Many people seek counselling help but are naturally concerned at the cost, so getting a Medicare rebate, mental health care plan or Employee Assistance Program help initially seems attractive. However, for some people the advantages are outweighed by the disadvantages. 1. Working with a counsellor means you are able to access your therapist directly. You don’t need a GP referral as you do for psychiatrists or some psychological treatments, so you don’t need to discuss intimate or distressing matters with your doctor and then retell them to the therapist. 2. Mental health care plans referring you to a psychologist require a formal mental health diagnosis, for example for anxiety and depression. You may later find that this has damaged your ability to insure yourself or your income, or is used against you in subsequent claims for workers’ compensation and similar. 3. The consultation is not noted in your hospital or doctor’ notes, does not appear on your Medicare/healthcare records or workplace records and is only seen by your therapist (except in a couple of legal circumstances). Medical records are accessed in numerous circumstances by insurance companies and for worker’s compensation cases. Recent cases in the media have highlighted the way in which insurers have “trawled” through peoples’ records in order to deny them their legitimate benefits. 4. You are able to access the therapist and therapy type that best suits your needs. Psychologists may be required by the conditions of the treatment to limit their therapy approaches, often to a medical model such as cognitive behaviour therapy. While CBT and other similar therapies are excellent, they may not be the best one for you at the time. 5. EAP sessions are usually very limited and, though they may be helpful for simple issues, are rarely enough for long-lasting change.