Thursday, May 31, 2018

Be Your Own Therapist: Support System Mapping 101

There are some common techniques and practices in the mental health professional toolbox that anyone can (and should!) use. Here’s one of my faves: the support system map.

We are very social beings, and when we don’t feel supported, we feel lonely and this fuels depression and stress.

As a first step to happiness, it makes sense to know how you stand in terms of support. This is why it is one of the very first things I tend to suggest in sessions.

Now, the support system map is dead simple to set up. You sit down with a sheet of paper and ask yourself, “Who makes me happy? Who can I call, visit, or see when I need support, advice or just a giggle?”

Some clients resist this exercise, saying, “I know who I can go to, and don’t need to write it down” but when they start, they inevitably discover it is incredibly useful because it highlights support strengths you may have overlooked and identifies areas you need to beef up.

This is one of the fundamental principles of therapy: just applying structure to the chaos can be enlightening.

Blog posts work best with examples, so I’m going to share my support system map.

Do note I work very hard on my connectivity because I work from home, and I live very far away from my family in a culture that I wasn’t born into. That’s a triple whammy (my choice!) and I love my life but I’m aware I need to be super careful.

So, here’s what I have

People I can say anything to at any time, and call in the middle of the night in an emergency
Tom, my husband
Ian, my brother
My mum
Plus four friends I’ve had for over twenty years, and two close friends I’ve had ten years

Friends I have a ‘mutual moan’ pact with whom I can Skype or Message anytime without an appointment

Author friends I have a ‘mutual moan’ pact with whom I can Skype or Message

Therapy friends I have a ‘mutual moan’ pact with whom I can Skype or Message
Problem area: up until six months ago I had two but they left Malaysia. Needs beefing up.

People I’d trust 100% to give me solid advice and counsel on either love or career
Seven friends

Friends in the neighbourhood I can go for a quick morning coffee with
Two friends

Lunch friends who always inspire me
Too many to mention

Friends to go to the pub with in the evening
Problem area: five years ago that was over a dozen people, but most have moved away and one passed away. Needs beefing up.

So, if you’re stressed and you’re not at the point where you need someone like me to talk to, create your own support system map and beef up all the bits you feel are lacking. Honestly, it’s a great help. Also, if you are unhappy at work, here’s a post onhow to use this together with self determination theory.

I’m off to see my mum for my annual holiday. I will be seeing my present clients but I won’t be taking on new clients until July 1st. 

Tuesday, May 22, 2018

On being a personal cheerleader, because we all need to hear it, “You can do it. You are also a hero.”

I realised last week that when I was little, I read fantasy books that were rich with strong, interesting and capable heroes and where female characters were one dimensional caricatures.

As I said in my sweet romance blog post, it didn’t bother me at the time. Ever since I wrote that, I’ve wondering why. I think I’ve come up with the answer and curiously, it has a lot to do with my therapy work.

I grew up in Amsterdam in the late 1960s and early 1970s (yes, I’m THAT old!). The Netherlands has been an egalitarian society for a very long time, and all the adults around me were solidly supportive.

When I didn’t do great on my schoolwork, my teachers didn’t scold. I was told, “If you’re trying, that’s good enough. It will come.”

My ambitions to be a pilot, or maybe a vet, elicited an, “Awesome!”

No matter what, it was dinned into me, “You can do it.”

When we moved to Scotland in the late 1970s, that support was spotty. My parents were rocks as were some of their friends and some of our teachers, but there were a lot of others who, frankly, were absolutely toxic.

For the first year, the bullying was stellar. In the school I attended, the teachers encouraged the kids to throw stones at me because I didn’t speak the language or share their religious beliefs.  

After I switched schools, the bullying disappeared. However, sexism was rife. One moment that really crystallized that attitude for me was the deputy headmaster who advised me that I should be a shop girl “because careers are for boys.”

So, what does this to do with my enjoying fantasy novels that have great male characters and few or no females? Just this: because of my early experience, I never associated strong and capable with being male.

From my earliest days I was taught that anyone could be a hero.

So, when I read Lord of the Rings, I was Frodo, Gandalf and Aragorn as easily as I was Galadriel. Reading the Rift War saga, I was Pug and Arutha as happily as I was Anita (although TBH I preferred the Valheru over all of them!)

And this leads me to my therapy work. I’m aware that my early training gave me the confidence and resilience I needed to reach for my happiness. It’s not always easy but that foundation has been a tremendous help.

Not everyone is as lucky. There are those who aren’t treated well by their parents, their families, their bosses, or their communities.

When they have a personal crisis, they feel they can’t open up because they would be judged.

“I’m supposed to be stronger than this.”
“If they knew, I’d lose respect.”
“I just need to talk through this, without being lectured.”
“It’s embarrassing, I don’t want anyone to know, but I need a second opinion.”

Back when I first signed up to do my Masters, I thought practice would be all about helping clients work through and manage issues. But over time I’m beginning to learn that for some people, it’s about needing temporary support, a personal cheerleader, if you like. Someone whose professional code means she will never tell.

I’m okay with that. I think we all need to hear it, “You can do it. You are also a hero.”

Wednesday, May 2, 2018

Cultural Appropriation, Cats And Anger

Keziah bought a prom dress and naturally showed it off to her friends on Twitter. Hours later, the young American girl was inundated with by mobs of haters screaming at her. Why? Because she was wearing a cheongsam.

What constitutes good manners is very much a matter of time and place. When I first went to Indonesia, back in the 80s, my good friend Mr Toebe gave me a dress from his native island, Savu.

“Wear it when we go to dinner,” he said.

I thanked him, and the next time we went out, I put it on.

Now, Savu ladies are petite and I’m a hulking great big European.

The dress was gorgeous, and Mr Toebe had taken the precaution of having two skirts sew together so it would cover me properly, but I looked as if I’d been stuffed into a carpet.  Fashion fail was putting it mildly.

Mr Toebe met me in the lobby of my hotel, took one look, and said, “Absolutely lovely.” Then, just as smoothly, “Better get changed. The restaurant is a little cold.”

Told you he was a nice man!

The thing is, over the years I have been given saris, kebayas, and a tonne of tops, hats, shoes and other fashion items. I’ve been grateful for the gifts and I’ve worn them to make my friends happy - whether they suited me or not.

I know that manners and customs change, and that’s fine, but I’ve been watching the spread of ‘cultural appropriation’ with dismay. 

“You can’t wear that dress!”
“You’re not allowed to get that haircut!”
“That coat is only to be worn by my people!”
“How dare you look the way you do!”

When I hear these sentiments, I think of my cats. When they’re in a bad mood, they start fighting over who gets the big comfy chair, over who gets the corner sofa seat, and who is entitled to getting lap time. 

They’re cats and they’re territorial because they can’t help it. But we are people and we should know better.

I get that anger is a problem. We're all frustrated by bad economies, by unmitigating unfairness, and by constant overcrowding and stress.

But I don’t like this trend. Policing how others look is the tool of controlling bullies. It’s not nice.

As for the mental health aspect of this, let me say this: if the sight of someone feeling beautiful and happy enrages you, there is something very wrong. And not only does that rage hurt others, but it's going to hurt you, too.

Note: I am a private counselling psychologist helping my clients manage stress and depression. I work online via Skype and Facebook Messenger. Email me via My current charges are RM100 or US$30 over Paypal per session. The first 20 minutes are free.

Thursday, April 19, 2018

Been raped or assaulted? Here’s a tip..

Rape, sexual assault, a snatch theft or house robbery that ends with you being injured - all of these violent events are severely traumatising.

These events are incredibly common and yet, we often struggle to even report them, never mind find help in managing with the emotional fallout.

Among the many reasons for keeping quiet, this is the one I hear often, “I wonder what I did to deserve this. What could I have done to prevent it?”

If this is you, then please let me ask you something.

Suppose you are walking down a path in the forest, eating a chocolate bar. A monkey rushes past you, snatches it out of your hand and runs off.

Who is to blame? You or the monkey?

It’s the monkey, right? The monkey chose to attack you.

Now, suppose you are sitting on a terrace, eating a chocolate bar. A monkey rushes past you, snatches it out of your hand and runs off.

Who is to blame? You or the monkey?

It’s the monkey, right? The monkey chose to attack you.

Now, suppose you are sitting by an open window in your home, eating a chocolate bar. A monkey dives inside, snatches it out of your hand and runs off.

Who is to blame? You or the monkey?

It’s the monkey, right? The monkey chose to attack you.

Now, when you were attacked, who was the monkey there? Who chose to attack you?

This is what it boils down to: it is the attacker who has the power. It is the attacker who decides to hurt you. You are the victim. You are not to blame.

You can see the logic in this, yes? So why do we feel as if we’re somehow responsible?

I believe it comes from a false belief that we live in a world of karmic balance.

We like to think that if we’re good, then good things will happen to us. So when shit happens, we wonder what we did to deserve it.

This is also the basis for victim blaming. When other people see a good person suffering, they are afraid. They want to believe that being good somehow protects them from the evil in the world.

They are so scared, that they would rather hang on to their false belief than see the reality. That’s why they hide in their fear and say, “s/he must have done something to deserve it.”

Fact: very bad things happen to very good people.

If you are the victim of violence, sexual or otherwise, please stand back from the situation and ask yourself, “Who was the monkey here?”  And believe me when I tell you, “It wasn’t you.”

Put the blame where it belongs, hold your head high, and know you are a survivor. 

Note: I am a private counselling psychologist helping my clients manage stress and depression. I work online via Skype and Facebook Messenger. Email me via My current charges are RM100 or US$30 over Paypal per session. The first 20 minutes are free.

Sunday, April 1, 2018

Has Your Friend Suffered A Sudden Loss? Practical Tips For Effective Helping When Expats Die Overseas

When someone dies overseas, red tape is a nightmare. Here are some thoughts on how to manage effectively.

We lost a friend in a traffic accident just over a month ago, and so our community has been in mourning. Now we’re climbing out of the initial shock, I thought I’d get this down in case others find it useful.

#1 Know You’re Not Thinking Straight
When someone young dies in an accident, devastating loss comes with an extra whammy of shock. That combination does some very strange things to your thinking.

For me, the last month has been like thinking through cotton wool. I’ve been slow to make connections and I’ve been forgetting things. My temper has been very much up and down as well.

This combination makes it difficult to attend to all the practical things that have to happen: arranging the funeral, and starting on the paperwork process to get the estate wound up.

When you’re an expat, red tape is a nightmare. So, if you are overseas and find yourself helping out in tragic circumstances, here are some practical tips.

#2 Hire An All Round Fixer For The Funeral Arrangements
Before you can bury someone, you need a death certificate. You also need to have that endorsed by the embassy of the person who died. If there is no living spouse, and no other direct family present, you will need extra paperwork that gives you the right to deal with funeral arrangements. 

You know what it’s like to do even normal things, like renewing a work permit: it takes multiple visits to find out what paperwork you need, and then you’ve got to queue, get everything in triplicate and even then there’s going to be something forgotten or missing.

My advice is that it’s not worth doing this paperwork yourself. You’re already stressed to the max, and to have to run around for days on end talking to officials, will likely bring you close to collapse.

Top Tip: there are funeral service companies that do it all for you. They have all the contacts so they know what paperwork needs to be done, and they have the clout to make sure it’s done swiftly and properly. Also, they don’t queue.

Important: Don’t go for a local company that only deals with local deaths! The paperwork involving a local death is different than that involving an expat. Pick a company that deals with expats.

The question you need to ask to check if the company is sound is:
How do I know the death certificate will be accepted back in my home country?
And the answer you want to hear is one that involves the local certificate being stamped by your embassy.

Recommendation: we are in Selangor, Malaysia and we used Dominick from Trinity Funeral Services.

#3 Grieving Spouses Are Blank With Grief
That cotton wool thinking that hit me is nothing compared to what hits the bereaved family. In my experience, it doesn’t matter if people cry or are calm, if they have lots of family around or none, if they are local or not - over the first few weeks, every one acts in the same way.

What you are dealing with is someone who will say, “Yes. No. Okay.” And a day later, they won’t even remember seeing you. They’re not being difficult. They’re just blank with grief.  This blankness lasts at least a month.

This leads to...

#4 Decide How You Need To Help
There are two extremes. Some people fight grief with action. They need to be doing stuff so they can put off the hurt that comes with loss. Other people are paralysed by emotion. They can’t think at all. 

Others still fall in the middle. They may keep busy by pursuing one particular task. Again, some go for a known comfort activity, such as cooking while others obsess over one aspect of the situation, perhaps intent on getting together the perfect funeral.

My advice: let people do their grieving in their own way, and match your support by complimenting the places where they’re not going.

So for the man who is focusing on funeral flowers and music but who just can’t deal with condolence calls, step in and offer to answer the phone and reply to the email and Facebook posts. 

#5 Keep Meticulous Notes
At the very least, you’re going to have to: inform family and friends over several countries, talk to the deceased’s landlord, deal with the deceased’s company (clearing out desks, handing over laptops etc), and then you may have to also look at canceling work visas, talking to accountants over taxes, etc etc. If there are kids left behind, add in dealing with schools.

My advice: Rope in friends. I have to say, the people who stepped up for us were absolutely totally amazing.  I won’t name them here, but oh boy, talk about respect.

Anyway, rope in friends, and share out tasks so you don’t overlap. Most of all, make sure you don’t drop a loop by keeping itemised to do lists.

My list was divided into headings: accommodation, school, family and friends updated, and so on.... I wrote down what had to be done, who was in charge of doing it, and I marked tasks to be done, in progress, and complete.

Now, to get back to your bereaved friend....

#6 Act Like A Secretary
Support during bad times is an art, and there are no fixed rules. I think it’s important to balance respect with relieving the burden.

I’d say, if you are roped in to help, act as a secretary.  You’re your friend’s PA, which means you take them over what needs to be done, and ask them what they want you to do.

Deal with urgent matters but don’t be shy about putting off less important decisions until later.

Warning: don’t sign anything and don’t let the bereaved person sign anything. Grief messes up your brain so it is at this point that crooks and con artists come out of the woodwork. If you’re not careful, you will sign up for paying endless fees for services that you don’t want or that are actually free.

Tip: the more they push and yell and threaten, the more likely it is they are crooks trying to intimidate you. Push back by saying, “Write a letter and the family will refer it to their lawyer.”  Even if there is no money to hire a lawyer, that legal bit will quiet the legit ones.

At some point the bereaved family will come out of the fog and take over. As long as you have it all down on paper, you won’t drop a loop.

#7 Breathe
It’s horrible, it sucks but when you feel overwhelmed, take a step back and remind yourself that it’s always difficult to adjust to violent sudden change.

Go do something nice for yourself. Surround yourself with friends, and have a laugh. My personal view is that mourning is made a little easier if you celebrate life.

I hope this helps.

Note: I am a private counselling psychologist helping my clients manage stress and depression. I work online via Skype and Facebook Messenger. Email me via My current charges are RM100 or US$30 over Paypal per session. The first 20 minutes are free.

Monday, March 12, 2018

How To Forge A Happy Marriage

Back in the 1980s, when I was doing my first degree in psychology, I came across a piece of advice. 

Men's Needs, the book said, run roughly on these lines:
1. Sexual Fulfilment
2. Recreational Companionship
3. An Attractive Spouse
4. Domestic Support
5. Admiration

Women's Needs, the book said, run roughly on these lines:
1. Affection
2. Conversation
3. Honesty and Openness
4. Financial Commitment
5. Family Commitment

The book was HisNeeds, Her Needs by Willard Harley Jr., a US family therapist, and published in 1986. If I remember correctly, these lists were compiled from talking to his clients.

When I read it, part of me was thinking, “This man is talking to and about white middle class Americans so how much does this really apply to me?” and also, “Well, it’s not very scientific, is it?” Also, I wasn’t too convinced that sex isn’t in the average woman’s top five. 

However, the lists did strike me.

How often have you heard a man moan, “She used to love hearing all about my job successes, but these days she just doesn’t care!”  That’s him missing admiration.

Or hear a woman say, “For once I’d like to be able to snuggle without having to a) beg for it, and b) having to follow it with a bonk!” That’s her missing affection.

Today I still have issues with the lists (and perhaps by now he’s updated them to reflect modern life) but I do use them. 

My weekends, for example, are for Us. I know it drives a lot of my friends insane because weekends in Malaysia are always chock full of weddings, dinners, birthday parties etc. However, while I value my pals, I value Tom more, and he isn’t keen on those kinds of events.

So our weekends are reserved entirely for us. We don’t do anything fancy. Most of the time we have a nice home cooked special lunch and then a film marathon on Saturdays.

More often than not, we talk all the way through them. For example, at the moment we’re watching Columbo and Lewis and it’s helping us work out the Perfect Murder. We’re pretty sure that if we decided on marital homicide, we’d get away with it.

Weird? Possibly. But we enjoy it. 

On Sundays, we do the fun lunch again and then we go out. It’s nothing fancy; just our local but we love it.

Again, we talk up a storm. It’s yap-yap-yap for two to three hours, about everything from the news to what’s going on at work. Me, I figure that covers Recreational Support for him and Conversation for me, plus with the chatter and the dressing up so we look nice, we cover a lot of the rest of the lists.

It’s not very glam, is it? But for us, going out to fancy places and doing the romantic wine-and-dine thing is stressful. We enjoy a home cooked meal in front of the telly and then a night out a stone’s throw away from home.  It’s what we did when we dated.

And that is, I think, the essence of the “needs” lists. Dressing up, talking, being affectionate, open conversations, admiration, commitment, and sex - they’re very reflective of what happens when you’re dating - or courting, if that is a better word. 

I don’t think there is such a thing as a recipe for a happy marriage. However, I do believe that many people forget to transfer the dating aspect of their courtship into their married life.

If anyone were to ask, that would be my number one tip for a good relationship: incorporate the things that made dating work for you into your everyday relationship.

What do you think?

Want to talk to me? You can find me here on Facebook. It’s my private timeline, but it’s open to the public, so just drop by; no friend request needed.

If you're looking for a counselling psychologist working online for stress and depression management, contact me via email at I work online via Skype and Messenger. My current charges are RM100 or US$30 over Paypal.

Monday, February 12, 2018

"I've got a problem with my boss, so why do you want to know about my mum?" Short answer: 'cause you're a special snowflake. Yes, really!

If you've not been into it before, you might worry about what happens during a therapy session.

So here's an example of how you might typically tackle a common problem, in the hope it helps sheds some light on the process.

Suppose you make an appointment to discuss an office problem. "My boss gives me orders, and when I ask a question, he yells," you say. "It's gotten to the point where I'm shaking just at the thought of talking to him. What do I do to fix this?"

The thing is, I can't tell you how to fix it straight off. I know what works for me, but not what works for you. You are a unique human being with your own style, character and circumstances.

Yes, you're a special snowflake! 

So what I have to do, is to get to you know you really well, and reasonably quickly. (Because you're paying me and you don't want to be hanging around for weeks on end)

So what are the steps to figure it out?

#1 I ask, "Tell me about the last three times your boss yelled."  We examine the situations in detail so I can see exactly what's going on. At the end of this, I have a better idea of your feelings, your personal style, your boss' personal style and so on.

#2 As a boss is an authority figure, I then look to see how you handle authority figures generally. So I ask, "How do you fight with your mum?" I might also ask about your dad, your teacher at school, your older sibs, former bosses - whatever works.

#3 At this point, I have a good idea of who you are, and of your personal style. The next step is to see if you already have successes in this area. So I ask you, "Have you ever been in a word fight and turned it around?"

#4 We now have lots of information about you and the situation, so now we look at general principles of how issues like your are resolved by other people. Generally, this involves me explaining theories and examples.

#5 Now we pick through everything, and we decide on an approach that a) suits your style and situation, and b) that has some good evidence for working with others.

And at this point, we go on to practice (modeling, we call it) in a safe space, and then we work up to you going out solo.

As you can see, most of it isn't rocket science but it does take a bit of work, especially when it comes to steps 4 and 5 which are often where clients get the most benefit.

I hope this helps, and if you're looking for a counselling psychologist working online for stress and depression management, you know how to contact me. I work online via Skype and Messenger. My current charges are RM100 or US$30 over Paypal.

Sunday, February 4, 2018

When scolding leads to lies...

On Saturday I left a bag of tangerines and pineapple at the hawker centre. When I went back the next morning, the man at the stall said, “Yes. No. Oh, I threw it away.”
I said, “You threw away perfectly fresh fruit? Come on, you know that’s not true.”
I knew he’d eaten it. He knew he was lying. 
So he said, “I will compensate you” and I said, “Man, it’s just fruit. Forget it. But don’t lie to me next time, okay?”

I bought my breakfast as usual and replaced the fruit but I was thinking about it on the way home, and I believe this is symptomatic of something else.

When someone leaves perishables, you keep them for a few hours. That’s only fair. But if at the end of that day nobody comes, you don’t chuck out perfectly beautiful, nicely wrapped tangerines and pineapple. That would be a waste. You eat them.

Okay, they were commercially wrapped so you could keep them up to three days. So maybe he could have put them in the fridge and kept them an extra day. But hey, it’s not a gold watch. It’s not money. It’s just bloody fruit.

So why didn’t he just say, “Oops, when you didn’t come back, I ate them”?

I think it’s because people are so stressed at the moment that they yell for nothing at all. It’s not uncommon to see people screaming at staff for bringing the wrong drink or the wrong dish. All that aggro has created a situation where people lie automatically, just to avoid a scolding.

What do you think? See the discussion here.

Sunday, January 21, 2018

“If it’s quackery, why is it working for me?”

One of the things I find fascinating about psychology is that it’s a field riddled with controversy.
“If it’s quackery, why is it working for me?”

The definition of psychology is that it is the scientific study of the human mind and its functions, especially those affecting behaviour in a given context. However, when you don’t have universal agreement on the definition of basic terms like normal and healthy, then you’re going to have a lot of fights over what’s proper.

As psychology is constantly evolving, there are a lot of discredited theories. That’s okay because we’re all learning. (Go the end of the article for a list - Freud is on it!)

To make it more complicated, there are con artists working in the mental health field.

Mental health attracts con artists for many reasons, including:
Scared=Easy Target: Desperate people don’t think clearly so they are easy to fool
$$$ Fast Money: Desperate people will part with money quickly, hoping that paying over hard earned cash will magically help them find a ‘fix’
Power Opportunity: It’s easy to influence frightened people. Cons and nuts find that being The Guru is an easy way to power.
From what I’m hearing, many of the ones here in Malaysia call themselves ‘Dr’, talk a lot about the unconscious, and the really cheeky ones run urine and blood tests - all at extortionate prices.

I’ve blogged before about how to avoid mental health con artists. Today I’m focusing on a sensible question I’ve been asked,  “If it’s quackery, why is it working for me?”

The answer isn’t a simple one but here are some points to consider.

#1 How much time do you spend on your mental health?
If the answer is, “Erm.... dunno. Minutes a month.” then you have to consider that spending a whole hour every week on identifying your issues is helpful all by itself.

Sometimes, all you need is to focus on what’s up and you can find the solution for yourself.

#2 Being upset means you don’t think straight
For most of us, thinking about a problem goes like, “Oh hell, I’m upset. Why am I feeling so bad? This sucks. I hate this.” And on and on and on for hours.

This is not helpful.

Sometimes just sitting down with a person who can help you focus on unraveling your thoughts is enough to clear the fog.

#3 Empathy goes a long way
When I said earlier that psychology is full of controversy, Freud springs to mind. Some of his theories were absolutely insane, yet he did some excellent work.

If you read his books and papers, it’s very easy to see why he was effective: he was genuinely interested in people and he was a kind, thoughtful man.

Sometimes, just having an understanding ear is enough to help.

This of course begs another question: “So if I see a quack who has good intentions, an empathetic attitude, and I’m willing to spend the time, what’s the problem?

A wacko quack can cause real damage
Just this: a wacko quack can cause real damage.

Think about it in terms of fixing a car. If you see blue smoke coming out of the engine, you can take it to a cowboy mechanic and one of two things happens: you strike lucky and it’s fixed, or you pay your money and you end up with a vehicle that blows up.

It’s the same with mental health. 

So, please look after yourself and avoid cons and quacks. Your mental health is too important to be in their hands.  
If you’re curious why rubbish is increasingly popular, you can read a classic like Carl Sagan’s Demon-Haunted World or check out Prof Patrick Grim who's one my favourites, or throw the terms pseudoscience into Amazon to see a list of current publications. It’s an awesome field, and worth taking a look at.

Curious what psychological theories are considered nonsense by insiders? Here’s a paper you’ll love. (Skip straight to page 518 for the list.) Pseudosciences included:
o       Jungian sand tray therapy for treatment of adolescent and adult disorders
o       Neuro-Linguistic Programming (NLP) for treatment of mental/behavioral disorders
o       Rage reduction therapy for depression
o       Freudian dream analysis for treatment of mental/behavioral disorders

Sunday, January 14, 2018

I Can't Pay For Therapy; How About Working With A Student Therapist?

This was written in response to a chat with a friend :-)

If you can’t afford therapy, one option is to work with a student therapist. There are pros and cons, so here’s a short list of things to take into account when you make your choices.

Students tend to be open to exploring options. That can be good if standard therapy approaches haven’t worked for you.

Students need hours, so they tend to favour long sessions. That’s good if you have issues that need lots of time to address.

It’s free. As students aren’t qualified, they can’t charge. At least, that’s the rule of thumb in Malaysia. I am hearing of other countries where students charge money; I find that very difficult in terms of ethics. See my next points.

Your student therapist is still learning, and that has implications. It’s just like asking a student doctor to give you an injection or medical exam; sometimes they’re terrific and sometimes they’re a bit clumsy.

As you’re not dealing with a fully qualified person, your sessions are not private. Your student therapist will be talking about your case with her supervisor, her tutor back at school, and then the examiner will see the notes as well.  In my school, we were also asked to present cases we were working on in class. In addition, your case may be evaluated by a licensing board.

All this checking and double checking is to make sure everything is being done right.

Should you be worried? Usually student therapists are pretty good about anonymising information and destroying notes after. But to be certain, ask for details. 

When students do their practice hours, everything needs to be documented and checked. This is to prevent fraud. This means contact hours are face-to-face sessions held in the supervisor’s place of work. This has implications for you because when the student therapist has completed her hours, she leaves. To prevent your sessions from halting abruptly, ask your student therapist how she will plan for this.

If you want online therapy, this may be difficult: students typically don’t work online or across borders because of the way hours need to be supervised and documented.

I knew when I was studying that I wanted to work online so I planned specially for it. I took an extra course in online therapy. On top of that, I also did an extra project, working online with overseas clients. Throughout, I leveraged my Masters Degree supervisors to make sure I was on the right track and I had an overseas teacher as well.  If you want to work online with a student, just ask how she’s getting her supervisors to work with her.

Note: I’m in Malaysia and I write from a local perspective. As countries have their own laws governing licensing and practice, you may have different or additional issues to deal with.

My advice: if you’re in doubt about a mental health provider or service, ask your family doctor to direct you to the proper organisations in your country. Mental health practitioners know it’s a minefield for the general public to find good quality help, and they tend to be generous about helping you find someone proper.

Want to work with me? I work online via Skype and Messenger and from home, so I can keep prices down. I charge US$30/RM100 per session. The first twenty minutes where we see if we can work together are free. Email me at for an appointment.

Wednesday, January 10, 2018

"Why is therapy never cheap?" - and why I'm only charging US$30 per session

One question pops up fairly often, "Why is therapy never cheap?" So here are some thoughts.

#1 We’re slow to start. It takes about seven years of school, Bachelors plus Masters, and apart from the classes, you need to spend roughly 1000 hours on unpaid internships that include some 300 therapy hours. Getting that done takes a year, sometimes more. So getting to the point where we can work costs a bomb.

#2 We do a lot of stuff you don’t see. You talk for an hour, but the second you leave, we’re writing up session notes. Then, before we talk next time, we read through the notes to prepare. While it varies, for every hour we talk, I tend to spend an hour on notes and prep.

#3 We're always studying. Every job involves constant learning but psychology is particularly intensive. I do constant journal sweeps as well as reading new publications, attending lectures and taking short courses. It costs money to stay current.

So there you go. As it is, I'm very affordable at RM100/US$30 per session. I'm keeping costs down by working online, and I have other revenue streams. Also, living in Malaysia means my cost of living isn't as high as in some other countries. Even so, it's not good ROI on my education investment. Frankly, the second the economy comes up again, so are my prices.  

Want to ask me about online therapy? Write to me at