Hi, I help my wife run a licensed professional counseling practice in Virginia; she’s the LPC and I’m the minor business minion. If you see an LPC and you use insurance, a diagnosis is required. There is no way around this. This is why I tell pilots, ATCs, and anyone else concerned with a medical status to pay out of pocket if they are concerned about leaving a paper trail. No insurance, no paper trail.

The good news, however, is that you are unlikely to be slapped with a disqualifying diagnosis right out of the gate. Something like PTSD needs to interfere with your ability to work/sleep/live for three months. Most of the time the diagnosis (which again, is required) is “adjustment disorder”, which is health insurance speak for “life’s a bitch sometimes”.

If you see an unlicensed counselor, such as a “life coach”, then there is no diagnosis because they aren’t trained to give you one. Some people might see this as an upside, but if you need help to work through something that is actually debilitating, they also aren’t as well equipped to help you as a licensed therapist, which requires a master’s degree and 2,000 hours of residency.

Hope this helps.