Counselling Appointments: Who Needs Them Most?

Many times I have reflected that I may have the nicest group of counselling clients in Vancouver. Sorry, other counsellors.

There are many reasons that my clients are so stellar: they’re committed, reflective, intelligent, diverse and kind. What really stands out for me, however, is their compassion. Since the onset of the pandemic, I have noticed an ongoing trend where clients will ask whether it’s ok if they book another appointment with me, or say, “maybe I shouldn’t make an appointment. Someone might need it more than me.”

While I would love to just make this this shortest Willow Tree Counselling article ever by cutting to the chase and saying that e-v-e-r-y-o-n-e deserves their counselling appointment, I thought it might be more interesting to reflect on the various reasons why—including compassion— people might offer to sacrifice their next counselling appointment to someone that they don’t even know.

Many Good Reasons

Empathy Abounds

The definition of empathy often cited is to feel others’ pain as if it was one’s own. By extension, offering a counselling space to someone in distress—known or unknown—is an act of compassion. And time and again, I meet clients that are wired that way.

Impact of the Pandemic

Statistics Canada reports a decline in Canadians’ mental health over the course of the pandemic, especially prevalent in youth. This effect that impacted public consciousness too, in that more of us seem to be talking about mental health now than ever before. And with this heightened awareness comes increased willingness to try to assist others in need of mental health care.

Perception that Counselling and Crisis Intervention May be The Same Thing

Sometime ago I wrote an article called Therapist 911, with the aim of elucidating the difference between counselling and crisis intervention. And one of the things that keeps this dividing line murky is the fact that many of us originally come to counselling during a time of crisis, even though counselling—in the long run—should help to facilitate deeper and systemic changes and not just emotional firefighting. Crisis intervention is a branch of counselling, but it’s most commonly delivered via hotlines and crisis centres and it not generally the main focus of counsellors in private practice.

Letting The Counsellor Down Easy

At the risk of stereotyping, we are a nation of famously polite people. And sometimes I think that offering to give up one’s appointment to someone else makes for a less-awkward exit when the time is right. Counselling clients should be assured that counsellors should never make them feel weird if they would like to end counselling, as this is the ultimate goal anyway! Saying “I feel like I’m done” also opens up a chance to talk about gains made in therapy over time.

Caregiving Impulses and Patterns

Some of us, related to social conditioning, family factors or trauma, have found ourselves in caregiving roles. And often it is a role like this that brings us to counselling in the first place—especially when we are seeking to free ourself from it. Sometimes caregiving can extend to something even as “minor” as booking, not booking, or rescheduling a counselling appointment.

Prevalence of First-World-Problems Mentality

While I believe that it is important to put our problems into perspective on a larger scale, we are also a culture of minimizers. And this includes minimizing what is going on for us personally. We may have set a bar in our minds where counselling is necessary or not and sometimes this is actually appropriate! If you are feeling great and don’t feel the need for an appointment, you probably don’t. If you are minimizing your own concerns or feeling guilty about your appointment, it’s probably a good idea to explore this with your therapist.

Perception That There Is An Ordering System for Trauma and Other Difficulties

I like to think that as a society we are growing more trauma-informed, which feels like a shift in the right direction from the zeitgeist early in my career. As trauma discussions have become more of a part of our public consciousness, however, I have noticed at times, a “comparison” of folks’ respective trauma, as in “A is more traumatic than B” or “this is the worst kind of trauma and that is much less traumatic.” By extension, some of us minimize what we are experiencing and whether or not it’s “severe enough” to go to our counselling appointment. I frequently remind people that it’s not just an event or situation that creates the trauma but the effect of the event on us.

To Recap

Things to think about when you’re questioning whether you should give over your counselling appointment to someone else:

Empathy and compassion also extend to oneself. When we’re hurting and we respond by looking after ourselves, we feel better and are a better human to be around, which in turn helps others.

By looking after our mental health, we lessen the psychological impact of the pandemic, particularly in the long-term. When we are well resourced from a mental health point of view, we are better able to be of service to others, particularly if they have less access to mental health services. (Not to be confused with caregiving, below).

Caregiving is sometimes necessary, particularly if you’re responsible to someone in your life whose vulnerable, however the road from there to co-dependency is shorter than we think  Left unexamined, co-dependency can erode one’s quality of life and minimize others’ self-responsibility. It’s a common and important issue that people bring to counselling.

We don’t need to be in crisis to attend counselling. In fact, you will likely get more out of the experience if you’re not. Sometimes we are in crisis, though, and if you have a pre-existing relationship with a counsellor, they’ll likely help you put it into perspective, based on their pre-existing knowledge of you and your growth in therapy. If you’re not, this is often a way that counselling starts. All of this to say that crisis or not, it’s all relevant.

Problems for counselling are not rank-able. It’s all about the effect on each person and not the problem itself. If a client has a need to talk about it, it’s pertinent for counselling.

Clients are not counsellor caregivers. Treating others in a respectful manner, including counsellors, does not conflict with cancelling an appointment or having a conversation with your therapist about being done counselling. If a counsellor tries to insist that you are not done therapy when you feel ready, this is not a good sign and you should trust your instinct to say goodbye. If you trust your therapist, and you feel that they are gently and non-insistently raising a legitimate concern about your departure, a conversation with them may be in order.

In conclusion, the above is my fancy way of saying that you deserve the appointment you’ve booked. All counselling clients are important, no matter what their circumstances.