Victoria, Psychologist, Counsellor, Couples therapy, couples counselling, Sex therapy, Tami-lee Duncan, "What's the difference between a counsellor and a psychologist?", "What's the difference between a registered psychologist and a counsellor?"

Frequently Asked Questions

Frequently Asked Questions

Everything you need to know
before getting started.

If you don't find what you're looking for here, get in touch directly. There are no awkward questions.

Working With a Psychologist

What is the difference between a Registered Psychologist and a counsellor?+

In British Columbia, both Registered Clinical Counsellors (RCCs) and Registered Psychologists provide therapy. Psychologists complete more advanced graduate-level training in psychology, thousands of supervised clinical hours, and professional examinations before registration. This training allows psychologists to assess and treat more complex clinical concerns — but many people simply choose a psychologist because they want the most rigorous clinical foundation available. For specialized concerns like trauma, sexual health, and pelvic pain, that depth of training is particularly meaningful.

Is therapy right for me?+

If something is affecting your quality of life, your relationships, or your sense of yourself — it's worth talking about. You don't need a formal diagnosis or a crisis to seek support. Many people come in with a general sense that something isn't working, without being able to name exactly what. That's a completely valid starting point.

What can I expect from the first session?+

The first session is primarily about understanding what brings you in and what you're hoping to get out of the work. I'll ask questions, you'll have space to share as much or as little as you're ready to, and we'll begin to get a sense of whether this is a good fit. There's no pressure to have everything figured out before you arrive.

How long will I need to be in therapy?+

It depends entirely on what you're working on and what you want from the process. Some concerns resolve meaningfully in 8–12 sessions. Others, particularly complex trauma or long-standing patterns, benefit from longer engagement. I work actively and don't believe in extending therapy beyond what's useful. My goal is to give you tools you can carry with you — not to create ongoing dependency.

Fees & Logistics

What does a session cost?+
$235 per 50-minute session — below the BCPA recommended range of $240–$250

This rate is intentionally set below the British Columbia Psychological Association's recommended fee range. Sessions are 50 minutes in length.

Is therapy covered by extended health benefits?+

Most extended health plans cover services provided by a Registered Psychologist. Coverage varies by plan — check directly with your insurer regarding coverage limits, reimbursement rates, and any required referrals. You will receive a detailed receipt after each session that you can submit directly to your insurance provider for reimbursement.

Do you offer direct billing?+

I do not offer direct billing at this time, with the exception of Veterans Affairs. Extended health plans vary widely in coverage, reimbursement rates, and documentation requirements — and direct billing platforms can introduce delays and errors. It's also worth noting that direct billing can affect confidentiality. Some insurers require access to clinical documentation, session notes, or diagnostic information as a condition of reimbursement. Paying directly keeps your file entirely private — no third party has access to your information, your diagnosis, or the content of your sessions. For concerns as personal as sexual health, trauma, or relationship difficulties, that distinction matters. Payment is collected at the time of your session and you receive a detailed receipt to submit to your insurer directly.

Do you offer reduced-fee sessions?+

I hold a small number of reduced-fee spots in my practice for clients experiencing financial strain. These spots are limited and not always available, but if cost is a barrier, you're welcome to raise this when you make contact. Requests are handled respectfully and confidentially.

What forms of payment do you accept?+

I accept credit card and electronic payment. Payment details are provided when your appointment is booked.

In-Person & Online

Where are you located?+

I see clients in person at two locations: Victoria, BC — #221, 560 Johnson Street, second floor of Market Square. Enter through the Regional Assembly of Text storefront.

Edmonton, AB — #506, 8215-112th Street. In-person appointments are available several days per month.

What types of appointments do you offer?+

I offer in-person sessions in Victoria, BC (ongoing) and Edmonton, AB (several days per month), as well as secure virtual appointments for clients across British Columbia and Alberta.

Are online sessions as effective as in-person?+

Yes. Research consistently shows that online therapy is as effective as in-person therapy for most concerns. Some clients find it easier to engage from their own space. Others prefer the structure and separation of coming in person. Both are valid — we can discuss what makes the most sense for you.

Specialist Concerns

Can therapy actually help with sexual pain?+

Yes — and not in a "it's all in your head" way. Psychological treatment for sexual pain is evidence-based and addresses the real neurological, physiological, and relational dimensions of conditions like vulvodynia, vaginismus, and dyspareunia. Most people with these conditions have spent years in a medical system that told them there was nothing to be done. There usually is. I've been working in this area for 15 years and I've seen meaningful change in a large majority of the clients I've worked with.

I've never talked about my sexual concerns with anyone. Is that okay?+

Completely. Most of the people I see have never had a frank clinical conversation about their sexual health before they come in. I know how to make this territory feel manageable — it's genuinely one of the things I do well. You don't need to arrive with language, a clear narrative, or certainty about what the issue is.

Do both partners need to attend couples therapy?+

Ideally, yes — but both partners don't need to be equally ready. In practice, one person often makes the first move before the other fully commits, and that's fine. I also occasionally work with individual partners where joint sessions aren't possible or where individual work is a better fit for a particular stage of the process.

I'm not sure what kind of therapy I need. Can you help me figure that out?+

Yes. Not everyone arrives with a clear sense of what they're looking for. That uncertainty is a legitimate starting point, not a problem to solve before we begin. Get in touch and we can figure out together what kind of support makes the most sense.

What to Expect From the Process

What happens in the first couple of sessions?+

The first one or two sessions are primarily evaluative — I'm getting a clear picture of what brings you in, what you're hoping to achieve, and what approach is likely to be most useful. By the end of that stage, I'll be able to offer more specific information about a treatment plan and realistic expectations for the work ahead. You'll also have enough of a sense of me to know whether this feels like a good fit.

How often should I come in?+

Where possible, I recommend starting with weekly or biweekly sessions — particularly in the early stages of therapy, when building momentum matters. As the work progresses, it's common for clients to transition to monthly or intermittent appointments. The frequency is always something we discuss and adjust based on what's most useful for you.

Will therapy feel uncomfortable?+

Sometimes, yes — and that's worth knowing in advance. Therapy often involves discussing things that are difficult, and you may experience uncomfortable feelings during or after sessions. Some clients also notice the resurfacing of memories or experiences that cause temporary distress. This is a normal part of the process, not a sign that something has gone wrong. I work carefully to ensure your emotional safety throughout and will always respect your limits about pace and depth.

What is the difference between short-term and longer-term therapy?+

Short-term therapy (roughly 4–10 sessions) is solution-focused and designed to address one specific concern. It can be very useful — but because most challenges are interconnected, working on them in isolation has limits. Longer-term therapy (10–30 sessions) allows for broader healing by addressing problems from multiple angles and working at the level of underlying patterns rather than surface symptoms. Some clients also find ongoing intermittent sessions valuable as a form of maintenance. All approaches are valid — what matters is that the approach matches what you actually need.

Cancellations, Records & Confidentiality

What is the cancellation policy?+

I require a minimum of 24 hours notice to cancel or reschedule an appointment. This allows the time to be offered to someone on the waitlist. Missed appointments and late cancellations (within 24 hours) are billed at the full session rate, and payment is required before rescheduling. If you're unable to give 24 hours notice, please contact me as soon as possible — I understand that life is unpredictable. Please be aware that two missed appointments or late cancellations may result in termination of treatment.

What happens to my session notes and records?+

I maintain clinical records as required by law and professional standards. These include any paperwork you complete and case notes from our sessions. All records are stored securely and confidentially in compliance with BC and federal privacy legislation (PIPA and PIPEDA). By law, client files are retained for a minimum of ten years before being securely destroyed. You are entitled to request a copy or summary of your records at any time — I recommend reviewing these together to avoid misinterpretation.

Is what I say in therapy confidential?+

Yes. Everything discussed in our sessions is protected by law and professional ethics, and nothing is shared without your written consent. There are a small number of exceptions where disclosure is legally required — specifically, if there is reason to believe you or someone else is at serious risk of harm, if there is suspicion of abuse or neglect of a child or dependent adult, or if a court of law subpoenas your file. These situations are rare. If confidentiality ever needs to be breached, every effort will be made to discuss it with you before any action is taken.

Does couples therapy have different confidentiality rules?+

Yes. In couples therapy, the couple as a unit is the client. This means there is a strict no-secrets policy — any information shared in an individual session or correspondence with me as your couples therapist may need to be shared with your partner. This policy exists to prevent conflicts of interest and to protect the integrity of the couples work. If critical information comes forward that one partner is unwilling to share, it may be necessary to end couples treatment and provide referrals for individual work.

Still Have Questions?

You're welcome to reach out
before you decide.

If you're unsure whether therapy is right for you, have questions about fees or scheduling, or want help deciding between in-person and virtual — get in touch. I respond to all enquiries personally.