• When should you seek counseling?
• What is professional counseling?
• Who are professional counselors?
• Will my health insurance cover counseling?
• How much does counseling cost?
• How long does counseling take?
• Is everything I say confidential?
• Does going to counseling jeopardize your security clearance?
• How do I find a counselor?

When should you seek counseling?

From childhood through late adulthood, there are certain times when we may need help addressing problems and issues that cause us emotional distress or make us feel overwhelmed. When you are experiencing these types of difficulties, you may benefit from the assistance of an experienced, trained professional. Professional counselors offer the caring, expert assistance that we often need during these stressful times. A counselor can help you identify your problems and assist you in finding the best ways to cope with the situation by changing behaviors that contribute to the problem or by finding constructive ways to deal with a situation that is beyond your personal control. Professional counselors offer help in addressing many situations that cause emotional stress, including, but not limited to:

• anxiety, depression, and other mental and emotional problems and disorders
• family and relationship issues
• substance abuse and other addictions
• sexual abuse and domestic violence
• eating disorders
• career change and job stress
• social and emotional difficulties related to disability and illness
• adopting to life transitions
• the death of a loved one

"Good indicators of when you should seek counseling are when you're having difficulties at work, your ability to concentrate is diminished or when your level of pain becomes uncomfortable," says Dr. Gail Robinson, past president of the American Counseling Association. "However, you don't want to wait until the pain becomes unbearable or you're at the end of your rope."

"If someone is questioning if they should go into counseling that is probably the best indicator that they should," says Dr. William King, a mental health counselor in private practice in Indianapolis, Indiana. "You should trust your instincts."

Joyce Breasure, past president of the American Counseling Association and a professional counselor who has been in private practice for more than 20 years, recommends counseling when you:

• Spend 5 out of 7 days feeling unhappy
• Regularly cannot sleep at night
• Are taking care of a parent or a child and the idea crosses your mind that you may want to hit that person
• Place an elder in a nursing home or in alternative care
• Have lost someone or something (such as a job)
• Have a chronic or acute medical illness
• Can no longer prioritize what is most important in your life
• Feel that you can no longer manage your stress

"If you're not playing some, working some, and learning some, then you're out of balance. There's a potential for some problems," Breasure says.

Robinson points out you don't have to be "sick" to benefit from counseling. "Counseling is more than a treatment of mental illness," she says. "Some difficult issues we face in life are part of normal development. Sometimes it's helpful to see what you're going through is quite normal."

What is professional counseling?

Professional counselors work with individuals, families, groups and organizations. Counseling is a collaborative effort between the counselor and client. Professional counselors help clients identify goals and potential solutions to problems which cause emotional turmoil; seek to improve communication and coping skills; strengthen self-esteem; and promote behavior change and optimal mental health. Through counseling you examine the behaviors, thoughts and feelings that are causing difficulties in your life. You learn effective ways to deal with your problems by building upon personal strengths. A professional counselor will encourage your personal growth and development in ways that foster your interest and welfare.

Who are professional counselors?

Licensed professional counselors provide quality mental health and substance abuse care to millions of Americans. Professional counselors have a master's or doctoral degree in counseling or a related field which included an internship and coursework in human behavior and development, effective counseling strategies, ethical practice, and other core knowledge areas.

Over 80,000 professional counselors are licensed in 48 states as well as the District of Columbia. State licensure typically requires a master's or doctoral degree, two to three years of supervised clinical experience, and the passage of an examination. In states without licensure or certification laws, professional counselors are certified by the National Board for Certified Counselors (NBCC). Participation in continuing education is often required for the renewal of a license or certification.

Professional counselors adhere to a code of ethics that protects the confidentiality of the counseling relationship; prohibits discrimination and requires understanding of and respect for diverse cultural backgrounds; and mandates that professional counselors put the needs and welfare of clients before all others in their practice.

Will my health insurance cover counseling?

If you an active duty member seeking counseling, this is normally done through the bases Mental Health Clinic. Understandably, many service members are not comfortable going to mental health for assistance and therefore they look elsewhere for assistance. In doing so, this can mean that the cost normally may be out of pocket. However, there are FREE services available to you. You can speak with a Base Chaplain, or make an appointment with a Military & Family Life Consultant, now located one most stateside bases in the Airman & Family Readiness Center. Additionally, see the link to Military OneSource Counseling Options at the bottom of the page.

Many insurance and coverage plans cover mental health services by a licensed professional counselor including some Medicaid programs, TRICARE (formerly CHAMPUS), and other government-sponsored health coverage programs. NOTE: Here in California there are only licensed marriage & family therapists and licensed clinical social workers. Most often they are covered by your insurance, but contact your insurance company for details. To query a list of providers from TriWest, see Other Resources at the bottom of the page. If you do not have health insurance, or if your coverage does not include mental health care or the services of a professional counselor, many professional counselors will work with clients on a sliding-fee scale or will offer a payment plan. Talk to your counselor about your options.

How much does counseling cost?

The cost of counseling can vary greatly depending on your geographic location and whether counseling is being provided by a community mental health center or similar agency or by a counselor in private practice. In general, the average paid fee for individual counseling sessions is about $65. Fees for group counseling are generally lower, about $35 per group session. For clients with health insurance that does not cover mental health care and others who cannot afford the counselor's standard fee, some counselors will lower their fee on a sliding scale basis or will work out a payment plan. Your counselor should explain to you, prior to beginning the counseling relationship, all financial arrangements related to professional services.

How long does counseling take?

Ideally, counseling is terminated when the problem that you pursued counseling for becomes more manageable or is resolved. However, some insurance companies and managed care plans may limit the number of sessions for which they pay. You should check with your health plan to find out more about any limitations in your coverage. During the first few counseling sessions your counselor should also discuss the length of treatment that may be needed to achieve your goals.

Is everything I say confidential?

All members of the mental health fields should subscribe to a Code of Ethics and Standards of Practice which require them to protect the confidentiality of their communications with clients. Most 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.

When it comes to military members, if you are being seen on-base at the Mental Health Clinic, the information you provide is not provided to your chain of command if you self referred. The same limitations of confidentiality that you have off-base apply, but the following situations are also reportable when being seen on base by anyone other than a Chaplain. Those include: suspicion of child abuse & neglect, suspicion of spouse abuse & neglect, individuals that are on the Personnel Reliability Program (PRP) (refer to AFI 36-2104), the commission of a crime in violation of Uniformed Code of Military Justice, federal or state law, and clear threats to mission accomplishment.

The Military & Family Life Consultants have a unique relationship to the military in the sense that you can see them on-base, however, they have the same limitations to confidentiality as an off-base counselor.

No matter who you see, or where you see them, off-base or on, they should provide you with their Statement of Understanding before your session starts. This will outline their Standards of Practice and detail the situations that they are mandated to limit confidentiality on.

Does going to counseling jeopardize your security clearance?

In April 2008, the Department Defense Department officials changed a question on the department's long-standing security clearance form referencing an applicant's mental health history because they believe it is needlessly preventing some people from seeking counseling.

The Standard Form 86, Questionnaire for National Security Positions, asks the applicant to acknowledge mental health care in the past seven years. It does not ask for treatment details if the care involved only marital, family, or grief counseling, not related to violence by the applicant, unless the treatment was court-ordered.

Officials said surveys have shown that troops feel if they answer "yes" to the question, they could jeopardize their security clearances, required for many occupations in the military.

As of April 18, applicants no longer have to acknowledge care under the same conditions, nor if the care was related to service in a military combat zone. The revised wording has been distributed to the services and will be attached to the cover of the questionnaire. The revised question should not show up printed on the forms unless the department has not depleted its pre-printed stock.
Read the announcement from the Official Air Force Web Site.

How do I find a counselor?

On-Base:

• The Mental Health Clinic (if you are a service member on active duty)
• Military & Family Life Consultant Program - Click the link for more information about the program or call the consultant at (530) 601-6915 to make an appointment.
• The Base Chapel
• Airman & Family Readiness Center

Off-Base: There are many different ways to locate a professional counselor in the community. Some common ways include:

• The National Board for Certified Counselors referral service (phone NBCC at 336-547-0607 between 8:30 a.m. and 4:30 p.m. Eastern Standard Time, Monday through Friday to find a certified counselor in your area)
• The yellow pages listed under counselor, marriage and family counselors, therapist or mental health
• Referral from your physician
• Recommendations from trusted friends
• Crisis hotlines
• Community mental health agencies
• Local United Way information & referral service
• Hospitals
• Child protective services
• Referral from clergy
• Employee Assistance Programs (EAPs)

Once you have found a counselor you are interested in seeing, you should ask several important questions, such as:

• Are you a licensed or certified counselor?
• What is your educational background?
• How long have you been practicing counseling?
• What are your areas of specialization (such as family therapy, women's issues, substance abuse counseling, etc.)?
• What are your fees?
• Do you accept my insurance?
• How is billing handled?
• Do you offer a sliding fee scale or a payment plan if I do not have insurance for mental health services?
• How can you help me with my problems?
• What type of treatment do you use?
• How long do you think counseling will last?

Some of these questions may be addressed during your initial phone conversation with the counselor and others may be more appropriately discussed in your first face-to-face meeting.

After you have had these questions answered by the counselor to your satisfaction, consider how comfortable you feel with the individual, since you will be working closely together during your counseling sessions. It is difficult to open up and share your problems with a stranger and you may feel awkward or anxious during your initial sessions. But it is also important that you have a "chemistry" or rapport with the counselor. Counselors have different styles, personalities, and approaches. Take time to evaluate how you feel interacting with the counselor and whether you believe that the two of you can work effectively together. If you do not feel at ease with a certain counselor, do not get discouraged. Instead, look for a different individual with whom you would feel more comfortable working with.

Together you and your counselor will set goals, work toward achieving them, and assess how well you are actually meeting them. Counseling can help you maximize your potential and make positive changes in your life. Finally, remember that counseling may be hard work at times but change and progress do happen. A professional counselor can provide the help and support to help you master the challenges of life.