Counselling

Counselling, also known as therapy, talking therapy or psychotherapy, gives people the chance to talk to a trained professional in a safe and totally confidential environment, to explore feelings, thoughts, and behaviour. Counselling has been shown to help people cope with everyday problems, distressing experiences, major life events, experiences from childhood, and difficulties relating to people. It is also commonly used as a key tool in helping to treat depression, anxiety, substance dependence and most other mental illnesses.

The aim of counselling is to relieve distress, improve coping ability, raise awareness and understanding of oneself and other people, and give an increased sense of wellbeing. At its best, counselling can help:

Put life situations in perspective
Help find practical solutions and approaches to challenges
Give a new sense of confidence in making choices
Deal more effectively with other people

When can counselling help?

Talking through problems is often very helpful, but sometimes, the people close to you can be too involved in the situation to be objective. Friends and relatives may also feel obliged to try to help fix challenges, by offering unwanted advice or blanket reassurance. Counsellors exist to provide an independent, trained listening ear, able to view your situation without involvement, and able to help guide you to the approaches to your problems that suit you best. Many clients also report that an appointment at a set time and place can be very helpful in working through issues.

Many people attend counselling for specific conditions such as depression or anxiety, or because of major life challenges such as relationship issues, grief and bereavement, violence or sexual assault, major illness, traumatic events, childhood abuse and situations, or substance issues. Counselling is often also useful for less obvious challenges, such as professional issues, family and parenting issues, personal barriers, phobias, improving self-confidence or breaking bad habits. Even for the mentally healthy, counselling can be a powerful aid to personal growth, helping improve self-understanding and direction in life.

What does a counsellor do?

Contrary to what many people think, the role of a counsellor is not to give advice. Instead, they help people question the way they look at things, the way they behave and react to situations or people, and help them develop strategies for dealing with their situations. Different schools of counselling may do this in different ways, but in general, the process involves getting to know their clients, listening to them, developing an understanding of their circumstances, and offering appropriate support and insight.

What are the main types of counselling?

Individual counselling – A counsellor meets a client on a one-to-one basis.
Couples counselling – A counsellor meets with two (or more) clients who are in a relationship. Some couples counsellors also meet with the people in the relationship individually.
Family therapy – A counsellor works with the whole family as a system to explore the way family members interact with each other and how they may be able to function better together.
Group therapy – A counsellor leads an open discussion or counselling exercise for a group of people, often with similar issues of concern (such as substance issues, grief, sexual assault, illness or anger), who get together on a regular basis to share their experiences.
Self-help groups – People who are experiencing similar problems, such as loss and grief, trauma, divorce or illness, meet to discuss common issues and problems, often without a counsellor to lead the discussion.
Phone and online counselling – Long-term phone or online counselling is generally the best option for people who find it difficult to physically visit a counsellor, for example people with a disability or living in remote areas.

What does it cost?

Counselling can be expensive – but you may be able to access rebates, or low-cost or free counselling.

In Australia, people experiencing a mental health disorder (such as anxiety or depression) may be eligible for a Mental Health Care Plan under Medicare, offering rebates for up to 10 individual or group sessions per year, with a psychologist, social worker, or certain other allied health practitioners. You will first to talk to your GP, psychiatrist or paediatrician, who will work with you to create and monitor the plan. For more detailed information, visit Better Health.

You may also be able to claim sessions if you have private medical insurance. Check your private insurance policy, or ask about rebates if selecting new coverage.

It is worth asking counsellors in private practice if they have a concession rate. Some will charge on a sliding scale depending on your income and circumstances and can offer greatly reduced and affordable rates.

Your workplace, school or university may provide free or low-cost counselling, or be able to help you meet the costs. Universities that teach counselling also often have clinics where their advanced students provide very-low-cost counselling. Community health centres and community welfare, family and relationships services often offer free or low-cost counselling. Be aware that there can often be a waiting list to access these counsellors.

Organisations that focus on particular issues, like the Centre Against Sexual Assault (CASA), often provide free counselling. Call WIRE for the most appropriate referrals for you.

Who can do counselling?

In Australia, the titles ‘psychotherapist’, ‘therapist’ and ‘counsellor’ are not regulated by government – anyone can use these titles. The titles ‘psychologist’, ‘psychiatrist’, ‘social worker’ and ‘occupational therapist’ require specific qualifications. As with any professional, it is important to ask about qualifications and experience before employing a counsellor.

Many health professionals undertake further training in psychotherapy and counselling. Other practitioners do not have a health profession background, but have completed training in psychotherapy and counselling.

Doctors (GPs)

Visiting your family doctor, also known as a general practitioner or GP, can be a good place to start. They may manage your mental health themselves, or refer you to a psychiatrist, counsellor or social worker.

Psychiatrists

To see a psychiatrist, you first need a referral from your GP. Psychiatrists are qualified medical doctors with an additional specialisation in psychology and mental health. Some psychiatrists may focus solely on conducting medical tests and prescribing and managing medication, while others have extensive training and experience in counselling. Many psychiatrists specialise in a particular disorder or group of disorders.

Psychologists

Psychologists in Australia are required to have either an honours degree plus a two-year supervised internship, or a postgraduate qualification, and may have a non-medical qualification that allows them to use the title ‘Dr’.

Counsellors / Psychotherapists

Counsellors and psychotherapists are people who have been trained to talk you through a variety of problems. They may have a range of different qualifications and employ different techniques and approaches.

Social Workers and Occupational Therapists (OTs) in Mental Health

In addition to focusing on you, social workers and OTs tend to have a particular focus on your environment and living arrangements and your life skills – like problem solving, daily routines, anger management and stress management.

What about medication?

In Australia, only doctors and psychiatrists can prescribe medication. If your counsellor is not able to prescribe, but thinks medication might be useful in your case, they may suggest you consider talking to your GP about medication. Your GP may be able to prescribe and monitor some medications themselves, or may, in turn, refer you to see a psychiatrist. All management of symptoms, side effects, and any decisions to stop or start medication should be done with your prescribing physician.

Medications have been generally found to work best in conjunction with counselling. For some people experiencing severe symptoms, medication can provide relief from symptoms, giving them a better chance to get the most out of counselling. If you are advised by a professional to take medication, take some time to make your decision. Do some research for yourself – there are many reputable web sites and organisations that can give you information to help you make this decision.

How do I find a counsellor to suit me?

Many people from different backgrounds, and with a wide range of qualifications, work as counsellors and therapists, giving you a range of options to find the right counsellor for you and your situation. Your counsellor should have experience with the issues you want to explore, and you should feel comfortable with them as a person.

Before choosing a counsellor, it’s a good idea to sit down and think about what you might want. For example, it may or may not be important to you that your counsellor is male or female, older or younger, or of the same sexuality or cultural background as yourself. You may want to list some specific issues you have, to ask potential counsellors about experience-wise. There are also lots of different styles and models of counselling; each counsellor will be ready to explain their process. If you’re unsure what style of counselling might suit you, calling WIRE or talking to your GP may be a good place to start.

It’s a good idea to ask some questions over the phone before making an appointment, and you may want to interview more than one potential counsellor. Apart from giving you the answers to specific queries, you may be able to get some idea of whether you’re likely to get on with the counsellor and if they’re going to be sensitive to your situation. Take a look at our checklist for some questions you might like to ask:

Practical Questions

How much do you charge?
Is there a concession rate, a Medicare rebate, or can I claim through private medical insurance?
How often would I see you? How long do the sessions last?
If I miss a session, do I have to pay for it?
How much notice do I have to give if I need to cancel?
Are you available if I need to talk to someone in between sessions?
Do you offer phone or online counselling sessions?
Do you charge for an initial meeting?

About the Counsellor

What training have you done?
Are you a member of a professional association?
What is your general approach or counselling model?
What techniques or methods do you use?
What areas do you specialise in?
Have you worked with people in my situation before? Can you give me an example of what you did together?
What understanding do you have of my (culture, sexuality, disability, religion etc)?

The Process

What happens in the sessions?
Who decides what gets talked about?
As far as you can tell, what kind of changes do you think I can expect? How long do you think that will take?

Confidentiality

How will you ensure my privacy?
Will you discuss me with anyone else? Who else has access to my file?
What type of information will you keep about me?
Can I read my file any time?
What happens to my file when I leave?

If you decide to go ahead and meet a counsellor, you can further discuss what you want before you commit yourself. Some counsellors don’t charge for a first meeting. There is no need for a commitment at any point – you are free to change your counsellor or the type of counselling you’re receiving at any stage.

What makes a good counsellor?

While there are many different approaches a counsellor can take, and many different areas of specialty and training, all good counsellors will:

Believe in you
Respect you and allow you to work through your experiences and emotions
Be able to respectfully challenge your perceptions or position when it’s necessary
Have faith in your ability to work through your problems
Allow you to make your own choices and respect your decisions
Be trustworthy and sensitive
Provide you with the information you need
Be happy to discuss issues surrounding confidentiality

Had a bad experience with a counsellor?

It’s not uncommon for people who have had an unsatisfactory experience with a counsellor in the past to feel hesitant about trying counselling again. Not all counsellors are the same – they use different methods and approaches, and of course will have different personalities, backgrounds and skill-sets. It may be helpful to think about why your previous counselling was unsuccessful, and then ask questions about those issues when interviewing potential counsellors, to find a provider who suits you and your situation.

What are my rights?

As someone who is receiving counselling, you have very clearly defined rights:

You should be treated with care, consideration and dignity
You have the right to begin and end counselling at any time
You can refuse experimental treatment, to be part of research, or to have students present at your sessions
Your counsellor should not engage in any type of sexual relationship with you

What can I do if I have a problem with my counsellor?

If you are unhappy about any aspect of your counselling, the best thing to do is raise your concerns directly with your counsellor if you can. If you don’t think you can do this, or after discussing the situation, you feel things haven’t improved, you can make a formal complaint and try to find another counsellor. Contact WIRE to discuss your options.

Are there any alternatives to counselling?

If you feel counselling is not possible, or just not for you, there are other ways to work through issues. There are many reputable books and internet resources available, as well as online and community support forums and groups. There are many alternative therapy styles that do not involve talking (for example, music, dance or art therapy), or you might prefer educational courses – there are courses available in stress management, building self-esteem, managing conflict, assertiveness training or parenting, just to name a few. Your local community health centre is a good place to go for information on what kinds of activities are available in your area.

Where do I go for help?

WIRE Women’s Support Line 1300 134 130
Relationships Australia Victoria 1300 364 277
Better Health Channel
Australian Psychological Society
Lifeline 13 11 14
1800 Respect 1800 737 732 National Sexual Assault, Domestic and Family Violence Counselling Service
Counselling services
Community health centres in Victoria
Family doctor (GP)
Self-help and mutual support groups