Counselling

The PMHP provides free therapeutic counselling at the same time and place where women attend for antenatal care.

Counselling is one way to support women in distress. It offers distressed women an opportunity and a safe space to tell their stories without fear of being blamed or judged. In a time of crisis, counselling gives women the opportunity to contain their distress, highlight their priorities and identify possible resources. This support empowers women to take the lead in managing their own problems in the future.

Each time I read the weekly supervision reports of our counsellors, I am struck by both the quantity and nature of the horrors facing our clients. Our counsellors are working with women on gang rape, homelessness, HIV, domestic violence, social isolation, and childhood sexual abuse – often with three or four of these confronting one woman. However,  it is equally remarkable that so many of these women, with a small amount of structured emotional and practical support, are able to draw on their resilience, cope with their circumstances, and care for their children.
Dr Simone Honikman
PMHP Director

What kind of counselling is provided?

The PMHP provides individual, face-to-face counselling by trained counsellors. Counsellors assess each client and adopt a flexible approach to suit individual needs. These interventions may include containment, psycho-education, bereavement counselling, debriefing of traumatic incidents, relaxation and breathing exercises, couple and family counselling, as well as suicide and impulse risk management. The PMHP maintains a continuum of care for all clients into the postnatal period.

For many women, the number of face-to-face sessions may be limited by their own practical constraints. On average, the number of sessions per client is between 2 and 3. Counsellors also liaise with external agencies, social services or support organisations to ensure a comprehensive continuum of care for their clients. The counsellor may also provide additional support by telephone. For more serious cases, the counsellor may refer clients to the PMHP psychiatrist. 

Less frequent than conventional therapy sessions, PMHP counselling is effective in that it provides a space for containment, empathy and positive regard at a time of crisis or distress. This is an intervention that provides meaningful support necessary to empower women and girls to identify resources and personal capabilities. This can enhance their resilience to difficult life circumstances and support them to nurture their children optimally.

Read more about counselling in our Basic Counselling Skills handbook here.

Does it work?

The PMHP incorporates a rigorous monitoring and evaluation process into its service programme. Statistical analysis of client logs and counselling data shows that, on average 

  • 57 % of clients report that their main problem is ‘much improved’ or ‘resolved’ after counselling
  • 94% report successful bonding with their baby
  • 85% report a positive life experience at the time of assessment

The latest analyses conducted in 2014 show that PMHP counselling has a beneficial impact on clients, in terms of mood, coping, and general functioning. We have also shown that our intervention builds the clients’ assertiveness and resilience to face the challenges of motherhood in difficult social and economic conditions.

Read the latest outcomes report here.

Counsellors’ experiences

Liesl Hermanus | Hanover Park Midwife Obstetric Unit

LieslOne of the biggest challenges I recall while doing my internship in Hanover Park in 2007 was accepting the little I was able to do for my clients. Five years later, I find myself back in this community and have come to the realisation that the little I thought I was doing back then could possibly have meant a lot and made a big difference to those I was trying to assist. Most of my clients don’t have any support, and for most of these women counselling will be the first time that they have the space to express their worries and anxieties and, more importantly, the first time that they will feel heard and understood.

There is a great need for the service in Hanover Park and surrounding areas. It has been an amazing experience seeing the Hanover Park PMHP site transition from a research to a service site, and a smooth transition at that. The MOU staff have long been waiting for this. They and the community are truly embracing the service. Having CASE and the Parent Centre on board has added so much more value to our site. Essentially we are all working towards a common goal, to improve the lives of those in and around Hanover Park be it through mental health services, support groups or parenting workshops. 

Antoinette Devasahayam | False Bay Hospital

Antoinette Devasahayam

Before training as a counsellor I was a staff nurse in maternity care, and worked in False Bay Hospital. My understanding of the needs and pressures of other staff has helped me to find ways of integrating mental health care into the work of the whole staff team.

“After many years in maternity care, counselling mothers-to-be felt like a continuation for me – there is a big gap in maternal mental health services. When you start doing the stats you see how many referrals there are, you see how big the need is. But, we are able to help with most problems, and it makes such a big difference to women.”

 

 

 Charlotte Mande Ilunga | Mowbray Maternity Hospital

CharlotteLoneliness, loss of identity, poverty and trauma are the main stressors that we see. Many refugee women have no one to talk to, and pregnancy makes them more vulnerable.

The refugee community represents a large portion of our clients. As we journey with them we dare to challenge the underlying traditions and myths surrounding pregnancy and motherhood, and the stigma about mental illness. As we explore misconceptions it leads to discovering the ‘silent killer’ – depression and other mental conditions untreated and even not addressed. The emotional support the women receive during pregnancy, labour and childbirth improve tremendously the outcomes for both mother and child.