Counsellors and Therapy and Sessions, Oh My! Counselling Demystified: What to Expect When You Reach Out for Help

Hey there, it’s your friendly neighbourhood counsellor here. In addition to authoring "How to Like Yourself," I am also a counsellor/therapist at Guelph University, and was previously a counsellor at Sheridan College. I also do some work with jack.org as a mental health support (this blog post is also up here on jack.org). I’m here to tackle the mystery that is counselling – the myths, the realities, the big and scary, and most importantly, why it is up to each and every one of us to know more about the realities of counselling.Why is this important?

Counselling session
Counselling session

Stigma, that’s why.

Everyone knows what to expect when they walk into a doctor’s office – right? You have to bring your health card, it’s paid for by the government in Canada, you know what extended benefits you have, and that you often have to wait a bit to be seen. Some doctors are good, some you don’t click with, and you keep searching until you find one you like; or, you take what they say with a grain of salt and, if you need to, you look for a second opinion. Sometimes doctor’s poke and prod you and it’s uncomfortable, but it’s all for the best in the long run… sound familiar to your experiences in a doctor’s office?

How many people can rattle off what a counselling session is like, just like that, as if it were no big deal?

Not too many. Here’s why that needs to change!

When someone has a physical ailment, people easily and quickly ask, “Well, did you see a doctor about that yet? I know a great walk in clinic where you don’t have to wait very long…” etc etc etc! That’s awesome! But if someone brings up the fact that they’ve been really down lately, what do people say? “Oh, well… it will get better, just take a walk or a hot shower, you’ll get through it!”

Sometimes that is helpful advice – but sometimes it is not enough. Normalising counselling is a super important step that we all need to start doing a much better job of so that people don’t feel so WEIRD when they sign up for an appointment. I have had so many students tell me how hard it was to pick up that phone to book a session and walk through the door for their first appointment. Then they tell me how relieved they were that they did finally book a session and how it wasn’t as big of a deal as they had made it out to be ahead of the appointment. A lot say they wish they had done it long ago, and that they wish that they (and their friends or family) hadn’t made the idea of seeing a counsellor such a big deal.

So it helps to know what counselling is all about – so you can encourage a friend or family member, or yourself, to check-in with a counsellor if it seems like it might be helpful!

What is counselling all about, really?

Well, it’s actually not a whole lot different than the explanation I gave about a doctor’s visit.

You will have to check out what you’re covered for, either under your own benefits, parents benefits, or what local community resources might be covered by the government (i.e. CMHA), or by your school tuition fees. There are lots of free resources – don’t be discouraged by thinking you have to pay for everything! There are some paid services if you want them, but there are also other solutions if this isn’t feasible for you.

You sometimes have to wait a bit – but sometimes you don’t! There are lots of resources that you can often access right away – walk-in clinics, or same-day drop-in counselling appointments are available at many colleges and universities, and there are always easy-to access phone lines staffed by trained counsellors such as Good2Talk or KidsHelpPhone. And you can always access those shorter-term resources while getting yourself on a waiting list for other types of counselling, resources, counselling groups, etc. that might have longer waiting lists.

Some therapists are good, and some you won’t click with – and you should definitely keep searching until you find the right one for you. Or, the same as with doctors, you may take what a therapist says with a grain of salt if you need to, and you have every right to look for a second opinion if you aren’t happy. A lot of people meet with one counsellor/therapist, don’t have a fabulous time, and rule out counselling altogether for good. If you did this with doctors, you could be in real trouble with your physical health! Remember that therapists are humans too, and like any person you interact with, some you will have good chemistry with, and some you won’t. That’s okay! If you don’t find your match right off the bat in counselling, keep searching. The right fit is out there for you – you will find them! It is your right to ask for a different counsellor if you are not finding the right fit for yourself.

Sometimes they poke and prod you and it’s uncomfortable, but it’s all for the best in the long run. It is also always your choice what you share! Just like doctor’s, this can be true of counsellors, too! Make sure you voice your opinions if there is something you are uncomfortable talking about, or if your counsellor asks any questions that you don’t want to answer. You are not required to share anything you don’t want to! But, if you are ready to talk about some of the hard stuff, sometimes you might become emotional in a session. It might be a bit uncomfortable, because those are tough emotions to feel. But this is okay! Do it if and when you are ready. And you don’t have to apologise to your therapist – they are there to take that journey with you, and to help you through it. This is the exact space and time that these types of emotion can be helpful to work through, and even ifit is a bit uncomfortable at the time, you are not alone, and you will have the right support to figure it all out.

What else can you expect? There are certain therapy approaches you might be introduced to, such as cognitive behavioural therapy (CBT), solution-focused therapy, dialectical behavioural therapy (DBT), narrative therapy, and many others. If you are ever unsure about a specific approach, just ask – the same as you would about what medication a doctor would prescribe you, you are free to ask any questions about therapy, confidentiality, or anything else in a session. Sometimes, counselling just follows talk therapy, which is the simple therapeutic act of speaking your thoughts and emotions out loud so you can feel some relief, re-process your thoughts, and have an opportunity to feel validated and heard, which can be really powerful just by itself.

What will it be like when I show up? When you show up, you will probably check in at a front desk, and then wait for your therapist in a waiting room that may or may not have other people waiting for their appointment as well. Your therapist will greet you, and bring you to their private office. There is no couch to lie on – contrary to those movies – but instead there are usually two chairs and a desk in the room, with some pictures and plants. Your therapist will then go over a confidentiality form with you, which you are free to ask ANY questions about. They may have a few preliminary questions for you, like your age or maybe questions about your medical history or who is in your family, or if you are in school, what program you are in. From there, it is often anything goes. This is YOUR appointment – you set the pace, the topics, the story. If you aren’t comfortable starting things off, the counsellor will start things off, and you can change the pace or style at any time. There is no “right way” to do counselling, and whatever you are most comfortable with is what will happen. Even if this means a little bit of small talk to get comfortable with the therapist. Even if it is a whole hour where you talk and vent things out. Even if you jump forwards and back in history, therapists are pretty good at keeping up and will ask if they miss anything in your story. Therapists want you to feel comfortable, at home, and they want to help you meet any goals that you might have for the session.

What do they keep writing down while you’re talking? The counsellor will take some notes while you speak – these are to record any details that you might share, mostly so we don’t forget! Your story is important and we want to make sure we get it right! Your counsellor may ask you some clarifying questions as you share your story, or may check into some things you haven’t brought up as you go – again, if you aren’t comfortable sharing anything, just say so!

Is it going to be weird talking to a counsellor? I can’t speak for everyone, but generally, if you have found the right fit for yourself with your counsellor, there will be very minimal feelings of weirdness. Yes, there may be some discomfort talking about difficult topics, but if it is a good fit, you should feel some relief through your therapist’s reaction to you and your story. We are NOT here to judge or condemn, we won’t change the topic and make the story about ourselves (as can often happen with family or friends when they aren’t sure what to say), and we won’t try to “fix” you, unless you are looking for some solutions or alternatives and you ask for this. We are here to listen, and help you make sense of whatever you are coming to counselling to talk about. We can provide strategies and skills to help you, if you want them. We can provide alternative ways of thinking, if you want them. Otherwise, we give you a space and time to talk about yourself, no interruptions, which is so rare to find these days.

What next? Depending on the service and the counsellor, most counsellors will ask you if you want to rebook. If you are unsure about the fit with your counsellor, you can tell them you will call back at a later time to rebook, and think about what you want and if you want to rebook with that therapist. If you do like the fit, you can often rebook at the end of the session, usually at about a 2 week interval depending on the situation, but sometimes it is 3 or 4 weeks based on the service type provided. You can ask for clarification about this from your therapist.

Therapists are there to help you. We want to hear your stories – we want to find ways to be helpful to you, and we are completely open to feedback if something isn’t working for you! Your relationship with the counsellor is just as important in therapy as the type of counselling you choose to do. It all starts with a conversation. So think about starting that conversation today, if you feel it would be helpful for your mental health, or encourage a friend or loved one to reach out to counselling services if they might benefit from it – the same ways as you would encourage a friend to head to a doctor’s office if they were concerned for their physical health.

Cheers,

Cheryl M. Bradshaw

P.S. if for some reason you are not finding counselling services are meeting your needs, in addition to the concept of keep searching until you find your fit, you do also have the right to speak to management or a supervisor to express your concerns. These conversations are taken very seriously and you will be heard - and you may just make the experience better for someone else in the future. Know your rights, and engage in them! You have a right to good, transparent, meaningful, safe, and helpful service - that's the whole point, after all!