03.How to choose a therapist
What to look for in a therapist
- Qualifications There are many different diplomas and degrees on offer. Be warned, though, that some impressive-sounding qualifications may not have accreditation with relevant peak bodies, and may not be government-accredited either. Your best bet is to look for membership of an industry association.
- Strengths and interests of person Some therapists specialise in particular areas such as drug and alcohol management, family therapy, eating disorders, sports psychology or relationships. Keep this in mind when searching or seeking referral for a therapist or counsellor.
- Approach Therapists and counsellors use different approaches, from cognitive-behavioural therapy, expressive arts and psychoanalytic therapy to somatic psychotherapy, hypnotherapy and transactional analysis and many more in between. You may find a particular approach more appealing to you – see More Information (below) for useful resources.
- Interpersonal compatibility The relationship between you and your therapist is an extremely important aspect of therapy. If you don’t click with them, move on as quickly as you can.
Better Access scheme
While some people may prefer to find a therapist on their own, others may choose to go through their GP. Doing so may give you access to subsidised care with a psychiatrist or psychologist.
The so-called Better Access initiative resulted from recognition that many people were not seeking or able to get the help they needed for many common mental health issues. The federal government's Better Access to Psychiatrists, Psychologists and General Practitioners through the Medical Benefits Schedule (Better Access) initiative commenced in 2006.
Under the scheme, which was revised in 2011, patients can receive Medicare rebates for 10 individual and/or 10 group sessions per calendar year with a psychologist or occupational therapist or social worker who’s had appropriate training in mental health services.
The treatment is an integral part of the General Practitioner Mental Health Treatment Plan and encourages a team-based, multidisciplinary approach to mental health care in the community.
The type of treatment offered is a two-tier system, with clinical psychologists offering what’s called “psychological therapy” and psychologists, social workers and occupational therapists offering “focused psychological strategies services” such as cognitive behavioural therapy, stress management or interpersonal therapy.
Some argue the difference between the two treatment types is ill-defined and notional at best, and that psychologists with skills, experience and training equal to or greater than those of clinical psychologists are being unfairly penalised with a lower Medicare benefit.
The Better Access initiative was designed to provide treatment for common mental disorders such as depression and anxiety, where short-term interventions are likely to be useful in cases of mild to moderate severity.
It wasn’t designed to provide intensive, ongoing therapy for people with severe, ongoing illness or with more complex or intensive care needs. In such cases, referral to Medicare-subsidised consultant psychiatrist services or state/territory specialised mental health services may be more appropriate, especially if affordability is an issue.
Telephone and web-based counselling
There are several free counselling telephone and online services on offer, the main ones being Lifeline, Crisis Support Services and Kids Helpline. A 2002 comprehensive review of such services for the federal government determined that the quality of service was of a high professional standard and that customers were very satisfied with the help they received.
These services are often staffed by volunteers who are professional counsellors, psychologists and social workers, and training at Certificate IV level may be offered to people who aren’t otherwise qualified. While best known for crisis support (the big ones are open 24 hours a day, 7 days a week), they also offer assistance with relationship issues, loss and grief, drug, alcohol and gambling problems and mental health and wellbeing.
MoodGym (Depression) and eCouch (depression, generalised anxiety and worry, social anxiety, relationship breakdown, and loss and grief) are free online programs designed and developed by staff at the Centre for Mental Health Research at the Australian National University, in collaboration with other experts. They provide evidence-based information and teach strategies drawn from cognitive, behavioural and interpersonal therapies as well as relaxation and physical activity.
There are many self-help therapy books offering information, insight and therapeutic strategies (usually based on cognitive-behavioural therapy). Though some are undoubtedly better than others, studies on the effectiveness of bibliotherapy for depression have found that it’s almost always better than no treatment, and sometimes as good as professional therapy. The Black Dog Institute website has a list of books that can help with depression.
• Australian Psychological Society (psychology.org.au)
• Australian Counselling Association (theaca.net.au)
• Psychotherapy and Counselling Federation of Australia (pacfa.org.au)
• Royal Australian and New Zealand College of Psychiatrists (ranzcp.org)
• Reach Out (information and resources for young people) (au.reachout.com)
• Black Dog Institute (blackdoginstitute.org.au)
• Mood gym (moodgym.anu.edu.au)
• E-Couch (ecouch.anu.edu.au)