Frequently Asked Questions about Counseling
At Pediatric and Adult Behavioral Counseling, we are a group of mental health counseling professionals that provide support, psycho-education, and clinically proven interventions to help you manage a wide range of behavioral and mood disorders. If you are struggling with a problem or are experiencing more bad days than good, counseling can be very beneficial. However, we recognize that the journey to finding the right counselor can be easy or extremely frustrating and so we have compiled a list of our most commonly asked questions in hopes to help you with your search.
Counseling is an opportunity for individuals, families, and couples to receive support and experience growth during challenging times in life. It does not matter if the problem is mild distress or life threatening. Counseling can you learn the skills you need to manage emotions and symptoms causing distress, improve relationships, communicate, problem solve, navigate life and improve your overall mental well being. Counselors will help you learn how to manage stress, anger, depression, anxiety, panic, fear, substance abuse, ADHD, low self esteem, OCD, marriage and relationship challenges, parenting problems, school difficulties, career changes, grief, divorce, trauma, PTSD, perfectionism, suicidal and homicidal ideation, self harm behaviors, bullying, co-dependency, abuse, and more. Most importantly, if you are struggling with a problem or are experiencing more bad days than good, counseling can be very beneficial.
Many types of mental health care professionals can help you achieve your goals. We work in partial and inpatient psychiatric hospitals, general hospitals, outpatient facilities, such as community mental health clinics, schools, private practices; churches, crisis centers, foster care, court, for profit and non profit sectors, and soon... police stations.
Please visit the National Alliance on Mental Illness to read descriptions of what to look for and what credentials to expect from a mental health professional in Michigan. Finding the right professional is easier when you understand the different areas of expertise and training.
We do not prescribe medications at Pediatric and Adult Behavioral Counseling. If you are seeking medical interventions to aid with your mental health symptoms, please consult with your pediatrician, primary care physician, psychiatrist or specialist.
Please visit our Rates page for private pay fees or our questions and answers about mental health insurance page for more information. If you sign up for our services, please carefully review our fee agreement. If there are any changes, you will be notified and a new fee agreement will need to be signed.
My child (or myself) needs counseling but I can't find anywhere that offers evening or weekend appointments. What do I do?
Due to the mental health crisis in America, there can be a 3-4 month waiting period to talk to a professional. It is true that evening, weekend and office appointments are the most preferred, however not always available. We do not provide waitlists at our practice because unfortunately, depression and anxiety do not pause until you talk with someone. Most of our client's have already tried everything to resolve issues on their own without success when they call inquiring about services, so waiting even a month to talk with someone could be detrimental.
Prior to the COVID-19 Pandemic, taking time off of school or work to for mental health reasons would be inexcusable. However, you would be amazed at how supportive employers and schools are when they hear that you and or your child are receiving mental health treatment.
According to a new survey from CNN in partnership with the Kaiser Family Foundation, 9/10 Americans are struggling with a mental health crisis. Schools are overwhelmed with children struggling with behavioral and mood disorders that impact their ability to learn, socialize, and be creative.
According to data supplied by the American Psychiatric Association, employees with unresolved depression experience a 35% reduction in productivity, contributing to a loss to the U.S. economy of $210.5 billion a year in absenteeism, reduced productivity, and medical costs. The Centers for Disease Control and Prevention has reported heightened levels of stress and anxiety, as well as significant increases in the rates of depression and drug overdose. The U.S. Department of Labor and the World Health Organization emphasize the importance of supporting the needs of individuals with mental health conditions in the workplace as the word experiences a mental health crisis driven, in part, by the pandemic.
Schools and employers recognize the need for mental health services as they also reach out for mental health support. You would be surprised how many business owners, CEO's, managers, supervisors, teachers, doctors, etc. schedule telehealth counseling appointments or sneak away to our office during working hours or lunch breaks for a session to de-compress. In return, they are able to be more effective and functional leaders, parents, partners, teachers, and individuals in society.
We encourage you allow yourself the personal freedom for you and/or your child to schedule appointments during the day if you need to talk to someone. We work with school districts and employers all over the state of Michigan to excuse students and employees for an hour or so a week to prioritize their mental health. We also see an increase of schools referring students to counseling to provide more support when they see them struggling. If one or two 45 -60 minute session per week will help you or your child become more productive at school, work, or home; and reduce the amount of behavioral issues or mental health symptoms... you may want to consider scheduling day appointments to start your journey towards mental wellness rather than waiting 3-4 months for help.
- 90% of US adults say the United States is experiencing a mental health crisis, CNN/KFF poll finds
- WHO: Mental Health at Work
- Increases in youth mental health revealed by the 2022 America’s Health Rankings Health of Women and Children Report,
- U.S. Department of Mental Health Discuss and Promote Mental Health Practices in the Workplace
- Risk and Insurance: The time is now for Workplace Mental Health Certification
I cannot speak for every agency, practice or hospital, but I will explain how our process here works. If you are reading this, then you have already taken the first step of gaining information, searching for places that seem like a good fit, asking for referrals, checking insurance benefits and private pay rates. Next, please take the time to read about our mental health professionals and their background, therapeutic approaches and specialties. The next step if you feel comfortable, would be to fill out our online form so we can make sure that we are a good fit and are able to accommodate your scheduling, insurance, and needs. We then will match you up with one of our qualified mental health professionals, send over intake documentation, answer any questions you may have and schedule your appointment.
The first appointment is called the intake assessment. Consider this as a starting point to see if you are both a good match. Your counselor will review all your intake documentation and assessments to best prepare to help you start your therapeutic journey. You will both get to know each other and if comfortable, discuss what brings you to therapy, identify goals that you would like to accomplish and discuss treatment recommendations. Be sure to ask your counselor any questions you may have.
If you and your clinician feel it is a good match, then we will schedule your next appointment. If not, we may recommend you to another one of our counselors that may be better suited and / or provide you with outside referrals because the main goal is helping you.
Counseling sessions are typically 45 to 60 minutes depending on the service provided. Some situations require shorter or extended sessions.
The process of trying to figure out what you need, who you need, and what might work can be terrifying, scary, exhausting, defeating and overwhelming; but the reward when you do find the right match can be life changing. The important thing to know is when searching for a therapist or counselor, if you meet with them and do not feel it is a good fit, even after a couple (or a lot) of sessions, please know that you are allowed to inform your helper and move on. The whole purpose of counseling is to find someone that you can trust and feel comfortable with. It is okay to "interview" several mental health professionals until you find the one that best serves you. We will even assist you in your search for someone that is qualified and a better fit for you whether it is within our own practice or outside of it. We do not believe in competition and have a wide network of professionals that would love to help you.
The number of treatments will vary depending on the problem and individual. After a thorough assessment, your counselor will discuss treatment plan recommendations and allow you to choose how often you would like to come. We recommend weekly sessions to start so that you and your counselor can build a therapeutic relationship, explore presenting problems and learn the skills or tools that will help you reach your goals. We have had clients complete their goals within six months and discontinue services. We have also had clients complete their goals and choose to continue therapy as they have found it personally beneficial. Each individual is different pending their needs, severity of symptoms, motivation, and commitment to change. Regardless, we will meet you where you are at and support you every step of the way.
When individuals start counseling it is very normal to feel a bit of anxiety. Our counselors are all trained and experienced professionals whom understand that therapy can be intimidating and scary when you start. We aim to make the environment safe and comfortable for you to talk about what is troubling you. We are experts on reading non verbal communication, so if we notice you are stuck on how to start or what to talk about, we will prompt conversation with open ended questions. Sometimes, silence can be therapeutic for you too.
Statistics say that if you are able to tell someone that you want to die, you may not really want to die, but you want the pain to go away. It is also a cry for help. Depression has a very real risk that at some point in the course of the illness, it is not uncommon for one to experience thoughts of suicide. While the emotional pain that triggers these thoughts may feel overwhelming, it does not mean that you will lose control or act on your thoughts. In most cases, talking to a professional or calling a crisis line such as 988 will de-escalate these strong painful emotions.
We will provide you with a safe place to talk about your suicidal ideation while providing crisis interventions such as creating a safety plan. A safety plan is a written set of instructions that we create together as a contingency plan should you begin to experience thoughts about harming yourself in the future. It contains a series of gradually escalating steps that you follow, proceeding from one step to the next, until you are safe.
There are many helpful approaches for individuals and their loved ones, when someone is in distress or at risk for suicidal behavior. Interventions and treatments have been developed in recent years for individuals who are experiencing suicidal ideation or who have made suicide attempts. Our goal is isn't to send you straight to the "mental ward," but we will refer you to the proper level of care if it keeps you alive because your life matters.
It is important to know that depression and anxiety is treatable. Suicide is preventable.
All of our Counselors adhere to the American Counseling Association Code of Ethics and Standards of Practice which require counselors to protect the confidentiality of their communications with clients. Michigan state licensure laws also protect client confidentiality. As a client, you are guaranteed the protection of confidentiality within the boundaries of the client/counselor relationship. Any disclosure will be made with your full written, informed consent and will be limited to a specific period of time. The only limitations to confidentiality occur when a counselor feels that there is clear and imminent danger to you or to others, or when legal requirements demand that confidential information be disclosed such as a court case. Whenever possible, you will be informed before confidential information is revealed.
By Michigan law, your counselor is required to report:
- Threats of harm to oneself
- Threats of harm to other
- Suspected child or elder abuse and/or neglect – if the client is the victim or perpetrator
I'm the parent of a minor. Am I entitled to access to all my child's medical files including the notes from their counselor?
When working with minors, confidentiality can be a tricky situation. All of our Counselors adhere to the American Counseling Association Code of Ethics and Standards of Practice which require counselors to protect the confidentiality of their communications with clients including minors. Michigan state licensure laws also protect client confidentiality.
There are a number of ethical standards within the 2014 ACA Code of Ethics to consider, including:
- A.1.a. (Primary Responsibility)
- A.2.a. (Informed Consent)
- A.2.d. (Inability to Give Consent)
- B.1.b. (Respect for Privacy)
- B.1.c. (Respect for Confidentiality)
- B.2.d. (Court-Ordered Disclosure: when dealing with legal concerns such as custody agreements)
- B.2.e. (Minimal Disclosure)
- B.5. (Clients Lacking Capacity to Give Informed Consent)
- B.6.e. (Client Access).
Standard B.5. covers the counselor’s responsibility to the client as well as to the parent or legal guardian:
B.5.a. (Responsibility to Clients): “When counseling minor clients or adult clients who lack the capacity to give voluntary, informed consent, counselors protect the confidentiality of information received — in any medium — in the counseling relationship as specified by federal and state laws, written policies and applicable ethical standards.”
B.5.b. (Responsibility to Parents and Legal Guardians): “Counselors inform parents and legal guardians about the role of counselors and the confidential nature of the counseling relationship, consistent with current legal and custodial arrangements. Counselors are sensitive to the cultural diversity of families and respect the inherent rights and responsibilities of parents/guardians regarding the welfare of their children/ charges according to law. Counselors work to establish, as appropriate, collaborative relationships with parents/ guardians to best serve clients.”
Standard B.6.e. discusses client access to records and states that counselors can limit access to the client record if there is a concern that harm could come to the client from such access. The counselor would need to document the rationale for the limited access in such cases.
Therefore, the counselor has an ethical responsibility to protect the confidentiality of the client and the primary responsibility to respect the client’s dignity and promote the client’s welfare. The counselor may have a custodial agreement that grants access to both parents. However, the client’s needs come first. If one or both of the parents accessing the file could harm the client, the counselor can limit that access. However, the counselor will want to discuss with the minor the risks and benefits of limiting access and work to prepare the client that access may be granted legally.
Research has shown that the therapeutic relationship contributes to 30 percent of client outcome. Therefore, it is vital to develop and maintain a positive and trusting therapeutic relationship with clients. A large piece of relationship building begins in the informed consent process. The counselor needs to help parents understand the limitations and expectations of confidentiality that the counselor is establishing to benefit the minor client. Although a minor cannot grant consent, he or she can assent. Obtaining agreement from the minor client for the process of counseling is an essential factor in working successfully with these clients.
For more information, please review the 2014 American Counseling Association Code of Ethics and Standards of Practice or you can review "Confidentiality Concerns with Minors"
Due to the widespread of COVID-19, our clinicians are able to choose tele-health or in person counseling sessions. Although we currently have limited availability for in office appointments, scheduling depends on your needs and whom the best clinician will be for you. We want to ensure the health and safety of our employees and patients and do whatever anyone feels most comfortable and safe with. We have had the same success working with individuals, families and couples remotely as we have in person. We encourage you to try telehealth if we are unable to schedule in office appointments with the clinician that would best serve you.
Telehealth allows us to provide counseling via audio and video over the internet. You can meet with your clinician on-the-go from your desktop, laptop, tablet, or mobile device (iOS or Android)—it’s your choice! Telehealth allows us to connect anywhere with secure and convenient appointments that save you time and hassle. There’s no need to worry about your health or safety when you can schedule and attend your appointments directly from a laptop or mobile device. Our telehealth system is HIPPA compliant.
Telehealth best serves the following:
- Individuals, couples and families that have busy schedules, but want to prioritize their mental wellness from anywhere at anytime as they can do visits during lunch, anywhere in the state that their clinician is licensed in, and on the go
- Individuals that may be more comfortable speaking to a professional in the comfort of their home rather than from the provider's office
- Individuals and families that have difficulty with attendance
- Those challenged with the barrier of needing transportation resulting in “no-shows.” This results in greater continuity of treatment - nami.og
- Families that are fractured, living separately, or have different schedules as it allows them to all "get into one room"
- Underserved individuals whom may need culturally competent and clinically specific clinicians
- Individuals that may struggle with anxiety or panic disorders at work, school or social situations as clinical interventions are the most useful when experiencing heightened emotions
- People with disabilities, areas with mental health provider shortages, and rural communities
- Individuals unable to travel to the clinician of preference due to distance, transportation, schedule, etc.
- and more
If you would like to schedule with one of our professional counselors, please fill out our online form. If you are struggling and need to talk to someone ASAP, please call 988. It is a national network of local crisis centers that provides free and confidential emotional support to people in emotional distress or crisis 24 hours a day, 7 days a week in the United States. They are committed to improving crisis services and advancing suicide prevention by empowering individuals, advancing professional best practices, and building awareness. If you or someone you are calling for services is an eminent threat to themselves or others, please call 911 or go to the nearest hospital.
No. Psychotherapy is an intimate process that involves a gradual building of trust between you and your therapist. Friendship and any sort of sexual relationship violates your counselor's Code of Ethics.
David McPhee articulates it beautifully when he states that therapy is a “practice relationship.”
It’s very real, but it’s also a very safe place for you to explore and try out new behaviors in a relationship — being assertive, expressing negative emotions, asking directly for what you want, allowing another human to comfort you, and any one of a hundred other roles and expressions. For YOU. It is in no way a practice relationship for the therapist. The therapist is trained, experienced, and skilled in it creating that safe place [setting boundaries, modeling behaviors, providing clinical interventions, etc.], and for that single hour makes you the center of their universe. During your session it is all about you, as it should be. That’s a wonderful, healing, empowering relationship.
Counseling is designed to be one-sided, giving you a safe place to open up without fear of judgment or worries about being selfish. If you find that your counselor starts to talk more about themselves and less about you, it is time to end the therapeutic relationship. Not only is this a violation of the ACA code of ethics, but it no longer serves you therapeutically. For more information, there is a great article that sums this up, "What Happens if you become Friends with your Therapist?"
My friend / family member is a therapist and I feel comfortable talking to them. Can they be my counselor?
Sorry, your therapist can't be your friend and if you ask your friend to be your counselor, they will say no. Friends are there to share your life experiences and thoughts together, but therapy is a special place that it is all about you. Therapists commit to years of education, clinical training and hours of supervision just to be able to become licensed to practice psychotherapy. During this process, they take an oath to abide by a set Code of Ethics. These ethics include the exclusion of having romantic relationships, providing services to their friends and family members, and also prohibiting social media friendships.
Top reasons that it time to discontinue counseling or start looking for another counselor are:
- Achievement of goals, reaching a plateau, and/or not having anything to talk about
- Counseling seems more like talking to a friend rather than a therapist
- Ethical violations: See ACA Code of Ethics
- Your therapist is no longer a good fit for your needs
- You're unable to establish a therapeutic relationship with your counselor or you just "don't click"
- You find yourself cancelling or skipping more sessions than you attend
- You are no longer benefiting from treatment
- Dissatisfaction of services
Please be sure to cancel or reschedule your appointment within 24 hours of your appointment with your clinician directly or our main office to avoid full charge of appointment via text, phone or email. Please note that insurance does NOT cover the cost of missed appointment fees and the card on file will be charged.