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Tag: Sarah McMahon

What to look for when choosing a counsellor or psychologist

The following guest post is shared with permission from the author, the wonderful Matt Glover from MGA Counselling Services. Matt wrote this following a discussion I had with him and two other professionals I admire, Sarah McMahon from BodyMatters and Jacqui Manning, The Friendly Psychologist. Sarah has also put together an excellent resource on how to select a therapist for eating disorders which may be viewed here.

Recently I was having a discussion with Dannielle Miller from Enlighten Education about what to look for when choosing a counsellor or psychologist.  In Australia, we still live in a culture that places some stigma on seeing a mental health professional, and so we are hesitant to ‘ask around’ like we do when looking for a plumber or dentist. If you’re wrestling with a mental health issues, a relationship problem, a personal issue, or just feel plain stuck, make sure you check the following before booking a session with a counsellor or psychologist.

1. Check the qualifications. While Psychology and Social Work are regulated industries, Counselling is not. Anybody can set themselves up as a counsellor and charge a premium without even a single hour of training. Online certificates and diploma’s abound in counselling, but these are little better than nothing at all. Many of them do not require any sort of supervised placement and barely scratch the surface of best practice when it comes to the different models of therapy. For counsellors, I would suggest sticking with those that have a Bachelor degree or above, from a reputable university. When you ring to make a booking, ask where the therapist did their training.

2. Check the accreditation. Make sure the counsellor you see is accredited at more than student level with one of the professional bodies. The professional bodies maintain a code of ethics for the industry and ensure that individual therapists are engaged in ongoing professional development and supervision. As a counsellor, I’m accredited through the Australian Counselling Association, but there are equivalent associations for Psychologists and Social Workers.

3. Check the experience. Regardless of your heart for helping people, it takes a while to become really proficient in the helping industries. I say to aspiring counsellors to try and get work with a larger agency before thinking about  private work or opening your own practice. I worked for 14 years for other organisations before opening MGA. When you ring a therapist, ask them how long they’ve been practicing. If they say “two weeks”, wish them well for their career, hang up, and call the next person on your list.

4. Check the specialty. Most of us have a field that we specialize in, based on our own interests and history. In my practice, we focus on sexuality, spirituality, and mental health, with individual therapists at MGA having more focused areas like relationships, eating disorders and the like. If you’re after some help with depression, for instance, make sure your therapist has experience working in that area. Associated with this point is the model of therapy. There’s lots of different ‘therapies’ – some will suit you and others won’t. CBT has been popular in the past but seems to be going out of fashion in recent years. Gestalt is still popular, as is person centered therapy. Acceptance and Commitment Therapy (ACT) is the model we use at MGA, but each client is treated according to their needs, not pushed through a conveyor belt.

5. Check the “fit.” If you find you don’t really click with your therapist, find somebody else. I don’t have any research to back this up at all, but my feeling is that at least 50% of a good outcome in counselling depends on how well you get along with your counsellor. If you have a counsellor that is rude, irritating, talks about themselves all the time, seems uninterested, hurries you along, doesn’t listen or even smells funny, then you won’t get the most out of your time together. You may even miss some important, helpful suggestions because you really just don’t like them very much. Sometimes a good outcome does take time, but you want to take that journey with somebody who you connect with well.

6. Check the reputation. This is a little harder to do, but ask around to see what sort of reputation a therapist has. Personal recommendations are not a rock solid guarantee (you have to get along well with them remember) but it’s nice to know that there is some good reports about the person you are seeing.

7. Check the responsibility. By this I mean, check that you have responsibility for where the sessions go and what it is you cover. I do a lot of work with the transgender community and I’ve lost count how many times clients say to me that their previous counsellor talked about nothing but their gender transition, despite the client wanting to see them for an entirely different reason. (Eg, bullying at work) In sessions, make sure you talk about what YOU want to talk about. As things unfold, you may uncover other things that you need to work on – a skilled therapist will help you do this. But if your counsellor insists on making you talk about things that seem irrelevant and they won’t give you a reason why, think about whether you should continue with them.

8. Check the practical stuff. Ask how long the sessions are, what the fees are, whether it has disability access, whether it is close to public transport, is there parking available, what are the opening hours and so on. Whatever practical things are important to you, ask about them. Also check to see if your therapist has any long holidays planned – sometimes a break in momentum can set you back, so if they’re going to be away for six months, ask for somebody else.

The lovely Jacqui and I on the set of channel 9's Mornings show.
The lovely Jacqui and I on the set of channel 9’s Mornings show.

Jacqui offered a few final thoughts in addition to these I thought worth sharing here too: “Also, I’d say that if the work feels confronting, that’s OK, therapy is meant to make shifts and sometimes these can feel uncomfortable but it shouldn’t stay that way for long. The therapist should be skilled at going at your pace, but if they’re not, it’s perfectly acceptable to ask them to slow down. And if you don’t click with one therapist? Don’t give up on the process. It’s like finding a good hairdresser, it can take time to find the right person to trust, but you don’t stop getting your hair done if you have had one bad haircut.”

Fat Talk — the experts weigh in

I had a rather heated discussion with Kerri-Anne Kennerley earlier this week on whether mothers should tell their overweight daughters they are fat.

So I thought it timely to call in the experts to shed some light on this whole “obesity crisis”. This week I am pleased to offer a guest post by Lydia Jade Turner, a psychotherapist specialising in eating disorder prevention and managing director of BodyMatters Australasia. Lydia’s partner at BodyMatters, Sarah McMahon, has also written an excellent piece on the problematic nature of the TV program The Biggest Loser, which ignores the many factors that contribute to obesity and implies that fat is a moral weakness: The Biggest Problem.

28545_392990322001_506257001_3957433_3718193_nA Weight Off Your Mind

The Dieticians Association of Australia (DAA) claim that 61 per cent of Australian adults and 25 per cent of Australian children are either overweight or obese. Surely this is alarming and a call for action? So why are a growing number of health professionals questioning these statistics? 

It is not well enough known that 95 per cent of obesity research is funded by private industry including Big Pharma. Corporations not only fund research, but entire university departments, charities, and educational programs as well. Seeing corporations jumping into bed with public health initiatives should raise suspicion. It is essentially putting the wolf in charge of the sheep.

Just last year the Centre for Obesity Research and Education (CORE) – a department of Monash University – published a study that found lap-banding procedures were appropriate interventions for obese teenagers as young as 14. What they didn’t reveal, however, was that the study was funded by Allergan, Australia’s largest manufacturer of lap-banding products. In mid-2010, Allergan sought approval from the Food and Drug Administration (FDA) to market lap bands to US teens after sponsoring clinical trials, essentially opening up the global teenage market for profit.

Then there was the 2010 Inaugural Obesity Summit (IOS) in Sydney, where professor after professor declared ‘conflicts of interest’ prior to presenting their research. As if somehow these confessions should exonerate them from the fact that their research was funded by Obesity Fat Cats International. One declared he was a board director for Reductil, “Australia’s most popular weight loss drug”. It was not surprising that his research found lap banding, followed by a lifetime’s prescription of diet pills, the appropriate solution to the ‘obesity epidemic’.

Reductil has since been banned due to over 200 adverse effects, including the death of an otherwise healthy 19-year-old girl. Diet pills have a long history of causing cardiac problems, yet it seems the same corporations that are forced to cancel their brands, continue to roll out new ones.

Obesity is a multi-billion dollar industry, with some health practitioners now referring to it as “Obesity Inc”. The situation is only getting worse. Most are not aware that it is now internationally accepted among those working within the field that not a single weight loss approach has ever been shown to be effective after two to five years, for 98 per cent of the population. This was acknowledged at The Australian New Zealand Obesity Society Conference (ANZOS) in 2009, and again at the IOS in 2010.

What is odd then, is why there seems to be a dialectic approach to obesity. On the one hand, the obesity “experts” don’t have solutions that work long-term for the majority of the population, yet at the same time continue to prescribe their shonky solutions. If Viagra had a 98 per cent failure rate, doctors would not be allowed to prescribe it. Yet most of the time, individuals who cannot “lose the weight and keep it off” are treated like failures, as though they are “not trying damned hard enough” and shamed in hostile programs like The Biggest Loser.

The reality is that obesity research is riddled with conflicts of interest. It’s best to check who funded the research prior to reading it. Obesity research typically does not account for a person’s history of weight cycling, life fitness, stress, socioeconomic status, history of weight loss drugs, and nutrient intake. Is it the case that the solution might be worse than the disease?

Some might argue that one should at least give weight loss a shot, even if it is accompanied by an extraordinary failure rate. The problem with this line of argument is that attempting to lose weight does not come without harmful consequences. Dieting for weight loss puts people at increased risk of disordered eating, including binge eating, emotional eating, and weight cycling, just to name a few. This has less to do with “willpower” and “laziness” and more to do with the hardwiring of our physiological responses to deprivation.

Obesity “experts” like to make many claims. These include the benefits of weight loss in those afflicted with diabetes. Yet independent studies show that these benefits usually drop off after six to 18 months. But when was the last time you heard that? The DAA’s Healthy Weight Week recommendations advise us to swap soft drink for diet versions. Do they seriously believe that putting aspartame – a chemical previously listed by The Pentagon as a biochemical warfare agent – into one’s body is healthier than real sugar? Although approved by the FDA, it is useful to bear in mind that a 2006 study found that at least 1 in 3 FDA panel members hold financial conflicts of interest.

Eating disorders charities are reporting that rates of disordered eating and unhealthy weight loss approaches are becoming normative in young people. Eight per cent of teenage girls currently smoke to control their weight. Schools are reporting that school children are refusing to participate in sport because they feel ashamed of what they look like in their gym clothes. And a recent study published in the International Journal of Paediatrics found that obese children are 63 per cent more likely to be bullied, irrespective of sex, socioeconomic status, race, and type of school they attend. No protective factors could be identified.

Research shows that stigma and discrimination are two of the highest predictors of poor mental and physical health. This discrimination is not limited to the schoolyard. Dr Lyn Roberts announced at the ANZOS Conference in 2009 that 84 per cent of health professionals discriminate against those who are obese or overweight. This has significant real-life consequences, with many obese people reporting they are reluctant to see their doctors, as they are certain to be lectured to lose weight while all of their ailments are blamed on the fact that they are fat. In some cases, cancers have gone unchecked – leading to deaths – due to the assumption that the person’s symptoms must be due to their fatness. The difficulty in accessing appropriate health care also confounds obesity research.

It’s time for this hysteria towards obesity to end. Independent studies are showing that it is actually fitness that is a better predictor of health, irrespective of what size a person is at (except at statistical extremes). We don’t actually know what is a “healthy weight” for any individual. Even if Body Mass Index (BMI) was not tainted by corporate funding, it would still only exist as a population measure.

In recent years, a global grassroots movement has taken off, known as the Size Acceptance movement. Health At Every Size (HAES) prides itself on exposing conflicts of interest in research, prioritising health over profit. It rejects the weight-based model to health, replacing it with a health-centred approach.

HAES acknowledges that our bodies are continually communicating with us. Whether you are constipated, hungry, or satiated, it helps to stop and listen. Intuitive eating teaches us to reconnect with our internal signals. If you eat highly-processed foods regularly, chances are you aren’t going to feel very well. Listening to our bodies is a skill.

HAES also encourages people to engage in physical movement that is pleasurable to them, instead of obsessively counting their steps with a pedometer or seeing exercise as punishment. Respecting body diversity and seeing health as an ongoing multi-faceted process will help to end the war against our bodies. Every day we can feel good about the fact that we have respected our bodies through health-giving activities, instead of hating ourselves for not reaching that number on the scales. After all, how can you truly nourish something you hate?

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