Counselling vs Therapy, and when to stop?

[Former-Member]

Today at the Dr, while having my Mental Health Care Plan reviewed, I raised the question "When do you STOP getting counselling / therapy?" It was my GP's opinion that:
(1) Ten sessions a year or apx one session a month, is not really enough for effective 'therapy' as such" (10 being the maximum subsidised / affordable sessions available a year - the public system).
(2) Counselling is something that never ends for some people ad its a good means of providing support to stay on track or a backup if things become too difficult (which is me I think).

I'm also conscious of "taxpayer funding" being wasted on me, like its a bit self indulgent getting expendive professional counsel... I am considering not continuing counselling next year, when my 10sessions stop, but I am a little afraid of being 'alone' if I come undone again, maybe land back in hospital.

Just wondering what others think about this?

[BlueBay]

Hi @Former-Member
No dont stop. I asked the same question to a previous DBT therapist and she replied "sometimes we need to see someone regularly just to check in and it's ok if you have to". I was and still am very scared of having no support so I will stay for however long I take.
Yes 10 sessions is not enough. It's ridiculous, I don't know how you're meant to get better in 10 sessions but then again I suppose better that than nothing.
If you need the support I would still continue. Even if you spread out the sessions and it will last longer.
It's not cheap seeing someone but at least you know you can go to them for support when need be.

[Kurra]

Hi @Former-Member and @BlueBay

I get confused with the terms counselling and therapy.
Are you able to explain this?

To me counselling means seeing my psychologist etc. This is mainly because not all people who claim to be counsellors have undertaken professional qualifications.

Therapy to me means things like DBT, CBT, art therapy, occupational therapy etc.

Maybe I'm just being dumb.

Take care. Luv n Hugzzz 💕 🎶

[pip]

Hi @ Kurra. Your understanding of counseling as opposed to therapy is spot on. Counseling either psychiatrist or psychologist is learning coping strategies, talking about various traumas and accepting we are not responsible for others feelings and actions. Therapy is more intense and the therapist usually has to work harder to gain the patients trust. Art therapy and O.T is more the physical side. Don't refer to yourself as dumb because you don't understand. A therapist will often try to 'walk' you through a traumatic event and guide you safely back. Counselors will listen and often challenge you on a decision you make, where a therapist will help you make the decision that's right for you.

[Kurra]

Thanks @pip
My biggest concern is that apart from psychologists etc there are people who work as counsellors and call themselves counsellors. This category is not necessarily comprised of people who have undertaken any training at all. Obviously in some circumstances this can/could be extremely dangerous.
Have a great evening 🎶💕

[Appleblossom]

As a person who understands the system pretty thoroughly, I thought you were right on the mark, but being tongue in cheek @Kurra with your maybe I am being dumb... maybe I am wrong?  I have learned that it is expected to insert such phrases into conversation in Australia more than in America ... with our cut down tall poppies syndrome ... otherwise one might be scorned as  "a know it all"

I dont think anybody actually knows the answer to that one @Former-Member .. when is enough enough ... on either side of the therapy/counselling fence.  I experimented with going without and taking the sessions as needed.  Before the recent changes in my approach and relinquishing my teaching studio.

"Counselling" usually suggests less thorough training but there are always exceptions. Better counselling courses are cropping up here and there and may even be more appropriate to delivering "effective care" than some psychology degrees.  Depends on the units taken and the individual and the reason why there is the "clinical"/non-clinical divide among psychologists.

I have a "counselling" and a "therapy" qualification but do not practise ... except on here . lol .. it has highly influenced my mindset and approach to people, family, students, peers, train travellers and people on the street etc.,

We can use the terms interchangeably in general conversation, but we can also get technical ..

Psycho-analytic therapy traditionally takes many years but after all it is a pretty new tradition (100 years) compared to some traditions.

For about 7, years my old GP managed my plans and I usually used less the the 10 and down to about 3.  That approach might work well for you @Former-Member keep the sessions under your belt for if you really need it but get support to go it alone as much as you feel fine.  I had about 5 years on very low antidepressant dose and low counselling session use.

Which is why I am not 100% sure about my "therapy" & med approach at the moment .. I am aware of the triggers and journalling them, so maybe I just need to fine tune this boundary thing ... but will follow through medical reccomendations as far as seems reasonable, (with some 2nd opionions ??) as I think that is the most responsible thing to do.

[pip]

@Kurra. Totally agree, there are also people who, while they have been 'trained' still have no idea. For instance if you need counseling for marriage/in-law problems, or problems with child/ren, the best person for this is someone who has experienced these issues first-hand and will understand your concerns. When I was having problems with my ex and his toxic parents, I asked my Dr for a referral to a counselor. The 'girl' I got was early 20's still lived at home, very happy home life, no clue about in-laws, marriage problems etc. I was told in no uncertain terms I had to be more understanding about my ex's need for his parents constant approval. I was also told to try to listen to their criticism as they were older and therefore 'knew best'. I walked out after 5 minutes, I did ask if there was an older married counselor available and was told I would need another referral. At this point I 'logged on' to beyond blue. The chap I 'connected' with, while not a trained counselor as such, was more helpful, supportive and caring. He helped me more than anyone because he listened and he was the one who told me my ex would not change unless he wanted to. He also told me because my ex was quite happy with himself, he would stay his parents child. This man is now my best friend, bf, still counsels me when necessary, he is working with my kids at the moment and he has told me he is always going to be there for me. Sometimes the best person is not necessarily 'trained' but their understanding and listening capacity is still there and better. Unusual for a guy to understand a woman, but there you are. We have just sorted out a personal problem between us.

[mrkotter]

@Former-Member 4.5 years. 3 years with my current psychologist and I'm going to keep going. I find problems keep popping up (illness) and she's really good. 

I think its totally personal. I find with my illness, bipolar, that I need her help. But I guess if an illness is less episodic than that person may not need a psychologist all the time. 

[Former-Member]

Wheres our moderayors here? Correct me if i'm wrong but i always thought:

COUNSELLING to be: a place to get council on a difficult matter, usually current issues, being heard, validayef and learning different perspectives & healthier coping skills.
THERAPY, I think, is more confronting, more structured with goals, homework, growth and positive outcomes. Going deeper, figuring out WHY we think, feel and to the things we do. Learning about our personality, behaviours, beliefs, values, getting in touch with who we are and taking charge to make changes.

Its interestimg my Dr thinks 10 spaced out sessions a year is not enough for effective 'therapy' but more about support and keeping on track...

Proper therapy might be like when a therapist boards an aircraft with someone for the sole purpose of overcoming a fear of flying, real on the spot practical application.

Just thinking out loud. A lot of the work we do is between sessions, hopefully the counsellor has dropped at least one epiphany that echoes in theind and causes good change.

[Former-Member]

Hey @Former-Member, for my two cents worth I've never really differentiated between these terms when it comes to what they offer.  As a Psychologist I've referred to the work I've done with clients as both counselling and therapy depending on the language they were most comfortable with.  I guess I would say that I've learned therapeutic approaches but practise them within a counselling framework.  I've always thought that therapy/therapists were more American terms but they seem to be used more frequently here now. 

Yes, the 10 session medicare model is woefully inadequate for many people.  I understand the line of thought that it's just to keep you on track given the limitations of what can be achieved in 10 sessions.  But it's there if you need it - and meet the threshold - so take it up if you feel that it would benefit you.