Information for people seeking services and counselling therapy for symptoms of psychological injury 

 

1. Who can provide me with a formal diagnosis of Post Traumatic Stress Disorder (PTSD)?

 

The people who are licensed to diagnose are psychiatrists and registered psychologists who have the designation APE behind their name. 
 

2. Do I need a formal diagnosis of PTSD to receive counselling therapy?

 

No, most people who suffer from symptoms related to one or more traumatic events will not meet the full diagnostic criteria of PTSD. That does not mean that they are not in need of counselling therapy. 
 

3. Who are the professionals who offer counselling therapy (psychotherapy) for people with symptoms of a psychological injury?

Many professionals are trained and qualified to provide professional psychotherapeutic services. These people are clinical counsellors, social workers, psychologists, and psychiatrists. Not all these people are trained and experienced in working with people with psychological injury. 

 

4. What is the difference between a psychiatrist, a psychologist, a clinical counsellor, and a social worker? 

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A psychiatrist is a medical doctor who did additional studies on a doctoral level in psychiatry. Psychiatrists are the only Mental Health specialists who can prescribe medication, and they are trained and licensed in providing a formal diagnosis. Not all psychiatrists do offer psychotherapy. 

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A registered psychologist is a person who has a background in psychology on a master’s or doctoral (Ph.D. or PsyD.) level. Psychologists work in a variety of different organizations and not all of them are specialized and trained in offering psychotherapy. Not all psychologists are licensed to diagnose mental health disorders. 

A clinical counsellor may have a background in psychology, counselling, or social work. Clinical counsellors are trained on diploma level, Bachelor’s level (BA), but many have a master’s degree (MA or M.Sc.) and there are also clinical counsellors with a Ph.D. (Doctor of Philosophy). Counsellors offer counselling therapy (psychotherapy). This is their main area of expertise. 

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Social workers either have a bachelor’s (BSW) or master’s (MSW) degree in social work and some social workers also have a doctoral degree (Ph.D.). Social workers, like psychologists, can be employed in many different settings and may have different roles. One of them can be offering counselling therapy. 
 

5. What is the difference between counselling and (psycho)therapy?

 

There is none. Some mental health professionals prefer the word therapy over counselling. In the past, the word therapy was used for the more “serious” mental health disorders. More recently the term counselling therapy is used to avoid confusion. 
 

6. What is the best treatment for symptoms of trauma? 

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Despite what has been published and repeated by many people in the field of mental health, there is no one treatment for trauma that is better than the others. Research conducted over the last 30 years consistently demonstrates that the approaches used in treating people with trauma symptoms share core active ingredients. These most important components of successful therapy are feeling respected, feeling safe, and working with someone who listens and who works on clients’ priorities.

 

Secondly, what is important is helping clients with tools and techniques to self-regulate and providing information on trauma, and how it affects the brain, sleep, concentration, and daily functioning. Even non-specific therapy approaches have been found to be equally effective in special trauma approaches. Psychodynamic, person-centred Therapy, Cognitive Therapy, Cognitive Behaviour Therapy, Narrative Therapy, Dialectical Behaviour Therapy, etc. have been found equally effective in working with trauma compared to exposure-based therapies, cognitive processing therapy, and others. 
 

7. If much different therapy approaches offered by a variety of mental health professionals can 

be helpful to me, how can I make sure to find a good therapist?

The more current approach in determining helpful service providers is focusing on competency. A competent Mental Health professional offering counselling therapy is trained in the area they provide a service in. This means that most of the professionals that may be a good fit are trained in trauma, grief, depression, anxiety, addiction, and other areas of mental health. Most of the specialized training is obtained through professional development courses after graduation. However, the best predictor of a good therapy outcome is the therapy relationship and the therapist’s ability to adapt psychotherapy to the preferences of the client. This means that the best therapy is individualized to the needs of the client. There is no one approach that fits all, and manualized approaches are not sufficient. Evidence-Based Practice (EBP) is exactly that “the integration of the best available research with clinical expertise in the context of patient characteristics” (American Psychological Association, 2006). 
 

8. Where to find a therapist who is a good fit?

 

When looking for a good psychotherapist, you can go on the Internet and type in some referral sources such as Psychology Today. What you can do is look for people who list trauma as an area they are trained in. Most private practitioners have a website. Look up more information and if you have questions that are not answered on their website, feel free to send an email. Ask them how long their waitlist is, ask them the fee for service, and if not stated on the website ask them about insurance and benefits. A good therapist will have no issues with answering questions.

 

One core component of ethical health service provision is “informed consent”. This means that clients have the right to ask questions and to feel confident about the choices they make regarding their health. After all, the service is for you and the quality of the therapeutic relationship is a core ingredient of successful therapy. Relationship building starts right there, finding a person whom you feel comfortable with, and who is open to listening to your feedback. 

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9. Is counselling a regulated profession in Canada? 

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Five provinces in Canada have regulated the counselling profession. These provinces are Ontario, Quebec, Nova Scotia, New Brunswick, and Alberta. Saskatchewan and Manitoba, as well as British Columbia, are working on regulation. Insurers, third party payers, and companies often stipulate conditions to ensure the quality of services. This means that in the absence of regulation, formal relevant education, years of experience, and membership in a professional organization can be included as requirements for hiring, referral, and inclusion in the list of approved providers. 
 

10. What about other non-psychotherapy types of support services and activities?

 

Peer support, as well as many other activities, are extremely helpful. Relationships with others are healing. Finding support within your own family and from others is crucial. Many people suffering from symptoms of trauma feel isolated. In addition to having support and feeling connected to others, any type of physical activity and relaxation is healthy, including yoga, meditation, equine therapy, walking in nature, and being involved in art, craft, and music.