Transcript for
How to find the right health professional

Narrator (VO) (00:02):

Welcome to the Emerging Minds Families podcast.

Nadia Rossi (Host) (00:05):

Welcome to today’s podcast. I’m Nadia Rossi. Few of us go through life without the need to visit a practitioner at one point or another, whether it’s falling off our bike when we are younger and needing a few stitches, going to visit a pediatrician with our children, or spending time with the psychologist or psychiatrist to talk through some difficulties we may be having. In Australia, we are fortunate to have a wide range of practitioners to support our needs as we navigate the ups and downs we may experience; professionals who are there to help us move forward and truly get the most out of life.

(00:38):

Today we are talking to Jackie Amos. She is a child and adolescent psychiatrist who understands how important and complex it can be to find the right support and a practitioner that you have confidence with and feel comfortable to meet your health care needs. Welcome, Jackie. Thanks for talking with us today.

Jackie Amos (Guest) (00:55):

Thank you for inviting me.

Nadia Rossi (Host) (00:57):

Jackie, for those listening who may not know, when we use the term ‘practitioner’, what do we mean?

Jackie Amos (Guest) (01:03):

The way that I think about it is that a practitioner is somebody who has undertaken some study, maybe got some formal qualifications, and belongs to a group of other like-minded practitioners, say occupational therapists or psychiatrists, and they’ve done that study in order to understand the ways that families work and the things that can trouble families in order to offer that expertise to families in times of need to try and help people through a difficult patch.

Nadia Rossi (Host) (01:35):

And how would someone access a practitioner?

Jackie Amos (Guest) (01:38):

It can vary. For example, if you wanting to access a practitioner like a psychiatrist or a psychologist where there might be rebates available from Medicare, some occupational therapists, physios, other people, social workers, all have some rebates available, then the general practitioner is your first port of call.

Nadia Rossi (Host) (01:59):

The GP.

Jackie Amos (Guest) (02:01):

The GP is the person who can write the referrals and check that you’re eligible for the rebates and often actually have a good list of people they’ve worked with before who they can refer you to or direct you towards.

Nadia Rossi (Host) (02:16):

When we think about practitioners and working in the space of mental health and wellbeing, what can someone expect when they’re visiting a new practitioner, I guess for the first time?

Jackie Amos (Guest) (02:28):

Well, obviously, when you first visit a practitioner, there’s a two-way process of needing to get to know each other. So it’s quite likely that the practitioner is going to want to talk to you about things that have been troubling you, what the difficulties are, what it is that’s brought you to them for help. But I think it’s also useful to think about it the other way around, that if you are seeking the help from a practitioner, then this is your opportunity to put them through a job interview, get to know them a bit, what their qualifications are, what are the things that they work with most often and feel most confident with, and are they a good fit for you personally? So I think it’s really important to remember that they’re not just getting to know you, but you are getting to know them. And that’s an opportunity to decide whether in fact they meet your criteria for the job that you would like them to do with you.

Nadia Rossi (Host) (03:20):

Because I feel like, essentially, you are starting your relationship that will go through certain phases of getting to know each other.

Jackie Amos (Guest) (03:28):

Absolutely. And getting to know each other is that very important first step because if that step isn’t done carefully and in enough detail, you can set off on a journey down a path that turns out not to be the right path for you and your family. And likewise, if you meet a practitioner and they just don’t seem quite right, you’re interviewing them and either their skillset’s not quite right or the fit between you and them as a person doesn’t feel quite right, you could find yourself taking a bit of a journey together and then having to disentangle yourself. So it’s good to really pay attention to the fit and do they fit for you early on.

Nadia Rossi (Host) (04:10):

And if someone is feeling uncomfortable in the conversations with their practitioner, is it valuable to talk to your practitioner about that and how you’re feeling in that process?

Jackie Amos (Guest) (04:20):

Definitely, because I think in phase one, there’s always that ‘getting to know you’ phase: there’s always a sort of anxiety; it’s a bit odd or new; it’s a bit uncomfortable. As long as it doesn’t feel like a really bad fit, it’s worth persisting at that point. But if you get into a therapeutic relationship with a practitioner and you’ve been going along and it’s felt good and you’re feeling like you’re connecting well and that this is a good fit, and then you start to feel uncomfortable, it’s a bit different because what it might mean is that the process is starting to get to the difficult things, to the core of the issue, to the painful things that we all as… via our nature as humans, like to disengage from.

(05:05):

And at that point, I think it’s really important instead of just pulling away or talking to other people, which you can of course do to get advice, but also talk to the practitioner. They may have some ideas about what’s going on. They may be able to reassure you that this is a normal part of a therapy process, that at times we need to talk about painful things and they should be able to give you a really good rationale or reason why this is happening now.

(05:35):

I think the other thing is it’s a good opportunity to test out, again: is this the right person? Because if you bring this forward to your practitioner and then they’re very defensive and prickly and don’t seem to be able to have a conversation with you about it, that might leave you questioning whether the practitioner can really help you through this tricky patch. But if they welcome your questions – they want to talk to you further about it, find out about the discomfort, can help you understand why this is part of the process, and then is spending time working with you problem-solving how to make the discomfort manageable – then I would say that you are with a good practitioner who’s able to really work together with you and that if you stick at it, you’re going to find your way through to a better place.

Nadia Rossi (Host) (06:28):

I think that that’s really great for our listeners to hear because I feel like, in that environment, you may feel slightly intimidated that ‘this is a professional sitting in front of me and maybe this is how I’m meant to feel’. And ‘maybe I’m meant to feel uncomfortable’. But you’ve really highlighted the uncomfortable bits that are good and the uncomfortable bits that maybe are not so good. Thinking as a parent, if you’ve taken your child to see a practitioner and that your child is expressing a discomfort in going back, what advice would you have for parents to support their child going through that process?

Jackie Amos (Guest) (07:02):

Yeah, that’s a really important question, and it’s going to depend a lot on the age of the child. So I think for parents with younger children, it’s an adult decision. So as the parent, it’s your job to do the job interview with the practitioner: notice how they’re engaging with your child, get a sense of, ‘is this practitioner right for my family?’ And if your decision is that ‘this is a good fit’, then I think it’s really important for that parent to hear the child’s reservations, talk about the fears, find out what it is that’s bothering the child, and then try and work with the child to provide the support that they might need to engage with a practitioner that you as the parent feel is right. I think too, bringing those concerns forward to the practitioner, helping the child to know that their concerns have been taken seriously, their voice has been heard, and hearing how the practitioner responds to that is another important part of that.

(08:04):

And absolutely, even though you feel it’s the right practitioner, that child simply can’t relax or connect with that practitioner, then it is a decision that ‘this is not going to work’. If the child really won’t engage, it can then be a number of pathways forward. The practitioner may engage with just the adult and help the child through suggesting and supporting different experiments or ways of working with the child at home, or it may be a matter of finding a different practitioner.

(08:35):

Obviously, that gets more complicated the older the child, because the older the child, the more important it is that they have their own voice; that we support them in their development of their independent decision-making; and their growing up process of taking more and more decisions for themselves with adults alongside. And so, I think with adolescents particularly, you’re going to lean in the other direction. If they really can’t get comfortable, you’re often going to have to make a decision sooner that it’s not a good fit.

(09:07):

But again, talking about what’s not working, finding out whether the fear is that they’re going to have to disclose painful things or confront painful things or talk about stuff that they find embarrassing or shameful, and reassure them and work with them about ‘this is part of what we need to do for you to feel better’; ‘this is tough, but the reward on the other side could be worth it’. I think that, again, it’s really important not to just immediately jump to ‘we have to change’, but to make sure that that’s really explored well and see if those barriers can be gently softened, bit by bit. But in the end, if a child or a young person is really uncomfortable – just may be the wrong person.

Nadia Rossi (Host) (09:53):

That’s saying like, ‘you are an expert in your family and your child and their needs’, but also ‘understand that it is a big process and it does get tough’, but also listening to your intuition and your child as well with the best path forward for them.

Jackie Amos (Guest) (10:08):

Yeah. And I think you raise a really good point, which is that practitioners are not necessarily experts, but they have expertise. They have knowledge and understanding about things that they can lend to you or share with you or give to you so that you can put that together with your understanding of your young person; your child; your family. And it’s together, by both bringing our different knowledges and understandings, that we can find a way forward. It’s, I guess, really important to remember that whilst the practitioner has something to offer – otherwise there wouldn’t be practitioners – you have to combine that with your understanding of your situation. Otherwise, you’re going to feel like somebody’s doing something to you rather than working with you. And nobody likes to feel like they’re having something done to them.

Nadia Rossi (Host) (11:02):

Absolutely.

Jackie Amos (Guest) (11:03):

That’s an uncomfortable experience. And really, ideally, with a practitioner, you should feel like you’re doing something together, not you are seeing them and they’re doing something to your family.

Nadia Rossi (Host) (11:14):

And as a practitioner supporting children in particular, do you consider the whole family in thinking about their care?

Jackie Amos (Guest) (11:22):

I think it’s incredibly important to think about the whole family. And again, the age of the child is important here, but very young children are not separate to the world that they live in. And they also can make all sorts of models about the situation that is happening in a family. And so, if as a practitioner we don’t understand the whole family, and the stresses and strains and pressures on the adults in the family, we are not necessarily going to be able to help the child, or help the family with the child. And sometimes, those pressures and stresses can come from a parent’s own experiences of growing up or being a child themselves.

(12:04):

And so, sometimes practitioners are going to want to think about those things together with a parent individually or a couple, separate to the work with the child. It can feel a bit nosy sometimes or a bit intrusive. And I guess there’s always the risk that we feel blamed once people start talking to us about ourselves when we’ve brought a child for help. And I guess what I want to do is reassure people that it’s not about assigning blame. It’s rarely helpful, but it is about: how can we understand the whole of this situation and all of the pushes and pulls and pressures that are in a family to find a creative way forward? And it may be that knowing a little bit about a parent’s own history can unlock a new healing pathway that just wouldn’t be apparent without that information.

(13:00):

If we move to adolescents, the same still applies, but adolescents can sometimes really be keen to see a practitioner on their own, and that can be very helpful. I think, for me, I always still want to have some relationship with the family because the family are the people that the adolescent is leaning into, hopefully, in between sessions. Or if the adolescent has lost connection or is feeling they can’t lean into the family, trying to help that happen in a safe way for everybody is very important because, in the end, the people we have are our natural supports. Therapists are great. They come into your life at times, invited by you, to offer some help, but they also go away. And so, if the therapist can help a family to reconnect or offer support to one another in ways that aren’t misunderstood or that aren’t painful for people, then that’s a really good outcome because when the practitioner leaves, the family are still there.

Nadia Rossi (Host) (14:01):

So they’ve taken the whole picture and you’ve given the family the tools to move forward in their own way.

Jackie Amos (Guest) (14:08):

That’s an ideal situation.

Nadia Rossi (Host) (14:10):

Ideal situation.

Jackie Amos (Guest) (14:10):

And then there are situations that are always going to need a different approach. And so, again, what I would say is, if a practitioner is suggesting certain ways forward or certain approaches, then ask them their reasoning, make sure it all makes sense and is logical, and make sure that you feel like you’ve got free choice in making a decision to go along with that or not go along with that.

Nadia Rossi (Host) (14:34):

Absolutely.

Jackie Amos (Guest) (14:35):

If you’re feeling pressured; feeling like you’re having something imposed on you, it’s probably going to be uncomfortable for a long time.

Nadia Rossi (Host) (14:43):

And when I’m thinking about accessing practitioners… in the media, we hear a lot at the moment about long waiting times. What would your advice be for people who are finding it difficult to access a practitioner?

Jackie Amos (Guest) (14:56):

It is a really difficult situation. There is a high demand and there are waiting lists. So that is a reality. The first piece of advice I would have is: even if there are waiting lists, if you have a practitioner you feel is going to be a good fit, get on their waiting list. Even if you’re afraid that the problem might resolve before you get to meet them, if you’re on the waiting list, then you’re in the process and you know are going to get there eventually. If you’re not on the waiting list, you’re not going to get to the practitioner.

(15:27):

The second thing is that if one practitioner’s full, they might know other people that your GP doesn’t know or that you don’t know, and they might be able to say, ‘try this person’ or ‘try that person’. Or ‘having heard a bit about your story, I think maybe this person would be a good fit’. So use the networks that the practitioners have to get recommendations, obviously.

(15:50):

I think the other thing is: if things escalate and it’s becoming more and more urgent, don’t just wait  – make contact with the practitioner whose waiting list you’re on – they may be able to help. If they can’t, go back to your GP – they may be able to help. And then in the event of it escalating and becoming really urgent, we have emergency departments. We have hospitals. And these places also can provide some crisis support, and there are crisis hotlines. A lot of the crisis hotlines are very good at supporting people at points where things have just become really stressful. And so, use those resources to tide you over and don’t give up. Don’t give up looking for someone.

Nadia Rossi (Host) (16:36):

What would your advice be to people listening today so that they can make the most out of seeing a practitioner?

Jackie Amos (Guest) (16:43):

I think the first piece of advice would be just try and be really open to having honest conversations, even if they’re painful. So sharing those awful fears you have. ‘Have I created this?’ is a fear that so many parents have. Share that fear. If there’ve been some traumas and difficult times in your family, share those because a practitioner is not going to judge. They’re there to understand. And so, trusting as best you can and bringing all the information forward will certainly get you further than holding information back. And maybe doing a little bit of preparation, thinking about, ‘What are the important things? What are the things that I feel comfortable sharing, but what are the important things that I might be less comfortable sharing?’ Make a list, have it with you as a prompt, because in the moment we tend to wall off the difficult things and they’re the bits that get missed and they’re often the things that can provide the best opportunity for change. And I think just be brave and you’ll get the best out of the conversations. Be brave, share what’s on your mind, what’s in your heart, and you’ll get the best outcomes.

 

Nadia Rossi (Host) (17:57):

Thank you, Jackie. Thank you for talking with us today. It has been so interesting to explore the ins and outs of visiting a practitioner because we know from experience that many people feel nervous or hesitant in taking that step to seek further support. If there was one thing you want listeners to remember from our time today, what would it be?

Jackie Amos (Guest) (18:18):

One thing. I haven’t got one. I’ve got two!

Nadia Rossi (Host) (18:21):

You can have two. You can have two!

Jackie Amos (Guest) (18:24):

The first would be, remember, at the beginning, you are interviewing the practitioner as much as they are interviewing you. And the second thing would be to be as open as possible, not only about the struggles that have brought you to the practitioner, but about anything that you are uncertain about or that’s starting to feel uncomfortable as you go through the process – because it’s only if a practitioner knows what’s happening for you, that they can adjust or help or talk it through.

Nadia Rossi (Host) (18:54):

Thank you. Thank you, Jackie.

Narrator (VO) (18:58):

Visit our website at www.emergingminds.com.au/families for a wide range of free information and resources to help support child and family mental health. Emerging Minds leads the National Workforce Centre for Child Mental Health. The Centre is funded by the Australian Government Department of Health under the National Support for Child and Youth Mental Health Program.