Counseling is working with a mental health professional to cope with the challenges that come with a cancer diagnosis. Counseling can help you understand your feelings and reactions, and it provides a safe place to talk about your worries.
A counselor cannot always solve your problems. But they can provide a helpful, outside viewpoint and they are trained to help you deal with difficult situations.
When does counseling help people with cancer or their loved ones?
It is normal to feel many different emotions when you have cancer or someone close to you has cancer. You might feel stressed, angry, or sad. When these feelings affect your daily life or when they last a long time, finding a counselor to talk to can help. Counseling can also help when you are dealing with uncertainty or in a period of transition, such as when a person begins or completes cancer treatment.
Even if you would not describe your feelings as severe, counseling can be helpful. Living with a cancer diagnosis or caring for someone with cancer is a challenge for everyone. Even a few counseling sessions can help you feel better.
How does counseling help?
Talking with a counselor can help you:
Learn how to cope with a cancer diagnosis
Feel less overwhelmed and more in control
Manage fears or worries about the future
A counselor can also help you talk with the people around you. For example, they can help you:
Communicate clearly with your health care team
Talk with family and friends and adjust to changes
Find resources and help you deal with changes to your work, career, and finances
Make important decisions
What are the different types of counseling?
The type of counseling you choose may depend on your needs, preferences, and finances. Types of counseling include:
Individual counseling. During individual counseling, you meet 1-on-1 with a counselor to talk about events, thoughts, and feelings. The counselor will listen closely, express caring concern, ask questions, and offer feedback.
Couples or family counseling. You and your partner or family meet with the counselor. The counselor listens to each person to learn how certain thoughts and actions may cause problems. You and your partner or family members can learn new ways to support each other and communicate in stressful times.
Group counseling. You meet with a group of people who have similar concerns. For example, you might go to a support group for people who have the same type of cancer as you. A counselor leads and guides the discussion and provides support. Group members can learn from the counselor and each other. It can help you feel less alone.
What kinds of counselors are there?
A licensed counselor is usually a mental health worker who completed training and passed a state test. Here are the main types of licensed counselor.
Psychiatrists. Psychiatrists are medical doctors. They specialize in finding and treating mental health problems. They can provide counseling and they can prescribe medication.
Psychologists. These specialists have a PhD or PsyD doctoral degree. This means they have advanced education and are trained to find and treat mental health problems. They can do counseling and research. Psychologists cannot prescribe medication, because they are not medical doctors with an MD or DO degree.
Licensed clinical social workers. These specialists have a master's degree in social work and advanced training in counseling. They also help with practical concerns, such as managing your health insurance and connecting you with local resources, like support groups.
Oncology social workers. Oncology social workers also have a master's degree. They provide specialized counseling, education, and referrals for people with cancer and their families. Your oncology social worker might also help you talk with your health care team and navigate the health care system. Learn more about how an oncology social worker can help.
Psychiatric nurse practitioners. These specialists are registered nurses who have a master's degree in mental health nursing. They treat mental disorders and provide counseling. Like psychiatrists, psychiatric nurse practitioners can prescribe medication.
Licensed counselors. This type of counselor has a master's degree in counseling. They may also be called licensed mental health counselors.
Licensed marriage and family therapists. These specialists have a master's degree and they are trained to help couples and families. They sometimes also provide individual counseling. Learn more about how a marriage and family therapist can help.
Licensed pastoral counselors. These specialists have a master's degree in ministry or divinity. They provide counseling from a religious or spiritual point of view. Learn more about spiritual support during cancer.
How can I find a counselor?
Before you look for a counselor, think about what you would like help with. You may have mental stress, such as depression or anxiety, that does not get better with time. In that case, you might need to see a psychiatrist, clinical psychologist, or psychiatric nurse practitioner. Or you may be looking for practical advice or general support for your mental health. In that case, you might need a clinical social worker, oncology social worker, or a support group guided by a counselor. Also, consider whether you would prefer in-person, online, or phone counseling.
Here are some ways you can find a counselor:
Explore counseling services provided by your hospital or cancer treatment center by asking at the facility's library or learning resource center.
Ask for a referrals from your doctor, nurse, or other cancer care team members to counselors in your area.
Find a list of counselors covered by your health insurance plan by calling your insurance provider or looking on its website.
Investigate whether there is an Employee Assistance Program (EAP) at your workplace that includes counseling services.
If you are a part of a support group, ask other group members if they may have suggestions.
Contact the local health department staff or local library staff about mental health services nearby.
You can also use the internet to search for mental health and cancer services organizations. Many of these organizations can refer you to a counselor. Some also offer limited free counseling by phone or online. Find a list of organizations that offer support and services for people with your type of cancer.
Other organizations that can help you find a counselor include:
American Association of Marriage and Family Therapy. This group has a database you can search that lists marriage and family therapists in the United States and other countries.
Association of Oncology Social Work. This group provides a list of resources for people with cancer and their families.
American Psychological Association. This group offers an online psychologist finding service.
CancerCare. This group provides various services with oncology social workers, including counseling, case management, and support groups.
National Register of Health Service Providers in Psychology. This group's database can help you find psychologists in the United States and Canada.
How do I choose the right counselor?
You might feel nervous about starting your relationship with a counselor. It might feel strange to talk about personal issues with a new person, even if they are a professional counselor. Before your first session, talk to different counselors you have researched by phone so you can get a feel for how you would work together. Ask the counselor beforehand if they charge for this first phone call. Often, there is no charge for a short call. Here are some things you might want to ask:
Describe your situation briefly, and explain why you are looking for counseling.
Ask if the counselor has experiencing treating people with cancer or other serious conditions. It is important that your counselor have this background.
Ask the counselor to describe the approach they might use to help you. Ask for more details if there is something you do not understand.
Ask the counselor to explain their professional, degrees, training, and licensing. You can double-check a counselor's credentials by contacting your state licensing board.
Ask about office hours, fees, billing, and what insurance plans the counselor accepts.
How much counseling helps can depend on how well you work with the counselor. Not every counselor or type of counseling will be a good match for you. If you do not feel comfortable after a few sessions, or think counseling is not helping, talk to your therapist about your concerns and consider finding a new provider.
How can I pay for counseling?
Counseling can be expensive, so it is important to consider the costs before starting. The cost usually depends on how much training your counselor has and where they work. For example, psychiatrists and clinical psychologists often charge more than licensed social workers or licensed counselors. This is because they have more extensive training. Counseling in a private practice often costs more than at the clinic. Group counseling often costs less than 1-on-1 counseling, and most cancer support groups are free.
Most health insurance plans cover some of the cost of counseling. Many will pay for a certain number of visits with a licensed counselor. You may have to pay part of the cost of each visit. This is called a co-payment or co-pay. Some insurance companies only pay for visits with certain types of counselors. Or they may only pay for treatment with specific counselors in your area. Contact your health insurance company to see what they will cover for counseling services.
If you are having a hard time paying for your counseling or you want to start, but do not think you will be able to afford it, here are some options:
Some hospitals and cancer centers offer free counseling to patients.
Local health departments or social services agencies may offer free or lower-cost counseling if you qualify.
Some local clinics and counselors allow you to pay based on your income. People who earn less money pay less for each visit. This is called a "sliding scale."
Medical schools may offer lower-cost counseling. Your counselor may be a student doing advanced training, with a licensed professional supervising them.
Learn more about managing the costs of cancer care.
Questions to ask the health care team
You may want to ask your cancer care team the following questions about counseling.
Who can I talk with if I'm feeling sad, anxious, or distress?
What symptoms and side effects of my cancer treatment could affect my mental health?
Are there counseling services at this medical center for patients?
Who can I talk with if I need free or lower-cost counseling services?