Commentary: It’s never too early to seek counselling or therapy
Clients often show up at the counsellor’s office when their issues interfere with day-to-day living. But counselling is more than just problem-solving, says social worker Yeow Ming Zhen.
SINGAPORE: Charmaine* and Tom* have been arguing over how he meets his buddies for drinks after work. From her perspective, he complains about being too tired to chat with her but somehow has the energy to hang out with his friends.
Charmaine feels helpless and hopeless about how little they communicate and is seriously considering divorce.
When she asks him to go for counselling, he dismisses counselling as simply talking that won’t change anything. Why would he waste his time talking to a stranger who doesn’t understand his marriage?
Stories like Charmaine and Tom’s may seem familiar. Individuals often consider counselling only as a last resort, after they have failed to resolve problems on their own or when problems affect their work or relationships.
COVID-19 has forced families to be together for long hours, exacerbating tensions that might have lurked beneath the surface. The past two years have seen rising numbers of divorce applications and reports of family violence.
There’s actually been a spike in the number of people in Singapore seeking counselling over the pandemic – to the extent that counsellors and social workers are facing burnout.
But do we only seek help when we are close to breaking point, when push comes to shove?
SOCIAL STIGMA OF THERAPY
It might have something to do with the social stigma long associated with counselling – it tends to be seen as for people who are unable to manage their own emotions, suffer after a traumatic event, or have serious mental health concerns. According to one study, 47 per cent of Americans believe that seeking therapy is a sign of weakness.
If we thought about our physical health in the same way, is it a sign of weakness to see a doctor when we are unwell or to consider medical treatment only at the brink of collapse? Is it a bad idea to seek our doctor’s advice about trying to lose weight to stave off diabetes?
By the time clients show up in my office, a small issue may have snowballed into a major crisis.
It could start as an argument about who is responsible for bringing the trash out. Over time, other “problematic” behaviours – who seems to always leave out dirty dishes, who comes home late more often – blur into a larger problem where one partner feels disrespected and expected to take on a disproportionate share of household responsibilities.
Perhaps it’s time to look at counselling as a form of preventive or supportive care too, rather than purely remedial. If conducted before problems fester, counselling can build up mental resilience and possibly avert interpersonal crises.
Counselling in such circumstances tends to prioritise problem-solving and managing its impact on our lives.
RECOGNISING WHEN PREVENTIVE COUNSELLING COULD HELP
But surely we shouldn’t be going for counselling at the slightest conflict? Day-to-day disagreements and anxieties can be the ordinary hiccups of life.
Preventive counselling should take place when we are aware that there is a problem but that it is still manageable enough to discuss and work through amicably.
One sign could be how often the same argument comes up or how easily we lose our temper. It could be when we feel we can no longer share our thoughts and feelings without being called names or getting into a quarrel.
Children and adolescents also show signs they are not coping well when they verbalise stress or fears, frequently cry over high-stakes events such as national exams, have regular nightmares, or lose sleep or appetite.
HOW SOCIAL WORKERS AND COUNSELLORS CAN HELP
Social workers and counsellors also do their part by identifying cases where preventive counselling can be done.
At the Family Service Centre I used to practise in, families often approach us with urgent financial difficulties. Bread-and-butter needs may mask more complex issues such as intergenerational poverty, marital strife, employment struggles, mental health and caregiving burden.
Instead of only addressing problems they raise, social workers and counsellors also provide counselling for families so they can avoid conflicts when discussing financial matters. We also check in on the children, because they tend to bottle up problems to avoid stressing or confiding in their parents.
For example, we have uncovered incidents of children bullied at school for being poor. In one case, the children were harbouring thoughts of dropping out to lighten their family’s financial burden. In just two to three sessions, the family decided against this drastic move that could have a long-term impact on the children’s well-being and future.
Preventive counselling helps clients rethink such significant choices, even getting divorced or married.
Remarkably, we see more couples who request pre-marriage counselling to help them work through any potential issues – from finances, relationships and extended family dynamics, to their perspectives on child-raising and physical intimacy.
These couples not only felt more confident about marriage but learnt to set boundaries and expectations which equips them for major transitions like moving into a new home and preparing for parenthood.
THERAPY ISN’T ALWAYS EXPENSIVE
Preventive counselling does not need to be a protracted affair. A few sessions could help put us on a healthier path.
Nor does it need to be expensive. A factor that holds people back from counselling is the cost. While private practitioners could charge up to S$200 per session, many counselling centres offer subsidised rates with means testing and may charge from as low as S$30 per session after subsidy.
The Ministry of Social and Family Development (MSF) and the National Council of Social Service have also introduced schemes to make counselling more accessible and affordable.
MSF launched a new alliance to boost Singapore marriages and strengthen family ties amid COVID-19, such as through marriage preparation and parenting support programmes. These are provided free of charge or at a small nominal fee.
Another MSF initiative is Strengthening Families Programme@Family Service Centres (FAM@FSC), which provides services and support to couples and families with early risks and stressors. Trained counsellors, family therapists and social workers at these centres provide counselling for couples and families for free. This service will be provided at 10 locations in Singapore by the end of 2022.
THE COSTS OF STRESSFUL FAMILY ENVIRONMENTS
Poor familial relationships take a heavy toll on individuals. A 2012 study on 1,026 married workers in Singapore showed that marital distress was a significant predictor of depressive symptoms, health and work satisfaction.
The results also suggested that marriage-to-work spill-over is real and costly for society. The loss of work productivity due to marital distress has been estimated at nearly US$6.8 billion annually in the United States.
Families remain the closest support system for many in Singapore. Preventive counselling and therapy can enable families in Singapore to support each other better and build strength to weather crises like COVID-19 again in the future.
*Names used in this commentary are pseudonyms.
Yeow Ming Zhen is a social worker who works with couples, families and children, and is currently the Head of Strengthening Families Programme@Family Service Centre at Methodist Welfare Services.