Counselling
Counselling offers a young person the opportunity to discuss an issue or talk through their options in a private and safe environment.
Many people participate in counselling as an opportunity to undertake personal development. It is not necessary to “have a problem” to find counselling useful. Counselling can be an essential tool for young people to reduce stress, discuss issues, and identify a course of action. This is important, especially considering the barriers young people face in accessing youth-specific information and confidential space.
Youth Workers are not expected to be trained counsellors, but you can use similar tools in engaging with and supporting young people. Accidental counselling may become a part of a youth workers job, when placed in a situation where a worker may have to take on an informal counselling role. Refer to ‘More Information’ for details on accessing ‘Accidental Counsellor’ training.
Active Listening
“The best way to understand people is to listen to them.”
– Ralph Nichols
Active listening is an essential tool used by counsellors that can be used to engage young people. Young people need to be listened to and treated with respect. Many people assume listening is any easy skill to acquire. However, too often we only half-listen to what a young person is saying. Active listening involves more than just hearing what they have to say, it involves a number of verbal and non-verbal queues that show you are listening to the view’s of a young person and taking them seriously.
You do not have to be a counsellor to employ active listening techniques.
Active listening:
- Demonstrates respect for young people.
- Helps to avoid misinterpreting young people’s situations or intentions.
- Uses a non-judgemental, accepting approach that allows young people to feel listened to without fear or reproach of criticism.
- Validates the feelings and concerns of young people.
- Encourages young people to open up by building and maintaining strong relationships.
The following table provides some basic do’s and don’ts to keep in mind when having a conversation with a young person.
Do’s | Don’ts |
Face the young person and stand or sit still while you are listening and ensure that your body language shows that you are interested. | Fidget or continue with other tasks while they are talking to you. |
Focus all of your attention on the young person, and think about what is being said. | Let your mind wander. |
Listen with an open mind and don’t pass judgement. | Criticise, diagnose, moralise and stereotype. |
Ask questions to test your understanding. | Pretend to understand when you don’t. |
Use a respectful, interested tone of voice. | Just think about what you are going to say next. If you do, you wont listen properly to what is being said. |
Watch the young persons non-verbal communication. It may give clues to the meaning behind the words. | Change the topic or start talking about yourself. |
Allow for silence as it lets the young person proceed at their own pace. | Speak over the top of the young person. |
For more information on active listening visit:
Web: www.hru.uts.edu.au/performance/support/CommunicatingEffectively.pdf
Finding a Private Practitioner
There are many different types of counselling services available in the ACT. Some services provide general counselling and some provide issues based counselling such as gambling or alcohol and other drugs. Counsellors can also be found in the Yellow Pages under:
- Dieticians;
- Alcohol and Other Drug Counselling;
- Career Counselling;
- Community Advisory Service;
- Counselling – Marriage, Family & Personal;
- Employment / Training;
- Medical Practitioners;
- Naturopaths;
- Pregnancy Counselling and Related Services;
- Social Workers; and
- Weight Reducing Treatments.
Accessing the Mental Health Services Through the Medicare Benefit Schedule
The Better Access to Psychiatrists, Psychologists and General Practitioners (GPs) was established through the Medicare Benefits Schedule (MBS) initiative. This section was developed in collaboration with the Department of Health and Ageing in December 2008.
The Better Access Initiative
From 1 November 2006 Medicare rebates became available for GPs to provide early intervention, assessment and management of patients with mental disorders, as part of a GP Mental Health Care Plan.
People with an assessed mental health disorder can access up to 12 Medicare rebated individual and up to 12 group allied mental health services per calendar year. The person needs to be referred by:
- A medical practitioner managing the patient under a GP Mental Health Care Plan or under a psychiatrist assessment and management plan; or
- A psychiatrist or peadiatrician.
Allied mental health services under this initiative include psychological assessment and therapy provided by eligible clinical psychologists, and focussed psychological strategies provided by eligible psychologists, social workers and occupational therapists.
Note: Referrals need to be provided by a GP, as required, in up to two groups of six sessions. The GP will assess the need for further services after the initial six sessions have been provided.
How to Support a Young Person To Access The Program
As a worker it is important that you are aware of the steps necessary to access the program. Below you will find several steps alongside each is a tip / comment, these should be read only as a guide. You may need to do some pre-planning and adapt the steps as you and the young person negotiate through the process.
Step | Tip / Comments |
The young person may be feeling unwell or their behaviour may have changed. | A young person may have told you they’re not feeling well or they’ve noticed their mood has changed. Or perhaps a friend or family member of the young person has expressed concern to you. Or perhaps through your interaction with the young person you have noticed changes. These changes could be signs of many things. It could be developmental or hormonal, they could be experiencing issues at school / home / with someone close to them, and / or it may be an indication of a change in their mental health. Remember these things can be interconnected. Everything in a young person’s life can impact on their mental health.
As a worker you play a critical role in supporting young people’s health and wellbeing. It’s recommended you access training on young people and mental health in order to be able to identify the early signs of change in a young person’s mental health. For information about training and professional development opportunities in the ACT download a copy of the Youth Coalition’s bi-monthly Training and Professional Development Calendar from www.youthcoalition.net. |
Discuss with the young person how they are feeling and if / what type of support they might like to access.
| Remember, untreated mental illness can significantly impact on a young person’s ability to participate in their lives and their community. As workers it’s important to remind young people they don’t need to “go it alone” and there is a range of support available.
The young person may or may not have a good understanding of mental health and the types of professionals that are available to support them. The Youth Coalition and Mental Health ACT have produced a brief glossary of terms written in a youth-friendly way, which was developed by Child and Adolescent Mental Health Clinicians, Mental Health ACT. Find it as part of The Coloured Kit at www.youthcoalition.net.
There is also a range of youth-friendly mental health information on the Internet. See the Mental Health Section for details. |
The young person wants to seek out additional support and get a mental health assessment from a GP. | |
Work with the young person to identify a suitable GP
| The young person may already have a GP. However, sometimes a young person doesn’t feel comfortable visiting their family GP. They may have questions or concerns about confidentiality. For youth-friendly information about GPs visit www.reachout.com.au.
Remember the ACT has some of the lowest bulk-billing rates in Australia.
At the GP’s surgery the receptionist or nurse, if there is one, can be a great contact person. Ask to speak with them, explain the situation (including barriers such as cost) and seek their advice.
The Junction Youth Health Service (02 6232 2423) has a GP, a list of GPs who bulk-bill and can provide referrals to GPs. Also check out the Health and Sexual Health Section of the Big Red Book for further information on accessing GPs in the ACT.
|
Visit a GP
| The young person may or may not have a Medicare Card.
If a young person is 16 and over, they have the right to see a doctor without a parent present. This can be important as a young person may want to seek professional help but may not want their parents to know about it.
Seeing a GP can be expensive, although some GPs will see the young person for free as long as they have a Medicare Card – this is called “Bulk-Billing”.
The young person should be encouraged to discuss the service – including length and cost of the consultation and whether any payment is required up front – with the receptionist when making the appointment.
The Junction Youth Health Services (02 6232 2423) will see young people with or without a Medicare Card.
For information on how to get a Medicare Card visit www.medicareaustralia.gov.au or check the factsheet available from www.reachout.com.au.
You can also help make the appointment with the young person. If you have the capacity it might be good to offer to accompany the young person to the GP. |
GP makes an assessment of the young person’s mental health | In order for someone to access mental health services through the MBS their mental health must be assessed by a GP. Often young people don’t feel comfortable talking about how they are feeling, particularly if they don’t know someone. They may have had a bad experience. As a worker it may be important to discuss this with the young person prior to them visiting the GP. It may be worth telling them that they need to be honest and not to minimise what is happening for them.
GPs are well trained and will treat what they say confidentially. However it’s important for young people to understand that if they have a GP Mental Health Care Plan prepared for them, a record of this service (but not the specific diagnosis) will be retained by Medicare Australia. Medicare Australia will not release patient information without permission, but insurance companies may request access to Medicare Australia records before agreeing to insure someone. This should inform the decision of a young person contemplating being provided with a GP Mental Health Care Plan.
It should also be noted that while a GP may assess the young person as having a mental disorder, the GP may choose not to put them on a GP Mental Health Care Plan if he/she feels such a course of treatment will be of little benefit to the young person.
In instances where a GP chooses to develop a Mental Health Care Plan for the young person, a range of treatment options may be considered including, if appropriate, referral to an eligible clinical psychologist, psychologist, occupational therapist or social worker for Medicare rebateable services.
For more information about GPs visit www.reachout.com.au. |
The GP has assessed the young person as having a mental health issue. | |
The GP and the young person develop a Mental Health Care Plan
A mental health practitioner is identified for the GP to make the referral to. | Some GPs may know about a lot of mental health practitioners and some may only know a little. As a worker you may be able to support the GP and young person to identify a mental health practitioner:
If you, the young person and the GP aren’t sure who may be appropriate give Youth and Well-Being, CatholicCare (02 6163 7600) a call. They provide youth mental health services in Canberra and have some great contacts.
Remember the practitioner needs to be registered with Medicare Australia in order to provide services that are rebated by Medicare. Under Better Access, Medicare will provide set rebates for up to 12 individual and up to 12 group sessions with eligible allied mental health professionals. Some practitioners require patients to pay the full amount in advance and some will bulk bill. This could be a critical access issue for the young person. However, if a practitioner appropriate for the young person has been identified and cost / method of payment is an issue ask to discuss it with them. Another option is to identify some brokerage funds the young person may be able to access. |
An appointment is made with the mental health practitioner. | Once all this work has been done it is now part of the worker’s role to support the young person to access this practitioner. This could involve providing transport or access to bus tickets and / or reminding them of appointments. |
More Information about the Better Access Initiative
More detailed information on this initiative is available at www.health.gov.au or by calling Medicare Australia on 132 150 (for providers) or 132 011 (for patients).