Ronda Gallawa-Foyt, MA, LMHC
Licensed Mental Health Counselor · New Direction Counseling · Vancouver, WA
Ronda holds a Master’s in Counseling Psychology from Lewis and Clark College and a Biblical Counseling Certification through the American Board of Biblical Counselors. With over 25 years of clinical experience, she has answered every one of these questions many times — and understands exactly what it takes for someone to walk through a therapist’s door for the first time.
✦ Key Takeaways
- The most common counseling FAQs are asked by people who are genuinely curious about therapy but uncertain whether it’s right for them — and the answers almost always reduce that uncertainty.
- You do not need to be in crisis, have a diagnosis, or have “serious enough” problems to benefit from counseling.
- The most persistent counseling myths — including that therapy never ends, that it means something is permanently wrong, and that Christians should just pray instead — are all false.
- Confidentiality is a legal and ethical requirement for licensed counselors, with clearly defined exceptions your therapist will explain upfront.
- Telehealth counseling is widely available, effective, and accessible from anywhere in Washington State through New Direction Counseling’s distance counseling service.
Most people who eventually start counseling say the same thing about what almost stopped them: “I didn’t really know what therapy was going to be like.” The uncertainty — about what happens in sessions, whether it actually works, whether their problems are significant enough to qualify — creates a gap between recognizing that something needs to change and actually doing something about it.
This article exists to close that gap. These are the most common counseling FAQs that people ask before their first appointment — honest answers from a licensed therapist with over 25 years of clinical experience, without jargon or oversimplification.
If you’ve been considering counseling and haven’t yet taken the first step, the answers below may be exactly what you need to move forward.
📋 Questions Covered in This Article
• What is counseling and how does it work?
• Do I need to be in crisis to start?
• What happens in the first session?
• How long does counseling take?
• Is counseling confidential?
• Does therapy actually work?
• What are the most common counseling myths?
• What’s the difference between counselor types?
• What is Christian counseling?
• Can I do counseling online?
• How do I know if a therapist is the right fit?
• What does counseling cost?
• How do I get started?
The Basics: What Counseling Is and How It Works
What is counseling and how does it actually work?
Counseling is a professional relationship between a licensed therapist and a client — designed to help you understand the patterns driving your emotions and behavior, process difficult past or present experiences, and develop healthier ways of thinking, feeling, and relating.
In practice, sessions typically involve structured conversation, guided therapeutic techniques, and practical tools you practice between appointments. Contrary to the cultural image of lying on a couch recounting your entire childhood, most modern counseling is active, collaborative, and focused on real, measurable change. Furthermore, it moves at your pace — you won’t be pushed into territory you’re not ready to enter.
What is the difference between a counselor, a therapist, and a psychologist?
These terms overlap significantly but have distinct clinical meanings:
- Licensed Counselor (LMHC, LPC, LPCC) — holds a graduate degree in counseling and a state license to provide talk therapy and mental health treatment.
- Therapist — a broader umbrella term covering multiple licensed mental health professionals, including counselors, social workers, and marriage and family therapists.
- Psychologist — typically holds a doctoral degree (PhD or PsyD) and may also conduct psychological and neuropsychological testing in addition to providing therapy.
- Psychiatrist — a medical doctor (MD) who specializes in mental health, primarily providing diagnosis and medication management rather than ongoing talk therapy.
All of these professionals can provide effective therapy. The right fit depends on what you need and what kind of therapeutic relationship works best for you.
What happens in a first counseling session?
First sessions are almost always more approachable than people anticipate. Your therapist will ask about what has brought you in, a bit of your personal history, and what you’re hoping for. Think of it as a conversation — not an interrogation, not a test, and not a commitment to anything beyond that first meeting.
Share only what you feel ready to share — there is no pressure to disclose everything at once. The therapist’s primary goal is to begin building trust and to understand your situation well enough to tailor their approach to what you actually need. By the end, most people have a clear sense of whether the working relationship feels like a good fit.
Does Counseling Actually Work? The Honest Answer
This is one of the most common therapy questions people bring to a first consultation — and fortunately, the honest answer is well-supported by decades of research.
of people who enter therapy show meaningful benefit (American Psychological Association)
of treated individuals perform better than the average untreated person (APA meta-analysis)
gains from evidence-based therapy are maintained at follow-up assessments years after treatment ends
However, outcomes depend significantly on two factors: the quality of the therapeutic relationship, and the client’s consistent engagement with the process — both in sessions and in practicing new skills between them. Therapy doesn’t happen to you; it happens with you.
What Drives Positive Outcomes in Therapy?
The single strongest predictor of whether therapy produces lasting results is the quality of the relationship between client and therapist — not the severity of the presenting concern, not the modality used, and not whether the client has “serious enough” problems. When both factors are present — good therapeutic fit and genuine engagement — the research outcomes are consistently strong.
Do I need to be in crisis to start counseling?
No — and this misconception prevents many people from getting help they would genuinely benefit from. Counseling is not a last resort for people at a breaking point. Many clients begin therapy to improve self-awareness, build better communication habits, process a life transition, or strengthen a relationship that’s already mostly good — well before any crisis develops.
Moreover, starting early, when concerns are manageable rather than severe, almost always leads to faster and more lasting results. The idea that you need to “earn” the right to counseling by suffering long enough is one of the most common and harmful counseling myths in circulation.
How long does counseling take?
This varies considerably by presenting concern. Many clients dealing with a specific, focused issue — a recent loss, work stress, a life transition — see meaningful improvement within 8 to 12 sessions. Others navigating complex trauma, long-standing relational patterns, or co-occurring conditions may benefit from a longer course of treatment.
A good therapist reassesses progress with you regularly and adjusts the approach — rather than keeping you in indefinite therapy without a clear purpose. Counseling has a goal: to give you the tools and insight you need to live your life more fully. When that’s achieved, sessions typically taper and end.
7 Common Counseling Myths — and the Truth Behind Them
Inaccurate beliefs about therapy keep more people from getting help than almost any other factor. Below are the most persistent counseling myths — each answered directly and without softening.
Myth #1
“Therapy is only for people with serious mental illness.”
The reality: Most people who see therapists do not have a clinical diagnosis. Counseling is equally beneficial for relationship difficulties, grief, life transitions, stress, personal growth, and simply wanting to understand yourself better. You don’t need a diagnosis to deserve support.
Myth #2
“Going to therapy means something is permanently wrong with you.”
In fact, seeking professional support for emotional and relational struggles is no different from seeking medical care for a physical health concern. It reflects self-awareness and a commitment to your own wellbeing — not a character defect or a permanent condition.
Myth #3
“A good therapist will tell me what to do.”
Actually, a skilled therapist is not an advice-giver or a decision-maker. Their job is to help you understand yourself more clearly, identify your own patterns, and develop the internal resources to make better choices — not to make those choices for you. This is what makes the gains last.
Myth #4
“Therapy goes on forever.”
What research shows: Most people complete a defined course of treatment with a clear beginning and end. Some clients choose to return periodically during difficult seasons — similar to how a person might see a doctor for an annual check-up. But ongoing, indefinite therapy without clear purpose is not what good clinical practice looks like.
Myth #5
“Talking about problems just makes them worse.”
Clinically speaking, unprocessed experiences don’t resolve by being left alone — they tend to compound. Therapy creates a structured, professional container for processing difficult experiences in a way that leads to integration and healing, not re-traumatization. This is fundamentally different from repeatedly venting without direction.
Myth #6
“Christians should just pray about mental health struggles.”
Consider this: Scripture itself commends seeking wise counsel (Proverbs 11:14, 15:22). Prayer and professional counseling are not in competition — they address different dimensions of the same person. Many of the most committed believers benefit enormously from Christian counseling that integrates both.
Myth #7
“Therapy is self-indulgent — there are people with real problems.”
Worth remembering: Your struggles do not need to be measured against someone else’s to be worth addressing. Anxiety, grief, relationship strain, and emotional exhaustion have real costs — to your health, your relationships, your productivity, and your quality of life. Addressing them is not indulgence; it is responsible stewardship of your wellbeing.
Privacy, Practicalities, and Common Concerns
Is Counseling Confidential?
Yes. Licensed counselors must follow strict legal and ethical confidentiality requirements. What you share during sessions remains private. Your employer, family members, and community cannot access your information without your explicit, written consent.
Specific, narrowly defined exceptions apply, primarily when you or someone else faces an imminent risk of harm. Your therapist will explain these exceptions clearly at the beginning of counseling. In all other situations, your counselor protects your privacy and keeps your information confidential.
For many people, this protected environment creates a sense of safety and trust. It can make it easier to speak honestly about personal concerns, emotions, relationships, and challenges that may feel difficult to discuss elsewhere.
Will my therapist judge me for what I share?
Professionally trained counselors don’t judge their clients. Clinical training builds exactly this capacity — learning to sit with a wide range of human experience, including what clients feel most ashamed of, without reacting with judgment or alarm. That non-judgmental presence isn’t an act; rather, it reflects a genuine orientation toward the person in front of them.
That said, if you ever feel judged or dismissed in a session, that is important information — and worth addressing directly with your therapist or taking as a signal to find a different provider.
A Note on Cost and Accessibility
What does counseling cost?
Counseling fees vary by provider, location, and whether insurance is accepted. Many private-pay counseling practices in the Pacific Northwest charge between $120 and $200 per session. For specific information about fees at New Direction Counseling, the frequently asked questions page includes current details about session rates and payment policies.
💡
Many people find that the cost of ongoing untreated mental health struggles — in reduced productivity, strained relationships, impaired decision-making, and physical health impact — significantly exceeds the cost of counseling. Investing in your mental health typically pays dividends across every other area of life.
Therapy Questions About Christian and Faith-Based Counseling
What Is Christian Counseling — and How Does It Differ From Regular Therapy?
Christian counseling is licensed, professional therapy that integrates clinical evidence-based techniques with biblical truth, prayer, and spiritual support. A qualified Christian counselor holds a state license — the same clinical credential required of all licensed therapists — plus additional training in biblical counseling.
The difference is not the quality of the clinical care — it’s the framework within which that care is delivered. Christian counseling treats faith as directly relevant to mental health — recognizing that for people of belief, the spiritual dimension of struggle is often inseparable from the emotional one. Addressing both leads to more complete healing for clients of faith.
Do I have to be a Christian to receive Christian counseling?
No. While the approach at New Direction Counseling is Christ-centered, clients at any stage of faith — including doubt, distance from God, or no faith background at all — are welcomed. The level of spiritual integration in sessions is always guided by the client’s own preferences and comfort.
What types of issues does counseling address?
Professional counseling is effective across a wide range of presenting concerns. At New Direction Counseling specifically, services include:
Online Counseling and Getting Started
Can I do counseling online?
Yes. Extensive research confirms that telehealth counseling is as effective as in-person therapy for most common mental health concerns, including anxiety, depression, grief, relationship challenges, and trauma. New Direction Counseling offers secure distance counseling for clients anywhere in Washington State — providing the same quality of faith-integrated, clinical care as in-person sessions, without the commute.
How do I know if a therapist is the right fit?
As research consistently shows, the therapeutic relationship is one of the strongest predictors of positive outcomes in counseling. You should feel safe, heard, and respected — not judged, pressured, or dismissed. Most therapists offer an initial session that gives you a real sense of the working relationship before committing further. In particular, pay attention to:
- Whether you feel genuinely listened to, rather than processed
- Whether the therapist’s approach feels suited to your specific concern
- Whether you feel comfortable being honest — even about the hard things
- Whether the pace and style feel sustainable for you
If the fit doesn’t feel right after a few sessions, it is always appropriate — and clinically encouraged — to look for a different provider. After all, finding the right therapist matters far more than staying with the first one you try.
How do I get started with counseling at New Direction Counseling?
Reach out
Contact New Direction Counseling by phone at 503-962-0945 or through the contact form on the website. There is no commitment required — it’s simply a conversation to see if we’re a good fit.
Schedule a consultation
A brief initial consultation helps determine the best approach for your situation and confirms whether in-person or telehealth sessions are the better option.
Complete intake paperwork
Before your first session, you’ll complete confidential intake forms that help your counselor understand your background and goals. This takes about 15–20 minutes and maximizes the time spent in session.
Attend your first session
In person at 3615 Grant Street, Vancouver, WA — or via secure video from anywhere in Washington State. You don’t need to have everything figured out before you arrive. That’s what the sessions are for.
Begin the work
Counseling unfolds session by session, at a pace that works for you. The hardest step is almost always the first one — and once you’ve taken it, most people find the process far more accessible than they expected.
“Plans fail for lack of counsel, but with many advisers they succeed.”
— Proverbs 15:22 (NIV)
Conclusion: Your Questions About Counseling Deserve Real Answers
Time and again, the most common thing people say after their first counseling session is that they wish they had come sooner. Not because they were suffering longer than necessary — though many were — but because the reality of therapy was so much less intimidating than what they had imagined.
Therefore, these counseling FAQs exist to close the gap between curiosity and action. If there’s a question you still have that wasn’t covered here, it’s worth asking. The worst that can happen is that you get an honest answer — and honest answers about counseling tend to make the path forward clearer, not harder.
New Direction Counseling is here when you’re ready. And if “ready” feels far away right now, the next step is simply a conversation.
New Direction Counseling · Vancouver, WA
Still Have Questions? Let’s Talk.
A consultation is the easiest way to get your remaining questions answered — and to find out if New Direction Counseling is the right fit for you.
Ronda Gallawa-Foyt, MA, LMHC · Licensed Christian Counselor · In-person in Vancouver, WA and telehealth statewide.
503-962-0945 · 3615 Grant Street, Vancouver, WA · Telehealth available statewide
Explore All Services at New Direction Counseling
- Christian Counseling in Vancouver, WA — Faith-integrated, licensed mental health support for individuals, couples, and families.
- Individual Counseling — Personalized one-on-one support for anxiety, depression, trauma, grief, and life transitions.
- Relationship & Marriage Counseling — For couples navigating conflict, disconnection, and trust recovery.
- EMDR Therapy Vancouver — Trauma-focused therapy for PTSD, complex trauma, and anxiety rooted in past experiences.
- Grief Counseling — Compassionate support for loss of every kind.
- Suicide Counseling & Bereavement Support — Specialized care for suicidal ideation, crisis recovery, and loss to suicide.
- Distance Counseling — Secure telehealth counseling from anywhere in Washington State.
- About Ronda — Clinical credentials, background, and approach to counseling.
- Frequently Asked Questions — Fee information, what to expect, and how to get started.
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