FAQ — Spectrum Counseling (2023)

General Questions

  • More information about this is available in our Fees and Insurance page.

    Health insurance can be confusing, so we’re happy to explain the process to you, and ensure that you fully understand exactly how much you’ll be paying us.

  • It depends on the availability of the counselor you see. However, most of our counselors have flexible schedules, and can easily see you at a different time every week.

  • We do deeply apologize that our new clients need to wait for services with us. Portland is experiencing a huge demand for mental health services right now, and there are, unfortunately, not enough experienced therapists in the area to meet the demand.

    We understand that it is hard to wait when you’re in pain. However, we want to help you any way we can. We are happy to provide you with regular updates to current wait times, and help you find available outside services if you’re in crisis or need help sooner.

  • Yes, we do. Some of our counselors have extensive training in couples’ counseling, and they work with couples of all ages, races, sexualities, and gender identities. In addition, they work with couples who are in open, non-traditional, or poly relationships. They also work with triads, communes, and poly families.

  • Most private health insurance companies will cover couples’ counseling. One exception is OHP. They will not cover couples’ counseling, as it is not considered a medical expense.

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Counseling for Transgender and Gender-Nonconforming Individuals

  • Yes. We write letters of recommendation for both hormones and surgery. We recognize that these procedures can drastically help improve one’s mental health. When your body finally begins to match the person you feel you are inside, you might feel happier, more relaxed, and less conflicted about your gender. We can process and discuss this in therapy.

  • The short answer: probably a few weeks, although each person is different. The long answer: The World Professional Association for Transgender Health (WPATH) states in their Standards of Care that “therapy is not a prerequisite” for either hormones or surgery. This means that, under WPATH Standards of Care, you don’t have to go through therapy before you can access these procedures. However, you do have to have a “mental health screening” to ensure that you are psychologically and practically prepared to start these procedures. Keep in mind that a “screening” is more of an assessment, and not really the same as therapy. Many doctors who prescribe hormones feel comfortable enough to do this screening themselves. For all surgeries, however, surgeons and insurance companies require that this “screening” be done by a mental health professional.

    In our practice, a typical screening usually takes about 2-4 sessions. During this time, we will collect your history, talk to you more about your gender, and make sure you understand the risks and benefits of hormones and/or surgery. We can also help you plan for the emotional, psychological, and financial aspects of surgery. After the screening, we will typically write you a letter (the most common scenario) or recommend further therapy (for some circumstances, such as substance addiction, as a client cannot safely take hormones while actively in addiction).

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  • We certainly do! However, our surgery assessments still usually take 2-4 sessions. We prefer to get to know you a bit, and to offer any support that we can in planning for your surgery. That said, if you’re looking for a more “one and done” longer appointment, we do know of some therapists who offer that, and we can refer you to them.

  • Most clients choose to continue therapy with us after we have written them a letter. We encourage this! Our clients have told us that being able to have a “transition ally,” and a safe, supportive space to discuss and reflect on their transition, was immensely helpful for them. In addition, many clients come to work on issues not related to, or only slightly related to, transition, such as trauma, anxiety, or family problems.

    Clients might also find that hormones can change their emotions, thoughts, or reactions to events. It can be helpful to have a therapist with whom to discuss these things.

    A few clients choose not to see us for therapy after we write them a letter, and that is perfectly okay as well. Some of these clients will return to us in the future if they face unexpected challenges during their transition.

  • In most cases, yes. Mental health conditions, such as depression and anxiety, can be related to the feeling that one’s body does not match one’s gender (gender dysphoria). Having access to medical interventions such as hormones or surgery can greatly help to reduce the symptoms of depression, anxiety, and other mental health conditions. In addition, having a mental health condition usually does not impair your ability to make your own medical decisions.

    The WPATH Standards of Care state that if you have a mental health condition, it must be “reasonably well-controlled” before you can be prescribed hormones or undergo surgery. What does “reasonably well-controlled” mean? This will probably be different for every client. You and your counselor can discuss what “reasonably well-controlled” means to you. In some cases, it might mean being able to come in and see us on a regular basis to process your feelings and get support. However, this does not mean we will delay writing you a letter; we usually simply write in your letter that you have a mental health diagnosis, and that we plan to address this with regular therapy. Or, “reasonably well-controlled” might mean that you have an established support system and a safety plan in place. We have never had a physician, or insurance company, reject a letter of recommendation based on a client’s mental health diagnosis. The medical community is becoming more aware that mental health diagnoses should not disqualify a transgender individual from obtaining medical interventions.

    Our clients tell us that it is a relief to be able to “be themselves” around us, and fully express their pain and struggles without worrying that something they say is going to disqualify them from getting a letter. We are aware that, historically, therapists have been “gatekeepers,” holding the unfair power to decide whether or not a client could access medical interventions. Our goal is to create as little hassle for you as possible to access these interventions, while at the same time providing you with individualized support under the WPATH Standards of Care.

  • Under WPATH Standards of Care, this is not true. You are not required to have therapy to get a letter of recommendation, only a mental health screening. Of course, many clients find that therapy can be extremely helpful to them throughout their transition. But the decision to pursue therapy is yours alone.

  • Yes, and we encourage it! As a parent, you have the greatest influence over your child— transgender youth with supportive families are exponentially less likely to suffer depression and have problems in adulthood. When a child or teen comes out as transgender, this means a change for the whole family in some way, and therapy can be very helpful to help parents, siblings, and other family members navigate that change. Therapy can help increase communication between you and your child, especially around topics like name change, appearance, medical options, transition at school, and coming out to other members of the family.

    Of course, sometimes your child will not want you to sit in on session. In this case, we’ll discuss our options and try to find some sort of compromise for all parties (maybe you will sit in for the first ten minutes of sessions, or only every other session).

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FAQ — Spectrum Counseling (1)


Can therapists answer questions? ›

The most common questions therapists receive involve experiences that are pertinent to the client's reason for seeking therapy. Many therapists will answer personal questions directly; some will not, but they will explore your reason for asking the question.

What questions are asked in a Counselling assessment? ›

A qualified counsellor will ask you questions about your current difficulties, the impact they are having on your life and aspects of your personal history. You will also have the opportunity to identify your goals of therapy, essentially what you would like to achieve from counselling.

What are the most common questions therapists ask? ›

9 Common Questions in Therapy
  • How does this problem make you feel?
  • What makes the problem better?
  • What positive changes would you like to see happen in your life?
  • In general, how would you describe your mood?
  • What do you expect from the counseling process?
  • What would it take for you to feel happier or more at peace?
21 Sept 2022

What should you not say in a counseling session? ›

Here are 13 things not to say to a therapist:
  • Telling Lies & Half-Truths. ...
  • Omitting Important Details. ...
  • Testing Your Therapist. ...
  • Don't Keep Apologizing for Feelings or Things You Express in Therapy. ...
  • I Didn't Do My Homework. ...
  • Detailing Every Minute Detail of Your Day. ...
  • Don't Just State the Facts. ...
  • Don't Ask Them What You Should Do.
15 Sept 2022

Can you tell your therapist too much? ›

The short answer is that you can tell your therapist anything – and they hope that you do. It's a good idea to share as much as possible, because that's the only way they can help you.

What are the top 5 questions to ask a counselor? ›

Setting Goals For Therapy
  • How often would you anticipate seeing me? For how long?
  • How do you set up counseling goals? What are they like? What is success for you?
  • What is typical session like? How long are the sessions?
  • What kind of homework/reading do you give patients?
  • How do I prepare for my first session?
3 Mar 2016

How do therapists assess you? ›

A psychological assessment can include numerous components such as norm-referenced psychological tests, informal tests and surveys, interview information, school or medical records, medical evaluation, and observational data. A psychologist determines what information to use based on the specific questions being asked.

What are the five 5 stages of counselling give the highlights of each stage? ›

There are five major stages that we will look at today:
  • Stage 1: Initial disclosure.
  • Stage 2: In-depth exploration.
  • Stage 3: Commitment to action.
  • Stage 4: Counseling intervention.
  • Stage 5: Evaluation, termination, or referral.
6 Apr 2022

What is the first thing a therapist asks? ›

During the first session, your therapist may ask you: What are your symptoms? What brought you to therapy? What do you feel is wrong in your life?

What is the first question a therapist asks? ›

Why are you seeking therapy at this time? People go to therapy for a variety of reasons. You'll be asked to explain why you're seeking therapy to give the therapist an idea of your goals.

Is it okay to bring notes to a therapy session? ›

It's generally best to keep note-taking during the session to a minimum. It can help to jot down brief thoughts and formulate sentences from these notes later. You might use shorthand, symbols, or other methods to help you keep track of your thoughts.

Why you shouldn't give advice in Counselling? ›

Ethical boundaries are strictly held in the field of a professional working in the mental health field like a social worker, psychotherapist and counsellor. Therapists can give their views and opinions only when asked from their patients/clients and unsolicited advice is a big no-no.

What therapists dont tell you? ›

10 Things Your Therapist May Not Tell You
  • We see tears every day. ...
  • We learn a lot from you. ...
  • We can't always help you. ...
  • We may do some re-parenting with you. ...
  • We are very strict about confidentiality. ...
  • We don't want to send you to a psychiatric hospital. ...
  • We don't take credit for your success.
16 Aug 2018

What are 3 signs you are seeing a good therapist? ›

Signs Your Therapist is Good For You
  • They actually listen to you. ...
  • You feel validated. ...
  • They want what's best for you. ...
  • They're a strong communicator. ...
  • They check in with you. ...
  • They take the time to educate themselves. ...
  • You view them as an ally. ...
  • They earn your trust.
30 Sept 2020

Do therapists think about me between sessions? ›

Your therapist's relationship with you exists between sessions, even if you don't communicate with each other. She thinks of your conversations, as well, continuing to reflect on key moments as the week unfolds. She may even reconsider an opinion she had or an intervention she made during a session.

Are therapists supposed to tell you what to do? ›

Telling You What To Do

It's OK for therapists to share their thoughts and opinions if you ask for advice, but they shouldn't be ordering you around. Therapy is supposed to empower you and give you the cognitive skills to make great decisions. Telling you what to do defeats that purpose and is an ethical grey area.

What body language do therapists look for? ›

Some of the things psychologists look for are your posture, hands, eye contact, facial expressions, and the position of your arms and legs. Your posture says a lot about your comfort level.

Why does my therapist watch my hands? ›

Hands. Your client's hands can give you clues about how they're reacting to what comes up in the session. Trembling fingers can indicate anxiety or fear. Fists that clench or clutch the edges of clothing or furniture can suggest anger.

What are some thoughtful questions? ›

Philosophical questions:
  • Where are you finding the most meaning in life?
  • What do you imagine your legacy will be?
  • How long do you think you'll be remembered?
  • What do you feel has been the most important thing you've done in life so far?
  • What lasting impact do you know you've made in the world?
27 Apr 2021

What is an example of a leading question Counselling? ›

Leading questions are another specific form of closed questions. In this case, the answer is contained in the question. For example, you might say, “You are going to sort out this conflict issue, aren't you?.” Leading questions are not true questions, because the coachee knows the answer you want to hear.

What are the 3 parts involved in a counseling session? ›

The three major stages of the Counseling process
  • Initial stage or the initial disclosure stage.
  • Middle stage or in-depth exploration stage.
  • Last stage or commitment to action stage.

What are the 5 stages of counseling? ›

The basic stages of counseling are: 1) Developing the client/clinician relationship; 2) Clarifying and assessing the presenting problem or situation; 3) Identifying and setting counseling or treatment goals; 4) Designing and implementing interventions; and 5) Planning, termination, and follow-up.

What is the most critical phase of counseling? ›

The clienthrapyst relationship stage is the most critical of them all.

What is the most important stage of counseling and why? ›

Opening: The initial portion of the counseling process is one of the most important because it provides both counselor and client the opportunity to get to know each other. It also allows the counselor to set the tone for the therapeutic relationship.

What are the 7 principles of counseling? ›

This chapter explains the "ethical principles" that guide the helping professions: autonomy, nonmaleficence, beneficence, justice, fidelity, and veracity.

What are the 6 core conditions in counselling? ›

The Core Conditions

These conditions can be expressed in plain English as follows: The counsellor is congruent (genuine). The counsellor experiences unconditional positive regard (UPR) – non-judgmental warmth and acceptance – towards the client. The counsellor feels empathy towards the client.

What are the 6 principles of counseling? ›

This chapter describes the six core ethical principles underlying ethical analysis in the profession of counseling. These principles are autonomy, nonmaleficence, beneficence, justice, fidelity and veracity.

How long should therapy last? ›

The number of recommended sessions varies by condition and treatment type, however, the majority of psychotherapy clients report feeling better after 3 months; those with depression and anxiety experience significant improvement after short and longer time frames, 1-2 months & 3-4.

What are 5 responsibilities of a therapist? ›

Mental Health Therapist Responsibilities:
  • Diagnose and treat mental health disorders.
  • Facilitate sessions with individuals, groups, or families.
  • Refer clients to specialists if necessary.
  • Create a treatment plan based on each client's needs.
  • Monitor client progress during treatment.

What do therapists do on the first visit? ›

Your first session will probably involve your therapist asking you a lot of questions about you, how you cope, and your symptoms (it's basically an interview). You may also chat about goals for therapy, expectations, and more.

What are the 3 basic tasks of the therapist? ›

According to Yalom what are the three basic fundamental tasks of a therapist? Yalom (2005) states that the three fundamental tasks of a therapist are "1) Creation and maintenance of the group, 2) Building a group culture and 3) Activation and illumination of the here-and-now." (p.

How do you introduce yourself in Counselling? ›

Before we get going today, let me explain to you a little bit about who I am and what I do. I'm the Behavioral Health Counselor for the clinic and I'm a [discipline can be mentioned here if desired; it may, however, be sufficient simply to be referred to as a counselor or consultant].

How do I go deeper in therapy? ›

How To Go Deeper In Therapy
  1. Find a therapist that makes you feel safe, heard and acknowledged. Looking for the right fit is tough work, but well worth it. ...
  2. Prioritize your concerns. ...
  3. Test the waters - are you ready to really open up? ...
  4. Bring it up! ...
  5. Embrace the process and not the fix.

What is the most important factor in therapy? ›

Therapist Empathy, Positive Regard, and Genuineness

The extent to which a client experiences the therapist as empathic and genuine is thought to be an important ingredient for a strong therapeutic alliance and effective psychotherapy.

Why does my therapist sit in silence? ›

The Benefits of Therapist Silence in Session

Therapist silence can help the client stay in charge of the session. When we don't jump in with an agenda, the client will often take more responsibility for setting the goal of the session and for deciding what is most important.

What is shutting down in therapy? ›

Sometimes we strike a nerve that causes our clients to feel too vulnerable, leading to a “shut down” response. This is a protective mechanism that probably served our client very well at some point in their life when there was a real threat.

Why would a therapist drop a client? ›

Therapists typically terminate when the patient can no longer pay for services, when the therapist determines that the patient's problem is beyond the therapist's scope of competence or scope of license, when the therapist determines that the patient is not benefiting from the treatment, when the course of treatment ...

Can you use your phone in therapy? ›

Typically, cellphones are allowed but there may be restrictions on use during specified times outside of treatment. or get a text for information on various treatment options.

Do therapists talk to each other about patients? ›

Knowing that you can say anything to your therapist and it will remain in the room helps you feel safe and builds trust between you and the therapist. For this reason, all therapists are legally and ethically bound to keep their sessions confidential and not share with anyone else what was talked about.

Should a counselor touch the client or not? ›

A recent paper from the Association for Play Therapy proposes that touch should be used cautiously, but the key ethical issues are to avoid exploitation, to touch only in ways that are consistent with the therapeutic goals and needs of the client, and to take developmental considerations into account.

Can counseling do more harm than good? ›

Yes, it's more likely that therapy will do good than harm. But the dark secret in the mental health world is that therapy can cause harm. People who've been to a bad therapist can tell you: bad therapy is worse than no therapy at all. A bad therapist can shut down your healing process instead of helping it along.

Do therapists believe their clients? ›

Most therapists have the luxury of believing their clients will tell the truth, or at least near truths, much of the time.

What can therapists not do? ›

All therapists are legally required to maintain confidentiality for their clients. Confidentiality means that a therapist cannot confirm or deny even treating the client if someone asks. Furthermore, they cannot discuss any revealing contact information, such as a client's name or demographics, outside of the session.

Are therapists supposed to give you answers? ›

Often, when people start therapy sessions they expect their therapists to provide tangible answers or give “quick fixes” to their problems. In other words, they want specific, concrete solutions for whatever issues that are troubling them. But most therapists avoid giving their clients advice.

Should therapist answer personal questions? ›

All therapist self-disclosure should be deliberate,” Henretty says. “Some research shows that therapist self-disclosure is something patients remember best.” On the other hand, if the therapist answers the question and remains focused on themselves for a substantial period of time, that would be a red flag.

Why won't my therapist answer my questions? ›

Sometimes therapists aren't comfortable answering certain questions. They may hit too close to home, or trying to think about how to best answer them may distract us from focusing on you. A good therapist will be honest and let you know that.

What therapists dont talk about? ›

Some of these topics include feeling incompetent; making mistakes; getting caught off guard by fee entanglements; becoming enraged at patients; managing illness; understanding sexual arousal and impulses; praying with patients as part of therapy; feeling ashamed; being fired; and not knowing what to do.

What makes a therapist unprofessional? ›

Therapist is contentious with you or frequently confrontational. Counselor doesn't remember your name and/or doesn't remember your interactions from one session to the next. Therapist does not pay attention or appear to be listening and understanding you. Counselor answers the phone during your session.

Do therapists give advice or just listen? ›

After all, your therapist is a trained listener, not advice-giver. That does not mean your therapist is merely looking at you and listening while you talk. Any skilled therapist will be listening acutely for specific signals, which they then use to guide the direction of the conversation over time.

How do you know your therapist is wrong for you? ›

Signs That Apply to All Forms of Psychotherapy
  1. Not Listening or Responding. ...
  2. Judging You. ...
  3. Telling You What To Do. ...
  4. Imposing Religious, Spiritual, Political or Social Beliefs. ...
  5. Not Being Sensitive to Your Beliefs or Background. ...
  6. Breaking Confidentiality. ...
  7. Encouraging You to Blame Everyone for Your Issues. ...
  8. Shaming Mental Illness.
12 Oct 2016

Do therapists report what you say? ›

In general, therapists are required to keep everything you say in confidence except for the following situations: planned suicide intent. planned violence towards others. past, present, or planned child abuse.

Should a therapist ever hug a client? ›

A therapist can hug a client if they think it may be productive to the treatment. A therapist initiating a hug in therapy depends on your therapist's ethics, values, and assessment of whether an individual client feels it will help them.

Should you tell your therapist you Googled them? ›

Googling a therapist can raise feelings of guilt for some clients, and I think that it is useful in therapy to discuss the relationship as openly as you feel able. I would suggest that having a conversation with your therapist around your internet search could be a great opportunity for good work in therapy.

Why do I feel like my therapist isn't helping? ›

Reasons, such as lack of trust or feeling misunderstood, may make you feel like therapy isn't helping. Here's how you can improve your experience. There are many reasons why therapy may not be working for you. Your therapist, the type of therapy they provide, and how they relate to you may be the reasons.

Why do therapists stay silent? ›

Done supportively, silence can exert some positive pressure on the client to stop and reflect. Non-verbal signals of patience and empathy by the therapist can encourage the client to express thoughts and feelings that would otherwise be covered up by too much anxious talk. Sympathetic silence can signal empathy.

Why does my therapist not say anything? ›

If your therapist doesn't say anything when you enter the room—and I mean not even a “hi” or a “how are you?”—it doesn't necessarily mean they're being rude. It's not a test, and it's not meant to make you feel a certain way. Believe it or not, the space is there so the therapist has less influence over the session.


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