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Consumer FAQs

Counseling / Therapist Fees

Who determines the fees and rates charged by counselors and therapists?

Fees, charged by counselors, therapists, and clinical social workers in private practice, are an example of free-market capitalism in action. Neither the government nor professional associations regulate or determine fees charged for counseling services.

Generally speaking, counselors, therapists and clinical social workers are Masters level counselors and charge less than mental health professionals with PhD or MD degrees. The American Association for Marriage and Family Therapy estimates that the usual fees for marriage and family therapy are about 60% of that psychiatrists charge and about 80% of what psychologists charge. I would consider fees of $100 to $120 an hour to be average in metropolitan areas of Washington State—and somewhat less in more rural areas where the cost of living is less.

Many counselors offer reduced fees based on income (sliding scales); however, counselors who are preferred providers with Health Maintenance Organizations or insurance companies generally don't offer sliding scales because they are prohibited by their contracts from charging any client less than they charge the insurance company clients.

EMDR & PTSD

What is EMDR? Should the counselor be EMDR Certified?

Eye Movement Desensitization and Reprocessing (EMDR) is an integrative psychotherapy approach that has been extensively researched and proven effective for the treatment of trauma. It is used to relieve the symptoms of post traumatic stress disorder (PTSD) and other mental health problems, originally using only movements of the eyes similar to those which occur naturally in REM sleep.

For more details:
See EMDR general information and EMDR-related articles.
See EMDR Certification information.
See PTSD information and PTSD-related articles.
To find an EMDRIA Certified Counselor in Washington State, click here.

Is PTSD or EMDR treatment covered by my insurance?

EMDR is approved by most insurance companies and professional organizations for treatment of PTSD.

See EMDRIA’s Clinical Practice Guidelines.

Chemical Dependency Counseling

I am planning to start school in the winter in the Chemical Dependency program. Can you tell me in simple terms, what I will be able to do with a two year AA degree? What is the potential income and job availability? I am 56 years old and trying to start a new career. I love to help people, however I do not want to make a choice that will not allow me to earn a living. I live in the tri-cities area. Any information positive or negative about this would be greatly appreciated.

Please see the Chemical Dependency Professional licensure requirements for more information.

“Counselor” vs. “Counsellor”

Is it "counselor," or "counsellor?" Why do we spell our occupation as "counselor," while the rest of the English speaking world spells it "counsellor?"

In the United States, we have inherited the spelling of counselor and counseling with one ‘L.’ As professional counselor in numerous specialties, we use one “L” so that we are not confused with attorneys.

Counselor Titles

What is the difference between a registered counselor, a certified counselor, an associate counselor and a licensed counselor?

In Washington State, anyone who practices as a counselor for a fee must be certified or licensed by the state in one of the recognized categories. The former category of "Registered Counselor" was abolished on July 1, 2010.

In Washington State the word "counseling" is legally defined as “employing any therapeutic techniques, including but not limited to social work, mental health counseling, marriage and family therapy, and hypnotherapy, for a fee that offer, assist or attempt to assist an individual or individuals in the amelioration or adjustment of mental, emotional, or behavioral problems, and includes therapeutic techniques to achieve sensitivity and awareness of self and others and the development of human potential” and must be certified, or licensed by the Washington State Department of Health.

"Counselor means an individual, practitioner, therapist, or analyst who engages in the practice of counseling to the public for a fee, including for the purposes of this chapter, hypnotherapists." This means the terms "counselor" and "therapist" are interchangeable titles.

"Psychotherapy" (defined for the first time, effective July 1st, 2009) means “the practice of counseling using diagnosis of mental disorders according to the fourth edition of the diagnostic and statistical manual of mental disorders, published in 1994, and the development of treatment plans for counseling based on diagnosis of mental disorders in accordance with established practice standards." [See DSM IV.]

The following is not a legal opinion however, based on the definitions above, it is Counseling Washington’s belief that a professional who identifies himself as a "psychotherapist" does patient assessment to identify any qualifying symptoms for a mental health diagnosis (unless clients had already been diagnosed) and treats "patients" (rather than "clients") using appropriate treatment plans based on their diagnosis.

In contrast, it appears that a professional identifying himself as a "counselor" or "therapist" can counsel clients without regard to whether or not clients have an identified mental health disorder. So while a "counselor" or "therapist" may be qualified to diagnose and treat mental health conditions, but apparently--by definition--they are free to work with wider scope of clients, from those "normal" clients with normal problems-of-living, to those with some degree of diagnosed mental health conditions using a wide variety of counseling techniques.

----Floyd Else, MA, LMHC, Webmaster

Attention Deficit Disorder

What are the symptoms of adult Attention Deficit Disorder(ADD?)

Adults with Attention Deficit Disorder often spend all day working and, at the end of the day, realize that they didn’t accomplish any of their goals for the day. They have difficulty prioritizing tasks, organizing time and materials, reading social cues, regulating emotions of their own and so on are all because they lack the necessary degree of executive functioning.

Please click here for more detailed information on adult ADD.

Can adult Attention Deficit Disorder (ADD) be cured?

Prioritizing, organizing, reading nonverbal cues, inhibiting inappropriate comments, and regulating emotions make everyday life for ADD adults challenging at work and at home. ADD adults tend to be people who can think creatively and see problems and solutions in a way their co–workers can’t. However for those brilliant ideas to be realized, they have to learn how to use executive function. The good news is that executive function skills can be learned and ADD adults can learn to understand and manage their gifts as well.

Please click here for more detailed information on adult ADD

Basic Requirements for Members of the Therapist Directory

How are members chosen to be listed in Counseling Washington’s therapist directory?

We don’t choose, actually they choose us. Therapists choose Counseling Washington as a reputable, trusted counseling resource to promote their private practices. In turn, Counseling Washington requires its members to be current Washington State license holders with a minimum of a master’s degree. All licensure statuses are verified by Counseling Washington. There are many listing types available to help build counselor and therapist private practices.

Counselors pay a nominal listing fee to Counseling Washington to display their private practice information. These listings may include a counselor profile, therapy group listing, counseling office space ad, counselor workshops, employment opportunities, etc.

Other supplemental listings (free of charge) currently available to authorized mental health care providers include:
(1) the Crime Victim's Compensation Program;
(2) counselors who are fluent in American Sign or a foreign language;
(3) authorized supervisors available to supervise counselors working toward full licensure.

Filing a Complaint

How would someone register a complaint against a therapist who has acted in an unprofessional manner?

Filing a complaint against counselor, therapist or social worker, believed to be unprofessional or unethical, may require becoming familiar with practices counselors should adhere to within the industry. If there is any question in your mind about the behavior of the therapist and whether it was proper, consult some ethics pages to review the standards that counselors try to uphold. For Washington State residents, consult the Revised Code of Washington RCW 18.130.180 dealing with unprofessional conduct.

Also recognize the limitations of confidentiality when filing a complaint: anonymous complaints cannot be made and the accused therapist is not bound by confidentiality in his/her own defense. If your therapist practices in the state of Washington, go to the Washington State Health Department, Health Professions Quality Assurance, Counselor Programs where you can find online complaint forms to start the process.

For more information see Washington State’s Complaint and Disciplinary Process.

Since laws are not uniform between states, you will need to determine what procedures are in place within your state. As state licensure becomes the rule, complaint procedures are also being established. Your state legislator should be able to advise you what state agency regulates therapists within your state.

A secondary approach is to file a complaint with one of the certification agencies that have certified the therapist. Look at the professional initials that the therapist uses after his/her name. For example: NCC is a certification of the National Board for Certified Counselors. Consult one of the following resources for clarification:

Missing Family Members--sons and daughters

Is there an online support group for someone that has lost a significant friend or family member? I have not seen or heard from my only child (34), married to an abuser/control freak in 12 years?

There is a wealth of online support groups and services on Counseling Washington’s resource page that may be able to help you.

Sex Offender Treatment Programs

How can I find a sex offender treatment provider in the Seattle or Eastside area?

The following information was provided by the Washington State Library: "Sex offender treatment providers in WA are licensed by the Washington Department of Health's “Health Professions Quality Assurance Sex Offender Treatment Provider Program.”

Washington State Licensing Requirements for Sex Offender Treatment Providers: Certifications for both fully certified and affiliate providers expire annually on the providers date of provider's birth. Renewals are considered timely if postmarked on or before the expiration date. Certifications that are allowed to expire are subject to an additional late renewal penalty fee. Courtesy renewal notices are sent approximately 30 days prior to the expiration date; however, the provider is responsible for renewing his or her certification prior to the expiration date.

Find a Sex Offender Treatment Provider/Counselor: The Health Professions Quality Assurance Customer Service Center has a booklet that contains a list of credentialed sex offender treatment providers. To request a copy of the booklet, contact them directly at (360) 236-4856 or email Customer Service at hpqu.csc@doh.wa.gov.

NOTE: Sex offenders should request treatment information from the court that sentenced them or from their probation officers.

Community Sexual Assault Programs in Washington State: Information for Survivors, Family and Friends. The Washington Association of Sheriffs and Police Chiefs web site offers additional resources for the public in the Washington Sex Offender Information Center. Read about the OffenderWatch program or view an online presentation.

Social Worker

Is a social worker qualified to do the same kinds of counseling as licensed mental health counselors and licensed marriage and family therapists?

Yes. Clinical social work is the professional application of social work theory and methods for the treatment and prevention of psychosocial dysfunction, disability, or impairment, including emotional and mental disorders of individuals and families. "Clinical social work" includes rendering a diagnosis based on the Diagnostic and Statistical Manual in current use.Clinical social workers provide 61% of mental health treatment in the country (SAMHSA, 2000) and have clinical training standards that are the equivalent or stronger than mental health counselors, marriage and family therapists, psychiatric nurses, and psychologists.

  • Clinical social workers are trained to provide diagnosis and treatment through psychotherapy and counseling of all mental health disorders, working closely with health care professionals who provide drug and other therapies for mental health disorders.
  • Clinical social workers had one of the highest satisfaction ratings of all mental health professionals in a 1995 Consumer Reports article according to 4000 consumers of mental health services.
  • Clinical social workers practice arenas include independent private practice, forensic assessment, mental health agencies, medical social work, school social work, and consultation to business.
  • Clinical social workers have one of the lowest complaint rates of any mental health discipline (less than 1% in Washington, according to Department of Health, 2003).
  • Licensed Independent Clinical Social Workers in Washington State have the highest standards for clinical social work licensure in the country including an MSW degree and three years of post-graduate supervised experience.
  • Clinical social workers contribute to fewer medical problems and decreased health care costs by treating the emotional disorders that lead to 50% of visits to family practitioners (Office of the Surgeon General, 2000).
  • Clinical social workers play an integral role in state, county, and city mental health programs in Washington, King County and Seattle.

Informational reference, February 27, 2004: Department of Health and Mental Hygiene, Maryland Social Workers Act, Health Occupations Article, Title 10, Subtitle 42 Board of Social Work Examiners, Chapter 01, Annotated Code of Maryland.

Treatment Programs Available for Indigents

How can an addict or alcoholic who has lost everything obtain chemical dependency treatment if they do not have money to pay?

Chemical dependency treatment for the indigent alcoholics and addicts seeking alcohol or drug rehab in Washington State is described under ADATSA - The Alcohol and Drug Abuse Treatment and Support Act. If you are looking for drug rehabilitation centers for chemical dependency treatment, there is also a web-based national directory provided by a federal agency.

The Substance Abuse and Mental Health Services Administration maintains the Substance Abuse Treatment Facility Locator.

Using Hypnosis to treat Alcoholism

Could you please provide me information regarding stopping drinking with hypnosis?

There are varying opinions about hypnosis and its effectiveness. Hypnosis can offer a very powerful intervention for drinking problems, as it does for most addictive targets.

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