Experiences of depression and recovery in Australia

Experiences with health professionals: Psychiatrists, psychologists and other counsellors

Most people we spoke to were seeing psychiatrists, psychologists or other counsellors for their depression, and had usually been referred by a GP. When discussing experiences of counselling, people often used the terms ‘psychologist’, ‘counsellor’ and ‘therapist’ interchangeably.
A few people had seen the same therapists for long periods of time, in some cases over twenty years. Other people had professional support over many years but would change individual therapists from time to time, if the relationship had become too familiar with a given therapist or treatment was no longer effective.
 
Reactions to experiences with psychiatrists, psychologists and other counsellors were varied. People who chose not to engage with psychiatrists or psychologists for their depression mentioned reasons such as not believing that ‘talking therapy’ could help, being intimidated by such encounters, or finding it too expensive. Most people had who received subsidised psychological counselling through the Australian government’s 'Better Outcomes in Mental Health Care' (Better Outcomes) and 'Better Access to Psychiatrists, Psychologists and General Practitioners' (Better Access) programs (designed to increase access to mental health professionals) were grateful for these initiatives.
 
Experiences with psychiatrists
 
Many people we talked with were seeing psychiatrists and a few had very long-term therapeutic relationships with their psychiatrists. The longest was 25 years with a few other people seeing the same psychiatrist for 10 to 15 years. Psychiatrists assisted mainly with mental health-related medication, with some providing talking therapies, including psychoanalysis. Experiences with psychiatrists were diverse. In many cases, the perceived quality of the relationship rested on whether people’s views about their diagnosis, the causes of depression, and views about treatment fitted with those of their psychiatrist. Nonetheless, if they felt the relationship was genuinely caring some people continued with the same psychiatrists even when they did not agree on diagnosis or treatment, or doubted that they could be ‘fixed’.
Long-term relationships with therapists were central to some people who didn’t have much social support.
In contrast with the accounts above, some people were critical about their encounters with psychiatrists.
Experiences with psychologists and other counsellors
 
Most people had seen psychologists or other counsellors and these experiences varied. Some were very positive and people engaged in long term counselling relationships which they described as beneficial. Qualities and approaches that people appreciated included patience, listening and support, working with patients at their own pace, being encouraging, helping people to understand and accept their own experiences as part of the narrative of their lives, and not imposing solutions on them. Sara said her psychologist helped her understand herself better and gave her ‘permission to understand [her] own vulnerability’. A few people were very proactive and assertive in their communication with therapists.
Some people said counselling helped them to understand the nature of their distress and prompted them to take an active role in helping themselves to feel better.
Some people preferred counselling over antidepressants. They appreciated the confidentiality and professionalism of the relationship and the space it provided for them to talk openly about their feelings. A few people commented on the benefits of counselling accessed through the Better Outcomes or Better Access programs.
A few people described significantly different experiences with other counsellors as compared with psychiatrists. In contrast to her negative experience with a psychiatrist, Emma, who experienced perinatal depression, found her psychologist very helpful.
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Some people thought counselling was too costly, or would not help. Others found their initial encounters with their counsellors unsatisfactory, but kept searching for the ‘right one’. A few people were critical about specific counselling methods, including nondirective approaches. As John said, ‘I do understand the ideas of client-led recovery, but when you're really sick - or for me, I just needed someone to be a little bit directive’. Rosie was told by her counsellor she did not in fact have depression, which made her feel worse.
Troy was satisfied with the initial treatment he received for his depression from a much older psychologist, but as the relationship went on he began to feel patronised. He reflected that a significant age difference could be a barrier to the ability of older therapists to relate to the experiences of younger patients. Millaa was referred to a school counsellor by an attentive teacher who became aware he was being bullied. At first he gained some useful insights and skills from the experience but soon became bored, finding the counsellor quite superficial.
Suzi’s experience captured that of a few people who had initially negative encounters with their therapists, but later found someone they liked and then formed a long-term therapeutic relationship. Suzi’s strongly negative views of psychiatry resulting from some unhelpful experiences were challenged by an understanding psychiatrist who offered exceptional support, even giving her a dog to protect her from her tendency to self-harm.


Last reviewed January 2016.
Last updated January 2016.

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