Photo of Serena Zhang, MC, RCC, CCC, Counsellor
Serena Zhang
Counsellor, MC, RCC, CCC
Verified Verified
1 Endorsed
Vancouver, BC V5T
Waitlist for new clients
My name is Serena and I am a Registered Clinical Counsellor (RCC #18636) with a Master of Counselling degree from City University of Seattle. In my practice, I draw upon various theoretical approaches like Narrative, Mindfulness, and Solution Focused Therapies, along with my background in biology to ensure therapy is tailored to fit each individual client. I focus on developing safe, supportive, and collaborative relationships that promote empowerment and self-discovery.
My name is Serena and I am a Registered Clinical Counsellor (RCC #18636) with a Master of Counselling degree from City University of Seattle. In my practice, I draw upon various theoretical approaches like Narrative, Mindfulness, and Solution Focused Therapies, along with my background in biology to ensure therapy is tailored to fit each individual client. I focus on developing safe, supportive, and collaborative relationships that promote empowerment and self-discovery.
(438) 600-0911 View (438) 600-0911
Photo of Monica L Pearson, MSc, RCC, (C)CGC, Counsellor
Monica L Pearson
Counsellor, MSc, RCC, (C)CGC
Verified Verified
Vancouver, BC V5T
Often becoming a parent- or struggling to become one- can leave us vulnerable and anxious in a way we have never before experienced. I feel a strong calling to offer help to individuals and families journeying through the reproductive years. I want to support you through struggles with fertility, or the grief after pregnancy loss. I can help with traumatic birth experiences, difficulties transitioning to parenthood, or relationship difficulties associated with any of these events.
Often becoming a parent- or struggling to become one- can leave us vulnerable and anxious in a way we have never before experienced. I feel a strong calling to offer help to individuals and families journeying through the reproductive years. I want to support you through struggles with fertility, or the grief after pregnancy loss. I can help with traumatic birth experiences, difficulties transitioning to parenthood, or relationship difficulties associated with any of these events.
(604) 330-1520 View (604) 330-1520
Photo of Shana Soo, Pre-Licensed Professional
Shana Soo
Pre-Licensed Professional
Verified Verified
3 Endorsed
Vancouver, BC V5T
Shana has a background working with children, youth, and young adults who face mental health challenges. Their work in the nonprofit and public health system includes working with those facing crises, houselessness, substance use, sex work, employment or educational challenges, trauma, and neurodivergence.
Shana has a background working with children, youth, and young adults who face mental health challenges. Their work in the nonprofit and public health system includes working with those facing crises, houselessness, substance use, sex work, employment or educational challenges, trauma, and neurodivergence.
(506) 909-0268 View (506) 909-0268
Photo of Chelsea Lee, RPC, Counsellor
Chelsea Lee
Counsellor, RPC
Verified Verified
Vancouver, BC V5T
Practice currently FULL - contact me for referrals... We all have our own unique realties and it is my passion to assist you in uncovering unhelpful thinking patterns and behaviours, while working through uncomfortable emotions to allow for a more enjoyable and fulfilling life. ​Whether you or a loved one are dealing with or affected by addiction, looking to explore a past hurt, navigating a loss, or are in a transitional period of your life - you’ve come to the right place. ​
Practice currently FULL - contact me for referrals... We all have our own unique realties and it is my passion to assist you in uncovering unhelpful thinking patterns and behaviours, while working through uncomfortable emotions to allow for a more enjoyable and fulfilling life. ​Whether you or a loved one are dealing with or affected by addiction, looking to explore a past hurt, navigating a loss, or are in a transitional period of your life - you’ve come to the right place. ​
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Photo of Nathalie Maginot, MA, Counsellor
Nathalie Maginot
Counsellor, MA
Verified Verified
1 Endorsed
Vancouver, BC V5T
How would it feel to foster a relationship with yourself rooted in acceptance and validation of all parts of you, yet with the courage to challenge yourself to break old patterns? How could this relationship affect your life and your relationships with others? In my counselling practice I aim to build a therapeutic relationship that feels safe to you and can act as a model and an experience for secure attachment, striving to support you in fostering a secure relationship with yourself.
How would it feel to foster a relationship with yourself rooted in acceptance and validation of all parts of you, yet with the courage to challenge yourself to break old patterns? How could this relationship affect your life and your relationships with others? In my counselling practice I aim to build a therapeutic relationship that feels safe to you and can act as a model and an experience for secure attachment, striving to support you in fostering a secure relationship with yourself.
(548) 482-5034 View (548) 482-5034
Photo of Brent Stewart, MA, RCC, Counsellor
Brent Stewart
Counsellor, MA, RCC
Verified Verified
Vancouver, BC V5T  (Online Only)
As a registered clinical counsellor, my main focus is on helping people to live more peacefully in the present moment; to live less ruled by worry; to live freer more joyful lives. In this work, I am guided by my training in four areas: clinical psychology, social psychology, philosophy, and mindfulness practice. My goals as a counsellor are to met you exactly where you are, listen deeply to your experience, and offer the most authentic support I can.
As a registered clinical counsellor, my main focus is on helping people to live more peacefully in the present moment; to live less ruled by worry; to live freer more joyful lives. In this work, I am guided by my training in four areas: clinical psychology, social psychology, philosophy, and mindfulness practice. My goals as a counsellor are to met you exactly where you are, listen deeply to your experience, and offer the most authentic support I can.
(819) 805-6590 View (819) 805-6590
Photo of Mark-Daniel Hughes, RPC-C, Counsellor
Mark-Daniel Hughes
Counsellor, RPC-C
Verified Verified
Vancouver, BC V5T  (Online Only)
I work with all ages from youth and young adults to seniors in navigating the complexities around trauma, depression, complicated grief, interpersonal relationships, vocational stress, addiction and struggles with self-identity and low-self worth. My approach encourages a team mentality where we work collaboratively to help you uncover what truly matters most to you. By identifying the misalignment between your values and your circumstances, we can more easily create a path to well being.
I work with all ages from youth and young adults to seniors in navigating the complexities around trauma, depression, complicated grief, interpersonal relationships, vocational stress, addiction and struggles with self-identity and low-self worth. My approach encourages a team mentality where we work collaboratively to help you uncover what truly matters most to you. By identifying the misalignment between your values and your circumstances, we can more easily create a path to well being.
(587) 801-5384 View (587) 801-5384
Photo of Emily Franklin, MC, RCC, Counsellor
Emily Franklin
Counsellor, MC, RCC
Verified Verified
5 Endorsed
Vancouver, BC V5T
Working with me, you can expect a non-judgmental, compassionate space. I welcome folks exactly as they are. I practice with cultural humility and intersectionality to provide a safe and collaborative relationship that enables clients to get curious about themselves. I help clients deconstruct negative self-beliefs, explore identity conflicts, explore formative familial/cultural dynamics, and develop self-understanding. I combine talk therapy (exploring past and present experiences; and how our emotions, thoughts, and body interact with one another), with attachment theory, emotions-focused therapy, and parts work.
Working with me, you can expect a non-judgmental, compassionate space. I welcome folks exactly as they are. I practice with cultural humility and intersectionality to provide a safe and collaborative relationship that enables clients to get curious about themselves. I help clients deconstruct negative self-beliefs, explore identity conflicts, explore formative familial/cultural dynamics, and develop self-understanding. I combine talk therapy (exploring past and present experiences; and how our emotions, thoughts, and body interact with one another), with attachment theory, emotions-focused therapy, and parts work.
(672) 648-0420 View (672) 648-0420
Photo of Anna Khaylis, PhD, Psychologist
Anna Khaylis
Psychologist, PhD
Verified Verified
1 Endorsed
Vancouver, BC V5T
Life can throw us a great deal of challenges and obstacles. Emotions, memories, thoughts - it can all be so overwhelming when we are trying to make change happen. I have been helping individuals, couples, and families heal for over 10 years. I provide assessment and treatment to individuals struggling with a wide range of challenges, including depression, anxiety, eating disorders, relationship difficulties, and substance abuse. I am particularly passionate about working with individuals with complex trauma and Post-traumatic Stress Disorder.
Life can throw us a great deal of challenges and obstacles. Emotions, memories, thoughts - it can all be so overwhelming when we are trying to make change happen. I have been helping individuals, couples, and families heal for over 10 years. I provide assessment and treatment to individuals struggling with a wide range of challenges, including depression, anxiety, eating disorders, relationship difficulties, and substance abuse. I am particularly passionate about working with individuals with complex trauma and Post-traumatic Stress Disorder.
(604) 706-1591 View (604) 706-1591
Photo of Kristen Hydes - Kristen Hydes Counselling, Registered Social Worker
Kristen Hydes Counselling
Registered Social Worker
Verified Verified
2 Endorsed
Vancouver, BC V5T  (Online Only)
I'm so glad you are here, and I hope to share a little about how I work and a little about myself along the way as well. I truly believe that fit is one of the most important parts about therapy & getting started can be often be one of the toughest parts. I am Registered Social Worker (RSW in both BC & ON) & Canadian Certified Counsellor (CCC) and have been working in various counselling roles over the past 10 years. I work from an intersectional feminist lens and notice the impact of gender, ableism, class, sexual orientation, race & socioeconomic status can have on mental health. I truly believe that 'feminism is for everybody'.
I'm so glad you are here, and I hope to share a little about how I work and a little about myself along the way as well. I truly believe that fit is one of the most important parts about therapy & getting started can be often be one of the toughest parts. I am Registered Social Worker (RSW in both BC & ON) & Canadian Certified Counsellor (CCC) and have been working in various counselling roles over the past 10 years. I work from an intersectional feminist lens and notice the impact of gender, ableism, class, sexual orientation, race & socioeconomic status can have on mental health. I truly believe that 'feminism is for everybody'.
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Photo of Catherine Falkner, RTC, BFA, Counsellor
Catherine Falkner
Counsellor, RTC, BFA
Verified Verified
Vancouver, BC V5T  (Online Only)
Anxiety and stress are incredibly common experiences that can feel overwhelming, especially when they lead to difficulty in managing emotions and finding inner peace. You are not alone in facing these challenges. Whether it be feelings of unworthiness, struggling with setting healthy boundaries or reconnecting with yourself with a new sense of joy. It can be scary to reach out and ask for help, and seeking support is a courageous step towards healing and growth.
Anxiety and stress are incredibly common experiences that can feel overwhelming, especially when they lead to difficulty in managing emotions and finding inner peace. You are not alone in facing these challenges. Whether it be feelings of unworthiness, struggling with setting healthy boundaries or reconnecting with yourself with a new sense of joy. It can be scary to reach out and ask for help, and seeking support is a courageous step towards healing and growth.
(782) 800-9337 View (782) 800-9337
Photo of Elyssa Carroll Goldman, MCP, RCC, Counsellor
Elyssa Carroll Goldman
Counsellor, MCP, RCC
Verified Verified
Vancouver, BC V5T  (Online Only)
Not accepting new clients
Are you feeling lost, down, overwhelmed or anxious? I offer a welcoming space where you can be yourself and share your thoughts, feelings and experiences without fear of judgement. Together we can explore patterns of thinking, feeling and acting, and experiment with possible changes to see what works best for you. I enjoy supporting people who are navigating anxiety, depression, ADHD, stress, burnout, relationship issues, low self-worth, struggles with identity, and other difficulties of being a person.
Are you feeling lost, down, overwhelmed or anxious? I offer a welcoming space where you can be yourself and share your thoughts, feelings and experiences without fear of judgement. Together we can explore patterns of thinking, feeling and acting, and experiment with possible changes to see what works best for you. I enjoy supporting people who are navigating anxiety, depression, ADHD, stress, burnout, relationship issues, low self-worth, struggles with identity, and other difficulties of being a person.
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Photo of Michaela Woeller, MA, Pre-Licensed Professional
Michaela Woeller
Pre-Licensed Professional, MA
Verified Verified
1 Endorsed
Vancouver, BC V5T
I'm here to collaborate with you in finding that compassionate, grounded part of yourself that can lead to the change you're looking for. Our work together will move at your pace—I'm here to support and walk alongside you as you navigate this journey. Whether you're navigating major life changes, dealing with relationship struggles, or healing from past trauma, I’m here to support you on your journey. It can look like facing anxiety, depression, self-doubt, or feeling disconnected from your emotions and body. I’d love to help you tap into your inner strength and resilience as we work through these challenges together.
I'm here to collaborate with you in finding that compassionate, grounded part of yourself that can lead to the change you're looking for. Our work together will move at your pace—I'm here to support and walk alongside you as you navigate this journey. Whether you're navigating major life changes, dealing with relationship struggles, or healing from past trauma, I’m here to support you on your journey. It can look like facing anxiety, depression, self-doubt, or feeling disconnected from your emotions and body. I’d love to help you tap into your inner strength and resilience as we work through these challenges together.
(343) 500-8255 View (343) 500-8255
Photo of Noa Rabin, MA, Counsellor
Noa Rabin
Counsellor, MA
Verified Verified
Vancouver, BC V5T
I am passionate about my work, and have dedicated the last 10 years of my life to helping people create change. My clients are dealing with real life issues - relationships, fertility struggles, adjustment to parenthood, family of origin dynamics, and major life transitions. I aim to create a space where clients are free to explore their fears, doubts, strengths, and needs. Some clients require a faster, more solution-focused therapy process, while others want to meet regularly and have that person to continually connect with and receive support from. I am open to both and see it as a privilege to be invited into people’s lives.
I am passionate about my work, and have dedicated the last 10 years of my life to helping people create change. My clients are dealing with real life issues - relationships, fertility struggles, adjustment to parenthood, family of origin dynamics, and major life transitions. I aim to create a space where clients are free to explore their fears, doubts, strengths, and needs. Some clients require a faster, more solution-focused therapy process, while others want to meet regularly and have that person to continually connect with and receive support from. I am open to both and see it as a privilege to be invited into people’s lives.
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Photo of Tessa Teng, BCYC, Pre-Licensed Professional
Tessa Teng
Pre-Licensed Professional, BCYC
Verified Verified
Vancouver, BC V5T
Waitlist for new clients
I am a student counsellor who believes in meeting each client where they are at, understanding that every person has their own story that shapes the way they experience the world. I am passionate about working with individuals who may be struggling with relationship challenges, life transitions, identity, anxiety, low self-esteem, and family conflicts. This includes individuals impacted by developmental disabilities, substance use, intergenerational trauma, racialization, identity, and mental health concerns.
I am a student counsellor who believes in meeting each client where they are at, understanding that every person has their own story that shapes the way they experience the world. I am passionate about working with individuals who may be struggling with relationship challenges, life transitions, identity, anxiety, low self-esteem, and family conflicts. This includes individuals impacted by developmental disabilities, substance use, intergenerational trauma, racialization, identity, and mental health concerns.
(778) 765-3853 View (778) 765-3853
Photo of Jessica Rathwell, MA, Counsellor
Jessica Rathwell
Counsellor, MA
Verified Verified
1 Endorsed
Vancouver, BC V5T  (Online Only)
Accepting Virtual Clients for counselling and clinical supervision- I work with adults and young people who are struggling with transitions, coping, relationships, grief, mental health or other concerns they'd like to talk over with someone they can feel supported by and who can help them build their toolbox for navigating their concerns. I also provide clinical supervision with practicum students and counsellors building their counselling practice. I love working with folks on their case conceptualization, treatment planning, and confidence in the tools and skills they can offer clients.
Accepting Virtual Clients for counselling and clinical supervision- I work with adults and young people who are struggling with transitions, coping, relationships, grief, mental health or other concerns they'd like to talk over with someone they can feel supported by and who can help them build their toolbox for navigating their concerns. I also provide clinical supervision with practicum students and counsellors building their counselling practice. I love working with folks on their case conceptualization, treatment planning, and confidence in the tools and skills they can offer clients.
(438) 834-0912 View (438) 834-0912
Photo of Luisa Ospina - Collective Healing Counselling and Consulting, MA, RCC, ATR, LPC, Counsellor
Collective Healing Counselling and Consulting
Counsellor, MA, RCC, ATR, LPC
Verified Verified
2 Endorsed
Vancouver, BC V5T
*Services by student counsellors and Associates available* People we work with describe feeling disconnected, invalidated, and powerless after experiencing trauma and injustice. Some have felt stuck and overwhelmed in the process of reconnecting with themselves, their communities, and in navigating the dominant culture. We support clients in processing their experiences and deepening their understanding of themselves and their relationships. We affirm clients' needs and desires and value reciprocity and collaboration. Honoring clients' knowledge, we invite clients to co-create safety and exercise their self-determination.
*Services by student counsellors and Associates available* People we work with describe feeling disconnected, invalidated, and powerless after experiencing trauma and injustice. Some have felt stuck and overwhelmed in the process of reconnecting with themselves, their communities, and in navigating the dominant culture. We support clients in processing their experiences and deepening their understanding of themselves and their relationships. We affirm clients' needs and desires and value reciprocity and collaboration. Honoring clients' knowledge, we invite clients to co-create safety and exercise their self-determination.
(604) 330-1636 View (604) 330-1636
Photo of Allahna Somji, Counsellor
Allahna Somji
Counsellor
Verified Verified
1 Endorsed
Vancouver, BC V5T
At its core, my therapeutic approach is centered around collaboration, drawing from anti-oppressive, trauma-informed, and client-centered frameworks, while highlighting the unique lived experiences each client holds. I work with individuals who may be struggling with experiences of anxiety, low self-esteem, life transitions, and more. I have a background of supporting and working with neurodivergent individuals and continue to do so in my practice.
At its core, my therapeutic approach is centered around collaboration, drawing from anti-oppressive, trauma-informed, and client-centered frameworks, while highlighting the unique lived experiences each client holds. I work with individuals who may be struggling with experiences of anxiety, low self-esteem, life transitions, and more. I have a background of supporting and working with neurodivergent individuals and continue to do so in my practice.
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Photo of Kathleen Milinazzo, RCC, Counsellor
Kathleen Milinazzo
Counsellor, RCC
Verified Verified
1 Endorsed
Vancouver, BC V5T  (Online Only)
Whether you’re dealing with daily stressors, life transitions, or relationship challenges, I'm here to help you find clarity and build resilience. One of my passions is clients' attachment styles. By understanding these aspects, we can gain insight into how they influence your current relationships and overall functioning. I find this exploration invaluable in helping you achieve a deeper self-awareness and improved interpersonal dynamics. Additionally, with extensive experience working with youth and families, I’m well-versed in addressing challenges related to school, learning disabilities, and risky behaviour.
Whether you’re dealing with daily stressors, life transitions, or relationship challenges, I'm here to help you find clarity and build resilience. One of my passions is clients' attachment styles. By understanding these aspects, we can gain insight into how they influence your current relationships and overall functioning. I find this exploration invaluable in helping you achieve a deeper self-awareness and improved interpersonal dynamics. Additionally, with extensive experience working with youth and families, I’m well-versed in addressing challenges related to school, learning disabilities, and risky behaviour.
(587) 741-9748 View (587) 741-9748
Photo of Davina Ma, MSW, RCSW, Clinical Social Work/Therapist
Davina Ma
Clinical Social Work/Therapist, MSW, RCSW
Verified Verified
2 Endorsed
Vancouver, BC V5T  (Online Only)
“Stress doesn’t cause burnout. Capitalism and white supremacy does” - Jenn Mullan. Are you a member of a marginalized community - BIPOC, LGBTQ+, women, people with mental health issues? Have you been struggling with people pleasing, imposter syndrome, caregiver fatigue, and/or coming to terms with a mental health diagnosis? It is exhausting to exist in a world that was not built for us. You matter, and you deserve to be heard in a safe space that does not blame you for not doing or being enough. With an anti-oppressive and decolonial approach, I support people of marginalized identities to process their grief and honour their rage.
“Stress doesn’t cause burnout. Capitalism and white supremacy does” - Jenn Mullan. Are you a member of a marginalized community - BIPOC, LGBTQ+, women, people with mental health issues? Have you been struggling with people pleasing, imposter syndrome, caregiver fatigue, and/or coming to terms with a mental health diagnosis? It is exhausting to exist in a world that was not built for us. You matter, and you deserve to be heard in a safe space that does not blame you for not doing or being enough. With an anti-oppressive and decolonial approach, I support people of marginalized identities to process their grief and honour their rage.
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See more therapy options for V5T

How does your Counsellor compare?

Number of Counsellors in V5T

100+

Average cost per session

$150

Counsellors in V5T who prioritize treating:

91% Anxiety
83% Depression
82% Relationship Issues
79% Self Esteem
74% Life Transitions
71% Trauma and PTSD
71% Stress

Average years in practice

7 Years

Top 3 insurances accepted

56% Manulife
51% Pacific Blue Cross
51% SunLife

How Counsellors in V5T see their clients

71% In Person and Online
29% Online Only

Gender breakdown

82% Female
14% Male
4% Non-Binary
FAQs - About Therapy and Counselling

How can I find a therapist in V5T?

Search for nearby therapists or counsellors by inputting your city, postal code, or a provider’s name into the search bar. From there, you can filter providers by the issues they treat, cost, insurance, gender, and other factors to find providers who are well-suited to your needs. To navigate between locations within the same country, enter a new city or postal code into the search bar.

Learn more about how to find a therapist

Is everyone in the Psychology Today Therapy Directory a licensed therapist?

Most Counsellors and Psychotherapists listed in the directory are certified by one of the main professional associations, mainly the Canadian Counselling and Psychotherapy Association (CCPA), and will have a Certified Canadian Counsellor (CCC) designation with their name. Social Workers listed in the directory must be registered members of the college specific to their province. To be listed in the directory, Psychologists must be registered with the psychological college specific to their province or territory.

Providers whose professional membership or primary credential has been verified by Psychology Today are signified by a “Verified” symbol. Given the considerable variation in professional regulation and prerequisites across Canadian provinces, some providers may possess significant professional qualifications without necessarily holding professional memberships or being obliged to acquire them. As a result, they may be selectively included without the "Verified" seal.

What’s the difference between a psychologist, a therapist, and a counsellor?

Psychologists, counsellors, psychotherapists and social workers can all provide counselling or talking therapy and have credentials and supervised, practical experience that enable them to do so in Canada.

Psychologists have a master's and/or doctoral degree and have passed both written and oral exams. Psychologists are able to complete mental health assessments and provide diagnostic information to clients as well as provide counselling therapy or psychotherapy. Counsellors and psychotherapists are expected to have a master's or doctoral degree in counselling psychology, social work, or a related mental health discipline and certification by a professional association, such as the Canadian Counselling and Psychotherapy Association. Registered Social Workers possess a Bachelor's or Master's degree in Social Work and where possible must be licensed or certified by the provincial government and/or regulatory college.

What type of therapy is right for me?

The type of therapy best suited to a particular individual depends on several factors, including their primary reason for seeking therapy, their preferred timeline (some therapy types last for a set number of sessions, while others are open-ended), and their personality and preferences—some may prefer a more structured approach. For many individuals, multiple types of therapy could provide a good fit.

How much does therapy cost?

The cost of therapy depends on a number of variables, including location and the therapist’s experience and training. On average, the cost of a therapy session in Canada could be between $100 and $200. If you have insurance, the expense of mental health care is typically lower, but it varies based on your insurance plan details and whether you choose an in-network or out-of-network mental healthcare provider.

What are more affordable or low cost therapy solutions?

Many therapists offer sliding scale payments, usually on a limited number of slots, which consists in an agreement between the therapist and a client to pay a reduced rate. Therapists who provide such arrangements often consider the client's income or ability to pay, but the extent of the discount is ultimately at the therapist's discretion. Furthermore, while group therapy may have different goals and benefits compared to individual therapy, it can be a more affordable solution to address certain types of issues.

If you are struggling to access therapy due to budget constraints, you could also consider public funded mental health services. Some types of outpatient mental health services are covered by Medicare, provided these are performed by a licensed mental health professional in the provinces or territory you reside in and who accepts the assignment.

Is online therapy cheaper than in-person therapy?

Many therapists charge the same amount for online therapy as they do for in-person therapy—though clients may still find this cost-effective if it cuts down on their transportation costs. Health insurance plans often offer equivalent coverage for online and in-person therapy; indeed, in many places, they are legally required to do so. Text-based or on-demand therapy apps may be cheaper than traditional one-on-one psychotherapy; however, the practice may be less effective and is not likely to be covered by insurance.

Is online therapy a good option?

Therapy conducted online can be just as effective as in-person therapy, as long as there is a strong alliance between the client and the therapist. To find a therapist who provides telehealth services to clients in your area, click “Online Therapy” on the directory homepage and search by your city or town or your postal code.

Are therapy sessions confidential?

Professionals licensed by regulatory colleges and those certified by associations such as the Canadian Counselling and Psychotherapy Association are obligated to uphold client confidentiality unless there is a legal reason that requires them to disclose information. Confidentiality is a crucial part of the therapeutic relationship and only under specific circumstances, such as when there is the potential or known harm to the client or others, or a court order, will a therapist be obligated to break the agreement. These exceptions to the confidentiality agreement are usually discussed during the initial consultation.