The "counselling couch"

Hi everyone,
Hope you are all well.


Apologies for not writing a blog sooner but I hope that you will find this one interesting and informative.




The "counseling couch".
This blog is to explain to you what happens usually if you decide to attend a counseling session in person.




Firstly, if you can, please do your research, sadly not everyone that calls themselves a counselor is a good one, you may also have to meet several to find someone you feel comfortable with and can develop a rapport with, trust them and feel able to open yourself up to them safely.
Counselors need to know a lot about you to help treat you in the best way.
Often you will be asked about things that you may not want to disclose or that upset you.
Examples are abuse of any type, how much substances you use if you use them and questions about harming yourself or others and/or crimes you may have committed.


Everything that you disclose to a counselor is confidential unless it concerns the safety of yourself and/or others.


If you feel distressed about a topic, it is okay to tell your counselor that you need some time out, go outside briefly, have a cigarette if you are a smoker (only tobacco please), have a glass of water but do go back in as there is nothing worse than leaving a session upset.




Most counselors no longer use couches, in fact I only know of one that does, they like to be able to see your face, look you in the eyes, encourage you to feel on equal terms with them and most will also be assessing your body language.
Often we say more with what our bodies, posture and hand movements, eye contact or lack thereof do than words.




Be prepared for a lot of questions.
It is not because we are being nosy, but to help us understand your situation, what you are going through and what is currently having an impact on your life, often it can be things or events from your past that you may not even realise.


If you make the brave decision to see a counselor if you have issues that you feel you need help with, it can be quite scary and cause you some anxiety beforehand.
That is normal, so please do not let this stop you from attending your appointment.




You will probably need your Medicare card and details of any possibly relative information.
Public services will not charge you but private ones will so it is important to ask the rates and any discounts you are entitled to through Medicare, private health insurance or in QLD, if your doctor gives you a mental health care plan you will receive discounts.
Most private counselors require a referral from your doctor.
It is a good idea to write any questions you have down and also a list of your past and present medications.




The assessment:
Depending on where you are seen and the therapist, the questions you may be asked can vary but I will give you examples of what my service requires.
Obviously you will initially be asked about your personal details, who you live with, how you receive income and what supports you have.
The counselor will then enquire as to why you have chosen counseling, what you think you need help with and any goals you may have.
Other questions will relate to your mental health, past and present, physical health, family history of any illnesses and ask you about your family, schooling, work history and what you currently do.
What hobbies you enjoy, or used to and how you spend your time.
They will need to know if you are on any medications or have been in the past and if you have any allergies.
You will be asked about substance use, you will not be judged and this information will not be given to the police.
They will ask about past experiences, have you been treated for mental health issues before, any significant events, any traumas and if you have been abused either as a child or as an adult?
Please be honest about this as it may have play a significant part in your treatment and counseling needs.
You will likely be asked about your sleep patterns.




The most important part of an assessment is your current mental health status.
For example, your mood, your level of anxiety, your current thoughts, if you are experiencing or have experienced hallucinations (http://www.webmd.com/brain/what-are-hallucinations#1) or delusions
(http://www.webmd.com/schizophrenia/guide/delusional-disorder) and if you have harmed yourself before or have any thoughts of harming yourself.
They will also ask if you have harmed others or feel like harming anyone.




After the main part of the assessment they will use this information to decide what you are suffering from and this is called a diagnosis.
Don't be scared by this as it is usually a guide to help the therapist work out what you need help with and what the options are.


You will likely be asked what you would like to work on and your goals, then prioritise these goals according to which ones you would like to address first.


You may also be asked to see your doctor for a physical check up and blood tests, as some illnesses can be caused by medical problems.




Your therapist will then discuss with you what your options are for treatment.
Please, if you do not understand anything, ask them to clarify it and maybe write it down for you.
If you do not agree with their suggestions you have the right to tell them.




There are different types of therapies but the most common is called Cognitive behaviour Therapy.
(http://www.mindhealthconnect.org.au/cognitive-behaviour-therapy-cbt) however there are other types of therapies and I personally use sometimes a combination of a couple, depending on the client, the diagnosis and their needs.
Other types of therapy. (http://www.goodtherapy.org/learn-about-therapy/types)




Some therapists will give you "homework" to do.
This may be handouts to read, goal setting lists, meditations recommended, exercises to try, there are a multitude of things.
It is important that you try and do these as a large part of successful therapy is your active involvement.
The therapist can guide you but cannot "make" you better without your input and even if you are prescribed medication, it is recommended that you also engage in therapy.
Medication can help treat the symptoms but usually not the issues involved or the cause.




At the end of the session which is usually about an hour, your therapist will summarise what you have discussed and the plan you will work towards.
Ensure you understand this and are happy with it.
They will then schedule you for another session.
Sometimes only a few sessions are required, in other cases you may need support for longer.




After your appointment you should feel better and happy that although you may have some work to do you now have someone that understands you and who will support you and guide you.


You may feel tired and drained, this is normal so please organise a period of rest afterwards and
congratulate yourself!
You have started taking control of your future and working towards a happier and more satisfying quality of life.