Tiffany Mills
Counselling & Psychotherapy

No. You don’t need a GP referral or Mental Health Care Plan. However, Tiffany is currently working on becoming an Accredited Mental Health Social Worker which means by late 2023 you can see your GP for a Mental Health Care Plan and be eligible for a Medicare rebate. Either way you will receive the same individualised therapy suitable to your requirements.

Yes. All your records are stored according to the PACFA Code of Ethics to protect your identity, privacy & confidentiality. Information about you is not passed on without your consent. If you require any reports or letters for any reason, I collaborate with you about what is included. There are a few ethical & legal exceptions related to confidentiality, including: Risks to your safety or the safety of a third party (if the circumstances are serious enough to justify disclosure); When required by the law e.g., reporting of child abuse; If I am subpoenaed by a court of law.

While the terms are used interchangeably, they are a little different. Counselling will help you deal with life issues that you are consciously aware of & provide practical & immediate attention to those issues. It can help you: Process strong emotions such as grief or anger Clarify issues & help identify options in important decision making Give you strategies for dealing with stress or anxiety Learn relational strategies for managing conflict & boundary setting Develop better communication skills Become better aware of your own values & beliefs Identify limiting thought patterns & beliefs Build personal resources to live life in a more meaningful, intentional manner Psychotherapy will address all of the above (as relevant to your needs), & then go deeper to explore the unconscious things we believe about ourselves & our world that affect the quality of our life & relationships. It can help you: Explore long-standing attitudes, thoughts & behaviours, & their origins Become deeply self-aware & self-connected, which improves relationship to self & others Discover the root causes of repetitive yet puzzling behaviours & choices that weave through similar contexts & relationships Discover a deep self-acceptance, which addresses worth and self-esteem issues Be empowered to get free from the grip of unconscious triggers or impulses that keep you feeling ‘stuck’ Achieve deep & lasting change (which leads to deeper contentment & peace) At times someone will present for counselling for an issue that can be resolved on the surface but will ‘pop’ up again when they stop using conscious strategies to manage that issue. This is usually an indication that deeper work is required. Counselling & psychotherapy in general can feel uncomfortable at times. Looking deeply at yourself can be unsettling! It takes courage but is very worthy work to do. It’s an investment in your future self that can set you free to live a healthy life where you are more able to cope with the inevitable difficulties of life. It is essential that you have a safe & collaborative therapeutic relationship with your therapist to be able to do this work.

It’s confusing! There are significant overlaps in areas of practice. The most important consideration is that no matter who you see, they need to be members of their associated professional body & thus meet rigorous standards to qualify & practice. One thing to remember is that not all Psychiatrists, Psychologists & Social Workers provide counselling or are especially skilled in it – they all have particular areas of specialty. A Counsellor is specialised in counselling, & even then may only focus on particular areas of counselling work. Psychiatrists are medical doctors with specialisation to focus on the cause, diagnosis, treatment, & prevention of mental health conditions. They routinely deal with complex & serious mental health illnesses. They approach mental health issues from a biological perspective first & consider possible underlying health or genetic conditions in their diagnosis. They then prescribe treatment in the form of medication, therapy or both & will monitor that treatment with regular or semi-regular appointments. Only GP’s & Psychiatrists can prescribe medications for any mental health conditions. Psychologists – General & Clinical - can work in multiple settings & assess, diagnose & treat a wide range of clients & areas of concern. They use evidence-based psychological approaches. They are often called upon to conduct psychological assessments & write reports for individuals, education & forensic settings, health & government departments. Clinical Psychologists provide a wider range of psychological services for mental health conditions that range from mild to severe & complex. They receive specialist training in the assessment & diagnosis of mental illnesses & psychological problems are & qualified to provide advice in clinical & compensation areas. They often conduct research on prevention, diagnosis, assessment & treatment & are involved in the design & implementation of treatment strategies in various settings (such as primary care, psychiatric & rehabilitation) & in the subsequent evaluation of treatment outcomes. Where appropriate, Medicare rebates are available via mental health plan referrals. (Source: Australian Psychological Society) Counsellors work across a variety of settings & use evidence-based approaches in their therapy. They draw upon a set of psychotherapeutic & psychological theories along with advanced interpersonal skills which emphasise the process of facilitation & collaboration. They also often employ other styles of therapy to uphold a client-centred process, such as psychoanalytic talk therapy, expressive therapies, somatic therapies, mentoring, career counselling & many more. Counsellors are non-diagnostic in their approach & work outside of a medical model, meaning they call people clients, not patients, & consider the social, political, cultural & spiritual contexts people come from taking into account how they affect their client. They work from an ethical framework based on respecting their client’s values, beliefs, uniqueness, & uphold the right to self-determination. “Psychotherapy & Counselling are professional activities that utilise an interpersonal relationship to enable people to develop self-understanding & to make changes in their lives.” (PACFA). A highly trained counsellor will recognise more complex mental illness & refer you to your GP to seek psychiatric diagnosis & treatment. This doesn’t mean you need to stop working with your counsellor. If you find the sessions beneficial & have a strong therapeutic relationship then it is advantageous to have ongoing counselling to support psychiatric care. Counsellors don’t require a GP referral, so none of what occurs during the process is recorded in your medical records. It’s important to note that any Counsellor you see should have appropriate tertiary education in the field, including supervised clinical practice hours & clinical supervision, & be a registered member of either PACFA or ACA, the two regulating bodies for the counselling profession. At the moment no Medicare rebates are available for counselling or psychotherapy. Social Workers, specifically Accredited Mental Health Social Workers (AMHSWs, or ‘clinical’ Social Workers), have additional training & expertise in order to specialise in providing psychological support to people. They use a wide range of evidenced based focussed psychological strategies & therapeutic interventions to help people with a wide variety of mental health disorders. The AASW calls them “experts in complexity”, as their advanced training allows for them to work with people across the lifespan & provide a unique contribution to the mental health space due to their holistic approach. AMHSWs are highly trained & educated professionals, meeting some of the highest standards of professional regulation in Australia. AMHSWs help individuals to resolve psychological problems, & associated social & other environmental problems, to improve their quality of life. Social Workers recognise the broader implications of an individual having a mental illness & the impact on friends, family, work & education & vice versa. Where appropriate, Medicare rebates are available via mental health plan referrals.

It really is up to you. We can collaborate to figure out what suits your needs & finances. Most people start by coming weekly or fortnightly for a while, then they space out their sessions as they feel more competent to manage their mental health with the skills they are learning. Research indicates clearly that people who attend counselling regularly tend to have better outcomes in therapy than those that attend sporadically. Many people find therapy valuable to come back to for check-ins after their initial work is done to maintain their mental health (as you would take care of other health needs). Some people find it helpful to have a tool for problem solving, especially when needing to speak to an impartial person who is on their team but not a family member or friend.

It’s vital to find a therapist with who you feel safe enough to talk openly about your issues - someone who “gets” you, is interested in what you want to achieve, & has the skills & insight to guide you there. If after 2 – 3 sessions you are not feeling connection, then you may have to try a few different therapists to find your ideal one, but don’t give up. It’s worth it to find the one that’s right for you. A proficient therapist won’t take offence because they understand that it is crucial to the therapy process to feel safe & comfortable with them (& we understand that we can’t be everyone’s cup of tea!). They may even be able to give you some recommendations for who to try next. There is, however, a difference between feeling internal discomfort associated with doing the work of counselling/psychotherapy & feeling uncomfortable with your therapist. Perhaps a part of your personal work involves learning to trust (a person &/or a process). You may need to push through that discomfort to learn from it rather than run from it. If this is a concern then definately talk to your therapist about it.