Psychotherapist: ‘There is a general understanding that a psychotherapist can work with a wider range of clients and can offer more in-depth work where appropriate’ (UKCP).

Psychotherapy provides long lasting change and resolution of the pervasive, underlying issues. Clients often report healthy lifestyle changes occurring after just a few sessions and many see a significant difference in their lives within the first three to six months. Psychotherapy works best when it is consistent and attended weekly.

Psychotherapists who have had rigorous training, have trained for at least four years and perhaps up to eight years. Trainee therapists are also required to have a significant amount of their own personal therapy per year and usually group therapy throughout the duration of their training. This means that rigorously trained psychotherapists have ‘walked the path’ similar to that which their clients will be journeying along.

Counsellor: Counselling normally focuses on a specific issue and tends to be more short-term work, from 6 sessions to 6 months. There are different types of counsellors. Some train for a few hours, some train for up to four years. The three main types of counsellors are:

• Support
• Therapeutic
• Psychotherapeutic

Therapeutic and psychotherapeutic counsellors are able to work at greater depth and with a wider range of issues. Counselling works best when it is consistent and attended weekly.

Social Worker: Social work’s primary focus is on the social determinants of health. This means that the social worker takes a holistic view of health and well-being.  They work towards maximizing human potential and they advocate for social change (AASW). If you are seeking a social worker for counselling or psychotherapy, be sure to check that they have post qualification training in counselling or psychotherapy.

Psychologist: Psychology uses scientific methods to study the mind and human behaviour – it is a medically orientated model. Psychologists work in many fields: health and welfare services, government departments, academic institutions, education, corporations, community agencies, training and development and in private practice (APS). If you are seeking psychotherapy with a psychologist, be sure to check that they have post qualification training in psychotherapy or clinical psychology.

Psychiatrist: Psychiatry involves the study of medicine and then training in mental and psychiatric illness. A psychiatrist prescribes medication.  Most psychiatry training these days does not include depth psychotherapy as it used to – it is mostly prescription based. Therefore, counselling or psychotherapy sessions are recommended alongside medication to help to get to the root of the problem. The latest evidence shows that psychotherapy works better than medication for symptoms such as depression and anxiety.

When looking for a therapist to work with, feel free to ask them questions about the following:

• Is the therapist registered and accredited with The Psychotherapy and Counsellors Federation of Australia? See PACFA
• Is the therapist a member on the The Australian Register of Counsellors and Psychotherapists ? See ARCAP
• Does the therapist have specific qualifications in counselling or psychotherapy?
• Does the therapist have at least monthly clinical supervision?
• Does the therapist participate in continued professional development?
• Has the therapist participated significantly in his or her own counselling or psychotherapy?
• What is the therapist’s theoretical approach and philosophy?
• Does the therapist work with individuals, couples or families?
• How long has the therapist been in practice?
• Does the therapist have experience in the issues that you are going to them for?
• Does the therapist participate in online discussion groups and maintain client confidentiality?

There is a profound difference between those counsellors and psychotherapists who have experienced an in-depth psychotherapy and those who have not (Elana Leigh).”

More here: Why your therapist should be in therapy

In the first session you might feel awkward or nervous – this is normal!  You may also experience some emotional pain throughout your therapy as you work through painful experiences – most people find this cathartic. The first session should be used as a way of getting to know the therapist and to see if he or she is the right person and if it is the right therapeutic modality for you. It is also a time for the therapist to get to know you. He or she will usually discuss therapeutic boundaries, confidentiality, the fee structure, social media policy, cancellations and how he or she works. At the end of the session, perhaps wonder:

• Is this someone I could come to trust?
• Did the therapist genuinely care?
• Did the therapist put me at ease?

It is perfectly acceptable to ‘shop around’ to find a therapist that you feel you can trust and work with.

I offer short and long-term counselling and psychotherapy. The length depends on each individual. After the first few sessions, many people feel ‘better’ from having talked about a problem for the first time. Often people come to therapy to work on problems that have been there for a long time. For others, they notice patterns emerging in their lives that they wish to change. Some people come to therapy not because they feel as though they have a problem but because they want to get to know themselves better. So… it really depends on the level of change you wish to achieve and how deep you wish to go. Therapy is not a quick fix but it does help people build healthier relationships, turn their lives around and make long-lasting changes.

A referral is not required to book an appointment. A referral is also not required for rebates from private health insurance companies.

Your sessions may be covered if you have private insurance. Please check with your provider regarding how to claim.

You want privacy: Whenever Medicare or Private Health Insurance is used, your private information, psychiatric diagnosis, presenting issues, treatment plan and progress reports, are available to the insurance company and, at times, to employers. Medicare, Private Health Insurance and Employee Assistance Programs often ask for detailed personal information about clients in order to make payment decisions. This review can undermine your sense of privacy and confidentiality necessary for effective counselling and psychotherapy. Once you have a ‘Mental Health Plan’ diagnosis, it becomes part of your health records forever. When you pay for counselling and psychotherapy out of pocket, there is no loss of privacy to third party companies.

You want to choose your own therapist: Many insurance companies limit your choice of therapists. Some “preferred providers” offer good treatment, keep their clients’ interests foremost, and try to keep treatment brief without sacrificing quality. At times however, the insurance company asks preferred providers to divide their loyalty between the client and the insurance company. Many clients prefer to choose their therapist personally and choose to avoid seeing a therapist with a potential conflict of interest. Other clients may want to work with a therapist who was highly recommended but may not be on the provider list.

You want to choose the length of your treatment: Medicare, Private Health Companies and Employer Assistance Programs limit the choice in therapist and the modality that you are able to use – usually medically orientated models such as CBT. They also limit the length of treatment. Most companies provide ultra-brief therapy (3, 6 or 12 sessions). The majority of people require more sessions than this to provide long lasting change. Self-paying for therapy is preferable in order to receive the type and length of treatment required to suit your needs.

You don’t want Medicare, Private Health Insurance Companies or Employee Assistance Programs making choices for you. When a third party is responsible for payment, they have the power to influence your treatment. A company employee evaluates your motivation, the severity of your problem, your progress, and makes treatment recommendations. The therapist must take the company’s recommendations into consideration or risk losing a contract to work with the company altogether. Many clients prefer paying for their own treatment to eliminate this outside influence.

You don’t want to be labelled sick: Whenever insurance is used for counselling or psychotherapy, the treatment must be “medically necessary,” which means that your therapist must label you with a mental illness or psychiatric diagnosis. When you pay directly, you may seek consultation from a therapist for any reason you choose. People use counselling and psychotherapy for emotional, psychological and spiritual growth, for help coping with stressful life situations, and for marriage and family difficulties, as well as for chronic and serious psychological problems. Having a psychiatric diagnosis on your health records can restrict your ability to qualify for future health and life insurance coverage as well as when applying for future employment or to become an adoptive parent for example.

This article has been adapted from ‘Why Self Pay?’ with permission from the American Mental Health Alliance.