Mental health articles

OF mental health care and mentally ill

Talking treatments and counselling

Some health workers feel that ‘proper’ health care should involve something more than ‘just talking’. Many doubt that talking can even be considered a treatment at all. This is why many health workers give medicines to just about anyone who comes to the clinic, and many people expect to be given medicines when they visit the clinic. Some may even tell you that they need an injection! It is important to clear up a few doubts and myths about talking treatments in health.

Talking treatments are more commonly called ‘counselling’. The term ‘counselling’ is used in different ways and can mean different things to different people. Thus, a caring person with no formal training could ‘counsel’ friends who are distressed. In this kind of counselling, counsellors often simply follow their own instincts and knowledge. While this approach has its own strengths, it is so particular to each individual that it may not be useful as a ‘treatment’ for others to learn and use. Counselling as a treatment is, in fact, more than ‘just’ talking to a friend. This is for two main reasons:

• There is a method to counselling. All counselling methods are based on a theory that explains why a person has mental illness and seeks solutions to problems.

• Counselling is given by health workers to whom people have turned for help. When advice and reassurance are given in this situation, it has a healing potential in itself. Counselling is a skill that can be learned by any health worker who has an interest and an open mind.

There is evidence that counselling does help people with mental illness. However, counselling is not a ‘competitor’ to medication. If you consider educating and giving proper reassurance as key

components of counselling, then you counsel everyone you work with. After all, everyone should understand something about their sickness. The process of education can make all the difference

between a person feeling satisfied with your help or being unhappy and seeking help from some other health worker.

Some other types of psychological treatment, such as problem-solving (see below), are simple, useful strategies that may be applied to a wide variety of clinical situations. Thus, as a general rule, the basic elements of counselling should be used for all the people who see you, regardless of their health problem. In some, you may also choose to use medicines on top of that.

There are some mental illnesses where more specific psychological treatments may be used with great effectiveness. In particular, these illnesses are the common mental disorders and alcohol and

drug dependence. The specific steps of a counselling treatment are as follows:

• give reassurance;

• provide an explanation;

• give relaxation and breathing exercises;

• give advice regarding specific symptoms;

• teach problem-solving skills.

While the discussion below deals mainly with common mental disorders, many of the principles will have more general use.

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