• If you have decided that therapy is a comfortable option for you, you can schedule a 15 minute contact session so you can assess whether you feel comfortable working with me and for me to get an idea of your motivations, expectations of therapy and what approach will be best. It will be a short meet and greet that can take place telephonically or by video call. I will be updating the website to include a calendar booking function for this meeting, but in the meantime, please email michellescottpracticeau@gmail.com to set up this time.

Before the session:
  • You will need to complete an informed consent form and a brief questionnaire that will take approximately 5 mins to complete. This is standard practice for psychology appointments in Australia.

In session:
  • I will discuss any questions you have about the consent form and then we will then focus on exploring what brought you for therapy and more about your life.
  • It is very useful in this phase to express anything that comes into your mind in the session so that we can make sense of this together. You may find this strange at first, but it is important to remember that the therapy process is different to a social interaction in that you have the freedom to express all your thoughts and feelings whether they are judged by you or others as pleasant or unpleasant or even considered socially unacceptable.
  • All your thoughts and feelings are important and valuable and they are the tools we use for further learning about yourself. 
  • I will not be sharing details of my life during this process because the therapy is your therapy and this helps to create a space for us to focus on your concerns. This may feel strange at first because this is different in social situations. You are welcome to think and talk about your feelings about the therapy relationship. We use your thoughts and imagined understandings of this relationship to help us figure out what your internalised map of relationships is. You may, for example imagine that a thought that you judge as unacceptable would offend me if expressed, but in a therapeutic interaction, we treat the thought with curiousity and empathy because it likely has deeper meaning that might make more sense than you imagine when you uncover where it comes from.
  • Many adults who decide to come to therapy make this decision with an adult/logical version of themselves. However, we carry all our child or baby feelings with us through life and this feeling self does not always operate in the same way as the world of adult logic. It is a part of the mind that has it's basis in early experiences
  • Often people judge their feeling self harshly or view their feelings a being a nuisance. We can sometimes feel anxious, vulnerable or ashamed of our messier feeling self. However, feelings are an important part of human functioning.
  • Humans have a range of feelings that are all important communicators what is happening in our body and mind. It would not be helpful for us if we turned our feelings off.
    • Our physical bodies are also equipped to sense physical feelings such as pain so that we attend to this. For example, if you stepped on a thorn and didn't feel pain, you would leave the thorn in your foot and it would get infected and could develop a life-threatening infection.
    • We have an emergency response sometimes to shut down pain and avoid it because it doesn't feel good. This can get us through to a place of safety in emergency situations, but may cause risk for problematic behaviours if we continually respond in this way. It is hard work to come to therapy feeling pain, vulnerability, confusion, anger, frustration, tiredness and yet these are all ordinary feelings and will be treated with curiosity so we can build empathy and integrate those experiences.
Therapeutic relationship and therapeutic frame
  • There is a lot of research that points to the key factor of success in therapy being the therapeutic relationship itself. 
  • Regular therapy at the same time, place and fee is what psychologists call the therapeutic frame. The therapeutic frame changes the relationship from an ordinary social relationship, which often has lots of social investments and expectations, to a therapeutic relationship where all thoughts, feelings and behaviours can be discussed with curiosity and understanding.
  • It is the main tool we use to allow distressing feelings to be thought about and processed in a safe way.
  • The closer the gap between appointments, the less difficult this process is.
  • If there is less time between sessions, there is more chance of accessing  our feeling part of ourself in the therapeutic relationship in a safe way which doesn't feel as overwhelming. The bigger the gap between sessions, the higher the chance that a person will either unconsciously move into engaging in therapy with a cognitive/adult self only or feel so distressed and have to manage feelings in isolation with little support.
  • If only an adult part of self enters therapy, it becomes less likely that we are able to address deeper concerns. This is because the mind has quite sophisticated mechanisms of protecting itself. Remember that these mechanisms have been very adaptive in our earliest life. Our aim is not to change these mechanisms, but rather to understand them so that you have more choice in coping mechanisms.
  • Sometimes if we have been living in an alarmed state of mind for too long, we may struggle to moderate the intensity of feeling. It feels like there is no “volume” control of the feelings. In these cases, we might also consider some distress tolerance methods. This will be discussed based on need and usually comes from a DBT therapy framework.
    People who struggle with intense swings in emotion often benefit from learning some distress tolerance skills.
    Mastering these skills provides some relief, however, the goal of this therapy is also to engage both an emotional feeling mind and a rational mind without putting one state as more important than another. All states of mind are important for living.

How long do I need to be in therapy?
  • The length of therapy can vary. At different points in our lives we experience different developmental challenges and therefore a person can enter therapy at different times in the life cycle. Therapy can help with alleviation of symptoms and some people may choose to stop therapy once the symptom is alleviated. However, for more long lasting prevention of automatic responses to problems longer term therapy can prove more useful. 
  • Third party funders usually approve an amount of sessions and and after completion of this amount (for example 6 sessions for medicare), I will need to write to the case manager to review. In the case of medicare, the case manager is your GP. You will need to visit the GP and they will provide another referral letter if needed. Please feel free to ask me questions about this process in the session.