Finding the right therapist for you
THE biggest barrier to gaining access to appropriate mental health services used to be the perceived stigma.
People are now much less reticent to seek help if they are struggling, reflected in about 10 per cent of Australians having accessed psychological services through the Better Access (Medicare rebate) scheme to date.
As stigma reduces and access improves, the question arises as to how you can find the right mental health professional for you.
A good starting point is to discuss this with your general medical practitioner, given their central role in making referrals within the health system. It can also be helpful to look up providers’ websites and to seek word-of-mouth recommendations from friends, family or colleagues.
The most suitable alternative might vary from one person to the next. It’s not so much the health professional’s objective characteristics, experience or credentials that makes the most difference, but the quality of the relationship between you.
In my view, the most basic thing is the client experiences the relationship as positive, and they experience the therapist as having a genuine interest in them and fostering hope. The therapist will hopefully be non-judgmental, open and a good listener.
An optimal therapist might still challenge you — indeed, some challenging might help you make progress more quickly. However, any challenge is best offered with tact, respect and obvious interest in your optimal wellbeing.
A constructive therapy relationship is collaborative, actively looking for and drawing on the client’s strengths and own resources. The client won’t be merely encouraged to passively accept the therapist’s authority.
A therapist might offer judicious advice, but not at the expense of encouraging the client to explore their own answers.
The therapist’s knowledge base is relevant as this will help engender trust and point to the additional benefits that the client might get from a professional beyond the support available from close friends or relatives.
It naturally helps if the health professional has a good familiarity with issues you might raise. This might include past trauma or an eating disorder or the need to review medication, all of which draw on specialised knowledge.
For example, if someone is dealing with complicated medication issues, it could be worth seeing a psychiatrist. If someone has trauma-related nightmares, it might be important to see a therapist with specialist experience in treating trauma reactions.
Optimal therapy will likely include some form of gauging progress in an objective manner. It helps to look for a therapist who has an active interest in reliable signs of progress, such as using questionnaires that monitor symptoms and/or positive wellbeing.
There would hopefully be a direction and structure to therapy, with a clear rationale for the therapy approach and some early indication of the likely frequency and number of sessions. An optimal therapist will typically be consistently professional in demeanour while still being themselves and having their humanity come through.
Once the client has found a likely suitable therapist, the next step is to help ensure you make the most of the therapy sessions yourself. This is greatly assisted by first clarifying what you seek from the therapy sessions yourself.
What are the issues you wish to raise and what are your specific hopes from therapy? How might things be in your life if the therapy proved to be successful? What steps are you ready to take to help you get there?
Naturally, there are other factors that affect accessibility such as therapist location, availability and fees. Once you have found the most suitable available alternative, it’s worth allowing several sessions to gauge your potential fit with the therapist. The first couple of sessions are often largely focused on assessment and planning a way forward together.
It’s reasonable to hope for some signs of progress within the first five sessions. This might typically involve some symptom reduction, greater understanding of the problem, more sense of direction and/or increased self-acceptance in dealing with the problem.
Naturally, progress with severe and longstanding problems tends to be more gradual.
If you feel that you’re not making progress over time and you’re not confident that your therapist is a good fit, there are always other options.
Chris Mackey is a principal psychologist at Chris Mackey and Associates, Geelong. Practical tips for positive mental health and wellbeing, including the Psych Spiels and Silver Linings podcast, can be found at chrismackey.com.au/resources.
THE MOST BASIC THING IS THAT THE CLIENT EXPERIENCES THE RELATIONSHIP AS POSITIVE, AND THAT THEY EXPERIENCE THE THERAPIST AS HAVING A GENUINE INTEREST IN THEM AND FOSTERING HOPE.