After weeks (or months) of putting it off, you book a longer appointment with your GP to talk about your mental health. You explain that you’ve been feeling low, anxious and overwhelmed. They suggest seeing a psychologist.

But how do you know if this psychologist is the right person for you?

It’s a fair question, and it matters more than many people realise.

So, what should you know before you book your first appointment?

What does a referral actually mean?

In Australia, your GP can refer you to a psychologist under a mental health treatment plan. This provides Medicare rebates for a set number of sessions.

To be eligible, your GP must assess that you have a diagnosable mental health condition that would benefit from treatment, such as anxiety, depression, sleep difficulties or stress-related concerns.

Most people can receive up to ten sessions a year with a Medicare rebate. Many psychologists charge an out-of-pocket fee, although some offer bulk billing. Rebates are higher for clinical psychologists than for other psychologists.

You’re not locked into the psychologist named on your referral. In most cases, you can choose a different psychologist and still receive a rebate.

Not all psychologists are the same

All psychologists are registered with the Psychology Board of Australia. Some complete additional specialist training and are endorsed in areas such as clinical, counselling, educational and developmental, or forensic psychology.

Endorsement reflects specialised training, not necessarily “better” care. What matters most is whether the psychologist has experience with your concerns and uses an approach suited to your needs.

Therapies based on cognitive and behavioural principles have the strongest and most consistent evidence, particularly when matched to specific problems.

For example, structured approaches are widely used for anxiety, sleep difficulties and depression, while parenting programs are commonly used for child behaviour problems.

The Australian Psychological Society’s “Find a Psychologist” directory and the government’s healthdirect Service Finder are good places to start looking for a psychologist.

What should you look for?

Referrals to psychologists are often based on practical factors such as availability or location, rather than whether the psychologist is the right match for the person’s needs. But the match can shape how helpful therapy is.

So how do you find the right fit? It can help to ask a few simple questions. Many psychologists offer brief introductory phone calls to help determine whether they’re a good fit. These are usually short and focused on practical questions, and are often provided at no cost. You may also find some of this information on the psychologist’s website, or get a sense of it over the first few sessions.

You can ask:

• have you worked with people with this problem before?
• what kind of approach do you use?
• what would the first few sessions look like?
• how will we know if this is working?

If you have several psychologists to choose from, you can book your first appointment with the one that seems like the best match.

What if you don’t have much choice?

In rural or remote areas, or if you need a low-cost option, choices may be limited. In these cases, the focus shifts to making the best use of what’s available. That may include telehealth or working with your GP to review your progress.

It’s also worth knowing that seeing a psychologist isn’t the only option.

Evidence-based online programs can help, particularly for common problems. For instance, programs such as MindSpot and This Way Up offer courses for anxiety and depression.

Free parenting programs such as Triple P and ParentWorks provide evidence-based support for child behaviour problems. These online programs can be a useful starting point, although they may not suit more complex difficulties.

You can also call Medicare Mental Health on 1800 595 212 to connect you with supports.

How do you know you’re on the right track?

So you’ve found a psychologist and had a few sessions. A good one can explain how they think about your problem and why they are using a particular approach.

Be cautious if, after a few sessions, your psychologist’s approach feels very generic, or it’s unclear how it fits your situation or problem.

You don’t have to like your psychologist for them to be a good fit. After the first few sessions, you should have a clearer sense of direction. They should make you feel understood, seem to “get it”, and be someone you’re able to work with. There should also be a clear plan or focus, and at least one useful idea or strategy.

Therapy can feel uncomfortable at times, that’s normal. But if you still feel unclear about the direction or not well understood, you have options.

You can talk to the psychologist, ask your GP for a different referral, or look for another psychologist yourself.

The key is not to stay stuck in something that isn’t helping.

The bottom line

Seeing a psychologist can be one of the most helpful steps you take for your mental health. But it’s not just about going. It’s about finding someone whose approach fits your needs and who you can work with.

When it comes to therapy, “available” is not always the same as “right”. You deserve the right fit.

Trevor Mazzucchelli, Associate Professor of Clinical Psychology, Curtin University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

As we enter the festive season it’s a good time to think about what all those celebratory alcoholic drinks can do to your gut.

Alcohol can interfere with the time it takes for food to go through your gut (also known as the “transit time”). In particular, it can affect the muscles of the stomach and the small bowel (also known as the small intestine).

So, how and why does alcohol make your poos goes weird? Here’s what you need to know.

Diarrhoea and the ‘transit time’

Alcohol’s effect on stomach transit time depends on the alcohol concentration.

In general, alcoholic beverages such as whisky and vodka with high alcohol concentrations (above 15%) slow down the movement of food in the stomach.

Beverages with comparatively low alcohol concentrations (such as wine and beer) speed up the movement of food in the stomach.

These changes in gut transit explain why some people can get a sensation of fullness and abdominal discomfort when they drink vodka or whisky.

How long someone has been drinking a lot of alcohol can affect small bowel transit.

We know from experiments with rats that chronic use of alcohol accelerates the transit of food through the stomach and small bowel.

This shortened transit time through the small bowel also happens when humans drink a lot of alcohol, and is linked to diarrhoea.

Alcohol can also reduce the absorption of carbohydrates, proteins and fats in the duodenum (the first part of the small bowel).

Alcohol can lead to reduced absorption of xylose (a type of sugar). This means diarrhoea is more likely to occur in drinkers who also consume a lot of sugary foods such as sweets and sweetened juices.

Chronic alcohol use is also linked to:

• lactose intolerance
• overgrowth of small bowel bacteria and
• reduced absorption of fats from the pancreas not producing enough digestive enzymes.

This means chronic alcohol use may lead to diarrhoea and loose stools.

How might a night of heavy drinking affect your poos?

When rats are exposed to high doses of alcohol over a short period of time, it results in small bowel transit delay.

This suggests acute alcohol intake (such as an episode of binge drinking) is more likely to lead to constipation than diarrhoea.

This is backed up by recent research studying the effects of alcohol in 507 university students.

These students had their stools collected and analysed, and were asked to fill out a stool form questionnaire known as the Bristol Stool Chart.

The research found a heavy drinking episode was associated with harder, firm bowel motions.

In particular, those who consumed more alcohol had more Type 1 stools, which are separate hard lumps that look or feel a bit like nuts.

The researchers believed this acute alcohol intake results in small bowel transit delay; the food stayed for longer in the intestines, meaning more water was absorbed from the stool back into the body. This led to drier, harder stools.

Interestingly, the researchers also found there was more of a type of bacteria known as “Actinobacteria” in heavy drinkers than in non-drinkers.

This suggests bacteria may have a role to play in stool consistency.

But binge drinking doesn’t always lead to constipation. Binge drinking in patients with irritable bowel syndrom (IBS), for example, clearly leads to diarrhoea, nausea and abdominal pain.

What can I do about all this?

If you’re suffering from unwanted bowel motion changes after drinking, the most effective way to address this is to limit your alcohol intake.

Some alcoholic beverages may affect your bowel motions more than others. If you notice a pattern of troubling poos after drinking certain drinks, it may be sensible to cut back on those beverages.

If you tend to get diarrhoea after drinking, avoid mixing alcohol with caffeinated drinks. Caffeine is known to stimulate contractions of the colon and so could worsen diarrhoea.

If constipation after drinking is the problem, then staying hydrated is important. Drinking plenty of water before drinking alcohol (and having water in between drinks and after the party is over) can help reduce dehydration and constipation.

You should also eat before drinking alcohol, particularly protein and fibre-rich foods.

Food in the stomach can slow the absorption of alcohol and may help protect against the negative effects of alcohol on the gut lining.

Is it anything to worry about?

Changes in bowel motions after drinking are usually short term and, for the most part, resolve themselves pretty efficiently.

But if symptoms such as diarrhoea persist beyond a couple of days after stopping alcohol, it may signify other concerning issues such as an underlying gut disorder like inflammatory bowel disease.

Researchers have also linked alcohol consumption to the development of irritable bowel syndrome.

If problems persist or if there are alarming symptoms such as blood in your stool, seek medical advice from a general practitioner.

Vincent Ho, Associate Professor and clinical academic gastroenterologist, Western Sydney University

This article is republished from The Conversation under a Creative Commons license. Read the original article.