Make sure that you find a psychologist with whom you feel you fit comfortably so you can share important information more easily and work together more productively.
It is important to find out if your therapist is registered with the College of Psychologists of Ontario or another regulated health profession. If your therapist is in supervised practice with the College of Psychologist of Ontario or is being supervised by another regulated health care professional you should be contacted by that supervisor before you speak with your therapist. Your therapist’s supervisor will want to speak to you to explain supervised practice and give you the chance to ask any questions you might have about it.
Your therapist should be comfortable about answering questions about their experience and expertise that are relevant to you and your concerns. Psychologists who are trained in evidence-based assessment and treatment should be comfortable describing how they would work with you in some detail and should answer your questions about their practice.
If a health care professional cannot answer reasonable questions to your satisfaction, consider consulting someone else.
For most mood and anxiety problems, CBT is at least as effective as medication. In addition, CBT is often more effective than medication in maintaining wellness and preventing relapse over the long term. However, many people benefit from a combination of medication and CBT. Often, medication is used to provide some relief from symptoms while CBT is used to provide long-term strategies for getting well and staying well.
Advantages of medications include the fact that they can provide significant symptom relief without a lot of effort. Disadvantages include side effects and the significant risk of a return of symptoms when a person stops taking the medication.
Advantages of CBT include the fact that it appears to be more effective than medication in maintaining wellness and preventing relapse. Disadvantages include the cost and the time and effort required to attend therapy sessions and do the homework.
People in supervised practice are registered as such with the College of Psychologists of Ontario and have nine years of clinical training and 3,500 hours of supervised clinical experience. While most of our Associates may have more years of clinical training and clinical experience, our Associates in Supervised Practice are young, bright, highly-motivated, trained in the most up-to-date treatments, and supervised by a senior psychologist with decades of experience. They are often an ideal fit for younger people or those who want a current, energetic, and youthful perspective.
Once initial goals are decided upon, expect a good clinician to discuss one or more approaches for helping you reach your goals. If you are not progressing, or if progress is too slow, your clinician should suggest modifying or changing the treatment approach. At each of these points you may want to ask yourself the following questions:
In evidence-based treatment you should expect an initial consultation/assessment session during which your therapist will ask you questions about your personal history and your background before asking you about the problem that brings you to therapy. At your initial consultation with CBT Associates, your clinician may ask you a lot of questions about symptoms based on a semi-structured interview that will enable an accurate diagnosis of your problem. At the end of the initial appointment you should have a better understanding of your problem and begin to work collaboratively with your therapist to set initial goals for treatment.
In subsequent treatment sessions, you and your therapist should work towards the goals that you have identified for treatment. Your clinician should be able to describe and discuss one or more approaches for helping you achieve those goals and should introduce specific tools and strategies for you to try between sessions. In evidence-based treatment, your therapist should give you specific tools and techniques to use and experiment with between sessions. If your therapist isn’t doing this, you are not getting evidence-based treatment.
In CBT you should begin to notice some progress after two to four sessions. If you do not, then your clinician should start a discussion about why treatment isn’t working as expected and suggestions some ways to change the approach to treatment.
For most problems, cognitive behavioural therapy (CBT) involves between eight and 20 individual, couples, or group psychotherapy sessions. Individual therapy typically consists of weekly 50-minute sessions. In circumstances where a person requires more intensive treatment, we may recommend longer sessions, meeting more than once per week, and/or scheduling house calls or videoconferencing to provide in-home therapy in our clients’ homes (an approach we have found to be efficient, effective, and convenient).
Most people know within two to four sessions if they are comfortable with their therapist and CBT is likely to be helpful. It usually takes longer than two to four sessions to experience any significant change in symptoms or distress. We encourage everyone to discuss their progress with their therapist after four to six weeks of treatment.
Little is known about the causes of depression and anxiety, and each person’s circumstances and experiences are different and complex. As a result, we are often unsure why a person is experiencing problems. It has been convincingly demonstrated that simply understanding why someone has problems will not help a lot. To overcome problems, people must move from understanding to action, by challenging and changing their thoughts, assumptions, beliefs, and behaviours.
Fortunately, although we know less than we would like to about the causes of anxiety and depression, we do know what works to help people get better and stay well. Thus, rather than looking back, the focus of CBT is on solving problems in the present and looking forward.
Most individual treatment sessions are scheduled for once each week and usually last 50 minutes (leaving the psychologist ten minutes between clients for record-keeping and any additional business, such as completing insurance forms). Couples and group sessions usually last longer.
We are flexible about how we deliver treatment and the level of intensity we offer. Fifty-minute sessions once per week at our office don’t work for everyone, so we also offer video sessions and options for more intensive treatment. More intensive treatment may include longer sessions; multiple sessions per week; treatments in which a senior psychologist provides the psychotherapy and an MA-level person helps out with in vivo exposure (which are helpful in the treatment of severe OCD); and, in extreme cases, home visits, which involve added costs for our travel time.
The Ontario Health Insurance Plan (OHIP) does not pay for psychologists’ private services. We set our fees according to the guidelines set by the Ontario Psychological Association.
Some extended health insurance plans will reimburse all or part of the fees paid to a psychologist. Also, the Canada Revenue Agency has ruled that non-reimbursed fees paid to a registered psychologist in Ontario may be claimed as medical expenses on your income tax return.
Extended healthcare insurance plans differ considerably in the types of coverage they provide. Please check your plan carefully to see what coverage it provides for psychological services, the claim procedure, details required on receipts, payment options, and if you require a letter of referral from your physician.
Payment for services is due at the end of each session, and a receipt is given when payment is received. Please retain these receipts for your insurance or income tax claims, if applicable. We accept payment by cash, cheque, Visa, MasterCard, or debit.
In some circumstances, we will bill a third party directly for the services you receive (e.g., your insurance company). However, this option is available only if the third party authorizes the treatment in advance and agrees in writing to pay for it.