The Essential Role of Counselling and Therapy in Mental Wellness

One of the major aftereffects of the COVID-19 pandemic was the repercussions for healthcare, not just in terms of physical health but also in terms of mental health. The pandemic has amplified serious mental health problems such as psychological distress, depression, anxiety and post-traumatic stress. People need mental health interventions now more than ever. This is where mental health counselling and psychotherapy play an important role.

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What is counselling?

Counselling refers to the practice of talking therapy wherein a trained therapist encourages you to talk about your feelings and emotions, listens to you and helps you deal with mental and emotional issues. The therapist facilitates the process of counselling and helps you understand yourself better but does not usually advise you on the issues you are facing. The process of counselling takes place in various modes. It could happen in person on a one-to-one basis, or in a group. It could also happen online, over the phone, through email, or live chat services. The number of sessions offered depends on your circumstances and needs. The aims of counselling and therapy include, but are not limited to –

• Help understand their life circumstances and themselves better
• Help clients resolve complex feelings and mental states, or at least manage them better
• Help clients recognize disruptive thought and emotion patterns and replace them with adaptive ones
• Providing a non-judgmental safe space for clients to talk about problems related to oneself and their life

When does counselling help?

Counselling can help you in coping with situations such as

• Facing difficult emotions
• Problems with relationships
• Undergoing difficult life events
• Dealing with traumatic experiences
• Experiencing a mental health condition
• Other issues related to self-concept and identity
• Experiencing a distressing physical health condition
• Confusion regarding life choices about education and career

Process of Counselling

While different types of counselling and psychotherapy follow different processes, they all still embody some form of relationship building, problem assessment, goal setting and intervention, and termination.

1. Relationship building

The initial sessions provide a chance for rapport formation between the therapist and the client. In this stage, the therapist engages in conversation with the client about the problems that are directly affecting them. The main aim of this stage is to build a positive relationship with the client, so that they feel comfortable in continuing the counselling process, and benefit from the same.

2. Problem assessment

After rapport formation and relationship building, the counsellor assesses the problems faced by the client in greater depth and detail. The therapist or the counsellor attempts to draw information regarding the client’s life circumstances and the reasons leading up to it. They might also collect information about triggers, timing, environmental factors, stressors, and other aspects.

3. Goal setting

Based on the information drawn from the previous stages, the therapist collaborates with the client to set appropriate and realistic goals aimed at dealing with the problems at hand. This process could have an additional element of using specific therapeutic approaches and practices, depending on the needs of the clients.

4. Termination

If the therapist sees considerable progress and believes that the client is now ready to deal with their problems independently, they might choose to terminate the therapeutic relationship. Therefore, termination is not entirely a stage but a necessary step signifying progress and moving forward. However, sometimes, the therapeutic relationship is also terminated upon the therapist referring their client to another therapist for various reasons.

Types of psychotherapy

There are various types of psychotherapy, drawing principles and ideas from different schools of thought. Some of them are explained below.

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1. Cognitive Behavioural Therapy (CBT)

Cognitive Behavioural Therapy (CBT) is one of the most common therapy forms in practice today. CBT aims to help clients identify and replace negative thought patterns and beliefs with more positive and desirable ones. This psychotherapeutic approach helps deal with a variety of issues including –

• Physical health conditions such as chronic pain and/or illnesses
• Life events such as divorce, breakups, loss/grief
• Issues related to self-concept such as low self-esteem
• Other stressful events including daily hassles and relationship problems
• Psychological issues such as mood disorders, anxiety disorders and phobias, addiction, eating disorders, personality disorders

CBT encompasses many therapeutic approaches such as Cognitive Therapy, Dialectical Behaviour Therapy (DBT), Multimodal therapy, and Rational Emotive Behaviour Therapy (REBT).

• Cognitive therapy aims to help clients identify and change inaccurate or distorted cognitions.
• Dialectical Behaviour Therapy (DBT) uses strategies like emotional regulation and mindfulness while dealing with disruptive thoughts and behaviours.
• Guided self-help is a treatment practice through which the clients actively participate in therapy by working on take-at-home tasks, assignments and workbooks.
• Rational Emotive Behaviour Therapy (REBT) aims to help clients identify irrational beliefs, actively challenge these beliefs and eventually learn to put them into constant practice.
• Multimodal therapy uses interconnected modalities such as emotions, sensation, imagery, cognitions, behaviours, interpersonal factors and biological substances to deal with psychological issues.

Read More: DBT For Teenagers

2. Interpersonal therapy

Interpersonal psychotherapy (IPT) is a form of therapy that is relatively short, and highly structured. This evidence-based therapeutic approach aims to focus on the present issues and set goals to resolve or deal with them. IPT helps in treating various mental disorders such as major depressive disorder, perinatal and postpartum depression, bipolar disorder, post-traumatic stress disorder, somatoform disorders, personality disorders, anxiety disorders, substance abuse, and eating disorders.

Some common forms of Interpersonal Psychotherapy include:

1. Dynamic interpersonal therapy helps the clients understand their thoughts, feelings and desires and that of others, and identify how those thoughts, feelings, and desires affect their behaviour.
2. Metacognitive interpersonal therapy is based on the understanding of basic social motives driving human behaviour. This type of therapy focuses on recognizing and overcoming maladaptive social behaviours using a deeper understanding of the underlying social motives.
3. Interpersonal and social rhythms therapy helps the client understand the importance of schedules such as sleeping and eating cycles and social functioning in treating bipolar disorder.

3. Psychodynamic therapy

Psychodynamic psychotherapy draws from psychoanalytic and psychodynamic theories proposed by Freud and other Neo-Freudians such as Carl Jung, Erik Erikson, Alfred Adler, and Karen Horney. The therapeutic approaches under this category often look at how unconscious forces influence individuals’ lives. A further exploration of childhood development and how it has led to problematic patterns in the adult client’s life is also conducted. Psychodynamic psychotherapy helps in dealing with psychological disorders such as depressive disorders, anxiety disorders, eating disorders and personality disorders. This therapeutic modality is often longer relative to previously discussed forms and uses techniques such as dream analysis, free association, Rorschach Inkblot tests, etc.

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New forms of therapy

Today, we have more therapies mushrooming, considering the mental health crises people are facing worldwide. Some of the new forms of therapy include expressive art therapy, affirmative therapy, dance movement therapy, Eye movement desensitization and reprocessing therapy, and hypnotherapy, among others.

Nevertheless, there is still an urgent need for more qualified and trained mental health professionals in order to effectively deal with mental health issues and ensure holistic health for all global citizens.

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