Frequently Asked Questions

Psychotherapy, also known as talk therapy, is a form of mental health treatment used for a variety of mental health conditions and with many different populations of people. This highly researched and evidence-based treatment is often recommended as a first-line treatment by doctors for several mental health conditions, and can be used in conjunction with medications and other treatments without interaction. Psychotherapy can be done individually, with groups, with couples, or with families. Clients work collaboratively with a therapist to create a safe, secure, neutral, non-judgmental, confidential environment to explore the client’s thoughts, feelings, experiences, behaviour patterns and reactions. Psychotherapy works by addressing challenges to gain new insight, learn new skills or find better ways to cope for the future. Find out more about Psychotherapy here:

Therapy is one of many effective treatments for mental health conditions or trauma related stressors.

If you have concerns about your mental health, visit your doctor to find out what treatment may be best for you. Symptoms of depression, anxiety, and stress may be caused by a variety of physical medical conditions and treatment will depend on the source of your symptoms. Due to the number of potential causes of mental health related symptoms, always consult a medical doctor before seeking treatment.

A common misconception is that you need to have a “big problem” in order to seek therapy. Many people who go to therapy do so because they would like someone to help them organize their thoughts, set goals for the future, improve productivity, grow their interpersonal skills or they would simply like someone to listen to them without judgment. Many people reduce the frequency of appointments once their initial problem has improved and continue seeing a therapist to stay on track with their process (known as maintenance sessions).

Psychotherapy is generally regarded as a safe form of treatment for most people. As with all health treatments, there is a small amount of risk involved. Psychotherapy may bring up uncomfortable or painful experiences and feelings. Although this is part of the reason Psychotherapy has been found to be effective, there is a small chance of retraumatization.

In order to minimize the risks associated with therapy, Psychotherapists are trained to follow the client’s pace and implement safety measures in the case that difficult feelings become overwhelming. These safety measures can include coping strategies, education about physical reactions to emotions, grounding techniques and objects, continuous monitoring and checking in with the client, training in specific therapeutic methods that address trauma, consulting with other therapists and supervision (ethical requirement).

There are so many amazing therapists out there with training in diverse and innovative therapeutic approaches. Therapist suitability is largely based on therapeutic approaches they use, their training and educational background, the mental health conditions they are experienced in treating, their personality and personal approach to therapy. Clients should also choose a counsellor that they feel comfortable talking to and trust.

The therapist/client relationship, also known as the therapeutic alliance, is one of the fundamental factors that can predict treatment outcomes. It is important to find a therapist who you feel comfortable with and one that personally suits you.

Anything! It is a therapist’s job to listen to the client, regardless of what they choose to talk about. Therapy offers a safe space for a client to explore thoughts and feelings they may not otherwise explore with others.

Therapists are legally and ethically bound to maintain confidentiality, similar to other health and allied health professionals.

Learn more about confidentiality and the limits to confidentially here: Confidentiality and Therapy

No! Therapy provides a safe and judgment-free space for clients.

Some people may be concerned that they will say something that will surprise or upset their therapist. Although this is a nice sentiment (it’s nice of you to worry about us), chances are you will not be telling a therapist anything that they have not heard before. Even if it is the first time a therapist has encountered the specific issue the client has brought forward, it is likely no more shocking than anything we have heard before. Therapists encounter difficult issues everyday including disclosures of death, sexual assault, crime, injustice, abuse, intrusive thoughts, harm to self or others, and many, many more. No topic is taboo in therapy!

What if I disclose something illegal or dangerous? To read more about the limits to confidentiality, click here: Confidentiality and Therapy

It depends! There is no prescribed length of time for treatment to occur. The duration of therapy can vary depending on factors such as treatment goals, conditions being treated, amount and severity of symptoms being treated, treatment approach, and individual client.

Your therapist should discuss tentative treatment structure and length when therapeutic goals are established early in treatment. Treatment plans are often revisited and revised continually throughout treatment.

But really, how long does treatment typically last? Research is varied with studies showing that 50% of participants indicated recovery of symptoms with an average of 15-20 sessions. Further research has indicated that specific approaches indicate “clinical significant” improvements with moderate treatment duration (roughly 12-16 weekly sessions). Source: American Psychological Association

Overall, a majority of psychotherapy clients report feeling better after 3 months of treatment, however some significant gains can be made with longer treatment. Source: APA PsycNet

It depends. Similar to the duration of therapy (listed above), there is no prescribed frequency for sessions to occur. Often, factors such as time, money, intensity of treatment, availability, and other life factors will impact how often you will be able to attend therapy. Having more infrequent sessions will likely not impact the quality of treatment you receive, however it may take longer to start noticing results.

Green Journey Therapy does not provide emergency counselling for people in crisis.

If you need EMERGENCY mental health support, please visit the link below to connect to a local mental health support in British Columbia:

LINK TO EMERGENCY RESOURCES

How do I know if I am in crisis?

Here are the signs that you are experiencing a mental health crisis. These are situations when you need immediate help. If you experience any of these signs, call any of the crisis numbers above, call 911 or go to the closest emergency room:

-Thinking about ending your life or trying to end your life

-Experiencing sensations that aren’t real and/or beliefs that can’t possibly be true

-Making choices that put you in serious danger

-Becoming unable to care for yourself, and it’s putting you at risk of serious harm

-Experiencing medication problems like serious side effects

-Experiencing an alcohol or any other drug overdose

-Taking a dangerous combination of substances (like anti-anxiety medication with alcohol)

Essentially no. You may discuss whatever you want with your therapist with very few limits

One potential limit, you may encounter, is a therapist’s professional boundary. In order to cope with the sometimes demanding emotional and relational demands of being a therapist, many therapists will have personal boundaries around discussing their private/non-professional lives with clients. These boundaries are typically not to hide information from clients, but rather to reinforce the emotional boundary a therapist builds to avoid allowing emotionally difficult situations they encounter at work, from leaking into their personal life.

On the other hand! It is understood in nearly all approaches to psychotherapy that the therapist is a human being. Certain personal disclosures may help to strengthen the therapeutic alliance and can even be beneficial to treatment outcomes. Clients often feel more comfortable and safe talking to a therapist that does let their humanity shine through, rather than working with a therapist with the emotional range of a robot. One of the fundamental aspects of therapy relies on the therapeutic alliance, and this often comes down to how compatible a client’s personality is with the therapist’s personality.

Other limits may include the avoidance of topics for legal or ethical reasons, although therapists are often exempt from traditional non-disclosure orders in the same way as doctors or lawyers. Due to our legal obligation to maintain strict confidentiality, therapists are forbidden to release any notes or information about clients except under certain specific conditions. These conditions include if a court of law provides a valid subpoena for that information; if abuse of a child, elder or vulnerable adult is disclosed; or if the therapist suspects the potential for immediate harm the client or someone else.

Find out more about the limits to confidentiality here: Confidentiality and Therapy

No. A therapist will listen to you, offer support, and help you to navigate specific issues, however it is not a therapist’s job to offer advise. Therapists help clients to better understand and identify aspects of their behaviour, thoughts, feelings, and motivations. Therapists may discuss possible strategies to try if there is potential therapeutic benefit to the client, however giving advice or personal opinions may have unfavourable results.

The goal of a therapist is not to get you to think, feel, or react like they do. Therapists should strive to help clients to better access the tools to understand, evaluate, and react to their circumstances. A common misconception is that the main goal of therapy is to change. Many therapists will tell you that change only comes as a result of an internal shift in the client that only they can provide. An internal shift may be a move toward acceptance, understanding, coping for any number of internal factors. By giving advice to clients, therapists risk undermining the innate, individual drives that exist in all of us, which many healers throughout history (including modern researchers) believe is the key to personal healing.

There are so many approaches to psychotherapy by a rich diversity of practitioners who are influenced by cultural, social, personal and professional. There is no such thing as a “typical session” since the fundamental elements of psychotherapy can be adapted in so many different ways, while maintaining the increasingly empirically validated evidence of psychotherapy as a treatment.

A relatively common structure for psychotherapy sessions is to begin with a small warmup, or client update. From this introductory phase of the therapy session, clients and therapists may focus on a specific theme, goal or topic for the majority of the therapy session. When the appointment is approaching its end, the client and therapist may choose to review what they have covered in the session, discuss future steps, or engage in a closing activity.

No! You can see a therapist regardless of if you have a referral or even an official diagnosis. Therapists can work with clients to treat individual symptoms or personal issues, although they may recommend seeking medical treatment if there is question of what is causing your symptoms. Ideally, therapy is used in addition to medical treatment and other treatment approaches.

Good question. Often clients are surprised that they are required to go over their medical history and current medications during the intake process with their counsellor. There are a few different reasons you are asked to provide this information:

1. Influences on Treatment - many medical conditions or medication effects can have an effect on mental health. Some symptoms connected to mental health conditions may be triggered, mimicked or escalated by medication side effects and other physical conditions. Differentiating symptoms that may be treated with psychotherapy verses symptoms that may be treated by your medical doctor, is necessary for effective treatment.

2. Cross Medical Communication - Therapists often communicate with other medical or allied health professionals to unify treatment goals, report findings or collaborate on treatment approaches. It is important that each professional has the same information and understand’s the client’s medical history in order to effectively coordinate treatment.

3. Therapeutic Treatment Planning - Therapists may use your medical or personal history to help them understand a client’s goals, avoid potential retraumatization, plan individual interventions (i.e. therapy activities), and to help the client connect current responses to past experiences.

4. Medical Emergencies - Although rare, medical emergencies can happen anywhere, including in the therapy office. Therapists must have a client’s medical history, including current medications and allergies, on hand in case this information is needed my ambulance or medical personnel, in the event that you are unable to communicate this yourself. Additionally, it is important for a therapist to avoid any potential allergens or medical triggers in their office.

There may be other reasons why your therapist asks for your medical history. Talk to your therapist if you have a concern about your personal information.

Although there are many different types of notes and reports that a therapist may write, there are three main types of notes that they will keep:

1. Session/Progress Note - This is the official medical documentation of a session. Similar to medical notes, progress notes (a.k.a. session notes or psychotherapy notes) record official observations made by the therapist, assessments, the therapeutic approaches/interventions used, and an update on the client’s progress compared to the treatment plan. Since these are legal medical documents, there are strict requirements for what should and should not be included in process notes. Progress notes are meant to be shared with other medical professionals, which is why these documents must meet certain requirements. These are documents that must remain confidential unless the client has given express, written permission for these notes to be shared (except during specific exemptions to confidentiality). Progress notes can also include treatment plans, termination reports and other documents that are meant to be shared with other professionals.

2. Process Notes - These are unofficial notes meaning that they are not meant to be seen by people other than the therapist. These notes are kept separate from a client’s official file and record. The purpose of process notes is not to provide information about the client, but rather to provide a space for the therapist to keep track of their observations, hypotheses, questions to ask supervisors and personal thoughts/feelings. This can be thought of as a therapist “diary” since it is a way for a therapist to record personal reactions, brainstorm treatment methods and reflect on their own practice as a psychotherapist. Like progress notes, there are regulations around what information can be included. These notes can not contain personal information about the client such as medical details, symptoms or the client’s treatment plan progress. These notes follow the same confidentiality requirements as other psychotherapy notes.

3. Supporting Notes - This is another type of official note that provides information about the client. Supporting notes may include intake forms, contact forms, signed agreements, or other documents that contain official client information. Although these notes are not necessarily formatted to be shared, the information included in them support the client’s official notes and document their official information for the therapist.

But do you keep records of what I say?

Almost never. It is not unheard of to include a medically significant quote by a client in an official document, but therapists often try to avoid this so they do not accidentally misquote a client or share more client information than is absolutely necessary.

The Exception! (kind of)

A therapist may ask you if you are willing to sign a form to allow recording of all or part of a session. Why would they do this? Occasionally, therapists are required to record audio or video from a session to demonstrate their therapeutic skills to a supervisor. The supervisor will be focusing on the therapist, not the client. Since these recordings contain highly sensitive confidential information, they must promptly be shown to the supervisor and then immediately destroyed. It is important for a therapist to communicate to you that clients are under no obligation to sign the form and that they will receive the same quality of treatment if they choose not to sign the form. Consent can be revoked at any time or for any reason. Nearly all therapists understand that giving permission to film or record a client’s therapy session is an incredibly difficult and vulnerable thing to agree to. Clients may feel like it is an invasion of privacy in a space otherwise used to express very personal and intimate details about themselves. This is why therapists should never pressure, guilt or manipulate you into giving permission to something you do not feel comfortable with. Consent is understood to be ongoing, meaning that consent can always be revoked without notice. If you do feel pressured by a therapist, learn more about reporting a therapist to their regulating body.

No. As a psychotherapist (aka Counselling Therapist), I do not provide official diagnoses, assessments or prescriptions. I do provide reports that can be sent to other medical professionals or funding sources upon request.

I offer psychotherapy treatment for symptoms of mental health conditions, however treatment can be done with or without a diagnosis.

Yes!

Yes, but they must agree to participate in therapy before you do.