Last month, I wrote the most basic of articles, How To Book a Counselling Appointment. It turns out that I had way more to say about the topic that I thought was humanly possible—so much so, that I decided to write this article, separately, so as not to overwhelm readers, although debatably, this may have happened anyway in part one!

More specifically, this month I would like to focus on what to expect once you have reached out to a counsellor through any of the methods I described last month.

The time it takes to contact a counsellor can be long, short, or somewhere in between. The most important thing is to make contact when you are ready. And it’s best not to do so to please others or when you don’t want to. Counselling seldom goes well in such circumstances.

Scenarios

OK, now that you’ve cleared that hurdle, let’s talk about possible scenarios that you might encounter when reaching out to a therapist:

Scenario 1

You are offered an appointment in a timely fashion. Congratulations! Your session is booked directly by a counsellor or their receptionist, if they have one. Likely, you will also be directed to forms to complete before your appointment.

Scenario 2

You contact a counsellor or counselling centre and you are asked to have a preliminary call with the counsellor, to help determine if you are a good match. If the match seems good, they may offer an appointment (if available) or recommend that you pursue counselling elsewhere that would better meet your needs.

Scenario 3

The counsellor is not immediately available and you are asked whether you want to go on a waiting list or cancellation list.

Scenario 4

You are informed that the counsellor is not accepting new clients or their waiting list is closed for the time being.

Scenario 5

You are referred to another counsellor. There can be several reasons for this, including the counsellor not being available to take new clients, the issue that you are seeking help with is not within the counsellor’s expertise, or you ask for a referral after recognizing that it’s probably not the best fit.

Scenario 6

You book an appointment online and a counsellor calls you to ensure that it is a good match, and if so, proceeds to register you as a client.

Scenario 7

You book an appointment online, fill out the paperwork online and show up at your appointment time.

Scenario 8

You are ghosted. I hate to say this, but I receive calls from folks that say they never received a call-back from the therapist that they contacted. I address this problem briefly, at the end of this article.

Common Questions

Why is it easier to get a counselling appointment with some therapists?

Typical reasons include:

• The therapist has room to take on new clients. (More on this below).
• You have contacted a group counselling practice which has a greater number of therapists to choose from, increasing the likelihood that one will be available to see you.
• You have called an employee assistance program or crisis service that has a policy to assign you to a counsellor within a rapid timeframe.
• While not a common option, you attend a drop-in counselling service.

Why are some therapists taking new clients?

There can be a number possible reasons for this which could, but do not necessarily include:

• The therapist is a new grad and just starting out.
• The therapist is not a new grad but has just opened their counselling practice.
• The counsellor is moving into a new market and is just getting established.
• The counsellor struggles with marketing their practice and not many people know about them.
• The counsellor does primarily short-term counselling which means there is more turnover in their practice.
• The counsellor has increased their hours.
• Client dissatisfaction.

Why Are Some Therapists Not Taking New Clients?

Like the question above, there can be a number of reasons for this:

• The therapist’s practice is full and cannot accommodate any new clients.
• The therapist has a good reputation in the community and receives a number of referrals from multiple sources.
• Clients are satisfied and prebook appointments in advance.
• The therapist has had to take extended time off for any number of reasons: medical, mental health, family situation, life circumstances…
• A major world event that has had mental health effects on an enormous amount of people. COVID-19 is a prime example of this.

What do I do if I don’t hear back from the therapist?

First of all, I want to express my sympathy to anyone who has reached out to a therapist and has not heard back. Before and after making the decision to pursue counselling, we often feel vulnerable and raw. The effect of not hearing back can be particularly profound.

Why does this happen? I offer the following as possible explanations, and not excuses.

• An email message doesn’t get through, or goes to spam. This happens more that one thinks. I usually receive at least one enquiry a month that goes to spam, despite email filters I have created to try to prevent this from happening. Server issues can also be a factor, for example, receiving an email days or weeks after it was sent.
• Their email reply to you accidentally landed in your spam folder.
• A message can get buried in a counsellors inbox, on a day where they have received a particularly large amount of email. A lapse in conscious thoroughness can result in a message getting missed.
• A voicemail is left for the therapist and a there is no way for the therapist to return the call: either the voicemail message cuts out when the client is leaving their number, the therapist’s phone does not register the missed call on their phone’s missed call list, the caller leaves a phone number outside of Canada that’s not covered by the therapist’s phone plan or the client does not have a voicemail set up where the therapist can leave a return message.
• It is unclear whether the counsellor can leave a message: the counsellor calls back and someone else picks up, or the receiving voicemail has no greeting. The counsellor is bound by confidentiality and cannot leave a message with someone else and also needs to be reasonably sure that they received the correct person, in order to leave a message.
• A potential client has texted and the counsellor does not use text messages as part of their communication.
• The potential client entered their email address incorrectly in the therapist’s contact form.
• The counsellor is distracted by a personal problem or is so busy that they forget to return a message from a potential client(s).
• The counsellor is on vacation and forgot to change their greeting or set an automatic email reply to reflect this.
• The counsellor is burned out or apathetic about their practice and is ignoring messages from potential clients. This should never happen and counsellors in such a situation could benefit from making a choice to rectify this such as taking time off, seeking clinical supervision/support/personal counselling or updating their website to indicate that they are not available to take new clients.
• The counsellor has achieved a lot of success and feels that they no longer have to return messages. I personally have never, ever felt this way, nor have I met a colleague that does either, although for some of us seeking counselling, this may be the first place we go to in our minds. This kind of situation can be especially triggering if we have a history of emotional abandonment, neglect, abuse or if we have ever felt unloveable, to name just a few possible pain points. In an ironic twist, these are the very reasons that may have caused us to seek counselling in the first place.

What do you do if you haven’t heard back from the therapist you contacted?

If you suspect that they might be a someone you would like to work with:

• Try another way of contacting the therapist in case they haven’t received your original message (for example, you may want to try phoning if you emailed).
• Ensure that your contact information is accurate and that you are reachable by that means.
  Provide a confidential way for the therapist to return your message, that only you will access.
• Assume the best before assuming the worst: administrative error is a more common reason for not returning client messages, particularly if the counsellor does not have administrative help.
• If you have tried the therapist a second time and have still not heard back. I recommend you reach out to a different therapist.
• Last, if you have reached out a second time and this time have received a response from the therapist, be sure to provide feedback about your experience originally not hearing back and see how the counsellor reacts. A humble therapist who takes responsibility, empathizes and makes changes if the problem was on their end, has personal and professional qualities that often bode well for a future counselling relationship.