Which Counsellor does What

In the area of counselling there's a bit of confusion around which counsellor has the best credentials. As I mentioned last week the most important element in counselling is how well you connect with your counselor. This has very little to do with which university degree your counsellor has.

I think of counsellors as people who are born into the world. People who seem to have a natural desire to prop people up who are down, people who can put themselves aside and fully absorb what their friends, colleagues or family and even total strangers are saying.  They usually aren't judgemental and are very warm toward others.  I'm pretty sure most of us have encountered someone like this.

Perhaps you are this person. You will have heard people say things like. "I've never told anyone this before I  don't really know why I just told you".  I use to think I must have a neon sign over my head that said "Come here, tell me everything". I felt very privileged that people trusted me enough to share their deepest darkest secrets. I have always genuinely wanted people to feel better or have an opportunity to tell their story.  We all have a story to tell and it really is important to have a person who can really tune in to you and hear that story.

What does a degree do you might ask. The degree has a two fold benefit to counsellors and their clients. The degree you take gives the naturals ways in which they can identify what they are doing to increase the natural skills that you already have and hone the skills into something which can provide greater meaning to your clients. The second fold is that it provides the counselor with a community into which they can become a part of which serves to protect or mitigate the effects of hearing everyone's darkest secrets. This comes in the form of professional supervision and ongoing training. Hearing everyone's troubles is a privilege, it's very rare that people want to hear your story.  The person you have heard all about walks away feeling better and then you are left with at least the shadow of their story. If you hear enough of these stories it does start to weigh you down and then in the end you can hear no more. The degree teaches self care and maintaining that natural gift. Planting your natural seed of counselling into fertile soil.

Most naturals find themselves at the doorstep of some kind of training ground because really they are searching for help in how to manage this gift or perhaps this curse. Let's have a look at some of these training grounds. The three main areas are psychology, psychiatry and counselling.  Most people see Counselling as the bottom rung of these fields, Psychology as the next rung up and Psychiatry as the pinnacle. Other areas include Social Work, Nursing and Community Workers.  Lets look at the psychology degree this degree has a high level of statistical work, there's a component of understanding the areas of the brain and what they are used for. Subjects you find in psychology degrees include 4 units of stats, abnormal psychology, developmental psychology and Introduction to psychology.  As a psychologist you might branch off into research or into face to face counselling or a mixture of both. It's very interesting finding out about the brain and I enjoyed these subjects a lot. These subjects are certainly helpful in understanding human behaviour. I intend to get my Post Graduate Diploma in straight psychology subjects.

Now psychiatry is also an interesting area.  This is a medical degree. Psychiatrist get to diagnose and treat particular psychiatric disorders. The really fun stuff of prescribing medication and nailing down the appropriate label.  To get a degree in psychiatry the first step is a degree in medicine and then a further 6 years of study in psychiatric disorders, diagnosing and treatments. You might find your psychiatrist less of a natural than your psychologist or counsellor. They do want you to get results that's for sure and they do care about you, more perhaps in the biological sense of the word rather than the practical sense. 

A counselling degree is all about the nuts and bolts of humanity. In the Counselling degree you are going to be learning all the different models of counselling. You will also learn about the basics of psychology and human brain function. You are going to be able to talk to people and decide which modality will suit them best. You'll be able to identify stressors in their lives and give them tools to use throughout their lives to assist them in relationships, personal growth, anxiety and depression. You will not be able to diagnose you can say it in your head but not out loud. In a way I think these labels aren't very helpful in obtaining a happy meaningful life which is the primary role of a counsellor. To help people find a happy meaningful existence using a variety of tools.  As a counsellor you can't use medicare however most psychologists gap fee is more expensive than what a counsellor charges anyway so I wouldn't let that stop you from considering a counsellor over a psychologist.

Bear in mind always these few questions.  Do I feel comfortable talking to this person? Do I feel confident that this person can help me reach my goals? Is this person suitably qualified to meet my needs? Does what they are saying make sense to me? Is this person really tuned into me? Is this person professional in their approach to me?

Things to watch out for in deciding if they are professional or not; counsellors who are very friendly and start talking excessively about themselves are out there. It's ok for counsellors to share a little bit about their own experience however, if you leave feeling like they just got a really good counselling session then probably it's time to look else where. If someone starts to impart their religiosity to you, get out of there, this is both unethical and not allowed. If a counsellor or psychologist starts to diagnose you or your family members, out you go, this is also unethical and not allowed.  A counsellor can say things like "I can see you are internalising a lot of these problems" that is not a diagnoses.  However, if they start saying things like you've got post traumatic stress syndrome, anxiety, depression and I think you've got a personality disorder as well. Get your little butt out of that chair pronto. They are not qualified to make these statements.  If I had a client that I think might have a personality disorder I would talk to my supervisor about this and then we would probably work out a way to get an appointment with a psychiatrist.  In our referral letter we might say something along the lines of...please see my client who presents with mood fluctuations, difficulty maintaining relationships and trouble sleeping. I would then leave it up to the psychiatrist who is trained in diagnosing and wait for my client to report back.  As I mentioned earlier psychiatrist have had 12 years of study and six year primarily on assessment and diagnosis of complex mental health conditions. They are the best person to do this job.  It is common place for counsellors and psychologists to work with psychiatrist in getting the best results for their clients. 

A psychologist can diagnose some mental illness however, they can not prescribe drugs. They can refer you to a GP and in the referral ask the GP to consider antidepressants however, if a psychologist identifies that a client may have bi-polar they must then refer to a psychiatrist. Testing for these more serious conditions is very involved and can take months to reach a clear diagnosis.  Anyone who thinks that they can diagnose in the first session is questionable. I have heard of a counsellor diagnosing a client's husband with the personality disorder of Narcissism. Very unethical bad counselling right there. What she could have said is "It sounds like your husband might need to see a counsellor himself" or she could have said "I can't diagnose your husband although I'm sure it would be a huge relief for you if I could it's best if your husband speaks for himself in this circumstance" or "It certainly sounds like your husband is causing you a few problems how about we bring him in here for a session or two".

So there you have it the difference between the different counsellors. My parting advice to you is trust your instincts if you feel that there is something not right about the counselling you are receiving ask to be referred to someone else or quietly look around.  You can always phone up have a chat before you book an initial appointment look at websites and make a decision that way.  Try to find someone that you are really at ease with because after all no matter the degree, the experience level or the practice the best counsellor for you is the one you have the best relationship with. There are professionals bodies who most counsellors are part of you can locate a counsellor who is registered with one of these organisations.  If you find a counsellor who isn't following the guidelines you can report them to these bodies.  It's best if you do report them as it is possible to do real harm to people when you are in the counsellors chair.  The Links to the counselling bodies are below.  These sites also have codes of conducts and ethical practices available for you to read.

Australian Counselling Association

Psychotherapy and Counselling Federation of Australia

Psychology Board of Australia

Medical Board of Australia

References

Corey, G. (2009). Theory and Practice of Counselling and Psychotherapy. Belmont CA: Brooks/Cole.

Day, S. (2008). Theory and Case Analysis, In Theory and design in counselling and psychotherapy. California, CA: Brooks/Cole.

Gerald, D., & Gerald, K. (2001). Basic Personal Counselling. Frenchs Forest NSW: Pearson Education Australia.

Jungers, C. M., & Gregoire, J. (2013). Counselling Ethics Philosophical and Professional Foundations. New York: Springer Publishing Company.