Therapy for teens and adolescents in regional NSW

In regional and more remote areas of Australia, many teenagers can struggle with issues due to feeling isolated and a lack of local supports to assist them with things they may be struggling with. This often means many young adults can struggle with their mental health silently due to feeling there is no-one to reach out to for support. This can also leave parents feeling very stuck due to not knowing how to help, as many teens can struggle to open to them.

We work with adolescents and teens across Australia (even cities like Canberra and Sydney) via telehealth and face to face. This is often a challenging time as relationships become more complex, hormonal changes occur and there is an increased pushed to fit in with others and be independent. Often, this is a time of finding out who we are, so things like sexuality and identity all come into the mix around the difficulties adolescents face and how they fit in the world.

Often teens benefit from connecting to someone entirely removed from the situation and family, as they may struggle to be honest and open up to parents about what concerns them. Having worked across numerous headspace sites before, adolescents is an area we have extensive experience in supporting. Even working with more complex issues such as trauma, loss, grief and self-harm is something we are quote experienced with.

Often, we also recommend the parent engage in reflective parenting as a part of this process. This is due to there often being a disconnection with a caregiver. This helps the parent to focus and unpack their experience, as well as finding new ways to better connecting with your loved one. Many parents can often feel very lost and helpless during this time when they don’t know how to help or what to do (this is usually a good indicator to get support!)

We also recommend doing this sooner rather than later, as early intervention tends to produce better outcomes in the long run. However, even if the issue has been happening for years, it is never to late to reach out and start chatting to someone! Therapy can vary in length, with issues such as trauma taking longer time periods. Teens can also experience more ‘episodic’ stress, which are more one of reactions to things happenings such as bulling, upcoming exams ect why may be less long term. Again, reaching out support can be key.

Men’s mental health in the Central West & Riverina

Living in the Central West and Riverina can pose many challenges for males accessing mental health support. Often, men are faced by stigma for reaching out for support around their mental health, making access to treatment a challenge. This often means many men, over time bottle things up and feel they cannot discuss these issues with their mates and even their spouses and loved ones. These matters can be more complicated when we are also managing part or current trauma, grief, loss or other things such as job changes.

This can come from difficulties growing up, where role modelling healthy emotions and how to speak out about these issues may not have been safe, or even create more risk. This can even become intergenerational over time, as we often take aspects of our own parenting, we want to change but may not be quite sure how.

Due to these issues men have much higher rates of death by suicide in regional areas, as well as higher incidents of depression, stress and anxiety that often goes unresolved for many years. It can also be initially quite daunting for men to reach out for support, as this also isn’t something we often see modelled when younger in a healthy way.

Even in cities, there can be long wait times for men accessing support or even the same barriers for those who relocated to a new area but can have those past experiences still haunting them, with difficulties reaching out. One advantage today is, you can access confidential and safe support online via video call or telehealth, which we often connect to other men seeking mental health support through. Some even tell us this can be less daunting due to not feeling the pressure they may experience when face to face.

We support men who have been through trauma, have relationship difficulties, difficulties connecting to their children and managing anger and other difficult emotions. We aim to work with you over time to support better and healthier relationships, managing emotions in better ways and to be better able to communicate. This may include helping process what has happened in the past, looking at where our parenting styles came from and much more.

Often, though, many men tell us the first and hardest part is attending that first appointment and reaching out. This is why we recommend the brief 15-minute phone chat to just get to know one another and ask any questions, as well as see if we will be a fit. There is no issue if you don’t want to proceed from here.

Therapy for teens and adolescents with neurodivergence in regional Australia

Teens with neurodivergent can struggle just as much as other teens when growing up. However, they can often face additional barriers that can be difficult to manage, such as forming relationships, working out their sexual identity and managing difficulties with bullying and trauma that they often experience at a higher rate than neurotypical adolescents.

This can make the world a scary and difficult place to navigate. These matters can often be worsened when in regional areas such as Cowra, Dubbo, Young and other towns with a lack of neuroaffirming support options for teens. This is where accessing support from us can be useful, as we have extensive experience supporting neurodiverse adolescents through a range of issues they often face when growing up.

We also aim to work with the parent when supporting a neurodiverse adolescent due to the need for their ongoing support. This also provides a place to safely unpack their experience and begin to look at things from different perspectives. The overall aim to better engage the relationship between the adolescent and parent.

Neurodiverse young adults can often have increased challenges due to the social barriers and exclusion they face. Often there is a want to connect and have friends, however this can prove difficult in regional areas where there is often more stigma around mental health challenges, as well as less peers on the same level to connect with. We often see difficulty pulling away from tasks such as gaming, as often this is where is a safe space to connect with others without all the additional social challenges. This can also be used as a method to manage difficult emotions and to cope with bullying or difficulties in school or at home.

We often support neurodiverse individuals with related traumatic experiences they have had growing up, as well as supporting them to develop their own sense of identity and finding their place in the world. Helping develops social supports and connects to likeminded peers, as well as managing difficulties with peer groups (such as bullying) can also be useful. We also have experience exploring gender and sexuality, supporting those with suicidal thoughts and self-harm.

It can often take some time to connect with one another and to see if we are a match, so we take the time in the first few sessions to ensure this will work and see what we can support with, as well as being upfront if we are unable to. At times, we might even recommend other treatments, either stand alone or in conjunction with things like family therapy, behavioural support or occupational therapies.

Working with neurodiversity means we also need to consider how to navigate difficulties with sensory overload and the anxiety that can come when there are sudden changes in routine in schedule, as well as meeting new people! This is often best as a longer-term option, and we support many plan and self-managed NDIS participants as a result.

Supporting neurodivergent people

Due to increases in awareness and understanding because of the NDIS and social media, there is increased awareness on neurodivergence such as autism and attentional issues. More and more we get enquires from parents looking for early diagnosis so they can begin support (if support is needed, that is).

Riverina Counselling provides neuro-affirmative therapy to those who are neurodivergent. This has been a barrier identified early on in places such as Young, Cowra and Forbes due to both lack of local services and professionals in these regions. Even in larger cities nearby, such as the ACT, Orange and Wagga Wagga, there can often be long wait times for support.

When working with neurodivergence, we try to do a few things differently. We work out a person needs and where they are at to determine the type of therapy that might be useful. For younger children this could be play therapy to develop play and social support in an interactive format. With adolescents we may use blends of art therapies, talk therapies and other modalities to help a person better express and understand themselves.

One advantage our clients tell is ‘we get it’. Matthew has diverse interests in areas such as fishing, anime, gaming, gardening and more that better support connecting with others. This often acts as a starting point to get to know one another to work out if we are a fit for therapy together. From here we take time to get to know one another and arrive at an area where support may be needed with a focus on a few specific things.

Riverina Counselling also aims to work with the parent to support them as well. This uses a process called ‘reflective parenting’ where we take time to understand the day-to-day barriers parents are concerned about, understanding themselves and their states more and the aim to connect the parent and child more closely. Often, these therapies take time and need multidisciplinary support such as speech and occupational therapy.

It is important when looking for NDIS support in this area that the line items are considered, as if social work or counselling isn’t on the plan, we quickly run into issues! Before we commence, we also recommend a brief and free phone chat for about 15 minutes. This is to ensure our approach and personalities are a match, as well as the chance to ask any questions.

What is psychosocial disability?

I often get a lot of emails around what psychosocial disability is, and I think the confusion is warranted with more awareness around mental health conditions and their impact on daily functioning, our relationships and even our sense of who we are and even our own identity. Psychosocial disability can be several conditions from anxiety, depression, schizophrenia, personality disorder, schizoaffective disorder, post-traumatic stress and more.

Psychosocial disability affects many Australians and often those in more rural areas such as Cowra, Dubbo, Orange, Parkes and Forbes can struggle more due to a lack of local services and the stigma that often still surrounds mental health. This often means people who are in more isolated parts of Australia can be affected due to less face-to-face supports, such as support work, to help manage the debilitating impacts the person with the condition must live with.

It should also be noted that many with Psychosocial disability also often suffer other health issues at the same time. This can be things from Autism to chronic illness such as chronic fatigue or diabetes. This can often further complicate things are more barriers are faced and less support locally to properly address these issues, as many go without care. We also acknowledge there can be limits to what therapy can achieve due to the difficulties with systemic issues and supports in regional Australia.

Due to this I support several rurally isolated (and even those in cities) people who struggle with these conditions. Therapy aims to do several things, such as manage issues with thought of self-harm and suicide ideation, aim to find ways to manage daily functioning, teaching strategies to manage ourselves in tough situations. Even just connecting with someone through telehealth, such as through their NDIS plan, can be a good way to begin accessing support.

Matthew also has lived experience of disability himself with learning and physical health. This can be extremely useful as many clients feel like they are talking to someone ‘who gets it’. An important aspect to that is also being aware of the limitations of therapy, as we cannot always fix everything. However, it can make it easier to manage and cope, as well as exploring new perspectives on things that may help. This can be things like pain management using pain techniques, breaking down and managing the day, coping with transitions and changes as illness progresses, such as multiple sclerosis and much more.

We try ‘to meet people where they are at’. This means we work with you in a way that aims to understand your needs and then approach working together from a shared understanding and starting point.

Social Workers can do Autism Testing for better rural access in the Riverina and Central West

Accessing testing services in Young for Autism and other conditions can be tricky, often people needing to travel to Orange, Canberra, Wagga Wagga or even Sydney. They often usually come with varying fees. Clients have told us they have had quotes form $2400 a test up to $4500 for the entire battery of tests!

Many don’t know, however, that social workers and even occupational therapists can do additional training to be able to test for autism. This is extremely useful in remote communties such as Cowra, Parkes, Yass and Gundagai as often people do not want to have to drive to the city (a day trip can be exhausting for people with neurodivergence!)

We have tried to make autism testing both accessible and affordable in the Riverina and Central West. Inbstead of charging a one of fee for all the tests, or high fee’s for each one, we charge and require payment for each indivual test, as we go. This means, for example, after the first test, if we it doesn’t look like progeressing with be of benefit, we can stop and there is no further unncessary testing nor high fee’s.

Each test come with a compelted report as after you have done the testing (even with a registered psychologist), you will still need a psychaitrist (or peadatrician for a child) to confirm the diagnosis. We therefore charge $800 per test (and report is included) plus any additional travel kilometers and hours. This aims to try and make autism testing more accessible and affordable, whilst providing the gold standard required to diagnose.

What else do I need?

We also recommend getting access to an occupational and speech therapist to assess functional capacity, do a sensory profile (we can also do this on request) nad  assess for further speech issues such as echolalia we often see in autism.

Bringing along school reports noting difficulties others saw during childhood and adolescents can also be incredibly useful for any therpaists or specialists to read. This further strengths and reliability of the assessments and past history, as well as given accounts from teachers that support to help reach a diagnosis.

It can also be useful to get a cognitive and attention assessment, as it is common for cognitive issues with autism and many also have a diagnosis such as Attention Deficit Hyperactivity (ADH or with autism, AuDHD). This can also help to understand the impacts of the conditions on one another, if they are present.

 What age do we do?

 We work from ages 4 all the way through to adults. We will soon do the toddler module as well.

Can we do this online?

Yes and no. Aspects need to be done face-to-face but a few of the other tests can be online. We can discuss this further once we progress to a phone call.

Therapy for Teens and Adolescents

One of the most difficult times in our lives is when we enter our teenage and adolescent years. We often see increased issues around social groups, peers, pressure from exams and even a bigger impact from the media on things like body image and self-expectations. In more rural areas like Cowra, Young or even Orange, teens also face increased risk due to the isolation and lack of resources these areas have to fall back on for support. This is also often a time when adolescents are finding out ‘their place in the world," as they develop a deeper sense of self-identity, as well as trying to work out who they are and where they fit in.

This also means they are at increased risk, as adolescents and teens can often struggle with thoughts of self-harm and suicide around these concerns. This risk is further increased if there is bullying or peer difficulties that might cause a sense of rejection from a group. Due to this, getting early and quick support is key to be able to ensure that risks do not go unaddressed nor continue to escalate. Riverina Counselling can even offer this ongoing therapy for teens and adolescents that are more regional and remote, often with less services to fall on.

We also aim to work with the parent briefly as a part of treatment. This isn’t so much your own therapy (though it may identify this as useful) but to also have a place to express concerns and develop ways and strategies to better connect and communicate with your child. This space also aims to let parents better develop their capacity to connect to their child and attempt to better understand what is going on inside, especially around emotions and emotional states.

Riverina Counselling believes that we need to engage the whole family to make change, though we acknowledge there may be other incidents such as sudden loss that may not need a parent to attend the reflective parenting component. We note that by attending, it tends to enhance treatment with your child, as this role modelling displays that it is healthy to have help seeking behaviours and to get support when things might become too difficult to manage.

From here, we aim to spend time developing a focus and how we got to the problem in the first place so we can develop a therapy to begin better understanding what causes us to get into trouble. This also helps develop increased self-awareness and early intervention skills should the issue arise again, as we can better see the early warning signs.

At times, we may even use our animals to support teens with more complex issues and trauma, as we also partner with Terapiya Cattery (www.therapycats.com.au) for animal supported therapies. We should note that some of these therapies may be long term with more complex cases and we recommend calling to discuss this prior to making a booking.

Welcome to our new site!

Recently, Riverina Counselling has begun to undergo some ongoing changes and restructure the way we work and do things. We are currently in the process of revamping the website to provide more information, as well as to be more user-friendly and appealing to visitors wishing to seek therapy services.

Over the coming weeks and months, we will continue to add, update and upgrade the site as we go, so do not be surprised if you notice any changes! Currently, we are predominately offering telehealth (video conferencing) or telephone therapy sessions due to the unique remote nature of where we are based, as well as that of regional Australia. We also continue to offer online Functional Capacity Assessments (FCA’s) to support NDIS applications and plan reviews, this can be within a reasonable distance face-to-face, as well as online via telehealth.

Over time, our aim is to expand our telehealth therapy services as well as increase our support in doing FCA’s as assessment to support the diagnosis of autism. These sessions do have a face-to-face component and are being done on a needs assessment basis, pending how far away someone is and how many people may need assessing. Over time we will aim to also expand our services to include Medicare, as currently we provide private therapy, NDIS funded support in self and plan managed participants, the NSW Victim Services Scheme, as well as certain private health providers that offer a rebate (please check this on an individual basis).

We will still continue to focus supporting those with trauma, psychosocial disability (especially areas such as schizophrenia and personality issues related to trauma) as well as autism and intellectual disability to name a few. We still recommend reaching out if there are further questions around this, especially as we are seeing major shifts in things such as the National Disability Insurance Scheme (NDIS). This is why we recommend making contact prior to commencing with any to ensure that we are able to rpovide support and there are no issues to engagement. An example being the recent shifts with NDIS ‘stated supports’. This means that if a plan does not have the correct catogory stated, we are umlikely to be able to support someone until this includes the needed services, such as social work.

As Riverina Counselling continues to grow, we will also aim to provide more comprehensive support and increased services across the region, though we are some way off achieving this so far, but stay tuned!