Thinking Healthy - John Julian

Conditions and 'understandings' to be accepted

into therapy

For individual therapy, there are several conditions and "understandings".  

For group therapy, after an initial assessment, everyone is welcome if the group is appropriate to their needs and can pay the requested means-tested fee.

Understandings

Becoming well and maintaining wellness requires the development of new habits. It is not just a matter of removing a 'pathology' or of cocooning one self in warm support. Compassion approaches used by John in CFT involves developing wisdom (understanding the the tricky nature of the brain) and courage. The motive for compassion is to address suffering, being sensitive to suffering and turning towards it, not away from it. Second, we need to respond wisely otherwise we can make things worse. When we move towards suffering and take steps to address it, we need the key qualities of courage and wisdom. These qualities are at the centre of compassion and Compassion Focused Therapy (CFT).

While a number of people occasionally gain instantaneous insights and change through cognitive therapy or meditation, change usually takes practice, practice and practice. Change comes from talking and/or reading with reflection and testing ideas, beliefs or patterns of response and practising the required new skills, including ways of thinking. This practice occurs in your own time. It is important to understand that we are complex beings in a complex society with many past and current influences. However, we can, with practice, literally design our own brain using our mind and practice (e.g. Hypocampus size in taxi drivers who do not use maps).

Secondly, neither therapy nor mindfulness is about feeling 'good' or leaving every session feeling 'relaxed' or 'good'. The first psychology of compassion involves engaging with distress. This may not be easy. It consists of noticing, tolerating, turning towards and engaging with distress.  If we use other methods, such as turning away (for example, by being busy all the time ) or blocking our pain and suffering, or using food, sex or drugs to block or deny it, emotional pain will get stronger.  Occasionally some exercises in sessions may lead to temporary increased distress or a "rupture" in the relationship, as part of a therapeutic process, transference, or a simple misunderstanding, etc., and if this occurs, the expectation is that you check in and talk about it  ith me.  "Ruptures" also appear in all relationships from time to time, and if this happens, it is important they are seen in the light of being another learning and therapeutic point.

The intention I always hold is one motivated by compassion.

Thinking Healthy also has a significant commitment to working towards a more just, equitable, diverse, and inclusive world. As part of this work, in 2022, we are developing a new organization with a participatory structure to explore ways of providing nature, compassion and mindfulness programs to a broader audience that may not easily be able to access these programs under the current 'fee-for-service' models used. Thinking Healthy has bought together a group of people and will host a social work student, to develop the new community-oriented group. This group, the Mindfulness and Nature Association (MANA) Inc., was incorporated in December 2022 and has now created its first program.

Since 2019, I have also attended training about whiteness and the issues of colonialism and concepts of white supremacy. Within the tangle of racism, inequality, violence, environmental degradation, toxic individualism, and unethical economics, Thinking Healthy celebrates and affirms life-sustaining processes and relationships. 

Conditions

For individual therapy, you need to agree to do homework! This involves compassion, mindfulness or relaxation practices, or a CBT/mindfulness/compassion experiment or skill. Reflection is always required. Secondly, some form of exercise is usually required: stretching, walking, Chigung, etc.    

I would also note that until November 2022, I held to the philosophy of original Medicare - that such services should be free and only charged people with very high incomes. Due to a change in Government policy, Medicare fees, starting with the Abbot Government, have not increased for years. I am no longer, broadly, able to make a decent hourly rate without additional charges for most people I see and maintain up-to-date therapeutic knowledge and skills. However, I continue to make an exception for people attending the clinic I run in Korumburra for people with no income or who are on Commonwealth benefits, even though this incurrs rental and and travel costs.

I attempt to keep administrative costs as low as possible to keep out of pocket fees low (and mistakes will occasionally occur because of this). If you want an administratively perfect service please choose another counsellor. However, please note thatI will not reduce my commitment to professional development to be able to offer a service based on the latest neuroscience and evidence about therapeutic approaches. 

The service consists of my available time Since April 2023 of one and half days a week. This will move to one day a week in July plus assiting with group work. It is not a public service that everyone can access, or have a right to access, and I reserve the right to assess and decide who I will see. This is made clear before we start – "Let's meet for a few sessions and see what can happen and if it is workable or useful" is a very common phrase I use.

Under no circumstances will people continue to be accepted for counseling or group work if they are violent or abusive in any way.  This includes verbally abusive (incl. name calling, swearing including swearing through the use of initials, etc) or drug-affected  (incl. alcohol) behaviour in individual or group therapy.

Unless compassionate grounds are agreed to, all appointments cancelled with less than 24 hours notice are required to be paid in full, and 50% of the appointment fee if less than 48 hours notice is given. I have in the past had a lenient attitude to missed appointments however this has been abused and therefore only one missed appointment without payment is now allowable unless there are clear grounds for compassion. It appears I am one of the few counsellors that still bulk bill people on benefits - that is there is no gap fee for people on low income. This needs to be respected and it needs to be understood that it is very difficult to run a private practice that bulk bills people on low incomes. After that it is your responsibility to pay - remember, you are an adult and need to take responsibility.

If you miss appointments I do not get paid. If I have not heard from you, then after the second missed appointment I need to place you on a waiting list - simply I cannot afford such lost income.

If I have not heard from you or your doctor for two week period after a review and have you not contacted me, I assume you no longer require your appointment times and they are offered to a person waiting.

We reserve the right to cease counselling at any point in time. Every counsellor/therapist has a certain level of trauma tolerance and a responsibility to to look after their health. At times the number of people being seen may need to be adjusted.  

Lastly, if a person misses two appointments, we reserve the right to cease offering appointments and to offer that time to a person on the waiting list.