Making the decision to undergo therapy is a daunting task for a significant number of Singaporeans. This article seeks to answer common questions that I commonly encounter as a clinical psychologist by new clients, or by individuals making enquiries about therapy.

What is psychotherapy? Is it different from counselling?

Both psychotherapy and counseling involves the services of a qualified professional to empower an individual to overcome life challenges, and to change their thought and behavioral patterns. The term Psychotherapy and Counselling are commonly used interchangeably as they possess considerable overlap. However, understanding these differences may be useful for your consideration while searching for a mental health professional.

Counselling often target on a specific issue, and resolving them at a conscious level. This may include learning to manage emotions (e.g. anxiety and stress), modifying depressive thoughts and behaviours, and evaluating options when making decisions.

Psychotherapy, or therapy in short, looks deeper in order to resolve issues which underlie presenting complaints. Like counselling, psychotherapy also explore your behaviour and thought patterns that are causing you distress. However, psychotherapy also seek to develop a deep understanding of one’s emotions by exploring their past. By creating an awareness of how one’s long-standing beliefs, thoughts and behaviours were shaped by past experiences, the individual can then break free from these unconscious influences.

To illustrate briefly, counselling with a client undergoing depression may involve the practice of relaxation techniques, and learning new behaviours to improve self-esteem. On the other hand, uncovering the past experiences of a client with depression in psychotherapy may reveal that the heightened emotional responses to criticism are fueled by the scars of critical parenting in his childhood- resulting in increased vulnerability for depression.

Who benefits from therapy?

Therapy and counselling benefits anyone! Therapy is not only for those who have been diagnosed with depression, an anxiety disorder, or any other mental health issues. In fact, you do not have to be experiencing unbearable amount of stress and difficulties! In Singapore, people often hold the belief that seeking therapy with a psychologist is only for those who have mental health issues and are facing difficulty managing their troubles. Of course, psychologists conduct therapy as a form of intervention for these individuals. However, if you are looking to understanding your emotions and cognitive processes better, experience personal growth, or to evaluate your perspective of life and happiness, therapy will provide you with the assistance you need.

Is therapy with a psychologist effective in the Singapore culture?

Most of the knowledge on psychological theories, psychotherapy and counselling are derived from the western countries. However, research has also shown that therapy is applicable in Singapore for the following mental health conditions including:

• Depression (Wong, 2016: O’Brien & Arthur, 2007)

• Anxiety (Wong 2016)

• Chronic Pain (Tan et al. 2009)

• Post-natal depression (Kok & Ratnam, 1994)

• Panic Disorder (Thevaraja & Gwee, 2015)

• Post-Traumatic Stress Disorder (Tan & Chew, 2015)

• Anorexia Nervosa (Utpala, 2015)

• Obsessive compulsive disorder (Tay & Gwee, 2015)

• Gambling Addiction (Manning et al., 2014)

• Insomnia (Seow et al., 2015)

As mentioned above, therapy is not only for individuals seeking treatment of mental health conditions. There is also evidence that undergoing therapy in Singapore improves well-being in the following areas: • Work productivity (Reb & Narayanan, 2015)

• Stress management and burnout (Yang, Meredith & Khan, 2017)

• Coping with chronic health condition (e.g. cancer; Chan et al., 2017)

• Smoking Cessation (Kit & Teo, 2012)

Common misconceptions about therapy in Singapore

1) Going for therapy means you are “crazy”

Is there anymore I can say?!?! The lack of understanding on mental health issues in Singapore has led to the stigmatization of mental illnesses. Again, I repeat. Therapy benefits everyone. It is not only meant for those undergoing depression, anxiety or other mental health conditions.

2) The psychologist will give you medication, and you will become dependent on psychiatric medication

Psychologists don’t prescribe medication. Psychiatrists, who are medical doctors that have undergone further training in mental health, are the ones who prescribe psychiatric medication. The quick fix mentality in Singapore may partly explain why some Singaporeans assume that recovery from mental illnesses require medication. While some may benefit from medication, not all issues can be overcome by medication. For example, the onset of depression following a divorce are not attributed by biochemical changes, and the individual will benefit from therapy to address his coping strategies and problem-solving skills.

3) The psychologist is an expert, and will tell you what to do to solve problem

Individuals coming in for therapy are essentially looking to discover their strengths, overcome their struggles and develop healthier thought and behaviour patterns. This cannot be achieved by requiring the client to let go control of their own thought processes and feelings. A good psychologist will empower you and support your growth in decision making. We may provide our opinion on what you have to say, but psychologists don’t solve your problems. Furthermore, most of our clients have more than enough people telling them what to do!

Choosing a professional for therapy in Singapore

Counselling and psychotherapy is not licensed professions in Singapore. Anyone can call themselves a counsellor, psychotherapist or a psychologist. Thus, I urge you to ensure that the counsellor, psychotherapist, or psychologist that you are working with has undergone necessary training required to assist you achieve the desired results, be it to overcome a mental health condition, or to achieve personal growth.

To assist you in your search, there are professional bodies and associations in Singapore, which maintains a register of professionals who meet their requirements in order to practice counselling or therapy.

One such body is the Singapore Psychological Society which maintains a list of registered psychologists across several fields of psychology, such as clinical psychology, counseling psychology, and educational psychology. In order to be a registered psychologist, one is required to have completed at least a Master Degree in an applied field of psychology (e.g. clinical psychology or forensic psychology) and have undergone a minimum of 1000 hours of supervised psychological practice.

Other bodies that you can refer to in searching for qualified professionals include the Singapore Association for Counselling and the Psychotherapy and Counselling Associatoon of Singapore.

It is easiest if you know someone who can point to you a recommended psychologist for therapy. Or else, you can narrow down your search by looking up the profiles of psychologists and therapists, and assess whom you feel will be a good fit for you. You can even contact the psychologist that you think is suitable, and briefly speak to him/her to assess if he/she meets what you need.

References.

Chan, A., Gan, Y. X., Oh, S. K., Ng, T., Shwe, M., Chan, R., ... & Fan, G. (2017). A culturally adapted survivorship programme for Asian early stage breast cancer patients in Singapore: A randomized, controlled trial. Psycho‐Oncology.

Kit, P. L., & Teo, L. (2012). Quit Now! A psychoeducational expressive therapy group work approach for at-risk and delinquent adolescent smokers in Singapore. The Journal for Specialists in Group Work, 37(1), 2-28.

Kok, L. P., Chan, P. S., & Ratnam, S. S. (1994). Postnatal depression in Singapore women. Singapore Medical Journal, 35(1), 33-35.

Manning, V., Ng, A., Koh, P. K., Guo, S., Gomathinayagam, K., & Wong, K. E. (2014). Pathological gamblers in Singapore: treatment response at 3 months. Journal of addiction medicine, 8(6), 462-469.

O'Brien, A. P., & Arthur, D. (2007). Computerised cognitive behavioural therapy (CCBT) in Singapore-a nursing anti-depression mental health promotion initiative. Australian Nursing and Midwifery Journal, 14(10), 39.

Reb, J., Narayanan, J., & Ho, Z. W. (2015). Mindfulness at work: Antecedents and consequences of employee awareness and absent-mindedness. Mindfulness, 6(1), 111-122.

Seow, L., Subramanian, M., Abdin, E., Vaingankar, J., & Chong, S. (2015). Sleep disturbance among people with major depressive disorders (MDD) in Singapore. Sleep Medicine, 16, S259-S260.

Tan, E. P., Tan, E. S., & Ng, B. Y. (2009). Efficacy of cognitive behavioural therapy for patients with chronic pain in Singapore. Annals Academy of Medicine Singapore, 38(11), 952.

Tay, S. Y., & Gwee, K. (2015). Wash it all away: Obsessive Compulsive Disorder. In Lange, G., & Davison, J. (Eds.). Clinical Psychology in Singapore: An Asian Casebook. NUS Press.

Thevaraja. N. G., & Gwee, K. (2015). Keep calm. It's not a heart attack: Panic Disorder. In Lange, G., & Davison, J. (Eds.). Clinical Psychology in Singapore: An Asian Casebook. NUS Press.

Utpala, R. (2015). Better Dead than Fed: Eating Disorder (Anorexia Nervosa). In Lange, G., & Davison, J. (Eds.). Clinical Psychology in Singapore: An Asian Casebook. NUS Press.

Winslow, M., Cheok, C., & Subramaniam, M. (2015). Gambling in Singapore: An overview of history, research, treatment and policy. Addiction, 110(9), 1383-1387.

Wong, C. S. (2016). Transdiagnostic group Cbt for mood and anxiety disorders in a psychiatric hospital outpatient clinic in Singapore. Bipolar Disorders, 18, 182.

Yang, S., Meredith, P., & Khan, A. (2017). Is mindfulness associated with stress and burnout among mental health professionals in Singapore?. Psychology, health & medicine, 22(6), 673-679.