Niamh Delmar is a Chartered Registered Counselling Psychologist and provides Psychological Support Workshops to work environments.
It can be overwhelming trying to navigate mental health support for yourself or others as people are often reluctant to seek help until distress becomes too debilitating to ignore.
It is confusing to discern among titles such as Psychiatrists, Psychologists, Psychotherapists and Counsellors. In an unregulated system, there are also some with little or no training.
Just when an individual takes the brave step, there are often waiting lists in the Public Health System and with Private Practitioners. For others, delays accessing intervention include fears, internalised stigma, misperceptions about therapy, finances and trying to 'tough it out.'
Sometimes the person may be unaware how distressed they are until close family or friends bring it to their attention.
For many, the first port of call is the GP. As most GPs do not have the time to conduct thorough mental health assessments, they usually refer on, which can be an arduous task in itself, especially if it is urgent.
Surveys reveal approximately 40% of their appointments involve mental health. So who does what in providing care?
Psychiatrists are trained as Medical Doctors and then specialise in the diagnosis and treatment of psychiatric conditions. They can be hospital, community or outpatient based in the public health service or in private practice. They provide a thorough diagnostic evaluation, appropriate interventions and can prescribe medication. The College of Psychiatrists of Ireland is their governing body.
Psychologists are trained in different specialities such as Clinical and Counselling. They conduct assessments, diagnose and provide evidence based therapeutic interventions. Training involves undergraduate degree for three years, followed by a Masters or Doctorate for two or three years and supervised work. Training also often involves being in personal therapy and work placements.
The Psychological Society of Ireland is the accrediting body and CORU is working on regulating the profession. Psychotherapists and Counsellors also provide therapy and are under organisations such as the Irish Association for Counselling and Psychotherapy (IACP) and the Irish Association of Humanistic and Integrative Psychotherapy (IAHIP).
The IACP website explains that professional therapists "offer caring expert assistance that can help you identify your problems and assist you finding the best way to cope with them." The Family Therapy Association of Ireland (FTAI) represents professionals qualified and trained to work with couples and families.
Professionals providing therapy use different approaches and can range from being directive, active and more clinical to non- directive and more passive. Some people may need space to explore and gain insights while others need structure and strategies.
Psychodynamic, Psychoanalysis, Cognitive Behavioural Therapy, Humanistic, Brief Therapy and Positive Psychology are some of the orientations used.
Trauma informed therapy is most beneficial to those with traumatic experiences in their past. Eclectic therapists integrate two or more approaches depending on the individual’s needs. Take some time to research what best suits your needs and presenting issues.
Finding the right therapist for you needs to take into consideration the age groups worked with, areas of expertise, gender issues and relevant experience.
However, beyond all of this, it is the experience of a meaningful interpersonal connection that is significant in therapy.
According to a meta-analysis conducted by the American Psychological Association task force on evidence-based relationships and responsiveness, a positive therapeutic relationship leads to better outcomes.
It found that setting mutually agreed therapeutic goals, seeking feedback and using the appropriate treatment method is as powerful as the approach used. The therapeutic alliance is also essential for the person to engage with and remain in therapy.
A collaborative therapeutic relationship, and tailoring sessions to individual needs have positive impacts. Fundamental to therapy are empathy, unconditional positive regard and genuineness, the core conditions of the person-centred approach pioneered by Carl Rogers.
Feeling valued and not judged in a safe and trusting environment is powerful.
If you feel ready to commit:
1. Explore all options to overcome barriers. If it’s financial, check out the HSE primary care free counselling or community, low cost, university or workplace services. Put your name down on waiting lists. Organisations such as Aware and Pieta House can also offer support.
If you have health insurance, check out what is covered and tax deductions. You may be able to arrange three sessions per month rather than weekly. People sometimes get financial support from others or prioritise the cost of counselling over socialising and other expenses. It is an investment in yourself and your future.
2. Identify your needs and research the different approaches. Seek recommendations while being mindful your needs may differ.
3. Ask questions about accreditation, approach used, areas of speciality and expected duration. Usually, information can be found in bios on websites. You wouldn’t attend a Medical Doctor that has no experience or qualifications, so treat this in the same way.
4. Look up the different professional bodies to see what is on offer.
5. Think about your therapeutic goals and what your expectations are. Therapy is not something that is ‘done’ to you, it is not a cure or a quick fix. In session is not like meeting up with a friend. It can be challenging. Commitment, self-awareness, willingness to change and work are elements for positive outcomes.
6. The first session or assessment is an opportunity to discuss your needs. Find out if this is the right fit for you or for the mental health professional.
7. You need to go into therapy with the right motives. This is not for anyone else but for you and your issues.
Getting help is a brave step that facilitates positive change, fosters personal growth and promotes psychological well-being. Better mental health impacts others in your life. Healing has also a profound impact on physical health as they overlap.
Availing of mental health support needs to be encouraged and accessible to all.
If you have been affected by issues raised in this story, please visit: www.rte.ie/helplines.
The views expressed here are those of the author and do not represent or reflect the views of RTÉ.
