What is the difference between counseling and psychotherapy? 
 

Though often used interchangeably, there is a subtle and practical difference between the two terms.

 

Counseling is about clarity and confidence. Clients experiencing major life changes, or those struggling with big decisions, might benefit from counseling. Treatment time can range from 6 weeks to 6 months. 

 

Psychotherapy is about change and growth. Clients seeking to understand themselves better, or those who wish to break away from unhealthy patterns in their lives, might benefit from psychotherapy. Treatment time can range from weeks to months to years. 

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How long does it take to feel better? 

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Many clients experience some relief after the first session, which has less to do with any therapeutic intervention, and more to do with the feeling of empowerment that comes with taking care of oneself. 

 

It takes time for concerns to develop, and it can take time to address them properly.

It is helpful to keep in mind that in most cases, by the time a client decides to seek treatment, they have usually been experiencing symptoms for a while. With counseling concerns, it's usually a matter of weeks to months before a client feels ready to move on. In other cases, it might take months to years, especially when the client wishes to focus on change and growth. 

 

Lastly, a crucial component of an effective therapeutic experience is the client's own willingness to participate in the process. 

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What if I've never had therapy before? ​

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I didn't experience therapy myself until my mid-twenties. I can remember feeling hesitant, confused and unsure about what would happen during my first session; everything I thought I knew about what therapy would be like came from books, movies or television. I think sometimes clinicians can forget that not everyone is familiar with the process. 

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I welcome those that are new to therapy and I'm here to tell you that it's not always like the movies, but sometimes it can be. The most important thing to remember is to be yourself. 

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What is a session like? ​

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The typical sequence of events is: consultation, intake, regular sessions and termination. 

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The consultation stage can be over the phone or via email and is useful to gauge whether we are a good fit for each other. 

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The intake session is the first session and it is different from regular sessions in that our goal during the intake is for me to gain some background information about the client, begin to understand their concerns and to assess for appropriate treatment. In other words, we figure out together what we want to work on and go from there. 

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The regular sessions are the process; this is when therapy happens. This part is dynamic and collaborative. It is important to know that each regular session is unique, and that the "work" happens in every aspect of the experience, including the conversations and the silences. 

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The termination session is the final session in which we review the work we have done together, the progress the client has made and then we say "Goodbye for now." 

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The most common misconception is that therapists give advice to clients. The only person that knows your life and your experience is you. I am human just the same and I have no magical powers nor any way to read a client's mind. My job as a therapist is to try and understand the world through your eyes and to facilitate perspective.

 

Imagine that life is a mountain to climb. You have your own mountain and I have mine. In session, the focus is all about how to get you to the top of your mountain in a way that makes sense to you and that feels good. It can be difficult, and sometimes impossible, to see our own blindspots. We can get caught up or lost in parts of the forest or stuck in the mud. My job is to look over at your mountain, and share what I might see. Maybe the trail you are currently on is headed in a different direction; maybe there is rock that is about to fall or maybe I can see where the trail gets better just beyond where you are now.

 

My purpose is to help you explore parts of yourself that you can't see alone. I will never tell a client what to do, because only they know what is best for them. 

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What is confidential? ​

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Confidentiality is one of the most important elements of therapy. Often clients are hesitant to be honest at first because they are not sure what will be kept private. Client confidentiality is a priority for me because it must exist for therapy to work. On top of this, I am legally bound to protect client health information and cannot share it without client consent or knowledge. ​

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There are only three situations that would require special attention:

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1. If I truly believe that a client plans to hurt themselves. 

2. If I truly believe that a client plans to hurt someone else. 

3. If a client shares information with me that involves the abuse of a child or the elderly. 

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The important thing to know about the above exceptions to confidentiality is that in the case that one of these concerns does arise, we will find a solution together. Regardless of any conversation, I value transparency and my focus is to collaborate with clients so that they always are a part of the process and they understand every step. 

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Aside from what is outlined above, everything a client shares with me is private. One of the best things about therapy is that clients have space to talk about things that they may not feel comfortable talking about anywhere else. Clients can talk about anything! Sometimes clients share about alcohol or substance use, sexual kinks or fantasies, secrets kept from a partner, stealing, the list goes on and on. 

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Will you judge me? 

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Clients sometimes make comments like, "Are you going to judge me?" and the answer to this is "Absolutely not." My training to become a therapist was heavily influenced by psychologist Carl Rogers' notion of Unconditional Positive Regard. This is the idea that no matter what a client says or does, I accept them as a person.

 

In everyday life, we frequently judge each other and put each other in boxes. When we judge each other, we are comparing everyone else to what we know and what we like (or don't like). Therapists go through extensive training to remove their personal bias as much as possible from work with a client. This means that when a client is in front of me, I accept them and their life experience wholeheartedly. I see a human who wants to feel better, and my focus is to help them make adjustments according to their own values, not mine. 

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Is it a safe space? 

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Time in session is often referred to as a "safe space." I prefer to call it a "brave space." ​

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Of course I want my clients to feel comfortable and safe when in session with me and I strive to foster an environment that feels accepting and warm. I prefer the phrase "brave space" though, because there comes a time in the process when it may be uncomfortable for the client to think about certain things or acknowledge certain behavior. 

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I can remember a time when I was in the client seat in my own therapy, and near the end of a session, my therapist said, "I wonder if that statement is defensive." I immediately felt agitated and thought to myself, "I am not being defensive!" After a few hours I thought more about it and then I realized that I agreed with my therapist and that I was afraid of being too vulnerable in that moment. 

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My point is that there may be times in the process when clients feel frustrated, disappointed, angry, irritated, etc. and that these feelings are normal, expected and an important part of the process. If the space in session were so "safe" all the time that a client never felt uncomfortable, there would be no opportunity for change in their life. 

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Lean into the discomfort and I will lean with you. 

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Do you take notes? 

 

"What are you writing down?" is probably the most common question from new clients. It can be disconcerting to share something vulnerable and see your therapist grab their pen and scribble down a note without saying anything. 

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The truth is rather unexciting. I do take notes because they are important for tracking the progress of treatment. It is helpful to be able to look at notes of sessions over time and evaluate whether sessions are helpful or not. Notes are objective and efficient. Notes often involve client's experience of treatment and goal setting. Notes can also be a requirement for insurance companies. 

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Clients can always ask to see their notes too. 

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Can I know you personally? 

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The client-counselor relationship is both intimate and professional. People share some of the most vulnerable, private pieces of themselves in session; often things that they have never told anyone else. Naturally, there is a bond that forms between the counselor and client and this bond is part of what helps facilitate change in the client's life.

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I consider my clients to be my friends, and I am my authentic self with them. However, because of the intimate nature of the relationship, boundaries are essential. Unfortunately, I cannot meet clients outside of session in any personal context. 

 

Every therapist is different, and some make a point to never self-disclose or share any personal information. My attitude toward self-disclosure is that I will only share a personal story or opinion if I feel it is relevant to the client's experience and if some aspect of my sharing could be somehow useful to the client in terms of treatment. I consider most of my life private and off-limits, however I welcome conversation around any questions a client may have. 

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What if we see each other on the street? ​

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If we happen to see each other in real life, in the street or at an event, my automatic reaction will be to act as if I don't know you at all. This is not meant to be rude, but rather serves to protect your privacy. I will never "out" you as my client in public. If you say "hi", I will say "hi" back. It is best to keep conversation to a minimum though, in order to respect each other's boundaries. Just know that I'm glad to see you out and about!