The following are some commonly asked questions about counselling. Some are about my specific practice, while others are more about counselling in general. If you have questions that are not listed here, please contact me and I will be happy to answer them.
General counselling questions
1) What is counselling?
Counselling is an opportunity to speak with a caring, impartial human being about worries, problems, issues or concerns that are troubling you and/or leaving you "feeling stuck" in some area of your life. Counsellors are professionals who have training and experience in the study of human behaviour, and in working with people to help them understand and resolve their issues and concerns.
2) Do I need a doctor's referral to see you?
No, you don't; in fact, most clients self-refer.
3) Is counselling confidential?
Yes. Everything you say in session will be kept in the strictest of confidence. I will not speak to third parties without your prior knowledge and consent.
There are limits to confidentiality, and it is important that you be aware of these. They are: 1) If you report an imminent harm to yourself or someone else; 2) If I suspect there may be a child protection concern for anyone under the age of 19; 3) If legally required by a court-order/subpoena.
It is ethical, as a therapist, to engage in ongoing supervision (including peer supervision), which I do. However, in these cases no identifiers (e.g., your name) are used. This allows the benefit of gaining support for our work from other therapists, while at the same time maintaining your confidentiality and anonymity. Please note that my supervisors and therapist peers are also bound by the same ethical agreement to confidentiality as I am.
4) What is the difference between a counsellor, registered clinical counsellor, psychologist, and psychiatrist?
There are a number of professions and professionals that offer mental health support services to people. The differences between these are due to things like education/training, types of populations served, types of issues worked with, and registration.
A counsellor is an individual who aims to support people with various psychological concerns. However, because the term counsellor is not a protected or regulated term, anyone can call themselves a counsellor, regardless of their level of education or training (if they have any--many people bill themselves as a counsellor based on life experience alone). It is important to know that people do not need to register with any organization in order to call themselves counsellors.
A registered clinical counsellor (RCC) is someone who has registered with the British Columbia Association of Clinical Counsellors (BCACC). This means they have been recognized by the BCACC to have a certain level of education and training that qualifies them to be a clinical counsellor. Typically, this means a minimum of a master's degree (e.g., M.A., M.Ed., M.Sc.). Many, including myself, have a doctoral degree (e.g., Ph.D., Ed.D., Psy.D.). An RCC is required to abide by the BCACC's rules, standards, and ethical guidelines. There is also a complaints process for people who feel the RCC has committed an ethical or professional violation.
A psychologist is someone who has graduate training in psychology. With some exceptions, in British Columbia a person must have doctoral level training (e.g., Ph.D., Psy.D.) to be registered as a psychologist. Many are trained in assessing and diagnosing psychological disorders, though not all do. Psychologists cannot prescribe medication, as they are not medical doctors. Psychologists in BC are regulated and licenced by the College of Psychologists of British Columbia, and must adhere to professional and ethical guidelines. Potential psychologists must go through a rigorous process before becoming registered.
A psychiatrist is a medical doctor who has specialized in diagnosing and treating mental health conditions. To become a psychiatrist, a physician must complete an additional five years of residency (i.e., training) in psychiatry. As medical doctors, they are the only ones in this group who can prescribe medications to their patients. Some conduct therapy as well, though this is less common. They are also the only ones whose services are covered by MSP (medical services plan) at no cost to patients. However, their wait lists are long (upwards of a year), and as most do not provide therapy their treatment may be more limited to prescribing and monitoring medications.
Counselling is an opportunity to speak with a caring, impartial human being about worries, problems, issues or concerns that are troubling you and/or leaving you "feeling stuck" in some area of your life. Counsellors are professionals who have training and experience in the study of human behaviour, and in working with people to help them understand and resolve their issues and concerns.
2) Do I need a doctor's referral to see you?
No, you don't; in fact, most clients self-refer.
3) Is counselling confidential?
Yes. Everything you say in session will be kept in the strictest of confidence. I will not speak to third parties without your prior knowledge and consent.
There are limits to confidentiality, and it is important that you be aware of these. They are: 1) If you report an imminent harm to yourself or someone else; 2) If I suspect there may be a child protection concern for anyone under the age of 19; 3) If legally required by a court-order/subpoena.
It is ethical, as a therapist, to engage in ongoing supervision (including peer supervision), which I do. However, in these cases no identifiers (e.g., your name) are used. This allows the benefit of gaining support for our work from other therapists, while at the same time maintaining your confidentiality and anonymity. Please note that my supervisors and therapist peers are also bound by the same ethical agreement to confidentiality as I am.
4) What is the difference between a counsellor, registered clinical counsellor, psychologist, and psychiatrist?
There are a number of professions and professionals that offer mental health support services to people. The differences between these are due to things like education/training, types of populations served, types of issues worked with, and registration.
A counsellor is an individual who aims to support people with various psychological concerns. However, because the term counsellor is not a protected or regulated term, anyone can call themselves a counsellor, regardless of their level of education or training (if they have any--many people bill themselves as a counsellor based on life experience alone). It is important to know that people do not need to register with any organization in order to call themselves counsellors.
A registered clinical counsellor (RCC) is someone who has registered with the British Columbia Association of Clinical Counsellors (BCACC). This means they have been recognized by the BCACC to have a certain level of education and training that qualifies them to be a clinical counsellor. Typically, this means a minimum of a master's degree (e.g., M.A., M.Ed., M.Sc.). Many, including myself, have a doctoral degree (e.g., Ph.D., Ed.D., Psy.D.). An RCC is required to abide by the BCACC's rules, standards, and ethical guidelines. There is also a complaints process for people who feel the RCC has committed an ethical or professional violation.
A psychologist is someone who has graduate training in psychology. With some exceptions, in British Columbia a person must have doctoral level training (e.g., Ph.D., Psy.D.) to be registered as a psychologist. Many are trained in assessing and diagnosing psychological disorders, though not all do. Psychologists cannot prescribe medication, as they are not medical doctors. Psychologists in BC are regulated and licenced by the College of Psychologists of British Columbia, and must adhere to professional and ethical guidelines. Potential psychologists must go through a rigorous process before becoming registered.
A psychiatrist is a medical doctor who has specialized in diagnosing and treating mental health conditions. To become a psychiatrist, a physician must complete an additional five years of residency (i.e., training) in psychiatry. As medical doctors, they are the only ones in this group who can prescribe medications to their patients. Some conduct therapy as well, though this is less common. They are also the only ones whose services are covered by MSP (medical services plan) at no cost to patients. However, their wait lists are long (upwards of a year), and as most do not provide therapy their treatment may be more limited to prescribing and monitoring medications.
questions about the counselling/therapy process
1) How many sessions will I need?
The number of sessions needed varies for everyone, and depends on many factors, including your goals, the complexity of your concern(s), and your motivation and willingness to make changes. Typically, we will check in with each other from session to session to track your progress toward your goals. On average, people find it can take anywhere from 3 to 10 sessions to see and feel progress. Some clients need fewer, while others need more. Many clients prefer ongoing long-term therapy, which I also provide.
2) What does the first session look like?
The first session is really all about getting to know you and the concerns that have brought you to therapy. Among other things, you'll have the opportunity to tell me a bit about what has brought you to counselling. I'll ask you questions throughout, to get clarification and a deeper understanding of your concerns. We'll begin to formulate some goals for our work together. You'll find the first session goes by very fast. Please see the Your First Session page for more details
3) I'm coming to see you for the first time. Can I book a longer session?
Some people find that they have a "story" that they wish to express when they first see a therapist, and this can take a while to get out. Also, it is normal to feel nervous coming to a therapist for the first time, and it may take a while to feel settled and comfortable opening up. For those reasons, you may wish to have a longer session for the first session or two. Please contact me so we can discuss this option.
4) Why are therapy sessions 50 minutes long instead of the full hour?
In the counselling profession, fees cover both the work of the counselling session itself as well as preparation and clinical note writing before and after. Thus, the industry standard is a 45-50 minute client hour. The remaining 10-15 minutes is used for my own preparation for the session and clinical note writing.
5) Will you solve my problems / "fix me"?
It is not the therapist's role to solve client's problems but, rather, to create conditions and ask questions that open up space for clients to gain a better understanding of themselves and explore new opportunities and possibilities. The therapist's task is, in part, to: a) create a safe and comforting place for this exploration to occur; b) to listen actively and attentively; c) to demonstrate compassion, care, and understanding; and d) to use their knowledge and experience to ask the "right" sorts of questions--questions that in themselves are interventions.
6) How do I get the most benefit from my therapy sessions?
Ask yourself: "Am I ready to commit to the time and work needed to achieve my goals?" and "Is now the best time for counselling?" The best therapy work occurs when clients are prepared and willing to engage in the depth of exploration needed to work on improving their lives.
Here are some suggestions that clients have found helpful:
a) Attend sessions regularly, at least at the beginning (e.g., if possible, every week or every other week)
b) Bring a notebook to sessions and write down important points/insights/ideas you'd like to remember
c) Reflect on sessions immediately or soon afterward (e.g., what stands out for you from today's session?)
d) Do assigned homework / practice strategies between sessions
The number of sessions needed varies for everyone, and depends on many factors, including your goals, the complexity of your concern(s), and your motivation and willingness to make changes. Typically, we will check in with each other from session to session to track your progress toward your goals. On average, people find it can take anywhere from 3 to 10 sessions to see and feel progress. Some clients need fewer, while others need more. Many clients prefer ongoing long-term therapy, which I also provide.
2) What does the first session look like?
The first session is really all about getting to know you and the concerns that have brought you to therapy. Among other things, you'll have the opportunity to tell me a bit about what has brought you to counselling. I'll ask you questions throughout, to get clarification and a deeper understanding of your concerns. We'll begin to formulate some goals for our work together. You'll find the first session goes by very fast. Please see the Your First Session page for more details
3) I'm coming to see you for the first time. Can I book a longer session?
Some people find that they have a "story" that they wish to express when they first see a therapist, and this can take a while to get out. Also, it is normal to feel nervous coming to a therapist for the first time, and it may take a while to feel settled and comfortable opening up. For those reasons, you may wish to have a longer session for the first session or two. Please contact me so we can discuss this option.
4) Why are therapy sessions 50 minutes long instead of the full hour?
In the counselling profession, fees cover both the work of the counselling session itself as well as preparation and clinical note writing before and after. Thus, the industry standard is a 45-50 minute client hour. The remaining 10-15 minutes is used for my own preparation for the session and clinical note writing.
5) Will you solve my problems / "fix me"?
It is not the therapist's role to solve client's problems but, rather, to create conditions and ask questions that open up space for clients to gain a better understanding of themselves and explore new opportunities and possibilities. The therapist's task is, in part, to: a) create a safe and comforting place for this exploration to occur; b) to listen actively and attentively; c) to demonstrate compassion, care, and understanding; and d) to use their knowledge and experience to ask the "right" sorts of questions--questions that in themselves are interventions.
6) How do I get the most benefit from my therapy sessions?
Ask yourself: "Am I ready to commit to the time and work needed to achieve my goals?" and "Is now the best time for counselling?" The best therapy work occurs when clients are prepared and willing to engage in the depth of exploration needed to work on improving their lives.
Here are some suggestions that clients have found helpful:
a) Attend sessions regularly, at least at the beginning (e.g., if possible, every week or every other week)
b) Bring a notebook to sessions and write down important points/insights/ideas you'd like to remember
c) Reflect on sessions immediately or soon afterward (e.g., what stands out for you from today's session?)
d) Do assigned homework / practice strategies between sessions
questions about fees, payment, missed/cancelled appointments, and session length
1) What are your rates?
My fees are currently $190 + GST ($199.50 total) per therapy hour. The therapy hour consists of a 45-50 minute therapy session; the remaining 10-15 minutes are for note writing and other administrative tasks. This is the industry standard for therapists.
For additional services outside of our regularly-scheduled appointments (e.g., phone calls, emails, letter/report writing, consultations with other professionals), the same hourly rate applies, pro-rated to every 15 minutes.
2) Are your services covered by provincial health care (MSP) or by my extended health insurance?
Unfortunately, counselling services are not currently covered by MSP.
Many extended health plans *do* cover the therapeutic services of a Registered Clinical Counsellor (RCC). Please check with your insurance provider to see if your particular plan does. In most cases, you will have to pay for my services upfront; I will provide you with a receipt that you can then use to make your insurance claim.
3) What if I have to reschedule or cancel an appointment? What happens if I forget and miss the appointment?
I understand that life gets busy. To help you remember your upcoming appointment, I send an email reminder three days in advance of your appointment, and a text message three hours before your appointment.
Please call or send me an email if you need to reschedule or cancel your appointment. Please give me at least 48 hours notice. If you give me less than 48 hours notice and I am unable to fill your spot, you will still be responsible for paying the full session rate. Similarly, if you forget or miss an appointment you will be required to pay the full session rate prior to our next session.
4) Why do you charge the full fee for late cancellations/missed appointments?
When you book an appointment with me, I commit that day and time to you, and must turn away other clients who would like to have that spot. This is particularly the case with evening appointments, which are popular and limited. When you miss an appointment or cancel with less than 48 hours notice, I am usually unable to fill that spot with another client who could use it.
To help prevent this, I will send you a reminder via email in advance of our appointment. This helps remind you of our upcoming session and gives you a day to cancel/reschedule the appointment if you wish.
You are welcome to leave a voicemail or send me an email to give me notice. In all cases, I will confirm that I have received your message. If you don't hear back from me, please send me another message in case the original one did not come through.
5) Are longer sessions possible?
Sometimes people find it beneficial to book sessions that are longer (e.g., 2 hours in length). Please let me know if you are interested in a longer session when booking.
6) How do I pay you?
Please pay prior to or at the beginning of each session. I currently have two main methods of payment. The first is via e-transfer, prior to the session, (sent to paulo@aspirewellness.ca). The second is to enter your credit card number in your client profile. This is a secure, PCI-compliant system (for more information, see this link: https://jane.app/guide/privacy-and-security/is-jane-pci-compliant). I will email you an official receipt once I receive your payment.
My fees are currently $190 + GST ($199.50 total) per therapy hour. The therapy hour consists of a 45-50 minute therapy session; the remaining 10-15 minutes are for note writing and other administrative tasks. This is the industry standard for therapists.
For additional services outside of our regularly-scheduled appointments (e.g., phone calls, emails, letter/report writing, consultations with other professionals), the same hourly rate applies, pro-rated to every 15 minutes.
2) Are your services covered by provincial health care (MSP) or by my extended health insurance?
Unfortunately, counselling services are not currently covered by MSP.
Many extended health plans *do* cover the therapeutic services of a Registered Clinical Counsellor (RCC). Please check with your insurance provider to see if your particular plan does. In most cases, you will have to pay for my services upfront; I will provide you with a receipt that you can then use to make your insurance claim.
3) What if I have to reschedule or cancel an appointment? What happens if I forget and miss the appointment?
I understand that life gets busy. To help you remember your upcoming appointment, I send an email reminder three days in advance of your appointment, and a text message three hours before your appointment.
Please call or send me an email if you need to reschedule or cancel your appointment. Please give me at least 48 hours notice. If you give me less than 48 hours notice and I am unable to fill your spot, you will still be responsible for paying the full session rate. Similarly, if you forget or miss an appointment you will be required to pay the full session rate prior to our next session.
4) Why do you charge the full fee for late cancellations/missed appointments?
When you book an appointment with me, I commit that day and time to you, and must turn away other clients who would like to have that spot. This is particularly the case with evening appointments, which are popular and limited. When you miss an appointment or cancel with less than 48 hours notice, I am usually unable to fill that spot with another client who could use it.
To help prevent this, I will send you a reminder via email in advance of our appointment. This helps remind you of our upcoming session and gives you a day to cancel/reschedule the appointment if you wish.
You are welcome to leave a voicemail or send me an email to give me notice. In all cases, I will confirm that I have received your message. If you don't hear back from me, please send me another message in case the original one did not come through.
5) Are longer sessions possible?
Sometimes people find it beneficial to book sessions that are longer (e.g., 2 hours in length). Please let me know if you are interested in a longer session when booking.
6) How do I pay you?
Please pay prior to or at the beginning of each session. I currently have two main methods of payment. The first is via e-transfer, prior to the session, (sent to paulo@aspirewellness.ca). The second is to enter your credit card number in your client profile. This is a secure, PCI-compliant system (for more information, see this link: https://jane.app/guide/privacy-and-security/is-jane-pci-compliant). I will email you an official receipt once I receive your payment.
for clients who have legal/court-related concerns
1) I am facing some legal/court-related proceedings or divorce/custody concerns and my lawyer has recommended I see a counsellor. Are you a good fit for me?
If you are seeking counselling to support your emotional and mental health needs, then I am happy to see you as a client. However, oftentimes when there are legal matters involved, there is a hope or expectation that counsellors will write letters of support, provide reports of sessions, and/or attend court proceedings to testify on behalf of clients. I do not provide these services.
For example, sometimes clients are recommended to attend a minimum number of sessions to "prove" they have gone to counselling, then receive a letter from the therapist attesting to this fact. If your main goal in coming to counselling is to meet a legal requirement, you would be better served by seeing a therapist who specializes in legal proceedings and is comfortable with testifying. Unfortunately, this is not an area of expertise for me.
If you are seeking counselling to support your emotional and mental health needs, then I am happy to see you as a client. However, oftentimes when there are legal matters involved, there is a hope or expectation that counsellors will write letters of support, provide reports of sessions, and/or attend court proceedings to testify on behalf of clients. I do not provide these services.
For example, sometimes clients are recommended to attend a minimum number of sessions to "prove" they have gone to counselling, then receive a letter from the therapist attesting to this fact. If your main goal in coming to counselling is to meet a legal requirement, you would be better served by seeing a therapist who specializes in legal proceedings and is comfortable with testifying. Unfortunately, this is not an area of expertise for me.