What to expect when seeking therapy

Dr Loretta Poerio
Senior Mental Health Adviser
Department of Veterans' Affairs

Now that 2020 is behind us and 2021 is well and truly under way, it is important to reflect on what last year has taught us and build the resilience necessary for the year ahead. For some, this could mean a slight adjustment, for others, a major lifestyle shift. 

As humans, we crave the known; we are creatures of habit. Routine gives us a sense of predictability and safety, which is critical for our survival on a range of levels. However, sometimes these habits, such as avoidance, can be unhelpful as they keep us in a spiral of behaviour that stunts our growth. Charles Darwin, in writing about the ‘survival of the fittest’ in his book, On the Origin of Species, emphasised the human capacity to adapt as the key to our success as a species. Those of our ancestors who were not able to adjust to their environment perished.

Therapy can be seen as a modern mechanism to help us adapt, especially when we are a little bogged down in life. There are many misconceptions around what therapy is, what it looks like, and what you can do to ensure you are seeing a registered (or accredited professional, in the case of a social worker) mental health professional.

What is essential in this process is that you know the therapist has the required understanding of the area that you wish to focus on. If it is trauma, then you can ask about their experience in this area, what the gold-standard treatments are, what are their academic qualifications, are they registered through the Australian Health Practitioner Regulation Agency? For mental health social workers, are they an accredited through the Australian Association of Social Workers?

These are important questions, as you want to be assured that the person has achieved a certain standard of practice, and that they know the evidence about what treatments are likely to work for you. You wouldn’t go to a medical professional who is not registered, so the same applies for therapists whether they be a psychiatrist, psychologist, clinical psychologist, mental health social worker or mental health occupational therapist.

The second important element in the human adaptation journey is to ensure that you and the therapist are compatible, and that there is a sense of trust. If you do not feel a connection — and it is not just your ‘avoidance’ talking — then it is important to raise this with your therapist. Often, an open discussion can create a space to adjust perceptions. If this does not resolve the compatibility issues, then you need to find another therapist. The therapeutic alliance is what enables trust to build, and provides a context in which empathy and the courage to do the work required in therapy is cultivated.

The third point is that there are many forms of psychotherapy, or talk-therapies. It is important to understand which ones have been shown to be effective for which conditions, and for whom. Ask your therapist questions about what they are doing, and what the research tells us works, and why. All talk therapies have the goal of reducing symptoms and enhancing wellbeing and quality of life. This is not something a therapist can do for you; you must want to be there and be willing to do the work necessary to help you help yourself.

Being prepared to do the work also prepares you for the challenges that are part of therapy. Healing often comes with needing to sit with discomfort, recalling memories that you have spent years avoiding, changing how you deal with situations and how you see yourself — something that can be upsetting, even overwhelming. The therapist can act as a guide; a person who has the training and experience to be there with you and provide the tools you will need to help you navigate to a safe harbour.

A therapist can assist you to achieve a level of insight and acceptance, teach you more effective and skilful ways to deal with life’s struggles, and to discover new ways of being in the world. What do you have to lose?

Next steps

Remember, if you have completed even one day’s service with the Australian Defence Force, you are entitled to unlimited mental health treatment for life with a mental health professional of your choice. You do not have to show that the condition is linked to service. You just need a Veteran White Card. For more information, see the ‘free mental health care’ page of the DVA website.

Alternatively, Open Arms — Veterans & Families Counselling can provide face-to-face or phone counselling, COVID permitting. Visit openarms.gov.au or phone 1800 011 046.