For those wanting to improve the lives of those living in the grips of depression, be prepared for a job full of rewards, but also full of challenging people and situations.
According to Australian Psychologist Leigh Matthews, a mental health practitioner with over 10 years of experience, there will be clients who don’t seem to “budge” for several sessions. In other words, they get stuck, and progress appears achingly slow.
But also, Matthews said in an e-mail interview with allpsychologycareers.com, “be prepared for at least one client to tell you that you have helped change his or her life.”
This, according to the director of the private psychology practice Urban Psychology in Brisbane, Australia, makes all the study and hard work worthwhile. As a depression counselor, individuals must also prepare themselves for a self-directed career that requires, working in isolation, booking clients, following up with clients, completing file notes, and writing correspondence to other professionals.
You must also enjoy variability, as no two clients will be the same, she said.
However the most important quality of a depression counselor, according to Matthews, is a genuine desire to help people. And counselors must have compassion and openness, qualities that aren’t necessarily taught. “If you are judgmental and non-accepting, how can you really hear people who need your help?” asked Matthews.
And listening - actively listening - and hearing what a client is trying to communicate, is a key component to psychotherapy, a therapeutic process used by depression counselors to effectively treat depressed individuals. There are a number of psychological processes, also called frameworks, now available to counselors, and most require specialized training to learn the implementation of their strategies.
But before counselors begin psychotherapy with a client, the client must be properly assessed and diagnosed. One of the most important aspects of any type of counseling, assessing a client requires a knowledge of the established assessment tests used to rate the severity of a client’s symptoms.
Assessment and Diagnosis
The Depression Anxiety Stress Scales (DASS) is the most commonly used test to rate the severity of depression and anxiety – two conditions that often coexist. This test is in the form of a questionnaire that the client answers regarding a number of symptoms commonly associated with the disorders that occurred over the past week. For each symptom, the client places a number from 0 to 3.
The depression counselor tabulates the results from the questionnaire to use as one component of the diagnosis. The other integral part of a depression diagnosis is the clinical interview performed by the depression counselor, an interview that should uncover aspects of depression not covered by DASS.
For example, DASS does not assess important considerations for depression such as sleep or sexual disturbances, or changes in appetite. It also does not ask about suicidal ideation, one of the most serious indicators of depression.
Matthews of Urban Psychology said that she ensures she conducts a thorough assessment, scheduling an hour and a half for the initial session with a client. Building rapport with the client is essential, she said. She also uses the DASS assessment throughout the course of therapy, regularly administering it after every one to two sessions to gauge progress.
After the depression counselor arrives at a diagnosis, the process of psychotherapy begins. Cognitive behavioral therapy (CBT) and interpersonal psychotherapy (IPT) are two of the most common psychological frameworks used in depression treatment
Matthews said she uses a blend of CBT along with a number of other therapies, depending on the unique needs of each client. These therapies include:
For severe cases of depression, when a client’s everyday functioning is critically impaired, such as an inability to get out of bed or leave the house, the depression counselor often working with a physician or psychiatrist will recommend medication. For more information see Medications for Depression.
Therapy Takes Time
In cases where clients take antidepressant medications, results often come faster than exclusively using psychotherapy to treat depression. And in many cases, the combination of psychotherapy and medication produces the most favorable outcomes.
However when a patient does need medication, it does not excuse the patient from learning and implementing a self-management regime, according to Matthews. This regime includes understanding and identifying the early warning signs of depression and the internal and external triggers of depression.
It also means setting goals and working toward change, and implementing a number of behavioral strategies known to effectively combat depression, such as exercise.
Psychotherapy often takes longer, but it has the most long lasting – and life changing – results.
Depression counselors must have hope for their clients, hope when their clients have none for themselves, advises Matthews, who also supervises psychologists-in-training at the University of QLD, and those completing their internships through the Australian College of Applied Psychology.
“An individual in this field must believe in all people’s capacity for change, and persist through each client’s hopelessness and times when the client is not making progress to see the outcomes of therapy.”
Counselors Taking Care of Themselves
In addition to helping clients develop strategies for managing depression, depression counselors need to apply self-care strategies to their own lives. Matthews advises finding joy every day, getting sunlight and exercise, and spending time with family and friends.
Also keep a “trophy box” for certificates, special awards, and positive feedback, Matthews said. It will boost your confidence on those days when the most resistant clients aren’t budging.
Finally, don’t expect perfection. Counselors certainly don’t expect it of their clients, so they shouldn’t expect it of themselves. Keep in mind that you’re human, just like everyone else.
Becoming a Depression Counselor
Depression counselors are also called psychotherapists, therapists, counseling psychologists, clinical psychologists, and mental health counselors. But whatever the name, they all are trained in methods of psychotherapy specifically designed to treat depression.
If you desire to make a difference in others’ lives as a depression counselor, consider a career in one these fields. Contact mental health counseling or psychology schools for more information. Usually an advanced degree such as a master’s or PhD is required.
Acceptance and Commitment Therapy (ACT)
Unlike psychodynamic theories, behavioral approaches emphasize changing behaviors before specifically focusing on emotions. Emotions are harder to change, and will often occur automatically without conscious effort.
However, behavioral approaches follow the framework that a change in behavior often results, impactfully, in emotional changes.
Acceptance and commitment therapy (ACT) follows this behavioral approach, emphasizing that behaviors and emotions can exist alongside each other, simultaneously and independently.
For example, ACT helps clients accept that they feel a certain way, such as anxious over an upcoming exam, or a job interview. However, instead of avoiding these activities because of anxious feelings, this therapy stresses the importance of noticing the anxiousness while still carrying through with the events.
And unlike cognitive behavioral therapy, ACT does not try and alter thoughts, feelings, or emotions. Instead it simply teaches people to acknowledge and accept these feeling and thoughts, but then move past them, distancing them as much as possible from their actions.
ACT is a form of mindfulness therapy, a therapy that helps individuals access their transcendent selves, selves that are separate from their conscious thoughts but are there observing and experiencing them. (see article on Transpersonal psychology.)
Like its name implies, the therapy encourages clients to act, acknowledging life’s difficulties, but coming up with a strong directive to live life to its fullest regardless of these difficulties.