Thinking Healthy - John Julian

Conditions and Understandings for Entering Therapy

Individual Therapy

To begin individual therapy, several conditions and understandings must be accepted:

• You must be willing to engage in home practice—this may include compassion, mindfulness, or relaxation exercises; CBT/mindfulness/compassion-based experiments; or skill-building tasks.

• Reflection is essential, both during and between sessions.

• Some form of physical movement is also usually encouraged (e.g., walking, stretching, Qigong).

• We will usually begin with the shared understanding:

  “Let’s meet for a few sessions and see what can happen, and if it is workable or useful.”

As part of a long road to retirement, I now also have Joanna Walz assisting me as a co-therapist, and Jo will sit in with many clients. 

I would also note that late afternoon appointments are kept for people who are working.

Therapy is not a public service and is not available to everyone on demand. I reserve the right to assess whether therapy with me is appropriate and sustainable, both for you and for my own well-being. Equally, the hours I work are now limited. Please note: I do not provide after-hours or emergency response. For urgent needs, use the Emergency & Crisis Support Contacts listed above.

Emergency & Crisis Support Contacts

If you are in immediate danger, please call 000 (Police, Fire, Ambulance).

Mental Health & Crisis Lines

• Lifeline — 13 11 14
  24/7 crisis support and suicide prevention service.

• Suicide Call Back Service — 1300 659 467
  24/7 counselling for people at risk of suicide, those supporting them, and those bereaved.

• Beyond Blue — 1300 22 4636
  24/7 mental health support for anxiety, depression, and emotional distress.

• Kids Helpline — 1800 55 1800
  24/7 confidential counselling for children and young people aged 5–25.

Domestic & Family Violence

• 1800 RESPECT — 1800 737 732
  24/7 support for sexual assault, family and domestic violence.

State/Territory Mental Health Crisis Teams

• Victoria — 1300 363 746 (24/7 Mental Health Triage Service)

• NSW — 1800 011 511 (Mental Health Line, 24/7)

• Queensland — 1300 MH CALL (1300 642 255)

• South Australia — 13 14 65 (Mental Health Triage Service, 24/7)

• Western Australia — 1300 555 788 (Mental Health Emergency Response Line – metro); 1800 676 822 (Peel region)

• Tasmania — 1800 332 388 (Mental Health Helpline, 24/7)

• ACT — 1800 629 354 (Mental Health Crisis Service)

• Northern Territory — 1800 682 288 (Top End Mental Health Service)

Health & GP Support

• Healthdirect Australia — 1800 022 222
  24/7 nurse advice line for physical and mental health concerns.

• Your GP — for ongoing medical or mental health needs.

How to Use This List

• If urgent (risk to self or others): call 000 immediately.

• If in crisis but not life-threatening: call Lifeline, Suicide Call Back Service, or Beyond Blue.

• If family/domestic violence is involved: call 1800 RESPECT.

• If needing state-based mental health intervention: call your state’s Crisis Team number above.

• If unsure: call Healthdirect or your GP for guidance.

Group Therapy

Following an initial assessment, group therapy is available to anyone for whom the group is deemed suitable and who can pay the means-tested fee. For groups auspiced by MANA, participation is by donation.

Core Understandings About the Therapy Process

1. Change Requires Practice

While sudden insight is possible, lasting change comes from ongoing practice—repeated reflection, testing of beliefs, and developing new habits of thought and action. Change does not come simply from removing a 'pathology' or being surrounded by warmth. It involves developing:

• Wisdom: Understanding how our brains can work against our well-being.

• Courage: Turning towards suffering rather than avoiding it.

These are the heart of Compassion-Focused Therapy (CFT). Compassion is not softness—it is the courageous, wise engagement with distress.

2. Therapy May Involve Discomfort

Therapy is not always relaxing or pleasant. Compassion practice asks us to notice, tolerate, and turn toward distress, rather than avoid it through busyness, denial, or harmful behaviours (e.g., food, alcohol, distraction).

Sometimes, exercises in therapy may lead to increased emotional discomfort or even a rupture in the therapeutic relationship. If that occurs, the expectation is that you speak with me about it directly. Ruptures can be a vital part of healing, and learning how to repair them is itself therapeutic.

However, if a rupture escalates to a client stating they no longer feel safe, therapy may be paused or discontinued for the client’s wellbeing. Generally, often what occurs in the counselling relationship is what also happens to the person in their life, and such patterns can then be more clearly seen, although this takes time for the client to step back and depersonalise the situation and reflect. While we also focus on providing a sanctuary of safety and safeness, if a client states that they no longer feel safe in therapy with me, sessions may be paused or discontinued, as safeness and safety, two different concepts, are the foundation for all therapeutic work.

3. Commitment to Equity and Inclusion

Thinking Healthy is committed to social justice, ecological responsibility, and inclusion. In 2022, we helped establish MANA Inc., a not-for-profit group offering compassion, nature, and mindfulness-based programs beyond the traditional fee-for-service model. We are also working to make these programs more accessible to those facing financial or systemic barriers.

Since 2019, I’ve undertaken training in whiteness studies, colonialism, and systemic inequality, and this learning continues to inform my practice.

Fees, Cancellations, and Accessibility

Bulk Billing and Fees

Until 2022, I worked in alignment with the original Medicare philosophy: that mental health services should be free or low-cost. Unfortunately, due to government policy changes and the low Medicare rebates, I now require gap fees to maintain a sustainable and professional service.

However:

• I continue to bulk bill people on low incomes.

• A charge may need to be introduced in 2025 to all individuals to cover costs.

Please note, in keeping fees as low as possible, with few out-of-pocket fees for people on an income benefit:

My priority is clinical care and staying current with neuroscience and evidence-based therapy.

Administrative matters will be attended to as capacity allows.

As of April 2023, I offer 1.5 to 2 days per week on Tuesdays and Wednesdays, with limited times on Thursdays, plus group work facilitation. Due to limited time, clients must:

• Take responsibility for showing up.

• Understand that this is not an emergency service.

• Acknowledge that if appointments are missed without notice, that the time slot may be offered to someone else.

• That I undertake other activities from Friday to Monday and may not check messages. Emergencies can be dealt with by other means as described above. Hence, non-urgent emails or texts will be answered during working hours, which may mean after several days. 

Cancellation Policy

Unless prior compassionate grounds are agreed upon:

• Cancellations within 48 hours incur a 50% fee.

• Cancellations within 24 hours require full payment.

• One missed appointment without payment may be allowed. After that, you will be moved to a waiting list.

If I do not hear from you (or your referring doctor) within two weeks after a review, your appointments may be offered to someone else.

Safeness, Safety and Respect

Therapy is a relationship based on mutual respect and the twin conditions of safety and safeness.

• Safety means freedom from hostility, abuse, or danger. It includes clear boundaries that protect both client and therapist from harm.

• Safeness means the felt experience of warmth, respect, and compassion that allows trust and courage to grow. Safeness comes from how we relate — with care, curiosity, and accountability.

I reserve the right to cease counselling or group participation at any time if:

• A person is verbally or physically abusive. This includes swearing, aggressive tone, derogatory remarks, name-calling (including through initials), or repeated critical attributions about my integrity, intentions, or professionalism.

• A person engages in disrespectful communication, including accusatory, belittling, or hostile comments (even if not phrased with profanity). Communication needs to be directed toward exploring your own experience, not assigning blame or negative characterisations to me or others.

• A person arrives to therapy under the influence of alcohol or other drugs.

• A person repeatedly misses appointments or refuses to take responsibility for their own behaviour.

• A person consistently refuses to engage in agreed therapeutic tasks (home practice, reflection, skills, etc.), such that therapy becomes unworkable.

Every therapist has a trauma threshold and a responsibility to maintain their own well-being. Therapy must be workable for both of us, and workable therapy requires both safety and safeness.

Final Note

I hold an intention of compassion in all my work, even when I am business-like! If you enter therapy with me, it is with the shared understanding that therapy is a collaborative, evolving, and sometimes challenging process. The path to well-being includes courage, patience, and practice.

Thank you for reading and reflecting.