FAQ

Why see a psychologist ?

Why see a psychologist?

There are many reasons you might consider seeing a psychologist, from wanting help setting goals or making changes in your life to getting assistance dealing with more complex or persistent problems affecting your everyday life. Regardless of the issues you are facing, it can be hard to ask for help or even sometimes recognize or admit that help is needed. Oftentimes, the longer we wait to seek help, the more anxious we can become about seeking help, and let’s face it: asking for help and making changes can be scary. However, there is no shame in admitting that you need help; everyone needs help at one time or another and the sooner you begin working toward change, the sooner you can begin moving on with your life.

Some common reasons for seeing a psychologist include: difficulties with school or job demands, learning/developmental disabilities, neurological impairments (e.g., Parkinson’s disease, multiple sclerosis), stroke / transient ischemic attack (TIA), brain injury, concussion, chronic health / medical conditions (e.g., diabetic neuropathy, epilepsy), substance or alcohol abuse, issues related to aging (i.e., normal aging, mild cognitive impairment, dementia), low self-esteem, anxiety, excessive worry, stress, discomfort in social situations, phobias/fears, obsessive and/or compulsive behaviours, difficulty sleeping, body image issues, and eating disorders.

If you are unsure whether your particular concern or issue warrants psychological intervention, there is no harm in calling to find out. A meeting can be booked in which we can discuss the issue(s) in more depth and together we can arrive at the best course of action.

What is a psychologist and how does it differ from a psychiatrist or a counsellor/therapist?

What is a psychologist and how does it differ from a psychiatrist or a counsellor/therapist?

The primary differences between psychologists and psychiatrists has to do with their level of education and the focus of their training. A psychologist is someone who has completed an MA or a PhD in psychology, which entails 6-10 years of specialized training and education in the nature of human thoughts, feelings and behaviour. As part of this training, psychologists also receive advanced training in the provision of various types of psychotherapy. Those who have completed a PhD may call themselves “Dr.”; those who terminated their training after obtaining an MA are called Psychological Associates. In order to use the title of Psychologist or Psychological Associate, a practitioner must be registered with the College of Psychologists of Ontario (CPO). In addition, all psychologists must declare their areas of specialized training (called “competencies”), which detail the type of psychology they practice (such as Clinical Psychology, Forensic Psychology, or Neuropsychology, for example), as well as the populations they serve (such as children, youth, adults or seniors). Upon registering with the CPO, or other provincial regulatory bodies, psychologists must practice only within their areas of declared competency. As a result, not all psychologists are able to work within all fields of psychology or with all populations, which is why it is important to check the areas of competency of your chosen psychologist before starting treatment or assessment. Psychologists are the only professionals qualified in the use of certain kinds of tests and assessment measures. Although psychologists often have a working knowledge of psychotropic medications, they are not currently licensed to prescribe medicine in the Province of Ontario.

A Psychiatrist, by comparison, is a medical doctor who specializes in mental health. Typically, their focus is on the biological aspects of mental health, as opposed to the psychotherapeutic aspects, and thus they often use medication to treat different mental health problems. While some psychiatrists do have training and experience in the provision of psychotherapy, the nature and degree of this training is often quite different from that of psychologists. Psychiatrists are registered with the College of Physicians and Surgeons of Ontario.

A Social Worker is someone who has earned a BA, and possibly an MA in social work. They are registered with the College of Social Workers and Social Service Workers.

The term “therapist” does not indicate the type or degree of education and training attained by a person providing services. Practitioners who go by the title of “counsellor”, “therapist”, “life coach”, or other similar titles are examples of unregulated service providers. For more information on regulated versus unregulated service providers, please see the section entitled “Why see a regulated psychologist / health professional?”

What is a neuropsychologist?

What is a neuropsychologist?

A question I often get asked is, “What is the difference between a clinical psychologist and a neuropsychologist?” The answer lies in the training and types of clinical experiences a student gets along the way. Simply put, a neuropsychologist is a clinical psychologist whose area of expertise deals with the relationship between the brain and behaviour. A neuropsychologist’s practice involves assessment, diagnosis, treatment planning and, in some cases, therapy and/or rehabilitation of individuals who have sustained any type of injury (or suspected injury) to the brain. In order to declare competency as a neuropsychologist, practitioners much have earned a PhD in psychology from an accredited university program, completed a minimum two years of training and supervision in a neuropsychological practice (at least one of which was at the post-doctoral level), completed an accredited internship placement (or the equivalent), and passed all mandatory examinations to become licensed for independent practice in their state or province.

Why see a regulated psychologist / health professional?

Why see a regulated psychologist / health professional?

In Ontario, psychologists are regulated health professionals, registered with the College of Psychologists of Ontario (CPO) to practice psychology and governed by the Regulated Health Professionals Act and the Psychology Act, 1991. Only practitioners registered with the CPO can call themselves “psychologists”. Becoming a registered psychologist is a highly structured process in which a candidate must meet several requirements, including completing a PhD in Psychology, completing a one-year post-doctoral internship and one year of supervised practice, during which time several written and oral examinations on jurisprudence, ethics and the profession of psychology must be successfully completed. Successful candidates must follow the Canadian Code of Ethics for Psychologists, as well as the Standards of Professional Conduct as stated in the Regulated Health Professional Act for the Province of Ontario. Psychologists are trained more generally in the assessment, diagnosis and treatment of mental health issues, although many have areas of concentrated experience and training. Members of the CPO must state their areas of declared competence, and only practice within those areas declared. All members of the CPO are required to attend workshops, conferences and seminars in order to ensure continual professional development.

By seeing a registered psychologist, a regulatory body monitors the professional and ethical standard of conduct of its members and is responsible for protecting the interests of the public by holding members accountable for their actions and the services they provide. By comparison, there is no minimum level of education or training for unregulated service providers, no way to formally verify credentials of service providers, and there is no regulatory body with legal authority to protect the interests of the public should any disputes arise. Practitioners who go by the title of “counsellor”, “therapist”, “life coach”, or other similar titles are examples of unregulated service providers.

You can verify that a practitioner is regulated and that he or she is in good standing by calling the CPO or by visiting the website (www.cpo.on.ca), which lists every member of the College, their standing, their areas of declared competence, and their current practice.

What is the intake process?

What is the intake process?

Getting started is easy. A doctor’s referral is not required – you may refer yourself simply by calling in to book an appointment. I make every effort to respond to all calls within 48 hours. The only information required to book an appointment is your name, a mailing address (or an email address), a number where you can be reached, and a brief description of the problem(s) you are struggling with to ensure my practice will be a good fit in meeting your needs.

Once we have set up an appointment, I will send you (via email or ground mail, whichever you prefer) a welcome package that includes standard information about treatment, a personal information form (e.g., name, age, brief description of the problem(s) for which you are seeking help), and a consent form for you to complete in advance of your appointment. You may either bring these forms with you to your first appointment, or send them back by mail or email. This information is used to help speed up the intake and assessment / treatment process so that we do not waste valuable time during session(s) gathering this information.

Prior to the commencement of treatment / assessment, an interview will be conducted to gather further relevant information, and you may be asked to fill out a few other short forms or questionnaires to help clarify you presenting concerns.

Click here for my Referral Form (not needed for self-referral)

What should I expect at my first therapy appointment?

What should I expect at my first therapy appointment?

The first appointment for therapy is largely geared towards information gathering and getting to know each other a little bit. We will discuss what Cognitive Behavioural Therapy (CBT) is, how it works, and how therapy sessions will be structured, and we will talk briefly about the issue(s) that have brought you in to see me. We will also discuss issues of privacy and the limits of confidentiality, and any questions or concerns you may have will be answered. If all seems agreeable to both parties then we will complete a small amount of paperwork to get the process started. Included in this paperwork is a consent form (of which we will both keep a copy) that indicates in writing that you have given informed consent to enter into treatment with me, as well as the details surrounding if you wish to stop treatment and the limits of confidentiality that we will have discussed previously. I will then conduct an interview to gather some background information (e.g., level of education, work history, relevant medical history, history of the problem(s) that brought you in for treatment, etc); this information will be used to help determine any diagnoses (if appropriate) and will be used to guide treatment.

As CBT is an active and collaborative process, we will sit at a desk during sessions which will allow us to look at materials together and move around as needed; there will be no lying down on couches like how you see in the movies. Therapy sessions last 50 minutes, but you will be charged for a 60-minute session; the last 10 minutes of each session is used by me for documentation / record keeping, and session preparation. Depending how the first session proceeds, a second information gathering session may be required. Otherwise, we will begin working on the presenting issue(s) at the start of your second session.

What should I expect when I come in for an assessment?

What should I expect when I come in for an assessment?

At the start of your assessment appointment, we will take some time to discuss very briefly the nature of the issue(s) you have been experiencing and the type of the assessment you will undergo (e.g., neuropsychological, baseline cognitive, psycho-educational / psycho-vocational, or specialty assessment). Once that has been established, we will begin the process of informed consent in which I will explain to you issues of privacy, the limits of confidentiality, what type of information will be gathered, how that information will be used, and your rights to access that information. I will explain briefly the nature of testing (i.e., what you will be asked to do, how long it will take, and when the results will be ready). You will also have the opportunity to ask any questions and we can discuss any concerns you may have. If all your questions and concerns have been addressed to your satisfaction and you agree to proceed with the assessment, we will both sign an informed consent form (and we will both keep a copy) and I will begin the assessment.

Regardless of the type of assessment, I will always conduct an initial interview to gather background information (e.g., level of education, work history, history of the problem(s) that brought you in for assessment, relevant medical history, etc.). This interview typically lasts 1-2 hours; the information gathered is used to help determine appropriate measures to administer, to assist with interpretation of test results, and to guide treatment recommendations. Depending on the nature of the presenting problem, I may request your written permission to interview a family member either in person or by phone in order to gather more information. Although the specific tests administered may vary somewhat depending on the nature of the assessment and the presenting problem(s), all tests are standardized measures designed to accurately assess cognitive functioning. For the most part, you will be asked to complete various tasks, including paper-and-pencil type measures, filling in questionnaires, putting things together, listening to or looking at materials, and answering questions.

Depending on the type of assessment, you should expect to be here for a minimum of one half day, and a maximum of 2 full days (with breaks for washroom, lunch and mental breaks, as needed). You will be informed of the expected duration of the assessment at the outset. Upon completion of the assessment, the tests will be scored and interpreted, and results should be available within one month’s time. A report will be drawn up which includes a summary of your relevant background information, the results of tests, any diagnoses (if relevant), and treatment recommendations. Once this report has been completed, we will meet again to go over the results together and discuss the treatment plan. If you were referred for an assessment by a third party, a copy of the report will be sent to the referring source. A copy of the report will also be kept in your file.

What is Cognitive Behavioural Therapy (CBT)? How does it differ from traditional psychotherapy?

What is Cognitive Behavioural Therapy (CBT)? How does it differ from traditional psychotherapy?

Cognitive Behavioural Therapy (CBT) is an evidence-based form of therapy that differs from traditional psychotherapy in that it is a structured, short-term, goal-directed, problem-focused, and active form of therapy. CBT is based on the realization that our thoughts (the “cognitive” part of CBT) can influence our feelings and behaviour about a given situation or event, and vice versa. Such thoughts are typically negative (e.g., “I can’t succeed in my new job”; “nobody will ever want to be my friend”; “I should have known better”; “I’ll never be as perfect as I should be”) and they happen so quickly that we are usually not even aware that such thoughts crossed our minds; we call these “automatic thoughts”, and they represent a distorted way of thinking about and perceiving experiences or events. CBT is a collaborative approach in which the client and therapist work together in a supportive and respectful manner, with the therapist helping the client to learn to recognize his or her patterns of behaviour and distorted thoughts. The client also learns and practices new ways of thinking about, feeling about and acting towards different situations and events in a safe environment. A major advantage of CBT is that the client learns how to be his or her own therapist, which is a useful tool in preventing relapse.

 

CBT model

An additional advantage of CBT as a treatment choice is that it does not require the use of medication in order to be effective. In fact, research has consistently shown that CBT is not only an extremely effective method for treating many types of psychological problems, such phobias, anxiety, panic attacks/panic disorder, obsessive-compulsive disorder (OCD), social anxiety, post-traumatic stress disorder (PTSD), anger issues, sleep and eating disorders, substance abuse, and chronic pain and illness, amongst others, but also that in some cases it is more effective than medication. It should be noted, however, that medication may, in certain cases, help an individual be able to more easily manage their anxiety levels and mental health problems in order to allow them to engage in the therapeutic process. If, through working together, it seems that medication may be helpful to ensure the best treatment, we can discuss various options and with your written permission I can work with your family physician to help establish the best care. Although psychologists typically have a working knowledge of various psychotherapeutic medications, at the present time we are not licensed to prescribe medication in the province of Ontario.

 

Anyone, regardless of age, education or background, can benefit from CBT provided they put the work in. Although it is a highly collaborative process with the client and therapist working together in sessions, the client is responsible for:

a) being ready and willing to take responsibility for making personal changes

b) coming to session ready and willing to work towards making changes

c) completing homework assignments (to the best of his or her ability) in between sessions as part of working toward end goals

d) coming to session willing and able to reflect upon his or her thoughts,  feelings and behaviours

How long does therapy take? How many sessions will I need?

How long does therapy take? How many sessions will I need?

There is no “one size fits all” answer to this question as many factors have to be taken into account when considering each individual case. For some, only a few sessions (e.g., 3 or 4) may be needed, whereas others may need to be in treatment for longer (e.g., 8-12 or more), especially if the issues being addressed are complex or multifaceted. Remember that CBT is a collaborative process and therefore much also depends not only on how each session goes but also on how treatment progresses in between sessions. Ultimately, it is the client who must make changes in his or her life; my job is to help you get there.

At the start of treatment an initial estimate of the number of sessions required to help you reach your goals will be determined and discussed, with the full understanding that this number may change as treatment progresses. If, due to financial constraints or other limitations, only a certain number of sessions will be possible, we will work together to prioritize the issue(s) that should be the primary initial focus of treatment, with secondary issues being dealt with should extra time be available and/or during subsequent treatment down the road.

How much does it cost to see a psychologist, and who pays for psychological treatment?

How much does it cost to see a psychologist, and who pays for psychological treatment?

Unfortunately, fees for psychological assessment and/or treatment are not covered by OHIP, and thus many clients must pay out of pocket. However, many people have extended health plans that provide full or partial coverage for services provided by registered psychologists. At the end of each therapy session or upon the completion of an assessment, the client will receive an itemized receipt detailing the costs associated with each service. These receipts may be submitted by the client to his or her insurance company for reimbursement, if applicable. Treatment and assessment services are charged by the hour, with an hourly rate set in accordance with the guidelines set out by the Ontario Psychological Association (OPA). I accept cash or cheque for services rendered; payment shall be made at the start of each therapy session/assessment.

Is there a cancellation or missed appointment fee?

Is there a cancellation or missed appointment fee?

There are no fees for cancelled appointments provided that a minimum of 24 hours notice is provided. Missed therapy appointments or therapy appointments cancelled with less than 24 hours notice are subject to a $25 fee; missed assessment appointments or assessment appointments cancelled with less than 24 hours notice are subject to a $100 fee. Fees are charged in order to offset the costs incurred of missed appointments; all such fees shall be applied to the total bill for the next session/appointment. A cancellation or missed appointment fee may be waived under certain exceptional circumstances. There are no fees associated with rescheduling therapy sessions or assessment dates provided 24 hours notice is given. Requests to reschedule are subject to the same fees as missed or cancelled appointments as indicated above.

If therapy or assessment appointments are frequently being rescheduled, cancelled or missed, we may need to discuss whether there are any issues currently hindering treatment and the appropriateness of pursuing treatment at the present time. From time to time issues do arise that are beyond the control of the client and which do, unfortunately, hinder psychological treatment, such as current life situations, financial or personal stressors, or readiness for change. If such issues are presenting a problem, we may discuss taking a break from treatment for a period of time until such factors can be resolved or at least lessened. This is not meant to deter you from seeking treatment but rather it is a means of ensuring that you are at your best and are ready, willing and able to commit to the hard work required to make changes in your life. Any such discussions will be open and honest and we will work together to determine what is the best course of action for you at the present time.

Do you do phone or email therapy sessions?

Do you do phone or email therapy sessions?

As a general rule, I do not do phone or email therapy sessions. All sessions are face-to-face in the office, primarily as a safeguard against breaches in your privacy and confidentiality. Emails can be sent to the wrong address, accounts can be hacked, and phone calls can be overheard, even when every precaution is taken to guard against such breaches. However, in certain instances when a session has to be cancelled or rescheduled, a brief phone conversation to touch base and troubleshoot may take place; notes will be taken during such conversations to be added to your permanent file. Any therapy-related issues included in an email will be redirected as a topic for discussion during our next session.

Are your services confidential?

Are your services confidential?

Your privacy is of the utmost importance. As a registered psychologist, part of my job is to ensure that your file and any personal information that is collected is kept secure and remains confidential. Personal information includes any information about you as a person, including characteristics (e.g., age, gender, income, education, address/contact information), health information, capacity to make decisions, and personal beliefs or views. Any such information that is collected is used and disclosed only to the extent necessary for me to provide services. At no point in time during treatment/assessment will your personal information (including topics discussed or even whether you are in treatment) be released to anyone, including other treating physicians/clinicians, insurance companies, legal representatives or family members without your written consent. There are, however, a few exception to the limits of confidentiality in which information would be shared without your prior written consent. Such instances do not arise frequently but they would necessitate releasing information in order to keep your or the public safe. Instances in which confidentiality could be broken are as follows:

1. If there are concerns about a child being harmed, abused or neglected, or if there are concerns about a child being at risk for harm, abuse or neglect

2. If you report having thoughts or intent for suicide or causing serious harm to another person(s)

3. If you report having been sexually abused by another health care practitioner (e.g., a doctor, dentist, nurse, etc).

4. If there is a court order or subpeona from a judge for release of information

Additionally, as a registered member of the College of Psychologist of Ontario, there is a chance that my practice could be audited as part of the Quality Assurance Program. In such an instance, a few of my files would be randomly selected and checked to ensure that I am following the rules and regulations regarding record keeping, maintaining client confidentiality, keeping files secure, and other professional matters. If audited, the focus is on my behaviour, not the client’s, and any information viewed remains strictly confidential. Psychologists are required to keep records for 10 years, after which they are destroyed.

Do I need a referral from my doctor?

Do I need a referral from my doctor?

A doctor’s referral is not required to seek treatment – you may refer yourself simply by calling in to book an appointment. If your health benefit provider / insurance company requires a physician’s referral before they will reimburse you, your doctor can submit the required paperwork.

Click here for Referral Form (not needed for self-referrals)

What if you do not treat the specific problem(s) I am experiencing?

What if you do not treat the specific problem(s) I am experiencing?

Although psychologists are trained and licensed more generally and thus are able to treat many different kinds of disorders or help with many kinds of psychological problems, all psychologists are required to declare their areas of competency which are based on experience and training in specific fields. My areas of declared competency are neuropsychology and clinical psychology, and I am licensed to work with adults 18 years of age or older and seniors; I am not licensed to treat or assess children or adolescents. If it so happens that I am not able to help you either because your needs do not fit with my areas of declared competency or because the issues or challenges you are experiencing could be better dealt with by a professional colleague who has more experience and training treating those specific issues (e.g., post-traumatic stress disorder, personality disorders), I will work with you to make an appropriate referral to ensure the best possible care.