Do I need a referral to see a therapist in Ontario?

You do not need a referral to see a private practice therapist in Ontario. For anyone posting their services publicly online on their own website or mental health counselling websites like Psychology Today, they require no referral. However, some programs are funded to provide mental health counselling for free and these often require a referral by a medical provider attached to the program, and in some cases may be self-referral when it is meant for the general public (such as some mental health programs attached to hospitals). For example, the Hamilton Family Health Team services about half of Hamilton’s population that has a family doctor. Through this not-for-profit umbrella organization that collaborates with individual family practices, mental health counselling positions are funded for their patients. Universities and colleges often provide free counselling to their students as well. However, there is often a small amount of therapists available to provide 1-on-1 counselling or run group programs in comparison to the size of the population that these services are available to. So, the trade-off is programs either run with a wait-list that may be many months long and/or the sessions available may be limited in number (usually around 6 sessions).

Also, some public programs restrict the type of therapy provided. For example, another free service, BounceBack, which is funded by the Ontario government, provides a structured CBT therapy program. CBT is an evidence based therapy and has tools useful for all persons as they are generally helpful for maintaining and developing better mental health. However, the structure of the program is a rigid protocol with a limited number of sessions. So, this one size fits all model will have its limits in its effectiveness with all persons and all contexts.

The benefit of private practice therapists is they are available immediately and there is no restriction on how long you can see them for, as long as that therapist is providing their services, which allows for longer-term work to be done. You can also look for whether a therapist offers sliding scale, which is the option where payment for sessions is less than their standard fee, provided you are someone who would benefit from a more affordable option. Each therapist has their own policies on sliding scale, so it is always good to clarify what they have to offer.

I, for example, charge $150 per session as my standard fee for one-on-one therapy of 50-60 minutes. I then offer sliding scale based on how many other clients I currently have that I am providing a discount to. So, I always encourage folks to reach out and let me know their limits, and we discuss from there what I can offer, and see what can be arranged.

Lastly, in private practice you may find a therapist specifically honed to what preferences you want in a therapist. In publicly funded programs, you will most often have no control over who you are assigned. There are many evidence based therapies that come with their own approaches and styles, with particular strengths to them. An evidence based therapy is one that has been studied for their usefulness in creating better mental health outcomes. Each therapist has their own strengths, different backgrounds in practising mental health, as well as different continued education in various therapy types. So, if you have the capacity, check out a few that offer free consultations to get a feel for what you may like or not like in a therapist!