I have had to find a counsellor and/or therapist for either myself or people I care about several times over the years. Throughout the next several articles, my goal here is to try to help you with finding the right person for you and your circumstances. These are the things that I wish I had known in the midst of what were very stressful times.
So you’ve made the decision to seek counselling for yourself or someone you care about, but now how do you find the counsellor that’s right for you?
You might have a friend,GP, or school counsellor whom you trust, who has recommended a great therapist and this can make the process so much easier. But what if this is your first time seeing a counsellor so you don’t know what to expect or ask for? Or maybe you’ve moved to a new location, or a great counsellor you saw years ago isn’t practising anymore? Or maybe, this time you would like to see a counsellor that specialises in a specific issue or modality but you don’t know how to go about finding them?
Then there is also the situation of that list of referrals that you’ve been handed by your GP or the school counsellor and discovering that each professional on the list is stating that their books are currently closed or they don’t work with that issue or age group anymore. This is an exhausting and frustrating process, and none more so when you are distressed and in the midst of a crisis.
I’ve attempted to answer this question over several articles with the intention to keep it simple but thorough. These are the things I wish I had known all those years ago when I initially started seeking therapists and before I became one myself.
I firmly believe that the first place to start is with your research! Even if you have been given a referral by a trusted GP, colleague or friend, it’s important to do your research, have some good questions, and to know the type of mental health professional that you’re looking for. I know, I know, that takes up time and we’re all short of that but here’s the thing - if you have prepared yourself then there is less chance of finding yourself in a disappointing or even painful therapy experience that costs you both time and money.
So, to begin with, lets take a brief look at the different types of mental health professionals who you may come across. You can explore the therapist that you have been referred to by the following steps, but you can also explore who else is out there and what they offer if you are not sure that the referral is the right person for your current circumstances. And of course, if you haven’t been handed a referral, this is a great place to start!
STEP ONE - LET’S CLARIFY WHO’S WHO SO YOU KNOW WHERE TO START
There can be some confusion regarding what kind of therapist you need. The first time I needed to find a counsellor was for postnatal depression - and I had absolutely no idea of how this all worked. It was my GP who recognised what I needed and referred me to the people who could help. Over the years I have had the experience of having to engage the services of all the professionals on the list below at one time or another for people I care about. Here’s a little explanation of who’s who to assist you with clarifying who the professional is that you’re looking for within your circumstances right now.
GENERAL PRACTITIONER (GP): Yes, start with your GP. Your GP will assess you from both a physical and mental health perspective. They can rule out any medical issues that may be affecting your mental and emotional health, complete a range of mental health assessments, prescribe medications, and organise medical tests. They can refer you to a range of professionals such as a psychiatrist, psychologist, social worker, mental health nurse, and counsellor/psychotherapist.
You can see your GP, Psychiatrist or Paediatrician, for a Mental Health Care Plan (MHCP) which allows for the Medicare rebate on up to 10 psychological services; or for an Eating Disorder Management Plan (EDMP) which allows for the Medicare rebate on up to 40 psychological services, and a referral to an appropriate psychologist/therapist/counsellor. Please note though that most counsellors and psychotherapists will not be able to accept MHCPs as Medicare doesn’t cover them as of yet.
Your GP will also usually have a lot of information for support systems in your local community.
So why would I need to see my GP for my mental health?
• They can assess your mental and physical health and rule out any medical issues
• They can prescribe medications
• They can provide you with referrals to a range of professionals
• They can provide you with a MHCP or EDMP which will assist with the costs
• Some do provide counselling
• They can provide information for support systems and programs in your local community
PSYCHIATRIST: Is a medical doctor who is able to assess, diagnose and treat mental health conditions, prescribe medications, organise medical tests, and examine physical and mental health from a medical perspective. They typically see patients who are experiencing serious and complex mental illness. Some psychiatrists will also provide counselling and/or psychotherapy.
You may also be required to see a psychiatrist if you are required to provide expert medical advice for issues involved with medications and other health conditions (eg, pregnancy), workcover, insurance, court matters, school/tertiary student support plans, or disability pensions.
Many patients who see a psychiatrist will also see a psychologist or counsellor/psychotherapist. You will need a referral from your GP or paediatrician to see a psychiatrist. Quite often a psychologist will refer through your GP, and they may also have a specific psychiatrist for your needs that they would recommend. It can take some months to get an appointment so if you have been referred to a psychiatrist then it is advised to make an appointment as soon as possible. This is also quite an expensive exercise so it is wise to take a look at what your private health cover offers you and if your doctor accepts your health fund. Medicare will cover some of the costs but you will need to discuss this when you are booking your appointment.
In Australia, in the event of a mental health emergency, you can call 000 for paramedics or present to the emergency department of hospitals for psychiatric evaluation and care. Please see what is available in your area so that you are prepared if the need arises. Hospitals such as St Vincent’s in Sydney, NSW are working hard to establish new models to provide for people who need this care. See: https://www.svhs.org.au/our-services/list-of-services/mental-health/psychiatric-emergency-care
So why would I need to see a psychiatrist?
• A complete and medical diagnosis for serious and complex mental health conditions. This can include conditions such as mood disorders, personality disorders, learning disorders, eating disorders, trauma/PTSD/CPTSD etc.
• Prescriptions for medications
• You require expert medical advice for issues such as medications for mental illness combined with other health conditions such as pregnancy for example
• Assessments/reports for work-cover, court matters, disability pensions, NDIS etc
• Assessments/reports/student support plans for school and tertiary students
PSYCHOLOGISTS: Are trained to find the cause of the existing mental health condition/s and can provide a diagnosis and work towards overcoming these mental health concerns. They do this using tools such as assessments, talk therapy, and therapeutic techniques. You will find psychologists who generalise and also those who are specialists within certain issues and/or age groups, genders etc. Psychologists are able to write reports and assessments that may be required for people who need things such as student support plans, disability support pensions, NDIS etc.
You can see your GP, Psychiatrist or Paediatrician, for a mental health care plan (MHCP) which allows for the Medicare rebate on 10 sessions; or for an Eating Disorder Management Plan (EDMP) which allows for the Medicare rebate on up to 40 psychological services, and a referral to an appropriate psychologist. You do not have to have a referral to see a psychologist, but you will have to pay full fee without the referral and MHCP or EDMP. Psychologist fees are expensive so it is worth checking with your private health fund provider what they cover, and with the psychologist which health funds they accept. As with psychiatrist appointments, it can take a while to secure an appointment so it is best to book an appointment or place yourself on a waitlist as soon as possible if there is a specific psychologist you wish to see.
And just in case you’re wondering what the difference is between a clinical psychologist and a general psychologist, here is a simple and basic explanation….The main difference is their qualifications and the level of Medicare rebate you receive (clinical psychologists are higher). Clinical psychologists have undergone extensive science-based training that equips them to integrate theory and clinical practice to work with psychological conditions that are mild to severe and complex - I believe it’s at least eight years. This training is highly specialised and states that those who have graduated are experts in mental health - they graduate with a Masters and/or Doctorate. General psychologists have trained for up to about six years and have studied a postgraduate degree in areas such as education, counselling, psychotherapy, neuropsychology, or criminal psychology for example. Both levels of psychologist will be trained in therapy and be able to treat a wide range of issues.
So why would I need to see a psychologist?
• They are able to provide you with a diagnosis of, and treatment for, general and complex mental health conditions. This can include conditions such as mood disorders, personality disorders, learning disorders, eating disorders, trauma/PTSD/CPTSD etc.
• Assessments/reports for work-cover, court matters, disability pensions, NDIS etc.
• Assessments/reports/student support plans for school and tertiary students
• They are able to provide treatment under a mental health care plan (MHCP) or eating disorder management plan (EDMP), NDIS, EAP, and Workcover, with a referral from your GP, psychiatrist, or paediatrician
• They can offer specialist therapy in areas such as sports psychology, neuropsychology, counselling, or psychotherapy for example
• They may offer group sessions, family sessions, as well as individual sessions
COUNSELLORS: Are trained mental health professionals that provide talk therapy, tools, and strategies to assist with challenges in their client’s life. By utilising a specific or various integrated modalities of therapy, they are able to listen and empathise without judgement, and collaborate with their clients to: clarify their issues and circumstances; work on their self awareness and self understanding; explore their options; support them in improving their mental health; learn skills that can build resilience, and to meet their client’s goals or hoped for outcomes; and work towards healing. You will quite often find counsellors are also trained in other professional mental health care areas such as psychotherapy, psychology, social work, or mental health nursing. You will find some counsellors that generalise but you will also find many counsellors that specialise in specific areas of therapy such as relationship counselling, disordered eating, postnatal depression, anxiety, trauma, financial, domestic violence, child & adolescence, addictions and recovery, hoarding, or bereavement for example.
To be accredited in Australia as a counsellor, they will need to have completed at least a Diploma in Counselling. However the expectation of the Australian Counselling Association (ACA) and the Psychotherapy and Counselling Federation of Australia (PACFA) is that professional counsellors will have continued their education to include a Bachelor of Counselling and/or a Master of Counselling or other forms of recognised undergrad/post grad education.
So why would I need to see a counsellor?
• They are able to treat and support a wide variety of mental health concerns and circumstances and many specialise in specific concerns such as: relationships, anxiety, depression, trauma, or life transitions for example
• They are able to work with both short term and long term issues
• Some counsellors are able to offer services that are covered under the MHCP, EDMP, NDIS, EAP, Workcover, and/or private health insurance
• They can be an important support and assist you whilst you are on a waitlist for a psychologist, psychiatrist
• Generally their fees tend to be less than a psychologist’s (even without the MHCP or insurance accessibility), therefore they can also play an important part in continuing your mental health care if your plan completes and you are not able to afford the full psychologist fee
• You may wish to see a counsellor to be able to work within a specific modality/therapy such as: Acceptance and Commitment Therapy (ACT); Eye Movement Desensitisation and Reprocessing (EMDR); Dialectical Behaviour Therapy (DBT); Attachment Therapy; Cognitive Behavioural Therapy (CBT); Emotional Freedom Technique (EFT); or Narrative Therapy for example
• They quite often offer counselling in the form of individual; couples; family; and/or groups
PSYCHOTHERAPISTS: Are trained to treat existing mental health condition/s and can provide tools and strategies to assist with resolving blocked emotional and mental issues that are at the core of behaviours, thoughts and feelings. They will do this utilising talk therapy and therapeutic techniques. There are many different specialisations that you might find in this field, such as behavioural therapy, art therapy, somatic therapy, equine therapy for example. You quite often will find that many psychiatrists, psychologists and counsellors are also trained in psychotherapy and integrate this work into their practice. To be accredited in Australia, the expectation is to have completed approved specialist training in psychotherapy or a particular practice of psychotherapy, and registered with the Psychotherapy and Counselling Federation of Australia (PACFA) and/or the Australian Counselling Association (ACA).
So why would I need to see a psychotherapist?
• Psychotherapists can treat and support many mental health issues including all forms of anxiety, depression, phobias, trauma, grief, overwhelm, and stress for example
• Some psychotherapists are able to offer services that are covered under the MHCP, EDMP, NDIS, EAP, Workcover and private health insurance
• You may wish to see a psychotherapist to be able to work within a specific therapy such as: Art Therapy; Animal Assisted Therapy; Eye Movement Desensitisation and Reprocessing (EMDR); Acceptance & Commitment Therapy (ACT); Attachment Therapy; Somatic Therapy, Psychoanalysis; Family Therapists, Marriage/Couples Therapists; or Dialectical Behaviour Therapy (DBT) for example
• They will likely also integrate classic counselling skills into their practice
• They quite often offer therapy in the form of individual; couples, family; and/or groups
SOCIAL WORKERS: Are trained in various aspects of human behaviour and development, and you will find them working in circumstances with families, social justice, disabilities, and physical and mental health. They are university trained and are qualified to assist people in crisis situations, to provide counselling, information, connections, referrals, advocacy, and support with challenging situations and environments. Your GP would be able to refer you to a local social worker, and you can also find them through hospitals, schools, community centres, aged care services, universities, drug and alcohol services, multicultural & refugee services, and Centrelink. You may also find some social workers in private practice, psychology clinics, counselling & therapy clinics, not for profit organisations, and medical centres.
Social Workers must meet the expected professional standards of the industry to be registered and accredited with the Australian Association of Social Workers (AASW). Social Workers in the mental health field will have additional training in mental health issues and are then able to be a member of the Accredited Mental Health Social Workers (AMHSW). Social Workers are also part of the allied health professionals in Australia.
Why would I see a social worker?
• If you are in a crisis situation such as needing housing, financial support, health or legal services
• Any sort of personal crisis, family violence, concern about welfare of children or a family member, mental health issues, affected by a natural disaster or any form of trauma
• They can help young people who don’t have adult support
• Issues with gambling, addictions, poverty, or unemployment
• If you are unable to look after your own health and wellbeing, or needing rehabilitation
• Needing support and help with health issues or a disability
• Personal and family counselling
• Advocacy and support
• Service co-ordination and care management
• They are able to take referrals from doctors for medicare rebates for the MHCP, NDIS, EAP, and Workcover.
MENTAL HEALTH NURSES: Have specialised training in mental health issues and working with people who have a mental illness. You will find them working in various community centres, nursing homes, hospitals, medical centres, and psychiatric hospitals. You may also find them working as counsellors in private practice, psychology clinics, counselling & therapy clinics, and not for profit organisations. Some specialist areas you may find them trained in include: postnatal depression, disordered eating, acute depression, psychosis, schizophrenia, substance abuse, and bipolar disorder for example. Their main focus is working with patients who have a mental illness, or helping a patient who is recovering from, or managing a physical illness. To be able to engage with a mental health nurse you will need a referral from your doctor or speak to your local hospital about the services that they offer. To be able engage with a counsellor who is also trained as a mental health nurse, you can contact the ACA or PACFA. You can also contact the Australian College of Mental Health Nurses for assistance.
Why would I see a mental health nurse?
• To provide counselling and strategies to work with and support mental illness, recovery, and emotional stress
• Education pertaining mental health and its treatment to help the patient and/or their family
• Advocacy and support with your doctor, psychologist, and mental health care plan
• Advocacy with Services Australia, housing, and community support programs
• Help with medications and symptoms
• They can provide help in a crisis
I also want to give a huge shoutout to the case workers, peer support workers, group facilitators, mentors, specialist coaches, sponsors, and volunteers, who work so hard in the field of mental health also. What they do is so important and integral to the well being, recovery, and healing of so many people.
I hope this article is helpful in terms of assisting you with a brief overview of who is who and what they do in this vast field of mental health professionals. The intention being for you to be able take a look at this overview and clarify what your needs are in this particular time. For most of us, we start with our GP and then decide based on their assessment. If we don’t require the need of a psychiatrist, social worker or mental health nurse as our first action - it’s then a matter of deciding if we need a psychologist or counsellor or psychotherapist - you will even find some who are all three!
A big part of this work, and some would argue - the most important part of this work - is making sure that you feel a connection with the practitioner who’s care you are in. This is where that research bit that I was talking about at the beginning of this article comes in - research the professionals you’ve been referred to. Take a look at their websites and profiles. Get a feel for how they work, the modalities and therapies they use, take a look at any material that they may have written, podcasts, YouTube videos etc. Take a look at reviews if they’re available. See what resonates. If they offer a short free call, take them up on it. We will delve further into the importance of this therapeutic relationship in the third part of this series.
In the next article of this series, we will narrow this search for the right counsellor for you down to your specific needs and your circumstances - including location, resources, and finances.
“Your mental health is everything - prioritise it.
Make the time like your life depends on it. Because it does”
-Mel Robbins
How Do I Find the Right Counsellor for Me? (Part 1)
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So What Actually is Professional Counselling?
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