Choosing A Cancer Counselor
Your comfort level and the counselor’s experience are probably the most important factors to think about when choosing a counselor. People who work in cancer treatment centers usually have more knowledge and experience with the usual emotional responses to cancer than counselors who work with people without cancer. A counselor’s experience with cancer, whether personal or professional, helps you see that your reactions are normal and can help you make sense of your situation.
For example, an experienced cancer counselor knows that a patient might feel depressed after treatment is finished. This might happen for some people because being in treatment and going to the cancer center means “I am fighting the cancer.” Once treatment is over, patients are sometimes surprised to find they are more worried than they were when they were getting treatment. A cancer counselor knows this is a normal response for many people.
The counselor can help the person with cancer see how this makes sense and not feel so strange and alone at times. And, an experienced cancer counselor will also be able to tell the difference between the normal sadness and loss you feel and a major depression that may require treatment. (For more on this, see Anxiety, Fear, and Depression.)
It’s also important to consider training or credentials when choosing a counselor. Your counselor should have at least a bachelor’s degree in one of the counseling fields. They might also have a master’s or doctoral degree. Counselors come from the fields of social work, psychology, psychiatry, psychiatric nursing, or pastoral counseling.
While credentials describe a person’s formal education in their chosen field, experience with cancer care is also important. And personality is important, too. Ideally, your cancer counselor will be warm and caring. Often the best sources for counselors come from someone who has had a good experience with the professional: word-of-mouth references. Just as you want to be sure the people on your medical team are competent, you should also apply the same standards to your psychosocial care. You should not feel shy about checking out your potential mental health counselor. Professionals who are secure in their abilities should be happy to give you information about their credentials and experience.
Sometimes people feel that unless a counselor has had cancer, they may not be able to help. A personal experience can certainly add to the counselor’s expertise, but living through the cancer experience with many cancer patients and family members is valuable as well. Even if a counselor has never had cancer, we have all experienced life crises and losses. A personal experience with cancer is only one factor to think about in choosing a counselor.
Do you feel safe sharing your concerns with this person? Do you trust their ability to help you? Do you feel that the counselor listens to you and understands who you are as a person? Do you think your family could relate easily to this person? Your reactions may be hard to understand or describe, but trust your instincts. If somehow you just don’t feel comfortable after a few sessions, it would be wise to try someone else.
Paying for counseling services
Most health insurance plans have some coverage for counseling, but coverage is often more limited than it is for medical services.
Mental health coverage is supposed to be available to most people with health insurance, but you may find that your coverage still doesn’t meet your needs. Some policies only pay for a limited number of sessions.
A managed care policy may limit your choices about whom you can see. Your insurance may have contracts with certain mental health providers, but not with others. Smaller employers may not be required to cover mental health treatment at all. Check on your co-pay and how much you will be reimbursed for your mental health provider.
If there are no free counseling services in the hospital or clinic where you are being treated, staff can usually help you get clear information about your insurance plan and what services are covered. Your oncology team should also know of services in the community that may use a sliding scale fee that adjusts to your income. They may be aware of services in the community offered at low or no cost to you, too.
How to know if counseling is working
Here are some ways to decide whether counseling is helping you and your family. Keep in mind that it takes some time to get to these results, and you have to do the emotional work for most of them:
- Am I getting more insight or understanding into my problems? Is it easier to see the overall picture, not just the details?
- Do I feel less anxious or worried?
- Is it easier to make decisions?
- Do I have a clear idea where I am now emotionally, what I need to work on now, and what can wait until later?
- Am I OK with how I am feeling and acting?
- Do I have a goal for completing counseling?
- Could I put into words how counseling is helping me or a family member?
Your family should be asking (and answering) the same questions if they are involved in the counseling sessions. If your answers to these questions are mostly yes, you are probably on the right track. If you don’t feel good about your answers to these questions, discuss them with your counselor. If the relationship with the counselor feels right, it may be that what you expect to get is different from what you are getting. It’s always possible that the counselor is not the right one for you. This may mean you need to find someone who is a better match for you. You may also need different types of support throughout the process and at different stages. The extra effort this takes could make the difference between a good outcome or a more painful one for you and/or your family.