In this interview Geraldine Kettle talks to us about brief therapy, our expectations when it comes to getting a quick fix, and how when it comes to therapy, “The client needs to be doing this for themselves, not for anybody else.” We hope you enjoy reading.
MyMind: You offer both brief/short-term and long-term psychotherapy. How brief do you think therapy can be while at the same time being effective?
Geraldine: The duration of therapy, whether brief or long term depends on a wide variety of things. The main things (but not limited to) to take into consideration are the presenting issue and how long it’s been a problem for the client, the client’s resources and the client’s willingness to engage. All of these can influence the duration of the therapy. Brief or short-term therapy can be helpful for people who are feeling stressed for whatever reason or for people who are well resourced but need extra support. Here, tools such as mindfulness and some psycho-education regarding stress management can be of great help to a client and make a huge difference in a short space of time. Brief therapy can also be helpful for people who may have recently experienced the death of a loved one. Quite often, people do not have an understanding of grief and bereavement and can find themselves feeling very confused as to what’s going on for them following a death. Brief therapy can help support the person going through this difficult time by allowing the client the time and space to grieve and process their loss. As to how brief short-term therapy can be, I don’t think that is something that can be definitively quantified. Every person is an individual and therefore different. In having said that, I have worked with clients for 6 sessions and observed change in them and saw their goals achieved. Other clients have experienced change in say 8-10 sessions. It really does vary and also depends on what the client is bringing to and gaining from the sessions.
MyMind: What advice would you give to someone who is looking for a quick fix to a mental health problem?
Geraldine: It is completely understandable that when a person is in distress about something, particularly when it is having a negative impact on their lives that they reach a point where they just want it to stop. They pick up the phone and make the appointment and attend in the hope that after a short number of sessions everything will be sorted and all will be well again. That is only natural. I see that a lot and I can see the person’s distress and upset in front of me and I truly understand that sometimes people just want, in a way, “to be fixed”. But the thing about therapy is that is it a process. And processes take time. As mentioned above, sometimes a client’s issues can be resolved in a short number of sessions. But not always. Sometimes it can take much longer and it can involve a lot of hard work and a long journey. But the client is not alone in the process. There are two people in the session, the client and the therapist and it is the therapist’s role to stay with the client and support them while they are going through their process. Yes, it can seem and feel overwhelming at times but I do feel that it’s important that the client allows themselves and gives themselves that time to work through their issues. If a person has been living a miserable existence for any length of time, they deserve the time and space, however long it takes, to change things around and be happier in themselves.
MyMind: People often feel their problem isn’t serious enough to warrant therapy. Do you think there is a right or wrong time to seek help?
Geraldine: People often continue to live with an issue without actually realising how much of an impact it is having on their lives. It is amazing how we can gradually adapt an issue into our everyday way of living so that it becomes normality for us, and then we don’t even recognise it as being a problem any more once it’s disguised within everyday life. Some people also have a tendency to downplay their state of unhappiness or whatever issue is bothering them and take the view of “Sure it’s nothing…I’m grand….There’s plenty of others worse off than me” etc. But what I would say is that, if there is something in your life that is making you unhappy or impacting on your quality of life or making you feel like you’re not quite yourself, then it may be worth your while considering taking some time out and exploring that in therapy. As to whether it is the right or wrong time, you will know it is the right time when you are ready. The right time for any client is when they are ready and wanting to explore these issues and are open to change. The client needs to be doing this for themselves, not for anybody else.
MyMind: You also work in the public system. What do you think is the biggest challenge it is facing today?
Geraldine: I think that the biggest challenge facing the public system today is a supply-and-demand one. The amount of people in the country who need (“demand”) both medical and mental health treatment is nowhere near what we provide (“supply”). The times we live in today are a lot different than what the previous generation lived in. People nowadays are a lot more health aware and knowledgeable as to treatments available and so, are more likely to get themselves checked out. Then there is the internet and Google which opens up a whole new encyclopaedia of knowledge regarding symptoms and diagnosis. Haven’t we all self-diagnosed from the internet at least once? This in turn puts more demand on our public health service. This is compounded by the fact that the country is in the depths of a recession and many people simply cannot afford health insurance. Therefore, we see more and more people going through the public health system. On the other side of that however, we have a strict embargo on hiring staff in the HSE, a department of health that is constantly in debt and an obvious lack of resources to manage the health of the nation. With regard to mental health, again, while there is clearly still a stigma attached to mental health issues, things are a lot different than they were generations ago. There has been much more awareness of mental health issues within the last few years, particularly through the media. People are much more aware of what to look out for when looking at depression, anxiety etc. It is ever so slowly changing and hopefully with more media input, education at all levels, and more campaigning, there will come a time when it is no longer considered “socially unacceptable” to have a mental health issue.
MyMind: Would you say community based mental health services like MyMind facilitate early intervention easier than hospital based care?
Geraldine: Absolutely. Without a shadow of a doubt. The two main issues with people when looking for help are accessibility and finance. Within our public health system and hospitals in this country we are lucky enough to have some wonderful psychiatrists, psychologists, psychotherapists, social workers etc who do magnificent work every day. However, the waiting lists to see these professionals are unbearably long for most people. As with most illnesses, medical or psychological, early intervention is crucial.
If a person has made the huge step of contacting somebody for help, it is neither appropriate nor fair to expect them to wait months or years for that help. With services such as MyMind, a person can see a mental health professional within days. Sometimes a client will also need to be referred to a psychiatrist etc but more often than not, the client can still attend psychotherapy on a weekly basis. A lot of people still associate issues such as depression, anxiety, eating disorders, etc with hospitals and being locked up and isolated from society. But that is not the case any more. The reality of it is that, while yes, many people still do need some level of psychiatric care either in hospital or on an out-patient basis, many people just need to be heard. Heard, understood and accepted for who they are.
Places like MyMind have easily accessible mental health professionals (psychotherapists, psychologists etc) who can provide this space in a non-judgemental way that means the client can be looked after in a multi-disciplinary fashion in order for them to reach their potential and gain the most out of life. Finance is also an understandable issue for many people. Most people cannot afford private health insurance and so go through the public system. MyMind make their services available to all individuals as they provide a service with negotiable fees. Even the full fee is reasonably less than the average fee for a psychotherapy session. There is also a reduced/low cost fee for those who need it. The idea that a person may not receive treatment for any illness (medical or psychological) because of money or affordability is one which I don’t like.
With the reduced fee at MyMind, it means that anybody seeking help for a mental health issue can be looked after. Community based services such as MyMind make it easier for people to access and afford help for mental health problems and in turn, take at least some part of the burden away before client and therapist even meet. And after that first meeting, the journey begins.