Over 40 Years of Service to the Mental Health Community

MaMHCA: Massachusetts Mental Health Counselors Association



About the Counseling Process

One of the missions of the Massachusetts Mental Health Counselors Association is to promote education about mental health counseling and mental health issues for the public. MaMHCA supports activities that inform and educate consumers about the counseling process.  The following series of questions reflect some of the issues that consumers should consider in choosing a Licensed Mental Health Counselor, or any mental health practitioner, and in evaluating the counseling process.

Referral  Resources

Do you have reliable referral resources who are competent professionals? Do you trust their judgment in psychotherapeutic areas?  Are they experienced in the referral process? Do they abide by National Professional Practice Standards and National Ethical Standards? Do they refer to licensed professionals and belong to one or more professional associations. Does the counselor you are considering have a good network of referral resources for their clients' potential needs.

Boundaries and the Therapy Relationship

Is the therapy relationship with this counselor the only relationship you have with him/her? Boundaries in a therapy relationship should be clear, safe and respectful. There is a potential problem of a boundary violation in a "dual relationship" with someone who is also your teacher, minister, spouse of a friend or co-worker, or parent of your child's friend.

Business Practices

Does the counselor return your call promptly? Can you get an appointment within a week, or sooner in an emergency? Is their office space professional and private?  Is there a clear and reasonable policy in regard to fee and insurance coverage?   Are you informed of emergency coverage and coverage during the counselor's absences?  


Does your counselor explain confidentiality and its limitations to you?  Are you informed that counselors have to receive your written consent for any communication (written or oral) between your counselor and another professional? 


Does your counselor respect your time: do sessions begin and end on time?  Have you developed mutually agreed upon short and longer term goals for your therapy?  Is the focus of your sessions on your issues, without inappropriate detours into the counselor's interests or life events?  Does the counselor respect your physical and emotional boundaries, refraining from suggestive or inappropriate physical and/or verbal behavior?  Does your therapist address your concerns, symptoms, and behavior in a manner that is respectful and helpful?  Does your counselor respect your questions and explain his/her theoretical approach and concepts? 


A good, working counseling relationship takes time for trust to develop and for change to occur.  If, however,  you feel a number of the above questions are answered in the negative, or you feel unsafe, disrespected or exploited in any way, you have some alternatives. You can question your counselor, ask for a consultation, seek a second opinion on your own, and/or leave the therapy.  In addition, the Division of Professional Licensure Registration in Massachusetts has a complaint process you may employ if you feel you have been subjected to unethical practices. 


Material in this section has been adapted from the series, Mental Health Brights, American Mental Health Counselors Association, Alexandria, VA.