Counselling: Do assumptions create unrealistic expectations?

A continual problem for mental health professionals is the idea that mental health is identical to physical health. If someone has a headache, they take a pill and it goes away. The extension of this approach to psychological problems explains the popularity of medications such as valium and prozac.

Over the last decade, many people appear to have factored counselling into the "quick-fix" equation. It's not all that uncommon to hear managers and supervisors make comments like, "I don't know what's going on with Fred. He went to counselling and he's still having problems." Such comments raise the question of just what is meant when we use the term counselling. Some organisations use the term to describe a problem-solving process for employees having difficulties, while in others it describes a disciplinary procedure.

The media talk about counselling as a mandatory treatment given to anyone in need (like Red Cross blankets), yet few people take the time to describe what they actually mean when this generic term, counselling, is used.

One of the reasons we have confusion and misunderstanding is because it's difficult to say there's a single procedure called counselling.

Someone once said... Counselling is what a counsellor does, and this is probably very close to the reality of the situation. While we can discuss communication skills, active listening, problem-solving, developing options and implementing strategies, no two counsellors are likely to work in the same way. This tends to be even more so when a psychological treatment or intervention is given the label of counselling. This raises two potential problems of assumption. Firstly, the assumptions we have about counselling which are based on our individual experiences, and secondly, the assumption that the counsellor knows what he or she is doing. The issue is that we may be wrong in either or both.

There is a persistent myth in the community that anyone trained in mental health or counselling can counselling anyone else for any psychological problem which presents itself. Many mental health professionals have concerns about how pervasive this myth is, especially when there is an increasing number of "counsellors" from a variety of backgrounds who believe some communication skills and a bit of knowledge is all you need to assist people who may have experienced extremes in stress and trauma.

If you are referring someone to a counsellor, know who the counsellor is, have some idea of their experience and some independent testimony as to their skills and area of expertise. Simple reliance on qualifications is insufficient when seeking assistance for the stress of serious trauma.