Monday, 14 April 2014

Attitudes to Professional Counselling in India: Awareness issues, Brighter side and a change for the better...


Article published: http://www.merinews.com/article/attitudes-to-professional-counselling-in-india-awareness-issues-brighter-side-and-a-change-for-the-better/15896755.shtml 
With an increase in a spate of suicides in modern Indian, mental-health concerns are much talked and worried about. Loneliness and exhaustion, two major by-products from heavily competitive and busy lifestyles are to an alarming extent mirroring an emotional unrest within the current Indian society.
 Matters that overwhelm the present generation are upping in number and witnessed in the form of multiple breakdowns behind closed doors that often go unreported. In this internet-era where “connection” is a gripping-point of masses fixated to social networking-sites, there is an emotional disconnect to its flip-side that is reaching newer heights of adversity.
Inspite of an advanced technology for an increased connectivity, there are countless number of people who find themselves lost when in need of support for their personal problems and do not know whom to talk to? In this given scenario, where rising need for psychological assistance and mental-health experts is felt, Indians in India in contrast, are still less aware of counselling practices in the country and apprehensive to seek professional help.
Findings from my cross-cultural study titled 'British and Indian Attitudes towards counselling' comparing British and Indian attitudes towards counselling, published in 'Counselling Psychology Quarterly', UK, report that there is lower awareness amongst Indians in India regarding counselling, even compared to those of Indians living abroad in Britain. And, also that those living abroad had a greater awareness about available counselling services compared to Indians in India.
At a time when there is an increasing mental pressure amongst citizens of all classes, it becomes important to bring to light the reasons why people within the country refrain from reaching out for a much needed and perhaps a 'secretly desired' professional assistance for their everyday emotional upheavals. It becomes important to understand, what causes this difference between the individuals with a common nationality to differ in their levels of awareness and attitudes towards an important service concerning mental health well-being?
The prevalent condition of Indians in India can be attributed to the fact that counselling in India is still far from being popularly recognised or governed by recognised body writes Arulmani, of The Promise Foundation, Bangalore, in his paper 'Counselling Psychology in India: At the Confluence of Two Traditions '. Additionally, most people in India view counselling as restricted to mental illness, while it can factually cater to a range individual aspects relating to development of personality, improving relationships, skills, increasing work performances and more.
According to widely accepted definition of counselling given by British Association of Counselling Psychology (BACP), counselling is a professional time-honoured service that helps “people explore and solve their own problems, increases self-esteem and helps people develop skills to resolve their past and present problems” using their resources and keeping in mind their subjective environments. In a given scenario where this knowledge is absent or there is partial awareness on this, very many individuals approach counselling for some entirely wrong reasons like “advice” and sometimes even seeking paranormal guidance. Most people in India are misguided about the role of counsellors. Largely, people thought of them as mind-readers, face-readers, handwriting analysts, body-language experts, personality analysts, future predictors and solution-providers.
These beliefs are contrary to the facts, but an authentic documentation from professionals who experience this reality in day-to-day practice can be an effective research-based tool for the spread of awareness about counselling in the right direction and for bursting myths about it. As a result, client expectations and legitimate counselling practices will be in sync for more benefiting therapeutic results and reducing disappointments from misguided information.
Interestingly still, findings from my research paper confirm that Indians with previous experiences of counselling (both in India and abroad) have a more positive attitude towards counselling practice. One can understand that Indians in India who were counselling clients were satisfied with counselling services received in the country and that they benefit from it as much as Indians using counselling services while living abroad in Britain. This can be viewed as the brighter side, and encouraging news for both counselling professionals and those interested in seeking their services.
The idea is that well informed citizens about this will be at an advantage for wiser decision-making and for using psychological support, which is better accessible today than ever before. It will also help a large number of people avail to financially viable means of counselling such as telephonic-counselling, psychological 'apps' on smart-phones and also services from non-profitable agencies.
A trend for physical fitness caught the interest of millions of people in the country and has gained widespread acceptance with visibly flourishing gyms. Mental-health too is hinting at the requirement of an increased attention to emotional well-being for better adaptability to fast changing lives. It is not only about mental sickness anymore, but about increased fitness and efficiency to be upbeat with life challenges. For this, there are several therapies offered by professionals focusing on individuals, families, groups, communities and organisations for skill development and empowerment.
Using this kind of counselling support is likely to bring a change for the better in terms of mental fitness. Also, it is important to remember, in the words of famous Arnold Schwarzenegger, “The mind always fails first, not the body. The secret is to make your mind work for you, not against you”.

With an increase in a spate of suicides in modern Indian, mental-health concerns are much talked and worried about. Loneliness and exhaustion, two by-products from heavily competitive and busy lifestyles are to an alarming extent mirroring an emotional unrest within the current Indian society.


Matters that overwhelm the present generation are upping in number and witnessed in the form of multiple breakdowns behind closed doors that often go unreported. In this Internet-era where "connection" is a gripping-point of masses fixated to social networking-sites, there is an emotional disconnect to its flip-side that is reaching newer heights of adversity.
- See more at: http://www.merinews.com/article/attitudes-to-professional-counselling-in-india-awareness-issues-brighter-side-and-a-change-for-the-better/15896755.shtml#sthash.epBgE8bd.dpuf
With an increase in a spate of suicides in modern Indian, mental-health concerns are much talked and worried about. Loneliness and exhaustion, two by-products from heavily competitive and busy lifestyles are to an alarming extent mirroring an emotional unrest within the current Indian society.


Matters that overwhelm the present generation are upping in number and witnessed in the form of multiple breakdowns behind closed doors that often go unreported. In this Internet-era where "connection" is a gripping-point of masses fixated to social networking-sites, there is an emotional disconnect to its flip-side that is reaching newer heights of adversity.
- See more at: http://www.merinews.com/article/attitudes-to-professional-counselling-in-india-awareness-issues-brighter-side-and-a-change-for-the-better/15896755.shtml#sthash.epBgE8bd.dpuf
With an increase in a spate of suicides in modern Indian, mental-health concerns are much talked and worried about. Loneliness and exhaustion, two by-products from heavily competitive and busy lifestyles are to an alarming extent mirroring an emotional unrest within the current Indian society.


Matters that overwhelm the present generation are upping in number and witnessed in the form of multiple breakdowns behind closed doors that often go unreported. In this Internet-era where "connection" is a gripping-point of masses fixated to social networking-sites, there is an emotional disconnect to its flip-side that is reaching newer heights of adversity.
- See more at: http://www.merinews.com/article/attitudes-to-professional-counselling-in-india-awareness-issues-brighter-side-and-a-change-for-the-better/15896755.shtml#sthash.epBgE8bd.dpuf

Tuesday, 8 April 2014

Basic Information on Counselling Services in India

In India there are several misconceptions regarding counselling. In-spite of increased demand for counselling services in the country and an increased accessibility to reach them; Indian masses are still apprehensive about seeking professional help for emotional or psychological issues. This is largely because of lack of awareness amongst majority and a sceptical attitude to explore what is “unknown” to them [2,7]. The majority of the population, still does not know the reasons why approach counsellors and what to expect from them. Also, more-often-than not are misguided. They confuse counsellors with "mind-readers" or believe that their practices are restricted to mental illness. These beliefs are contrary to the facts, and therefore, this blog contains very basic information that one needs to know about counselling. The aim is to facilitate awareness amongst general public and  help them make an informed choice while seeking mental health services for assistance. This is likely to help in reaping maximum benefits from available treatments offered by experts.

Counselling is for whom?

Counselling is for an individual, family, group, community and organization and everyone ranging from all age-groups and socio-economic backgrounds. It is for those ones who wish to deal with certain aspect(s) of their life in abetter manner than they already do. Counselling is for those who would like to have positive changes the ways they think, feel, behave and act in day-to-day situations to cope better with difficult times and to experience more fulfilling results in given situation [1].

Counselling is for what?  

One can approach counselling for crisis as well as non-crisis situations.  
Crisis situations are those such as domestic violence, addictions, mental disorders, fatal illnesses, personality disorders, childhood disorders, trauma, suicidal ideation, eating disorders, etc. 

Non-crisis situations could range from a host of daily life struggles such as interpersonal issues, relationship troubles (marital, family discord, parent-child concern), temperament and attitudinal issues (anger, moods, stress, loneliness), study and exam concerns, cognitive challenges (memory, concentration, learning problems), work performance, work-life balance, emotional turmoil, mild mood-disorders, anxiety and depression, and career guidance.

Who are the professionals and service providers?

Counsellors (Counselling Psychologists, Clinical Psychologists, and Industrial Psychologists) provide with the counselling. Some are independent practitioners running their own clinics, or employed in profitable, non-profitable as well as government organizations.

Counselling Psychologists and clinical Psychologists more frequently specialize in providing psychotherapies. Several psychologists specialize in providing one or more types of psychotherapies. Therefore, they are often also called as “Psychotherapists”. Beyond therapy, clinical psychologists are qualified to conduct psychometric assessments such as IQ tests, EQ tests, aptitude tests, clinical diagnostics&assessments (mental disorders).
One may take note that, not all clinical psychologists are expert psychotherapists. Sometimes, they are solely focused on testing and assessments. And, not all psychologists work with all age-groups. They sometimes have particular focuses based on gender (e.g. for women), specific issues (e.g. domestic violence, LGBT community, marital problems, learning disability) and specific causes (e.g. underprivileged children, sexual abuse).

Commonly applied therapies: Cognitive-Behavioural Therapies (CBT), Dialectic Behavioural Therapy (DBT), Emotional Movement Desensitization and Reprocessing (EMDR), Neuro-psychological Linguistic Programme (NLP), Solution-focused therapy, Narrative therapy, Brief therapy, and family therapy (Systems Approach) [1, 2, 4, 5, 6, 8]. 

Additionally,  for special needs there are 'remedial therapists' and 'special-educators' for problems such as learning disabilities. An industrial psychologist is an expert for employee assistance in corporate and organizational set-up and also conducts training (HR department). An extension to their work dimension is 'vocational' and 'career guidance'. 

Following a different spiritual school of thought with scientific means, there are 'hypno-therapists' who treat client problems with the use of hypnotherapy.
On smaller larger platforms psychologists are involved in providing psychological training, mental health awareness programmes, life-coaching and personality development programmes, and community empowerment work.   

What happens in counselling? How is different from talking to family?

Empathy and emotional support form basis to counselling. This is a support one possibly finds from family or friends. However, adding to this support a therapist is trained and skilled to appropriately conveying this for more consistent relief. It does not replace the warmth and love from close-ones, but provides an added advantage of reliability with absolute confidentiality and an unbiased and non-judgemental attitude to intimate most problems. 

Most importantly, counsellors are guided by professional and ethical principles that are mandatory to be followed. This makes personal sharing to be placed in trustworthy hands.   

Also, how many-a-times, one finds themselves in a position where 'nobody is able to understand you? Or How often even the most closest experienced family member or a friend is unable to support your times of emotional turmoil? And, also isn't it common experience that others happen to find the most important matter of your life as a trivial issue, something that will heal with time or 'just leave it'?

Factually not everyone can bear the weight of our stories. Therefore, a counsellor is a trained professional who is an expert in providing the necessary psychological assistance for a range of worries major or minor, intensive or casual and rare or routine. The concept is if it matters to you it does matter and if it has made you feel bad you have the right to feel so. However, rational or irrational the problem maybe, optimistically, there will be a way towards working through it. On the part of the individual, willingness to change is the key. 
With the use of psycho-therapeutic tools, counselling involves a methodological approach to guide client reflections and to lead an increased self-awareness for skill-development, behaviour modifications, development of better coping strategies and an enhanced ability for independent decision-making. 

A client and counsellor together work through the process. It becomes a customized or tailor-made process for every individual, depending on their available resources and environments. The entire journey for positive change requires co-operation of the client, i.e., to follow up with the action plans in order to get the desired outcomes. A counsellor is a catalyst to the process until the time of counselling termination. 

In a basic counselling process, one can expect guiding questions, introduction to therapeutic-orientations, relaxation and calming techniques, role-plays, home-work exercises, feedback exchanges, reading materials, training and regular follow-ups.

Sessions are planned depending on the nature of the problem. 6 to 12 sessions for short-term therapies and 15 to 20 sessions or more for long-term therapies. Length of counselling period depends on individual problems and the chosen course of therapy. It could take couple of months to a year for more visible positive outcomes. It is a step-by-step gradual process and requires patience.


What a counsellor is NOT going to do? 

Give you ready-made solutions, advice, make decisions for you or give validations/approvals or do your tasks for you. 

What can one expect as an outcome?

Depending on the goals, the aim is to attain a notable progressive change in terms of feeling, thoughts and actions and could be in an overall personality or an aspect of it.
Educational Qualifications&certifications of mental health professionals

Masters in Psychology (Clinical psychology/Counselling Psychology/Industrial Psychology) is mandatory for individuals to qualify as practicing Psychologist or counsellor. They are not allowed to prescribe medicines. 

A Psychiatrist is qualified with at least an MBBS degree, and prescribes medicines. Not all psychiatrists practice Psychotherapy or qualified to do so.

Role of Psychiatrist?

Combination treatment works effectively incase of mental-illnesses, i.e., symptoms of mental disorders can be effectively brought in control after which the client is able to respond to counselling therapies. Therapies generally foster self-management techniques and smooth functioning of routine life [5]. Few of the psychiatrists practice psychotherapies along with medical prescriptions. They also employ psychologists for application of therapies for their patients.

Note: Incase of mental disorders, prior to visiting a mental-health expert, carefully take notice of behaviours&symptoms and make a conscious note. These will benefit the treatment in order to progress in right direction. In absence of properly noted symptoms, the diagnosis could be erroneous and can lead to greater damage. Do not hesitate to ask your mental-health expert about the accurate name of the disorder diagnosed. Do not hesitate to take second opinions whenever required. Ask for revision in medicines incase of overwhelming side-effects. Consult the professionals before the discontinuation of medicines.


Important References:


1. BACP (October, 2010). What is Counselling and Psychotherapy? BACP: Customer Service. Retrieved on April 8, 2014 from http://www.bacp.co.uk/crs/Training/whatiscounselling.php
2. Kingdon, D. (June 20, 2006). The ABC of Cognitive-Behavioral Therapy for Schizophrenia. Psychiatric Times. Retrieved on October, 4, 2013 from http://www.psychiatrictimes.com/schizophrenia/abcs-cognitive-behavioral-therapy-schizophrenia
3. Kumar, A. (2011). Mental Health Services in rural India: Challenges and prospects. Vol. 3, No. 12, 757-761. Department of Rural Management, Xavier Institute of Social Service, Dr. Camil Bulke Path, Ranche, India. 

4. Mayoclinic staff. Depression (Major Depression). Treatments and Drugs. Mayoclinic. Retrieved on September, 23, 2013 from, http://www.mayoclinic.com/health/depression/DS00175/DSECTION=treatments-and-drugs

5. Mintz, D. (October, 1, 2013). Combining Drug Therapy and Psychotherapy for depression. Psychiatric Times. Retrieved on October 4, 2013 from http://www.psychiatrictimes.com/articles/combining-drug-therapy-and-psychotherapy-depression

6. Nolen-Hoeksema, S. (2005). Abnormal Psychology. 3Rd Edition. Publisher: Tata McGraw-Hill Companies, New York
7. Syed, S.N., Baluch, B, Duffy, L. & Verma, V. (2012). ‘British and Indian Attitudes towards Counselling: A quantitative comparative study’. Counselling Psychology Quarterly, volume 25, pg. 63-72, Routledge Taylor & Francis Group, UK.
8. Psychological Treatments. Sane Australia. Retrieved on September 24, 2013. http://www.sane.org/information/factsheets-podcasts/549-psychological-treatments