What to expect when you see a psychologist

Written by Medibank

It could be lovesickness or heartbreak, or the death of someone close to you. It could be a stressful job, a difficult family relationship, or trouble making changes in your life. Or you could be feeling anxious or sad all the time, and not even be able to pinpoint why.

There are plenty of reasons why you might seek help for your mental health. Psychologists are there to help you feel better, teaching you strategies for managing your thoughts and feelings. Just as you would go to the doctor to treat an infection or injury, psychologists are experts on the human mind and have evidence-based tools for treatment.

And yet, we often don’t think about our mental health in the same way as our bodies. For a lot of people, the idea of seeing a psychologist can feel pretty daunting. Often, it comes with feelings of shame, embarrassment and fear.

“Mental health issues are often still seen as a sign of weakness, and there’s a bit of a stigma,” says Ros Knight, clinical psychologist and president of the Australian Psychological Society. “I think some people are loathe to see a psychologist because they think it means they’re admitting defeat and that they’re weak.

“When you have a physical illness, you know the faster you go to a GP when you notice something’s wrong, the more likely it is that it can be fixed quickly. We should look after our mental health the same way.”

What does a psychologist do?

There are lots of myths and misconceptions about what psychologists do, which can contribute to people’s discomfort. Movies and television often don’t help much with this image.

“A lot of people think we’re magicians,” Knight says. “They think we can mind-read and will pick them apart, and that all their weaknesses will come to the fore. That’s not what we do at all. What we do is help people to change, from a science-based perspective. How far that goes is up to the person who sits in front of us.”

Psychologists in Australia must have at least six years of university training and supervised experience. Many hold Masters degrees or PhDs, and have specialised training in specific areas of practice. The Psychology Board of Australia has a strict code of ethical and professional practice that all registered psychologists must follow, and they are required to engage in ongoing professional development to keep their knowledge and skills up to date.

Unlike psychiatrists, they are not medical doctors and cannot prescribe medication. But psychology is a science, and therapists do much more than just listen to you vent. “There’s definitely a perception that we’re going to sit on the couch and talk all about childhood, and that it’s just a long-winded chat that goes nowhere,” Knight says.

There are lots of different therapies and techniques a psychologist might use to help you. Some of the most common ones include cognitive behavioural therapy (which teaches you to challenge helpful thinking patterns) and interpersonal therapy (which focuses on solving relationship problems).

“You should have a sense of something changing, either through that conversation or through doing things between sessions. It’s really essential to understand that it’s aimed to be proactive and productive.”

Referrals, costs and rebates – what you need to know

A good first step in seeking mental health support is to talk to your GP. You can see a psychologist without a referral, but you will need one to get a Medicare rebate.

After asking you some questions about what’s going on and how you’re feeling, your GP may decide to refer you to a psychologist and write you a mental health treatment plan. This plan entitles you to a Medicare rebate on six sessions with a mental health professional, to be used within the calendar year.

You should be aware that in many cases the rebate does not cover the full cost of a psychology session, and you will likely also have to pay an out-of-pocket fee.

Once you’ve had your six sessions, you can return to the GP for a referral for an extra four sessions, bringing you to a total of 10 Medicare subsidised sessions per calendar year.

For more than 10 sessions, you will need to pay the full fee. This is where private health insurance can also help. If you have Extras cover that includes psychology, your private health insurer may pay benefits towards further psychology sessions, up to your annual limits.

Your first session – what to expect

It’s natural to feel nervous about your first session. Psychologists understand that you may be feeling vulnerable about opening up and sharing personal information with someone new.

In a typical first session, your psychologist will start by explaining what you need to know about the Psychology Board of Australia’s code of ethics and professionalism, and what you can expect from working with them.

“Confidentiality and privacy and all the restrictions around seeing a psychologist should be explained to you, so that you feel comfortable. There is a very high level of privacy, so you should feel very safe about what’s happening to your information,” Knight says.

“Then most psychologists will ask lots of questions about what brought you through the door. What’s happening, how it’s affected you, and how that fits generally into your world, who you are and your previous experiences.”

It can feel like a lot to reveal, but giving as much information as you can will help your psychologist understand how they can best help you.

“The first session is lots of questions, but towards the end you’re in a space to talk with the psychologist about the best approach going forward.”

Getting the most out of therapy

To get the most out of your psychology sessions, Knight says it’s important to be an active participant. “Be willing to talk. Be willing to be open and put things out there, because if you’re hiding something your therapist may misdirect,” she says.

“Like everything else where change is concerned, be willing to put in the effort. Change really depends on you doing the things during the week your therapist suggests to make that time effective.”

And if you don’t feel comfortable with your psychologist, it’s perfectly okay to look around for someone else. Trust is essential, so it’s worth finding one you click with.

“Therapists understand that not everyone is going to particularly like them and their style. It’s an individual choice – none of us are magic, and personality and other attributes come into how comfortable we feel,” Knight says.

“If you’re not comfortable after a couple of sessions, then call it what it is and move on and try another therapist.”

To find a psychologist near you, you can search the Australian Psychological Society directory.