What's the difference between psychologists, psychiatrists, and counsellors?

Psychologists have graduate-level training (Master's or PhD) in a specific branch of psychology, for example, counselling. Their main treatment modality is "talk therapy" and behavioural interventions (such as cognitive-behavioural therapy) and they do not prescribe medication. Psychologists' services are generally not covered by the public health care system, unless they are employed in a hospital, school, or correctional setting. Private practice psychologists can usually be accessed by self-referral.

Psychiatrists are medical doctors (MD) with expertise in mental health. They can prescribe medication, and this tends to be their main treatment modality. In Canada, psychiatrists' services are paid for by the public health care system. To see a psychiatrist, you typically need a referral from a family doctor or access through a hospital-based program.

Anyone who provides counselling can call themselves a counsellor as it is not currently a regulated title in Alberta. It is in your best interest to seek out a counsellor who is a member of a regulatory body that provides registration or licensing (such as the College of Alberta Psychologists), as this indicates the provider has met defined standards of training and must follow certain practice guidelines, and you have recourse in the event you ever wish to make a formal complaint.

Do I need a doctor's referral to see a psychologist? Does a doctor's referral cover the fee?

You do not need a doctor's referral to receive services, and having one does not cover the fee unless this is required by your insurance plan for coverage, which is rare (please check with your plan administrator regarding the details of your coverage).

Is everything I say in counselling confidential?

Most but not all information shared with a psychologist in Alberta is confidential. The exceptions include imminent risk to safety, child abuse or neglect, and certain situations which are mandated by law. The details of confidentiality and its limitations will be explained prior to the start of counselling services. When seeing a psychologist, your information is stored securely and privately (not on Netcare, the electronic health record in Alberta, unless you are receiving services within the public system or AHS).

What should I be prepared to do in counselling?

Your role in counselling is to attend sessions ready to talk about your concerns in an open and honest way. You may be assigned "homework" tasks between sessions to help further your progess. You are welcome to take notes in counselling sessions to help you remember what we talked about. If your sessions are virtual (over video or phone), please be in a quiet and private location with reliable technology. Although a psychologist may ask you difficult questions or bring up painful topics at times, you should never feel forced to do anything you don't want to do and you should always feel that the counselling process is collaborative.

What will happen before and in the first appointment?

Before your first appointment, you will be asked to fill out forms asking for your contact information and your written consent to receive counselling. At the start of the first appointment, I will review important details related to counselling services, such as the confidentiality policy and how fees and payments work.

I will invite you to tell me some general information about yourself, so that I can get to know you better. We will then talk about the reason why you are seeking counselling. After gathering this information, we usually have a conversation about your goals for counselling (what do you hope to achieve?) and create a plan for getting there. If there's time, we will start talking about the issues more in-depth. I may teach you some strategies relevant to your problem, to give you some practical tools right away.

How long does therapy take?

This is highly individual and depends on many factors, such as the presenting problem and your preferences. Some clients want to address a particular issue as quickly as possible; some prefer a longer therapy process for exploration or ongoing support. You may wish to consider ahead of time how much time, energy, and financial resources you wish to invest into therapy.

In general, the typical course of therapy in my practice is between 5 and 15 sessions, with each session being 50 minutes long and spaced out by 2 to 4 weeks. Initially, it is best to have more frequent sessions and later on, the frequency can decrease.