Community Counseling Agencies: What To Expect

What are Community Counseling Agencies?

While every area will have different names and funders of community counseling services, these are typically agencies (often run by local governments) who specialize in providing mental health treatment at either no cost or at a low sliding-scale rate. Like other forms of treatment, services may include things such as individual therapy, group counseling, couples counseling, and specialized treatment services depending on the presenting issue.

One of the concerns around community counseling is that these agencies are often staffed by less experienced professionals. While it may be true that your therapist may have less years of experience (or still be under supervision for licensure), community counseling agencies still usually have a well-developed supervision program for therapists, meaning that even the less experienced practitioners receive regular guidance and support from more seasoned professionals.

The Downside to Community Counseling

While community counseling may be the best fit for your budget, there are several trade-offs you should know about before seeking this service:

• Wait-lists: Due to the high demand for this service, community counseling agencies may have much longer wait-lists than private service providers; depending on how they are funded, they may limit services to those who present with the highest need for treatment in combination with other factors, such as patient income.
• Less choice: While community counseling agencies are staffed with trained and supported professionals, it is unlikely that you would have the option to select a therapist – instead, most agencies will have you conduct an assessment with an intake coordinator and place you with a provider based on their availability and service specialty. While you may still be able to request a new therapist should you be dissatisfied, this process will take time and may result in a gap in service delivery.
• Employee turnover: Since many therapists start their career working within these settings, their pay is usually lower than what they could receive working in private settings or in specialized organizations. As a result, these agencies experience higher rates of therapist turnover, leaving you at-risk for starting work with a therapist, only to be transferred to a new one after several months.

How Much are Services?

Fees at counseling agencies are typically based on a “sliding-scale”. This means that the fees will be higher or lower depending on your household income. Some agencies will ask you to bring in proof of income such as a paystub. Other agencies will do things less formally, and ask you “What can you afford to pay?”

The most important thing to note is that each agency will have their own unique way of setting fees. This should be part of what you ask when you first call to set up an appointment. If they are not able to give an exact answer, then ask “Can you tell me what the fee range is, and how the exact fee is arrived at?”.

Many agencies will have the policy that “no one is turned away due to inability to pay”. Some might have a minimum fee.

Which is the Best Qualification of Therapist at a Counseling Agency?

Counseling agencies are often the training ground for new therapists. There are different names given to therapists that are in training that are worth understanding if you are seeking treatment from a counseling agency.

Basically, the best therapists will be “licensed or fully licensed”; below that are “associates or interns” and the least qualified will be “trainees”. All things being equal, you will get the best care from the most qualified therapist. When you call be sure to ask, “What are the qualifications of your therapists, and can I choose my therapist?”. For a further discussion of therapist qualifications, read this article.

Can I get Marriage Counseling at a Counseling Agency?

This will vary depending on the counseling agency. The best thing to do is ask.

Some agencies might have strange rules regarding this. For example, they may only do individual counseling, but agree to see the spouse as part of the individual’s treatment. This essentially is marriage counseling, but is designed to comply with certain internal guidelines of the agency. If you call and they say they do not offer marriage counseling, you should follow-up and ask if they would “let a spouse participate as part of an individual’s treatment?”.

Questions to Ask on Your First Call

Should you decide to seek out a community counseling agency for care, make sure to ask the following questions before starting treatment:

• What is your therapist’s experience level? If you are being assigned to a therapist that is still under clinical supervision, how experienced is their supervisor?
• What are your fees and how are they determined?
• What is your therapist’s area of expertise? What kinds of services are they able to provide? Should your needs change (for example, transitioning from individual to family therapy), will the provider be able to make this transition?
• Does your therapist plan on staying with the agency for the amount of time you think you’ll need treatment? (Note that you may not receive an accurate answer to this.) If a change in therapist is required, whether by your request or through turnover, what policy does the agency have in place to prevent gaps in care?

As you begin a journey into community counseling, remember that patience and flexibility is key. If the cost of treatment is the most important factor for your decision around the type of service to use, community counseling may be the best choice. But if cost is less of a factor, and you need timely treatment that you have more “say” in, community counseling may be a more frustrating experience.