Ideally, counseling is terminated when the problem that you pursued counseling for becomes more manageable or is resolved. However, some insurance companies and managed care plans may limit the number of sessions for which they pay. You should check with your health plan to find out more about any limitations in your coverage. During the first few counseling sessions your counselor should also discuss the length of treatment that may be needed to achieve your goals.
All members of the mental health fields should subscribe to a Code of Ethics and Standards of Practice which require them to protect the confidentiality of their communications with clients. Most state licensure laws also protect client confidentiality. As a client, you are guaranteed the protection of confidentiality within the boundaries of the client/counselor relationship. Any disclosure will be made with your full written, informed consent and will be limited to a specific period of time. The only limitations to confidentiality occur when a counselor feels that there is clear and imminent danger to you or to others, or when legal requirements demand that confidential information be disclosed such as a court case. Whenever possible, you will be informed before confidential information is revealed.
When it comes to military members, if you are being seen on-base at the Mental Health Clinic, the information you provide is not provided to your chain of command if you self-referred. The same limitations of confidentiality that you have off-base apply, but the following situations are also reportable when being seen on base by anyone other than a Chaplain. Those include: suspicion of child abuse & neglect, suspicion of spouse abuse & neglect, individuals that are on the Personnel Reliability Program (PRP) (refer to AFI 36-2104), the commission of a crime in violation of Uniformed Code of Military Justice, federal or state law, and clear threats to mission accomplishment.
No matter who you see, or where you see them, off-base or on, they should provide you with their Statement of Understanding before your session starts. This will outline their Standards of Practice and detail the situations that they are mandated to limit confidentiality on.
In April 2008, the Department Defense Department officials changed a question on the department’s long-standing security clearance form referencing an applicant’s mental health history because they believe it is needlessly preventing some people from seeking counseling.
The Standard Form 86, Questionnaire for National Security Positions, asks the applicant to acknowledge mental health care in the past seven years. It does not ask for treatment details if the care involved only marital, family, or grief counseling, not related to violence by the applicant, unless the treatment was court-ordered.
Officials said surveys have shown that troops feel if they answer “yes” to the question, they could jeopardize their security clearances, required for many occupations in the military.
As of April 18 2008, applicants no longer have to acknowledge care under the same conditions, nor if the care was related to service in a military combat zone.
The revised wording has been distributed to the services and will be attached to the cover of the questionnaire. The revised question should not show up printed on the forms unless the department has not depleted its pre-printed stock.
- The Mental Health Clinic (if you are a service member on active duty)
- The Base Chapel
- Airman & Family Readiness Center
- Military Family Life Counselors
Off-Base: There are many different ways to locate a professional counselor in the community. Some common ways include:
• Tricare – Go to https://tricare.mil and click on the link to search for clinician. There you can search for a specialty. For example, select “Behavioral Health/Mental Health,” specify your location and then distance you are willing to travel. When you hit search it will give you a list of providers within that distance and provide you their contact information.
• The National Board for Certified Counselors referral service (phone NBCC at 336-547-0607 between 8:30 a.m. and 4:30 p.m. Eastern Standard Time, Monday through Friday to find a certified counselor in your area)
• The local listings, (yellow pages or online) listed under counselor, marriage and family counselors, therapist or mental health
• Referral from your physician
• Recommendations from trusted friends
• Crisis hotlines
• Community mental health agencies
• Local United Way information & referral service
• Child protective services
• Referral from clergy
• Employee Assistance Programs (EAPs)
Once you have found a counselor you are interested in seeing, you should ask several important questions, such as:
• Are you a licensed or certified counselor?
• What is your educational background?
• How long have you been practicing counseling?
• What are your areas of specialization (such as family therapy, women’s issues, substance abuse counseling, etc.)?
• What are your fees?
• Do you accept my insurance?
• How is billing handled?
• Do you offer a sliding fee scale or a payment plan if I do not have insurance for mental health services?
• How can you help me with my problems?
• What type of treatment do you use?
• How long do you think counseling will last?
Some of these questions may be addressed during your initial phone conversation with the counselor and others may be more appropriately discussed in your first face-to-face meeting.
After you have had these questions answered by the counselor to your satisfaction, consider how comfortable you feel with the individual, since you will be working closely together during your counseling sessions. It is difficult to open up and share your problems with a stranger and you may feel awkward or anxious during your initial sessions. But it is also important that you have a “chemistry” or rapport with the counselor. Counselors have different styles, personalities, and approaches. Take time to evaluate how you feel interacting with the counselor and whether you believe that the two of you can work effectively together. If you do not feel at ease with a certain counselor, do not get discouraged. Instead, look for a different individual with whom you would feel more comfortable working with.
Together you and your counselor will set goals, work toward achieving them, and assess how well you are actually meeting them. Counseling can help you maximize your potential and make positive changes in your life. Finally, remember that counseling may be hard work at times but change and progress do happen. A professional counselor can provide the help and support to help you master the challenges of life.