When to consider counselling
Most of us will need help at some time in our lives. At least 1 in 6 women and 1 in 8 men will experience depression and 1 in 3 women and 1 in 5 men will experience anxiety at some time. Beyond Blue says that 3 million Australians are living with depression or anxiety right now.
All of us will experience grief, relationship stress, work stress, tricky family situations, or change at some point over the course of our lives.
Counselling or therapy helps when:
- Talking to a friend is not enough to solve the problem
- The feelings or problems seem beyond our control
- Nothing we have tried seems to be making a difference
- The problem is interfering with our daily life
- The problem is distressing to ourselves or others
- We need someone confidential and impartial to help
Once we realise there is a problem, the sooner we seek counselling the better. Just like when we break a leg or an arm, the earlier we get treatment the better the outcomes. The longer we wait the harder the healing process becomes.
How to find a psychologist
- Ask a friend who they would recommend
- Ask your GP
- Do on online search. The Australian Psychological Association (APS) has a ‘find a psychologist’ service to find a registered professional in your area. See: www.psychology.org.au.
Things to consider when making your decision
Age or Gender
Does this matter to you or not? The research says that as long as you like your therapist and feel they understand you, their age or gender does not generally matter.
Make sure they have general registration as a psychologist without any conditions (i.e. they are in good standing without any complaints against them, and are safe and competent practitioners). You can check this on the register of health professionals at: www.ahpra.gov.au.
Some psychologists have additional training in an area of practice endorsement, such as sports (work with athletes), organisations (work with organisations not individuals), clinical (work with mental health), counselling (work with couples, families), or educational and development (work with children). You may choose to see someone with the additional training or not. It’s up to you.
Do they have experience in your particular problem; for example, are they trained in working with depression, anxiety, couples therapy etc.
This may or not matter to you. Therapists have different models of working and follow different therapy types such as cognitive behavioural therapy, psychodynamic therapy, or solution-focused therapy. They all have a solid evidence-base, so this is a consideration only if you have a preference.
Location and availability
Would you prefer them to be close to your home or are you happy to travel, and are they available at time when you can see them.
The APS recommended fee is currently around $250 for a 50-minute session. Most therapists however charge less (between $150 and $170 in Melbourne). How to cover the fee:
- Pay out of pocket
- Check your Health insurance to see if you have psychology cover
- Get a mental health care plan from your GP. This involves a chat with your GP and then getting a referral to the psychologist of your choice. It allows for up to ten sessions per year to be eligible for a Medicare rebate. You only pay the gap between the fee and the Medicare rebate.
More than with any other health profession or service (e.g. cardiologist, plumber), the therapist not only needs to be skilled, but there needs to be a good relationship between you and them. While it might be ok to see a cardiologist with poor bed-side manner but great skills, or a grumpy plumber who can fit in your roof crawl space and gets the job done, when seeing a therapist a sense of trust and respect is important. In fact, the better the rapport between therapist and client, the better the therapy outcomes.
So, after two or three sessions, if you are not happy with your psychologist, (e.g. you don’t like their approach, you think it’s not helping, you think it’s a poor fit, there is a personality mismatch), you should go to another one. The research says that about 25% of clients will need to change therapists to find a better fit. Therapists know this, and expect that some clients will want to move to a different therapist. You can talk with the therapist about this if you feel comfortable and they can suggest a referral for you, or if not, just cancel and make an appointment with someone else.
What will happen in the first session?
- The first session is mainly about information gathering, with the ‘real work’ starting in the sessions later.
- You will be asked to provide some information about yourself, the problem or issues that you are having (why you made the appointment), how long things have been going on, and what you have tried.
- You will be asked to fill out some paperwork (contact details etc) and possibly a questionnaire about how you are doing on the day.
- You will have a chance to ask questions of the therapist about how they work, and the therapy process.
- The therapist will give you some idea about the treatment they think might work for you, and why, and ask you if you would like to engage in the treatment.
- You will be told about confidentiality, making appointments, fees, re-scheduling appointments etc.
- You can go by yourself, or take a friend or family member if you like. They can sit in the waiting room or attend in the counselling room – it is up to you.
- It can be effective to have a coffee immediately after the session and take a moment to reflect on the session, making some notes in a journal.
- The first session always feels a bit strange. It’s new, and the process of telling a ‘stranger’ (although a professional) our problems takes some getting used to if you have never done it before. Some anxiety or apprehension about the process is completely normal, and the therapist will be expecting this. Telling our stories for the first time can bring up emotions we are not expecting (like anger, tears, grief). The therapist is trained to deal with this. It takes courage to seek help. People generally feel better after their first session than they do before it. A sense of relief is not uncommon.
How do you know if it is working?
- Be sure to establish clear goals with your therapist (e.g. I want to overcome feelings of anxiety when I am with others).
- Measure the progress to your goal with your therapist. It will take more time to reach some goals than others.
- It is always a two steps forward, one step back process; however you should be able to see differences in your thoughts, behaviours, emotions or relationships.
- It is a good sign if you begin to feel a sense of relief, and a sense of hope.
- Sometimes other people notice changes in you (sometimes they love these changes, and other times they are confused by them).
How long do you need to see the psychologist for?
- This is completely up to you.
- Usually, clients stop going to therapy when their goals are reached, and the initial problem or issues are resolved.
- Sometimes this is a short time 5-10 sessions, and other times it may take longer. It depends on how long the problem has been around for, and whether it is a simple issue or a deeper one.
- You and your therapist will discuss when it is time to begin the process of ending the work together.