Mental health and wellbeing is now a topic that is openly discussed in our community and the options of professional services are vast.
But how can you know if you should see a psychiatrist, psychologist, counsellor – or would an app be enough to help you?
Each person has different life experiences that accumulate and add to an individual life story, which determines how each perceives and approaches the world in which they live.
Biological predispositions and/or impacting life events such as trauma, grief, loss and other circumstances can influence our thoughts and emotions in a negative way, so that a psychological intervention of some kind is beneficial.
In a world of online tools and great Apps that we can engage with, there is still a need for a more in-depth professional approach for additional support.
When determining which level of support may be required, a quick self-assessment of what your needs are can be advantageous.
Some questions to explore may be:
- Am I in immediate risk and require crisis care – if so seek appropriate agencies such as your doctor, hospital and/or crisis intervention services such as Beyond Blue or Lifeline. See details at the bottom of page.
- Am I able to function in my day-to-day life? (eg get out of bed, manage personal hygiene and go about day-to-day activities such as work, school and social engagements/connections with friends).
- Am I able to maintain self-care practices?
- Are there particular thoughts that keep ruminating?
- Do I find my emotions are in balance or am I struggling with emotional regulation?
- Where are my levels of motivation?
- Can I maintain healthy relationships?
- Individualise your list to suit your understanding of a balanced lifestyle and wholeness.
Your responses to these questions may give you an idea of what level of support you would benefit from, although having a conversation with your doctor to identify if a psychiatrist or psychologist may be more appropriate for your needs is a great first step.
What to Expect from Counselling
Another option may be meeting with a counsellor / psychotherapist to journey with.
Often, I find clients who have not attended counselling before are uncertain of what to expect and present with a level of anxiousness. My intention in this article is to hopefully offer an insight into the counselling process, and what counselling is and is not.
As described by the Psychotherapy and Counselling Federation of Australia, known as PACFA:
Counsellors are fully present with their clients, using empathy and deep listening to establish positive working relationships. Counselling is effective when clients feel safe, understood, respected, and accepted without judgement” (PACFA. 2013).
As a therapist who works across a wide array of presenting concerns, my role is to welcome the client into the counselling space and connect with each person to establish what is known as the Therapeutic Relationship.
The therapeutic relationship is essential to assist the client to feel comfortable enough to share their inner thoughts, emotions, and intimate details of their life. Naturally, how much a client shares is determined by them.
A client always has the autonomy to choose!
Counsellors are trained in a variety of methods and therapies and some may specialise in a particular therapeutic model or utilise a more integrative approach, dependent on specific client needs. Qualified practitioners who are registered with an Australian standard of practice organisation such as PACFA or ACA (Australian Counselling Association) have strong qualifications and adhere to ethical practice requirements to maintain membership. This offers the client an assurance that their therapist is a certified practitioner.
Building a rapport by engaging in a conversational approach is important.
Contracting and Confidentiality
To begin the session, a therapist will introduce a term known as “contracting”. This means that there is often a brief form to complete with basic personal information details, as well as an agreement by the client that they give permission to enter into therapy and understand the requirements of this process.
Confidentiality is one of the clauses that is most important for the protection of the client.
This assures the client that their details cannot be shared with other professionals unless they have given their consent for the therapist to do so. The therapist will discuss the Duty of Care aspects that they may have to invoke in case of a high level of presenting risk to the client and through a collaborative approach will outline how this may impact confidentiality. This aspect of contracting only takes a few short minutes to discuss and is for the benefit of the client’s wellbeing, and is only required for the first session.
The Counselling Session Begins
A good counsellor will connect with their client and invite them to share why they considered scheduling an appointment. It is important to note that counselling, although founded in evidence-based practices, does not adopt a strong clinical overtone.
Gathering a history and any information the client shares will assist the counsellor to gain a deeper awareness of the presenting circumstances. By the end of the session the therapist will be able to offer a strategy which is manageable/realistic for the client, to work towards their therapeutic goal. People often attend counselling for a variety of reasons which may include mental health or goal setting and establishing a healthy life balance to promote a positive view for future outcomes.
A counsellor cannot “fix” you, however they journey alongside you offering professional insight, guidance, tools/skillsets to apply to engage with unhelpful thinking patterns and emotional dysregulation.
In counselling, your therapist will introduce various therapeutic models such as Cognitive Behaviour Therapy, Couples Therapy, Creative Therapies, Trauma models and so forth that support the client with specific skills to apply to their situation to bring change and growth. This is the process of counselling – a collaborative therapeutic relationship that introduces the client to new ways of being by self-managing and directing their own journey towards healing and wholeness.
Working within the therapists’ Scope of Practice is an ethical factor which means that if a client presents with needs outside of the therapist’s ability, then a referral pathway is discussed, and recommendations are offered to provide additional support for the client.
You may hear the term “multidisciplinary team” which means that as the client, you are able to attend counselling, as well as continue to work with other health professionals such as Psychiatrists, Psychologists, GP’s, Dietitians, Physiotherapists, or any other provider that is a part of your overall team of practitioners. This also includes spiritual care.
What Counselling Is Not
Counselling is not about making medical assumptions or diagnoses for the client. Being trained in areas of mental health allows a therapist to have an informed understanding of many diagnosed conditions and most are equipped to work with these, in association with the multidisciplinary team.
Counselling is also not about pushing you into areas of discomfort or triggering trauma responses. Ethical practice requires that you, as the client, have the autonomy of choice and can say no at anytime if you perceive a sense of discomfort in the style of therapy being used.
As a qualified practising Counsellor, I see clients from a range of backgrounds, faiths and cultures who attend for a particular issue they want to work through. Often this can be achieved in weekly or fortnightly appointments for varied periods based on an individual’s needs.
I often find that these clients will complete the original focus point and continue to check in from time to time for maintenance. That is the beauty of counselling, it can be whatever the client wants it to be. You, as the client can design how the journey looks for you.
If you would like to experience counselling, then I would recommend creating a check list and highlighting key points that stand out to you. Ask yourself, “What is it I need right now?”
Make an appointment with a counsellor you feel best suits your personality and approach to life. Read their profiles and ask friends for recommendations.
If you begin with a therapist and feel that you are not connecting after a few sessions, then find one that you can build a rapport with. The therapeutic relationship and rapport you have contributes greatly to the effectiveness of positive outcomes.
Author: Wendy Smith, B Counselling, PACFA.
Wendy Smith is a professional counsellor working with adults and adolescents. As an Integrative Therapist, she uses different modalities ranging from evidence-based practices such as ACT and CBT, drawing from others when appropriate. Wendy has a deep passion to see people find restoration and growth on their journey to wholeness and wellbeing.
To make an appointment with Brisbane counsellor Wendy Smith, try Online Booking – Wishart. Alternatively, you can call Vision Psychology (Wishart) on (07) 3088 5422.
Crisis care contacts:
- Beyond Blue – https://www.beyondblue.org.au/get-support/get-immediate-support OR phone 1300 22 4636
- Lifeline – https://www.lifeline.org.au OR phone 13 11 14
- PACFA. (2013). Definition of Counselling. Retrieved from https://www.pacfa.org.au/definition-of-counselling