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. 3^Rd 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

http://www.nhscareers.nhs.uk/explore-by-career/psychological-therapies/careers-in-psychological-therapies/psychotherapist/the-talking-therapies/

http://www.dbsalliance.org/site/PageServer?pagename=wellness_brochures_psychotherapy