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The Big Tent of Psychotherapy

Life can seem like a circus at times. We can feel like we are goofy clowns needing to always act silly or angry lions having to growl at everything. We could feel like brave acrobats, smiling in the face of danger, but needing to engage in death-defying stunts. We could feel like cyclists trying to balance on one wheel, contortionists trying to fit into impossible spaces, jugglers keeping all the balls in the air at once, or majestic elephants dancing to others’ tunes. Most of the time, we feel like ringmasters trying to keep all our different acts running smoothly, as part of a big show.  

Life presents its challenges in a similar vein. Sometimes our needs are about doing better in some areas, like managing our time and achieving the goals we have set for ourselves. At other times, we want to reduce our distress by managing our difficult emotions or problematic behaviours, like addictions. Deeper still, we need help with understanding our unhelpful patterns or in dealing with relationship issues. We could need help with managing our social situations or our physical pain. We might wish to work on our issues as individuals, or as parents, couples or families. We might need assistance in coming to terms with traumatic issues that happened decades ago, or yesterday. Perhaps we need to find ourselves, our identities, or our own answers to life’s challenging existential and spiritual questions. Often, we can feel that we are trying to manage more than one of these challenges, again as part of some big show. 

Psychotherapy is a framework that attempts to be an answer to these varied questions and challenges that present themselves to us. Psychotherapy can be the big tent, the space where all these different roles, problems, needs, wants and desires reach awareness, exploration, discussion, insight, and resolution. People often view psychotherapy as applicable only to others and not to their own problems. We often experience ambivalence about psychotherapy, with one part our self moving towards getting help, while another part wanting to avoid it at the same time. There are too many preconceived notions and stigmatizing ideas about psychotherapy in the media and culture around us to list here. Needless to say, such notions and ideas hurt rather than help. As discussed above, psychotherapy remains an important framework for a wide range of life’s problems. The various styles and techniques of psychotherapy, such as psychodynamic therapy, CBT, Rogerian client-centered therapy, ACT, DBT, EFT, IFS, mindfulness-based therapies, and so on, address one or more of these complex problems. Experienced practitioners can integrate many different styles of psychotherapy to tailor the treatment to each individual for addressing their scope of problems. If someone has even a dim awareness that their problems would be helped by talking to someone, they should seek professional help for their own unique issues. Psychotherapy is a big tent, and in a skillful and meaningful way, it addresses the challenges of life at many levels. It helps us to live and work freely, it helps the show to go on.

Dr. Ashwin Mehra, C.Psych. is a psychologist at the Centre for Interpersonal Relationships (CFIR). He provides psychological assessment and treatment services to children, adolescents, adults, couples and families, and supports them to understand and overcome a wide range of difficulties related to anxiety and mood disorders, traumatic experiences, substance use and addictions, and interpersonal difficulties.

The Importance of Ecology in Mental Health Care

by Jonathan Samosh, B.A.

What is mental health care? Many people think that mental health care focuses on understanding our internal psychological world and relieving the distress that might exist within it. This perspective is indeed important for effective mental health care. However, a whole wide world also exists outside of our internal psychological experience. In fact, understanding how we all exist within many ecologies can have significant implications for our mental health.

‘Ecology’ refers to all of the complex social systems within which we live. For instance, our families, neighbourhoods, schools, cities, economies, laws, governments, and cultural expectations. In mental health care, ecology means that we want to understand our internal psychological world and all of the many important elements of our external worlds too.

Psychologists with an understanding of ecology can provide mental health care in many ways to promote the wellbeing of individuals, couples, groups, organizations, and communities. With awareness of the diverse ecologies that exist all around us, psychologists can see the bigger picture that enhances treatment to relieve individual psychological distress, alleviate couple relationship difficulties, empower marginalized groups, and address inequalities in social systems. This is the power of ecology in mental health care.

At CFIR, ecology informs psychological services relevant to a diversity of human experiences, such as culture, gender, relationships, and financial means. Read more about CFIR’s multicultural treatment service, gender and relationship diversity service, and accessible low fee psychological service options here.

Jonathan Samosh, B.A. is a counsellor at the Centre for Interpersonal Relationships (CFIR) under the supervision of Dr. Dino Zuccarini, C.Psych. and is currently in his third year of training in the clinical psychology doctorate program at the University of Ottawa. He provides psychological therapy and assessment services for adults and couples experiencing psychological, emotional, and relationship distress in a variety of areas, such as anxiety and stress, depression and mood, anger and emotion regulation, grief and loss, traumatic experiences, self-esteem issues, life transitions, personal growth, existential issues related to meaning and purpose, relationship difficulties, and issues related to sexual functioning.

Evidence-based Treatment at CFIR

Over the past 35 years, there has been a substantial amount of research conducted to identify psychotherapy treatments that work. Research suggests that many different types of treatment approaches might be beneficial for a wide variety of disorders. It is vital that a clinician who is providing you treatment is trained in empirically-supported treatment interventions so that you know that you are getting the most scientifically investigated treatment interventions. 

Recently, evidence-based practice has come to mean more than empirically-supported treatment (Canadian Psychological Association, 2012). Evidence-based practice involves the thoughtful and informed use of the psychological research base to inform clinical treatment practice. It’s also essential that your clinician be able to attend to a wide range of individual differences and personal client factors (e.g., attachment style, coping styles, cultural factors) in treatment, as well as consideration and use of research in supporting clients in their healing process. 

The clinicians at CFIR are invested in providing empirically-supported treatments, tailoring treatment to individuals based on their needs and individual differences, and ensuring that we are kept abreast of leading-edge research related to your presenting issues.

Assessments 101: What You Can Expect from an Evaluation Through CFIR

There are different times when someone may need to access psychological assessment services.

Take, for example, situations where a family physician or a vocational rehabilitation organization refers a patient for evaluation through psychological tests. Or when an assessment needs to happen as part of an initial intake with a mental health professional.

Psychological assessment contributes important information to the understanding of individual characteristics and capabilities, through the collection, integration, and interpretation of information about an individual (Groth-Marnat, 2009; Weiner, 2003).

One of the key objectives for testing is to identify the factors that have contributed to concerns related to an individual’s emotional or mental health. At CFIR, depending on your concerns, and our assessment (and any diagnosis if rendered or requested), we will make recommendations about whether a specific treatment approach or a combination of approaches may be required to help you with your problem.

CFIR’s Assessment Services offer comprehensive, scientific and evidence-based psychological evaluations for children, adolescents, adults, and couples.

1.    The Adoption Assessment Service offers comprehensive psychological assessments for individuals and couples who are considering adopting a child. Our clinical psychologists are highly trained and have conducted numerous adoption assessments of caregivers and families wanting to adopt children domestically or internationally (e.g., South Korea, Philippines, Columbia). Click here for more information.

2.    The Alcohol & Drug Evaluation Service offers comprehensive psychological assessments of your own or your loved one’s alcohol and drug use. Our clinical psychologists use the information acquired to determine whether alcohol and/or drug use diagnoses are applicable and outline treatment plans for those wanting or needing to change their substance use. Click here for more information.

3.   The Attention Deficit & ADHD Assessment Service offers comprehensive, scientific and evidence-based psychological assessments for children, adolescents and adults struggling with attentional issues or disorders. These assessments are administered when individuals have experienced struggles with attention, concentration and/or hyperactivity that have negatively impacted academic or work performance or relationships. Click here for more information.

4.    The Autism Spectrum & Developmental Disorder Assessment Service provides comprehensive, scientific, evidence-based psychological testing to children, adolescents and adults to render or clarify diagnoses of autism spectrum or developmental disorders. 

There is a great deal of research that suggests that early identification and treatment of autism spectrum disorders can lead to significant improvements in an individual’s life. An assessment is the first step in the process; we can identify whether a diagnosis of autism spectrum disorder is applicable or not and make recommendations so that appropriate treatment can be put in place in the community as well as at school. Click here for more information.

5.    The Career & Vocational Assessment Service provides comprehensive psychological evaluations to support you or your loved one to find a new career that is best suited to your needs, interests, strengths, and goals. We provide a thorough assessment that uses a variety of scientific, evidence-based questionnaires to assess various factors (e.g., occupational interests) that are important in clarifying your career possibilities. Click here for more information

6.    The Couples & Pre-Marital Assessment Service provides new couples or couples in long-term relationships a comprehensive assessment of their couple relationship for the purpose of helping partners to identify their relationship strengths and address areas of difficulty within the relationship. Click here for more information.

7.   The Disability, Injury & Accident Assessment Service offers comprehensive psychological assessments of mental health symptoms, physical symptoms, and functioning in many domains (e.g., home, school, leisure). There are other symptoms and concerns that can occur following an accident, traumatic injury, or the onset of a physical illness or disability. These can include but are not limited to, depression, anxiety, trauma (PTSD), acute and chronic stress, adjustment to transitions and loss, functional impairments, and physical symptoms (e.g., chronic pain, fatigue). Click here for more information.

8.  The Fertility & Third-Party Reproduction Assessment Service provides individuals, couples and third-parties (i.e., donors or surrogates and their partners) with psychosocial assessments/counselling in preparation for all forms of assisted reproduction as required by a fertility clinic or lawyer. Click here for more information.

9.   The Immigration & Refugee Assessment Service provides comprehensive psychological evaluations for foreign-born (i.e., outside of Canada) adolescents and adults who have applied for residency through the Immigration and Refugee Board. Click here for information.

10.  The Neuropsychological Assessment Service provides comprehensive psychological assessments to support clients in understanding their brain functioning as it relates to emotions, behaviour, and cognition. Click here for information.

11.   The Personality & Interpersonal Functioning Assessment Service offers comprehensive psychological evaluations of you and your loved one’s personality and interpersonal functioning. Typically, these types of assessments provide important information about the habitual ways that you tend to think, emotionally react and relate to others in everyday life. This information is important as some individuals struggle in everyday life as a result of some features of their personality and their manner of engagement with others and this blocks them from living a rich, meaningful and purposeful existence (e.g., developing and reaching personal goals, creating greater self-resilience, and developing strong relationships with others). Click here for information.

12.  The Psychodiagnosis & Mental Health Assessment Service offers comprehensive psychological evaluations of your or your loved one’s mental health concerns. Psychodiagnostic assessments provide a framework to understand your current psychological or psychiatric symptoms, challenges, and strengths. Click here for information.

13.   The Psychoeducation Assessment Service offers comprehensive psychoeducational assessments for children, adolescents and adults for the purpose of assessing cognitive and intellectual functioning, attention deficits and ADHD, learning challenges and giftedness. Click here for information.

14.  The Trauma & Dissociation Assessment Service offers comprehensive psychological evaluations of symptoms associated with traumatic experiences for the purpose of providing or clarifying diagnoses including Acute Stress, Adjustment, Post-Traumatic Stress, complex PTSD or Dissociative Disorders, and making treatment recommendations to address your concerns and struggles. Click here for information.

Contact us today to book your initial appointment. Services provided through CFIR are covered by most private extended insurance plans as well as Medavie/BlueCross (RCMP, Veterans Affairs, Canadian Armed Forces) and CUPE. CFIR Psychologists are also recognized as approved providers of the Canadian Interim Federal Health Program (IFHP) for Refugees.

We believe that everyone should be able to access quality services and receive optimal psychological care. Let us know if you would like to learn about our accessible low fee psychological treatment & assessment services options.

Call us now further information about the psychological services offered through our Ottawa and Toronto locations or to book a session with one of our counsellors.