What to Expect in a Counseling Relationship

by

American Mental Health Counselors Association

Perhaps you have considered the possibility of consulting with a counselor for help with a particular problem. You may even have had experiences with another mental health professional in the past. While there are many variations in counselors' personalities, areas of expertise, and therapy approaches, there are some basic guidelines which can help you evaluate a particular person to decide if she/he is likely to be a reliable professional.

Referral Source. Is the person who referred you to this counselor a competent professional? Do you trust this person's judgement in psychotherapeutic areas? You may be tempted to follow the recommendation of a friend or relative, which may lead you to a good professional. Remember, however, that your friend may lack the expertise to judge a professional's qualifications, and if she/he is currently a client of that counselor, you may not be able to develop a needed sense of privacy, trust, and exclusivity for an optimal relationship. Is the counselor licensed by the state and/or a member of one or more professional organizations?Boundaries for Therapy. Is the therapy relationship with this counselor the only relationship you have with him/her? There is a potential problem of a dual relationship with someone who is also your teacher, minister, spouse of a co-worker or friend, or parent of your child's friend.When, Where, and How Much? Does the counselor return your call promptly? Can you get an appointment within a week, or sooner in an emergency? Does the counselor you contact have a professional office space, with privacy? Is there a clear and reasonable policy in regard to fee and insurance coverage?Privacy. Is your therapy strictly confidential? Do you know the limits of that confidentiality, such as situations involving abuse, harm to yourself or another, or treatment with a minor or a spouse? If you're in a group, is there a confidentiality policy you trust? Do you feel safe? Can you talk about anything troubling you and feel respected?

Getting Started. Does your counselor respect your time; is she/he on time for sessions? (Emergencies do happen but shouldn't be frequent.) Sessions should start and end on time even if you feel you're just getting started. After one or two sessions, can you and your counselor agree on what you will be working on and what your short and long-term goals of therapy will be?

Respect. Does the counselor respect your physical boundaries and refrain from uncomfortable or suggestive behavior, both physical and verbal? Does the counselor initiate or seem to want physical contact with you to meet his/her own needs? The focus of the sessions should be on your issues without inappropriate detours into the counselor's interests or current life events.Does your counselor identify and interpret your behavior, symptoms, and concerns in ways you feel respectful and helpful to you, or do you feel "labeled," "sick," "crazy," or just crummy about how your counselor seems to see you?If you have questions about therapy or a particular technique, can you ask without your counselor responding defensively or turning the tables to make it seem as if you're the problem?

Unfortunately, too often clients are uninformed consumers, and recently, more reports of bad therapy are surfacing. Ultimately, the only check you have on a particular counselor is your own expertise and intuition. Ann Landers once advised a reader, "If your relationship with your therapist feels icky, it probably is." While a good relationship takes time for trust to develop and for change to happen, if you feel unsafe, disrespected, or exploited in any way, you should take action: question your counselor, ask for consultation, and /or leave therapy.

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