Challenges of finding a care provider in a small town
Reprinted from "System Navigation" issue of Visions Journal, 2014, 10 (1), pp. 15-17
I'm a relationship counsellor and hospice volunteer in Vernon, BC, so I could just speak from a professional point of view, but I am first going to speak as an individual searching for a counsellor or therapist of my own.
I grew up in a small town of about 25,000 people in the Kootenay region of BC. In 1997, just before I moved to Vernon, I lost my mother in a head-on car accident that instantly took her life. It was then I first experienced the challenges of living in a small town and needing to find someone to guide me through emotional recovery.
Where does one start?
When I was seeking a professional to speak to about the very painful loss of my mom, I struggled with what people often grapple with in this kind of search: Do I need a counsellor? A therapist? A psychiatrist? A psychologist? What is the difference? How do I know if they are covered by my benefits? Where do I find them? What makes one better than the other? What if they can’t help me, then where do I go?
At the time, I wanted to be invisible. I didn't want people to ask me about the accident. I didn't like walking down the street in my little town and seeing people whispering and hearing them speak my mom's name. And I didn't want people to know I was emotionally wounded and needed help—didn't want them to see me as 'weak.' I just wanted to disappear; I wanted it all to disappear.
There are always pros and cons of living anywhere. Some of the pros of living in a small town are a strong sense of community, familiarity and the benefit of only having one or two places to go to find what you're looking for, instead of having to choose from many options.
Unfortunately, these pros can also be cons, especially in the mental health field when you are trying to remain faceless. When it came time to start my healing, however, it was going to be impossible to stay hidden in what felt like a glass house because everyone knew everyone else.
Having limited options may make decision-making easier, but for me, there was more to it than that. What if I know them? What if they knew my mom, who also worked in the mental health field? What if they know my friends? How do I know I won't show up in a social setting with them? What if I didn't like how they were dealing with me? What if I didn't get along with them? What if I felt judged? Then what? Then who?
These concerns reduced my options in mental health to probably fewer than a handful of choices. It was frustrating and rather scary. And what if I needed a specialist? They were even fewer and farther between, and I didn't even know where to look. And how often would I have to see them? How far away might I need to travel to see them? Could I afford to leave town for appointments?
Through word of mouth, I ended up seeing a professional at the hospital in town and the cost was somehow covered. I don't remember if he was a psychologist, a psychiatrist, a therapist or a counsellor, but I do remember how uncomfortable I felt. I left his office thinking maybe I wasn't in too bad of shape—but also like I hadn't actually been helped. I decided to just struggle through on my own for a while, thinking that maybe what I felt was normal!
Trying a slightly larger small town...
I decided that if I was going to have a chance to fully heal, I needed new surroundings. It hurt too much, seeing places I'd had lunch with my mom or places we had lived, or driving by where the accident happened. I moved to Vernon (population of 58,000) a few months later, and once again looked for a helping professional. I wanted confirmation—by someone who knew what they were talking about—that I was going to be all right.
Being new to town made it a bit easier in that I knew I wouldn't know them, and they wouldn't know anything about me. But still, I worried about whether I'd meet them later in a social setting. That, however, was a risk I had to take, because what scared me more was being emotionally unhealthy—was I going to "snap" one day, or had I worked through the grief? I felt okay, but was I?
I simply opened a phone book and called for appointments. I met with two or three counsellors before I found one I connected with; one I felt really understood what I was going through. I didn't want a 'textbook with a treatment plan.' I wanted someone who would talk to me in words I understood and not look at me like I was a wounded animal.
Finally I found one I felt safe enough with to share my pain and who didn’t make me feel judged. I don't know if he held a diploma or a PhD, but he had worked for years in the field. He seemed to be reasonably priced—between $75 and $100 per hour, which was covered on my employment benefits plan at the time, allowing me 12 sessions in one year. What was most important to me, though, was finally being able to open up and to feel like someone was listening.
In my counselling sessions, we discussed the loss of my mom and what it was like for me. We also talked about other obstacles I'd faced in my earlier years. After about six months of seeing him every couple of weeks, I felt good enough about my emotional state to stop regular counselling sessions. I still have a counselling session every few months, however. This provides me with a support person who is not directly involved in my life, but who listens with care and supplies me with the life tools I need.
My fear of bumping into my counsellor in public actually came true once, but he handled it professionally, not addressing me until I waved at him. It felt safe and cured my fear of my problems being public.
Help is out there!
It's only in the last two years that I pursued a profession as a counsellor. After experiencing first-hand how hard it was to find the right person to share my deepest emotions with, I decided I wanted to be that person for others. And, having experienced various obstacles and concerns as a client has definitely helped me as a professional. I truly understand the meaning of confidentiality and appreciate the importance of that, especially in a small town.
Thanks to the Internet, a lot of the concerns I had as a client are now more easily answered. You can search for just about anything or anyone by typing in just a few words, though finding the right person for you can still be a struggle.
Most of my clients find me on the Internet. I have my own website and am also linked to other websites such as Psychology Today, Twitter, Facebook and LinkedIn. However, I do enjoy the benefits of living in a small community. Local bulletin boards show my card, and word-of-mouth referral from clients, friends, colleagues and other professionals has proved invaluable.
Word-of-mouth referrals can work to the advantage and disadvantage of a professional, as the word about you could be good or bad. But in my case, it has served me well. Doctors who work in the same building often refer clients to me—not something as readily done in an urban centres where, in very large buildings full of service providers, there isn't the same connection and camaraderie. It eases the minds of clients when I come 'doctor recommended.' They have one professional referring another and don't have to go through the kind of search I did when I needed help.
Ask your doctor, your chiropractor, a nurse or other professionals you may be seeing. Most of these care providers have a list of people they trust and they’re usually happy to refer you.
Be patient and don't settle for help from just anyone—it's so important to find someone you're comfortable with and feel safe with. And if they don't 'feel' right to you, ask them to refer you to a colleague. This may sound odd, but as a counsellor I would respect that. A counsellor will often feel the lack of connection, or they may not specialize in what the client needs to work on, so may be very happy to refer you elsewhere.
It took me many years to realize that seeking emotional help doesn't mean you are weak. It takes a great deal of strength to ask for help when you need it to deal with what this world sometimes hands us.
About the author
Jennifer is a Registered Therapeutic Counsellor and the sole owner of Querencia Counselling (www.querenciacounselling.com) in Vernon, BC, specializing in relationships and communication. She also helps clients with grief, loss and self-esteem, and provides life coaching