Five Signs To Look For In A Good Therapist

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When it comes to identifying a suitable therapist, there isn’t one size that fits all. A palpable difference is to be found between a good therapist and a therapist that will suit a patient’s needs. A good therapist is someone who is adequately qualified and fulfils the basic characteristics of a professional therapist, whereas a therapist who would suit a person’s particular requirement refers to the area of concern the person is seeking help in (child counselling, relationship counselling, marital counselling, family therapy, etc). Though a majority of therapists are trained to handle and help a wide variety of population, and deal with various mental health concerns, only a few of them prefer to super specialise in a particular field.

Here’s a list of a few important points to bear in mind while deciding on a counsellor:

1. Know the difference between a psychiatrist, a counselling psychologist, and a clinical psychologist.

A psychiatrist is an individual who has obtained an MBBS followed by an MD in Psychiatry. They are authorised to prescribe medications, and a majority of them mostly deal with diagnosis.

A counselling psychologist is an individual who has attained an M.A. or MSc. in Counseling Psychology. They usually deal with the aspects of therapy and treatment.

A clinical psychologist is an individual who has obtained the degree of M.A. or MSc. in Clinical Psychology. They predominantly engage in testing and diagnosis, and primary treatment.

In reality, these professions aren’t as well defined and they have the tendency overlap. Here, it is important to keep in mind that only a Psychiatrist can prescribe medications.

2. The qualification of the therapist is of utmost importance.

Ideally, an individual who holds an M.A. or MSc. in Counseling Psychology is referred to as a counsellor or therapist. However, there are individuals who take up certificate courses which differ from their field of work, and choose to specialise in a particular kind of therapy, given as a variety of therapies do exist. In India, due to a lack of licensure and standardisation, it might be slightly tricky to identify an individual who is an authentic professional in this field though there are individuals who are accredited practitioners from organisations like Rehabilitation Council of India (RCI) and University Grants Commission (UGC). It helps for the patient to ask about or learn of their therapist’s qualifications before committing to them.

3. Experience of the professional

There have been mixed reviews about a professional’s experience on the basis of research. It is difficult to decide this as a therapist-client relationship is subjective in nature and each person has their own experiences to draw a conclusion from. Even so, to a large extent, years of experience do not matter as much as the professional’s qualification, the client-counsellor relationship, and the area or areas of concern being handled and addressed well by the counsellor.

4. Super Specialised Professionals

With reference to dealing with specific concerns, one might want to seek a super specialised professional. For example, if a child with autism has an academic concern, a remedial educator will be of better help and if the child has a concern relating to behavioural and social skills, a counseling psychologist will be better suited. One might not always be able to get in touch with the exact professional they need as at most times, one is unaware of the actual concern. In such a scenario, approaching any mental health professional is usually helpful. Based on the client’s requirement, they will usually be referred to a more suitable professional.

5. Therapy takes time

It is common for clients to want to know the approximate number of sessions that they would have to come to therapy for and how long the same would take to bear fruit. This information is slightly difficult for therapists to provide after the first or second session. When it come to seeing the results of therapy, it usually takes a few sessions for the person to identify changes in themselves. Counseling doesn’t consist of one problem for one solution but involves a vast range of techniques. It also does take a period time for the client and counsellor to develop a bond and work towards improvement. It usually takes around 2–3 sessions for a client to feel comfortable and for the therapist to help the client based on their specific requirements. It’s only post this that actual therapy can take place. As a client, if you are uncomfortable with your therapist, you can always state that point and request for a referral elsewhere. What is also helpful is to find a therapist who practises close to your home or at someplace you would not have to travel for hours to.

Though the definition of a “good counsellor” is hard to come by and each professional functions based on numerous factors such as school of thought, client requirement, their own beliefs, etc. there still are a few characteristics that a standard therapist should more than likely exhibit. Here’s what to look for:

  • A good therapist will come across as sincere and empathetic.
  • They will be fairly organised when it comes to scheduling appointments and creating plans of therapy.
  • A good therapist is a genuine listener.
  • They will try, as much as possible, to adhere to the time frame of the session.
  • They will not provide judgments on or decisions for your life. A good therapist will be non-judgemental, and base their ideas on observations and interactions with the client.
  • A good therapist will usually encourage you to think for yourself and will try and not advise you on matters until they feel a need for the same.
  • They will not let their personal bias and opinion come into play. If you feel unsafe and judged, you can question them about the same and look for another therapist.
  • A good therapist is usually resourceful and will help you to the best of their abilities.
  • Good therapists also have an insight into the role they play in their sessions and are aware of their shortcomings.
  • Good therapists charge efficiently for their services. Though the fees are dependent on a variety of factors such as time, personal expertise, method of therapy and so on, therapists’ fees (in a city like Mumbai) usually range from rupees 500–2000 per session.

When an individual seeks help or therapy, there are chances that they might not be able to bond well with the therapist and that the level of client-counsellor comfort does not develop. In such a situation, it is important for the client to talk to their therapist. The therapist will usually try another approach and if that fails, they are more than likely to recommend the client to another therapist. When this occurs, the client is requested to give a chance to another therapist and is also requested to avoid having a prejudice against counselling, as far as possible. Therapy or counselling is often a method of trial and error. In a number of instances, the counsellor-client fit is usually a success. It is important to bear in mind that what a professional therapist or counselling session can provide, no other professional will be able to.

The most crucial step is to convince oneself or the concerned person to go for counselling. As mentioned above, therapy takes time. Give yourself the time you need to heal and the space you require to do so. Therapy is a lifestyle change, where one learns to be more aware of their own thoughts and emotions, trying and learning to better deal with them.

A vast majority of the population, irrespective of their literacy level, believe in the myth that one seeks the help of a psychologist only when they are suffering from a severe mental disorder. But the fact remains that, irrespective of having a serious mental health concern, it is always advisable to go in for therapy and enhance your life, to help you live more fully.

There is a hesitancy observed in patients to pay the required fee to their therapists. While there are therapists who charge an obnoxiously high amount of fees, paying no fees or asking for a discount isn’t ethical either. Yes, the session might be like a conversation and no, you won’t get a prescription, but it is important to realise that the therapist has given you their time and expertise, which is something that you wouldn’t have received otherwise.

It is essential to take professional help when you feel the need for the same and to not let social stigma deprive you of a better life. The last point to bear in mind and remember is that— It is completely okay to not be okay.

References:

Gladding, S. T. (2014). Counseling: A Comprehensive Profession. (7th Ed.). Pearson Education. New Delhi: Indian subcontinent version by Dorling Kindersley India pvt ltd.

Bansri Mehta is a Counselling Psychologist and Volunteer Researcher at One Future Collective.

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Queer Infocus | July 2020

The Beginning, Middle and End: A Tryst with Depression

Mental Health and Transpersons in India

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At least once in our lifetimes, all of us must have experienced what it feels like to be left out. It could have been not being chosen to play in a sports team or not being given a role in a school drama, being the last one to finish food during breaks, being the last in a running race, having to sit alone in a cafeteria, and so many other situations — irrespective of the cause of being subjected to it. Take a pause and try to recall. How did — being left out feel? Being ridiculed for not “fitting in”? Being labelled as an outcast only on a superficial basis with no solid reasons at all? It wasn’t a pleasant feeling, was it? We might have felt uncomfortable and hurt, and none of us must want to spend the rest of our lives feeling so.

When we were in school, some of us might have belonged to the middle category. The other sets of students being overachievers in academics and those students who were supremely good in athletics, and then there were those students who were somewhere in between — achieving decently in academics but not making it to the ranker’s list, or doing well in sports but not being brilliant enough to get selected for competitions. And that is where the perpetual mindset and socially influential label of being “not good enough”, or being the middle ones, or never being able to conform to the set standards of the “best” in the society came from. The weight of these labels is obviously not a happy place to be in and to spend a lifetime in that category can be quite stressful.

Transpersons in India sadly share a similar plight. They are constantly told that they don’t “fit” into the socially approved constructs of the male-female binary, they are regularly rattled with insensitive comments and are subjected to feelings of ignorant hate. They are those people who are struggling to be “good enough” on a daily basis, they fight each day to live as who they are; not because they suffer from any physical illness, but rather because they are victims of unruly social norms and rigid stereotypical attitudes. To be surviving in such a harmful social atmosphere is a task and such situations are a definite breeding ground for serious mental health problems.

Understanding related terminologies

Before we shed light upon their specific mental health and related conditions, it is important for us to understand a few terminologies with respect to the transpersons population. Sex refers to the classification of an individual on the basis of their biology. Gender refers to the state of being of a sexual identity with reference to social and cultural differences. Intersex refers to individuals born with physical characteristics that do not fit into typical binary notions of male or female bodies. Cisgender refers to individuals who identify with the gender that biologically corresponds to their sex at birth. Transperson usually refers to individuals who identify their gender as that of the sex that is not their birth sex. Transpersons are grouped in two major categories — Transmen and Transwomen. A Transman refers to an individual who was assigned the sex of a female, but identifies as a male. A Transwoman refers to an individual who was assigned the sex of a male, but identifies as a female. The term transperson is an umbrella term and includes a few other gender-related categories as well.

Sexual orientation refers to a person’s sexual identity with respect to the gender to which they are attracted. The sexual orientation of an individual bears no relevance to their gender identity. Over the years, the LGBTIQ+ (Lesbian, Gay, Bisexual, Trans, Intersex, Queer, Questioning, and others)has developed as a vibrant and strong community. They are a population of people who are united in having gender identities or sexual orientations that differ from the heterosexual and cisgender norms.

What does literature say of Mental Health issues amongst transpersons in India?

In India, the concept of transpersons is popularly understood in the form of the ‘Hijra’ community. An article published in 2017 in The American Journal of Psychiatry, titled “Understanding the Mental Health of the Hijra Women in India”, written by Dr. Vikas Jayadev, highlights the plight of hijras in India, with respect to their physical well-being and mental health concerns. It emphasises the lack of research conducted and literature available with regard to this population. The article comprises of the available literature and sheds light on the serious and troubled conditions of people belonging to the Hijra community — their physical health problems including high rates of HIV and, mental health problems like depression, anxiety, self-harm, suicidal tendencies and substance abuse. “Aside from poor sexual health, this patient cohort experiences perceived and internalised stigma, isolation, discrimination, and victimisation that predisposes them to mental health issues” writes Dr. Vikas.

A quote from the December 2016 report on the Psychology Today website titled ‘Why transgender people experience more mental health issues?’ reads as follows — “The American Psychological Association pointed out in its March 2016 report on the impact of discrimination, that adults who are LGBT and have experienced discrimination have average stress levels of 6.4, compared to 6.0 for LGBT adults overall. Among adults who are non-LGBT, stress levels are 5.5 for those who have experienced discrimination and 5.0 for non-LGBT adults overall.”

A study from Boston, published in 2015 in the Journal of Adolescent Health, reported that 180 transperson youth had a two-fold to three-fold increased risk of psychiatric disorders – including depression, anxiety disorder, suicidal ideation, suicide attempt, self-harm without lethal intent – when compared to a control group of youth.

A review written in 2014 on research about suicide and the transpersons’ population found “an unparalleled level of suicidal behaviour among transperson adults”.

The transperson population is direly affected by mental health problems like depression, anxiety, suicidal ideation and self-harm. The statistics and information available are staggering and alarming. There is always some form of stigma attached to seeking help for mental health troubles, and to add to that, the severe stigma attached to belonging to the trans community makes it harder for people of the community to reach out for help. If they do so at all, there are chances of them being mistreated or not treated at all.

Transpeople were for the longest period of time considered to be pathologically ill. It is in the latest Diagnostic and Statistical Manual -V that the diagnosis of Gender Identity Disorder was replaced with Gender Dysphoria. The worldwide medical fraternity no longer refers to transperson individuals as having an illness, but rather that they have a choice and right to decide their way of living. This is all nice and fine on paper, but the harsh and haunting reality is the misguided and ignorant views of the general population on people belonging to the transpersons community.

One Future Collective is the outreach partner for the Trans Diamond Festival. This article series, across platforms, is a result of the ongoing effort of Make Room India and One Future Collective to discuss issues of the transgender community and build an ecosystem towards strengthening the trans rights movement in India.

Bansri Mehta is a Volunteer Researcher at One Future Collective.

We’re updating our website!

Queer Infocus | July 2020

The Beginning, Middle and End: A Tryst with Depression