Counselling and Help for Depression and Mental Illness.
Counselling and help for depression and mental illness.
Ultimately, counselling is (or should be) about learning and practicing how to HELP YOURSELF. A counsellor’s job or task is to help others to help themselves! A misconception among general society about counselling relates to advice giving. A counsellor should only give advice in particular situations or under certain circumstances such as if somebody is imminently going to hurt him/herself (the counsellor could rightfully use “shoulds” then in such circumstances). Generally, for a counsellor to give advice is going against the principles of what counselling is about or intended to be (if used correctly). A core idea of counselling as a general rule of thumb is for the client (or person receiving counselling) to grow in him or herself and become self-sufficient as far as handling/managing current and future problems, NOT to become dependent on a counsellor or ANYBODY else to make decisions for them (such as advice giving) which will only hinder or stalemate personal growth and resolution of problems.
Then, what is counselling? Yes it is a helping relationship in that the counsellor helps people to help themselves. A counsellor does not (or should not) DO for others (apart from in exceptional circumstances). Counselling is a therapeutic relationship conducive to personal growth, awareness and the development of problem solving skills in order to deal with general life issues. However, counselling is an ever-evolving field or practice and there are many specialist counsellors who are highly competent and very, very skilled in areas such as grief and loss. There is some debate about whether counselling and psychotherapy are different, and generally there does tend to be differences. As a general rule or guide, even though a counsellor may practice general or specific types of psychotherapy, a counsellor is generally or often not as well endeared in formal recognised qualifications as psychotherapists.
What are psychotherapists? They are various practitioners with training and skills in psychotherapy ranging from family therapists to psychiatrists. They are professionals who may have masters or doctorate degrees in particular mental health fields and they are generally licenced, certified and registered and this means that they are recognised by governmental agencies or particular other psychological agencies. A counsellor may have recognised skills too, but not necessarily in the form of a masters or doctorate degree. A counsellor may obtain a diploma of counselling and psychotherapy but never obtain higher qualifications.
The term “therapist” may loosely be used as a broad term covering counsellors and more recognised psychotherapists. Speaking in loose terms, a physiotherapist, a diversional therapist, a pastoral counsellor, an art therapist, a hypnotherapist, a counsellor, a psychologist, a behaviour therapist and many others could all be loosely termed or grouped as therapists. A constable and a sergeant are both police officers but one more highly recognised and a similar comparison could be made between a counsellor and a psychotherapist. An interesting point to note also is that studies have revealed/concluded that paraprofessionals (those with somewhat minimal training such as those who have only had a few hours of training in communication skills such as active listening, using reflective skills, empathy and the like, and others such as college students and those with no formal qualifications in “therapy”) can obtain very positive results in working with those presenting for treatment of general life problems. In other words, many people can be aided in a “therapeutic” relationship or atmosphere with non-professionals (non-therapists) as much as certain professional people who are therapists. It’s not always the case such as in adults who present with more disturbing issues, but the point is that helpers may not absolutely need to be an “expert therapist” in order for others (generally speaking and in general situations) to reap benefits of personal interaction in dealing with general life issues. Certain types of theories and those used in many forms of counselling state and believe that humans have the capacity for self-healing with general problems or issues in life. But it is ideally suitable to associate with others when we need to whether we are facing depression, anxiety problems, relationship problems, addictions and so-forth, and a part of the healing package or the “ingredients” that are required for many of us to overcome various problems is to communicate ( in one way or another) with paraprofessionals, non-professionals AND sometimes professional people in whom may come in the form of a warm, empathic and accepting counsellor.
How might a counsellor help? What benefits are there in seeing a counsellor? How DO they help? What role can they play? Many questions may be asked and these seem to be some common ones. A counsellor may be able to help in various ways and some of this will be the actual approach that they use (“approaches” here meaning an actual school of thought as in different types of psychotherapies). Counsellors are generally trained at least in certain aspects of psychotherapy (such as Person-centred therapy developed by Carl Rogers) and will generally have certain skills not only in areas such as communication skills, conflict resolution, portraying a congruent attitude and demonstrating unconditional positive regard and so-forth, but they generally are able to utilise skills of particular techniques used in various forms of psychotherapy. Counsellors may not be as skilled or have specific expertise skills as somebody such as a psychologist who is trained in helping those with mental health problems, but they still do have a fairly large repertoire of “things up their sleeve” that they can use for helping to work with others (remembering that counselling is or should be about helping others to help themselves). Most counsellors are renowned or have a reputation of being very warm-hearted people. It may be pleasantly surprising to discover some of the benefits in talking to a non-judgemental, empathic, listening, open-minded, genuine or “real” person, as a climate of such an environment in such cases can contribute to personal growth and/or other positive aspects that may be so fruitful in fighting or facing the battle of mental health issues.
A counsellor can help by using certain skills, by actually wanting to listen to you and in other ways such as helping you to become more aware of parts of yourself, using your own inbuilt skills and abilities, practicing certain skills and techniques, right though to simply offering you a non-judgemental attitude and a caring relationship, helping you to find suitable other people who have specialist skills in helping in all sorts of different areas, helping you to vent feelings and thoughts which in itself can be therapeutic, dealing with unresolved issues of the past and becoming more fully-equipped to maximise the value of the present and putting things into place for future problems or challenges, assisting you to challenge negative self-defeating beliefs, reconstruct healthy, rational or adaptive ways of thinking and much, much more. Counsellors may not be psychiatrists or have quite the in-depth knowledge of mental health issues and disorders, but they can offer aspects of healing in oneself to a lot of people with various mental health problems.
A counsellor can actually help somewhat by merely “being there”. Certain psychotherapies believe in such significance of the counsellor being present meaning that it is so important to provide people with a warm, accepting and empathic environment for counselling. The counsellor being genuine, empathic and accepting you whole-heartedly despite any shortcomings what-so-ever is seen to be crucial and (according to some therapeutic approaches) people can then begin to discover their potential to handle life’s adversaries. However, strong debate exists that this is simply not enough. More is needed and in the form of “added” therapeutic techniques and methods. I personally agree and when coming to dealing with mental health issues, particular skills and techniques are needed to be offered by the counsellor to those dealing with psychiatric problems such as depression, psychosis, anxiety disorders and other. However, generally speaking, a counsellor’s role includes accepting you whole-heartedly, being free of any biases towards you what-so-ever, being their absolute true selves towards you and seeing things in your eyes (how YOU see things) or at least acknowledging them (what might be termed “seeing your subjectivity”). Therefore, a counsellor should work with you in a genuinely caring manner and at least offer you a non-judgemental listening ear. They should be able to take anything you may disclose or “show” as being compared to like a dry sponge soaking up a spill of water. They will be able to support you non-judgementally and demonstrate belief in your ability to overcome whatever you are dealing with. That may sound “nice”, but what else could they offer you or what else could or should you expect? This depends on presenting problems of the client and what therapeutic approach they are working with such as Person-Centred Therapy, Gestalt Therapy, Cognitive-Behaviour Therapy, Solution-Focused Therapy and so-on.
We’ll stick with talking about mental health issues for now. Certain types of approaches (of psychotherapy) are far better suited to dealing with mental health problems than other approaches. For example, a very reputable and comprehensive type of psychotherapy for dealing with depression is called Cognitive Therapy. It offers deep and insightful methods of helping to deal with depression. What may this have to do with counselling? It depends on what we actually interpret counselling to be. Some state there is little difference between counselling and psychotherapy, while others think otherwise. I am of a firm belief that psychotherapy is “deeper” than general counselling, particularly when it comes to terms with working within the mental health sector and actually addressing psychiatric problems and disorders head-on. Some people “compare” counsellors and psychotherapists to be basically alike and in such cases a counsellor would be seen to offer you a psycho-therapeutic framework meaning that they will work with you by using certain techniques of particular types of psychotherapy. So you could expect this from a counsellor if a counsellor is regarded more-or-less as a psychotherapist. However, if one is to regard counsellors and psychotherapists differently in terms of the skills, approaches, methods and techniques that are put on show by them (or what they could offer you), it would be seen then that counsellors are different so they would help somewhat differently to other professionals. So, if professionals such as psychotherapists and psychologists work within a psycho-therapeutic framework but not necessarily counsellors, what else then can counselors offer you? They can offer you general support as in consolidating or expanding the foundations or the repertoire of available help on offer. They should have a solid, broad knowledge and awareness of many other “branches” of help, others who can help, other agencies (governmental and non-governmental) and a whole platform of supportive networks of help out there in general society that are available for those who need them. They should be able to offer a foundational type of support in themselves in most cases though ( meaning that they should be able to be a part of your cornerstone or central resource of support). General Practitioners can (and quite often do) play a large and highly significant role too.
Paraphrasing is a technique or what is known as a micro-skill used by counsellors and other helpers such as psychologists. Micro-skills are simply specific techniques used by helpers to communicate more effectively. This is important because people with mental health issues generally feel that they need to be heard or if they don’t necessarily feel that way, they can at least quite often find benefit in feeling heard and understood (remember that people with mental health problems still unfortunately face other issues such as stigmatisation and discrimination). Paraphrasing is a technique which will enhance a feeling of being heard and understood.
But what is paraphrasing? The essence of paraphrasing is reflecting back to the person in need (for example, someone with depression while they are talking) the really important and significant content (or words) of what they are saying. Key words or words that are similar are reflected back to them but not necessarily repeating word for word or sounding like a gabby parrot. The most important information is re-expressed in a clearer way and basically reflected back to the person BUT in the helper’s OWN words. Another term for paraphrasing is “reflection of content”.
An example could be:
Julie who has an anxiety disorder:- ” I can’t get anything done. I feel awful and nothing is going right. I always seem to be in a hurry, I have no time for myself and nobody seems to even appreciate what I do anyway. My anxiety is just getting worse and worse. I’m gonna crack!”
A short simple paraphrase could be:
“It seems that things are pretty difficult at the moment”
“It sounds like getting things done the way you want is a real problem just now and it’s a lot to cope with”
Paraphrasing is a bit different to summarising and it is also different to reflecting a person’s FEELINGS. It is the CONTENT of what they are saying that is rebounded or reflected back to the person in the hope or with the purpose that they will feel heard/acknowledged and understood as to the “theme” of what they are saying.
There will be more information and examples about counselling and communication micro-skills such as summarising in other posts.
All the best, and have a nice day.
Article written by Paul Inglis.