Counselling the Mentally Ill

As always, Dr Tan came across as a compassionate person. He acknowledged the late-comers by saying things that made them feel comfortable and self-accepting. I felt blessed to be associated with the top psychiatrist in Singapore and to be a student of his.

Psychotherapy is the systematic use of a human relationship for therapeutic purposes of alleviating emotional distress by effecting enduring changes in a client’s feeling, thinking and behaviours.’ - Strupp 1986

Time Limited Psychotherapy is not suitable for long-standing personality disorders, chronic and persistent mental illnesses (such as schizophrenia and bipolar disorder. CBT has been demonstrated to be effective for Depression, Anxiety Spectrum Disorders, Eating Disorders, Sexual Disorders and Substance Abuse.

I learnt different techniques to solicit information from the mentally ill clients who may be vague or give monosyllabic replies and some resistance to boot. I need to find a balance between letting the patient tell his story in his own words and in obtaining information from him using Opening Techniques. Clarification Techniques (Patient-Centered) are used for Specification, Checking Symptoms, Probing (for delusion), Interrelation (for disordered thinking) and Summarizing (for psychotic clients).

I can also choose the Interviewer Directed Steering Techniques at some points – Continuation, Echoing, Curbing (irrelevance) & Transition (smooth or abrupt )

In dealing with Resistance, we use the techniques of Acceptance, Confrontation, Looping, Exaggeration and Induced Bragging.

It was helpful that the techniques were illustrated with transcripts of dialogues between therapist and client.