Counselling and emotional support

Why should I find a counsellor early rather than waiting?

The time to connect with a counsellor or psychologist is before you are in crisis. Finding a good fit, building a working relationship, and getting into a regular rhythm of support takes time. If you wait until you are overwhelmed, you are also less able to engage with the process of finding someone.

Many people feel reluctant to seek counselling because they believe their distress is not "bad enough" to warrant it, or because they feel others are suffering more. Neither of these is a reason to go without support. The bar for seeking help is simply that life is harder than it needs to be.

For both the patient and the carer, connecting with a psychologist or counsellor in the first months after a diagnosis gives you the most time and the most benefit. You can process decisions, manage anxiety about the future, maintain your relationship with each other, and build the emotional resources you will need as things progress.

Are counselling sessions covered by Medicare?

Under the Medicare Better Access initiative, a person with a mental health condition can access up to 10 individual psychology sessions per calendar year with a Medicare rebate. To access this, ask your GP for a Mental Health Treatment Plan. The GP assesses your mental health needs and prepares a plan that then allows you to see a psychologist at a reduced out-of-pocket cost.

For people managing the psychological effects of a serious illness, a GP will almost always support a Mental Health Treatment Plan. You do not need to have a diagnosed mental health condition in the traditional sense. Anxiety and distress related to a terminal diagnosis is sufficient.

The Medicare rebate for a psychologist session (as of recent years) is around $137 for a standard session and higher for longer sessions. Many psychologists charge above the rebate amount, so there will often be a gap. Ask the psychologist about their fees and gap amounts before your first appointment. Some psychologists in community health settings bulk bill entirely. Healthdirect (healthdirect.gov.au) has a find-a-health-service tool that can help you locate bulk-billing psychologists and mental health services in your area.

What should I look for in a counsellor or psychologist?

For grief, serious illness, and end-of-life situations, you want someone with specific experience. A generalist counsellor is not always the right fit. Look for a psychologist or counsellor who has experience in grief and bereavement, palliative care, or health psychology.

The Australian Psychological Society has a Find a Psychologist directory at psychology.org.au where you can search by area of practice. Palliative Care Australia can also provide referrals to counsellors experienced in end-of-life contexts. Your palliative care social worker may have recommendations for your area.

The relationship matters as much as the credentials. If the fit is not right after two or three sessions, it is worth trying someone else. A counselling relationship that does not feel safe or helpful is not serving you.

Is there counselling support for carers?

Carers often put their own psychological needs last. The emotional experience of caring for someone with a terminal illness involves anticipatory grief (grieving a loss before it has happened), exhaustion, fear, isolation, and the specific weight of watching someone you love decline. All of this is legitimate and significant.

Seeking support for yourself as a carer is not taking something away from the person you are caring for. It is how you remain present and capable for them. A carer who is not psychologically supported tends to reach a point of collapse, which benefits no one.

Carer Gateway offers free counselling and coaching specifically for carers at carergateway.gov.au. This is a good starting point if you are not sure where to go or are concerned about cost.

What psychological support can my palliative care team provide?

Palliative care teams include social workers and psychologists. If you are already connected to a palliative care service, ask them directly about counselling support. Many provide this as part of the service, at no additional cost, for both the patient and the family.

Palliative care social workers are particularly skilled at navigating the practical and emotional intersection of a terminal illness. They are not the same as a psychologist, but they provide meaningful support and can refer on to a psychologist when more intensive support is needed.

What is peer support and where do I find it?

Peer support, connecting with others who are in a similar situation, can be a powerful complement to professional counselling. Knowing that your experience is shared, that others have managed what you are managing, and that there is a community that understands can reduce the sense of isolation that accompanies a terminal illness in the family.

Cancer Council Australia (cancer.org.au) has support groups in most states for patients and carers, and an online community. Carers Australia runs peer support programs. Many disease-specific organisations have online communities and peer support programs.

Peer support works alongside professional support, not instead of it. Both are valuable.

Should I plan for bereavement support now?

If you connect with a counsellor or psychologist before the death, that relationship does not have to end at the death. Continuity of support through bereavement is one of the strongest predictors of healthy grief outcomes. When you are interviewing potential counsellors, ask whether they offer bereavement support and whether they would be willing to continue working with you after the death if that is something you want.

Bereavement support through palliative care teams is also typically available for family members for a period after a death. Ask your palliative care team what is offered.