Frequently Asked Questions

  1. What is a Psychologist?
  2. What is a warrant for Psychologists?
  3. What do you mean by Mental Health?
  4. What is the difference between a Psychologist and a Psychiatrist?
  5. What is the difference between a Counsellor, Psychotherapist or Psychologist?
  6. How Should one Choose Between a Counsellor, Psychologist and Psychotherapist?
  7. Is psychological therapy for me?
  8. What does psychological therapy involve?
  9. Is psychological therapy with children and adolescents different in structure to therapy with adults?
  10. Do you write reports?
  11. How long is each session?
  12. What is the cost of sessions?
  13. How many sessions will I require?
  14. How regularly are sessions held?
  15. Which type of treatment will you choose in therapy with me?
  16. Will you require any information before I commence psychological therapy?
  17. With whom will you share my personal details?
  18. How do you know if change has occurred during therapy?
  19. What happens if there is minimal or no change during therapy?

  What is a Psychologist?   While there are a number of types of Psychologists with different specialist areas such as education (Educational Psychologists) or the structure and function of organisations (Organisational Psychologists), psychological therapy is generally offered by Clinical or Counselling Psychologists (hereinafter referred to as 'Practitioner Psychologists'). Practitioner Psychologists specialise in the assessment, diagnosis and treatment of a wide range of mental health difficulties such as depression and anxiety. They also have the training and skills to help people learn to cope more effectively with life issues, such as a relationship break-up, bereavement or a stressful situation at work.

Psychologists are trained in the use of structured and specialised therapies which can often be more effective than general supportive counselling. The outcomes of these therapies tend to be supported by research and are therefore referred to as evidence-based therapies. Psychologists tend to use a variety of evidence-based treatment models and have the knowledge and experience to use these treatments to tailor a course of therapy to suit each client's individual goals and situation. Practitioner Psychologists are also trained in the use of psychometric tests, such as intelligence (IQ) tests or personality inventories which enable them to inform their practice and make recommendations regarding the support that clients could be provided, for example, in their work or school environments when particular needs are identified. They do not, and cannot prescribe medications. They can work with adults, adolescents, and/or children on an individual, couple, family, or group basis although they may choose to specialise with a specific client group.

  What is a warrant for Psychologists?   The Malta Psychology Profession Board (MPPB) is responsible for issuing Psychologist warrants in Malta. Local and overseas training and experience of applicants is therefore scrutinised in order to determine whether it meets the minimum warrant criteria set by the Board. It is illegal to practice under the title of 'Psychologist' unless one is warranted.

When choosing to commence therapy with a warranted Psychologist, one can be assured that s/he will receive the highest level of psychological care and treatment. To qualify as a Psychologist one must have a minimum of a Masters degree level of education in a highly competitive course with limited places, meaning that only the best and most suitable applicants are selected. In Malta, only after a minimum of six years of university study and an additional two years of full-time supervised training, can one become warranted and practice under the title of Psychologist. Some Masters Psychology graduates, after completing their formal Masters training, refer to themselves as 'Psychologist - in training' until they complete the additional two years of supervision. This indicates that they are still to receive their warrant. You may come across Psychologists who mention other registering bodies such as the Health and Care Professionals' Council (HCPC). This indicates that they may also hold a warrant from overseas. For example, the HCPC is responsible for warranting (known as registration) of Psychologists in the UK. Currently the HCPC requires that Psychologists have a minimum of a doctoral level of training in order to meet registration requirements. Psychologists who are registered in the UK would therefore be able to use the title 'Doctor' and therefore require further years of formal educational training in order to practice.

It is always best to ensure that one consults with a Psychologist who is warranted by the MPPB. When a Psychologist holds a warrant, apart from assurance that they have received the gold standard training mentioned above, they are also held accountable to the MPPB for maintaining good standards of care. This means that they would need to maintain a high level of professional conduct and ethics and to undertake a minimum amount of supervision and continuing professional development in order to retain their warrant.

  What do you mean by Mental Health?   Individuals suffering from mental health difficulties generally suffer from a set number of symptoms that result in a diagnosable disorder such as clinical depression or anxiety. While the word 'depression' is used quite often in society and usually refers to low mood, one would need to have a number of further symptoms such as changes in diet and sleep pattern to be classified as clinically depressed. There are a number of mental health difficulties that vary in range and severity, with the need for professional support becoming more necessary with an increasing number of symptoms and reduced psychological functioning. While people may go through a number of stressful situations in their lives a number of factors, including their level of social support and their temperament (personality) ,will determine whether they go on to suffer from diagnosable mental health difficulties in times of stress.

  What is the difference between a Psychologist and a Psychiatrist?   Psychiatrists are medical doctors whereas Psychologists are not. Psychologists and Psychiatrists have the same fundamental aim - to alleviate psychological distress and restore mental health and functioning. Resultantly, they may often work jointly on cases and liaise frequently in order to ensure the best and most consistent care for clients. Both Psychologists and Psychiatrists are trained in diagnostic evaluation; however, Practitioner Psychologists generally have more extensive training in offering psychological therapy. A Psychologist will help the individual to understand the factors underlying the problem and teach them practical and psychological techniques to reduce current symptoms and avoid relapses.

Generally speaking, Psychologists provide ongoing weekly psychological treatment, whereas Psychiatrists provide assessment/diagnosis and risk management services, and prescribe and manage psychiatric medication. Psychiatrists can also conduct physical examinations, order/interpret brain assessments (e.g., EEGs, CAT scans, MRIs), and administer Electro Convulsive therapy (ECT).

Although parallel in many respects to a Practitioner Psychologist, a Psychiatrist takes the point of view that emotional and behavioural problems are medical problems that need treatment. As such a Psychiatrist is trained in abnormalities and their prevention and cure meaning that they are less likely to become involved in the long-term care and support of stressful life events that do not lead to mental health difficulties.

  What is the difference between a Counsellor, Psychotherapist or Psychologist?   The terms “counsellor” and “psychotherapist" are often used interchangeably and have many similarities, but there are some important differences as well.

Understanding some more of the differences between them may be helpful in choosing the type of therapy that will be most effective for you as an individual.

Counselling refers to the process that develops a healing, safe, and therapeutic relationship between a professional and an individual. It is based on the principles of Empathy, Confidentiality, Unconditional Positive Regard, Client Self Determination and Respect. Research is consistently revealing that the establishment of a therapeutic relationship in a professional setting is the main contributor of positive outcome for the client.

With reference to Psychotherapy, there are several different types of therapy that fall under the general heading of psychotherapy, including approaches such as Drama Therapy, Family Therapy, Cognitive Behavioural Therapy, Dialectical Behavior therapy, Acceptance and Commitment Therapy, Psychoanalytic Psychotherapy, Play Therapy, EMDR, Emotionally Focused Therapy and many more.

Psychotherapists undergo in depth training in a particular form of psychotherapy.

Counselling Psychologists, Psychotherapists and Counsellors in Malta are all trained in Counselling.

These professionals may be qualified or trained to provide one or a mixture of the following: psychological services, counselling and psychotherapy. For instance a Psychologist may be trained to provide certain psychological assessments, counselling and psychotherapy (e.g. an Educational Psychologist trained in Play Therapy) or a Counsellor may be trained to provide counselling and certain psychotherapeutic techniques (e.g. a Counsellor trained in EMDR therapy).

While a Psychotherapist is qualified to provide counselling, a Counsellor and a Psychologist may or may not possess the necessary training to provide psychotherapy.

In Malta to practice as a Counsellor, Psychotherapist or Psychologist requires professionals to undergo Masters level training and a number of years under supervised practice for the respective disciplines. Warrants for Counsellors, Psychotherapists and Psychologists are regulated through the respective regulatory institutions set up according to the law.

  How Should one Choose Between a Counsellor, Psychologist and Psychotherapist?   When choosing a therapist, it is helpful to learn about the differences noted above, as well as the background of specific providers and the approaches they use. The choice could come down to personal preferences, research evidence, access, or insurance coverage.

The most important step, however, is to find a therapist you can trust. In fact, the level of trust a person has in their mental health care practitioner plays a big role in whether the therapy will be helpful at reducing symptoms and improving wellbeing.

  Is psychological therapy for me?   Psychological therapy is for anyone who wants to live a more fulfilling life, reduce symptoms or improve their general sense of wellbeing. Some people want some advice (we try not to give advice but rather to help you explore options and reach the best decision to suit your personality and circumstances) while other people need help with more serious problems.

  What does psychological therapy involve?   Psychological therapy through The Psychology Clinic commences through a process of assessment which can begin prior to your first appointment when we will try to gain an understanding as to your difficulty, via telephone discussion and intake questionnaire completion, in order to ensure that each client is matched with a therapist who specialises in their presenting difficulty. Following this stage you will be invited for an assessment session during which you will be able to explore your difficulties and how they are impacting on your general level of functioning and sense of wellbeing. There are occasions when the assessment process can last more than one session. When your Psychologist feels that s/he has gained a good understanding as to the case s/he will inform you of their clinical formulation and also advise you regarding the most suitable therapeutic technique/s and the plan moving forward, including the number of sessions you are likely to require. While psychological therapy tends to be held on a one-to-one basis, there are times when more individuals will be present, for example, if the problem lies within the couple relationship or if there is a parent-child difficulty. The Psychology Clinic is able to provide an assessment report that will include a summary of your difficulties, a formulation and recommendations. You can request this at any stage of the therapeutic process.

  Is psychological therapy with children and adolescents different in structure to therapy with adults?   The term 'child' is used to refer to a person aged 0-12 years. An adolescent is aged between 13-17 years. An adult is anyone who is over the age of 18. The structure of therapy and treatment utilised will vary depending on the age of the child or adolescent. With increasing age therapy becomes similar to adult-based therapy which involves talking. Young children are generally unable to express themselves through talking therapy, therefore play-based therapy is used in order to facilitate the therapeutic process. In this manner children can re-enact any difficulties through play with the purpose of therapy being focusing on the themes of play in order to resolve any difficulties and improve wellbeing. Adolescents are more likely to talk in therapy but may require aids including feeling and discussion cards. These resources are all available through the clinic.

Parents are generally invited to the initial assessment with a child or adolescent and may be asked to attend a separate parent session in order to ensure that parent opinion as well as any relevant developmental and family history is obtained in order to ensure the best care for the client. Not all psychological therapists utilise this approach and may commence by immediately seeing the child or adolescent individually. Taking a more holistic approach to assessing younger age clients is considered the gold standard and is used within international communities. The Psychology Clinic tends to comply with this approach given our extensive overseas training and work experience.

  Do you write reports?   Yes we can write reports for court proceedings or general psychological reports that can include a number of psychometric measures such as cognitive assessments (learning assessments to aid in school statementing). Reports do incur an additional fee, which we will discuss with you before proceeding. The fee must be paid in full before receiving the report.

  How long is each session?   The initial assessment session can last between 60-90 minutes, depending on your requirements. Each follow up sessions will last 50 minutes. Child-based sessions can sometimes last for 30-45 minutes if it is considered inappropriate to hold longer sessions, possibly due to client difficulties with sustained attention or other neurodevelopmental difficulties.

  What is the cost of sessions?   Please contact The Psychology Clinic directly in order to discuss fees as the cost of sessions can vary depending on the Psychologist you are allocated or the type of session scheduled (initial, follow-up or full assessment requiring psychological testing and a report). Assessment sessions can be of varying duration and will therefore also vary in cost.

  How many sessions will I require?   Different cases vary therefore it is difficult to advise regarding the exact duration of therapy prior to its commencement, however, at The Psychology Clinic we try to ensure to resolve your difficulties in as brief a duration as possible, while ensuring that high quality and evidence-based therapeutic approaches are maintained. A number of factors including the presenting problem, how chronic the difficulties are, as well as client temperament and motivation, will impact on how long it takes to resolve difficulties. Generally, following the assessment process, we will be able to give you a rough guideline as to how long you would be expecting to attend psychological therapy.

  How regularly are sessions held?   With regards to frequency of sessions, weekly sessions are advisable initially, however, these can be reduced in frequency as difficulties begin to resolve. Collaborative interventions are central to our practice and therefore we will work with you in order to ensure that you are comfortable with the treatment plan, including how frequently we meet and when sessions are reduced towards the end of your treatment.

  Which type of treatment will you choose in therapy with me?   Research consistently indicates that the therapeutic alliance (i.e., the client-therapist relationship) is the most important factor in therapy, not the type of therapy modality used. At The Psychology Clinic we ensure to offer you consistent and sensitive therapy that is based on genuineness, listening and positive regard.

We use treatment modalities that are backed by scientific research, known as evidence-based therapies. This is because such treatment has been demonstrated to be effective in both the short-term and the long-term in comparison to other therapeutic approaches. Cognitive Behavioural Therapy (CBT) is the psychological treatment that has the best evidence to date, for a wide range of disorders including clinical depression, anxiety disorders, substance use disorder and Post Traumatic Stress Disorder (PTSD). There are a number of therapies that have been developed from CBT but that borrow from Eastern practices and incorporate mindfulness, such as Acceptance and Commitment Therapy (ACT). These therapies are becoming increasingly popular scientifically and can be used as an alternative to traditional CBT. We are able to utlilise both of these approaches and will select which approach to use based on each individual case.

During therapy, we also use other treatment modalities if they seem appropriate, such as Person Centred therapy (aims to provide a non threatening non judgmental environment in which individuals can reconnect with their values and sense of self-worth and thus find a way to move forward); Psychodynamic therapy (focuses on the past in helping to resolve the present) Schema Therapy (identifying you "life traps" which often develop during childhood), Solution Focused Therapy (focuses on the goals that an individual wants to achieve rather than the problem(s) that they seek help for) and systemic therapy (focuses on the family or other bigger system that one functions in, attempting to change the whole system by working with families as a whole rather than the individual). The latter approach can be particularly relevant for child and adolescent therapy.

  Will you require any information before I commence psychological therapy?   Yes. We will have a 10-15 minute discussion with you in order to gain an understanding of your difficulties. This is for the purpose of ensuring that you are matched with the right therapist and that the therapist is prepared to assist you on the day of your initial assessment. You will be asked to complete a questionnaire to ensure that the initial session is as focused and tailored as possible to your difficulties and needs. This will ensure that we will begin to work on your difficulties as expediently as possible.

  With whom will you share my personal details?   Every session is private and confidential. This means that all information discussed during psychological treatment remains within the four walls of the therapeutic room. Sometimes it is in the best interest of the client that their personal information is shared, for example, if they experience learning difficulties and require funding to assist with their learning. In this case they may opt to provide written consent for their information to be shared by the Psychologist to a select number of parties specified within the consent form. A Psychologist will always seek your consent prior to sharing your personal information. If your Psychologist is concerned about your safety they may need to share your information to ensure you are not at risk. Psychologists at The Psychology Clinic will always inform you of parties they need to liaise with on the rare occasion that they need to share your personal information without your consent in order to keep you safe.

Psychologists are bound by a Code of Ethics (set by the Malta Psychologist Profession Board), holding them accountable in terms of confidentiality. Breaches of confidentiality are a very serious matter and can lead to the Psychologist warrant being suspended or revoked. We would like to ensure you that we take matter of confidentiality and wider ethical issues extremely seriously.

  How do you know if change has occurred during therapy?   Change is usually measured by using psychometric testing or questionnaires that are specific to your presenting problem and your goals for change. These are administered at the beginning, towards the middle and the end of therapy to ensure that change has occurred. This process is essential as the therapeutic approach can be altered if change is not happening as expected.

  What happens if there is minimal or no change during therapy?   If there is no change during psychological treatment, it is usually due to one or more of the following reasons:
  1. For therapy to be successful there needs to be a strong client-therapist relationship (referred to as the therapeutic alliance). A good therapeutic alliance results in the client feels safe, secure, not judged, and validated by the therapist. Also, the therapist needs to be perceived as being professional and optimistic of change no matter how chronic the difficulties. If there are difficulties with the therapeutic alliance these can be discussed during psychological therapy in order to help facilitate change.

  2. Clients will vary in their level of motivation for change. They might, for example, have been encouraged by a partner to access psychological services in which case they may not be as motivated for change in comparison to someone who attends of their own accord. If someone is unwilling to make meaningful change in their situation or has little trust in the helping process they are less likely to experience meaningful change when accessing psychological therapy. A client may be aware there may be issues to work on, but for one reason or another, may not be ready to commit to real change in their lives, known as being in the pre-contemplative Stage of Change. In this case it is important to explore these issues in therapy with the scope of shifting beliefs to help facilitate change or consider terminating therapy until the client feels ready to make real changes in his or her life.

  3. A third reason for minimal change during psychological treatment is if there is a problem with the formulation (or mini-theory explaining what led to the presenting problem and what maintains it). This can happen as a result of a number of factors including the client not being fully forthcoming about their life situation or background; or the psychologist placing less emphasis than necessary on particular factors. A competent Psychologist will always provide opportunities to explore periods when therapy appears stuck at which stage the case can be reformulated and therapeutic options can be reconsidered. In rare cases there may be a client-therapist mismatch in which case options for referring a client onto a more suitably matched therapist could be explored.

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