Working with a Psychologist in Nova Scotia - FAQsAre you considering starting therapy for the first time?
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Frequently Asked Questions About Therapy
This FAQ is for people who are considering starting counselling or therapy for the first time.
Although it generally focuses on those looking for counselling in Nova Scotia or those trying to make sense of reviews of psychologists in Halifax, much of the information is relevant for anyone thinking about working with a psychologist or therapist, regardless of where you live.
For those who are considering booking an appointment with me, I will also provide additional information that may be especially helpful to you.
Why do people decide to start therapy?
For most people, choosing to start therapy or counselling can be a difficult decision. Many are often reluctant to ask for professional help for psychological, interpersonal, relational, or emotional issues.
When faced with a difficult situation or problem, it is understandable that your first reaction is to try to solve it yourself and not immediately enlist the help of a mental health professional (an approach I generally agree with).
If you are unable to find an acceptable solution to your difficulties, the next step may be to consult with family members or friends, search for help online, etc.
However, sometimes personal challenges and mental health issues are too great, the problems are too numerous, too long-standing, and seem too overwhelming to handle by yourself.
In these situations, there is a very good chance that you can benefit from more targeted, regular, scientifically-supported professional mental health treatment, such as working with a psychologist. Doing so can both accelerate your progress / personal growth...and also create more durable long-lasting changes in your life.
Do I need a referral to see a psychologist in Nova Scotia?
No, you do not need a referral to see a private psychologist in Nova Scotia. You can book an appointment with a Nova Scotia psychologist in private practice without a referral. In this regard, it is very similar to seeing a dentist - you can self-refer by directly contacting the therapist or clinic you wish to work with.
Are psychologists in Nova Scotia covered by insurance / provincial health care?
No, the fees of private practice psychologists in Nova Scotia (or anywhere in Canada) are not covered by general provincial insurance (in Nova Scotia, this is your MSI health care card).
However, many workplaces, private insurance providers (e.g., Blue Cross), and universities have programs that cover therapy and other psychological fees and I can direct bill most policies.
For example, if you have dental coverage or physiotherapy coverage, you likely have insurance to see a psychologist as well. Also, fees for psychological services are tax deductible in Canada so save your receipts for any counselling or assessment services.
My take:
It is unfortunate that the fees of Nova Scotia psychologists are not covered by the general health care plan, but this is the reality.
As far as private or company insurance policies go, if you have insurance for mental health or counselling services, registered psychologists will always be eligible.
The term "Psychologist" is a legally protected name and those using it must be registered with the Nova Scotia Board of Examiners in Psychology to ensure that they are qualified to offer service to the public. In contrast, the generic term "therapist" can be used by anyone and requires no specific standards for education, training, practice, or competency – which is why private insurance will not typically cover services offered by these individuals.
Note: Insurance providers may offer coverage for "Registered Counselling Therapists" (RCTs) in Nova Scotia.
If I see a psychologist does this mean that I am “crazy”?
No – not at all. Millions of high functioning people use counselling to address important issues or concerns. Seeking therapy is healthy and demonstrates that you wish to take control of and responsibility for your life – it does not mean that you are weak or “crazy”.
If I see a psychologist, will my problems be solved?
Although research has consistently found that therapy is helpful for dealing with psychological, emotional, and personal problems, seeking counselling does not guarantee that all your problems will be “solved”.
My take:
I can promise that I will try my best to help you address the problems you are struggling with. However, at times, other types of interventions or other professionals may be better able to assist you. In these cases, I would encourage you to seek these services in addition to or instead of therapy.
Sometimes a team approach to mental health is best, and at other times working with a psychologist may not be the most appropriate option.
Is what I discuss confidential?
Yes.
When you see a psychologist in Nova Scotia (or anywhere in Canada), the content of your session is not released to any person or organization without your permission. Not even the fact that you are a client is confirmed if someone asks.
However, there are several exceptions to confidentiality when working with a psychologist.
For example, if a child is in need of protection or if someone is in immediate physical danger, psychologists are legally required to take action to prevent this from happening - even if it requires breaking confidentiality.
In rare cases, a psychologist may have to disclose confidential information if he / she is subpoenaed to testify in court.
My take:
Confidentially is absolutely essential for effective therapy.
Without confidentiality there is no trust.
Without trust there is no therapeutic alliance.
Without an alliance there is no progress.
What is the difference between a psychologist and a psychiatrist?
These two terms and professions are often confused, but they really are quite different in practice.
A psychiatrist has degree (MD) from medical school and can prescribe medication for psychiatric conditions (e.g., anti-depressants, anti-psychotics, etc.). A small percentage of psychiatrists may offer psychotherapy to their patients. Appointments are often much shorter than an appointment with a psychologist. In Nova Scotia, you must have a referral from your family doctor to book an appointment with a psychiatrist.
A psychologist earns his or her degree from a graduate school. For Nova Scotia psychologists, both Masters level (M.A., M.Sc.) and Doctorate level (Ph.D.) therapists can use the title "Psychologist" if they have completed the necessary education, training, work experience, and meet registration requirements (although only those with PhDs. can use the term "doctor"). A referral is not necessary to book an appointment with a psychologist in Nova Scotia. Appointments with a psychologist are typically more frequent (every few weeks) than those with a psychiatrist (every few months).
My take:
Psychologists generally receive more training in therapy and assessment (such as for learning disabilities) than psychiatrists do and as such, specialize in these areas. It is not uncommon for someone to meet with a psychiatrist or family doctor for occasional medication needs and with a psychologist for ongoing therapy or counselling.
Depending on the presenting problem, the right combination of medication plus therapy can produce the best possible outcomes. I am not “anti-medication” as it can be very helpful when used appropriately.
However, I also respect the fact that many people do not wish to use medication, would like to stop using it, or would prefer to address their difficulties through counselling rather than drugs.
How long are individual therapy sessions?
Therapy sessions with psychologists are typically 50 minutes long. The remaining 10 minutes of the hour are used for note taking and administrative work related to your client file.
My take:
I try to keep my appointments to 50 minutes, but sometimes this is not possible and I will break this rule if it is necessary to extend the session. And no, I do not charge extra if I decide to go overtime – this wouldn’t be very ethical would it?
How long does therapy last?
In the past, it would not be unusual for someone starting classic psychoanalysis to attend three sessions per week for months or even years.
Today, this approach is quite uncommon and most psychologists in Nova Scotia follow therapy models that are significantly shorter and are specifically designed to produce positive changes much faster.
While the length of time one may invest in therapy will of course depend on their presenting concerns and goals, the duration of therapy today is typically measured in weeks or months, not years.
If I start therapy should I start or stop taking medication?
Psychologists cannot advise clients on the use of medications. If you are considering starting, stopping, or changing your medication, please consult your physician.
Do I need to discuss my dreams, look at ink blots, or lie down on a sofa?
No.
These are just a few (of many) psychologist stereotypes and are not requirements for therapy.
My take:
Dreams:
If you believe that it is important to talk about a particular dream, there is no harm in doing so and at times this can actually be quite helpful. However, you will never be forced to discuss anything you do not wish to share.
Ink Blots:
Interesting, but not something I use in my own practice.
Sofa
Completely your call. Whatever makes you comfortable!
I have heard the term "blank wall" in reference to psychologists - what does this mean?
It was once believed that psychologists should remain 100% neutral at all times and avoid direct questions from clients (i.e., the blank wall). The theory is that personal information or opinions added by the therapist can sabotage client progress by adding unnecessary elements into the relationship.
My take:
While there is some merit to this approach at times (after all, therapy is for the client, not the psychologist), I believe that clients deserve honest feedback and answers to questions. If I am asked a direct question, I will always provide a direct answer, and will not avoid it with a response such as “Why is this important to you?”
To stay with the visual metaphor, I suppose I actually prefer to have something written on my wall :)
Do you offer evening and weekend appointments?
Yes, a limited number of evening and weekend appointments are available.
Please see "Appointments" for more information.
Additional questions?
For more information, see “Halifax Psychologists and How to Choose One” or feel free to contact me if you have any questions that are not covered here.
