Cap Psych Pod Episode 1: Starting Your Therapy Journey

Today we’re joined by Brenda Weaver, our Practice Manager. Brenda has been with the clinic since 2015 and manages everything from intakes and payment to keeping the office running day to day. Today we’ll be covering some FAQs pertaining to taking the first steps in finding a therapist, information you may need to research before reaching out to a clinic of a therapist and how to go about getting that first appointment booked.
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How do you suggest someone begins their journey to finding a therapist?
B: The first step is probably to talk to your GP; let them know your concerns, let them know what’s going on with you. They may have a referral source for you. If they don’t, just start doing your own research on therapists in your area, ask friends and family if they have any recommendations. A good resource that I sometimes recommend is the Psychology Today website- there you can filter by location [and] specialty in order to find a therapist that might be able to help. Some will note if they’re accepting new clients or not.

K: Oh, that’s good- that’s helpful so you don’t just randomly reach out to a bunch of people and if they’re not taking any new people, it’s not just wasting your time.

B: Exactly. It’s hard enough to take the first step without being turned down 100 times… maybe not 100, but you know what I mean.

So, when you do go about reach out to someone, what is some information should you include in your initial message for them?
B: So, we need to know if you’re looking for an assessment or if you’re looking for therapy- we can touch on that a little bit more later. We need to know if you’re looking for yourself or if it’s for a family member; if it’s for a child, we need to know the custody arrangements- if parents are together or not. If they are together, great! If not, then we need to know who has decision making [authority]. It’s a good idea to come into this open book so everybody is on the same page. We need to know if you’re looking for a certain type of therapist: Registered Psychotherapist, Psychologist, Social Workers- there are so many different kinds. It’s important to let us know if you are looking for a specific modality- CBT, DBT, something like that. And of course, we want to know the reasons that you want therapy. Give us as much information as possible so we can find the best therapist to suit your needs. We have to speak to the therapist to be sure that they can work with you on your concerns, but everything is confidential to the office, so you don’t have to worry about that at all.

K: Right, that’s good. So, just about the different modalities, typically, do you think that a GP, if they’re referring you to a therapist, would specify “I think EMDR would be helpful” or “CBT would be helpful” or anything like that?

B: Sometimes they do, but sometimes they just say “you need talk therapy” or whatever, which could be a bunch of different ones. Kind of depends.

K: And I guess you could just ask your therapist too, once you are set up with someone.
B: Exactly.

Touching on the therapy and assessment aspect, what’s the difference between therapy (or treatment) and an assessment?
B: Okay, so a lot of people think that you need to have an assessment before you can have therapy- that’s not the case. The definition of therapy is a treatment intended to relieve or to heal a disorder. It’s generally an hour-long session where you speak with your therapist about your mental health concerns or issues in your life and they can help you through. An assessment is an evaluation using testing measures to determine a diagnosis and to give recommendations. Assessments have to be done with a Psychologist and a Psychometrist (in our office anyway) to do the testing for them. Once the testing is completed, scoring and data interpretation is done, a draft report is written, and we set a feedback appointment at which time you’ll get a diagnosis and recommendations. Often times, the recommendation is to seek out therapy, but it all depends on what is found in the scoring and data interpretation.

K: Right, and I’m sure a lot of people don’t know about the fees too, so that’s probably something that they need to check in on before they go ahead and book.

B: Fees are definitely something that you need to discuss with your therapist or admin before you go in to do an assessment.

K: Never good to have surprises like that.

B: No, definitely not, and I mean they can be pricey so you definitely wan to make sure that if you have coverage, that the coverage will cover specifically the assessment as well.

Can you explain the difference between a Registered Psychotherapist, Registered Psychotherapist Qualifying, Registered Social Worker, Psychologist and Psychiatrist?
B: Well, there’s a lot of different types out there. Psychotherapy is kind of like an umbrella term for anyone who does therapy. A Registered Psychotherapist belongs to their own college, they can work with individuals and/or families depending on their training.

Qualifying Psychotherapists are in the process of completing their clinical hours, and still have to write their final exam to become *autonomous. They are able to provide counselling services while under supervision.

Social Workers often times have a master’s or a bachelor’s degree. They provide support to people with mental health issues as well. Depression, anxiety and PTSD are some of the issues that RSWs can offer support with. They also belong to their own college, and they can work with different age groups depending on their training. At our office, everybody is under the supervision of a psychologist.

Psychologists have a doctoral degree; they focus on emotional and behavioural aspects of mental illness using different techniques of psychotherapy. They can treat, as well as complete testing to see if a psychological diagnosis is present. They are governed by the College of Psychologists.

Psychiatrists also have a doctoral degree, and they have the ability to diagnose patients through testing. Psychiatrists are also medical doctors, so they have the ability to prescribe medication to their patients. Essentially, if you need medication for depression, for example, you’d need to see a psychiatrist, however you could see a psychologist or a psychotherapist for treatment and they can refer you to a doctor for medication, or back to your GP for medication if needed.

How do you suggest someone finds a therapist whose background aligns with their specific concerns?
B: Well, connecting with your therapist is really important- I would say to read the therapists’ bio from all the clinics around you. Be sure to read them and choose a few possible ones, then you can kind of narrow it down. Also, in an office where there’s an admin, when you give your information, they can often match you up with the best therapist to fit your needs.

K: Okay, that might kind of just speed things up a little bit if there is [an admin].

B: It does, yeah. And once you’re talking to somebody you can get more of a feel as to what they need, and kind of match up personalities too with the therapist which is kind of nice.

In that regard, what would happen if a client isn’t connecting with their therapist? Would it hurt the therapist’s feelings if they try to find someone new?
B: That’s a really good question. Your therapist is going to have your best interest at heart. If there isn’t a good connection for you, there probably isn’t a good one for them either so they would definitely want you to move on to someone else that would be able to help you. Just be honest with yourself if things aren’t working out and start looking for someone new. It isn’t beneficial to anyone if you continue seeing a therapist and you aren’t getting anything from the appointments. It’s best to just move on if the services aren’t quite for you.

K: Right, and if you do have coverage, it’s just kind of a waste of your coverage if you aren’t actually getting anything out of it.

B: It absolutely is, yeah, for sure.

What would happen if you share custody of a child who needs to meet with someone? What’s that process like?
B: So, this can be tricky sometimes. In cases of shared custody, it’s preferred that both parents are on board for therapy for the child. Often in the case of younger children and adolescents, the therapist will meet with parents to get some background and to discuss possible treatment. Having both opinions is really helpful. If the parents prefer not to be together for the session, a split session or two totally separate sessions can be arranged. Fees would be charged for both sessions though.

K: So, it’s best just to be honest if you don’t get along with an ex and you don’t think it’s going to be beneficial, then just do it on your own.

B: Absolutely. The majority of people try to put the best interest of the child first, but sometimes there’s so many hurt feelings that parents just cannot be in the same room or on the same computer screen together, and we understand that. We’ll do our best to make everybody comfortable.

K: And then it would be in the kids’ best interest too, if they know that and they can just do things separately.

B: Absolutely. The other thing that I should mention too is quite often adolescents aren’t on board with therapy, so make sure if you’re seeking out a therapist for your child/ teen that they really are on board. I usually tell people to have them read the bio with you to make sure that they think that they can connect with the therapist.

K: Right, they need to be open to actually talking to someone because if you just put a kid in a room, they’re not going to just start talking to someone with no desire to.
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B: For sure. [If they] go in cold and “I don’t really want to talk to you” it’s hard for the therapist as well- it’s like pulling teeth to get them to talk. Obviously, they’re not in a place where they’re ready to talk.

Can you explain the consent process for if a child comes to see a therapist?
B: So, legally a child 12 years old and above can sign for consent for therapy. What we do in our office is we have both the child and a parent sign consent in order to rule out any issues when it comes to confidentiality and to billing; I mean, let’s face it, these sessions cost money- you need to know the prices. The best thing to do is to ask your clinic or your therapist about procedures.

Also with billing, can you explain the insurance process? How to tell if you’re covered for a specific therapist, etc?
B: The best thing to do, obviously if you have a handbook, look it up. If not, you can call your extended health benefit company to find out if they will cover [and] what type of therapist they will cover. We usually send out the wording, so it’s whichever type of therapist “Under Direct Supervision of Dr. Garcia” in our case. Some will cover Registered Social Workers, some won’t. Some will cover Psychotherapists, some won’t. It’s definitely best to have a little conversation with them first just to make sure they will cover.

What is the difference between direct billing and submitting a claim to your insurance company?
B: Direct billing is when the office bills the insurance company directly. Not all offices do this- we don’t, so basically, you pay us after the session and then you submit the claim yourself. Quite often you can do it online- we’ll send you a receipt and you can just upload it directly to your insurance portal.

You had mentioned that the therapists in our office are supervised by Dr. Garcia- can you explain what that means?
So, the supervision is for insurance purposes, so extended health benefits cover [sessions]. The other reason is so the therapists have someone to discuss a case with; find additional ideas, additional resources to help their client. It’s always kind of nice to have somebody that you can bounce some ideas off and to get some advice in helping with their treatment. It’s also possible that they need a signature of the supervising psychologist for a form or a letter; quite often it would have to be from a doctor, so the psychologist, then, would be the one to do as well as the treating therapist. So, the supervisor needs to know at least parts of the case before signing.

Thanks so much to Brenda Weaver for answering some of out FAQs about starting a therapy journey. If anyone has additional questions about seeing a therapist at our office specifically, they can give the office a call or they can submit a form through our website.