- If you do not feel comfortable with a counsellor by the third visit, get a new one. Feeling comfortable is different than liking. You may not like your counsellor, but you may still feel comfortable talking to them. On the flip side, if you come to like a counsellor too much (i.e. - start seeing them as a quasi-friend) this can have a negative effect on counselling as you may start to worry about their opinion of you. If you find a counsellor who you feel understands and respects you, but whom you do not see yourself wanting to be buds with, you have found the right person.
- There are some lines that therapy should never cross. Therapy should never become sexual in nature, meaning it should never involve any kind of physical involvement that can be construed as sexual. This does not mean you would never talk about sex or sexual feelings, it just means that you would never become involved with your counsellor in this manner.
- Another important line is the confidentiality line. This line can only be crossed when one of two situations occur: 1) when you threaten to harm another person(s) and the therapist has good reason to believe these threats are real, 2) when you threaten to harm yourself and the therapist has good reason to believe that these threats are real. The "good reason" usually has to be proven by behavior in past therapy session or from previous behavior in the world at large. It can't generally be a "gut feeling" on the part of a therapist.
- A psychologist can not discuss anything you say in therapy with your parents, your teachers, your relatives, a social worker, or any other third party without your consent (except in situations noted above). If you invite your parents into a therapy session, you must tell your counsellor if there are some things you still wish to keep confidential, as this is the same thing as giving consent. Saying "I want to talk to my parents about ___, but I am definitely not ready to tell them ___." should do the job. The fact that you are a minor does not mean that a counsellor is free to discuss your therapy with your parents or guardians.
- Psychologists can NOT prescribe medication. They can not even recommend over-the-counter and herbal products. Only psychiatrists can do this. Most psychologists have not been trained in medicine. A licensed psychologist who has been trained in medicine still can not prescribe medication unless they are also a licensed psychiatrist.
- Most therapy involves little more than talking. Depending on the type of therapy the counsellor you choose practices, this talking can be very structured, or very open. Many psychologists use tools and techniques to give them clues as to what you need to talk about. These include things like; drawing (art therapy), word associations, imaging, ink blot testing, aversion testing, diary/journal keeping, behaviour monitoring and/or modification, charting of events, relaxation techniques, regression therapy, standardized testing and even hypnosis. If any of these techniques makes you uncomfortable, say so right away.
- Some counsellors like to tape sessions so they can review exactly what is said, rather than relying on short-hand notes. They must always ask your consent before turning on the tape, and many will ask a second time once the tape is on so the consent is recorded. You can ask for the tape to be turned off at any time. You can consent to the taping of some sessions, but not of others. Consent must be given at the beginning of each session UNLESS you sign a waiver before hand. When signing the initial treatment papers, read them carefully to make sure that you are aware of this waiver (if there is one). If you refuse to sign the waiver, a counsellor may refuse to treat you, as the tapes are sometimes required by insurance companies for reasons of liability. The chances of you actually being turned away for this reason are quite slim, but you should be aware that it can happen. If it does, just get a new counsellor -- any counselling relationship that starts off with you feeling as though your concerns don't matter will not be successful anyway.
- Counsellors do not take your feelings personally -- so let them all out. Cry, scream, punch pillows (never people), sing, stare at the therapist... do whatever it takes to get out your feelings without doing damage to people, creatures or property. Do not worry what a counsellor "thinks of you". Do not feel the need to apply social niceties to your sessions. If you are so mad all you can do is swear, than swear. A counsellor may ask you why you need to use this type of language, but they will not tell you it is wrong. You go to therapy to let out the feelings that may be causing your depression. People assume depression is always about sadness; it isn't! Depression can be about: frustration, anger, resentment, helplessness, hopelessness, feeling rejected, feeling misunderstood, feeling alienated, self-loathing, lack of self confidence, lack of self control, and many other complex emotions. Depression is not just being sad, although sadness can be a factor, depression is about not feeling satisfied with your life and having that dissatisfaction cause you to give up "the fight". Sometimes dissatisfaction drives people to do better, in depression it causes people to want to give up.
- A counsellor should not make you feel like you are being judged. The nature of therapy may make you feel under a microscope, but you should not feel as if somebody is making morality calls about what you say or do. If you go to religious therapy, expect that faith to play a strong role, but do not let the counsellor make you feel bad about what you are saying. If a counsellor tells you that your feelings are wrong, get a new counsellor. Feelings are never the problem, how people act on their feelings are what causes problems. Having bad feelings, but being able to talk about them and let them out without acting on them, is what therapy is all about.
What to Expect from Depression Counselling
What a counsellor should and should not do for you.
by Jessica Stevenson
for About.com
If/when (and you should) you go to a counsellor remember the following things:
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