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Demistifying Counselling – Answering Some Common Questions

Demistifying Counselling – Answering Some Common Questions

Who needs counselling?

Practically anyone can benefit from counselling. It is a common misconception that you need to have a diagnosed mental health illness in order to seek professional help. Sometimes people seek counselling to deal with workplace stress, a relationship break-up, general feelings of unhappiness with no obvious cause, or to talk through a particular family issue. Whatever the cause, people often take a while to make up their mind and seek professional help. For example, research shows that it’s typically 6 months between the time when a person first thinks they have some psychological issue and the time they actually walk into the counselling room.

How therapy can help?

Counselling can help in many different ways, below are some of them:

  • It provides a safe and non-judgmental space to discuss personal issues that you may not wish to talk about with family or friends.
  • It allows you to gain a different perspective on things – often when we are in the midst of a situation it is hard to see all angles or remain objective.
  • It helps you come up with various solutions and approach problems in ways you may not have considered before.
  • It helps you gain insight into your thinking patterns and core beliefs that often operate under conscience yet guide a lot of your feelings and actions.
  • It can teach you new skills in how to better regulate emotions, resolve interpersonal issues, problem solve effectively, or increase self-care.

Summed up in a sentence – through counselling you can increase self-knowledge, gain more control of your surroundings and feel like you have A CHOICE rather than merely respond to events.

Which professionals can practice counselling?

In Australia, the only profession that is properly regulated for the provision of counselling is psychology. Every psychologist is registered with the Australian Health Practitioner Regulation Agency (AHPRA) and is eligible to provide therapy under the Medicare system. While I don’t doubt that there are good counsellors, psychotherapists, social workers, and life coaches that also provide excellent therapy, there is currently no regulation mechanism that governs them as stringently as psychologists.

In addition, some psychiatrists may also provide counselling but it is not their main area of training or competence, nor is there usually enough time for that in their shorter sessions.

How do you choose a psychologist?

Choosing the right psychologist for you is very important because establishing a good relationship is the foundation for effective work. There are now numerous researches that have demonstrated that the quality of the therapeutic relationship is more important than other factors including the type of therapy or the amount of therapist experience. Yes, that’s right, this is evidence-based and widely accepted in the psychological community, as well as what we are taught at university!

What it means for a person beginning therapy is that they should pay particular attention to how they feel with their therapist – do you feel heard and comfortable with them, do you like them as a human being, are you able to connect on a personal level? You should listen to your gut feeling and if you don’t click by the second session, just move on and find someone else – it’s not you or therapy not working for you, it just means you haven’t found a good match.

There are various ways you can choose a psychologist: you can ask people for recommendations, your GP will certainly have suggestions for referrals, or you can research online yourself. A good place to start is the register of the Australian Psychological Society which lists thousands of practitioners with full profiles that you can sort by various criteria such as location, therapies used or issues to work on.

How much does therapy cost?

I am a practical person so I think this is an important consideration (which is why I am upfront about fees on my website). There are obviously not set rates for psychological services but typically they can range anywhere between $120 to $220 for a 50-minute appointment (The APS recommended fee is $241 which I think is a bit ridiculous). A higher fee does not necessary mean better service, rather it can be due to the location or the policy of the practice, or the reputation of the psychologist (again, not necessarily a guarantee for better service). There are also a range of places that offer bulk billing so you don’t have an out-of-pocket expense. Many practices may also offer discounted rates for certain groups of people (e.g. students), so it’s worth asking.

My personal philosophy is that therapy needs to be affordable, while not undervalued, which is why I have set my fee on the lower end of what I deem reasonable. Since I have the freedom to choose my rates, I sometimes offer reduced fees to clients in financially-stretched circumstances in order to allow them continuous access to counselling they may otherwise lose.

What to expect from the first session?

Typically, the first session will feel different from most consequent sessions as there is a lot of history and questions to get through. Your therapist will need to get an overview of what is going on in your life currently, what issues have prompted you to seek help, what is your living situation (relationships, work, family etc), and your health history. They will also give you a general overview of what to expect from therapy, how it works, and answer any questions you may have.

At the end of the session they should summarise the main points, give you an opinion of how it may be best to proceed and clarify your goals for therapy. They may also provide you with some reading materials or recommend resources (e.g. mindfulness or relaxation apps), as well as suggest further referrals.

In my experience, many people are quite nervous before the initial session which is completely normal. Also, it happens relatively often that a new client will burst into tears a minute after they have set on the chair and start apologizing, not having expected such a strong emotional response. Again, perfectly normal and nothing to be ashamed of! For some people, this is literally the first time they have opened up about their issues or admitted to certain thoughts and feelings after keeping them suppressed for ages. Be assured, there is a box of tissues in every counselling room for a good reason.

How long will I need counselling?

This is entirely subjective and can vary based on many factors, including a client’s motivation, the type of issues presented, financial resources etc. In addition, you do not need to attend counselling weekly unless you are starting out or you are dealing with more pressing or serious issues. I often suggest to clients we start off the first 2-3 sessions weekly to get us going and then spread it out every couple of weeks if I think this may be more beneficial. Alternatively, if I think a person really needs ongoing support or is at risk of harm, I will strongly encourage them to commit to weekly sessions for a while and try to be flexible so we can make sure this is available to them.

Medicare offers rebates for up to 10 psychological sessions per calendar year which may sound like a lot but is really not. Ten sessions is pretty much a minimum when working through issues like depression, anxiety or trauma so don’t assume this is an adequate number just because our health system considers it to be. Having said that, sometimes a lot of good work and progress can be achieved even in a couple of sessions, especially if the problem was specific and the client highly motivated.

In summary

So there it is, my take on the most common questions I hear from new clients. Hopefully I have managed to alleviate your anxiety about picking up the phone and booking a session. If you have been considering counselling for a while, don’t be another 6-months statistic and give it a try sooner, rather than later!