COUNSELING & MENTAL HEALTH QUESTIONS
What types of problems do students typically come to counseling services with?
It is a common misconception to think that only seriously ill or "crazy" people need counseling help. Studies show that over eighty percent of people can benefit from counseling at some time in their lives. So, it is normal to need counseling when special concerns or difficult feelings arise. Most people have a problem with anxiety, depression, stress, relationships, etc., at some point. Students come to counseling with a range of problems. Many have issues related to their normal development such as identity or relationship issues. Others are dealing with more specific psychological issues such as depression, anxiety, post-traumatic stress, bereavement, substance abuse, or eating and body image issues. Some students are not sure what the problem might is but just know they are not functioning or feeling the way they normally do. They might notice having a harder time studying, eating or sleeping too little or too much, or otherwise just not meeting their day-to-day obligations. A counselor can help students sort out what is wrong in order to help get students back on track. Don't put off seeking counseling or therapy. If you are considering it, this is an indication that you probably could benefit from the experience.
What happens in counseling?
Generally, you will meet with your counselor regularly for about 45-50 minutes at the same time once each week. At these meetings, you will discuss your concerns and often provide some historical information. Counseling is a collaborative effort between the counselor and client. Professional counselors help clients identify goals and potential solutions to problems which cause emotional turmoil; seek to improve communication and coping skills; strengthen self-esteem; and promote behavior change and optimal mental health. Through counseling you examine the behaviors, thoughts and feelings that are causing difficulties in your life. You learn effective ways to deal with your problems by building upon personal strengths and learning ways to encourage personal growth and foster your interest and welfare. It is not unusual for students to feel nervous or uncomfortable at first, but this usually dissipates as your counselor helps you talk about your concerns.
Who is eligible to use the counseling services on campus?
All currently registered SMU students are eligible for services and allowed 10 individual therapy sessions per academic year. Students who want or need more frequent or longer-term contact with a counselor are referred to off-campus resources. Faculty and staff are not eligible for SMU’s counseling services but may contact our professional staff for consultation regarding student concerns. You can contact the counseling staff by calling 510-869-6629.
Is a spouse or partner eligible for services?
A spouse or partner is eligible for services if they are also a registered student. Couple’s counseling with a non-student partner is decided on a case-by-case basis and only after the registered student is seen for an assessment first.
How do I set up an appointment at the SMU SHAC?
If you are able to be seen at the Student Health and Counseling Center (SHAC) on the Oakland campus, setting up your first appointment is easy and students can usually be seen within the same week. The SHAC is located on the Oakland campus and is open Monday – Friday between 8:30 – 5:00pm. To set up an initial appointment please call 510-869-6629. Initial paperwork is required and takes approximately 20-30 minutes to complete in our office. In the first appointment you can share about your concerns and the counselor can assess your current situation and help decide on a plan with you. If off campus resources are recommended, your counselor can help you access those.
**If you are on the San Francisco Peninsula or Sacramento campuses and are not able to come to the Oakland campus, you can obtain 10 free counseling sessions through the Sutter Employee Assistance Program (EAP). They can be reached at (800) 477-2258 or online at: http://sutterhealth.org/eap/
Will my health insurance cover counseling?
To be seen by the SHAC's counseling staff, insurance is not required and all sessions are free. If you wish to use services off campus, many insurance and coverage plans cover mental health services by a licensed professional counselor. Call your insurance company and ask about your mental health coverage options. They can inform you of your benefits (e.g. how many sessions per year are covered, what your co-pay may be, etc) and will provide you with a list of local providers who accept your insurance. See this Finding An Off Campus Provider handout for more information and helfup tips. If you do not have health insurance, or if your coverage does not include mental health care or the services of a professional counselor, many professional counselors will work with clients on a sliding-fee scale or will offer a payment plan. Talk to your counselor about your options or see this Local Low Fee Counseling Centers list as a place to start.
How much does counseling cost?
At the SHAC's counseling services students are allowed up to 10 sessions of counseling per calendar year and all services are free of charge. In the community the cost of counseling can vary greatly depending on your geographic location and whether counseling is being provided by a community mental health center or similar agency or by a counselor in private practice. In general, the average paid fee for individual counseling sessions is between $125-200/hour in the SF Bay Area. Fees for group counseling are generally lower, about $40 per group session. For clients with health insurance that does not cover mental health care and others who cannot afford the counselor's standard fee, some counselors will lower their fee on a sliding scale basis or will work out a payment plan. Your counselor should explain to you, prior to beginning the counseling relationship, all financial arrangements related to professional services.
What happens in the first appointment?
Generally, you will meet with a professional counselor or therapist regularly for about 45-50 minutes once each week. At these meetings, you will discuss your concerns with the counselor. The goal of counseling is to learn about our habits and patterns of feeling and behavior and how they cause us problems. We can then learn new habits and patterns which will be more successful for us. Although it seems strange to think that we might not know ourselves completely, experience has shown that many of the problem-causing habits and patterns are things we have done all our life and are so automatic that we don't even think about them as learned or optional behavior. Counseling provides a special setting in which we can learn about ourselves. This can help us to be more effective in our relationships with others and with ourselves. It takes time, helpful observations and support to recognize and change our ways of living.
Will I need to take medications?
Being seen for psychotherapy by a counselor does not necessarily mean you will need to take medications. Many psychological problems can be successfully treated without the use of medications. If you and your counselor decide that medications should be considered as a adjunct to counseling, your counselor will discuss referral options with you. You will need to see a physician (such as a psychiatrist) to be prescribed any medications. It is important to let your counselor know about any medications you have already been prescribed.
What do I look for when I talk with the counselor on the phone before the session and/or in our first sessions?
The most important question is the one you will ask yourself: How do I feel about this person? Do they seem comfortable and compatible for me? Do they seem empathetic? Naturally, you will feel somewhat anxious with each of the therapists you meet, but there will be differences in your feelings toward each. Pay attention to these feelings. Also, don't ignore your feelings. If you have a creepy or uncomfortable feeling, bring it up to the therapist or choose someone else—but don’t give up! One size does not fit all and sometimes it takes “trying on” a few therapists to find the right fit.
Is everything I say confidential?
All members of the American Psychiatric Association (APA) subscribe to the Code of Ethics and Standards of Practice which require counselors 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 law in the State of California provides the following exceptions to confidentiality, but even in these circumstances you will be informed before confidential information is revealed whenever possible:
- If the counselor has knowledge of abuse of a child, elder, or a person with a disability.
- If the counselor has knowledge of intent to harm himself/herself or others.
- If the counselor receives a court order to the contrary.
How can I get the most out of my counseling sessions?
You can maximize the progress you make in counseling by being actively involved in the work you and your counselor are doing. Some suggestions include:
- Be on time and try not to miss any of your scheduled meetings, consistency is important with counseling
- Between sessions, make time to think about the things you have discussed with your counselor. Journaling about topics discussed can be helpful.
- Invest in following through on any homework assignments, readings, or books your counselor has suggested for you
- Be as honest and open with your counselor as possible.
Will my counseling records be a part of my academic record?
All counseling records are confidential and are not part of the academic record.
Do some graduate schools, professional board or regulatory agencies request counseling records?
Yes, some graduate schools, professional board or regulatory agencies request counseling records. It is the decision of the student to acknowledge whether s/he has received therapy when asked. However, counseling staff can only release information with the student's written permission.
How long will you keep my records on file?
We follow the state and national guidelines for retaining confidential records. All such records are required to be kept on file for seven years after your last session. If you are a minor, your records will be kept for seven years after you reach the age of 18. After that seven years, your records will be destroyed.
How do I find a good counselor in the community?
If you do not want to see a counselor on campus, the Counseling Center also has a referral list of private therapists, Low Fee Counseling Clinics and other options in the bay area. Some other good options for finding the right provider include:
- Ask friends and family members: Sometimes the right therapist for your friend may not be right for you, but it is a starting place. Some people do not want to 'share' a therapist with someone they know.
- Get a referral from another professional source -- e.g., your family doctor, etc.
- Call your insurance company and find out if you have mental health benefits. They can assist you with finding a provider in your area that is covered. Also see the Finding an Off Campus Provider handout for more helpful questions to ask and tips.
Should I consult my physician first before being seen?
Consult your doctor for a check-up before beginning counseling to make sure your condition is not due to or made worse by a physical disorder can be a good step. Many illnesses can affect mood, concentration and so forth. Some conditions (e.g., depression or severe anxiety) require treatment with medication. The therapist should refer you to a psychiatrist for a medication consultation, if your condition warrants.
How do I know when I am done with counseling?
Give therapy a chance. Consider the first couple of months as a trial period. It usually takes at least that long to experience progress, depending on your problems and issues. Progress is usually inhibited by changing from one counselor to another frequently. In considering when to discontinue treatment, ask yourself whether the problems that caused you to seek counseling have been resolved and whether any additional problems or issues have come to your attention that you may wish to resolve. Also consider the advice of your counselor. A frank discussion of the advisability of terminating treatment is usually useful. Remember that no decision about counseling or psychotherapy is irrevocable. While you may seek advice from others, decisions to begin and end treatment and the choice of counselor are yours alone.
If I think my friend needs help, how do I get him or her to come in and see a counselor?
It can be very difficult when someone you care about is in pain. You might find yourself feeling helpless, frightened, frustrated or angry. It is very hard to make a person seek help if they don’t want to or don’t feel they need it, and counseling with an unwilling client is usually not very effective. Here are some things you might offer as a friend:
- Let your friend know that you are concerned. Suggest that he or she make an appointment with a counselor to see if we can be of help. Try to phrase the communication using “I’ language, rather than “you” language. For example, “I care about you and I am sad to see you are hurting” rather than “You are in trouble and need help.”
- Offer to sit with your friend while he/she makes an appointment.
- Offer to accompany your friend to their first appointment, and either wait in the waiting area or go to the appointment with him/her.
- Call or come into the counseling center yourself, and talk with a counselor about your worries about your friend. You will not need to tell the counselor your friend’s name, and you do not necessarily even need to let your friend know you came in. The counselor may be able to offer you suggestions about how to interact more effectively with this friend, as well as to manage your own feelings about the situation.
- Surf the web or the bookstore for information about your friend’s problem(s), and pass it along to your friend. Invite him/her to compare reactions with you about the information, or talk about the information with a counselor.
However, remember that you cannot force anyone to get help, you can only encourage, support and offer resources. If you find yourself becoming too involved or your friend’s problems are overwhelming you and affecting your life or work negatively, please contact the counseling center for a consultation and for your own support.