Frequently Asked Questions

Counselling is an opportunity to explore and process difficulties related to behaviours, thoughts, feelings, memories and relationships.  

Counselling services can provide greater self-awareness, insight, and coping. I believe that the client is their own “best expert” and I, therefore, work in a collaborative manner.  

Counselling may require that you be willing to explore difficult topics or memories and try new or different behaviours.  

These experiences can sometimes lead to stronger than usual emotions.  Effective counselling tries to minimize or manage these feelings, however, this requires cooperation between client and counsellor, and willingness on the client's part to express when emotions become difficult to manage. 

It is your right to have the information you disclose remain confidential. For this reason, the information you choose to disclose will remain strictly confidential, except where given written permission.  

While you have a right to confidentiality, some limitations to this apply including the following exceptions:

• In order to provide you with the best quality services counsellors will occasionally seek consultation with other colleagues. Clinical supervision allows your counsellor to discuss cases and get suggestions for interventions. The information provided to the clinical supervisor is confidential between your counsellor and the supervisor. Your counsellor only discloses information pertinent to receiving support in providing quality care to you, names are removed from case descriptions or aliases are used.

• By law your counsellor is obligated to break confidentiality and report any information that is disclosed regarding intent to harm yourself, intent to harm someone else, and child abuse.  Additionally, counsellor notes on sessions can be subpoenaed by a court of law.

• All clients accessing services within Valerie MacNeil Counselling are also asked to bear the confidentiality of other clients in mind and refrain from sharing any information about other clients; as well as refrain from identifying other clients in public as belonging to our clinic.

Registered Clinical Counsellors (RCCs) are members of a professional counselling organization called the British Columbia Association of Clinical Counsellors. 

BCACC requires its members to meet specific, extensive criteria in counsellor education and training. Its members must also adhere to a strict code of ethics in their work with clients. A counsellor with an RCC designation meets and commits to continuing to meet, the highest standards for their profession. 

A counsellor without an RCC  designation will likely not meet these standards for training, education, and ethical behaviour. To have counselling covered by your extended benefits often requires you to see an RCC.

Every person and every set of circumstances is different, but 10-12 sessions are common. 

Some situations will require more sessions. Clients who would like to resolve multiple challenges, or who would like to focus on personal growth may choose to work with a counsellor for an extended period. 

Clients generally attend once a week, ideally, but may attend every other week if needed. This is to attain continuity and maximize the benefits of your sessions. Once therapy is complete, follow-up or 'check-in’ sessions can be arranged, and if a new challenge arises, further counselling is available.

Your appointment time is reserved just for you and because of this, other clients have been placed on a waiting list. A late cancellation or missed visit leaves a hole in the therapist’s day that could have been filled by another client, as well as a loss of income for the therapist.

As such, I require 24 business hours notice for any cancellations or changes to your appointment. This means that appointments on Monday or following a long weekend must be cancelled before the appointment time on the previous Friday. 

Patients who provide less than 24 hours notice, or miss their appointment, will be charged a cancellation fee of $157.50, due the day of the missed appointment. No exceptions. 

Until the cancellation fee has been paid, the client will be unable to book another session. For late cancellations due to bad weather or illness, a phone or virtual session will be offered at the booked appointment time. In the event of illness, Valerie will attempt, if possible, to find another time within a day or two, to have the phone or virtual session. 

If you choose not to have the phone or virtual session at one of the times offered, you will be required to pay the full fee the same day. 

Counselling sessions last 50 minutes and are offered at $157.50 per session, which includes GST. Payments are due at the time of service and a receipt will be issued at the end of the session. 

If for any reason you need to miss a session, I require 24 hours notice.  Failure to do so will result in a charge for the full session fee ($157.50).

Please note that I may not able to be available for crisis support. If there is an emergency between sessions, please contact your physician, your local hospital emergency, or the Vancouver Island Crisis Line at 1-888-494-3888. I will endeavour to return phone, text or email messages during my business hours which are Monday through Thursday 9-4.

I have had many years working in the field of substance abuse and based on this, I have realized that for effective substance use treatment, there are many approaches. I do not try to fit you into any particular philosophy because everyone is different. 

I work with clients who are seeking help with substance abuse to discover the most effective treatment plan based on their unique needs. I use elements from Cognitive Behavioral Therapy, Transtheoretical Model of Change, and Motivational Interviewing, and I take a biopsychosocial approach based on the belief that many factors lead to substance use and dependency (biological, psychological, and social), and it is by examining and treating all of these factors that will set you up for success. 

Dependency treatment is not just about the behaviour (stopping use), it is about the thoughts and feelings that accompany substance abuse and the reasons why substance use developed in the first place. 

In my experience, there is always a reason why you became dependent on or abuse substances, and why you are compelled to self-medicate.

This model was developed by Prochaska and DiClemente in the late 1970s and is a framework for understanding behavioural change that is often used in substance use treatment.

According to the work of Prochaska and DiClemente, there are 5 stages of change and these are pre-contemplation (not ready to change), contemplation (getting ready to change), preparation (ready to change), action (making the change), and maintenance (keeping up with the changes implemented). 

Relapse has also been added to this change process because relapse can be a part of recovery from substance abuse. I advise clients to use a relapse as a learning experience instead of beating themselves up because it happened. Clients come to me seeking help at all stages of this model and I am effectively able to work with them at any stage in a compassionate and non-judgemental way.

Motivational Interviewing is an evidence-based counselling method that assists clients to change unwanted behaviour by exploring their motivation to change, in other words, their reasons for wanting to change. 

I like this method because it allows me to meet clients where they are currently as opposed to using an authoritative style. This method also allows me to be curious about the client’s unique set of circumstances so that I may then collaborate with them to create an individualized treatment plan. I believe this empowers clients to draw from their own experiences and wisdom, thus setting them up for success.

What does codependency mean for you?

Definition of Codependency: Codependency in its simplest form can be defined as the loss of self by caring for and doing more for others than you do for yourself. 

Codependency is a learned behaviour. It can be unlearned and that is done by working on yourself.  Codependence is complex, just as every person is unique, so is the way each person experiences codependency. There is no such thing as a diagnosis of codependency. It often involves engaging in certain behaviours. 

Don’t compare yourself to others, we all have different experiences. The first step in change is awareness. We cannot change something we are not aware of

The world needs giving, loving, and compassionate people. However, you also deserve to experience the same in return. 

The cycle of receiving and giving is sometimes difficult for people who are codependents because they're often in one-sided relationships. And when you continue to enable this, despite your best intentions, it deprives the person you're sheltering of the lessons they need to learn and grow. The truth is, you can only give so much for so long before you start suffering. Being in this kind of dynamic holds you back. If you are in some way, either intentionally or unintentionally hindering your loved one from experiencing the consequences of their behaviours or substance use, you make it easier for them to continue this behaviour. You also make it less likely for them to acknowledge that a problem exists. 

Codependence is characterized by a preoccupation with, and dependence on, people or things outside the self, such as feelings, boundaries and needs, often to the point of having little self-identity. It is also characterized by enmeshment in relationships, and by enabling, caretaking, controlling and approval-seeking. These behaviours are often an attempt to reduce anxiety and create a sense of safety, self-worth, and identity.

People at risk for developing codependence include friends and relatives of chemically dependent people, people in recovery, adults from dysfunctional families, and families with secrets or unresolved trauma.

Those at risk for developing codependent tendencies include friends and relatives of chemically dependent people, people in recovery, adults from dysfunctional families, and families with secrets or unresolved trauma.

You may be dealing with codependency if you struggle with...

• Approval-seeking or people pleasing

• Fear of being alone or abandoned sometimes means enduring an unhealthy relationship to avoid this.

• Feeling selfish or guilty for not meeting the needs of others.

• Feeling not good enough or feeling like you're too much or too little.

• Diminishing yourself or your accomplishments or being embarrassed or uncomfortable receiving recognition, praise, or gifts.

• Difficulty asking for help.

• Rescuing or fixing others, to your demise.

• Covering or taking a fall for others or making excuses for someone else’s behaviour.

• Giving your finances and other resources to depletion. 

• Over-responsibility or doing more than your fair share.

• Rescuing others while neglecting yourself.

• Trying to keep others happy.

• Afraid of being left out or rejected if you don't do what is expected.

• Putting aside your interests and hobbies to do what someone else wants.

• Feelings of guilt, shame, or self-blame.

• Perfectionism.

• Giving advice when people don't ask for it

• Taking on the responsibility of other people’s emotions, feelings, or behaviours.

• Minimizing, altering, or denying how you truly feel.

• Difficult making decisions.

• Believing someone else is incapable of taking care of themselves without your help.

• Offering advice and directions without being asked.

This is not an exhaustive list; are there any other behaviours you engage in that you think may be related to codependency?

Does this feel familiar to you or a loved one? Together we'll devise a plan to rebuild your sense of self! Book your first appointment or contact me to learn more.