Deciding to start therapy is often the hardest part. The logistics shouldn't be. But if you've ever tried to figure out how therapy works in Ontario, you know it can feel unnecessarily complicated. Who's covered by what? What's the difference between all these titles? How do you even find someone?
This guide walks you through the practical stuff. No fluff. Just what you need to know to get started.
The Short Version
If you're looking for the quick answer: You don't need a referral. You can contact a therapist directly. Look for someone registered with CRPO (College of Registered Psychotherapists of Ontario). Many employee benefit plans cover Registered Psychotherapists. Virtual therapy is widely available and just as effective for most concerns.
That's the basics. The rest of this guide goes deeper.
Do You Need a Referral?
No. You don't need a referral from a doctor to see a Registered Psychotherapist in Ontario. You can contact a therapist directly and book an appointment.
A referral is only required in specific situations:
- Psychiatrists: You need a referral from a family doctor
- OHIP-covered programs: Hospital-based mental health programs typically require referrals
- Some insurance plans: A few insurance plans require a doctor's note (check your specific plan)
For private psychotherapy with a Registered Psychotherapist, you can just reach out directly.
Understanding the Different Titles
This is where it gets confusing for most people. Here's a breakdown of who does what in Ontario:
Registered Psychotherapist (RP)
Regulated by CRPO. Specialized training in psychotherapy. Can provide talk therapy for anxiety, depression, relationship issues, life transitions, and most mental health concerns. This is who most people see for therapy. You can verify any RP's registration at crpo.ca.
Psychologist
Has a doctoral degree (PhD or PsyD). Can provide therapy and psychological testing/assessments. Regulated by the College of Psychologists of Ontario. Often higher fees and longer wait times than RPs.
Psychiatrist
A medical doctor specializing in mental health. Can prescribe medication. Covered by OHIP but requires a referral from your family doctor. Often focused on medication management rather than ongoing talk therapy.
Social Worker (RSW)
Can provide counselling and therapy. Regulated by the Ontario College of Social Workers and Social Service Workers. Often found in community agencies, hospitals, and private practice.
For most people seeking therapy, a Registered Psychotherapist or Social Worker is a good fit. If you need medication, you'll want a psychiatrist (get a referral from your doctor). If you need psychological testing, see a psychologist.
How Much Does Therapy Cost?
Let's be direct about the money part.
Private Pay Rates
In Ontario, private therapy typically costs $120-200 per individual session. Rates vary by therapist experience, location, and specialty. Some therapists offer sliding scale rates based on income.
Insurance Coverage
Most employee benefit plans cover Registered Psychotherapists. Coverage typically ranges from $500-2000 per year, sometimes more. Your plan may list it as "psychotherapy," "mental health services," or "registered psychotherapist."
Benefits Reset in January
Many benefit plans reset in January. If you've been thinking about starting therapy, the new year is a good time. You likely have fresh coverage to use.
Check your benefits package or call your insurance company to find out:
- Your annual coverage amount for psychotherapy
- Whether you need to see specific providers
- If a doctor's note is required (most plans don't require this)
For more details on costs and insurance, see our costs and coverage page.
Finding a Therapist
Online Directories
- Psychology Today: The most comprehensive directory. Filter by location, specialty, insurance, and more.
- CRPO's Find a Therapist: Search only registered psychotherapists.
- Google: Search "therapist near me" or "online therapy Ontario" to find local and virtual options.
What to Look For
- Registration: Make sure they're registered with CRPO, the College of Psychologists, or OCSWSSW (for social workers).
- Specialty: Do they work with what you're dealing with? (anxiety, depression, relationships, etc.)
- Availability: Can they see you when you're available? Evening and weekend appointments matter for many people.
- Virtual or In-Person: Many therapists now offer both. Virtual can be more convenient, especially in winter.
Virtual Therapy: A Good Option
Online therapy has become standard in Ontario. Research shows it's just as effective as in-person therapy for most concerns, including anxiety and depression.
Virtual therapy makes sense if:
- You live outside a major city
- You have a busy schedule or long commute
- You prefer the comfort of your own space
- It's winter and you don't want to deal with weather and parking
Learn more about online therapy options in Ontario.
What Happens in a First Session
The first session is mostly about getting to know each other. Your therapist will probably ask:
- What brought you in (what's been going on, what prompted you to reach out now)
- Some background about your life (work, relationships, family)
- Any previous experience with therapy or mental health treatment
- What you're hoping to get from therapy
You don't need to have everything figured out before you start. It's okay to say "I'm not sure exactly what I want to work on" or "I just know something needs to change." That's what therapy is for: figuring it out together.
How to Know If It's a Good Fit
Research consistently shows that the relationship between you and your therapist is the strongest predictor of good outcomes. More than the type of therapy. More than the therapist's credentials.
After your first session (or first few sessions), ask yourself:
- Did I feel heard and understood?
- Did I feel comfortable enough to be honest?
- Did I feel judged or criticized?
- Can I imagine talking to this person about difficult things?
It's okay if the first therapist you try isn't the right fit. That happens. Many therapists offer a free 15-minute consultation call before you book, so you can get a sense of fit before committing.
What If You Can't Afford Therapy?
Money shouldn't be the only barrier. Here are some options:
-
Employee Benefits
Many people don't realize they have coverage, or forget it resets each year (usually January).
-
Sliding Scale
Some therapists offer reduced rates based on income. Ask about this when you reach out.
-
Community Mental Health Centres
Ontario has centres that offer lower-cost or free services. Wait times can be longer, but it's an option.
-
Student Counselling Services
If you're a student, your school likely offers free counselling. University services are often underused.
How Long Does Therapy Take?
There's no standard answer. It depends on what you're working on, your goals, and what feels right for you.
- Short-term: Some people come for 8-12 sessions to work through a specific issue or transition.
- Medium-term: Others work with a therapist for 6-12 months for deeper exploration.
- Ongoing: Some people continue therapy as an ongoing support, checking in regularly.
You're not locked in. You can stop whenever you feel ready. Your therapist should check in with you regularly about how things are going.
Common Concerns
"I don't know what to talk about"
You don't need to have an agenda. Your therapist will help guide the conversation. Start with what's been on your mind lately.
"What if I cry?"
That's okay. Really. Therapists expect it. They have tissues. Crying is often part of the process.
"I don't want to be a burden"
This is what therapists do. Listening to difficult things is literally the job. You're not a burden. You're a client.
"What if I'm not 'sick enough' for therapy?"
You don't need to be in crisis. Many people come for stress, life transitions, or just to understand themselves better. There's no minimum suffering required.
Ready to Start?
The hardest part is often just reaching out. A 15-minute consultation can help you figure out if therapy makes sense and if we're a good fit. No pressure.
Frequently Asked Questions
Do I need a referral to see a psychotherapist in Ontario?
No. You can contact a Registered Psychotherapist directly and book an appointment. A referral is only needed for psychiatrists or OHIP-covered hospital programs.
How much does therapy cost in Ontario?
Private therapy typically costs $120-200 per session. Most employee benefit plans cover Registered Psychotherapists, usually $500-2000 per year. Many benefits reset in January.
Is therapy covered by OHIP?
OHIP only covers psychiatrists and hospital-based programs. Private Registered Psychotherapists aren't covered by OHIP, but most employee benefit plans cover psychotherapy.
What's the difference between a psychotherapist and psychologist?
Both provide talk therapy. Psychologists have doctoral degrees and can do psychological testing. Registered Psychotherapists specialize in psychotherapy. For most therapy needs, either works well. RPs often have shorter waits and lower fees.
Can I do therapy online in Ontario?
Yes. Virtual therapy is widely available in Ontario and research shows it's just as effective as in-person for most concerns. It's especially convenient in winter or for those outside major cities.
What happens in a first therapy session?
The first session is about getting to know each other. Your therapist will ask what brought you in, some background about your life, and what you're hoping to get from therapy. You'll also get a sense of whether you feel comfortable with them.
How do I know if a therapist is right for me?
The relationship matters more than credentials or therapy type. After a session, ask yourself: Did I feel heard? Could I be honest? Did I feel judged? Most therapists offer free consultations so you can assess fit first.
What if I can't afford therapy?
Options include: employee benefits (often reset in January), sliding scale rates, community mental health centres, student counselling services, and Employee Assistance Programs (EAP) through your workplace.
How long does therapy take?
There's no standard timeline. Some people come for a few months, others longer. You and your therapist will check in about progress. You can stop whenever you feel ready.
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