Articles & Links

Elements of Counselling; A handbook for counsellors

“Elements of Counselling; A practitioner’s handbook” is a book I and some colleagues
published a while back. The third edition has updates on existing content and some new
material. The book has been used by lay and professional counsellors, working in a wide
variety of situations and settings. In the book we look at aspects of counselling and at
psychotherapy. We talk about how lay counsellors usually offer shorter term therapy, and
how, despite this, they, just like psychotherapists, need training, support and supervision,
either from colleagues or from professionals who can help them understand and process
what they’ve heard from clients.

Even if you’re not a counsellor, the book is informative about the counselling process, and
what you might expect when you see a counsellor or therapist. There is sound information
about how sessions are structured, framed and formalized and what this does for both the
safety and boundaries of the counselling or therapeutic enterprise. There’s a section in the
book devoted to HIV and Aids, with information on pre- and post-test counselling and on
ARV therapy. The book comments on the supervision process as well as on topics every
counsellor and therapist need to be familiar with, like dealing with trauma.

In the section on children and parents we devote space to a method of working
therapeutically with children called ‘Special Time’. The big question when it comes to child
psychotherapy is ‘Who needs the intervention?’ Would it be better to see the parents, or the
child, or, as is often the case, both? Sometimes you can help a child best by seeing the
parents. Other times it might be necessary to bring the child to therapy. This can usually be
established through a consultation with the child’s caregiver. Here is something from
Elements of Counselling on Special Time, a method of being with a child who is given the
opportunity to play with an observant, caring adult.

“Gaps in developmental opportunities and the availability of attuned caretakers early on are
not necessarily undone by later improvements in attention and care towards children. If the
child’s development gets stuck, the child can be impaired in their social and emotional
repertoire.

A brief intervention, Special Time, involving careful observation and attentive playfulness can
identify and sometimes help remedy some of these gaps. This intervention is done directly
with a child. Observations and information about areas of difficulty for the child are then
communicated to teachers and caregivers.

Special Time offers children an experience of what they may have missed out on at an
important stage of development. It is neither psychotherapy, nor is it counselling. It is a
medium of relating and communication which offers the child special time to play.”
Special Time, in Elements of Counselling is written by D Hadley, M Tandy and T Coats.

Another area we focus on in Elements of Counselling is Depression and Anxiety, as well as
Substance Use and Abuse, which is on the rise in SA. We know that early detection and
treatment of depression and anxiety can make a huge difference to someone’s mental health
and to the way they work, relate and carry out their daily tasks. The problem is people often
fail to read the tell-tale signs correctly. Irritability is a major symptom of depression, along
with low mood, altered libido, changes in sleep, appetite, impaired concentration and
feelings of guilt or low self-worth.

Sometimes there isn’t one single event or marker one can point to as the cause of
depression. Instead, it can be the effect of an accumulation of stressors, which can all wear
you down into a less than optimal state where you may have become short-tempered, or
rude, or where you may be feeling that there are just too many demands being placed on you.

These are all warning signals which indicate that you might be suffering from depression.

The World Health Organization fact sheet on depression states:
– Depression is a common mental disorder. Globally, more than 300 million people of all ages suffer from depression.
– Depression is the leading cause of disability worldwide and is a major contributor to the overall global burden of disease.
– More women are affected by depression than men.
– At its worst, depression can lead to suicide.
– There are effective treatments for depression

Being able to talk to a skilled counsellor or psychotherapist is probably still your best bet.
However, more people are turning to mindfulness meditation practices to improve their
mental health. Popularised by John Kabat-Zinn, today there are thousands of programmes
offering trainings of one sort or another in mindfulness. I have been a meditator for many
years and can offer guidance in some basic meditation practices. This isn’t a substitute for
therapy, but may be used together with it,

Mental Health Resources

Mental Health Guidelines (NICE – United Kingdom)
→ View Guidelines

South Africa’s Mental Health Policy Framework and Strategic Plan
→ View Policy Framework

South African Depression and Anxiety Group (SADAG)
For online mental health support, including crisis support.
→ Visit SADAG

Child Mind Institute
→ Visit Website

World Health Organization (WHO)
→ Visit Website

Seizures & Epilepsy
→ Visit Website

Your mental health is as important as your physical health.

Your mental health is as important as your physical health. By Matthew Solan,
Executive Editor, Harvard Men’s Health Watch Reviewed by Howard E. LeWine, MD, Chief Medical
Editor, Harvard Health Publishing; Editorial Advisory Board Member, Harvard Health Publishing
(November 1, 2024)

Men often pride themselves on being helpful problem-solvers. However, sometimes they
need help dealing with their own problems stemming from emotional issues.
Many men have trouble processing their feelings and putting them into words, so they need
help finding solutions to their problems, says Dr. Stephanie Collier, director of education in
the division of geriatric psychiatry at Harvard-affiliated McLean Hospital.

This is where confiding in a professional therapist can help. Sometimes talking about a
problem with a friend or family member is useful, but other times it’s better to speak with
someone outside your circle, so you can feel more relaxed and open about sharing without
worrying about feeling judged, says Dr. Collier.
When you need help
Depression and anxiety are the most common reasons men seek professional help. Such
feelings often arise from grief, like the death of a spouse, friend, or family member. Other
situations that can trigger similar responses include health issues, financial anxiety, or the
loss of independence (like no longer being able to drive).
In addition to the trademark symptoms of prolonged sadness and lack of energy, men with
depression may adopt self-destructive behavior, like alcohol or opioid abuse. They may
experience changes in their social life, such as soured relationships or withdrawal from
favorite activities. Anxiety also can cause irritability, insomnia, and trouble with memory and
concentration.
While men may recognize these changes, they may not know the root causes, or if they do,
what they can do about them, says Dr. Collier. A therapist can work with you to identify the
source of your problems and then devise a strategy to resolve them.

Questions to ask a potential therapist
A good rapport with a therapist who matches your specific needs is essential for a successful relationship. Here are some
questions to ask as you consider working with a therapist:
 What’s your training?
 What certifications or degrees do you hold?
 How long have you worked in this field?
 What kinds of treatment or therapy do you use?
 What are the advantages and disadvantages of the different approaches, including medication?
 How does the treatment work?
 What are the chances that treatment will succeed?
 How soon should I start feeling better?
 How will we assess my progress?
 What should I do if I don't feel better with therapy?
How to find a therapist
The first step is to speak with your doctor about your situation, feelings, and symptoms.
They should be able to point you to a therapist who can help with your specific issues says
Dr. Collier. Online sources are also available. Many kinds of professionals offer therapy
(both in-person and virtual). They have different approaches based on their training,
education, and areas of experience.