Well meaning but hazardous - how to tell when to listen to mental health advice
We have never before had such easy access to discussions and advice about mental health, we see it on socials, in the media, our friends and workplaces are talking about it… it’s become a hot topic that shows no signs of becoming less hot!
In many ways this is great! Finally moving away from the stiff upper lip, let’s not talk about feelings approach is a psychologists dream! But we have now hit up against a new challenge… with so much information out there how do you know what to listen to and what to disregard?
We see this in therapy all the time, we see the impact of people thinking that nothing works for them or even worse people living with the impact of detrimental mental health advice. The sad truth is that for many, bad mental health support is far worse than no mental health support. We see cases where well intentioned people have inadvertently given poor advice and this has had a catastrophic impact upon a person’s wellbeing. This can mean the first part of the work we do with them is mending the damage of previous “support” before moving into working on the area that required support in the first place.
This is not to say that advise and support is coming from a bad place, often people share information from the best of intentions, wanting to share things they have heard or things that have helped them in the past. This is what makes this issue so hard. Personal experience or interest in the topic can validate and support someone in their journey but it is rare that this is sufficient to treat someone with the expertise needed to create meaningful change.
A metaphor I sometimes use is that as a clumsy person I have ended up in A&E a fair few times, one time I had to have a metal pin put through my foot. Now from that experience I know what it is like to have a broken foot and have it mended. I understand the process of how to fix it and I read up on the operation so I have a good first hand knowledge this procedure… but that does not mean that I am in any way equipped to perform this procedure on someone else! My personal experience is not the same as my surgeon’s training and experience.
This might seem like an extreme example but the thing is that therapy can actually change our physiology. Just like a surgeon changed the structure and function of my foot during that surgery, so too a therapist changes the structure and function of our brains through neuroplasticity. Our brains are made up of billions of neurons wired together and how they are wired creates our reality. This means it has the potential to create distress or wellbeing, a fact that we as Clinical Psychologists are acutely aware of and this is why we are so careful with our therapeutic approach. We follow the research and evidence base and combine this with our experience and knowledge of the person to tailor therapy to re-wire problematic connections and help the person meet their goals. It could be argued we are over cautious, too nerdy, spend too much time reflecting and refining our approach! But when someone’s wellbeing is at stake I would argue that flippancy is dangerous!
Now obviously there are levels of support and different options to access, not everyone needs expert or intensive support. It is also important to acknowledge that we are positioned from a clinical, western stance and completely appreciate that this is not the only valid option. However after years in the field I have learned to spot the themes and signs that are important to look out for and I have outlined these below:
Does their training match your needs? As aforementioned there are different levels of support and that’s ok but it’s important to think does this person have the training needed to support you, ask them about their training and registration with professional bodies. If you are looking for anything more intensive than space to talk it is important to choose someone who has been trained in an evidence based treatment and is registered with the HCPC or BABCP. No decent clinician would be offended by being asked this and should immediately be able to provide you with these details.
Are there mechanisms for accountability? It’s important to think about who holds your clinic accountable - do they receive supervision? Are they professionally registered? Who would you be able to talk to if you had concerns about the care you are receiving?
Do they prioritize your needs over their agenda. This is a big one for me, it’s a huge red flag if you feel pushed to talk about things that make you feel uncomfortable or you feel that the sessions are not tailored to your needs. This is particularly the case when looking at trauma, your clinician should support you to manage distress and emotions before digging into traumatic events and you should always be listened to if you express that you are not ready to explore a topic.
Have you seen change? This is an indicator of whether the approach is working for you, even with complex cases you should be able to notice changes in your thoughts, feelings, actions or understanding. If you have had many sessions and little change it’s time to ask why. There is an interesting paradox here in the private sector regarding cost. I have seen many people where they have had 20+ sessions of counselling because it felt more affordable but then seen less progress than we have seen in 6 or fewer sessions. The irony is then that the more expensive option actually turns out to be the cheaper one!
Does it work for you? A personal bugbear for me is poor application of good principles. This is a hallmark of undertrained or inexperienced clinicians. Mindfulness is the most common victim, it has a good evidence base, the ability to cause good change but is so often applied as a panacea or without reference to how, why or when it works. I cannot count the times that I have experienced people trying to lead mindful body scans to large groups of people hailing it as a safe and effective way to restore peace and improve wellbeing. For many in the room this may be helpful but for people sitting their with a history of eating disorders, uncomfortable physical experiences, active flashbacks or neurodiversity you may be putting someone in an incredibly difficult position where they may feel othered or actively unsafe. Even for people without these difficulties mindfulness needs to be tailored to be effective. This fundamental misunderstanding of the approach being used can make a good approach either ineffective or actively unhelpful. Good clinicians carefully consider who the approach is developed for and how to ensure it is used safely, there should always be options and choice, you should always feel supported and consenting in any approach that is aimed to change the way you feel.
Do you feel safe and understood? This links to the point above therapy can be challenging, it can be hard work and it can lead to strong emotions but you should always feel that the person leading you is able to contain your feelings and meet your needs. Therapy is a partnership where you are working with your clinician to meet your goals, if it veers away from this it’s important to raise this and your clinician should adapt to support you. If they don’t that’s a huge red flag!
Do they recognize their own limitations? We all have limitations, there is no perfect therapist with all the answers and as clinicians we should be able to know where our limitations are and when we are not the right person for you. Clinical psychologists are one of the most highly trained mental health professionals but we all have areas that we are less practiced in, when we meet a client that falls into this bracket it is our duty of care to recognize this and support the person to find the support that is right for them. Again this comes with training and experience. If you feel that the advice you are receiving falls outside the scope of the person’s training it is time to name that and potentially move on. Your wellbeing deserves more than someone giving it their best shot!
I hope these points are handy in navigating the minefield of mental health and well-being advice. Remember that just because something sounds good, doesn’t mean it is! Check out the credentials and remember if something doesn’t work for you or feel right it’s unlikely that you are the problem! It’s probably the approach or delivery. You deserve great care, keep searching until you get it!!!
If you have any questions do feel free to contact us at info@corecollective.uk and we will be happy to support!
Written by Nicola