How can I tell if I really need counselling?
Your symptoms or difficulties don’t have to be of a particular severity for you to benefit from reaching out. Counselling sessions can also help you to simply gain more clarity on an issue, change some difficult behaviors or thought patterns, or even embark on a journey of creative self-discovery. You may seek counselling as a result of recent life changes, or because of a crisis, or you may be encouraged to seek counselling by family members, friends or colleagues.
It is important to realise that, though some people have distinct issues i.e symptoms — such as panic attacks or insomnia— many clients simply feel a lack of meaning and seek a sense of purpose in their lives. Also, it’s good to think of symptoms as signalling that an underlying problem exists and needs to be addressed.
What happens in a counselling session?
What happens in a session very much depends on the approach of the counsellor and the style of therapy. In other words, there isn’t really a typical counselling session. Your counsellor will be trained in listening and in asking questions to make you reflect around certain themes, and of course in providing a safe environment in which to explore your issues. With most types of therapy you are free to discuss what you wish, from everyday events, dilemmas, feelings, and thoughts, to regrets, aspirations, memories and dreams.
Often, shorter-term forms of therapy, like cognitive behavioural therapy (CBT) and solution-focused therapy, can be more structured and provide practical exercises to help you understand your thoughts and actions. Psychodynamic therapies and psychoanalysis explore how childhood experiences and trauma affect patterns of behaviors today. By a process that often also includes working with the unconscious (such as dreams, fantasy, play) a person can help to gain access to their feeling life as well as finding an ethical compass in life. This process is often longer and can involve a year of work or more.
What issues can counselling help with?
Clients come with a wide range of problems, including:
- abuse (including physical, verbal, and sexual abuse)
- addiction and substance misuse
- anxiety (generalised anxiety problems, panic attacks, agoraphobia, social anxiety, claustrophobia)
- depression (including suicidal thoughts, low mood, social withdrawal)
- eating problems (including bulimia, binge eating, negative body image)
- low self-esteem and lack of confidence
- obsessive-compulsive disorder
- phobias and fears
- relationship issues (breakups, divorce, affairs, loneliness, life adjustments, marital problems, arguments, jealousy, wedding and premarital issues)
- sexual problems (impotence, internet/pornography/sex addiction, loss of desire, infertility)
- trauma (including post-traumatic stress disorder from accidents, rape and other attacks/incidents)
- workplace issues (stress, work-life imbalances)
What kinds of people seek counselling?
Counselling can assist anyone really. You don’t need to have a specific problem or suffer from a certain type of symptoms. It’s also very common to feel a general lack of purpose or have an overall existential sense of something missing from your life.
How do I start with a counsellor/therapist?
To book a consultation you can contact the counsellor(s) or therapist(s) of your choice directly through their profiles. Use the filters to hone in on the type of therapist that fits your needs.
If you are not sure who to choose, feel free to email us to email@example.com
In the event that the therapist you meet with feels you would benefit from a different type of counselling or psychotherapy approach, they will normally recommend another specialist for you to consider.
How do I know which counselling approach is most suited to me?
There are many kinds of established therapeutic approaches nowadays, psychodynamic psychotherapy, Gestalt therapy, and cognitive behavioural therapy (CBT). You can read more about each type in this blog post.
Don't worry if you are simply not sure what particular approach would be suited to you. Your first appointment will be an assessment where you can discuss your issues and goals for therapy. Many therapists nowadays are also what is known as 'integrative' or ‘eclectic’, meaning they are trained in several types of therapy they can mix to best match your issues.
How do I know which therapist is best for me?
You can learn about each therapist and their approach by reading the individual profiles under 'Therapists'. You can also write our admin team (firstname.lastname@example.org) who can provide you with further guidance.
For your therapy to be effective, it's important you work with a counsellor or psychotherapist you feel you can eventually trust. At your first meeting both you and the therapist will have an opportunity to honestly decide if you will benefit from working together. And if after several sessions you simply don't feel the therapist is a good match, you are free to stop the process and try with a new therapist.
What if I want to try more than one kind of therapy?
Many therapists are what is known as ‘integrative’ or 'eclectic’ in their approach, meaning they are trained in and combine a variety of psychotherapeutic approaches to best help their clients. If this is of interest, look at individual profiles under 'Therapists' to find one that offers the several types of therapy you are interested in, or write us and we can advise you further.
You can also book a trial session with two or more therapists to figure out what type of counsellor and therapy matches your needs and personality.
How long should I expect to have to continue counselling?
The length of your treatment will very much depend on your unique circumstances and needs and the type of therapy you choose.
Cognitive behavioural therapy is designed to be short-term and will often last six to 20 sessions. Psychodynamic, psychoanalytic, and existential therapies tend to be longer term, and many last for many months or even years. Research shows that psychodynamic therapies longer than 18 months are very effective for symptoms such as depression.
Keep in mind that once you start sessions, new issues and angles can arise that you then want to explore. It is of course possible to also see improvement faster than you expected.
Will my counselling sessions be confidential?
Yes, counselling sessions are confidential. The exception would be if you were to pose a danger to yourself or others, in which case the relevant parties would be notified.
Is my counsellor qualified?
The therapists and counsellors who are listed on It’s Complicated have all provided evidence of a qualification (whether a university diploma or certificate from a relevant organisation). If you have questions about the counsellor's right to practise in your country, please ask the counsellor directly or contact your local regulatory body.
What happens if I don't think the therapist is a good match for me?
If you do not feel the therapist is a good match, you are free to end the process and book a trial session with a new therapist of your choice. It is perfectly normal to not find the best match with the first therapist you try.
I only want one session, will the therapist be able to help?
Generally your first session will be used as an assessment and consultation, rather than for treatment. This allows you to identify your issues as you see them, and for your therapist to start to gain an idea of what your needs are. So unfortunately, having just one session is unlikely to have any lasting benefit for you.
How frequently do I need to attend sessions?
The standard format is weekly sessions, which will help you make gradual and steady progress. In some cases, a therapist will agree to a less regular frequency, such as bi-weekly, or even once every three weeks (for instance in the case of couple’s therapy). Some therapists also agree to two or more sessions per week, if you both deem it beneficial and they have the availability.
Can I speak to a counsellor before my appointment?
This depends on the therapist and you can look specifically for a therapist who will do a phone consultation before you meet. But often, since therapists are in sessions with clients during most of the day, they simply can't make time to talk to every potential client. In this case, consultation appointment is the time to ask any questions you might have, find out about how your therapist will work with you, and discover if you feel a connection.
Remember that while many trial sessions proceed to a full course of treatment, you are under no obligation to continue.
Does my GP need to refer me for an appointment?
No. You are free to refer yourself to any of the therapists displayed on It’s Complicated. The only exception is if your insurers require you to have a GP referral in order to gain coverage for treatment.
What is the difference between a psychiatrist and a psychologist?
In basic terms, a psychiatrist is a registered doctor who can diagnose mental illness and prescribe medication. Psychologists and psychotherapists will offer talking therapy and would not typically provide diagnoses or medication (though they will have a good understanding of the diagnosis or even medication that might be applicable). Where necessary they will liaise with psychiatrists to support you further.
Can a counsellor prescribe medication if I need it?
Counsellors are not eligible to prescribe medication, but psychiatrists can assess you for a prescription, and this can complement your therapy work.
Will my counsellor be available for me in a crisis?
Your counsellor will be available to you at your scheduled appointment time only. In the case of an emergency you will need to seek other resources. Go to the nearest hospital, call 112, or contact one of the crisis centers e.g. in Berlin it's called Berliner Krisendienst.
Can I use my health insurance to pay for counselling sessions?
This depends on the nature of your insurance. Check with your provider to see if counselling sessions are covered, how many sessions can be included if so, and if there are any other requirements (e.g. the type of licensure the counsellor holds). With most private insurances, you will first have to pay, and then apply for a reimbursement.
Do I have to contact my insurance first, or book an appointment first?
If you are familiar with the terms of your policy and are aware that therapy is covered, you are welcome to make an appointment with a therapist. If you are uncertain of the terms of your policy, it is advisable to speak to your insurers before booking to ensure that therapy will be covered.
Why do some therapists accept insurance referrals while others do not?
Some insurers only accept counsellors with a certain type of license or they only cover certain types of therapy. This means therapists offering other types of counselling and psychotherapy are not eligible to register with them. While in-network therapists tend to be more affordable, looking for one can be a long and arduous process depending on your insurance type and where you live. In Germany, those who have public insurances, such as TK or AOK, can get their therapy covered in full, but then they have to find specifically a “psychological psychotherapist” (psychologischer Psychotherapeut) with a so-called Approbation and a Kassensitz. These therapists often have 3 to 6 month waiting list and you won’t have a lot of choice in regards to type of therapy (psychodynamic psychotherapy, psychoanalysis, and behavioural therapy are the only modalities that are paid for by the public health insurance in Germany).
That’s why seeing an out-of-network or private pay therapist can be a way to avoid many common insurance headaches and get started with your therapy faster. Other benefits of self-payment compared to getting therapy covered by health insurance is anonymity (no documentation of personal data and diagnoses are given to official administrations), less bureaucracy (in that you don’t have to struggle with a lot of paperwork and bureaucratic processes with the public health insurance provider), and of course completely free choice of not just the therapeutic method, but also the duration, location, language, etc.
What hours are therapists available?
This varies depending on the therapist you choose. If you need therapists that work at certain hours, for instance outside of normal working hours, you can filter after the specific times that you need, or send a message to your therapist of choice to ask about their working hours.
How does couples counselling usually work?
Again, it very much varies depending on the couples counsellor you find – in fact, you can find couples counselling within every kind of therapy. Oftentimes a session will be longer and cost more. Typically couples counselling is scheduled less frequently (every second week or every three weeks) but this is something you discuss and decide with the individual counsellor). To find a fitting couples counsellor, choose the category “couples counselling”.
Why do I have to pay for missed/cancelled therapy sessions?
In order to reserve a certain time slot just for you there will be a cancellation policy that applies. Your therapist will share this cancellation policy with you prior to your first appointment. Missed sessions outside of the agreed to terms will be charged at the full fee, unless otherwise agreed upon with your therapist.
How can I pay for a therapy session?
This depends on the therapist and has to be decided with the individual therapist you choose. Payments are either done before your session, after your session, or by bank transfer by the end of the month.
Why do the costs vary from therapist to therapist?
Each of the counsellors sets their own individual rates. Reasons why some therapists charge more than others can be based on their own principles, the extent of their experience and knowledge of working with clients, the types of therapy they offer, their own circumstances, etc.
Why are the fees so high?
Therapists set their own fees to reflect their years of experience, knowledge, and skill. Prices also encompass the cost of the locations for you to meet your therapist in.
Do you offer flexible pricing, such as discounts for students or those who are unemployed?
It’s good to find out how much you can afford to budget for therapy. Some therapists offer a sliding scale fee for unemployed and/or students, so be sure to talk to potential therapists about whether their fees are flexible and what the cost to you would be for each session.
Will any of my information be shared?
Therapists are committed to your privacy, so sharing your personal information is a rare occurrence.
There are two exceptions. The first is if your therapist was to become aware that you are an imminent danger to yourself or others, or that someone else is a danger to you. You would first be encouraged to seek necessary support, and if you were unable or unwilling to do so your therapist has a duty of care to seek this support on your behalf.
The second exception is if your therapist were to become aware that you intended to commit a major crime of any sort. In such a case they have a legal obligation to disclose such information to the relevant authorities.
Note that for the purposes of therapy, personal drug use or addictions are not considered to be criminal activities (unless they involve anyone underage). They are seen only as areas to be addressed in therapy.
My partner, friend, or family member really needs therapy. Can I refer someone for counselling?
You may be very concerned about someone's well-being and would like to see them have counselling. While it is best if the person in question reaches out for support themselves, we are able to take enquiries from you on behalf of someone else, but you should have their full consent.
What if I have a complaint?
Complaints about your therapist or the room your sessions are in should be raised with her or him directly. If you are not satisfied that your complaint has been addressed, then you should take this up with the counsellor's accredited body
What’s the difference between psychotherapy and counselling?
What if I want my therapy covered by the German public health insurance?
If I use a coupon code (for example, for 1 or 3 months) and I buy a yearly subscription, how does the discount work?
When does my yearly subscription start and end?
What are the cancellation terms if I cancel my monthly subscription?
What are the cancellation terms if I cancel my yearly subscription?
Can I be listed on It’s Complicated if I’m not a therapist, but another kind of practitioner (counsellor, psychologist, psychoanalyst, psychiatrist, coach, etc.)?
In Germany there are certain rules and policies regarding who can call themselves therapists and psychotherapists, which you can read about here, but as long as you can provide sufficient credentials to back up the professional title you use, you will be able to be listed in the directory.
No matter which city or country you are based, you are responsible for looking into which rules and legal terms apply to the use of professional titles.
We're here to simplify your search for the right kind of therapist or counsellor. If you're in an emergency situation, visit instead our resource section for appropriate help.
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