MR KHALIL GAREEBOO is a clinical audiologist and trauma-informed counsellor in training.
He helps people with their hearing concerns and needs as well as supporting them through
their trauma journey. He also recently qualified as a Lifeline crisis support counsellor.
BY KHALIL GAREBOO
When I first started my clinical journey, I realised the importance of counselling skills in audiology. While the fundamentals of counselling were taught at university, it was not until I started working directly with clients that I realised how counselling is a critical aspect of the profession.
While most of the audiological workload involves conducting hearing assessment, writing clinical notes and reports as well as hearing aid fitting and adjustment (depending on the workplace), there is the human aspect of our work which is undeniably present and should be addressed in a sensitive and appropriate manner.
I migrated to Australia from Mauritius after I had been looking for a rewarding profession in the allied health industry that combined people and technological skills. I discovered audiology as it was a good fit which combined these skills, and my passion for helping people.
I pursued my audiology studies at Macquarie University by completing a Bachelor of Speech, Hearing and Language Science in 2016, then a Master of Clinical Audiology.
After graduating, I moved to Mildura in regional Victoria to work at a major independent provider where I completed my clinical internship and obtained my Certificate of Clinical Practice. I later moved to Geelong to work with Amplifon during the peak of the COVID19 pandemic.
At the end of 2022 I returned to work for another independent provider in Forster, regional NSW. Although I enjoyed living regionally, I missed the benefits of living close to a major city so moved to Lithgow to work for a major adult rehabilitative hearing services provider to be nearer Sydney.
I am now undertaking a research program in public health, with a focus on hearing and vision loss, at Macquarie University under the supervision of Professor Bamini Gopinath.
Be a good listener
Throughout my career I have seen patients experience significant distress in their lives, notably those with sudden sensorineural hearing loss or traumatic head injury resulting in hearing loss. Simply conducting a hearing test would not be appropriate.
However, once I switched from being a clinician to being a good listener, I noticed that the clients would regain their composure and were more receptive and grateful.
That’s when I decided to upskill and chose to enrol in mental health classes such as “accidental counselling” courses through Relationships Australia and mental health first aid classes with Mental Health First Aid Australia.
Lifeline defines “accidental counselling” as enabling people to master difficult and challenging conversations. It aims to help those who would like to safely and effectively support colleagues, family, friends and strangers who are in distress or experiencing a crisis.
This led me to undertake a Diploma of Counselling course online with TAFE NSW to expand my counselling skills. The course was highly insightful and valuable as it provided me with the soft skills required to work with a wide range of people as well as knowledge and understanding of the Australian mental health system.
I was immediately drawn to the field of crisis intervention and management as I found it most rewarding. It motivated me to start volunteering as a phone crisis support worker at Lifeline in 2024. This typically involves a year-long internship (depending on personal progression through the course contents, milestones, and volunteer hours) which is nationally accredited and recognised. I was taught how to respond to and manage crisis situations, including suicide prevention and domestic and family violence.
Mental well-being
The World Health Organization defines mental health as a state of mental well-being that allows people to manage life stresses, achieve their abilities, study and work property and thus contribute to their community. It says it is a key component of health and well-being that forms the foundation of our individual and collective capacities to make informed decisions, and develop and maintain relationships thereby influencing the world we in1.
According to Australia’s National Study of Mental Health and Wellbeing, 8.5 million Australians aged 16 to 85 years have experienced a mental disorder at some time in their life. Half meet the criteria for a lifetime mental disorder diagnosis having experienced sufficient symptoms of that disorder in the last 12 months2.
Australia’s mental healthcare system is under a lot of strain due to shortages of mental health professionals and affordable services, according to Lifeline data. Additionally, people seeking mental health support often feel confused and overwhelmed trying to navigate the system3.
While often overlooked in audiological practice due to a wide range of factors, clinicians should not overlook this critical aspect of their client’s well-being. This will often impact and inform the clinicians’ interactions with their clients. A holistic approach to client care will incorporate aspects of counselling such as active listening, empathising, reflecting content and feelings, as well as validating the client’s views and experiences4.
However, Australian research shows many audiologists shy away from exploring clients’ mental health conditions and their effects on them during the appointment due to a lack of confidence and skills involved in discussing these issues with their clients5.
Australia’s standard of care in audiological practice focuses on a client-centred or family-centred approach, depending on whether the practitioner works with adults or children6.
This approach acknowledges the client or family as experts in their own lives and circumstances, thereby empowering them to make informed decisions based on the information provided by the clinician during the appointment in a collaborative and engaging manner7.
This approach is valid in clinical practice as it yields positive outcomes for client-clinician interactions. But I believe it often fails to address the psycho-social dimensions of clients, especially those diagnosed with mental health conditions or experiencing crises.
SAFETY, TRUST AND CHOICE
Trauma-informed care, which is well recognised and established in the mental health field, focuses on the principles of safety, trust, choice, collaboration, empowerment, and respect. This ensures the client’s past traumatic experiences are acknowledged without re-traumatising them during the appointment8.
It is based on the knowledge that many individuals living with mental health conditions have experienced trauma in their lives, its impact may be lifelong and it may affect not just the person but their emotions and relationships as well.
“Trauma” can be a lauded and often misunderstood term. It is described as an event, series of events, or set of circumstances, experienced by an individual as physically or emotionally harmful or life-threatening. It has lasting detrimental impacts on their functioning and mental, physical, social and emotional well-being for clinical purposes9.
This includes adverse childhood events, domestic and sexual violence, discrimination and stigma (e.g. sexism, racism, ageism, homophobia, etc) as well as societal and structural barriers. The benefit of this approach is that it promotes recovery and healing from trauma by reaffirming the client’s strengths and resources to develop goals and strategies which are best suited for each client10.
While this approach requires additional training to implement it appropriately in the appointment, many audiologists already possess a basic understanding and knowledge of trauma-informed practice which can be applied in an audiological setting. This is particularly the case for audiologists who have experienced and recovered from traumatic experiences. I strongly encourage clinicians to practise and develop those skills which will result in improved rapport and trust with clients, thereby leading to better outcomes for patients.
RESOURCES
For more information about trauma-informed practices in Australia, please visit the Blue Knot Foundation at blueknot.org.au/ or Phoenix Australia at phoenixaustralia.org/.
• If anyone is experiencing any form of crisis or issues relating to mental health, please call Lifeline (13 11 14), Beyond Blue (1300 22 4636) or SANE Australia (1800 187 263) or visit their websites, lifeline.org.au/, beyondblue.org.au/ or sane.org/.
•Anyone experiencing domestic and family violence can call 1800 RESPECT (1800 737 732). See also 1800respect.org.au/.
References
1. World Health Organization. (2022, June 17). Mental health. World Health Organization. https://www.who.int/news-room/fact-sheets/detail/mental-health-strengthening-our-response
2. Australian Bureau of Statistics. (2023, October 5). National study of mental health and wellbeing. Australian Bureau of Statistics. https://www.abs.gov.au/statistics/health/mental-health/national-study-mental-health-and-wellbeing/2020-2022
3. Herald Sun (2025, March 19). Alarming research shows extent of mental health “crisis” in Australia. APS in the Herald Sun. Psychology.org.au; Australian Psychological Society. https://psychology.org.au/insights/research-shows-extent-mental-health-crisis
4. Burnard, P. (2005). Counselling skills for health professionals. Nelson Thornes.
5. Bennett, R. J., Meyer, C. J., Ryan, B., Barr, C., Laird, E., & Eikelboom, R. H. (2020). Knowledge, beliefs, and practices of Australian audiologists in addressing the mental health needs of adults with hearing loss. American Journal of Audiology, 29(2), 129-142.
6. Audiology Australia (2022, December). Professional Practice Guide.
https://audiology.asn.au/wp-content/uploads/2023/07/AudA_Professional_Practice_Guide_2022.pdf
7. Boisvert, I., Clemesha, J., Lundmark, E., Crome, E., Barr, C., & McMahon, C. M. (2017). Decision-making in audiology: Balancing evidence-based practice and patient-centered care. Trends in hearing, 21, 2331216517706397.
8. NSW Health. (2022). What is trauma-informed care? Principles for effective support. NSW Health; NSW Government. https://www.health.nsw.gov.au/mentalhealth/psychosocial/principles/Pages/trauma-informed.aspx
9. Grossman, S., Cooper, Z., Buxton, H., Hendrickson, S., Lewis-O’Connor, A., Stevens, J., Wong, L.-Y., & Bonne, S. (2021). Trauma-informed care: Recognizing and Resisting re-traumatization in Health Care. Trauma Surgery & Acute Care Open, 6(1), 1–5.
10. Blue Knot Foundation. (2021). Building a trauma-informed world. Blue Knot Foundation. https://blueknot.org.au/resources/building-a-trauma-informed-world/
