Counselling Explained

What is Counselling? What is therapy?

Some people prefer the term “counseling” others prefer “therapy” or “psychological therapy” but in a wider sense they are interchangeable.

Psychological difficulties are caused and maintained by factors that are not entirely conscious to the client (this is also true for other areas of health and medicine). The psychologist helps the client to identify the relevant factors and helps to build skills to manage the challenges more effectively. Therapy also helps you to be better prepared to manage future challenges.
The work we do together is a collaborative process guided by the clients’ input and the therapist’s knowledge and best practice. Therapy really is applied learning psychology, you learn the cognitive, behavioural and emotional skills that lead to a better quality of life.

What qualifications do Clinical Psychologists and Psychologists hold?

Clinical Psychologists have a Masters degree in Psychology plus 2-5 years of clinical training and supervised practice as a minimum requirement. In addition, a minimum of 56 professional development hours are required every year.

Clinical psychologists are trained in the provision of a range therapies with demonstrated effectiveness in treating mental health disorders such as anxiety, depression, substance abuse and more complex presentations such as posttraumatic stress disorder and personality disorders.

Further, clients find help with grief and loss, significant life transitions, developmental issues, relationship difficulties or parenting problems, domestic violence, sexual abuse/assault, trauma, maintaining healthy lifestyles or stress management.

What do we do in counselling and psychotherapy?

Therapy helps you identify the relevant factors of your difficulties and help create necessary steps for your solution. This is true for every one but from there it really depends on your individual situation. For instance, we work together on insights into the dynamics of your relationships. Often education about the nature of psychological difficulties helps to manage them better.

Skill building is a very important and wide area in counselling. If you are a general thinking, the skill building will include to think more in specific terms, if your decision making is impulsive or based on emotions, we work towards making smarter decisions. If you have trouble feeling good we work towards how to do things that make you feel good eventually. The list really goes on, from increasing psychological flexibility, gaining clarity, emotional regulating, perception and judgement. Even managing pain and anger can be goal we work collaboratively towards.

We all do this by using conversation as the vehicle for change.

What to expect in the first 1-2 sessions of counselling?

The first session is often a bit longer (60-90 minutes) to have enough time to explore your concerns and the circumstances that brought you to counselling.

Most people are somewhat nervous, which is understandable, given the private nature of the topic. Please remember, therapy is confidential and we are there to support, not to judge.

Understanding the nature of problems is important before deciding how to address them, is particularly important when it comes to human difficulties, given their complex nature. Time to reflect usually is time well spent. With effectiveness in mind, we cannot and therefore should not rush this process. Slow means quicker, if that makes sense. Notwithstanding, some issues only require some new impulses and change can be quickly achieved.

How is treatment planned?

Appointments are 50 minutes long. Therapy is learning something new about yourself and others. Humans learn by practicing and repetition. Therefore, regular appointments, usually weekly or fortnightly allow to gain traction and to maintain momentum. Some clients feel better after a few sessions, lasting change is often the result of working on issues consistently for some time.

Similar to learning an instrument, consistent practice which may include journaling between sessions, does the trick, even if you do not recognise immediate results.

For best outcomes a certain number of sessions should be pre-agreed on (e.g. six). We are confident that we are able to help, therefore a certain predictability of the process is beneficial for the client and allows for covering important topics.

Therapeutic approaches used

New Paths Psychologists have both academic and post-doc practical training and have a good grasp of best practice. As client you can rest assured that the psychologist uses the expertise to find the approach that is promising to help you.  New Paths Psychologists have completed training in several contemporary and advanced approaches for both short-term and long standing problems and complex conditions, including

  • Cognitive Behavioural Therapy
  • Acceptance and Commitment Therapy (ACT)
  • Interpersonal Therapy
  • Clinical Hypnosis
  • Family Therapy
  • Family Constellations

Remember, the training and experience of the practitioner influences the case formulation and the chosen therapy approach. Each approach has a different focus of difficulties to address. As long as you choose a well-trained practitioner, you should not have to worry about treatment approaches. Same, when you give your car to the workshop for servicing, the mechanic is the main factor, although the tools play a role too.

How private and confidential is therapy?

Privacy and confidentiality has a very high priority. Under normal circumstances every detail remains confidential. For instance, if you accidently meet your psychologist outside the practice she would not know you and would not greet you. This is to protect your privacy. However, some exceptions apply, for instance, your file is subpoenaed or your or someone else’s life and well-being are at risk. If you are referred by a GP or another third party, reports about the therapy process are produced and sent to the referred. Please discuss any concerns.

What is my and the therapist’s role?

The psychologist’s role is defined as being an expert for the process: finding out what you need, finding what works for you, offering support or being receptive. The client provides the content of what should be discussed in our sessions, as only you know what is important for you. Please be as open as you can.

Other therapies have not helped at all, what to do?

Not all therapist are trained the same way, but even more important, not all therapists have the same skills. The therapy is rendered by the person, not by the tool or the therapeutic approach. Therapy contains much more than the therapy technique as such. Like your car is not serviced by the spanner but by the mechanic.

It is important to find a therapist who has experience in a certain area, in addition to specialised training, e.g. for couples therapy.

Isn’t therapy really expensive? Can I afford it?

If you were fully paying out of pocket, therapy can be an investment of a couple of hundreds per months, depending on the frequency of sessions. With a Medicare rebate the average monthly cost of therapy usually between $200 and $250 (a bit more in the first 1 month, less in the fourth month, based on a total of 10-12 sessions).  Many people who have undertaken therapy for a while, confirm the value of therapy. We do support those who are serious about working in therapy but struggle with costs with sliding scale options. Please enquire.

Why don’t you offer free services / Bulk-billing?

Medicare bulk billing fees are not compatible with practice viability. Practice costs are rising by between 4 and 6 per cent a year yet Medicare has not adjusted their fees since 2012. In fact, Medicare fees are effectively less than 50% of the fees recommended by the APS (Australian Psychological Society) which accurately reflects real cost of running a psychology practice. The rebate is nothing more than a subsidy to help the patient cover the cost of the psychological services.

How long does counselling or psychotherapy take?

Everyone is different and so is the length of treatment. Factors that contribute are the severity of your issues, how long you have been suffering for, the level of trust you have in the therapy and yourself, your motivation and resources (including but not limited to education, family support and financial independence).

Typically, 12-18 sessions are advised. A word of caution, there is generally no quick fix to long term, clinically relevant problems. The reason for this is the nature of human learning. Difficulties have been stabilized by learning processes, hence therapy is both de-learning and re-learning. Like learning a new instrument requires practice and repetition and is not done in a month, learning in therapy requires some repetition to make learning solid.

What may seem like ‘much’ effort, it is rewarding and have your results for a long time, sometimes a life time.

In some cases, fewer sessions can be appropriate but more sessions may be required for long term issues such as bipolar disorder, post-traumatic stress disorder or addictions. Ethically, we do not wish to compromise in our care and our standards are informed by evidence-based therapy.

What counselling is not?

Therapy is not passive “treatment” and very unlike treatment at the dentist. Your collaboration makes the difference and leads to results you aim for. While we provide guidance and support, the more you dedicate your time and attention to the counselling process, the better the outcome will be. Like learning to ride a bike, practice leads to confidence. Same is true when you learn to express your feelings, journal your reflections, increase your frustration tolerance etc.