Questions about therapy and counselling methods

 

What models of therapy do you use?

I'm an integrative therapist who avoids rigid or dogmatic application of any one of the four main models I've trained in to date. Experience has helped me realize that you simply can't expect all clients to respond to one model of therapy. So I do my best to tailor the sessions to you, your experiences, and the issues you're bringing to therapy. I use a combination of best practice approaches drawn from both evidence-based (CBT and ACT) and relational/systemic (Satir and EFFT) frameworks that promote self awareness, self acceptance and emotional resilience in relationships. I'm also informed by Response Based Practice (RBP) which directs me to each person's experience of acts of oppression within patriarchal and colonial systems that create barriers to safety and support and cause harm.

I've trained extensively in the US and Canada in ACT and CBT. These were my initial, foundational clinical trainings. Over the last half of my career I've trained intensively with Satir Transformational Systemic Therapy (STST) based on the work of Virginia Satir (aka the "Mother of Family Therapy") and Emotion Focused Family Therapy (EFFT). My exposure and learnings with Response Based Practice came via my graduate school coursework and MA thesis. I now participate in ongoing supervision and consultation groups with an RBP trainer and therapist, and an RBP Team based in Kamloops BC. 

 

What is ACT? 

ACT is the acronym for Acceptance and Commitment Therapy. I like to think of this model as CBT's "creative cousin" because its founders developed mindful and creative approaches to intrusive thoughts, feelings and the myriad ways people experience life's problems. The goal of ACT practitioners is "psychological flexibility". ACT addresses difficult thoughts and feelings. The approach embraces an ethic that  we can have difficult and painful thoughts or feelings, but they don't get to have us! Similar to CBT, it's a helpful framework for taking a step back and really seeing your thoughts and feelings for what they are: content your mind gets good (sometimes too good) at producing based on experience and exposures, or based on fears of what may or may not happen. In other words, you can feel despair and think despairing thoughts without succumbing to despair by shutting down, or shutting out people who are close to you. Difficult emotions are attended to in ACT therapy as something you can be supported to feel without judgement and without resorting to behaviours that trigger you to avoid, placate, or anesthetize thoughts and feelings (eg. using alcohol or drugs, overeating, procrastinating).  Clients are also helped to "diffuse" rigid thoughts, often expressed as rules and expectations using creative techniques that help them make decisions about which thoughts best fit with their own values. We don't have to "buy in" to everything we hear in our own heads. Not everything we feel or think in a given moment deserves the same weight or trust. We can take actions that fit with our values even when they are accompanied by doubt, fear or other difficult emotions. 

 

Why use ACT in conjunction with other models like Satir Family Therapy and Response Based Practice or EFFT?

These approaches respect all human responses as part of a person's genuine experience of life, relationships, and themselves. Counsellors are encouraged to see problem behaviours as symptoms (observable indicators of struggle and suffering both internally and externally) and not as the primary targets of intervention. Those of us who train in and employ these approaches avoid labelling, judging, or pathologizing people and their experiences. It's very important to be seen as someone who is trying, striving, and doing what you feel you have to in the face of adversity. It's also helpful to place your responses in the wider context of family, community, culture and systems. Many people suffer by over-personalizing their experiences; they blame themselves for problems that often include the failure of larger groups or systems. Some people hold themselves responsible for the actions of others in ways that cause them more harm than good. Our experiences don't belong only to us. They are part of a larger context that includes how we experience ourselves within wider systems and institutions. Many people face significant barriers to services and systems because of race, gender or ability. These are key factors when determining how best to intervene on a given problem. It's vital that counsellors make an effort to understand the barriers faced by clients in their efforts to heal and help themselves.  

 

What is EFFT? 

This is the acronym for Emotion Focused Family Therapy. Developed as an adjunct to other models of change, EFFT includes effective communication strategies for difficult personal interactions that help people really listen, and respond in ways that make others feel really heard, and really understood. It helps people diffuse heated emotions and avoid common pitfalls during times of conflict, like resorting to criticism, defensiveness, blaming, shaming, or minimizing. Emotion coaching scripts are one EFFT tool that's used to address escalating arguments. Research has shown its effectiveness for giving parents a way of responding that diffuses common conflicts with their kids. This approach gives parents and caregivers a way to de-escalate arguments. Trust builds over time and people often open up more to the influence of others when emotion coaching is used. 

 

What experience do you have with LGBTQ2IA+ clients?

I've worked and trained with Queer community members and leaders both in public and private clinical settings, with youth and adults. I am cisgendered and consider myself a Queer ally and have completed "Queering your practice" workshops with Our Landing Place, a community of LGBTQ2IA+ clinicians based in PEI who provide guidance, consultation and training to clinicians who work within this diverse community. For more info check out ourlandingplace.com. Specifically I've worked directly with lesbian couples, gay youth and adults, and transgender youth and young adults. 

Practical Questions (fees, fee coverage, privacy, duty to report, consults etc): 

How do I pay for sessions? 

All fees are paid by e-transfer. The email is provided on your consent for services form. Sessions are payable after receiving your invoice by email, typically the day of your session. The total must be paid in full before your next scheduled session.  Payment by cheques may be permitted only after prior arrangement is made (pre-paid sessions in advance, with confirmed deposit) ahead of scheduled sessions. 

 

Can I pay for my sessions with a credit card? 

Sorry, no, I'm only accepting e-transfer payments at this time. 

 

Are your fees covered by third-party insurance plans? 

Check your plan to see if you're covered for services with a Registered Clinical Counsellor or RCC (most plans like Blue Cross cover this designation). Also a good idea to check the limit of your plan - the total amount of sessions covered to plan and budget accordingly. Please request a receipt if needed to obtain reimbursement. I don't provide third-party billing at this time. 

 

What is informed consent? 

Informed consent is the process undertaken both verbally and in writing (consent form) to outline the type of service being offered to a client. It's meant to outline risks of that service and limitations to privacy/confidentiality. Those limitations are important to consider as therapists are required by law to act to report abuse of minor children and other members of population deemed vulnerable (eg. elder abuse). Everyone is Canada is subject to court orders (from Judges not lawyers) which can mean that client files, including sessions notes, are made part of public record in court. These factors and limits to privacy are discussed and signed off on prior to start of services, but it remains a fluid process. Clients who've undertaken therapy for weeks or months who suddenly disclose abuse of a child or senior are subject to reporting, despite the status or length of therapeutic relationship at that time. This can be a very difficult process for the client who places considerable trust in their therapist to protect their privacy. It's important to note that Counsellors are not required to prove abuse of a minor or vulnerable person has occured, they are only required to suspect abuse based on the client's report.  This also applies to self-harming and suicidality reported by minors. Report by an adult of intent to do harm to themselves or another is also reportable. I've had to call police for adult clients who have described their intent to suicide with a plan and means to do so. I've also had to report child abuse after a disclosure in family therapy work. I've continued to support those clients with considerable time and care given to repairing trust following such a report. At other times I've been able to create safety agreements with clients involving family members or other trusted people in that plan to support them in crisis. It's vital that all clients remain aware of these exceptions to privacy and confidentiality as they endeavour to form a therapeutic alliance with their counsellor. 

 

What does it mean that the therapist consults and participates in clinical supervision?

It means my practice is accountable to my professional community. Supervision is a kind of "quality control" for counsellors. It's also akin to rounds common in hospital settings where clinicians share observations and benefit from each other's insights into the care of a client/patient. The cost of such consults is built into the cost of therapy. Since I started as a counsellor I've spent years working in integrative settings where I regularly consulted with colleagues and supervisors, and in community health and child protection with other professionals like nurses, doctors, psychiatrists, teachers, and school counsellors. This is always done with written consent of the clients. My current consent form lists only those individuals and teams that I presently consult with. Anyone outside of that group identified by the client themselves (eg. clients who ask me to discuss an assessment with their physician, or to consult with another therapist they've seen) requires additional written consent to undertake a consult. Confidentiality applies across these supervisory relationships, just as it does between clients and therapists. Only first names or pseudonyms are used in supervision, and other identifying information is altered to protect the identity of the client whose case is being presented in supervision.