BSocWk, AMHSW, MAASW, MACSW, MANZMHA, MPACFA.
I have been a Clinical Social Worker for 30 years and an Accredited Mental Health Social Worker for over half of that time, and am currently completing my Masters of Counselling.
While each of my previous professional positions has been highly generalist in nature, each has seen me working with people in the community who experience a range of mental health issues including:
- mood disorders such as depression, Bi-Polar Disorder, Post-Natal Depression, Dysthymia and Seasonal Affective Disorder;
- anxiety disorders such as panic attacks, generalised anxiety disorder and Post Traumatic Stress Disorder (PTSD);
- personality disorders such as Borderline Personality Disorder and Narcissistic Personality Disorder; and
- dissociative disorders such as Dissociative Identity Disorder.
Many of these people have had co-occurring substance use issues, and others have experienced significant trauma (eg chronic childhood abuse, Defence Veterans, Victims of Violent Crime such as sexual assault). My framework for professional practice has developed in accordance with the requirements of these past positions, and I have a particular interest in working with people who have experienced trauma.
My therapeutic approach is eclectic in nature, drawing on a broad knowledge and theoretical base which includes:
- Cognitive Behaviour Therapy (CBT);
- Person-Centred Therapy;
- Strengths-based Theory;
- Interpersonal Therapy;
- Psycho-educational Therapy;
- Skills training (eg assertiveness, communication, personal effectiveness, resilience, problem solving, relaxation techniques, anxiety management strategies, goal setting, anger management strategies, stress management strategies);
- Lowenberg’s Broad Typology of Problems;
- Motivational Interviewing;
- Alcohol education;
- Systems Theory;
- Neuro-Linguistic Programming (NLP);
- Satir’s Communication Model;
- Attachment Theory; and
- Crisis Theory.
I vary my interventions in response to clients and their situations. As my interventive repertoire is broad-based, I am able to work with a broad range of people with issues encompassing a wide spectrum.
In each of my previous positions, I have undertaken comprehensive psycho-social assessments encompassing peoples’ living situations; mental health issues; their economic situation; employment; education; legal situation; drug and alcohol use; social history (including family, friendships, culture, language, religion, sexual history, marital status, special interests); responses to illness (including affective and cognitive, expectations and perceptions, interpersonal factors); and so on.
In conducting my assessments, I often meet with the person’s carers/significant others, to gather additional information and to ascertain the impact of the presenting problem/s on the person’s home life. People often don’t realise the extent to which the people in their lives are being impacted upon by their illness or behaviour. Providing such information can be very powerful in altering a person’s perspective and/or motivation to make alterations.
I adopt a person-focused care approach in my professional practice. The assessments I undertake are aimed at accumulating a comprehensive knowledge of people and their lives, as I am of the belief that such knowledge provides the basis for better recognition of problems/needs. It also facilitates appropriate care.
Person Centred Therapy
I specifically focus on the whole person in my assessments and interventions with people. A person-focused care approach also guides care and intervention with consideration of the changing/various contexts in which people live and work.
For example, a person may be experiencing stress and a lack of confidence in their ability to manage a child’s difficult behaviour. However, they function very well as a manager in their job.
In such a situation, I may highlight the success they have at their job and assist them to analyse the reasons they are successful in that realm and identify the skills they utilise at work. The process may then see us working out how they could put these skills to work in relation to their management of their child’s difficult behaviour. In essence, I bring their strengths to the fore so they can see how they can use them in another situation. I am of the opinion that better care results when a person’s whole life is recognised, rather than just their diagnosis.
Defence Force and Veterans
I identify strongly with Defence personnel, veterans and their families, as I come from a family with a generational history of Defence Force service; for example my father was a career soldier and is a Vietnam Veteran.
During the period between August 2003 and May 2012, I worked in private practice and I provided services to the clients of Veterans’ and Veterans’ Families’ Counselling Service (VVCS – now called Open Arms), such as:
- general psycho-social/psycho-therapeutic counselling;
- adjustment and relationship counselling;
- parenting support;
- anger management;
- basic life skills (re)training;
- drug and alcohol counselling;
- stress management;
- grief and loss counselling.
The issues for which clients were referred included mental health issues such as PTSD; Bi-polar Disorder; depression; anxiety; relationship difficulties; anger management; parenting; drug and alcohol misuse. Many of these issues were related to veterans’ and serving members’ overseas deployments.
In each of my positions I have routinely provided:
- psycho-social assessment;
- crisis intervention;
- bereavement intervention;
- provision of education and information;
- case management;
- service co-ordination;
- resourcing; and
These activities have been undertaken to maximise psycho-social functioning for the client and their significant others; and to ensure awareness of and access to required support services.
A Collaborative Approach
I frequently work with other professionals such as psychologists, medical practitioners – general and specialist, nursing staff, occupational therapists, physiotherapists, speech therapists, chaplains, rehabilitation counsellors, supervisors and military commanders to maximise the participation of the person and their significant others in the process of resolving issues and future planning; and to maximise the person’s and their significant others’ adjustment to change. In many instances I have worked collaboratively with these professionals in managing cases in order to affect optimum outcomes for our mutual clients.
I have undertaken group facilitation to provide support and education to various groups of people including those with specific issues (eg cardiac patients, survivors of sexual assault, women with post-natal depression), and general issues such as stress management, relaxation training and coping with change.
I have facilitated the development of informal support networks (for example, a support network for the partners/carers of people with end stage renal disease ie dialysis patients) and broader community development activities such as the establishment of a free bus service between Hervey Bay and Maryborough Hospitals (a journey of 30 minutes). I have also provided professional development activities to colleagues (eg presentations on neuro-linguistic programming (NLP), team building, impacts of sexual assault).
In my professional practice, I adhere to the principle of client self-determination. I work from a strengths-based, person-centred framework and believe that each person is the expert in their own life. I see my role as:
- enabling and assisting people to enact their choices and achieve the goals they set for themselves in their lives;
- providing additional information to people to enable them to make informed choices;
- advocating on their behalf and/or teaching people skills in advocating on their own behalf.
For example, while in private practice, I worked with the wife of a Veteran who had developed dementia. She was struggling with his condition but wanted to continue to care for her husband at home. The Veteran also wanted to stay at home. I advocated, on their behalf, with the Department of Veterans’ Affairs (DVA) to secure in-home assistance, regular respite care and home modifications. This enabled the couple to live the way they wanted to live. Additionally, I continued to provide counselling support to the woman which included psycho-education about her husband’s condition, and strategies that would assist her in coping with the stress involved in caring for her husband.
Relapse prevention is a vital component of the recovery process for people with mental illness. This entails maximising wellness for people by reducing the likelihood and impact of relapse. It involves empowering people to recognise early warning signs of relapse and developing appropriate response plans. This requires identifying risk and protective factors for mental health and implementing interventions that enhance these protective factors and eliminate or reduce the impact of risk factors. Relapse prevention is based on communication and understanding between the person experiencing mental illness, their family and carers, health professionals involved in their care (primary and specialist) and community support services about access to support or treatment if there are early signs of relapse.
The Wellness Recovery Action Plan (WRAP) is an example of a recovery and self-management approach. While working in Community Mental Health in NSW as a Case Manager, I utilised Wellness plans with people. The benefits included increased confidence for the person who was central to their own plan. We worked together to enable them to monitor and maintain their own health with input from their support network, and to plan strategies for managing any deterioration in their mental health.
It is vitally important as a worker to build trust and respect with the person throughout contact with them. This allows for better intervention overall including relapse prevention planning. The plans I have used include identifying, in collaboration with the person with whom I’m working, times of high risk; warning signs and strategies to combat them; dealing with setbacks; coping skills; social support; consequences of the relapse. Most people reported that the process of relapse prevention planning assisted them greatly in terms of their confidence, empowerment and hopefulness.
To make an appointment with Brisbane Psychotherapist Merryl Gee try Online Booking. Alternatively, you can call M1 Psychology Brisbane on (07) 3067 9129.