- What is psychological treatment?
- What is a clinical psychologist?
- What is the difference between a clinical psychologist and a psychiatrist?
- Is it confidential?
- What if something happens in therapy that I don’t like?
- How many sessions will I need?
- How can I prevent a relapse?
- How long is each session?
- Can I get rebates from private health insurance or Medicare?
- What happens if I can’t attend?
- Do I need to bring anything to my appointment?
- How do I make an appointment?
What is psychological treatment?
The term psychological treatment refers to a range of talking based interventions which aim to help you better understand your thinking patterns, habitual behaviours, emotional responses, and communication skills. This understanding can help you decide whether to accept or change things about yourself that have been causing issues in your everyday life. This process is likely to lead to a greater sense of wellbeing and improved quality of life.
Psychological treatment can help with recovery from an episode of mental illness, as well as prevention of future episodes. It can also help you cope with and adjust to difficult events or transition periods, or simply help you understand yourself better and move forward in a positive direction. The most effective psychological treatment occurs when you find a therapeutic relationship in which you feel respected, listened to, and secure enough to allow yourself to be vulnerable. Talking about yourself and your inner world can be very confronting and takes great courage, but the rewards are immense.
Some people prefer to access psychological treatment individually, while others respond best to group therapy. There is a large body of research investigating which therapy frameworks have the best outcomes with particular presenting complaints. It is the ethical duty of a psychologist to maintain a good understanding of this research and to apply therapeutic frameworks in line with the research findings. Psychologists refer to this as “using an evidence based treatment approach.”
What is a clinical psychologist?
Clinical psychologists are trained in a range of techniques and therapies with demonstrated effectiveness in treating mental health issues. They hold particular skills for applying psychological theory and scientific research to solve complex clinical psychology problems requiring individually tailored interventions.
Clinical psychologists may also be involved in research, teaching, or designing treatment programs in various settings (such as psychiatric, rehabilitation, and primary care).
What is the difference between a clinical psychologist and a psychiatrist?
Research indicates that many mental health conditions benefit from a combination of biological treatment and talking intervention. If you choose to see a psychiatrist and a clinical psychologist and consent to them communicating with each other about your treatment, this is called entering a “shared care” arrangement.
Broadly speaking, there are three main differences between a clinical psychologist and a psychiatrist:
Training
In Australia, a psychiatrist has successfully completed a medical degree and at least one year of full time equivalent general medical training. They have then successfully completed additional training in psychiatry, which takes a minimum of 60 months (full time equivalent). A psychiatrist has therefore completed at least eleven years of education and training in medicine and psychiatry.
In Australia, a registered psychologist has completed at least six years of education and training in psychology. This includes a Bachelor degree and an Honours program, and then usually a Postgraduate degree such as Masters or PhD. Clinical psychologists are trained to conduct psychological assessments, make diagnoses, and provide psychological treatment.
Treatment Approaches
Psychiatrists are able to recommend and prescribe psychotropic medications. Many psychiatrists have admitting rights to a psychiatric hospital and/or day program. Some psychiatrists provide talking interventions, whilst some choose to focus purely on biological treatments.
Clinical psychologists provide talking interventions but do not prescribe any biological treatment. Clinical psychologists do not have admitting rights to hospitals or day programs.
Both psychiatrists and clinical psychologists have training in assessing mental illness and making diagnoses as appropriate.
Medicare Rebates
The Australian Government structures Medicare rebates differently for psychiatry and psychology. For current information on the rebate structure, you can visit the Medicare website.
Is it confidential?
Psychologists take your privacy very seriously. Sarah understand that for you to feel comfortable talking you need to feel confident that none of your personal information will leave the room. With this in mind, Sarah will keep everything you tell her confidential, with a few important exceptions:
- If Sarah becomes aware that a child is suffering abuse or neglect, she is mandated to report this (and any information directly pertaining to this) to the Department of Human Services Child Protection Service.
- If Sarah receives a subpoena, she will be legally compelled to release information that is directly relevant to the legal matter at hand.
- If Sarah believes you are at acute risk of committing suicide or seriously harming someone else, she will provide this information to your next of kin and a relevant emergency service so that you can receive urgent treatment.
Sarah will make every effort to inform you if any of these exceptions occur, and to tell you what information she will release (and why). Sarah will always endeavour to inform you ahead of time and let you have a say in how much information is released whenever possible.
Please note that if you are referred to Sarah under a Mental Health Treatment Plan, she will send a feedback letter after your first session and again at the end of each block of sessions. These letters are to provide your referrer with a basic overview of the treatment framework being used with you and the progress you are making. These letters help your referrer to decide whether or not to allocate more Medicare rebates for you. Sarah would be happy to provide you with a copy of any letter at your request.
From time to time Sarah will discuss your case with a trusted colleague to help clarify her understanding of you and the best treatment approach for your presenting complaints. This process is called seeking supervision and is a routine part of practicing ethically as a psychologist. It is done without mentioning any identifying information whatsoever.
What if something happens in therapy that I don’t like?
In any interaction with another person there are likely to be times when you feel upset by something that has been said or done. There may be times in therapy where something has upset you and you feel like Sarah hasn’t noticed or hasn’t tried to repair damage done to the therapeutic relationship.
Ideally there will be sufficient rapport and trust for you to feel comfortable raising any issues with Sarah directly so that you can work together on repairing and learning from it. Raising such issues within a therapeutic relationship can be a safe way to practice this skill, which can benefit your other relationships immensely.
It is common to worry about offending people with feedback about things that have upset you. This needn’t be a concern in your therapeutic relationship as Sarah’s main priority is creating a safe space for you to make the best possible use of your treatment.
If you believe that Sarah has behaved in an unethical manner, it is important to know that you can raise your concerns directly with her regulatory body, the Australian Health Practitioners Regulation Agency (AHPRA).
How many sessions will I need?
The number of sessions required depends on your treatment goals and the complexity of your condition. If you are seeking treatment for a single issue that has been present for a relatively short time, you are likely to experience good and lasting results with 6 sessions or fewer. If your issues are more complex or longstanding then you are likely to need more than 10 sessions a year, possibly over a few years.
In your first session with Sarah, you will discuss and prioritise your treatment goals. It might be helpful to have a think about these goals before you attend, but this is not essential. As treatment progresses you will have several opportunities to review your treatment goals and adjust the treatment approach as needed.
How can I prevent a relapse?
Sarah believes that it is important to maintain gains after completing therapy. You may choose to schedule ongoing maintenance sessions at a very low frequency to keep yourself on track implementing the changes you’ve made in active phase of your treatment and problem solving any new challenges as they arise. If you have recovered from an episode of psychosis, mania, or depression, you may want to ask Sarah about completing a Relapse Prevention Plan.
How long is each session?
Approximately 50 minutes of the one hour session is spent talking with you. Sarah uses the remaining time to reflect on and document the session, which is an ethical and legal requirement. Letters and phone calls to other members of your treating team are completed outside of the session. Resources that may help to support and extend the work done in the session will also be collated and sent to you outside of session time.
Can I get rebates from private health insurance or Medicare?
Depending on your insurer and your level of cover, you may be able to claim a rebate using the extras cover from your private health fund. You do not need a referral to claim rebates from your private health fund.
If you have a referral letter from a psychiatrist or a Mental Health Treatment Plan from a General Practitioner, you will be eligible for Medicare rebates.
A Mental Health Treatment Plan entitles you to claim 6 Medicare rebates of $128.40 per calendar year. At the discretion of your GP, you may be allocated an additional 4 rebates for a total of 10 per calendar year. A referral letter from a psychiatrist entitles you to 10 Medicare rebates per calendar year.
What happens if I can’t attend?
If you can’t attend, please let Sarah know as soon as possible by phone, SMS, or email. If you can give at least 24 hours notice this gives Sarah the opportunity to contact people on her cancellations list so that they may be offered an appointment. If you’ve ever been on a cancellations list you will remember how helpful it was when the health professional was able to offer an earlier appointment to you.
If you fail to attend a scheduled appointment without giving any notice and this occurs more than once, Sarah will charge the full session fee. This fee will need to be paid before any further appointments will be scheduled. This fee is not eligible for a Medicare rebate or private health refund. Appointment reminders are sent via SMS 48 hours prior to each appointment.
Do I need to bring anything to my appointment?
To save a little time in the initial appointment you might choose to sign and bring this consent form to confirm that you understand your rights and responsibilities. If you are uncomfortable signing this consent form you can discuss your objections with Sarah at the initial appointment, or you are welcome to contact her beforehand.
You will need to provide Sarah with your referral letter or Mental Health Treatment Plan if you want her to submit your Medicare claim on the day of your appointment. It is helpful if this is faxed or emailed before your first appointment, or you can bring it with you on the day.
How do I make an appointment?
If you are considering making an appointment, the first step is to contact Sarah for a brief conversation to decide whether you might work well together. Sarah currently consults on Wednesdays, Thursdays, and Fridays. She is also available via Skype for appointments outside these hours, but please note that Skype sessions are not eligible for Medicare rebates.