Author: Dr Elizabeth Woodcock

The last HSC exam finished on 5 November, and results come out on Wednesday 16 December. For many families, these six weeks feel like they should be a relief. Yet plenty of Year 12 students find the waiting harder than the exams. If your teen seems flat, restless or on edge, here’s what may be going on, and how you can help.

Why the wait can be hard

For more than a year, Year 12 gave your teen a clear routine and a goal. Now the timetable has gone, the result is out of their hands, and friends are scattering. Common reactions include:

• Replaying the exams, going over answers they think they got wrong.
• Comparing themselves with friends or posts online.
• Worrying about “what’s next”: university offers, a gap year, work or moving out.
• Feeling lost without structure, sleeping late and losing motivation.
• Perfectionism that makes anything short of a top mark feel like failure.

These feelings are common and usually ease once results arrive and plans take shape.

Signs it may be more than stress

Keep an eye out if, for more than two weeks, your teen:

• seems persistently low, tearful or irritable
• withdraws from friends and things they used to enjoy
• has big changes in sleep or appetite
• is drinking or using other drugs to cope
• talks about feeling hopeless or worthless.

These can be signs of depression in adolescents or anxiety, and it’s worth talking to your GP or a psychologist.

How parents can help in the weeks before results

1. Skip the exam post-mortems. Questions like “How do you think you went?” keep the exams going in their head. Let them raise it.
2. Help them rebuild some routine. Regular sleep, meals, movement and time with friends make a real difference to mood. Casual work, a short course or a project can give the days shape.
3. Talk about the future as a set of options. University offers are one pathway among many. TAFE, a gap year, work and later entry are all common routes. Your teen’s school careers adviser can talk through options before and after results.
4. Keep celebrations safe. If your teen is heading to schoolies or end-of-year parties, agree on a plan together: who they’re with, how they’ll get home, and that they can call you any time with no lecture.
5. Notice your own worry. It’s natural to feel anxious about results too. Teens pick up on this quickly, so find another adult to talk to about your own worries.

Planning for results day

A little planning takes the edge off the morning itself. Ask your teen how they’d like the day to go. Some want to check results alone, others with a parent or friend. Agree on what you’ll do whatever the result, such as a meal out or a quiet day.

When results arrive, react to your teen, not the number. Ask “How are you feeling about it?” before offering your view. If they’re disappointed, listen first; practical next steps can wait until the next day. An ATAR is a ticket into some courses, not a measure of your child’s worth or future.

For Year 11 students starting the HSC now

Term 4 is the start of the HSC year for this year’s Year 11s. Healthy habits now help with stress later: regular sleep, short focused study blocks with breaks, and keeping up sport and friends. Our page on exam stress and study skills has more practical ideas, and our page on perfectionism in young people may help if your teen is very hard on themselves.

How MindBox Psychology can help

Our clinical psychologists see teenagers and young adults for stress, anxiety, low mood and perfectionism, using evidence-based approaches such as Cognitive Behaviour Therapy (CBT). Sessions are face-to-face at our rooms in St Leonards, Sydney, or online anywhere in Australia. Parents are welcome to book a session on their own to talk through how best to support their teen.

You don’t need a referral to book. Medicare rebates may be available with a referral and Mental Health Treatment Plan from your GP or paediatrician. Private health funds and self-managed NDIS may also cover some costs. To book, call 02 9438 2511, email hello@mindboxpsychology.com.au, or meet our clinical psychologists.

If you need help now: call 000 in an emergency. Young people can call Kids Helpline on 1800 55 1800 (24/7), and anyone can call Lifeline on 13 11 14 (24/7).

Someone nearby is chewing, slurping, sniffing or tapping a pen, and within seconds you feel a wave of anger, disgust or panic. You know it’s “just a sound”, but your body reacts as if it’s an emergency. If that sounds familiar, you may have misophonia.

What is misophonia?

Misophonia means “hatred of sound”. It’s a strong emotional and physical reaction to specific everyday sounds, usually sounds made by other people. In 2022 an international expert panel agreed a consensus definition, describing misophonia as decreased tolerance to specific sounds or the things linked to them.

Common trigger sounds include:

• chewing, crunching, slurping and swallowing
• breathing, sniffing and throat clearing
• tapping, clicking pens and keyboard sounds
• sometimes the sight linked to a sound, such as watching someone chew.

Reactions can include irritation, anger, disgust, anxiety, a racing heart, muscle tension and a strong urge to escape. Many people then feel guilty or embarrassed about how strongly they reacted.

Misophonia often starts in late childhood or the early teenage years, and the people closest to you, such as family members, are often the hardest to be around.

Is it a real condition?

Yes. It isn’t yet listed as a separate diagnosis in the main diagnostic manuals, but researchers and clinicians recognise it, and it can seriously affect family life, study and work. It’s different from hyperacusis (sounds feeling physically too loud) and tinnitus (ringing in the ears), although some people have more than one.

Why does it happen?

The causes aren’t fully understood. Research suggests the brain’s threat and emotion systems become very sensitive to particular sounds. Each time a trigger leads to distress and then escape, the link can grow stronger. It’s not a sign that you’re a difficult or intolerant person.

Practical ways to cope

• Use background sound strategically, such as music, a fan or white noise, in situations where triggers are likely, like family meals. Avoid wearing earplugs all the time, which can make you more sensitive to sound.
• Talk to the people you live with at a calm time, not in the moment. Explain that it’s a reaction you don’t choose, and agree on a few small adjustments.
• Plan escape routes kindly: “I need five minutes” rather than snapping.
• Lower your overall stress and tiredness. Like most reactions, misophonia is worse when you’re already on edge.
• Notice the first signs in your body, such as tension or heat, and use a calming skill early.

Does treatment help?

Research is still growing, but Cognitive Behaviour Therapy (CBT) currently has the strongest evidence. In a randomised trial in Amsterdam, 37% of people who had 3 months of group CBT improved significantly, compared with none on the waiting list.

Therapy for misophonia usually includes:

• understanding your reaction, and reducing guilt and shame
• skills to lower physical arousal and shift attention
• gradually changing how you respond to trigger sounds, at your own pace
• Acceptance and Commitment Therapy (ACT) skills for living with discomfort without it running your life
• for teenagers, working with parents on family routines and responses.

If you also notice ringing in your ears or everyday sounds seeming too loud, an audiologist can check for related conditions.

Misophonia treatment at MindBox Psychology

Our clinical psychologists in St Leonards help adults and teenagers with misophonia using CBT and ACT. Sessions are face-to-face or through online counselling anywhere in Australia. You don’t need a referral to book. Medicare rebates may be available with a referral and Mental Health Treatment Plan from your GP. Private health funds and self-managed NDIS may also cover some costs.

Your child starts blinking hard, sniffing, clearing their throat or shrugging a shoulder, again and again. It’s natural to worry. The good news is that tics are common in children, they often settle on their own, and there’s a lot parents can do to help.

What are tics?

Tics are sudden, repeated movements or sounds that a child doesn’t fully control.

• Motor tics are movements, such as blinking, grimacing, head jerking or shoulder shrugging.
• Vocal tics are sounds, such as sniffing, throat clearing, coughing, humming or repeating words.

Many children feel an uncomfortable urge just before a tic, a bit like the feeling before a sneeze. Doing the tic brings brief relief.

How common are tics?

Very common. According to the Royal Children’s Hospital Melbourne, about 1 in 8 school-aged children have tics for a short time. About 1 in 100 have tics that last longer than a year. Tics usually begin in the early primary school years, are often strongest around 10 to 12, and frequently ease in the teenage years.

Tourette syndrome is diagnosed when a child has had several motor tics and at least one vocal tic for more than a year. Despite how it’s portrayed on TV, swearing tics are uncommon.

What makes tics worse?

Tics come and go, and change over time. They’re often stronger when a child is:

• stressed, anxious or excited (school start, birthdays, holidays)
• tired
• being watched or asked about their tics.

They’re often weaker when a child is absorbed in something, such as sport, music or a favourite game.

What parents can do

1. Don’t comment on the tics. Asking your child to stop, or pointing tics out, usually makes them stronger. Children can sometimes hold a tic back for a short time, but it’s tiring and the urge builds.
2. Never punish tics. They’re not deliberate or naughty.
3. Keep routines steady, especially sleep.
4. Notice stress. Help your child find calming activities, and plan ahead for busy times.
5. Talk to the school. Agree on a calm, consistent response with the teacher, and a way for your child to take a short break if they need to.
6. Focus on your child, not the tic. Build confidence through their strengths and interests.
7. Answer questions simply. If siblings or friends ask, a short explanation helps: “It’s a tic. Their body does it without meaning to, and it’s not catching.”

When to get help

Most children with tics don’t need treatment. It’s worth seeing your GP or paediatrician if:

• tics are painful, frequent or disruptive
• your child is being teased, or avoiding school or activities
• tics last longer than a few months
• you notice other concerns, such as worry, OCD-like behaviours or trouble concentrating, which often occur alongside tics.

Your GP or paediatrician can check for other causes and talk about all the options.

Therapy for tics

The main psychological treatment is CBIT (Comprehensive Behavioural Intervention for Tics), which includes habit reversal. A psychologist helps your child:

• notice the urge that comes before a tic
• learn a “competing response”, a small, gentle movement that makes the tic hard to do, until the urge passes
• find out what makes their tics worse, and change those situations where possible
• learn ways to relax and manage stress.

CBIT works best for children who are motivated to practise, usually from around 8 or 9 years of age. Parents learn how to support practice at home without focusing on the tics.

Help for tics at MindBox Psychology

Our clinical psychologists in St Leonards help children and teenagers with tics and Tourette’s and the worries that often come with them, such as anxiety. Sessions are face-to-face or through online counselling anywhere in Australia. You don’t need a referral to book. Medicare rebates may be available with a referral and Mental Health Treatment Plan from your GP or paediatrician. Private health funds and self-managed NDIS may also cover some costs.

A redundancy, a separation, a move, a diagnosis, a new baby, retirement. Big changes are hard for everyone. Most of us feel unsettled for a while, then gradually find our feet. But sometimes the distress is stronger than expected, or it doesn’t ease, and everyday life starts to suffer. When that happens, it may be an adjustment disorder.

What is adjustment disorder?

Adjustment disorder is a strong emotional or behavioural reaction to an identifiable stressor or life change. According to the diagnostic criteria described in the MSD Manual:

• symptoms start within three months of the stressor, often within days
• the distress is out of proportion to the situation, or it’s getting in the way of work, study, relationships or daily life
• symptoms usually ease within six months once the stressor and its consequences have settled.

It’s one of the most common reasons people see a mental health professional. It isn’t a sign of weakness. It’s a sign that you’re carrying more than you can manage alone right now.

Common triggers

• relationship breakdown, separation or divorce (for children, see adjustment to separation and divorce)
• job loss, a new role, or workplace conflict
• moving house, city or country (see immigration and acculturative stress)
• a diagnosis or ongoing health condition (yours or a loved one’s)
• becoming a parent, or children leaving home
• retirement
• for children and teens: changing schools, family separation, or a new sibling.

Signs to look out for

Adjustment disorder can show up in different ways. People often describe it as “adjustment disorder with anxiety”, “with depressed mood”, or a mix of both.

• feeling constantly worried, tense or on edge
• low mood, tearfulness or hopelessness
• trouble sleeping or concentrating
• feeling overwhelmed by everyday tasks
• pulling away from friends or activities
• irritability, or in young people, behaviour changes such as acting out or school avoidance
• thinking about the change constantly, and struggling to move forward.

Adjustment disorder or something else?

The key differences are the clear link to a recent change, and the expectation that things will settle. If symptoms are severe, last well beyond six months, or follow a traumatic event, a psychologist will check for other conditions such as depression, anxiety or PTSD, so you get the right help.

What helps

There’s no single treatment that’s best for everyone, and the research is still growing. What usually helps is a mix of practical support and short-term therapy:

• Talking it through with a psychologist, to make sense of the change and how it’s affecting you.
• Cognitive Behaviour Therapy (CBT) skills to manage worry and unhelpful thinking.
• Problem-solving: breaking the situation into steps you can act on.
• Looking after the basics: sleep, regular meals, movement, and a daily routine.
• Staying connected with people and activities that matter to you.

Some people also see their GP to talk about whether medication might help for a while. Many people need only a few sessions to get back on their feet.

Getting help at MindBox Psychology

Our clinical psychologists in St Leonards see adults, adolescents and children going through difficult life changes. Read more about treatment for adjustment disorder. Sessions are face-to-face or through online counselling anywhere in Australia. You don’t need a referral to book. Medicare rebates may be available with a referral and Mental Health Treatment Plan from your GP or paediatrician. Private health funds and self-managed NDIS may also cover some costs.

If you need help now: call 000 in an emergency, Lifeline on 13 11 14 (24/7), or Beyond Blue on 1300 22 4636.

For many people, faith isn’t a side issue. It shapes how they understand suffering, relationships, guilt, forgiveness and hope. So it makes sense to wonder whether a psychologist will understand that, or whether you’ll have to leave an important part of yourself at the door.

You don’t have to choose between your faith and good psychological care. Here’s what that can look like.

Common worries Christians have about therapy

• “Will my psychologist dismiss my beliefs?” Psychologists in Australia work under a code of ethics that requires them to respect clients’ religious and spiritual beliefs. Your faith is part of your life, so it’s part of the conversation if you want it to be.
• “Does needing therapy mean my faith isn’t strong enough?” No. Anxiety, depression and trauma affect people of every faith. Seeing a psychologist is like seeing a doctor for a physical illness. Many Christians see it as one of the ways they look after the life they’ve been given.
• “Will I be pushed to change my values?” Good therapy works within your values. A psychologist’s role is to help you live in line with what matters to you, not to replace it.

How faith can be part of therapy

How much faith features is up to you. For some people it’s simply knowing their psychologist respects it. For others it’s a more active part of therapy, for example:

• drawing on prayer, Scripture or church community as sources of strength and support
• working through guilt, shame or perfectionism, including beliefs about what God expects
• exploring forgiveness, after a betrayal or hurt
• making sense of grief, illness or loss, and questions such as “Why did this happen?”
• untangling worries that have taken on a religious form, such as fears of having sinned that keep repeating, which can be a form of OCD.

The therapy itself is still evidence-based: usually Cognitive Behaviour Therapy (CBT), Acceptance and Commitment Therapy (ACT) or related approaches, with your beliefs woven in.

Does it work?

Yes. A meta-analysis of 97 studies with more than 7,000 clients found that therapy adapted to clients’ religion or spirituality worked as well as standard therapy for psychological distress, and led to greater gains in spiritual wellbeing.

What to ask when you contact a practice

• “Are any of your psychologists Christians, or comfortable including Christian faith in therapy?”
• “Can I talk about my faith openly in sessions?”
• “How would you approach my concern for someone with my beliefs?”

It’s fine to ask these before booking. A good fit with your psychologist matters, and feeling understood is part of that.

Faith and therapy at MindBox Psychology

At MindBox Psychology in St Leonards, several of our psychologists are Christians and bring this perspective into therapy when clients would like that. Monique Shipp, Hannah Reid and Mimi van Wyk see children, teenagers and adults, and Chloe Kim sees adults. All of our psychologists respect each client’s faith and values. If you’d prefer a psychologist who shares your Christian faith, let us know when you book. Read more on our Christians and Psychology page.

Sessions are face-to-face or through online counselling anywhere in Australia. You don’t need a referral to book. Medicare rebates may be available with a referral and Mental Health Treatment Plan from your GP or paediatrician. Private health funds and self-managed NDIS may also cover some costs.

If you need help now: call 000 in an emergency, or Lifeline on 13 11 14 (24/7).

Most of us have something we’d rather avoid, whether it’s spiders, heights or the dentist’s chair. A phobia is more than a dislike. It’s an intense fear that’s out of proportion to the actual danger, lasts six months or more, and leads you to avoid the thing you fear, or to get through it with a lot of distress.

Phobias are common. A World Health Organization survey across 22 countries found that about 1 in 14 people (7.4%) have a specific phobia at some point in their life. Most phobias start in childhood, at a median age of 8. Yet fewer than 1 in 4 people with a phobia get any treatment.

Common phobias and what they mean

You don’t need to know the name of your fear to get help. Psychologists group phobias into five types: animals (spiders, dogs), the natural environment (heights, storms, water), blood, injections and injury, situations (flying, lifts, enclosed spaces), and “other” (vomiting, choking, loud noises).

Why phobias stick around

A phobia often starts with a frightening experience, seeing someone else’s fear, or simply hearing scary information. But avoidance is what keeps it going. Every time you avoid the feared thing, you feel instant relief. Your brain learns “that was dangerous, and avoiding it kept me safe”, so the fear grows. You never get the chance to learn that you can cope.

Signs a phobia is worth getting help for

• You avoid places, events or health care because of the fear (for example, skipping blood tests or vaccinations).
• The fear is starting to limit your work, travel or family life.
• You plan your day around the possibility of meeting the feared thing.
• Your child’s fear is stopping them doing things other children their age do, or causing big meltdowns.
• With needles or blood, you’ve fainted or come close to it.

What treatment involves

The main treatment for phobias is exposure therapy, part of Cognitive Behaviour Therapy (CBT). With your psychologist you build a “fear ladder”, starting with steps that feel manageable, such as looking at a picture, and gradually working up to the real thing. You stay with each step until the fear starts to settle, and your brain learns that the danger was smaller than it felt.

It’s always done at your pace and with your agreement. Nothing is sprung on you. Some phobias can be treated in a few sessions, and some specific phobias can be treated in one longer, carefully planned session. For people who faint at the sight of blood or needles, there’s a specific skill called applied tension, which helps keep your blood pressure from dropping.

For children, parents are part of treatment. You learn how to encourage brave steps without forcing them, and how to respond to fear in ways that build confidence.

Phobia treatment at MindBox Psychology

Our clinical psychologists in St Leonards treat phobias in children, adolescents and adults. Sessions are face-to-face, which suits exposure work, and some steps can also be practised through online counselling anywhere in Australia. You don’t need a referral to book. Medicare rebates may be available with a referral and Mental Health Treatment Plan from your GP or paediatrician. Private health funds and self-managed NDIS may also cover some costs.

If you’ve started looking into therapy, you’ve probably come across two sets of letters: CBT and ACT. Both are evidence-based, both are practical, and both are used every day by clinical psychologists. So what’s the difference, and does it matter which one you choose?

What is CBT?

Cognitive Behaviour Therapy (CBT) looks at how our thoughts, feelings and actions affect each other. When we’re anxious or low, our thinking often becomes more negative and less balanced. That shapes what we do, such as avoiding situations, and avoidance can keep the problem going.

In CBT you learn to notice unhelpful thoughts, test how accurate they are, and replace them with more balanced ones. You also change behaviour step by step, for example by gradually facing feared situations. CBT is one of the most researched therapies there is, and it’s recommended in Australian and international guidelines for anxiety, depression, OCD, panic and insomnia.

What is ACT?

Acceptance and Commitment Therapy (ACT), said as the word “act”, grew out of the behavioural therapy tradition and was developed by psychologist Steven Hayes and colleagues. Rather than changing the content of difficult thoughts, ACT changes your relationship with them.

In ACT you learn to:

• Notice thoughts as thoughts, not facts or orders (“I’m having the thought that I’ll fail”).
• Make room for difficult feelings instead of fighting or avoiding them.
• Be present, using mindfulness skills.
• Clarify your values: what really matters to you.
• Take committed action: small steps towards those values, even when anxiety or self-doubt comes along for the ride.

The aim is psychological flexibility: being able to feel what you feel and still do what matters.

The key difference, in one example

Imagine you’re anxious before a work presentation and your mind says, “Everyone will think I’m incompetent.”

• A CBT approach might help you examine the evidence. Have past presentations gone badly? What would you tell a friend? You’d work towards a more balanced thought, such as “I’m prepared, and one stumble won’t define me.”
• An ACT approach might help you notice the thought without arguing with it, let the nervous feeling be there, and give the presentation anyway because your career matters to you.

Both lead to the same place: you give the presentation. They just take different routes.

Is one more effective than the other?

For most common problems, the research suggests they work about equally well. A meta-analysis of 39 randomised trials found ACT worked better than waitlist, placebo and usual care, and found no significant difference between ACT and CBT. A 2020 review of 20 meta-analyses, covering more than 12,000 participants, found ACT effective for anxiety, depression, substance use and chronic pain.

CBT has the larger and longer research base, especially for specific anxiety disorders, OCD and insomnia, so it’s often the first recommendation for those. ACT can be especially useful when:

• you’ve tried to “think your way out” of anxiety and it hasn’t helped
• you live with something that can’t simply be fixed, such as chronic pain, a health condition or grief
• perfectionism, self-criticism or overthinking are part of the picture
• you want to feel more connected to what matters, not just less distressed.

How to choose

You don’t need to decide on your own. In practice many psychologists draw on both, because modern CBT already includes mindfulness and acceptance skills, and ACT uses behavioural steps. In your first session your psychologist will ask about what’s going on, what you’ve tried and what you’d like to change, then suggest an approach. If something isn’t working for you, say so; the approach can change.

Some questions to think about:

• Do I want practical tools to challenge my thinking? (CBT may suit you.)
• Have I spent a long time battling my thoughts? (ACT may suit you.)
• Is there something in my life I can’t change that I need to live alongside? (ACT may suit you.)
• Do I have OCD, panic or insomnia? (CBT-based treatments are the first-line treatments.)

ACT and CBT at MindBox Psychology

All of our clinical psychologists use CBT, and several, including Audrey Tokatlian, Chloe Kim, Michaela Joseph and Dr Macy Chan, also use ACT. We see adults, adolescents and children. For younger people, see ACT for children. If you’re comparing other therapies, you might like our post on DBT vs CBT.

Sessions are face-to-face at our rooms in St Leonards, on Sydney’s lower North Shore, or through online counselling anywhere in Australia. You don’t need a referral to book. Medicare rebates may be available with a referral and Mental Health Treatment Plan from your GP. Private health funds and self-managed NDIS may also cover some costs.