Therapeutic Approaches

Cognitive Behavioural Therapy (CBT) is a type of therapy that addresses how thoughts affect behaviours and emotions. The purpose of CBT is to help clients gain an understanding of their common thought patterns and to become more conscious of the effect that these thoughts have on their emotions and behaviour. CBT often involves “homework” where clients are asked to take note of certain reactions or write down their thinking patterns. CBT is often used to treat depression and anxiety but it is an important therapeutic approach that can be helpful for all clients.

Dialectical Behaviour Therapy (DBT) is a type of psychotherapy that utilizes a cognitive-behavioural approach in helping people learn new skills and strategies so they can build better lives. DBT focuses on helping clients change the behaviour patterns that they are struggling with through weekly sessions. The sessions aim to teach core skills including mindfulness, distress tolerance, interpersonal effectiveness, and emotion regulation skills.

DBT is an evidence-based model of therapy that helps people to cope with a variety of problems in their life. DBT is a skills-based treatment where people learn skills and strategies so they can cope with, and change unhealthy behaviors. DBT, stems from “dialectical,” meaning the idea of bringing together two opposites- acceptance and change. DBT teaches people how to live in the moment, develop healthy ways to cope with stress, regulate their emotions, and improve their relationship with others.

Individuals in this program will attend a 12-week individual training, facilitated by a trained DBT therapist. Exercises are provided so that individuals can practice the skills in between sessions that focus on changing the behavior patterns they are struggling with. The purpose is to help people introduce effective and practical skills into their lives, which they can use when they are distressed. These skills are intended to replace unhealthy and negative behavioral patterns.

DBT is divided into four categories: Mindfulness, Distress Tolerance, Interpersonal Effectiveness and Emotion Regulation.

Acceptance and Commitment Therapy (ACT) is a mindfulness-based behavioural therapy where clients learn to accept their inner thoughts and feelings instead of suppressing them, allowing them to face their problems head on while also employing methods to solve them.

ACT uses six core processes to help clients develop psychological flexibility:

1. Acceptance: Embracing all of your experiences, including unwanted ones.
2. Cognitive Defusion: Noticing your thoughts and thinking processes without trying to alter them.
3. Being Present: Allowing yourself to be fully aware of your experiences as they happen at this very moment in time.
4. Self as Context: Getting in touch with your deep sense of self.
5. Values: Recognizing what matters most to you and what you truly want your life to be about.
6. Committed Action: Doing things that bring value to your life.

Eye movement desensitization reprogramming (EMDR) is an effective trauma treatment and most clients report positive effects after only a few sessions. It is an internationally recognized treatment method that is used by thousands of therapists around the world. It was discovered by a Psychologist named Francine Shapiro in 1987. EMDR uses elements of many therapeutic approaches in combination with eye movements or other forms of rhythmic stimulation to stimulate the brain’s information processing system. The intention of EMDR is to help people process traumatic events and to decrease emotional distress. EMDR is based on the theory that when a person is upset by a particular event, their brain cannot process information as it does ordinarily. A particular moment becomes “frozen” and remembering an incident/trauma may feel as bad as going through it the first time because the images, sounds, smells, and feelings haven’t changed (EMDRIA, 2000). These memories can have a lasting negative effect on the way a person sees the world and relates to other people. It can also change how people see themselves in relation to the world. For example an abused child may grow up thinking “I’m not good enough”. EMDR helps to resume normal information processing of these “frozen” moments and the negative beliefs that are attached to them. After an EMDR session the images, sounds and feelings no longer are relived when the event is brought to mind. What happened is still remembered, but it is less upsetting (EMDRIA, 2000). Also, because the memory has become integrated, the negative beliefs associated with the event can become more rational and realistic. Therefore the adult that felt “I’m not good enough” may begin to see that the abuse was not their fault and instead may begin to believe “I am good enough”.

Brainspotting is an evolution of EMDR and is a technique that uses eye movements to release unprocessed trauma. It is based on the theory that many mental and physical issues are related to stored traumatic memories and experiences. With the use of resources development and processing the client is able to connect with stored information and process it. This allows for integration of experiences and emotions on a very deep physiological level. It is based on the work of David Grand.

Cognitive processing therapy (CPT) is an evidence-based treatment that is effective in treating individual’s diagnosed with PTSD or struggling with stress symptoms associated with traumatic events including but not limited to work-related trauma as may be experienced by first responders, child abuse, rape, and major life-threatening accidents. It is a type of cognitive-behavioural therapy that focuses on client goals as well as their thoughts, emotions, behaviour, and physiological responses to reduce trauma symptoms and improve psychological well-being. CPT uses a combination of assessments, psychoeducation, worksheets, and homework to help clients challenge and alter unhelpful beliefs and thoughts related to their traumatic event. In addition, modifying their behaviour through promoting a new and healthier understanding of their lived experience.

It is highly recommended that clients commit to 12 weekly therapy sessions to get the most benefit out of the CPT program.

Mindfulness based therapy is a form of treatment that helps you learn acceptance of feelings, being present in the moment and quieting your mind. This theraputic technique can help you regain focus in order to increase your appreciation and enjoyment of life’s experiences. Mental control is often achieved and one can feel more able to regulate their feelings, thoughts and experiences. Research indicates it is particularly effective for individuals with depression and anxiety conditions.

Psychodynamic psychotherapy involves the development of a relational basis for exploring inner self and relationship experiences. It not only looks at thoughts, feelings and emotions as many other therapies do, but it also helps an individual become more aware of their inner self, including one’s desires, expectations, and internal dilemmas which can be out of our daily awareness. This type of therapy involves developing an environment with the therapist where you can feel comfortable to be honest and have freedom to explore your history and experiences. Usual topics include exploration of early life relationships with parents or caregivers, family, community, and cultural systems of influence, and coping (both conscious and unconscious) that may emanate from these experiences. Common purposes for entering psychodynamic therapy include common mental problems such as anxiety, depression, and trauma, as well as broader goals such as expansion of ability to express and feel a range of emotions, exploration of feelings of unfulfillment or emptiness, and development of greater richness in relationships. Given the importance of establishing a flexibly secure relationship between client and therapist, this form of therapy involves more frequent appointments if desired. While a variety of approaches might be used, the connection of one’s developmental origins with their here-and-now experience of self and therapist is a hallmark of this approach.

Modern interpersonal psychotherapy is a brief attachment focused psychotherapy that focuses on helping individuals resolve interpersonal problems and symptom recovery. It is an empirically supported treatment that was originally developed for depression, and is often commonly used for eating disorders, relationship problems and mood regulation. Through the relationship between the therapist and client, a client learns about himself or herself, their attachment patterns past and present, and learns new ways to have healthy relationships.

Gestalt Therapy is a client-centered approach that helps clients focus on understanding what is happening in the present rather than what they may perceive to be happening based on past experience. The word “gestalt” means whole, and gestalt therapy is guided by the principle that humans are best viewed as a whole entity, mind, body and soul, and is best understood when viewed through a client’s own eyes by bringing the past into the present. This may be achieved by re-enacting the moment and discussing how it feels right now through role-play, confrontation, empty chair therapy and other techniques to bring the issue to life in the therapeutic setting. Gestalt therapy emphasizes that in order to alleviate unresolved anger, pain, anxiety, resentment, and other negative feelings one must actively express them in the present.

Narrative Therapy is a unique approach to Psychotherapy where you are guided towards defining your story outside of pathologies or arbitrary diagnosis. Narrative therapy allows us to see our stories or experiences through a positive/ constructive lens while externalizing our problems. The approach built to empower, is a collaborative approach where the therapist guides us to discover our values and recognize our skills to navigate problems. Externalizing the problem would allow rebranding the problem in a wider socio-cultural context allowing us to approach the issue objectively. Narrative therapy allows us to work on self-compassion. It also facilitates a positive relationship with our issues making any negative experiences palatable. An invaluable tool in couple’s or family therapy, Narrative therapy brings objectivity to conflict. It can also be effective in PTSD and mood disorders as it promotes kindness and compassion towards ourselves.

Sex therapy is an ongoing conversation between client and therapist; there is no personal touching in the office. People often come to sex therapy because something is not going well in their sexual lives, such as an inability to get or maintain an erection during sex, or painful intercourse, for example. Sex therapy is a specialized type of psychotherapy where you can address concerns about sexual function, sexual feelings and intimacy, where the therapist can offer education, talk therapy, offer homework exercises and other resources/referrals for further exploration in individual therapy or couples therapy.
What can sex therapy help address?

• Pain during intercourse
• Difficulties with arousal/orgasm
• Premature ejaculation
• Issues with intimacy/desire
• Out of control sexual behaviours

Solution focused brief therapy is a type of short-term therapy that concentrates on finding solutions in the present. Unlike traditional therapy that analyzes problems, pathology, and past life events to determine how or why the problem was created; it aims to help people finding tools, setting goals, and developing a clear plan to immediately manage symptoms and cope with challenges.

Through emotion-focused therapy (EFT) clients can learn to rule their emotions instead of letting their emotions rule them. This type of therapy offers clients the ability to experience their emotions in a safe setting where in identifying, accepting, and tolerating difficult emotions people can learn to explore, make sense of, and flexibly manage their emotions.

EFT emphasizes the awareness, acceptance, understanding, and transformation of emotions to help clients make change. Emotion focused therapy also offers methods to help clients become more aware of their emotional needs.

Attachment-based therapy involves the therapist working to help the client overcome the effects of their negative early attachment issues by establishing a secure bond where they can then help the client communicate more openly and better explore and understand how their current feelings and behaviours are associated with earlier experiences. A result of attachment-based psychotherapy includes finding new ways of behaving and being better prepared to form strong bonds in other relationships.

Prolonged exposure therapy is a common form of psychotherapy for post-traumatic stress disorder (PTSD). The experience of unwanted thoughts, disturbing nightmares, feelings of hopelessness, depression, and hypervigilance are common after traumatic events, and may lead you to avoid thoughts, feelings and things that remind you of the trauma. PET is based on the associative learning theory. When a trauma occurs things in the environment at the time are associated in the brain with the traumatic event which then causes fear and anxiety when we encounter them outside of the trauma. PET treatment utilizes imaginal exposure in which a therapist will guide you in discussing and retelling the events of the trauma while processing the event by exploring thoughts and feelings. PET treatment also utilizes in Vivo exposure which involves real life interaction with safe things that a client has been avoiding, and creating an “exposure hierarchy” based on the distress caused during interaction. Over time, these techniques will help to decrease the unwanted traumatic reminders while creating less distress when recalling the trauma. The goal of PET is to gradually help you re-engage with life in a safe environment thus strengthening the ability to properly distinguish danger from safety and decrease symptoms of PTSD.

You have probably had those internal arguments with yourself when one part of you wants one thing and another wants something completely different just as much. Internal Family Systems Therapy (IFS), developed in the early 1990’s by Dr. Richard Schwartz, sees humans as made up of many parts that interact, as in the above example, in much the same way people do — arguing, protecting, loving, criticizing, and so forth. When things are going right, a person’s compassionate, caring, and curious Self guides these parts — when things are going wrong, often a wounded part or parts have taken over leadership.

In IFS therapy, the client and the therapist explore the client’s inner world, identifying and getting to know the various parts that are showing up in the client’s life and causing distress. The intention of IFS therapy is never to try and get rid of parts, even the most painful and damaging ones. Instead, we try to understand how the client’s internal system works, why certain parts act in certain ways, and help guide the Self back into the leadership role to heal and transform the wounded parts that are causing so much pain.

Sensorimotor therapy combines talk therapy with alternative forms of physical therapy by reviving memories of traumatic experiences through and paying attention to the physical responses they elicit. The therapist will then focus attention on techniques such as deep breathing and relaxation exercises to relieve symptoms. Sensorimotor therapy believes the mind, body, spirit, and emotions are all related and connected to each other. As a result, the stress of past emotional and traumatic events causes changes in the body as well as body language. The goal of somatic therapy involves discovering the awareness of the mind body connection and using interventions to release the tension, anger, frustration, or other emotions that remain in your body from these negative experiences. Freeing you from the stress and pain of the unconscious physical responses affecting your daily life.

Art therapy is a tool therapists use to help patients interpret, express, and resolve their emotions and thoughts. Patients work with an art therapist to explore their emotions, understand conflicts or feelings that are causing them distress, and use art to help them find resolutions to those issues.

Play therapy is defined as the systematic use of a theoretical model that establishes an interpersonal process, in which trained therapists use the therapeutic power of play to help children prevent or resolve psychosocial difficulties and achieve optimal growth.  The eight guiding principles of play therapy include: 1) forming a warm, friendly, therapeutic alliance with the child, 2) accepting the child, 3) establishing a therapeutic environment that fosters permissiveness, 4) recognizing and reflecting back the feelings the child expresses, 5) recognizing and respecting the child’s ability to solve their own problems, 6) being nondirective and letting the child lead the therapy, 7) recognizing that therapy is a gradual process, and 8) establishing limitations to anchor therapy in reality.