Finding a Therapist Guide

Defining “Best”

When looking for a therapist, it can be tempting to just search for “best therapists” or “top therapists” in Vancouver. But what you’re probably going to get is a random list of therapists listed in Yelp or Psychology Today, or you’re going to land on some strategically-optimized therapist profiles that may not actually be best for you and your needs.

But how could that be? Surely if a therapist appears busy, has some good testimonials, and says they treat the concerns you’re searching, they’ll be able to help. Right? Well the truth of the matter is: while a therapist may be exceptionally competent and have a thriving practice, therapy is a deeply personal experience. Education, personality, therapeutic approach, and lived experience all play a unique role in whether or not we feel connected to our therapist.

And that’s the take home message: counselling is a deeply intimate and personal process. What one person needs in order to heal and meet their goals may look totally different to what the next person needs. In fact, one of the things we learn as therapists in graduate school is “we can’t be the perfect therapist for everyone,” because our therapeutic style and personality sometimes just doesn’t jive, no matter how many degrees, diplomas, and certifications we may have.

Now, that’s not to say that a recommendation from a friend or acquaintance doesn’t have value – it absolutely does. At ARC we are incredibly proud of the word-of-mouth referrals we receive, and appreciate every single recommendation to our services.

Having said that, here are some more practical and tangible things to consider when you’re trying to find the best therapist for you:

Competency & Regulation

To many peoples’ surprise, counselling is not a regulated profession in British Columbia. That means anyone can call themselves a “counsellor,” “therapist,” or “psychotherapist,” despite having little or no formal training, and without having to prove they have the education and competencies to provide quality mental health care.

So, what does that mean for you as the client? It means that if you want to receive a minimum standard of care from a qualified and ethical therapist, you should connect with someone who has one of the following designations:

• Registered Clinical Counsellor (RCC)
• Registered Psychologist (RPsych)
• Registered Social Worker (RSW) or Registered Clinical Social Worker (RCSW)
• Canadian Certified Counsellor (CCC)

All of the above designations mean the clinician has completed formal post-secondary training, is accountable to a code of ethics, and has the minimum competencies to provide mental health support without doing harm. Of course, bad apples still do exist, but the idea is that these checks and balances help to limit incompetent or unethical providers, and for extreme situations, there are complaints processes available.

To be clear, Registered Clinical Counsellors (RCC) are not included in the Health Professions Act (HPA), and RCCs have membership with an association (BCACC), not with a college. Essentially what that means is: RCCs have said “In the absence of regulation for counselling therapists, I want to communicate to the public that I am sufficiently educated and trained to provide psychotherapy, so I am voluntarily registering with the British Columbia Association of Clinical Counsellors (BCACC) and agreeing to pay their dues, follow their ethical code, and be accountable to my community.”

All RCCs must have a minimum of a master’s degree in counselling psychology (or related profession), and carry active professional liability insurance. This is also why extended health benefits (EHB) through work and school usually cover the services of RCCs.

Specialization

Like most professions, counsellors may practice more generally, or they may specialize in working with specific presenting issues or populations. Specialization generally occurs at the intersection of a therapist’s unique interests, experience (professional and personal), and specific post-graduate training.

It is important to make sure that the therapist you are seeing has – at a minimum – what we call “scope of practice,” both for the concerns you are seeking help with, and the demographic you belong to.

For example, all of our therapists at ARC work with general anxiety and depression, but some have further specialization in treatment of OCD, chronic pain, PTSD, and other concerns. In the same way, some of our therapists work exclusively with individual adults, while others may work with couples or youth as well.

When you reach out we will do our absolute best to match you with a therapist who has the scope and specialization for your presenting concerns. If we can’t, we will honestly and transparently suggest a referral to another therapist or clinic that can.

Therapeutic Approach

Therapeutic approach (or modality) can be thought of as the way in which a therapist understands and treats your challenges or symptoms. We think of therapeutic approach as the lens through which a therapist understands their work.

Therapeutic approaches can vary significantly from therapist to therapist. Some therapists are more present-focused, while others see great value in understanding your history and past experiences. Some therapists are directive, taking on an “expert role,” while others are grounded in the belief that “clients are the experts of their own lives.”

When evaluating whether or not a therapist’s approach aligns with you, we encourage you to ask questions. Some good questions are:

• How does your therapist anticipate change happening?
• How do they view their job/ role as your therapist?
• Does your therapist provide homework outside of therapy?
• How do they measure success in therapy?

These questions can help you to get a sense of how well your therapist’s approach fits and aligns with your unique needs.

Personality

When a professional comes highly recommended, it’s easy to overlook personality. But the truth of the matter is: we want to enjoy and connect with the professionals we’re working with!

Feeling alignment with your therapist’s personality and values allows you to feel a greater sense of connection, and increases the chances of feeling understood in your therapy sessions. It also increases the chances of you trusting your therapist, and feeling safe enough to open up about your inner world – paving the way for difficult thoughts, feelings, and experiences to be processed and healed.

As challenging as it can be, we encourage you to be as honest as possible with your therapist about feelings of connection, or lack thereof. Together you can navigate any blocks that may be present – or alternatively – have a discussion about referring you to another therapist who may be a better fit.

Some good questions to ask yourself when determining personality-fit are:

• Do I feel comfortable with my therapist’s demeanour and presence?
• Do I feel like my therapist can relate to my experiences and concerns?
• Do I feel confidence in my therapist’s capacity to understand what I am sharing?
• Do I feel encouraged or even inspired by my therapist?

Taking the time to reflect on the above questions can do wonders in evaluating whether your therapist is a good fit for you.

It’s important to note that when seeking a therapist, it’s helpful to remain open-minded and understanding of the reality that all human beings are different, and that everyone’s experiences in life are unique. In the same way that a doctor can treat a patient with arthritis without having experienced arthritis themselves, a therapist does not need to have had similar life experiences to you as their client. They just need to have the range to connect to your experiences in a way that makes you feel seen and understood.

Availability

When starting therapy, we want to reduce as many barriers for ourselves as possible. If you and your therapist are having difficulty mapping schedules, or you find yourself struggling to make appointment times work, this can result in feelings of defeat and frustration.

Ultimately some compromise may be involved if you want to work with a therapist that you feel deeply connected to, or specializes in your concerns – especially if the therapist is busy or has a waitlist. However, it still has to feel practical, sustainable, and should not feel like a constant barrier to getting support.

One of the ways to reduce scheduling challenges is to be open to virtual and online counselling. Many therapists have limited days they are available in-office, but have greater flexibility for virtual services. If in-person sessions are preferred or necessary (e.g. for privacy or safety reasons), then it may be helpful to connect with a therapist who is close to your home or work. In any case, prioritizing availability certainly sets you up for success when starting your therapeutic journey.

Fees & Cost

One of the most common challenges to seeking mental health services is the cost involved for clients. Unfortunately, private counselling services are not covered by government healthcare or MSP, so clients are required to pay for services out-of-pocket. While there are sometimes exceptions to this (e.g. some clinics direct-bill ICBC when there is a motor-vehicle claim involved), for the majority of people it means paying anywhere from $100-200 per session for therapy.

While this may seem steep, it is important to recognize what is behind the rate. Registered Clinical Counsellors and Registered Social Workers (Masters Level) have all completed a minimum of six years post-secondary schooling, sometimes more, and this is not including all the additional trainings and workshops attended, as well as the cost of maintaining and operating a practice. Registered Psychologists in BC have completed a minimum of nine years of post-secondary training, and this is reflected in the BCPA recommended rate of $235 per hour.

At ARC our standard rate is $175 per 50-minute session for individual therapy, and $195 for couples therapy. For more information about our rates please visit our Fees page.

The good news is that for many people, extended healthcare benefits (EHB) through work or school cover counselling services. The maximum coverage is set by each individual group plan, and we always recommend checking your benefits plan before coming in, so that you have a better understanding of how many sessions may be covered and how to budget accordingly.

For some people, paying upwards of $100 per hour for therapy is just not feasible, or doing so would mean only having a very limited number of sessions. In this case, we recommend connecting with a low-cost, free, or community service provider. Willow Tree Counselling has an extensive PDF of low-cost counselling services that is updated frequently. Foundry BC is also a great resource for youth and young adults between the ages of 12-24.

Therapy is meant to improve quality of life, not add further stress, so if cost is a concern, it is best to reduce that barrier by seeing a provider who can see you for as long as you need without constantly worrying about fees or how many sessions you can afford. This will allow you to dive into the therapeutic work more freely, improve continuity of care, and allow more space and time for meaningful change to occur.

There is no question that therapy is an investment of time, energy, and money. As long as you are committed to the process and seeing benefit, we strongly believe that money spent on your mental wellness is money well spent.