What to Expect When Working with a Student Therapist: How Low-Cost Therapy Can Help You Heal

For many years, I was fortunate to have insurance coverage through an employer that made psychotherapy and counselling easily accessible. It was a true gift to be able to support myself without financial stress. A few years ago, that changed. I suddenly found myself without that coverage and facing the true cost of accessing care for myself or my children. It felt like an astronomical amount of dollars compared to my income, and completely inaccessible. For individuals and families living on a modest or even a reasonably comfortable income, often the cost of psychotherapy is staggeringly out of reach. This is especially true when you have children who need therapy at the same time, or if you are a couple seeking relationship therapy alongside individual support for both partners.

I get it.

For many people, this is when they ask their family doctor about publicly funded services. These services can be life changing and are a necessary (and underserved) part of our health care systems. In my experience, however, they are often limited. You often do not have any choice in selecting a therapist who is a good match for you and you are assigned to a therapist as space becomes available. There can be long waits for service. There can be limitations on the type of therapy, or the number of sessions provided. And you might find that there are other legitimate reasons that these fantastic free services aren’t working for you or your family. They are very important services, that I believe should be prioritized and expanded, but don’t work out for everyone.

When that isn’t the right path for you, what are you supposed to do? It isn’t fair or just. Everyone should be able to access high quality mental health care, but $150-180 per hour, for who knows how long, is often impossible.

What to do?

Student therapists, or intern therapists, during their practicum placements can be exactly what’s needed to fill that gap in service. At first glance, this is because they offer truly affordable options. They typically charge under $100 a session, and often under $50. They offer sliding scale options, or pay-what-you-can, and many student therapists offer free sessions where needed. So, whether you can afford $80, $40, $20, $5 or nothing per week, there’s someone out there who can help you. But there are more reasons to work with a student.

They are highly trained, finishing up their academic credentials, and currently learning and gaining experience with the application of all their learning. They are often very insightful, up on the newest research, looking at things with fresh eyes, and at the top of their game.

According to some research (for example research by Daryl Chow and Scott Miller), therapists typically have their best results in the first two years of practice – as that is the plateau of effectiveness for the average therapist. That sounds dire, but there is a sunny side to this fact! Psychotherapists in training are inside the period of that upward trend. They are motivated, actively researching the issues of their clients to find the best treatment models, getting a very high number of hours of supervision, and therefore their ability to case conceptualize is on fire! In my experience, one of the reasons for this is that student therapists have to spend a lot more time making sense of the psychological framework they are working from to understand their clients, they spend more time talking about specific cases with experienced supervisors and reflecting more deeply about their clients. Also, they’re success and graduation are tied to how well they do in their practicum. According to Chow and Miller’s research about feedback informed practice, or deliberate practice, it seems that doing more of these things is connected to better performance, no matter where a therapist is in their career. But student therapists are steeped in this. You can expect to receive very high-quality care.

And a third benefit of working with a student exists. Many student therapists take their clients with them into private practice after they graduate. Sometimes they continue to provide reduced fee services to those special clients who joined them on their practicum journey. I can say that those first few clients have stayed on my mind and heart, even if I no longer see them. It’s always worth asking whether the student therapist you hire will be able and willing to continue treating you after they complete their practicum placement.

What to expect in a session with a student therapist

Your first point of contact might be the therapist themselves, or it might be the clinic that is hosting their practicum placement. This could mean you first speak with an intake coordinator, who asks you some questions to match you with the most appropriate therapist. They know that you are vulnerable and that it can be difficult or even not appropriate, to share intimidate details about your mental health or life circumstances – so remember that you only need to share as much as you feel comfortable sharing to try to find a good therapeutic match. You can always switch therapists later, so remember to share based on your comfort level.

Your first session will be an intake session, where the therapist will get to know about you, your hopes and goals, what’s challenging you that you’ve come to work on, and some of your life history. They might ask about your career, your family of origin, any relevant medical history, who you live with, and more. Again, they should absolutely be aware that as strangers, you might not yet feel comfortable sharing some things, and that it’s absolutely ok for you to wait until you feel comfortable to share about something. It can take a few or more sessions to build a therapeutic relationship that is trust-worthy enough for that kind of sharing. Take your time. Go gently. Remember that students are also learning, are under a high level of supervision by experienced practitioners, and follow ethical guidelines, including to not cause harm.

Common Concerns

Will the therapy be as good as working with a fully licensed therapist?

• All therapists are different, and there are better and worse therapists at every level. Positive outcomes are closely tied to the success of the therapeutic relationship, more than years of experience or type of therapy used.
• Sometimes there is a specific type of therapy that a student might not have training in, that the client would benefit from. In that case, it may make sense to seek out a therapist with that training.
• Some issues may be outside the scope of student therapists – it depends on the student and their supervisor whether they will take on more complex cases. It’s a good idea to ask about this, if you aren’t sure.
• Some student therapists come with a plethora of life experience, or past counselling experience. Sometimes they are updating credentials but have many years under their belt already. Sometimes this is a second career, and they have plenty of life experience that makes their therapy highly effective.

What if I feel it’s not working?

This one I have a short and sweet answer to. If you feel it’s not working out – tell your therapist! It’s scary to do that. And it’s also a beautiful way to repair the therapeutic relationship and begin to move productively forward. But also, if you can’t do that, or if you did that and got a less than satisfactory response, you shouldn’t feel compunctions about finding a new therapist. Not every pairing is a good match, and it can take time to find the right one. Each appointment is a job interview, especially at the beginning.  Give it a fair chance and then move on if needed.  Your therapist should also want what’s best for you, whether that is themself or referring you on to someone who might be a better fit.

So, how do you find a student therapist who is a good fit?

Find a Student Therapist is the only student-specific therapist directory in Canada. Unlike other directories, where you might sift through many listings to find the students, FAST only lists students. Use the filters and search bar to narrow down your results – search for the language you speak, ethnic affinity, your current challenges, pronouns, and more. Then read the therapist’s “Get to know me” section to get a sense of their unique personality. Send them a message through the form on their page and set up an initial call.

Practical tips

When looking for a match, think about what you want to work on, or what’s been bothering you. Think in terms of headlines or chapter headings – a simple sentence that describes the problem without getting into all the details.  Look for a therapist who seems to align with your values and goals or otherwise feels like they might be able to ‘grok’ you, get you, be on the same vibe, or however you think about this. Don’t be afraid to switch if it doesn’t work out.

I encourage you to consider working with a student therapist as a powerful step toward better mental health. Find a student therapist today at www.findastudenttherapist.ca and take your first step toward healing.

This blog was informed by a variety of research and clinical experience. Below are a few of the resources that informed it.

Chow, D. L., Miller, S. D., Seidel, J. A., Kane, R. T., Thornton, J. A., & Andrews, W. P. (2015). The role of deliberate practice in the development of highly effective psychotherapists. Psychotherapy, 52(3), 337–345. https://doi.org/10.1037/pst0000015

www.darylchow.com

www.scottdmiller.com