which they pay.
You should check with your health plan to find out more about any limitations
in your coverage. During the first few counseling sessions your counselor
should also discuss the length of treatment that may be needed to achieve
Is everything I say confidential?
All members of the American Counseling Association subscribe to the Code
of Ethics and Standards of Practice which require counselors to protect
the confidentiality of their communications with clients. Most state licensure
laws also protect client confidentiality. As a client, you are guaranteed
the protection of confidentiality within the boundaries of the client/counselor
relationship. Any disclosure will be made with your full written, informed
consent and will be limited to a specific period of time. The only limitations
to confidentiality occur when a counselor feels that there is clear and
imminent danger to you or to others, or when legal requirements demand that
confidential information be disclosed such as a court case. Whenever possible,
you will be informed before confidential information is revealed.
How do I find a counselor?
There are many different ways to locate a professional counselor. Some
common ways include:
Once you have found a counselor you are interested in seeing, you should
ask several important questions, such as:
- The National Board for Certified Counselors referral service (phone
NBCC at 336-547-0607 between 8:30 a.m. and 4:30 p.m. Eastern Standard
Time, Monday through Friday to find a certified counselor in your area)
- The yellow pages listed under counselor, marriage and family counselors,
therapist or mental health
- Referral from your physician
- Recommendations from trusted friends
- Crisis hotlines
- Community mental health agencies
- Local United Way information & referral service
- Child protective services
- Referral from clergy
- Employee Assistance Programs (EAPs)
Some of these questions may be addressed during your initial phone conversation
with the counselor and others may be more appropriately discussed in your
first face-to-face meeting.
- Are you a licensed or certified counselor? What is your educational
background? How long have you been practicing counseling?
- What are your areas of specialization (such as family therapy, women's
issues, substance abuse counseling, etc.)?
- What are your fees? Do you accept my insurance? How is billing handled?
Do you offer a sliding fee scale or a payment plan if I do not have insurance
for mental health services?
- How can you help me with my problems? What type of treatment do you
use? How long do you think counseling will last?
After you have had these questions answered by the counselor to your
satisfaction, consider how comfortable you feel with the individual, since
you will be working closely together during your counseling sessions. It
is difficult to open up and share your problems with a stranger and you
may feel awkward or anxious during your initial sessions. But it is also
important that you have a "chemistry" or rapport with the counselor.
Counselors have different styles, personalities, and approaches. Take time
to evaluate how you feel interacting with the counselor and whether you
believe that the two of you can work effectively together. If you do not
feel at ease with a certain counselor, do not get discouraged. Instead,
look for a different individual with whom you would feel more comfortable
Together you and your counselor will set goals, work toward achieving
them, and assess how well you are actually meeting them. Counseling can
help you maximize your potential and make positive changes in your life.
Finally, remember that counseling may be hard work at times but change and
progress do happen. A professional counselor can provide the help and support
to help you master the challenges of life.
Source: American Counseling Association
Page last modified or reviewed on October 4, 2010