9 Questions You Might Want to be Answered by Your Therapist Before Starting Your Journey!

1. Is your therapist trained in scientific, evidence-based treatments that are proven effective?

Over the past 40 years, numerous psychological treatments have undergone intensive scientific investigation to examine their effectiveness in helping individuals with a wide range of psychological disorders. To date, numerous empirically-supported treatments have been identified. It is important that your therapist is well-versed in what treatments are most beneficial for you based on scientific evidence. Application of these treatments alone, or in combination, provide you with optimal treatment options.

Our registered psychologists have received 3000-4000 hours of clinical training in evidence-based treatments prior to graduation, and supervise psychotherapists and social workers in the implementation of these treatments.

2. Is your therapist flexible to provide different types of treatment, or is he or she offering only one type of treatment (e.g., CBT)? Does your therapist have a preferred treatment approach or can he or she be flexible if his or her preferred approach does not fit well with you?

Not all treatments work for everyone. Not all treatments will fit your concerns and needs!

Research study after research study demonstrates that, while psychological treatments do work, not all treatments work for everyone in any study (e.g., some drop out of treatment, some do not fare as well, and some don’t achieve any significant change). It’s unclear about whether one particular brand of treatment fits better with any type of child, adolescent, adult, couple of family. From a practical viewpoint, however, some clients may want a briefer therapy option that targets their symptoms without going into a lot of depth, while others want an in-depth exploration and understanding of their difficulties. Sometimes symptoms are addressed first, and then a deeper exploration of underlying self and relational causes are explored for the purpose of acquiring deeper change.

Many psychologists and psychotherapists will combine a variety of strategies to help you achieve your treatment goals. For example, at CFIR, our psychologists, psychotherapists and counsellors may use a variety of cognitive-behavioural, dialectical-behavioral, or mindfulness-based strategies to help you diminish your emotional distress and symptoms, and then turn to various experiential or psychodynamic approaches to support you to become more aware of your self and your self in relationship with others for the purpose of creating change at a more profound and deeper level.

It is important to find a therapist that can respond to your needs and concerns by offering a variety of treatment approaches in both a short and longer-term format. CFIR mental health professionals are skilled in a variety of evidence-based treatment models and in short and long-term treatment. They are able to help you reduce your immediate distress and diminish your symptoms, as well as help you to understand and change deeper self or relational issues underlying your difficulties.

3. Does your therapist provide you with a comprehensive assessment of your condition (i.e., interview and questionnaires)?

Assessment is important to understand the nature of your difficulties and can help guide treatment and inform the direction of your recovery process. Similar to a medical doctor, who might use interviews, and ask that you complete a variety of tests (e.g., blood pressure, blood and urine tests, ultrasounds and other technologies) to understand the nature of your health issues, psychologists also conduct extensive interviews and administer questionnaires to help with their understanding of your difficulties. There are numerous factors that can contribute to your current issues. A combination of clinical interview and scientific, evidence-based measures will help your mental health practitioner understand the unique circumstances underlying your present concern.

A clinical interview and questionnaires can also save numerous dollars, hours and treatment sessions as a lot of information is ascertained all at once and used to identify contributing factors to your distress and concerns early on in treatment— as opposed to these factors being discovered over a lengthy period of time, or not discussed at all. Psychometrically-sound (i.e., reliable and valid) questionnaires can save a lot of in-session time by gathering important information about factors underlying your condition in a timely manner.

A thorough assessment can also provide important information about what to expect in terms of the duration of your treatment. At CFIR, our comprehensive assessment will help us to identify contributing factors underlying your concerns, and based on this assessment establish realistic timelines for your recovery from your condition.

4. Is your mental health practitioner well-trained? Is he or she either a provincially registered care provider or supervised by a registered clinical psychologist?

It is important that you seek treatment from a practitioner who has been well-trained and a member of a professional college in Ontario (e.g., College of Psychologists, College of Psychotherapists, College of Social Workers). Registration with a College denotes that your practitioner has completed education and training that has met the standards of practice for the profession.

Registered psychologists have the most training in evidence-based psychological treatments. Our registered psychologists supervise psychotherapists and social workers in the application of evidence-based treatments in their practice with their clients.

5. Have you been able to speak to or meet your therapist prior to starting your therapy to ensure your therapist will be a good fit for you?

Your relationship with your therapist is the most important aspect of your treatment and recovery from your symptoms and distress! Research studies suggest that the single largest factor in whether a client changes during a course of therapy is the nature of his or her relationship with a therapist—whereas the treatment itself accounts for a less amount of your change. It’s important, therefore, to make sure you are comfortable with your therapist and how he or she will work with you to address your concerns.

Making sure that your therapist is a good fit for you is very important to us! Associates at CFIR offer you a FREE 30-minute consultation as a way for you to find out whether he or she will be a good fit for you! Meeting your therapist in person will give you a sense of whether you feel comfortable with him or her or his or her office and physical surroundings. It will also be an opportunity for you to learn more about how your therapist will work with you to address your issue. It’s an important time to ask whether he or she is flexible in providing different treatment options. There’s nothing more frustrating, and costly, for you and your loved ones than to start with one therapist, spend numerous sessions working in one treatment approach, only to find it’s not working or fitting well with you. If your therapist primarily works in one treatment modality (e.g., only CBT, or EFT, or Psychodynamic), it’s important to know whether he or she will be able to switch treatment direction if therapy is not working for you.

At the beginning, and at minimum, you’ll want to make sure that your therapist listens to your concerns, will involve you in setting your treatment goals, and has a clear sense of how he or she will work with you. It’s also important that he or she identify which treatment approach they might use to help you achieve your goals, and whether they are flexible to offer different treatment options.

It’s important to ask whether or not your therapist can provide different types of treatment. If your treatment is not working for you, it is important that your clinician can provide you with other options or refer you to someone else who might be able to meet your needs for a different type of treatment. Clinicians at CFIR are skilled in employing different treatment models and often integrate different treatment approaches to offer you the best treatment possible.

At CFIR, clinicians will provide a confidential, compassionate and caring environment to help you to explore and address the difficult thoughts, emotional reactions and behaviours that have been of greatest concern to you or your loved ones. We work collaboratively with you to identify your treatment goals and offer you many different types of treatment options to ensure that you get the help that you need. We are flexible and can change our treatment approach with you, if you find that significant progress has not been experienced using one approach.

6. Is you practitioner well-informed about the expected number of sessions required for treatment of your concern or condition? Does he or she have a clear definition of what constitutes change or ‘recovery’ of your condition? Is your practitioner promising you a quick, short-term treatment for your condition?

It’s important that you receive sufficient treatment to recover from your mental health concern! Your therapist should have some sense of the treatment dosage (i.e., number of sessions required) to reduce your symptoms or to recover from your mental health issue. Typically, 50% of clients feel better after about 7-8 sessions, and 75% report marked improvement after 20 sessions. There is, however, a significant body of research that points to the expected duration of treatment for a wide range of psychological issues (i.e., number of sessions required for symptom reduction or recovery from your condition). It’s important that your treatment provider know the research so he or she can give you some sense of what you might expect in terms of your treatment duration. This knowledge is important as both you and your therapist will be able to assess whether treatment is working for you in the expected time frame (i.e., creating significant changes in your life), and allow you to adequately plan for the cost of your therapy.

There are no quick, short-term treatments when it comes to creating meaningful and significant change. Only on rare occasions will 1 or 2 sessions suffice—usually when services are sought to acquire information or education on a condition or topic. Diminishing symptoms and recovery from your condition will, however, require more sessions and commitment to change than one or two sessions. Typically, short-term treatment requires between 8-20 sessions to ensure significant symptom reduction and recovery for most conditions. However, some conditions require upwards of 12-14 months of consistent treatment for recovery.

7. Is your therapist covered by your workplace insurance, and can you afford the number of required sessions to help you by either using your insurance coverage or paying ‘out of pocket’?

Not all mental health care practitioners are covered by workplace insurance programs. Clients who don’t review their workplace insurance prior to receiving psychological services can find themselves very disappointed, and out of a lot of money, when they find out that they are not covered for their sessions. It’s important to find out how much coverage you have, and to figure out how much ‘out of pocket’ money you’ll need to be able to attend sessions consistently and until significant change has been realized. It’s important to learn at the outset about how many sessions you’ll be able to afford with your insurance coverage and ability to pay ‘out of pocket’.

Registered psychologists tend to be covered by most workplace insurance programs. However, if you are seeing a psychotherapist or social worker, you’ll want to verify whether their services are covered under your program. At CFIR, psychotherapists and social workers are supervised by a registered clinical psychologist, and receipts are issued under the supervising psychologist. Some insurance companies will accept these circumstances, while others will not. It’s up to you to verify with your insurer whether your insurer will cover your sessions.

Since most individuals will require more sessions than their insurance covers, it’s important for you to evaluate whether you can afford to pay for sessions ‘out of pocket’ once your insurance has run out. It’s important to have these discussions with your therapist to ensure that your treatment is not disrupted by lack of financial resources. Based on your insurance, and ability to ‘pay out of pocket’, your therapist may determine given your presenting concerns, that other treatment options may be better for you (i.e., workshops or group therapy, or seeing a psychotherapist or joining our Reduced Cost Services program). In the event that you find yourself out of insurance dollars, and your ability to pay ‘out of pocket’ reduced, you may want to alter the number of sessions you attend per month, or take a break from therapy until which point your workplace insurance kicks in again.

At CFIR, we offer you different options to ensure accessibility and affordability of services. If you have run out of insurance and are having difficulties paying for services ‘out of pocket’, our counsellors, who are supervised by our psychologists, can be seen for a fraction of the cost of seeing a psychologist. Referral to our counsellors is seamless and ensures continuity of your treatment with minimal disruptions.

8. What is your therapist’s fee? Does he or she offer a wide range of fee options (i.e., sliding scales) or services in different formats (i.e., individual, couple, family, group therapy, workshops) to ensure accessibility and affordability of psychological services?

It’s important that your therapist fees be known to you and agreed to you prior to therapy commencing. Also, depending on your insurance coverage and ability to pay ‘out of pocket’, you might also want to ask about whether your therapist has variable fee options (i.e., able to offer a lower fee to ensure accessibility and affordability).

At CFIR, various mental health practitioners offer their services and at varying fee ranges depending on their education and training experience. We also offer different treatment options in different formats (i.e., individual therapy sessions, workshops or group therapy). Our psychologists’ fees range from $180-$220/session, which is below the Ontario Psychological Associations recommended fee of $225.00/session. Our psychotherapists’ fees range from $100-$155/session. Our counsellors’ fees range from $90-$110/session. We also offer weekend workshops ($33.50/hour) or group therapy sessions for $62.50/1.5 hour session.

9. Does your therapist offer short, medium and long-term treatment options?

Some issues can be addressed in fewer sessions than others. It’s important to figure out whether your concerns can be addressed in a shorter versus longer-term treatment frame. A therapist who can provide both short-term and long-term treatment options offers you flexibility to address your presenting problem or any other issues that emerge during the course of your therapy. According to research, some conditions require a lengthier treatment time.

It’s important that your therapist conduct a proper assessment and is aware of the research about treatment duration for your condition. With a proper assessment, your therapist should be able to indicate whether treatment should be short, medium or long-term. At CFIR, Associates are flexible in being able to treat a wide range of conditions in a short, medium or long-term format. We will be able to address symptoms in a short or medium-term format, but may suggest a long-term format based on your presenting concerns and our assessment. Either way, we can accommodate to your wishes as well. Even if a recommendation for long-term therapy is made, short-term therapy options can be offered if this is preferred by the client (i.e., focusing treatment on symptom reduction, problem-solving and crisis management, and skills building).