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General information about psychological assistance, aimed at France:

Why and when to consult?

A few years ago, people hardly dared to talk about personal problems, let alone mental illnesses. It occurred quite often that people did not know what to say to someone suffering from depression or anxiety. Almost ashamed, someone turned to a psychologist or psychiatrist.
Society has evolved and today it is recognized that it can happen to anyone, sooner or later, that someone will experience psychological problems. So it has become easier to use the services of a psychologist.
There are no right or wrong reasons to consult a psychologist. Often they are reasons such as:
- Someone has personal difficulties: someone is not feeling well, someone is afraid of this or that, someone is anxious, depressed or stressed; in short: you know that something is not going well, which prevents you from developing yourself.
- Someone is going through a difficult stage in life: one might need help with painful events, such as a serious illness, divorce, loss of work, mourning, failure, etc.
- Someone is experiencing difficulties in his/her relationship with others: as a partner, in the family, or being alone and in isolation.
- Someone has difficulty with his sexuality.
- Someone wants to live differently, without necessarily having to build another existence. Someone wants to get to know himself better, further develop his possibilities, enrich his life and go through a personal development.
- Someone has to make a decision and needs help to get the advantages and disadvantages clear, to prepare for the consequences of a decision, to get more clarity, etc.
- Someone wants to orientate themselves: where should I put my energy, along which route do I let my career run, my life?

All these reasons, and many others, are valuable and legitimate. We usually think that we have to solve these difficulties ourselves, we also think that we can no longer control our lives. Unfortunately, it is not always possible to find the necessary sources in ourselves or our surroundings to deal with the situation we face. A professional can then help you make decisions, make choices and solve the problems with satisfaction. In fact, just like a physical complaint, the sooner you take action, the better.

Whom do you consult?
No matter how much help and support our friends and family offer us, it can be very useful to consult a professional. But who? A psychologist, a psychiatrist, a psychoanalyst, a psychotherapist? Even if their duties match on certain points, these professionals differ in their training and approach.

The psychologist has completed a university course specializing in psychology (level Bac +5). This study focuses on acquiring knowledge about nowadays humans and, for clinical psychologists, developing a capacity to pay attention to the difficulties of the psyche. The psychologist knows different conversation skills and techniques. The psychologist can use test material to measure intellectual capacities, skills or the personality of his patient. The psychologist often chooses a certain psychotherapeutic approach to specialize in, or a field in which he focuses his expertise. The title of psychologist is protected, which means that all psychologists must have a Master’s degree and a license in psychology and have followed an internship in their field.

The psychiatrist is a medical doctor who has done a specialization, as compared to a cardiologist and a surgeon. He specializes in psychiatry, that is in treating serious mental illnesses, usually by prescribing medication. He can, because he is a doctor. He also uses conversation techniques and psychotherapy to treat his patients In France, the title of Psychiatrist is protected, which means that all psychiatrists are specialized doctors and must be members of the Order of Physicians.

The psychoanalyst uses one of the psychotherapeutic approaches, the psychoanalysis, developed by Sigmund Freud. It is almost always a psychologist or psychiatrist who has followed additional specialized training in psychoanalysis. Neither the title nor the performance of psychoanalysis is protected in France.

A psychotherapist is someone who offers psychotherapy. This title is not protected in France; there is no clear regulation on the implementation of psychotherapy and there is no university education in France that trains for this (in the Netherlands it is a protected title, though). The title of psychotherapist may therefore be used by psychologists and psychiatrists who offer psychotherapy, but other people may also do so, whether or not they have had appropriate training.

The growing interest in psychology has led to the development of multiple forms of "psychotherapy"; services for the personal development of people, and clinical relevant but also fraudulent methods. From that point of view, caution is required. It is recommended that you ensure that the person you are contacting is a professional, with a thorough education, who is committed to the ethical rules as prescribed by his trade union. Only then will you be assured that your trust and effort will be rewarded, and you will be protected against possible malpractice.

Where do you find a psychologist?
* The location: - In the public sector: Hospitals: it is often possible, usually on the indication of the general practicing doctor, to consult a psychologist in a hospital in the area. The first step is to talk to your own doctor. Schools: people who often go to schools can consult a school psychologist when it comes to their children's learning/school problems. You can contact the school management or contact the BAPU (Bureau d'Aide Psychologique de l'Université).

Psychologists also offer psychotherapeutic help in other public sectors (psychiatric hospitals, prisons), but those services are, of course, only reserved for people living in those institutions.

The psychological services in public institutions have the advantage that they are free; unfortunately there are too few and cannot meet the demand. It can therefore happen that there are long waiting lists.

- In private practices: Many psychologists offer their services in their own practice. These services are not reimbursed by social insurance.

* The request for help: Many psychologists make a distinction in their practice based on their education and experience for which group of people they offer help; children, adolescents, adults, the elderly, groups, companies... Others have developed their competitions to provide assistance to a specific question. Examples include psycho-judicial work (for example, as a witness in a court case about the custody of a child), mediation (in the event of divorce), career planning, etc. And finally there are psychologists who specialize in specific problems (alcoholism, addictions, eating problems, psychosomatic problems, etc.)

But all psychologists, even those who have not specialized, have followed a course that is sufficient to guide the person who is consulting them in finding out the problem he is facing.

The choice of a psychologist:
It often seems difficult to choose a psychologist. Here are a few options to simplify this: * As with other professionals, the experience of friends and acquaintances can be useful in recommending a psychologist they know. That is perhaps the best frame of reference. Make sure that the recommended person has the title of psychologist. * Your doctor can very well recommend a psychologist. * You can also contact one or more psychologists yourself. If you feel comfortable with one of them, make an appointment. Because the relationship between psychologist and patient is important in therapy, it is only after the first meeting that you can better assess whether you are ready for treatment.

In case of emergencies:
If a person in your environment is in crisis, so that he has lost control of his daily life, is confused, reacts very aggressively or is suicidal, do not hesitate and contact the emergency services (SAMU = 15) Or Take this person to the nearest hospital very quickly. If you feel very bad, for example very depressed or anxious, and you need help quickly, contact your doctor quickly. There are also telephone emergency services that are available day and night and can help you find a solution to the problem at that time. Their telephone numbers can be found on the first page of the Pages Jaunes of your department.

What is Psychotherapy?
First and foremost, psychotherapy starts with the decision to face personal problems and to improve the way of life. You thereby also enter into a process of an enrichment process, although this - and that must be said - is a demanding process. It is a personal approach, in which the psychotherapist helps you to investigate your situation, clarify it and initiate a change process. It is not a ready-made solution, not a panacea, it does not happen automatically.

What happens during psychotherapy?
Psychotherapy consists mainly of having an individual appointment (often weekly) with the psychologist in his practice, or via Skype or by telephone, for a fixed period of time (half an hour, 50 minutes or an hour). It is often said that 'being in therapy' is the same as telling his problems to a silent psychologist, and often people compare therapy conversations with talking to friends. However, it is not comparable. Firstly, they are not conversations aimed at socializing: the exchange between psychologist and the person in therapy focuses on very specific goals and themes. All topics that are addressed are focused on those goals. The conversations revolve around your personal life, your emotions and what is important to you. It is often also about what you have learned in your past and your childhood. Secondly, it is true that attentive listening by the psychologist involves part of the therapy, more or less dependent on the psychologist's approach. But in most therapies, the therapist intervenes: he asks questions, gives reactions to your story, asks you for clarifications of your story and motives, asks you to express your emotions and describe them in relation to events.

The psychologist sometimes works with exercises that help you concentrate, relive or imagine an event. He can also make proposals for conducting behavioral experiments in the time between 2 therapy sessions. He is attentive (more or less dependent on his education) to the relationship that takes place between you and him, to your attitude towards him with both positive and negative aspects.

Am I alone?
Psychotherapy usually takes place between you and your psychologist. Sometimes people from your environment are involved in the therapy, for example if there are relationship problems or family problems. This never happens without your knowledge and consent. Group therapy is also possible, in which the psychologist works with a group of people who can help each other because they have the same problems. If that is the case, your psychologist will inform you about this and ask if you want to participate. You will never have to deal with a group without having been informed in advance.

Does therapy take a long time?
Psychotherapy is a process of change. We all know that changing behaviours, attitudes, and responses is not a simple and rapid process. Usually you cannot reach your goals in one or 2 sessions. Yet psychotherapy does not have to last for years. According to the current standard, a few months to a year are enough to achieve good results. The duration of the therapy does depend on a number of factors, such as the severity of the problems, the goals that are set, the choice of the therapeutic approach, and the adaptation time (of feeling comfortable with the therapist and therapy, etc.), and it may sometimes be necessary to be in therapy for more than a year.

When does the therapy stop?
There are no strict rules for stopping therapy. You can stop your therapy whenever you want, because you are not obliged to continue the therapy or to pay in advance. The psychologist can also complete the therapy when the goals are broadly achieved. It is not necessary to arrange everything to end a therapy; it is normal to follow therapy and return a few months or years later if there are other problems. It may also happen that a psychologist has to end the therapy, for example if he is going to work somewhere else or if he estimates that the help of another professional is more appropriate. In that case, the psychologist must ensure that this termination is not detrimental to the patient.

Do I have to continue taking medication?
The psychologist does not prescribe medication. If you were taking medication before you started the therapy, consultation with your prescriber and the psychologist may take place with your permission, to coordinate psychotherapy and medication therapy. This collaboration is increasingly common and in many cases has a good effect, for example with certain physical problems (stomach ulcers, heart problems, sadness complaints, etc.).

Which form of therapy?
For several years, various approaches within psychotherapy have been discussed, such as psychoanalysis, gestalt therapy, behavioural therapy, cognitive therapy, relaxation techniques, etc.

What is a psychotherapeutic approach?
The psychotherapeutic approaches, or "psychotherapies," are applications of various theoretical models developed by researchers, psychologists, or psychiatrists to explain the psyche of man, or his personality, his behaviour, his emotions. These approaches assume the "method" of psychologists. There are techniques associated with these psychotherapeutic approaches, the most famous being relaxation techniques, psychodrama, creative therapy, hypnosis. These form the tools available to the psychologist who is trained in his own direction.

What approaches are there?
There are many different psychotherapeutic approaches. The most important ones are briefly discussed here.
* the psychodynamic / analytical method: Is strongly influenced by psychoanalysis and appeals to the subconscious. This approach seeks a connection between current problems and experiences or conflicts that have played or were resolved in the individuals past. The patient is helped to become aware of unconscious influences and conflicts, and to get rid of them.
* the existential / humanistic approach: This approach focuses on the human ability to lead and develop its existence. The emphasis is on the present, on the ability of man to be aware of his abilities, to understand himself, to adapt and to act. The psychologist facilitates the self-examination of the person who consults him, and helps him to experiment with new ways of being and actions. The Rogerian approach, Gestalt therapy, the self-development method are examples of approaches that support this idea.
* the behavioural therapeutic / cognitive approach. The specialists of the behaviourist approach assume that the psychological difficulties lie in the thought patterns (= cognitive) or in (no longer appropriate) behaviour, learned by the person in his own environment. In this approach, these behavioural and thought patterns are investigated, in combination with the environmental factors of the person. Then new patterns are learned that replace the old thoughts and unwanted emotions. Behavioural therapy and cognitive therapy are the best known forms of this approach.
* the system / interactional approach Within this approach, it is assumed that personal problems arise and exist within the interaction of someone within his environment (family, friends, working environment, etc.). After analysing the problem situation, the purpose of this therapy will be to change the relationships around this person and his environment. Within this approach, people important to the patient are often involved in the treatment. Family therapy is an example of this form of therapy.

How do I choose the shape that suits me?
The psychologist's choice depends on various factors and not just on the psychotherapeutic approach. In fact, and studies have shown, the one or the other approach is no worse or better than the other. The core for success of a therapy lies more in the contact between psychologist and patient than in the therapist's method. There is no miracle method. In addition, it is a fact that most psychologists apply multiple methods, appropriate to different approaches.

Instead of asking about the approach, it is more convenient to ask about his methodology and method. Then you have a better impression of whether you like it. You can also ask about the specific experience of the psychologist, for example with children or couples.

By the way, a great deal of comparative scientific research (including depression, anxiety and psychosis) has been conducted into behavioural therapy and cognitive therapy versus other forms of therapy. This has shown that when someone falls back on old behaviours, these forms of therapy help to recover quicker compared to other forms of therapy.

In any case, beware of 'popular' therapies and 'new flows' that promise all kinds of miracles and ultra-fast recovery for all problems or that consist of a union with a closed group or even a cult. Such 'psychotherapies' usually prove to be expensive and can even destroy your personal development.

The above text is a free translation from French of an article on www.psychologue.fr

Are my rights protected?
Your rights are protected if you consult a psychologist. Today there are many people who are not psychologists and use various titles as 'psychotherapists' or 'specialists in human relationships'. If you want to be able to properly protect your rights, you must ensure the professional identity of the person you are going to.

All psychologists have also committed themselves to the professional rules laid down in the Professional Ethics of Psychology (published by the NIP in the Netherlands). This professional ethics encompasses the general principle of human rights, protects his private life and guarantees professional secrecy.

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