10 Questions to Ask Your Prospective Counsellor or Therapist Who Works In English

Questions for Therapists

Have you reached a turning point in your life and want to find therapy in English?

Do you need counselling for relationship issues, stress or a break-up?

Or would you like to find an English speaking coach to improve life generally?

Here are ten important questions to ask your prospective counsellor or therapist. I’ve provided my own answers to give you a sense of where I fit according to these criteria:

1. How long was your therapy training?

My therapy training commenced when I started training as a counsellor in 1989 and it has not stopped since! Over the last 20+ years I have undertaken Bachelors and Masters degrees in Social Work, specialist narrative psychotherapy training through the Dulwich Centre in Adelaide, Australia and completed many short courses and workshops in a range of therapeutic approaches. These include CBT (cognitive behaviour therapy), mindfulness, psycho-education (including motivational interviewing), stress management, relaxation strategies, problem solving, anger management, therapy for adult survivors of child abuse and couples counselling.

A good therapist does not stop his or her education simply when a qualification is achieved. Professional development must be ongoing. Each year I attend a number of training activities and conferences and regularly share the outcomes of these with my clients.

2. Under which title, coach, counsellor or psychotherapist would you be allowed to work in your own country?

In both Australia and England, I am allowed to use all 3 of these titles: coach, counsellor and psychotherapist. In Sweden the title ‘psychotherapist’ (or psykoterapeut in Swedish) is a protected title and only practitioners licensed by the Swedish National Health and Welfare Authority – Socialstyrelsen – can use that title. I have not applied to be licensed as a psychotherapist in Sweden and instead refer to myself as a samtalsterapeut (counsellor) or narrative therapist in my work. Psychotherapist training in Sweden is limited to certain methods or approaches and applicants for a Swedish license must demonstrate compliance with particularly Swedish requirements. I have found that most of the people who meet with me are far more interested in the benefits of a therapist who speaks their language and understands their culture than they are in meeting with someone who fits precise Swedish requirements or works through the Swedish healthcare system.

3. How often do you have supervision?

I generally attend supervision at least twice a month and my commitment to supervision meets the recommendations of the AASW and BACP. Supervision for counsellors and therapists is not the same as supervision in a management situation. It means something completely different. It is about discussing professional issues in a structured way and ensuring the counsellor or therapist is taking care of their own well-being. It helps counsellors, psychotherapists, psychologists and social workers ensure their integrity and ethical practice. Counsellors and therapists in private practice will generally be paying for private supervision from a more or equally experienced person. I have such an arrangement with a more experienced practitioner and also engage in regular peer supervision with colleagues.

4. How long have you been practising?

I began practicing as a counsellor in 1989 and have worked across the community, government and private sectors over the years. Since 2005 I have been specialising in mental health counselling and therapy. I commenced private practice as a therapist and mental health counsellor in 2008.

5. What is your theoretical approach?

My practice is informed by a range of theoretical approaches. When undertaking advanced therapeutic work with people, it tends not to be helpful to be limited to a singular technique or method. In Sweden, counselling and therapy is dominated by Cognitive Behaviour Therapy (CBT or KBT) and Psychoanalysis but there are many other ways of working together if these do not appeal to you. I am particularly drawn to dialogical and narrative practices and the work of a number of well-known therapists including Harlene Anderson, Johnella Bird, Art Fisher, David Epston, Michael White. If you would like more information about these approaches, I would be happy to send you some links if you email me for details.

6. Do you offer a 50 or a 60 minute hour?

My standard appointments are 60 minutes but longer appointments (75 minutes or longer) can easily be negotiated. I generally leave at least 15 minutes between appointments and, if I have more time available, I usually don’t mind if we continue a little longer if it is helpful to you.

7. What do the initials behind your name actually mean?

Currently the initials after my name are: BSocWk, MA, MAASW (acc.). They stand for Bachelor of Social Work, Master of Arts and Member of the Australian Association of Social Workers (accredited).

8. Are you an accredited member of a professional organisation?

Yes, as above, I am an accreditated member of the AASW in Australia. This accreditation means I have a qualification awarded by a professional association as a specialist mental health provider and can offer focussed psychological services under the Australian government Medicare program when I am meeting with clients in Australia (similar to the services provided by psychologists that are reimbursed by the government there). The AASW supports my practice in Europe and represents my professional interests, however unfortunately Medicare will not reimburse appointment fees unless we meet in Australia.

9. Do you have insurance?

Yes, I hold both professional indemnity and public liability insurance.

10. Are you registered for tax in Sweden?

Yes, I am fully registered with Skatteverket, the Swedish tax authority and required to invoice moms (consumption tax) on my services in Sweden. If you require your invoice made out to a particular company name, please advise me in advance.

Extra question: How old are you?

Some people want to know how old I am and I am quite open about my age. I was born in 1969 so at the time of writing this, I am 43 years old.

You can read more on the About Ash Rehn page. If you are interested in making an appointment, please contact me by email or phone. I’m happy to answer any further questions you might have.

Can Depression that Started in Sweden be Treated with Exercise?

man running

man runningImprovement to mood is one of the most obvious effects of exercise. But can exercise actually be used as a treatment for depression?

An article recently featured in the Stockholm daily newspaper Dagens Nyheter says it can.  Jill Taube, a Swedish psychiatrist, has written a book about how exercise can help to cure mental illness. She points to studies that show the effects of exercise not only last longer than those of antidepressant medication, but physical activity appears to prevent the recurrence of depression better than antidepressants.

Exercise: A Prescription for Depression

Taube’s exercise ‘prescription’ echoes what the health and fitness experts have been saying for at least 20 years: a combination of cardio and strength activities for 30-45 minutes, at least 3 times a week. Obviously those who have not been exercising need to take it easy to begin with and build up to this. But the idea that there is something people can do themselves about depressed mood is great news for those who want to recover from depression and need more hope in their lives (although it might depress the drug companies!).

Antidepressent Use in Sweden, an Increasing Trend

What makes this research so remarkable is that Sweden has one of the highest rates of antidepressant prescription. According to OECD statistics, Sweden has the 3rd highest consumption rate of antidepressants in Europe (after Iceland and Denmark). And antidepressant prescription is on the rise in Sweden. The National Board of Health and Welfare (Socialstyrelsen) has issued guidelines to try to cut the rise of prescribed depression medication and encourage the use of talk therapy. But these changes will take time because the culture around prescribing antidepressants needs to change. A survey of GP attitudes from 2004 indicated that most doctors considered drug treatment with antidepressants alone was effective and sufficient in most cases of depression. Less than half the doctors thought that psychotherapy was required as a complement. This is despite reliable evidence of the effectiveness of talk therapy against moderate depression and the combination of counselling with medication being considered best practice. There is also evidence that effectiveness of antidepressant use really depends on the therapeutic relationship between doctor and patient.

Relief for Anxiety and Depression through Exercising

As a doctor, Taube is concerned with biochemical explanations of how exercise actually works and the article in Dagens Nyheter explains some of this. For the layperson it’s enough to know that it does work. Therapists are familiar with the way depression often goes hand in hand with anxiety (I often describe them as hanging around together, like schoolyard bullies) so it’s no surprise that exercise appears to help relieve anxiety as well.

Taube, who has herself experienced depression, is a dancing enthusiast but explains that other exercise like taking a walk or spin class can give the mind a break from Anxious Thoughts. We know that mental health difficulties can generally lead to poor physical health not only because problems like anxiety and depression stop us from getting out and enjoying life, but because the drugs that are prescribed for them have a slowing down effect on those who take such drugs. So people who are taking medication because they are affected by anxiety, depression and other mental health problems often gain weight and suffer cardiovascular difficulties or musculoskeletal problems because they don’t move themselves as much. Of course it is important to still seek the help of health professionals, particularly if you are experiencing a severe depression or having thoughts of wanting to end your life. Talking together regularly with a doctor, counsellor, therapist or psychologist is a better alternative to just taking drugs on your own.

In 2012 I will be continuing Walking-Talk Therapy  for those who want to have therapeutic and coaching conversations ‘on the go’. Going for a walk together through Rålambshovsparken, along Norr Mälarstrand or around Riddarfjärden is a great physical alternative to sitting down. Of course, if you prefer to talk inside, we can still meet over a tea or coffee in my private consulting room at Fridhemsplan. And for those who are outside of Stockholm or prefer more privacy, online counselling is always available over the internet.

Send me an email or call me on 08-559 22 636 and leave a message if you would like to make an appointment.

Jill Taube’s book “Själ och Kropp” is widely available from book retailers and online, but unfortunately only in Swedish at this stage.