The Better Access scheme changed Australian mental health. It made therapy financially accessible to people who previously could not afford it. That is a real and important thing.
What the Better Access Scheme Was Designed For
It was designed for a particular kind of difficulty: moderate depression, specific anxiety presentations, adjustment to life stressors. For these presentations, ten sessions of structured, evidence-based treatment produces real results. The evidence base is substantial. The approach is appropriate.
For some people, a structured course of CBT or skills-based work is not just useful but genuinely transformative. It creates real change. Many people who eventually find their way to longer-term relational work have already completed something like this, and the earlier work made this one possible.
Why Ten Psychology Sessions Often Is Not Enough
The difficulty is that a significant proportion of the people who walk into a psychology office are not bringing that kind of difficulty. They are bringing something older, more structural, more relational. Something that presents as anxiety or depression but is not, at its root, a symptom. It is a way of being: a pattern of self-experience and relating that formed early and has been running ever since.
Ten sessions was not designed to reach that. Not because the therapist was inadequate, or because the person had not worked hard enough. But because that kind of change does not happen in ten sessions. It happens across a sustained period of emotionally present, relational work, the kind where the relationship between therapist and client has time to become something real, conflicted, disappointing, surprising, and transformative.
What Depth Work Addresses That Symptom-Focused Work Does Not
It addresses the character-level structure that generates the symptoms. The anxiety that has not responded to management techniques, not because management was done poorly, but because anxiety here is not the problem: it is how someone’s nervous system learned to organise itself when feeling was not safe. The depression that lifts slightly and returns, not as a treatment failure, but because it was not an illness that arrived from nowhere; it is a long-held position in relation to hope, aliveness, and the possibility of being received by another person. The relationship patterns that repeat: not random, but what someone learned to expect from people, laid down before they had language for it.
This is not a better kind of therapy than what Medicare funds. It is a different kind, for a different depth of difficulty. The work in this practice is shaped by what the person is actually carrying, not by a predetermined number of sessions or a framework applied uniformly across every presentation. For some people, that means shorter, focused work using ISTDP. For others, it means something longer, at the level of who someone is in relationship.
Many people who find their way here have already completed a course of structured work that provided real benefit. What brought them here is the sense that something was not quite reached. That is the territory this practice works in. If that description is familiar, a first conversation costs nothing beyond an hour.