Helping Professionals

professionals

1.  Location
2.  Credentials
     a.  Psychiatrist
     b.  Psychologist
     c.  Psychological Associate
     d.  Social Worker
     e.  Counsellor
     f.  Psychotherapist
3.  Specialization
4.  Treatment Orientation
5.  Cost
6.  Goals
7.  Relationship
8.  Red Flags
9.  First Session

View Printer-Friendly List of Questions

Choosing a professional (e.g., psychologist, social worker, counsellor, psychotherapist) to assist you in coping with your anxiety condition can be a confusing process. It is recommended that you request names of professionals from your physician and/or from others experiencing a similar condition; however, keep in mind that you may meet with a professional who comes highly recommended and not feel that you will be able to work with that person. There are many factors to consider when choosing a helping professional:

1. Location
Are you able to easily access his / her office? If you are currently having difficulty leaving your home, does this individual do home visits or offer telephone support? It is important that the person’s office location not become an obstacle to your ability to attend appointments.

2. Credentials
In the province of Ontario, there are many different service providers who offer therapeutic services. However, only certain service providers are regulated health professionals. A regulated health professional is someone who is licensed by the provincial government. Choosing a regulated health professional is important because it means that the individual has met a certain standard of training. Questions to ask a potential helping professional include:

What is your educational background?
Are you currently licensed to practice in Ontario?
What professional organizations do you belong to?
Do you have up-to-date liability insurance (“malpractice insurance”)?
Who are you supervised by?

With respect to supervision, it is important that your helping professional is supervised by another helping professional or is part of a supervision group. This means that the individual discusses their cases with other members of their profession to get feedback and problem-solve. Taking part in the supervisory process demonstrates that your helping professional is committed to continually improving his/her skills.

a.  Psychiatrist
A psychiatrist is a medical doctor who received additional training in psychology and mental health. A psychiatrist completed medical school as well as an additional four years of education. Psychiatrists are trained to diagnose and treat patients of all ages. They use both medication and therapy to treat anxiety conditions. Psychiatrists are regulated health professionals who can formally diagnose patients with psychological conditions. Psychiatrist’s services are paid for by the government of Ontario (OHIP).

b.  Psychologist
A psychologist is a professional who has a PhD. A psychologist has completed between 6 to 8 years of education, a one-year supervised internship, as well as passed a professional exam. The term “psychologist” is protected, which means only individuals licensed with the Ontario Psychological Association can call themselves a psychologist. Typically, a psychologist has completed his or her education in one of the following areas: clinical psychology, counselling psychology, clinical neuropsychology or educational/school psychology. Although psychologists are trained to treat everyone with a psychological condition, they are required, by their regulatory board to only practice in areas in which they are competent (e.g., for which they have received specialized training and in which they have professional experience). Psychologists can formally diagnose patients as well as use therapeutic techniques to treat anxiety conditions; however, they cannot prescribe medication. Psychologists are regulated health professionals and their services are covered by Extended health benefit plans but not OHIP. Through hospital programs, the fees of a psychologist may be covered.

c.  Psychological Associate
A psychological associate is a professional who holds a master’s degree as well as four years of relevant experience. The term “psychological associate” is protected, which means only individuals licensed with the Ontario Psychological Association can call themselves a psychological associate. Psychological associates can formally diagnose patients as well as use therapeutic techniques to treat anxiety conditions; however, they cannot prescribe medication. Psychologists are regulated health professionals and their services are covered by Extended health benefit plans but not OHIP. Like psychologists, through hospital programs, the fees of a psychological associate may be covered.

d.  Social Worker
A social worker (MSW) is a professional who has a Master’s Degree in the field of social work (2 years in graduate school). Social workers have different levels of education (Bachelor’s degree, BSW / 2 year college program, SSW) but it is typically social workers with Master’s Degrees that offer therapeutic services. The term “social worker” is protected, which means that only individuals registered with the Ontario College of Social Workers and Social Service Workers can use it. Social workers offer therapy services but they do not diagnose psychological conditions or prescribe medications. Some extended health benefit plans will pay for the services of social workers. There services may also be available through hospital or community-based programs.

e.  Counsellor
A counsellor is a professional who offers therapeutic services. Most counsellors have a master’s degree (e.g., psychology, counseling, and education) as well as additional courses in their area of specialization (e.g., addictions); however, the term “counsellor” is not protected, which means that anyone in Ontario can call themselves a counsellor. Counsellors can provide therapy services but they cannot diagnose anxiety conditions or prescribe medication. Their services are not paid for by OHIP, although some extended health benefit plans will pay for the services if the individual is supervised by a Psychologist. Most professional counsellors belong to the Canadian Counselling Association or the Ontario Association of Consultants, Counsellors, Psychometrists and Psychotherapists. This means the individual has met the professional standards of that organization but he or she is not regulated by the provincial government.

f.  Psychotherapist
A psychotherapist is a professional who offers therapeutic services. Most psychotherapists have a master’s degree (e.g., psychology, counseling, and education) as well as additional courses in their area of specialization (e.g., cognitive-behaviour therapy); however, the term “psychotherapist” is not protected, which means that anyone in Ontario can call themselves a psychotherapist. Psychotherapists can provide therapy services but they cannot diagnose anxiety conditions or prescribe medication. There services are not paid for by OHIP, although some extended health benefit plans will pay for the services if the individual is supervised by a Psychologist. Most psychotherapists belong to the Canadian Counselling Association or the Ontario Association of Consultants, Counsellors, Psychometrists and Psychotherapists. This means the individual has met the professional standards of that organization but he or she is not regulated by the provincial government. The government of Ontario has just begun the process of creating a board to regulate the profession of psychotherapy.

3.  Specialization
While mental health professionals are trained to help all individuals suffering from psychological conditions, it is in your best interests if you seek out the services of someone who has both educational experience and professional experience in working with individuals who have your particular anxiety condition. Questions to ask a potential helping professional include:

What type of experience do you have in working with individuals who have my condition?
How many individuals with my condition have you treated?
What training have you taken related to treating anxiety disorders?

4. Treatment Orientation
A professional’s treatment orientation will determine what they believe causes anxiety conditions as well as how they will go about treating your anxiety condition. Research generally indicates that cognitive-behavioural interventions are the most successful in reducing anxiety symptoms. Questions to ask a potential helping professional include:

What types of techniques do you use to treat my anxiety condition?
What types of techniques do you find to be the most successful / least successful?

5. Cost
Some professionals offer a sliding fee scale (the cost of counseling is based on an individual’s income). It is important to find out the cost for each method, payment methods the individual accepts, as well as how long the process will last.

6. Goals
It is important to find out what the professional thinks is a successful outcome of your relationship with them. With an anxiety condition, success is considered to be the reduction of your anxiety symptoms as well as the development of healthy coping strategies. A professional should not promise that your anxiety condition will disappear by the end of treatment. Questions to ask a potential helping professional include:

What would you consider to be a successful outcome of our therapy sessions?
How long does it usually take to treat my particular anxiety condition?

Most professionals work with anxiety sufferers for between 12 and 20 sessions; however, some individuals require long-term assistance as they are dealing with multiple problems and conditions. The sessions typically begin on a weekly basis and then spread out to twice a month or monthly as the individual learns to better cope with their symptoms on their own. The goal of treatment should be the reduction of anxiety symptoms, reducing avoidance behaviours, reducing unhealthy coping strategies, and increasing the use of healthy coping strategies.

Keep in mind that you should begin to experience some progress after at least 4 to 6 sessions. If you are not experiencing any progress, it could be that you have not developed a good working relationship with your helping professional or you are not ready to begin the therapeutic process. Although many people feel that they are ready to make changes, treatment of anxiety conditions is a difficult process: one that can at times feel very frightening and overwhelming. The treatment of anxiety symptoms requires that individuals do a great deal of therapeutic work between sessions. If you are having difficulty committing to the process, it is important that you discuss this with your helping professional. He or she can assist you in understanding why you may be having difficulty actively working towards reducing your symptoms of anxiety.

7. Relationship
The majority of helping professionals use similar techniques and methods, although to varying degrees of success (refer back to the section on Credentials). A crucial part of choosing a helping professional is your ability to develop a working relationship with that person. Review the following statements after the initial session(s) with your helping professional. You should be able to answer “yes” to the majority of the statements.

I can speak openly without the fear of being judged or reprimanded.
My helping professional takes the time to explain techniques or theories to me. I am comfortable asking questions if I do not understand something.
We set goals during our sessions and these goals, and my progress towards them, are regularly re-evaluated.
My helping professional does not act like he or she knows everything and can solve all my problems. He/she is willing to admit to making errors or apologizing, if it's appropriate.
I am able to identify positive changes in my thoughts, behaviours, and feelings.
My helping professional demonstrates respect for my gender, culture, lifestyle, and beliefs. I do not feel “less than” my helping professional.
My helping professional demonstrates empathy and concern for my circumstances and does not mock or belittle me.
My helping professional uses language that I understand.
I can disagree or express different viewpoints and my helping professional does not get upset.

8. Red Flags
If at any point you have concerns about your helping professionals behaviour or something that happened in one of your sessions, contact the Regulatory Body under which your helping professional is licensed.

Physical contact that makes you uncomfortable.
If your helping professional asks for money to invest in a business or for other purposes.
If your helping professional offers to meet you outside of your sessions for social purposes.
If your helping professional offers you any type of alcohol or non-prescription medication.
If you hear that details of your session(s) were shared with other individuals, without your written consent.

8. First Session
When you first meet with your helping professional, he/she should explain the following things:

The process for scheduling and canceling appointments.
The cost of each session and payment methods.
His/her therapeutic orientation and plan for your initial sessions together.
What confidentiality is and when he/she has to breach confidentiality.
How the helping professional protects your privacy.
What to do if you are in a crisis situation.
How and under what circumstances the helping relationship is terminated.