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Laura Park, Practice Manager  Medicare is a fantastic thing and I’m so grateful to live in a country where there is assistance for healthcare costs, however, when it comes to accessing mental health treatment, it can be pretty confusing to begin with - Are there bulk billing services? Do I need a referral? What about the sessions my doctor talked about? This is a whole new world for most people!
So let me fill you in. My doctor said I’d get free sessions... Some clients have come to us saying that their doctor advised that their referral will allow them to access free sessions, but that is not the case for most private practices. The bulk billed rate is less than half the fee recommended by the Australian Psychology Society to see a psychologist in private practice. At Hopscotch and Harmony, we receive no government subsidies so we just couldn’t keep our doors open if we bulk billed. I just can’t afford any out of pocket costs ... I hear you - everyone’s financial circumstances are different and having to choose between utility bills and therapy is a real situation for many people. There are some services where bulk billed sessions are available - Headspace is one we often refer to for clients who are unable to afford any out of pocket expenses, where the client is between the ages of 12 and 25 years. Schools can also be a place to access these services so it is worth checking with your school to see what is available if finances are a barrier to accessing treatment. There are other low-to-no cost services that can be found via a Google search - “low-to-no cost psychology services, Victoria, Australia”. So what will Medicare give me? Hopscotch and Harmony clients can access rebates through Medicare if their doctor or paediatrician has completed a Mental Health Treatment Plan for them and they have a referral letter to see a psychologist. This referral letter should state how many sessions the doctor wants you to attend. When seeing a psychologist with general registration, this entitles the client to up to twenty rebated sessions per calendar year (recently increased from 10 sessions!). The client pays for the appointment and then the rebate (around $90) can be claimed after the session is complete. This can easily be done online through the MyGov app. What if I need more sessions? Here at Hopscotch and Harmony, we know that ongoing need for sessions is variable and the number of sessions our clinicians recommend to you will be based on your presenting needs and treatment plan. Research shows that clients are more successful in reaching their therapy goals and make lasting changes after attending at least 18 sessions with their therapist. But we recognise that every situation is different. You may need more, you may need less. If you require more sessions after exhausting your 20 Medicare rebated sessions for the year, you may have Private Health Insurance cover that you could use, or you may pay the full fee for a few sessions until January rolls around and you can access another 20 Medicare rebatable sessions. We would love nothing more than if there were fully subsidised sessions for all who need them, when they need them, but unfortunately that is not the world we’re living in. At Hopscotch and Harmony we pride ourselves in providing a quality service at below industry standard pricing (the Australian Psychological Society recommend a minimum hourly rate of $253) and in doing everything we can to ensure that our clients receive maximum value for the investment they make in their mental health.  With the ever-rising COVID-19 pandemic case numbers across Victoria, it’s more important than ever that we all take steps to protect ourselves and the larger community from the spread of this virus, as well as other colds, coughs, and ‘flus that can be common at this time of the year.
You, as the client, need to feel empowered to take the steps that keep you and your family safe. Hopscotch and Harmony are committed to helping you do this by moving 100% to Telehealth across both the Geelong and Melbourne practices while we are in Stage 3 or 4 restrictions. Telehealth services will continue until the COVID-19 situation stabilises. Unfortunately, as we know, this is taking a lot longer than any of us had thought or hoped for! New to Telehealth services? We sometimes hear concerns from parents that they do not think their child will be able to engage in therapy over Telehealth. It might reassure you to know that Telehealth is an evidence based way of providing services to members of the community. If you are considering Telehealth services but think your child might struggle, please remember that we can offer an array of options:
Telehealth often gives clinicians and children an unusual opportunity of being able to work within the child client’s own space, within their comfort zone, and on issues that commonly impact them at home. One common concern that parents can have is that their children struggled (or are struggling with) remote learning. This can sometimes lead parents to believe that their child will also struggle with Telehealth sessions, or that they won’t get much out of them. It’s really important to remember that your child’s sessions with a therapist should look and feel VERY different to school lessons, and your child’s clinician has a range of options to make your child’s session engaging, fun, and helpful. It’s also really important to remember that even where attended face to face, sessions in the clinic don’t look or feel like ‘normal’ (i.e. pre-COVID) appointments at the moment! Masks, eye protection, physical distancing requirements, hand sanitising, lack of wait rooms, and the necessity to clean and sanitise all rooms, toys, and therapeutic tools between clients mean that our sessions would look very different to what our regular in-clinic sessions are like. In fact, Telehealth often gives the clinician and your child MORE freedom and ease with which to connect and work together. What if Telehealth isn’t right for me or my child? For the vast majority of clients, Telehealth services will be an appropriate therapeutic modality. If, in the rare instance, your child’s presentation means that Telehealth services are just not right for them, it may mean waiting until Stage 3 and 4 restrictions are behind us. Unfortunately due to a very high demand of clients currently requesting Telehealth appointments we are unable to reserve your spot and there may be a wait when you are ready to return. At present, Medicare will continue to offer a rebate for Telehealth sessions until the end of September 2020. Should this change and affect your rebates for Telehealth, we will be in touch to discuss. Whilst we hope to see you back in the office sooner rather than later, this may take longer than any of us had wished for. In the meantime, please consider Telehealth services as an evidence based alternative to face-to-face appointments to protect you, your family, your clinician, and the community at large. Stay safe and warm and we look forward to seeing you soon! Laura Park, Practice Manager  The COVID-19 Pandemic has seen us all wrestling with changes to the way we live our lives and how we connect in our communities. We have all had to adapt quickly to rules and restrictions quite beyond our control. Many families are juggling reduction or loss of employment with the added pressure of kids learning from home.
It is hardly surprising that these circumstances have resulted in additional stress and anxiety levels, and an increased need for psychological support. We are grateful that the Government have acknowledged the need for this additional support and have announced measures to ensure that people can continue to access rebated sessions with their psychologist beyond the existing ten rebated sessions through the Better Access to Mental Health Scheme. As of Friday 7 August, clients who have already accessed ten rebated psychology sessions after completing a Mental Health Treatment Plan with their GP and receiving a referral to Hopscotch and Harmony can return to their doctor to request a review and a re-referral for an additional ten rebated sessions. This will help our clients to continue to work towards their therapy goals with that financial assistance from Medicare. What do you need to do to make this happen? If you currently have a Mental Health Treatment Plan (MHTP)
If you have already exhausted your ten rebated sessions for 2020
At Hopscotch and Harmony we are committed to supporting our clients to reach their therapy goals and to emerge from this most unusual time with increased resilience, insight and skills to thrive in the next chapter of their lives! If you would like to book an appointment please click here **Enjoy this guest post from friend of the practice, Charlie. We came across this piece when Charlie's mother shared it in a homeschooling Facebook group. Charlie accepted our invitation for this to be published on our Hopscotch & Harmony Blog because we knew how helpful it would be to other children and parents. Thank you Charlie!  Hello, I'm Charlie. I started homeschooling at the beginning of year 6 in 2020. I will admit that sometimes when it comes to schoolwork I can behave in ways that some people might call “defiant” and “stubborn”. I want to help other families find a way to have a happy and fun time homeschooling, so I'm writing this to help other people even though I don't love writing. I'm going to talk about possible reasons for defiance now (these are from my experience and are not 100% going to apply to all children). Most of the time I don’t know what triggers me to become defiant in the first place. But later, when I can think about it I realise I was anxious. I don't always know the reason for me being anxious. But sometimes I do, for example–
So, we have looked at some things that caused me to behave in ways that some people would call “defiance”. Here are some solutions to try which I think might work. Once again these are not 100% going to accommodate every child's needs, but they helped me. .
If I can help one family homeschool more happily, this will make all this writing worth it! Thank you Charlie.
For most children, there is not going to be a long-term negative impact on their education by stepping back from school-based academic learning for a few months. If remote learning is creating more problems than it's solving for your family, it might be time to step back and consider your options. You have a choice here. I know it's far from perfect. I know things are hard right now. But there is another option. Check out the video... Jessica Cleary, Psychologist As a homeschooling parent of many years as well as a psychologist, I can tell you right now that what you're being asked to do is not real homeschooling. This is SO much harder. And looks very different. It is schooling at home during a crisis. Let me tell you what to focus on if you're feeling lots of anxiety and stress with schooling at home during this time of Coronavirus (COVID-19). Tamsyn White, Principal Psychologist  I don’t know about you, but for me the world seems to have changed so much in the space of just a few short weeks. At the end of February, COVID-19, or the Coronavirus, was barely on my radar and I certainly wasn’t aware of just how much it was going to start impacting my life. Lots of the clients I work with, my colleagues, and my friends, have reflected the same thing back to me, too. One of the biggest changes for my clients is that, before COVID-19 really hit our consciousness, the word “Telehealth” was probably rarely heard. These days, if you’re tracking the news like I have been, the word seems to be everywhere! So what is Telehealth? Well - despite lots of people just hearing about it for the first time - Telehealth is not new. In fact, there are practitioners from lots of different disciplines who have been offering Telehealth services for many, many years. Some services ONLY offer Telehealth services. For example, our clinic’s director, Jessica Cleary, has been offering Teleheatlh appointments to women around Australia who have been experiencing parenting stress for a number of years now; our Speech Pathologist, Meg Tasker, has worked for a Telehealth provider, offering speech pathology services to clients locally, and some who don’t even live in Australia; and I myself have provided Telehealth treatment to clients who live rurally in the past. Telehealth has really broadened the scope of the clients who we can reach out to and help. We, as a clinic have almost always had Zoom (like Skype) appointments as an option if a client can’t attend the rooms on the day of their appointment. You might also be reassured to know that there is some really good evidence that tells us Telehealth can be just as effective as face-to-face therapy in most cases. In fact, there can be a stack of benefits to Telehealth for clients - not least of all that we get an insight into where you (or your child!) lives, and can help you identify things in your own home environment that can be used in your journey to wellbeing. There are some things to think about that can help you and your child get the best out of their sessions:
Above all - we’re all in this together. I’m so glad that we have this option to continue working with you through this hard and stressful time in the world. Please don’t hesitate to reach out to us if you think we can help you with something we haven’t thought of. If you live in Australia and would like to book a Telehealth session with Hopscotch & Harmony for you or your child, please click the button below to complete our booking form and we'll get back to you as soon as possible.
Jessica Cleary, Psychologist Parents and educators are in uncharted waters as we seek to support ourselves and the children in our care through the current pandemic. Here are my thoughts on how to navigate conversations with kids on coronavirus. Tamsyn White, Psychologist  In our work as psychologists, we often hear from children and young people that they are feeling so distressed that they are experiencing suicidal thoughts. Of course when they hear this, many parents feel extremely worried. Such distress in children and going people can manifest in lots of different ways in terms of behaviour, emotions, and impact on relationships and functioning at school, home, and workplaces (where relevant). What to look out for - warning signs:
What can you do? Talk and listen to your teen: The expert on how your young person is feeling is your young person themselves. Check in with them often about how they’re travelling and let them know you’re always there for them, even if they don’t want to chat. Check in on yourself It’s natural to feel frightened, overwhelmed, or even angry if your teen lets you know they’ve been thinking of harming themselves. It’s important to let your child or adolescent know that you love them and support them, and that you need to keep them safe. Try to communicate calmly, without judgement, and try to help them see that it’s safe to talk to you. Make sure you ask them directly Parents are often worried that if their teen or child hasn’t had thoughts of suicide, they will be created if asked directly. This is a myth, and research has shown us that asking directly can be very protective. Avoid using euphemisms such asking if they’ve been thinking about “doing something silly” to themselves. Rather use direct, non-judgemental language. Simple is best: “Have you had thoughts about hurting yourself, or taking your own life?” should be a question we are all comfortable asking our loved ones. Plan with your child for their safety If your child or adolescent does let you know that they are having thoughts of harming themselves, make sure you’re prepared to engage in some safety planning. Ask them whether they have a plan to hurt themselves, and ask them to work with you as a team to help keep them safe. This might mean removing access to means, helping them manage their social media time, increasing their connection with supportive family and friends, and seeking professional help. Be prepared to contact services In a crisis where a young person has, or is just about to harm themselves, it is best to present to your hospital's emergency department - via ambulance if necessary. In situations of less urgency, where future potential risk is identified by you, you can gain assistance from your own General Practitioner, the local hospital Child and Adolescent Mental Health Services, and sometimes from school counsellors, if they are available. Where to go for help: Kids Helpline is a free, private and confidential 24/7 phone and online counselling service for young people aged 5 to 25. They can be contacted by phone on 1800 55 1800 or website: https://kidshelpline.com.au/get-help/webchat-counselling/ Lifeline provides free, 24-hour Telephone Crisis Support service in Australia. Volunteer Crisis Supporters provide suicide prevention services, mental health support and emotional assistance, via telephone, online, and face-to-face. Call 13 11 44 or visit their website: https://www.lifeline.org.au/about-lifeline/contact-us Area Mental Health Services (AMHS) triage provides mental health information, advice and referral. Each AMHS has a centralised triage number. www.health.vic.gov.au/mentalhealth/services ARAFEMI Carer Helpline provides free, confidential information, support and referral for family, carers and friends of people with a mental illness. 1300 550 265, 9am to 5pm weekdays www.arafemi.org.au/family-support/telephone-helpline.html Australian Centre for Grief and Bereavement provides a range of education, counselling, research and clinical services for those working in and affected by experiences of grief and bereavement. 1800 642 066. www.grief.org.au Beyondblue provides information about the signs and symptoms of depression, available treatments, how to get help and links to other relevant services and support groups. 1300 22 4636, 24 hours/7 days. www.beyondblue.org.au
Jesse Diggins, Psychologist  Part of my role as a school psychologist is responding to critical incidents that involve aggression and violence. I’ve learned to be able to face these situations with calmness and confidence. Many of the techniques I employ are taken from Therapeutic Crisis Intervention developed by Cornell University. The techniques and principles in this model are highly generalizable and can be applied by families. The beauty of this is that as complex and daunting as aggressive behaviour can appear, the way to respond can be simple and involves answering 3 questions: 1. What emotions am I feeling right now? If we are not emotionally regulated when we respond to a child there is a high likelihood that this will only perpetuate the situation. The child’s need remains unmet and they now also have additional stress. As the saying goes (and neuroscience attests to), ‘when we are at our angriest… we are at our stupidest’. Speaking of, when children are highly emotionally dysregulated they don’t have access to their pre-frontal cortex which is responsible for problem-solving, reasoning and perspective taking. So, asking them to ‘make a good choice’ at the height of aggressive behaviour probably isn’t going to work. We should try and emulate what we can see a duck in a pond look like; on the surface it is calm and graceful, underneath is a little more frantic but that is hidden from view. 2. How are environmental factors influencing the situation? Many times, behaviours are influenced by those observing it. Removing other children or adults can be the catalyst for de-escalation. Similarly, removing yourself partially or fully as a responder (when safe to do so) can also be what is required for de-escalation to occur. 3. What does my child feel, need or want? Behaviour is almost always a form of communication that expresses a need. Identifying and reflecting back your child’s need or feeling goes halfway to solving the problem. There is a difference between caving into unrealistic demands and simply demonstrating to your child that you can hear and understand their frustration. Children may need up to a few hours to recover and return to a baseline state. This is the time to have that conversation about what they can do to get their needs met next time in a more adaptive way.
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