Rate This Article to Enter to Win $1,000!
Back to the January Issue

What Happens at Counseling?

By Stacy Hill, MSW

Being a student can be stressful. You’ve got your schoolwork to focus on, plus all kinds of other things going on. Sometimes it can help to talk with someone about the many responsibilities you’re balancing, or sort through an experience or feeling. If you’re in need of an unbiased ear, meeting with a counselor may be right for you.

Reasons to Talk

There’s a common misperception that the only people who work with professional counselors are those with serious mental health concerns. In truth, anyone can benefit from having a place to talk and focus on him- or herself.

You might talk with a counselor because:

• You want to be more assertive
• You’re questioning the health of a relationship
• You’re having trouble sleeping
• You are concerned about a friend or family member
• You want to feel better about your body or yourself in general
• You feel sad or anxious
• You’re having trouble concentrating
• You’re overwhelmed by all your responsibilities
• You want to talk about something that happened, recently or in the past
• You want to talk about your use of alcohol or other drugs
• Someone has hurt you—emotionally, physically, sexually, or in another way
• You need a confidential place to share your feelings and experiences

This is just the beginning. There really isn’t anything you can’t talk about with a counselor.

Who They Are

So, who are these people? “Counselor” is a catchall term for people who have been professionally trained to listen and help people. Sometimes called “therapists,” there are different types, with different degrees. These may include: 

• Social workers
• Psychologists
• Psychiatrists
• Licensed Mental Health/Professional Clinical Counselors
• Psychiatric nurse practitioners
• Graduate and doctoral students in the above professions

Usually social workers, psychologists, and counselors are the people you will meet with for discussion of what motivated you to come for counseling. Psychiatrists and psychiatric nurse practitioners often focus on prescribing medications and supporting those who take medicines with their concerns.

If you’re curious how the person you’re speaking with has been trained, ask! Feel free to ask where they went (or go) to school, if they have a specialty, and if they have particular ways in which they like to work. Counselors are there to serve you, so they want you to feel informed and comfortable.

What They Do

Some people think, or hope, that a counselor solves their problems or tells them what to do. While some will make suggestions, their main focus is on helping people figure out what they want to do, and how they want to do it.

Some counselors do more listening than talking, and others ask many questions. Overall, the goal is to get to know you and what you’re hoping to accomplish by meeting.

Because most insurance carriers cover a maximum number of sessions (for a given issue), you will be encouraged and assisted to build a toolbox of skills that you can use in many areas of your life. A counselor’s goal is for you to feel confident and balanced: in short, to be your best self.

At an Appointment

When you first come in, you’ll likely sit down for 1-1.5 hours together. The counselor will ask you questions, some about who you are and what made you decide to make an appointment. He or she will probably also ask some questions about your family and your experiences in general. The goal here is to help you feel at ease and put your current situation into context.

This is also your opportunity to share how you’re feeling. There’s no need to be embarrassed or feel shameful about anything you might say. The job of a counselor is to be non-judgmental and provide you with a safe place to be honest and open. Plus, they hear all kinds of things every day. No matter how strange, shocking, sad, funny, difficult, or sensitive it is, they’re prepared to hear about it.

Everything you talk about with a counselor is confidential. If something is to be shared with another practitioner, or someone else, you will have to consent in writing. The only exception to this rule is if you are in immediate danger of hurting yourself or someone else.
After this initial “intake” appointment, you’ll likely set up another time to meet with your counselor. These sessions are usually 45-50 minutes long. In them, you’ll continue to talk about what’s bothering you, and work together to resolve the issues.

Sometimes the work you want or need to do requires more time than the counselor you are seeing can offer, or he or she feels you’d be better served by another person (who may have different or additional skills). If this is the case, you’ll be provided with a referral. This may be to another person in the same practice or to someone elsewhere. Many counselors collaborate with other professionals in a similar field, so they can recommend someone they trust. If you have questions about the process, always ask. 

If You Don’t Click

Working with a counselor is something that requires trust and openness. Just like in any other relationship, you might not connect with the first person you meet. This is completely okay, and something counselors are accustomed to hearing.

If you’d like to try talking with someone different, tell the counselor and/or the person who makes appointments. You can simply say that you think you might get more out of the experience with someone who has a different approach. If you describe what you’re looking for, you’ll likely get a recommendation. Sometimes it can take a few tries to find the right match, and that’s normal.

Counselors and therapists are great resources, no matter what it is you’d like to work on. There is no issue too small, or too big. Reaching out to talk is something students do every day. If you need support, it’s likely as easy as picking up a phone. 

Take Action!

• If you’re looking for an unbiased ear, consider talking with a counselor.
• If someone you know is having a hard time, support him or her in seeking help.
• Set aside concerns of embarrassment or shame. Thousands of students seek counseling every day.
• Contact a trusted health care provider or your insurance carrier if you have questions or to make an appointment.
• Remember that counseling conversations are confidential.

STACY HILL is a health educator and writer in Boston. She has her master's in social work from Hunter College at the City University of New York.

To learn more about the background of your counselor, feel free to ask. You can also check out these organizations:

National Association of Social Workers

American Psychological Association

American Psychiatric Association

American Psychiatric Nurses Association

American Counseling Association

Association for Addiction Professionals

Find Out More or Get Help

>>> Go To Setting S.M.A.R.T. Goals