Blog

Wednesday, 22 November 2017 00:00

Good news!

This is the K2 item version

Your answers today suggest you have no or very low symptoms of depression.

You probably are experiencing the normal ups and downs of life.

If you feel sad, but are not depressed, it could be that you’re grieving. Have you experienced some form of loss - a loved one, friendship break-up, death of a pet, health crisis, changed your job or residence?  In that case grief and loss counselling may help.

If you don’t meet the criteria for a depressive episode, but life seems pointless or meaningless anyway, existential counselling may be useful to you.

Otherwise, incorporate these factors into your life to increase your resilience and reduce risk of depression:


 

    •  Sleep - try to get at least 7 hours a night. For more tips on sleeping better, click here.

    •  Exercise - aim to complete 30 minutes of moderate physical activity on most days of the week.

    •  Social connection - make an effort to keep in contact with friends and family. 

    •  Maintain a routine - get up at the same time everyday and do activities that you previously enjoyed. Like the previous tip, even if you don't feel like it, the benefits will accrue if you persist.

    •  Practise mindfulness - there is evidence to show that mindfulness practice, involving non-judgemental awareness, can help in recovery from and prevention of depression. 

     


 

Download this depression prevention checklist to help build your resilience.

If you think you might benefit from counselling, click here to find out more and make an appointment. 

Tuesday, 13 June 2017 00:00
Is counselling effective?

Many people hesitate to seek help for life’s challenges or to address psychological conditions because they are afraid counselling won’t work. This is understandable. In the modern era - since the twentieth century at least - we have learned to expect that you can see your doctor and she or he will prescribe something, usually a medicine or a simple surgical procedure, that will make the problem go away. 

But psychotherapy (or counselling - I use the terms interchangeably) doesn’t seems different to these medical interventions in several respects. 

Someone who has never seen a psychologist or counsellor could straight away think of some of these differences, and why they might be a barrier to getting started:
  • It takes more than one visit, so perhaps it’s going to be expensive
  • Nobody I know talks about having done it, so I don’t know what happens in counselling
  • I don’t know how it works. At least with medicine I know it affects the chemicals in your body to set things right.
  • Even if it was quick, and I knew what happened in counselling and had some idea of how it’s supposed to work, how would I know it was working for me? Mental distress is not tangible or visible like a skin condition or a bacterial infection, where even people other than the patient can see or hear the difference.
Would it surprise you to know that psychotherapy is actually more effective than many medical treatments?

A couple of paragraphs of (painless!) statistics

Scientists use a statistic called effect size to be able tell how much more effective one treatment is than another (or than no treatment at all). It is used in health and medicine to tell you whether one treatment offers any benefits, in education to demonstrate whether a new teaching approach or resource improves students’ results and in agriculture to examine whether a breeding, crop management or fertilization strategy increases yield or reduces disease. As you can see from those examples, one of its main strengths is that you can use it in ‘real world’ or field research as well as in laboratory studies.

In the world of medicine, authorities such as the United Kingdom’s National Institute for Clinical Effectiveness (NICE) provides a guideline of achieving a moderate effect size of 0.5 to show that a minimally important difference (or MID)1. A MID, in layman’s terms, is a difference that most patients would notice. So this guideline of an effect size of 0.5 tells us that the treatment or procedure makes a difference that you’d probably notice. Makes sense doesn’t it? Nobody is interested in a difference that they can't notice. So this is the standard NICE requires to recommend medical interventions like spinal surgery and arthritis medication, but also for psychological treatments. For example when the patient says, “my sinuses have cleared” or “it’s hurting a lot less” or “I can stand comfortably”.

Minimally Important Difference

So how does psychotherapy fare on that measure?

Very well it turns out. Extensive reviews of psychotherapy studies consistently produce effect sizes averaging 0.8. So in brief, if you complete a course of psychotherapy, there’s a 79%2 chance that you will end up better off than the average person who didn’t seek treatment. This is with the ‘average’ therapist.

And what about therapists at the ACT of Living?

A little history first. Ever since I started practising counselling in 1994, I’ve been interested in questions like “Did the client get better?” “How much better?” “What could I do to make what I do more helpful?”. To me, asking these questions seemed obvious. Possibly that’s because i had spent much of the previous decade working in a sales environment where success and failure are tangible and binary - you either sold the widget or not! It’s not quite that straightforward in the field of mental health, but putting myself in the shoes of a client, I figured there would have to be a way to measure when a client detects a minimally important difference

Fortunately my curiosity led me to a group of researchers interested in the same questions. They had developed a couple of simple tools to measure when clients had improved or gotten worse (Outcome Rating Scale or ORS), and how helpful they found the therapist they worked with (Session Rating Scale or SRS) (because the latter had proved to be a major factor in improving the former). So from 2001 I started using these simple tools and tracking the effectiveness of the work I did. 

Naturally, when I founded The ACT of Living, I wanted to make sure that the work we did with our clients would be as effective as possible. Up until this time I'd been practising what you might call "effectiveness measures 1.0". With more and diverse practitioners coming on board at ACT of Living it was time to find something a bit more sophisticated, and at least as reliable as the old measures.

Effectiveness measures 2.0

Then in 2013 I came across ACORN - A Collaborative Outcomes Resource Network. ACORN coordinates the collection and processing of massive numbers of outcome and alliance questions administered by therapists in behavioral healthcare organizations, educational settings and community health care including private practice. As of the date that I am writing this post, May 25, 2017, ACORN has collected data from over 700,000 cases, with 76% of these clients being in the clinical range when they started therapy.

We commenced using the ACORN tools in late 2013, and our Associate Practitioners have used them with each client since then. Using these tools allows us to be able to tell: 
  1. when a client is improving, 
  2. when a client is not improving, and 
  3. when a client is deteriorating. 
This last point is really important, because research has shown that in psychotherapy, regardless of the kind of clients, their diagnoses, the counsellor’s qualifications or the counselling setting, approximately 7% of people who start therapy will actually get significantly worse. Obviously we want to minimise that, so if we know that that deterioration has started to happen we can change the approach we use with the client, or refer them to a more suitable therapist. I hope you can see that this will save you time, money and heartache.

How effective is therapy at The ACT of Living?

Considerably more than at the average counselling setting in the ACORN database. Since 2008 through to 2017, therapists in the ACORN database overall have produced an effect size of 0.78 for the clinical cases they've seen. Across 2015, therapists at the ACT of Living produced in effect size on their clinical cases of 0.99.

2015 ES

So if we say the average ACORN therapist is like an average therapist anywhere else, what this means is 79% of the time you will better for having seen them compared to just waiting to get better. Whereas if you see a therapist at The ACT of Living, 84% of the time you would have been better off for having seen them. Five percent may not seem much, but of course if you were one of the five percent, there's a 100% chance you’d be happier about it!

Percent Clients Improced

But there's even better news. Across 2016 for clients whose initial scores put them in the clinical range (think of this as severe distress) therapists here at The ACT of Living produced an effect size of 1.15. What this means in percentage terms is that you’d now be likely to better off 87% of the time with us than if you hadn’t sought therapy. Or if you’d seen an ACT of Living therapist in preference to an average therapist, you increased your chances of reliable improvement by 10%. Not only that, but your chance of getting significantly worse, instead of being 7% would only have been 2%. And the rate of improvement for our 2016 clients was faster than for those seeing the “average” therapist - by more than a factor of two times.

Improvement Deterioration

ACT of Living is an award-winning clinic

Recently Dr Jeb Brown, director of the Center for Clinical Informatics which coordinates the databases for the ACORN network, awarded The ACT of Living an acorn Center of Excellence (ACE) award for our achievements over 2015 and 2016. He had this to say about the 2016 results:
 “...all of the therapists [at ACT of Living] would be classified as "Highly Engaged" in FIT [Feedback Informed Treatment] and use of deliberate practice.  They are in the upper 15% of therapists. 

Your results exceed the gains reported in this study, which are already large.  Your effect size increased from .99 in 2015 to 1.15 in 2016.  This result in 2016 places you in the upper 5% of all sites using the ACORN platform."

Can we help you?

If you’re looking for a counsellor, I hope you’ll feel more reassured that by seeing an ACT of Living Associate Practitioner you’re giving yourself the best chance of improving your situation. To speak with one of our psychologists, email This email address is being protected from spambots. You need JavaScript enabled to view it., phone 03 9939 9437 or just click here to complete a self-referral form.

Footnotes

  1. Details on MID and ES from http://www.pocog.org.au/doc/MID%20FAQ_Dec2014.pdf
  2. It’s just a coincidence that the 79% figure is close to the ES of 0.8. Effect size can be higher than 1.0, but percentage of course cannot be greater than 100%. So an ES of 0.5 means you’re better off than 73% of untreated people, for an ES of 1.5 the figure is 92%

 

Wednesday, 05 April 2017 00:00

ACT of Living Privacy Statement (for www.actofliving.com.au)

Privacy Statement

This site is owned and operated by The ACT of Living. We recognise the importance of privacy protection. Because we gather certain types of information about our users, we feel you should fully understand our policy and the terms and conditions surrounding the capture and use of that information. Our policy for dealing with any personal information that you might disclose to us while visiting this website is explained below.

The type of personal information that we collect from you will depend on how you use our website. You can be certain that the information we receive about you will be treated as strictly confidential.

Personal information collected when you visit our public site

We do not collect or use any personal information on visitors to our website, through the use of “cookies” or other software or hardware techniques. We look at the number of hits the site receives and keep track of the domains from which this site is accessed. Under no circumstances does The ACT of Living divulge any information about an individual user to a third party.

The circumstances under which we disclose information about you

It is our policy not to sell or pass on any personal information that you may have provided to us unless we have your express consent to do so. An exception to this is where The ACT of Living may be required by law to disclose certain information.

How we handle emails

We will preserve the contents of any e-mail message that you send us if we believe that we have a legal requirement to do so. Emails sent to or from The ACT of Living are routinely monitored for quality control, systems administration and legal compliance purposes.

What to do if you believe the information we hold about you is inaccurate

If you believe that any information that we hold about you is inaccurate or out of date, please contact us and we will review and update the relevant information.

If you wish to discuss this policy

Please contact us and we will be happy to answer your questions.

Legal Framework

The ACT of Living website is covered by the federal Privacy Act 1988, which is an Australian law that regulates the handling of personal information about individuals. This includes the collection, use, storage and disclosure of personal information, and access to and correction of that information.

The ACT of Living website is covered by the Victorian Health Records Act. The Health Records Act 2001 created a framework to protect the privacy of individuals’ health information. It regulates the collection and handling of health information. The Act:

  • gives individuals a legally enforceable right of access to health information about them that is contained in records held in Victoria by the private sector; and
  • establishes Health Privacy Principles (HPPs) that will apply to health information collected and handled in Victoria by the Victorian public sector and the private sector.
DISCLAIMER

The information provided on this website is for use of a general nature only and is not intended to be relied upon as, nor to be a substitute for, specific professional advice. No responsibility for loss occasioned to any persons acting on or refraining from action as a result of any material in this publication can be accepted.
Wednesday, 29 March 2017 00:00

counselling therapy

People are referred to us for the treatment of:
  • Depression
  • Anxiety
  • Compulsive Behaviours
  • Obsessional Thinking
  • Stress Management
  • Addictions
  • Panic
  • Agoraphobia
  • Low Self-Esteem
  • Lack of Motivation
  • Lack of Direction


Counselling starts with listening to you as you relate your concerns. We’ll often ask questions for clarification. We do this because we're trying not only to understand what has been or is happening to you, but also how you see the world. We’ll often ask questions that are aimed at finding out what resources and strengths you have available in your life. A resource can be anything from a friend to a skill to membership of a religion, club, family or culture.

Once we’ve asked enough questions – and sometimes well before then – we’ll start generating solutions to your problem. A solution can take several forms, depending on the problem, the person and the environment in which the problem shows up. For some people the solution will be that the problem stops showing up. For others it will be that the problem shows up in a different way – it seems to be no longer a problem, or not as distressing. For yet other people the solution may be that they show up in a different way – as more resourceful, skilful, patient, graceful, confident, peaceful or happy.


What counselling isn’t.

Counselling is not teaching, giving advice, coaching, sympathising, psychoanalysing or making someone do what they should do or what is good for them. However, at different times these things may happen in a counselling session. But always in a context of respect and with the intention of reducing suffering.

To understand more about our approach to counselling and therapy email or call us today!



 

Wednesday, 29 March 2017 00:00

clinical-supervision-training


Help fulfil your Continuing Professional Development requirements for:


  • Membership: Australian Psychological Society

  • Membership: College of Counselling Psychology

  • Requirements: Medicare CPD

  • Provider: Focussed Psychological Strategies



Our founder Julian McNally offers supervision to psychologists, counsellors, social workers and other human service professionals. He specialises in supervision for those interested in Acceptance and Commitment Therapy. However he does offer supervision for other purposes and using other models than traditional one-to-one office-based supervision. .


In particular, the supervision on offer is suitable to fulfil Continuing Professional Development requirements with the Psychology Board of Australia, for Australian Psychological Society membership and College of Counselling Psychology membership, and for Medicare CPD requirements for being a provider of Focussed Psychological Strategies (FPS) items. If you are a clinical psychologist, you would be able to justify the ACT supervision we offer as it is an evidence-based treatment.


Julian has a broad portfolio of experience within supervision, as well as considerable personal experience in both group and individual supervision situations. This has included participating in and facilitating supervision groups with both single- and multi-discipline teams as well as with collegial groups of unrelated practitioners like the Melbourne ACT Peer Supervision Group which Julian coordinated for two years.


Our aim in providing supervision is to enhance both your effectiveness in session with clients, but also to support you in your ongoing professional development and growth. To that end, Julian routinely introduce supervisees to practices and models outside their experience/training.


Whilst Julian's own training and practice includes interpersonal approaches such as Rogerian counselling, Functional Analytic Psychotherapy and narrative therapy, he rarely use their methods in supervision "I do try to inform my practice with their philosophies though. The supervisee is not a therapy client! At the same time I promote the presence of the supervisor/practitioner in the room to model this skill for the supervisee/client."


Channels of supervision currently in use include in-person and telephone. He also has interested in providing online chat including video chat if technical problems can be overcome simply.


Activities in supervision include case discussion, questioning, reflection and reflective listening, role plays and simulations and between-session writing.


To find out more about supervision with Julian, call him on 0425 603 702 or email This email address is being protected from spambots. You need JavaScript enabled to view it. and we can arrange a free initial consultation to establish suitability and a supervision agreement.



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