Talk therapy isn’t for everybody, I spent years saying that I would rather be stabbed to death with a rusty spoon than see a ‘shrink’, but that was fear of the unknown and a lot of unfounded stigma talking. As I have grown up emotionally, I have realised that you certainly don’t have to be “crazy” to seek therapy! There are many reasons that people seek out therapy and several different types of therapy that will assist you with coping mechanisms for all the various things that life throws your way. As I come to terms with the fact that I have a life long mental illness, I have really embraced therapy and the positive effect it has had on my life and I now feel that seeing a therapist is absolutely essential for my own personal mental health and wellbeing.
Below I have discussed a few different aspects of therapy:
Therapy gives you a safe environment in which to confidentially share your fears and concerns, work on undesirable behaviours or reactions to situations or events and come to terms with and process traumatic events.
Different therapists will have different specialities and depending for your reason for seeking therapy you will be able to seek out someone who specialises in relationship issues, family concerns or postnatal depression, some may focus on helping adult survivors of childhood abuse and trauma while others may have high levels of experience in bipolar or eating disorders etc. Chances are if you live in a city, no matter what concerns have led you to seek out therapy, there will be someone about who specialises in that area.
You may have heard terms like DBT, CBT, and EMDR bandied about the place, these are all styles of treatment which are targeted to help certain types of issues, just click them to find out more!
A Counsellor will have a diploma of counselling, their focus is mostly on providing guidance to their clients in understanding themselves better, helping them make positive changes in their lives and assisting to resolve general psychological concerns and issues. Counsellors may use techniques such as Cognitive Behavioural Therapy.
A Psychologist has a university degree in Psychology they have extensively studied the science behind as well as the process of human behaviours and emotions. They are well qualified to work with clients in developing coping strategies and tend to work with people that may have reoccurring problems over longer periods of time, some will go on to do further training and earn a PhD to become “clinical psychologists” which gives them more experience in areas of severe mental illness but in Australia they are not able to prescribe medications.
A Psychiatrist is a fully qualified medical doctor who has gone on to do further training and specialise in the field of psychology and mental health. They have the ability to make formal diagnosis of mental illness as well as prescribe medications. Some will provide a level of talk therapy, but many only have short appointments and have a strong focus on pharmacological solutions. If you find a psychiatrist who you click with and is also willing to provide talk therapy, then hang onto them for dear life and never let go!
You can have a discussion with your General Practitioner about what sort of therapy might best suit your needs, you will need a referral from them anyway in order to claim a Medicare rebate if you see a psychologist.
HERE is a link to a list of Psychologists and Counsellors providing therapy in Australia, you can use the search tool to find someone in your area.
Treat your first session as more of an interview, remember they will be working for you, this is someone you may end up baring your soul to and so it is important that you feel comfortable with them and that you feel validated and heard as well as have your thoughts and opinions challenged (in a constructive and kind manner) if required.
The therapist will normally use the first session to find out basic info about you, they will ask why you have come to speak to them and then ask a bit about your lifestyle and family situation e.g. are you partnered, single, have kids, study, work, diagnosed physical or mental health conditions etc (every single one I have ever been to has begun by sketching themselves a little family tree!)
It can be really helpful to make a list of different things you want to talk about or ask your therapist about in the time leading up to your appointment, and this doesn’t just go for the first one – I have been seeing therapists for many years and I still find it necessary to do this. Also have a think about the priority order if there are multiple items, it is surprisingly easy to have a million questions and not remember a single one when you actually get into the office or start talking about something that is of less priority and then ending up not discussing what you really wanted to in the first place; therapy isn’t cheap so you want to make the most of your session!
I have been through a few therapists over the years, my first one was AMAZING she validated me while I came to terms with the diagnosis of my illness, she gave me wonderful advice and generally kept me alive when I really didn’t want to be. She was unfortunately (for me) offered the job of a life time and left the industry. Then I had an AWFUL experience with someone who had no idea where I was coming from at all, she was nice enough but she talked over me constantly and jumped to incorrect conclusions all the time. We were on two totally different pages and it was never going to work out. I eventually found the courage to move on from her, okay I hate confrontation so my version of moving on was basically just telling her I couldn’t afford it anymore and I went without therapy altogether for about six months.
There are some excellent articles floating around the interwebs in relation to ‘breaking up with your therapist’ that I read after the fact, I will try and link one here at some point. I have since found an amazing therapist who ‘gets me’ and is full of practical advice, I found her as a student offering free counselling and now that she’s qualified I can’t afford to see her regularly but she is okay with our intermittent visits and when I do see her she offers stacks of practical strategies which have really helped me. My psychiatrist is extremely expensive but she is also a rare gem and I wouldn’t trade her for the world as she offers excellent talk therapy rather than simply dishing out medication. So long story short, keep trying until you find someone who is a good fit with you!
Unfortunately therapy costs money, sometimes it costs a whole lot of money. Depression has a habit of telling us that we don’t deserve help and when help costs a lot of money we can feel even less worthy. But I promise that prioritising your mental health will save you financially in so many other areas that if you can physically afford to do it then feeling unworthy of therapy is not a valid enough excuse not to. You are worth it.
I can’t speak for other countries, but here in Australia it averages between $120 – $250 per 50 minute session with a psychologist, sessions with clinical psychologists and psychiatrist are more expensive, these sessions are subsidised a little bit by medicare, if you have hit your safety net then they are subsidised massively ( for example, my psychiatrist is $350 per hour, I get $150 back from medicare and if I hit the safety net I only end up out of pocket around $40.) If that is unaffordable there are still a few options available, you can enter into a ‘GP mental health plan’ which entitles you to six sessions per calendar year subsidised dramatically by medicare, if the psychologist determines that you need it, then they can write a letter to your GP and the GP can organise a further four medicare subsidised sessions totalling ten altogether.
You can have free sessions with mental health workers and psychiatrists through your local state mental health service if you are having an acute episode of mental illness or are in a crisis situation, unfortunately because these are government run there is limited funding, sessions are short and only available for a limited period. The sessions with psychiatrists are focused mostly on medications and all of the health care professionals tend to rotate through quite quickly and have a tendency to contradict each other, even in regional areas the chances of seeing the same mental health worker for more than a few months or the same psychiatrist twice is minimal. I recommend always taking friend or relative with you to act as an advocate as when you are unwell it can be difficult to remember all of the things that are being said to you. While the public system can get you out of a jam short term, these services are not designed for ongoing care. Social workers may be able to point you in the direction of more long term low cost treatment options in your area but there is unfortunately a big gap in the system.
Sometimes you can get cheap or even free sessions from psychology or counselling students in their final year of university. They are fresh faced and eager to help which makes up for their lack of experience and they have to build up a certain amount of practical time with clients in order to finish their degree so consider contacting a university and finding out if they offer any low cost therapy options. The only thing with this is you may not be able to see the same counsellor long term or once they have finished their degree you may still be able to see them but it will of course start costing money and counselling is not subsidised by medicare.