Increased mental health awareness is leading to demand for therapists to serve couples and families. Licensed Marriage and Family Therapist, Lead Clinician, Rabiya Mahomed-McGeoff talks to SunHealth about being one of the most important confidants a person or family can have.
What is a Marriage and family Therapist?
A Marriage and Family Therapist is a mental health professional trained in psychotherapy and family system, and licensed to diagnose and treat mental and emotional disorders within the context of marriage, couple and family system. A Marriage and Family Therapist treats a wide range of serious clinical problems including adult schizophrenia, depression, marital problems, anxiety, individual psychological problems and child parent problems.
How did you become a couple and family therapist?
When I did my undergraduate studies in Psychology, one of my professors was a Marriage and Family Therapist.
He introduced systems theories and they made sense to me. So I decided to pursue marriage and family therapy.I did my Bachelors in Psychology with a minor in Women Studies at University of Massachusetts. I did my Masters in Marriage and Family Therapy at Alliant International University in the US. After completing my Masters, I did clinical experience for two years, completing 3000 hours of direct client contact (which is a requirement in the State of California before one can seat for the licensing exams.)
I sat for the two exams and passed. I got licensed as Marriage and Family Therapist in California, USA.
What do you most enjoy about your work?
Giving clients hope, a voice, walking them through transitions and seasons in their lives and seeing them gain insight on their issues.
What is the most challenging thing about marriage and family counseling work?
The most challenging thing is when I work with teenagers where parents don’t want to get involved.
They just drop their children and expect me to fix their children. In most situations you find that parents are the ones with problems and are the ones who need therapy not the children.
What is the biggest myth about therapy?
That you only go to therapy when you have problems. That is not the case; therapy empowers and helps to facilitate personal growth in one’s life. For couples, therapy helps with tune in and awareness of issues before there is a problem.
It strengthens the family and the marriage bond. And also the assumption that therapy is free. I still get amazed by my educated friends who get shocked that therapy is a paid profession.
In general, what do specialists in this practice offer?
We offer couples therapy, individual therapy, child therapy, and group therapy on different issues; grieve therapy, premarital counseling, divorce mediation and recovery.
We consult for organisations on different issues including restructuring, retrenchment and workplace communication.
How do you stay detached from your counselling work? Is it even possible?
I have been practicing for more that 10 years now, throughout the years I have created some rituals that help me to transition from work to family life.
I have learned to set clear boundaries. At the end of my work day I put my phone on a silent mode for 30 minutes. I write down things that I have accomplished on that day and one thing that I am thankful for. I do basic breathing exercises. When I close my office door that’s the end of work – when I get in the car I listen to music until I get home.
What experiences are most useful for people becoming counsellors?
You need to be passionate, enjoy working with people and be willing to learn from your clients.
What seems to be the biggest obstacle for clients in therapy?
Not taking responsibility for the choices one has made over the years.
Mental health problems seem to be skyrocketing in our society lately? What are the reasons for this and what can be done about it?
I don’t think mental health issues are skyrocketing. Mental health issues have always been there. It is only that in our culture when we don’t understand something we find a way to label it. Mental health was often labeled as “botsenwa, mopakwane or boloi.”
There was a stigma for a person suffering mental health problem and their family. Often times they were ridiculed and treated as outcasts and shame to their families. Now people are beginning to be open about mental illness and it seems like it is skyrocketing because of the increased awareness.
We need to educate people more about mental health so that they can be aware and be sensitised on mental health issues.
That is a step to destigmatising mental health and learning the importance of early intervention, which can make a difference in one’s life.
If there is one thing you wished your clients or patients knew about treatment or mental illness, what would it be?
Mental health is a real illness. It’s not a character defect and it is okay to live with mental illness.
I have heard that after a couple has a child, which is notably one of the happiest times in anyone’s life that the satisfaction and overall happiness in the marriage can dramatically decrease. Is this true, and why is this? What can couples do to sustain their marital happiness after children?
Having a child is a transitional time in a couple’s life. The reason why it feels like a couple’s happiness has decreased is that the couple did not prepare for the transitional period and therefore they don’t know how to behave, or support each other with the introduction of this new person in their lives.
It is important for the couple to prepare for this period. This is another time in a couple’s life where couple’s therapy is necessary to help process and explore different ways of preparing for the anticipated additional member of the family.
The challenging thing in this transitional stage is that one partner takes a back seat while the other one is the driver of all things baby.
It is a normal transitional challenge and with preparation and awareness it can be handled better to ensure that the fire keeps burning.
What do you do to personally cope with stress in your life?
I pray, read, exercise, spend time with the people I love, balance family life and work life.
If you had your schooling and career choice to do all over again, would you choose the same professional path? If not, what would you do differently and why?
I will do it all over again. I feel honoured and humbled when people come to my office and choose to trust me with their inner fears. It often gives me joy to see them walking away with a smile.
As a therapist I make a difference in people’s lives.
What is the best advice you can offer to readers on leading a meaningful life?
Be true to who you are as a person.
Caroline Gartland speaks on Children and Mental Health
Tell us about yourself and your background
I’m originally from the UK but have been in Botswana for eight years so this is now home! I have a Combined Honours degree in Psychology an MSc in Mental Health and have had a pretty varied career.
I started off working with offenders doing rehabilitation programmes; went on to support the victims of domestic violence then ended up working in Child and Adolescent Mental Health Services for the National Health Service.
I’ve done a lot of work, mainly voluntary, in different fields since being in Botswana but my passion is now Early Childhood Mental Health.
What does your work entail?
Early childhood mental health is mainly working with parents, caregivers and teachers to help them understand how children develop and the best ways to support their mental health and brain development as they grow. It’s about providing training and opportunities for families to bond with their children and introducing new ways of playing and interacting.
What sparked your interest in early childhood mental health?
Quite simply, having my own children! My daughter was born five years ago and I was fascinated watching her develop and grow. It occurred to me that the younger you begin to consider mental health and provide tools for resilience against life’s adversities, the better outcomes you are likely to have.
I began reading everything I could get my hands on, and completed a diploma in Infant Mental Health. I’ve worked down the lifespan but I feel I’m now where I belong, working with babies and young children.
What mental health issues have you observed in children in Botswana?
Mental Health is still stigmatised around the world and Botswana is no exception. Most people immediately think of mental illness, but mental health is about so much more; we all have mental health and some days we are fine and able to deal with life’s challenges and some days we need more support and tools under our belt to help us cope.
Young children can experience mental health problems. Anxiety is a common one, but we are more likely to focus on the behaviour we see rather than how the child is feeling. An anxious child who refuses to go to school may be labelled as ‘difficult’ or ‘naughty’ but what they are expressing is a painful emotion that they need help dealing with.
Describe one thing you find fulfilling and challenging about working in this industry.
Working with children and families is a pleasure and a privilege. To make life a little bit easier for someone is all that matters, you don’t have to be out there saving the world to make a difference.
My major challenge is time. I would love to do more, I’d love to do an MSc in play therapy and a couple of other therapeutic techniques I’ve come across in Europe but that gets put on hold as I focus on my own family and business.
Can you share an anecdote about how mental health consultation works?
I think that education, understanding and connection are the three keys to giving a child the best start in life. Led by that, SensoBaby provides classes in the community for parents and caregivers to connect with their infants.
We offer workshops on parenting and play to foster understanding of child development and wellbeing and we are available to troubleshoot specific problems an individual or agency has with the young children in their care or the systems they have in place. When it comes to individual parents, mostly what they need is to feel heard, supported and guided in their parenting choices.
You can read all the baby books in the world but they won’t give you the answers you need for your child, through responsive parenting and connection, you’ll find you have the solutions you need.
What advice do you have for child-care providers or early childhood teachers who are at their wits’ end over a child’s challenging behaviour but don’t have access to a consultant?
Empathy is an important and undervalued skill – the ability to consider another’s viewpoint. What is that child feeling? Their behaviour might be challenging and hard to deal with but often the root cause is an unmet need. There’s a famous quote from an American Clinical Psychologist, “The children who need love the most, will ask for it in the most unloving ways.”
Does a mother’s mental health affect her foetus? How important would you say is paying attention to women’s well being during pregnancy as with their physical well being?
100% yes. It is so important to support a woman’s wellbeing during pregnancy. As an example, if the mother experiences significant stress and rising levels of cortisol (the stress hormone) during pregnancy, the foetus will be affected and in some cases will be more sensitive to stress in childhood or later in life.
Pregnant women and new families (Dads as well!) deserve nurturing care themselves and shouldn’t be afraid to ask for support. SensoBaby run FREE monthly coffee mornings to support pregnant and new mothers because we understand the importance of maternal wellbeing.
Do smart phones and television make our children mentally ill as is often purported?
I don’t think technology is always the villain it’s made out to be. The key is in the relationship with that technology. Moderate use of TV’s and smart phones are fine, as long as they aren’t a substitute for outdoor play, imaginative play and meaningful interactions. If a child is crying or upset and we hand them a device to keep them quiet then we have missed an important opportunity for connection, helping them process what is going on and supporting them to calm down and settle themselves.
Now, I know you are involved in an exciting programme that helps caregivers and children to bond and get the children off to the best start in life through play. Can you say a little bit about that work and just how you are seeing it play out?
SensoBaby is our baby; a project born from passion and a desire to support families in Botswana. We offer play-based classes for children and their caregivers that are underpinned by the principles of child wellness as well as early foundations for learning.
When you provide developmentally appropriate opportunities to play, you learn so much about your child. That understanding and observation builds strong connections, which will form the basis of that child’s future relationships and self esteem. Play is so much more than ‘a fun activity.’
We offer a number of trainings and workshops for parents, nannies and community stakeholders and hope to increase our offerings this year. Our community partnerships and voluntary programmes have been successful so far and we hope to see more impact in 2018.
We currently serve the Gaborone community but would like to expand throughout Botswana as opportunities arise. The response to SensoBaby has been fantastic so far and we can’t wait to see how far we can go with the concept!
Terence Mohammed explains intricacies of clinical trials
What does a lab manager do?
As BHP laboratory manager, I am responsible for providing an oversight in the technical operations of the laboratory, including the clinical trials processing and testing labs. As part of the laboratory management, I also provide leadership in planning, implementing and completion of research activities and to ensure that laboratory operations and data generated is in accordance with Good Clinical Laboratory Practice. The lab manager is also expected to provide an oversight on the laboratory quality management system and laboratory expenditure.
Describe your career trajectory. How did you get to where you are now?
I joined BHP in 2007 as a laboratory research assistant. I worked for two years in various BHP clinical trials for diagnosing and monitoring of HIV/AIDS in clinical trials participants. In 2009, I got transitioned to the BHP research laboratory to work as a research fellow where I got assigned to work on various basic science projects. In 2014, I worked as a research laboratory coordinator where I was mainly involved in day to day routine management of the research laboratory activities including; conduct of research projects, preparation of education activities and mentoring of new research fellows, students and interns. In 2015, I got promoted to the position of deputy laboratory manager where I assisted the lab manager in overseeing the technical operations of the lab. In 2017, I got promoted to the position of lab manager.
What’s a typical day/week at the Botswana Harvard Partnership (BHP) for you?
I participate in a lot of weekly meetings; laboratory management and departmental meetings. I am also expected to attend meetings for the various clinical trials which we provide laboratory services to. These include local site meetings and international conference calls with study principal investigators and sponsors. I also review and authorise laboratory orders ensuring continuous operation of laboratory work and within allocated budgets. In addition, I also allocate time to walk around the different laboratory departments on a regular basis in order to interact with staff and learn more about their challenges. This facilitates discussions on how to improve our laboratory operations and working environment.
What are the main health and safety issues for lab technologists?
Exposure to blood, bodily fluids and tissues, which may contain infectious agents and also exposure to ultra-cold materials such as liquid nitrogen and dry ice. However, all necessary laboratory safety trainings are mandatory and staff has access to personal protective equipment including lab coats and gloves which are a requirement for certain tasks.
What aspects of your role do you enjoy the most?
I enjoy the daily interaction with researchers in the field of HIV/AIDS, both locally and internationally. It makes me proud to be part of a team that is working towards ending the HIV/AIDS pandemic in our region as it has decimated the population for over two decades now. With our work, I hope Batswana become increasingly cognisant of the task ahead of us and unify to bring an end to the pandemic.
What would you say the biggest challenge in your field is? Discuss one thing in particular?
Supply of laboratory reagents and consumables can be challenging as sometimes we experience supply stock-out and delays in delivery.
On a basic level, what skills does your job demand?
A lab manager should be able to organise and run effective meetings. It is important to set up an effective meeting agenda and be able to assign key action items to staff
-To be able to communicate effectively and create a positive atmosphere in the working environment. It is also important for the lab manager to be able to motivate staff and also be approachable to staff whenever required.
-A lab manager is expected to have leadership skills in order to provide direction to team members and ensure that the institution goals are effectively met.
-To be able to manage budgets and always be alert to ensure that the laboratory current spend does not exceed target spend.
You have done some research on HIV-1c gp120 in recently and chronically infected individuals in Botswana. For starters what is HIV-1c gp120? A brief background on the research and what the findings were?
Gp 120 stands for glycoprotein 120. This is a protein found on the outer surface of HIV and it used by the virus to enter human cells thereby causing infection. Previous research has shown that gp120 characteristics and properties could be susceptible to change overtime during the progression of the disease. Therefore, we used two groups of study participants at various stages of disease progression (i.e. recently and chronically infected) to see if there are changes in structure and properties of gp120 during the course of the disease. This research highlighted the need to further investigate gp120 in order to get information that maybe useful in the development and designing of an effective vaccine
What advice would you give someone interested in becoming a research fellow?
I would advise them to read a lot in their field of interest and also be aggressive enough to seek opportunities of attachment to a relevant institution. Furthermore, they should seek to interact with experts in the field in order to keep themselves in the loop should a research fellowship become available.
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