19 Apr 2018

BY: Anna Keyter

Assessment / Counselling / Couple Counselling / Online Counselling / Online Counsellor / Online therapist / Online Therapy / Treatment

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Therapeutic Relationship Online Therapist
Factors that promote or hinder the therapeutic relationship | Online Therapist:

There are endless factors that could affect the therapeutic relationship. Hill (2014) stresses the importance of understanding one’s own motives for becoming a counsellor and monitoring them. Personal therapy contributes to a counsellor’s own growth and self-understanding which is an important aspect when assisting clients. For instance, issues that a client may raise may stir up helper personal issues. The therapist needs to be able to bracket uncomfortable reactions and attend to the client’s issues in order to promote constructive therapeutic interactions. Furthermore, counsellor and client variables should be considered, these include personalities, belief systems and demographics that could affect the helping relationship. Sometimes people get along, and other times it is a mismatch. As a therapist, it is crucial to understanding your own biases, assumptions and worldview to be open to the norms, values and cultural heritage of helpees (Sue & Sue, 2007).

Therapist’s Intentions

A helper’s intentions are based on everything s/he knows about the client at a particular moment. These motives are not always apparent to the counsellor or client at the time because they discover different layers of feelings, thoughts and emotions as they go on (Hill, 2014).  Cozolino (2004) stresses the importance of focusing on exploring the client’s experiences in the moment. If the counsellor is not with the client moment-by-moment, s/he won’t be able to formulate intentions based on the current situation (Hill, 2014). Therapists should be present to assess the client’s information and decide on specific skills.

Counsellor Skills

Clients react by reevaluating their needs, goals and decisions based on the counsellor’s intervention. Brew and Kottler (2016) are of the opinion that clients believe counsellors have the power to assist them but first, it is important to gain confidence in their counselling skills. That being said, Cozolino ( 2004) highlights the importance of being good enough as a therapist. He states that even though environments are not perfect, it could still be adequate when there exists a good therapeutic relationship. The information gained from the client should be based on the therapist’s skills.  These skills include reflecting on feelings, facilitating self-disclosure and asking open-ended questions. A professional attitude and having the right manner when probing is also conducive to the intervention process (Hill, 2014).

In Conclusion

Self-understanding contributes to a counsellor’s ability to listen to the thoughts and feelings of their clients in a nonjudgmental way (Rogers, 1961).  A professional therapeutic relationship is all about listening empathically and supporting clients through difficult times.  Counsellors facilitate a different perspective on problems and assist clients to take action to improve their lives (Hill, 2014). In order to help clients make sense of ambiguity and confusing stimuli, therapists assist in defining goals. Helpers further assess and reevaluate the client’s goals as a reaction to interventions. The helping relationship is thus an interaction between the helper’s intentions and the client’s reactions. A counsellor’s own awareness guides the selection of effective interventions. By paying attention to the client’s feelings the therapist can develop an appropriate treatment plan.

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Brew, L. & Kottler, J.A. (2016). Applied Helping Skills: Transforming Lives (2nd ed). Los Angeles: Sage.
Cozolino, L. (2004). The making of a therapist. New York, USA: W.W. Norton & Company.
Hill, C. E. (2014). Helping skills: Facilitating exploration, insight, and action (4th ed.). Washington, DC: American Psychological Association.
Sue, D. W., & Sue, D. (2003). Counseling the culturally diverse: Theory and practice (4th ed.). New York: Wiley.
Rogers, C. (1961). On becoming a person. London, United Kingdom: Constable Publishers. Available online library (2004 ed)

09 Mar 2018

BY: Anna Keyter

Assessment / Treatment

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Critical perspective on Scientist-practitioner Model
Why a critical perspective on Scientist-practitioner Model?

With the DSM 5 changes, there is a renewed international reflection on the scientist-practitioner model also known as the medical model.   Mental and medical health professionals, as well as researchers, are familiar with the scientist-practitioner concept.  This article will take a moment to reflect on the true meaning of the scientist-practitioner in counselling.

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08 Mar 2018

BY: Anna Keyter

Assessment / Treatment

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Counselling Assessments using DSM-5 Diagnostic Tool

Counselling Assessments using DSM-5 Diagnostic Tool:

Main reasons for Counselling Assessments using DSM-5 Diagnostic Tool;

The DSM (also known as the Medical Model) stands for Diagnostic and Statistical Manual of Mental Disorders.  The latest addition is the DSM-5 and is distributed by the American Psychiatric Association.  Interestingly, there is a parallel classification system that was developed by the World Health Organisation, called the International Statistical Classification of Diseases and Related Health Problems (ICD-10).  Psychologists and Psychiatrists use these diagnostic tools to a large degree for medical insurance purposes.

DSM-5 Definition of Mental Health

A mental disorder is a syndrome characterised by clinically significant distur­bance in an individual’s cognition, emotion regulation, or behaviour that reflects a dysfunction in the psychological, biological, or developmental processes un­derlying mental functioning. Mental disorders are usually associated with signif­icant distress or disability in social, occupational, or other important activities. An expectable or culturally approved response to a common stressor or loss, such as the death of a loved one, is not a mental disorder. Socially deviant behaviour (e.g., political, religious, or sexual) and conflicts that are primarily be­tween the individual and society are not mental disorders unless the deviance or conflict results from a dysfunction in the individual, as described above.

Various Criticisms of the DSM-5

Not Focused on Culture

Renato Alarcón from the Department of Psychiatry and Psychology, Mayo Clinic College of Medicine (1), highlighted the limitations of current diagnostic practice.  Criticisms include the relevance of culture during diagnosis.  He mentions that the cultural content should be taken into account during psychiatric diagnosis and the main, well-recognised cultural variables, including adequate family data, explanatory models, and strengths and weaknesses of every individual patient should be considered.


Furthermore, Professor Winfried Rief (2) is concerned that the DSM is a “profit-making, lucrative franchise for the APA.”  What is concerning is that 25% of the American population qualifies for a psychiatric diagnosis yearly.  In addition, 50% will be diagnosed with a psychiatric disorder in their lifetime.   By defining milder conditions in the DSM-5, it distracts from attending to the severely mentally ill.


Ben-Zeev, Young and Corrigan (3) published a paper on the stigma associated with mental illness.  They found that a psychiatric diagnosis can have devastating effects on the lives of mentally unwell people, their families and carers.  Whats more, they highlighted three types of negative outcomes (1) public stigma (2) self-stigma, and (3) label avoidance.

In defence of the DSM

Frances and Widiger (4) describe the DSM-V as the best current tool for diagnosis.

Our classification of mental disorders is no more than a collection of fallible and limited constructs that seek but never find an elusive truth. Nevertheless, this is our best current way of defining and communicating about mental disorders. Despite all its epistemological, scientific and even clinical failings, the DSM incorporates a great deal of practical knowledge in a convenient and useful format. It does its job reasonably well when it is applied properly and when its limitations are understood. One must strike a proper balance.

So where to from here?

Whilst not all counselling professionals focus on the DSM-5 criteria, it will remain the main diagnostic tool for many psychologists and psychiatrists for years to come.  Medicalising mental well-being is a major concern of the DSM-5.  In practice, the DSM-5 should be treated as a tool rather than be-all and end-all.  When using the DSM-5 as a diagnostic tool, be mindful of the long-term effects it can have on people.

Need to know more?  Call us +(64) 9 888 0779  or complete the contact form.

(1) Culture, cultural factors and psychiatric diagnosis: review and projections

(2) DSM-5 – Pros and 

(3) DSM-V and the stigma of mental illness

(4) Psychiatric Diagnosis: Lessons from the DSM-IV Past and Cautions for the DSM-5 Future




02 Jan 2018

BY: Anna Keyter

Online Counselling / Online Therapy / Treatment

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Online Counselling in New Zealand

Online counselling in New Zealand is becoming commonplace.  Web therapy, phone therapy, text therapy or online therapy is a way to interact with your counsellor using a website, phone or mobile app as a therapeutic tool. This post provides information on online counselling in New Zealand.

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02 Oct 2017

BY: Anna Keyter

Featured / Online Counselling / Online Therapy / Treatment

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Best Online Therapy

There are benefits for both online and in-office therapy, keeping in mind the two are not mutually exclusive.  Some people are adamant that in-office therapy should not be replaced but complement online sessions.  If you are comfortable with combining online and traditional counselling, then continue with in-person therapy alongside online therapy.

Questions to ask: Who would provide the best online therapy for you?  How do you choose between available online solutions?

In this post, I will provide you with a checklist to select a reputable online counsellor.  Once you have decided that online therapy is the way to go, you would be able to make an informed decision about selecting an online counsellor.

Best Online Therapy checklist
  • The American Psychological Association (APA) suggests that you have an initial face to face meeting before committing to therapy
  • Get information on potential counsellors on social media platforms such as LinkedIn or Facebook
  • Sometimes a Google search will provide information such as credentials and qualifications
  • It is important that you find a person who will provide a tailored service best suited to your specific needs in terms of interventions and skills
Checklist: Adapted from the American Psychological Association:
  • Decide if online therapy the right tool for you
  • Check that your therapist is registered with the Psychologist board, Psychotherapy board or the New Zealand Association of Counsellors? Remember, licensing protects you.
  • Are you using online apps? Is the site or app secure? Will the information I provide remain confidential? Psychotherapy works in part because psychologists ensure that clients have a safe, private space to share deeply personal and sometimes difficult stories, thoughts or emotions.


In conclusion

For your own peace of mind, do a Google search on your potential provider and check online ratings.  You can also view potential online counsellor profiles on platforms such as Facebook, LinkedIn or Google+


If you want to find out more about Online Therapy, please call us 098880779 or email us info@onlinetherapy.co.nz.
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