FAQs

Please call or email if you would like to make find out more about how I work or to make an appointment:

0411257483 within Australia

+61411257483 outside Australia

trishwalsh@iimetro.com.au

It is vital for prospective clients to check me out before booking an appointment. Have I got the skills, knowledge base and approach you need from seeing a practitioner?  Do I have any views or affiliations which you might find offensive? Does my personal style suit you or not?

Equally, it is my ethical responsibility to ensure that I can reasonably provide you with the type of counselling, psychotherapeutic and psychological methods and outcomes you need or would like from consulting with me. As the professional I have a duty of care to you to disclose information prior to the commencement of sessions which I know could reasonably affect your trust in me, your sense of personal and psychological safety, and the safety of your information.

If after talking we agree to go ahead with booking an appointment I will send you a confirmation email (or letter) with a pre-disclosure document for you to read before you come to the first session. You will need to read and understood the document (or have it read and explained to you), to have any questions or concerns addressed, and to sign the document in the first session before the commencement of the therapy.

Sitting in the same room face to face allows communication between client and practitioner through all senses. This is ideal for the client’s sense of security in the therapeutic relationship, to get a good sense of the therapist, to feel safe when exploring difficult issues and states, and to protect sessions from interruption, intrusion or being overheard. For the therapist, information from the client comes not only from what they say, but from how they look, dress, mannerisms, body language – all the things human beings pick up about each other when with each other in person.

Secondly, as terrific as technology can be when it’s working well, VoIP calls can be interrupted by visual and audio disturbances. This is highly disruptive to therapeutic connection, process and effectiveness **. Telephone quality on the other hand is generally more reliable if the service provider has adequate coverage and strength at your location.

Having said this, there are circumstances in which I agree to work with people by telephone or by audio-visual services on the internet (VoIP):

• Clients living in remote regions or countries who have no reasonable access to a suitable practitioner within a day’s reach
• Clients with whom I have an established and successful working relationship who move out of the ACT & region permanently or for a substantial period of time, who wish to continue the work they’ve embarked on with me, and who have the ego strength to hold the ongoing work and therapeutic relationship at a distance. If there is a suitable alternative practitioner nearby I encourage clients to check them out, as face-to-face sessions are preferable with a suitable therapist.
• Clients who suffer from mobility, medical or psychiatric issues which prevent them from accessing me at my rooms. For instance I am located on the first floor of an apartment block which has no elevator. Someone who is frail, unsteady on their feet or who is wheelchair bound or uses walking aids will not be able to access my rooms. For people suffering from agoraphobia phone or internet may be the only way they may be able to access therapy initially.

Each case is considered individually. I retain the right to make the final decision about whether or not to take on a client using telephone or VoIP. My decision will be based on the nature of the restrictions experienced by the client, any alternative means of access open to the client, and my own judgement as to whether the work is likely to be successful given the nature of the client, the issues for which they wish to consult me, and what the client wants from sessions.

* Of VoIP’s (Voice over Internet Protocol) available, Skype is perhaps the most widely used. There are others such as VSee, Zoom, Team Viewer, and Google Hangouts. I prefer to use VSee: the connection provides secure, two-way, private video sessions. Privacy of calls on VSee is more secure than other VoIP’s having been developed specifically for health and medical consultations over the internet.

** Call quality can vary on the day between providers of VoIP. Sometimes it may be necessary to switch during a session from one provider to another to achieve a better quality of VoIP call. It is a major drawback of counselling sessions using VoIP. Other things which can affect VoIP call quality are the strength of your internet connection, what other programs you have open on your computer at the time, how many other people are using your internet connection at the same time.

The standard consultation length is 75 minutes. Shorter and longer sessions may be negotiated if deemed appropriate by both parties. Consultation fees are $170.00 for 60 minutes, $200.00 for 75 minutes, and $240.00 for 90 minutes. Phone calls and emails between sessions, reports, letters and affidavits requiring 15 minutes’ work or more will attract an hourly fee of $170.00 applied pro rata.

Payment can be made at the time of the appointment in cash, by cheque or via EFTPOS. Internet payments may be made by direct deposit or internet transfer prior to sessions. Notation on the bank or internet deposit should include the client’s initials and the date of the appointment being paid for.

If a third party is paying for sessions at any time other than at the time of the consultation, a payment agreement will be reached before the commencement of the first session. A written memorandum of understanding will be entered into between the third party responsible for session fees and Trish Walsh Counselling Pty Ltd before the commencement of the sessions regarding confidentiality, payment, any reports and other professional services to be provided.

Clients are required to cancel or change appointments at least 24 hours prior to any booked appointment. If less than 24 hours’ notice is given, and if events leading to the change or cancellation of appointment were foreseeable or preventable, a cancellation fee of half the booked session fee will be charged.

Private Health Insurance Policies, Workers’ Compensation, EAP schemes.

Some private health insurance companies (eg BUPA, Medibank Private), employee assistance schemes (eg, and accident and workplace insurance will cover a part of or the entire session fee. Check with your insurer or employer to see if and under what conditions and types of cover they pay for counselling sessions. Alternatively, contact me and ask me directly.

Medicare

You cannot claim a Medicare rebate on my counselling fees. Counsellors and psychotherapists do not qualify for this scheme.

You may claim a Medicare rebate for fees charged by suitably qualified and registered social workers and psychologists. To claim a Medicare rebate for psychological and social work services you have to be provided with a Mental Health Plan by your GP. To qualify for a Mental Health Plan you need to be diagnosed with a mental health condition.

This diagnosis remains on your medical record with your doctor and with Medicare. This can potentially cause unanticipated difficulties in other areas of your life, such as:

• seeking employment in certain fields,
• obtaining some types of insurance policies or paying a higher premium for certain sorts of cover,
• in legal proceedings such as  family law matters

to mention a few.

Think carefully through the pros and cons of claiming a Medicare rebate, giving due consideration to the issues for which you are seeking help, whether they constitute a mental health condition, whether your life choices and eligibility in some circumstances might suffer limitations or lead to exclusion due to a diagnosis of a mental health condition.

Of course affordability is an issue for the vast majority of people. In this regard be aware that some psychologists’ and social workers’ fees can exceed those charged by counsellors & psychotherapists. This can vary depending on how experienced the practitioner is and how keenly their services are sought after by the public.

So it is advisable when looking for a worker to spend some time analysing the true cost over the course of the therapy you may need. Do your sums by calculating the fee charged before the rebate and factor in the rebate for the number of eligible sessions to see how much you will be out of pocket. How does that compare with another practitioner who may charge a lower fee and be as suitable or perhaps more suited to meeting your needs, particularly if you are not suffering from a mental health condition (see FAQ’s for more information about the differences between a counsellor, psychotherapist, social worker, psychologist and psychiatrist).

Also be aware that after rebatable sessions have been fully used for a 12 month period (there is a limit of 5 sessions per 12 month period, with the possibility of an extension of another 5 sessions within that same 12 month period if deemed necessary to treat the condition successfully) you will be out of pocket for the full fee.

Limits of this discussion
What follows is brief description of each discipline to draw out the differences between the professions. Whilst there can be overlapping skills and methods used in the various disciplines, understanding how your practitioner has trained and goes about providing their professional services is vital to both parties having the best chance of achieving a successful result.

My purpose here is to assist people who are seeking help from talk-therapies to make a choice between the professions in line with what they feel will best suit their needs. These are not ultimate definitions.
Also see in FAQ’s: “How to Find the Right Practitioner.”

The main characteristics & differences between talk therapies

Counselling

Counselling involves collaborative discussions in a supportive and confidential environment. The client’s presenting issues comprise of perceptions, behaviours or external forces that compromise their quality of life and impact on their personal potential, productivity and enjoyment of life. Problems may be located or be seen to be located internally, interpersonally, externally or a combination of these.

Counselling aims to relieve distress, to explore and develop the client’s inner life and personal awareness, enhance personal, interpersonal and social functioning, and enhance a person’s capacity to manage everyday affairs. The end goal of counselling is either to resolve the client’s issues, transform them into opportunities, develop a greater acceptance and ability to live with these issues, or reduce or transform the issues to a more tolerable level.

Collaborative discussions rely on a relational, rather than a top down advisory approach. They focus on developing narratives that give meaning and context to client concerns. These narratives must be congruent with the way the client sees the world. Through the collaborative process client and counsellor decide on and implement therapeutic processes to address the client’s issues. The quality of these discussions therefore relies on the development and maintenance of a trusting relationship between client and counsellor.

Making attitudinal and behavioural changes is typically experienced as a challenging process. Through attention to constructing a therapeutic relationship, counsellors must earn the right to guide the client to new understandings, to support and provide feedback on the client’s attempts to change or develop attitudes and behaviours.

Many counsellors specialise in one or more areas of counselling issues: for example: relationships, LGBQTI, career, drugs & alcohol, to name just a few. For a comprehensive list of the sorts of issues counsellors may specialise in, click on this link https://www.goodtherapy.org/learn-about-therapy/issues

Some counsellors offer a specific model of practice or theoretical stance; for example: art therapy, gestalt therapy, narrative therapy. The theories and models offered in the counselling profession are many and varied. For a comprehensive list and description of models and theories, clink on this link.
https://www.goodtherapy.org/learn-about-therapy/types

Please refer to the Counselling Style page on this website for details on my clinical practice.

This section includes information found at
https://aifs.gov.au/cfca/publications/defining-and-delivering-effective-counselling-and-psychotherapy/counselling-and-0

Psychotherapy

Many people come to psychotherapy because they are experiencing discomfort,
dissatisfaction or suffering in their lives. Some come seeking further development.

Psychotherapists work with people who have a wide range of presenting concerns: depression, anxiety, sleeplessness, eating problems, illness, addiction, trauma, abuse, relationship difficulties in personal life or at work, communication, intimacy and commitment problems. A psychotherapist helps a client build understanding and acceptance of how they make meaning of their life. Together they create life-giving solutions to old and to new problems. A psychotherapist and client work together to understand conscious and unconscious aspects of the present: the lived experience of the client.

A key element of the practice of psychotherapy is the relationship between the therapist and the client. This process may include looking at how earlier experiences impact on the person’s daily life and future. Together they may refer to personal history, experiences in family of origin, relationship history, imagination, illness as well as sexuality, spirituality, ethnicity and culture.

This section includes information found at http://www.pacfa.org.au/definition-of-psychotherapy/

Social Work

Social workers provide clients with their professional services in many settings.

Many social workers provide clinical and case management services directly to
individuals, couples, families, and groups. Social workers serve clients dealing with a range of challenges including poverty, physical and mental health issues, addiction, and family problems. They may provide clinical services, such as therapy or counselling, and connect people to resources in the community to help them overcome challenges.

Social workers are trained to view people and their issues in the context in which they live. This person-in-environment perspective informs many areas of social work.
Some social workers do not work directly with individual clients. Instead, they work in community organisations, government, and advocacy groups to alleviate
poverty and social injustice on a big-picture level.

Whether professionals choose a career as a school social worker, child social worker, medical social worker, or another social work path, their work may quite possibly involve individual services for people in need of support along with program development and advocacy to improve the institutions, systems, and policies impacting their client population.

This section includes information found at www.socialworkguide.org

Psychology

Psychology is both a science and a profession, devoted to understanding how
people think, feel, behave and learn.

As a science, psychology is the study of the human mind and its wide-ranging
functions and influences. Psychological research advances our understanding of
human emotion, personality, intelligence, memory, perception, cognition, attention, and motivation, as well as the biological processes that drive these human functions and behaviours.

The goal of psychology is not just to study human thinking and behaviour, but to
put that knowledge into practice, to help people, communities, and society in
general to solve day-to-day problems and improve quality of life.

Psychology is therefore also a profession, devoted to helping people and the
community find solutions to real life problems such as improving mental health
and wellbeing, learning, performance, relationships, and societal cohesiveness.
Psychologists are primarily trained to use scientifically proven techniques in their treatment of clients. These include cognitive behavioural therapy, dialectical behavioural therapy, mindfulness techniques, to name some of these.

This section includes information found at www.psychology.org.au

Psychiatry

Psychiatry is the branch of medicine focused on the diagnosis, treatment and
prevention of mental, emotional and behavioural disorders.

A psychiatrist is a medical doctor who specialises in mental health disorders (psychiatric disorders). Psychiatrists are qualified to assess both the mental and physical aspects of psychiatric disorders.

People seek psychiatric help for many reasons. The problems can be sudden,
such as a panic attack, frightening hallucinations, thoughts of suicide, or hearing “voices.” Or they may be more long-term, such as feelings of sadness, hopelessness, or anxiousness that never seem to lift or problems functioning, causing everyday life to feel distorted or out of control.

Because they are medical doctors, psychiatrists can order or perform a full range of medical laboratory and psychological tests which, combined with discussions with patients, help provide a picture of a patient’s physical and mental state. Their education and clinical training equip them to understand the complex relationship between emotional and other medical illnesses and the relationships with genetics and family history, to evaluate medical and psychological data, to make a diagnosis, and to work with patients to develop treatment plans.

Specific diagnoses are based on criteria established in APA’s Diagnostic and
Statistical Manual of Mental Disorders (DSM-5), which contains descriptions,
symptoms and other criteria for diagnosing mental disorders.

Psychiatrists use a variety of treatments – including medications, psychosocial
interventions, various forms of psychotherapy, and other treatments (such as
electroconvulsive therapy or ECT), depending on the needs of each patient.

After completing thorough evaluations, psychiatrists can prescribe medications to help treat mental disorders. Psychiatric medications can help correct imbalances in brain chemistry that are thought to be involved in some mental disorders.

Patients on long-term medication treatment will need to meet with their psychiatrist periodically to monitor the effectiveness of the medication and any potential side effects.

This section includes information found at https://www.psychiatry.org/patients-families/what-is-psychiatry

Firstly, it is important to understand that counselling, psychotherapy, social work and psychology techniques differ significantly from each other. You can see information regarding the distinctions on this page.

Secondly, within each of these disciplines, a practitioner may specialise in a single or a selection of issues (eg depression & anxiety, eating disorders, bereavement, gender & identity, etc). Or they may use particular theories or techniques (narrative therapy, art therapy, cognitive behavioural therapy, etc.).

Thirdly, you will know that seeking professional help from a talk therapist is usually a big step to take. You are entrusting your private information and guidance towards wellbeing to this professional. If it doesn’t work out for you when you do see them it can be that much harder to find someone else and start over again. You are well advised to check prospective practitioners before making a choice.

Here are some suggestions for doing this.

1. Think first about what you have in mind for yourself; ask yourself what you want from sessions. Write your wishes down. Here are just a few ideas to get you thinking about what matters to you:
   • Do I want someone who will listen to me carefully, someone who will advise me, someone who will teach me techniques?
   • Do I want someone who is non-judgemental about my values and lifestyle, or someone I can trust to give me moral and lifestyle advice?
   • Do I want someone I can access nearby or would I prefer the anonymity of a practitioner who operates and lives at a distance from me?
   • What day of the week, time and cost that suits me best?
   • Do I want someone who already has sound knowledge of the issues and a set way of working with what I want to work on? Or would I prefer someone who comes to my issues without any preconceived views and who will be open to working with me and my issues with fresh eyes and responsive to my individual disposition, views and experience?

Then:

2.  Ring a selection of practitioners to discuss what you want. Or check out their website if they have one. Get a feel for how they work and their personal style before you make up your mind whom you will see.

If a practitioner is not willing to give you a brief, general description of the way they may work with the type of issues you bring prior to you making an appointment, think twice about making an appointment with them.