Counselling Options
Lately I have been reflecting on my profession and the way it is evolving. Counselling has been around for a long time in many iterations. The mental health professions are always changing and there is greater recognition that services are diverse and include practitioners who bring vast knowledge and experience.
Counselling is a self-regulated profession, which means it is up to individuals to decide to register with a peak body like ACA or PACFA, and adhere to best practice policies and procedures. This requires a certain level of education, training and participation in ongoing professional development and supervision to remain eligible for peak body membership annually.
Self-regulation means anyone can call themselves a therapist if their work involves helping or supporting people, without having formal tertiary qualifications or professional oversight. As long as they are not breaking the law, they can provide a service that looks and sounds like Counselling, but doesn’t have stringent structures in place. This can allow for more autonomy and flexibility in service provision, and represents people who may not have had access to formal education.
Unfortunately, when there is no engagement with formal structures of accountability and oversight, there are far too many opportunities for things to go wrong, both for therapists themselves, like being vulnerable to burnout, or for their clients, like exposing people to retraumatisation, neglect and risk.
The Counselling and Psychology professions are currently at a crossroads, with the draft National Standards being finalised, and consultation occurring before being rolled out. I am hopeful that these standards will clarify some of the issues we have in the helping professions around qualifications, accountability, inclusion and access.
At the moment, there are many options for people to access therapy and support, and it is becoming increasingly more available to choose a pathway that suits your needs. It is useful to understand what your choices are and to be able to access resources that lets you make informed decisions about what services are accommodating and accessible to you personally.
There are free services available, and these are mostly through hotlines and crisis short term brief therapy pathways. This means you can call a hotline in an emotional or mental health crisis and talk to someone to diffuse the situation. They might give you some resources like phone numbers to the nearest hospital or websites to explore. It is highly unlikely that you will call that number again and get the same person, so you won’t be able to form an ongoing strong therapeutic relationship with the Counsellor, a crucial aspect of successful therapy work. However, talking to someone who is caring, is a good active listener and supports your emotional needs in the immediate emergency, can be crucial to getting through a desperate moment before it escalates.
Other services that do this and are free do exist, but they are limited. For example, places like Better Help offer ongoing therapy with a Counsellor of your choice, but you might only get a certain number of sessions. I had an interview with Better Help, and one of the things I disliked was that I was told the more clients I saw, the higher the pay rate. In other words, therapists are encouraged to move clients through and speak to more people, rather than spend time giving a quality service to clients by forming ongoing therapeutic alliances that are person centered and client led. That doesn’t mean that the service doesn’t work. In fact it might be perfect for people who need short term solution focused therapy about a specific issue that is impersonal, structured and affordable or free. But if you want a more tailored approach, these kinds of services might fall short.
The Employee Assistance Program or EAPS model is also popular. I remember participating in this scheme some years ago as a public service employee, when a family member passed away suddenly. I was able to use the EAPS service at my work to access a one off Counselling session and I was even allowed to take some family members with me to have a group session. My workplace paid for it, I chose the location to accommodate where my family members lived and we had one session that helped us to acknowledge the shock of the event and begin to process some of the grief. Honestly, it barely put a dent in the long term impact of the bereavement process and my workplace was not encouraging me to pursue ongoing therapy that they would have to pay for. Some executives even disagreed with my inclusion of family members even though it was a documented entitlement. It seemed like EAPS was simply there to make sure I got my act together quickly so I could get back to work. But it did help, it was something at least. Bare minimum, but better than nothing.
More recent attempts at securing EAPS type work has felt similar. It has been made abundantly clear that the priority will be the needs and stability of the employer providing the EAPS service, not the employee accessing Counselling through EAPS, nor the individual therapy provider or Counsellor. Again, there is a place for EAPS and it works, but the idea that workers are entitled to have workplaces that promote their safety and wellbeing, especially their mental and emotional health, can sometimes turn into an opportunity for a company to tick a Work, Health and Safety box and make sure staff are well enough to work, not become well as a human right!
Community based services that are government funded or independent are struggling. They often have stringent criteria, a lack of availability, huge waiting lists or inadequate expertise to handle ongoing therapeutic relationships. Many are religiously affiliated, geographically centered and therefore not widely accessible, or simply struggle to allocate limited funds to frontline work, after having paid the numerous other expenses it takes to operate a small organisation. These services rely heavily on volunteers and can be rather exploitative and unhealthy service delivery models. Again, some service users thrive within this model and community based care can flourish when services are created at a grassroots level that is then linked to larger structures of funding and support. It is how the Women’s Refuge Movement began and how the refuge I worked at started. With excellent management over 50 years, Bonnie Support Services has become a network of outstanding community support services for women, children and families in the area. Some refuges didn’t survive though. Without excellent financial, ideological and relationship management, many sadly closed their doors and have not been replaced.
Another new initiative has begun through St Vincent’s Hospital in Victoria. This will be the first time Counselling will be delivered through the Medicare Mental Health Check In system. Clients can call into a Counselling service or access support online, and receive professional support that is then linked to the hospital system if more intensive mental health care is required. It is the beginning of something important, but at the moment, employment options are not flexible or inclusive of providers who require diverse work options. Post graduate experience is required which excludes many who join this profession, like myself, as mature age students. Many people who become Counsellors have decades of work and lived experience providing support, sometimes before titles and courses existed, and obtain their formal qualifications later in life, AFTER, having accumulated face to face hours of work that simply isn’t counted. Many of us have immense carer responsibilities, raising children or caring for elderly or disabled family members. Many of us are slowing down and have different energy levels to 20 somethings fresh out of school and university who can work “full time hours in a fast paced environment”. It doesn’t mean we don’t have expertise, quite the opposite. Our wisdom, quiet calm and the quality of what we have to offer as therapists can’t be measured in KPIs or hours with a bum on a seat (or a headset on). Of course this model will be evolving, and I hope that once it is established, more casual and flexible options will be made available to allow Counsellors to do this work that have arrived from many different roads.
There is always the AI option which is a cross between convenient and terrifying. AI is not an alternative to human connection, however it can be a tool to provide a place to start, a resource that you can then take to therapy. It is NOT therapy.
Like many of us, Counsellors and Psychologists often embark on private practice to be able to create services that are niche, bespoke, individualised and flexible for both practitioners and clients alike. These can be expensive, inaccessible and may feel insecure due to the current self-regulated model of the profession, something that might be changing with the implementation of the National Standards. But it’s the path I have chosen, one I was very resistant to at the beginning, having come from working in community organisations, public service or larger business and corporate environments. Becoming a sole trader was not on my Bingo card! However, it feels like it fits. I have created a boutique service that allows me to do the therapy work that I love, centering the clients who resonate with me and will benefit from the years of work, lived, education and training experience I have to offer. I insist on keeping prices low and services flexible and accessible, and I have insisted on staying accountable to and engaged with an evolving professional network that includes a peak body (ACA), government structures and obligations, and diverse networks of support, particularly the online space. This can be tricky to navigate, and one of the things I find most exciting is finding like minded people to learn from, share ideas and provide holistic care to clients.
Diversity of services are important and I am a firm believer in the idea that if you need therapy, you can find and access something, anything, to get you started and then keep going until you find something that fits. It’s always better to try different things and ultimately trust your intuition and your decision making to take you to the next level of self-awarenes, self-care and transformation.
That gap between thinking about talking to a Counsellor and reflecting on your first session can be a chasm. The first step is often the hardest, but once you take that initiative to take care of your emotional and mental wellbeing, you rarely regret it. I offer a FREE initial consultation so all you invest is your time and attention for 30 minutes to get you started. Who knows what the next step may be, or you might not need one after that at all.
If you have questions, don’t hesitate to reach out on the Contact page. Or go ahead and Book your first FREE session and we can talk about your options.
I look forward to meeting you.
