When considering psychotherapy (or counseling), a person often is at a point of some
urgency, or possibly even crisis. Not every therapist is going to be a fit for the problem
at hand. Sometimes getting help immediately is more important than looking for “the
perfect fit”, but when possible, asking a few key questions can ensure effective
outcomes. If a potential client doesn’t know what to ask, the counselor may describe
some basic practice policies and ask specific questions about the potential client’s
primary reason for calling. Prior to opening my own practice, I was unable to be on
insurance panels and therefore established a lower cost counseling model that has
become a mission of our practice. This opportunity. at first appearing as an obstacle,
has shaped a business model that excludes third-party interaction in our practice and
has been leveraged to lower costs to the consumer. Other counseling offices accept
multiple kinds of insurance and are well-suited for not just filing claims, but providing
acceptable treatment plans to insurance providers. Those skills increase chances that
therapy can continue uninterrupted until a client is comfortable with terminating therapy.
Some agencies provide court-ordered (often called “mandated”) treatment and are
well-suited for interaction with probation, drug court, or other legal entities, while many
standard private practices decline those cases and defer to those specialized agencies
as best positioned to serve the needs of that prospective client. Another example would
be cases that may involve some kind of (future) expert testimony. When the
professional is either not fully qualified, doesn’t feel prepared, or simply isn’t comfortable
in such a situation, they often decline cases where expert testimony is a key component
of therapy. They do so to avoid potential harm to the client, especially if harm could
come as a result of testimony that opens confidential records. Avoidance of harm is one
of the strongest tents of health care. When a counseling professional determines they
are not prepared for such situations (which can happen in workman’s compensation
claims, accident/injury cases, or other legal interaction cases), a counselor may refer to
another professional or not accept the case. While counselors are not ‘fortune-tellers’
and have no crystal ball, the goal is to do their best in anticipating needs that are best
served by their skills and practice models. Counselors often build a referral list of
alternatives in the community for the purposes of screened referrals, when that is
deemed the better response for a potential client.