Your therapy can be delivered either in-person or virtually, depending on circumstances and your preference.
This is of course the traditional method of therapy. You attend our practice in downtown London, and meet in-person with your psychologist for your therapy hour. Under normal circumstances, this is the preferred method of delivery for psychotherapy. Meeting in-person allows for optimal assessment and therapeutic connection.
In-person therapy is not always possible or practical. When inclement weather, illness, or travel precludes an in-office visit, teletherapy can be a good alternative. Our practice provides the option of both individual and couple therapy via a virtual platform designed specifically for healthcare, called doxy.me. There is no download needed; you simply click on a link a few minutes before your designated appointment time, and you will land in our virtual waiting room where we will connect with you. Doxy.me uses state-of-the-art security and encryption protocols, making it compliant with Ontario’s Personal Health Information Privacy Act (PHIPA) requirements. If videoconferencing is not available or practical, telephone therapy is also an option.
Approaches to Therapy
In theory, each of the approaches to therapy below is separate and distinct. In practice, we are always using an approach that is to some extent integrative. Your psychologist will take into account any stated preference you might have for a given approach and will use their expertise and their accumulated knowledge about you in order to craft an approach that will best meet your needs based on your personality, your symptoms, and your goals.
Insight-Oriented (or Psychodynamic) Therapy
Insight-oriented counseling is an emotion-focused, experiential form of treatment that explores the ways in which past painful experiences and the emotional expectations developed during our younger years actively contribute to current difficulties in our functioning. This type of therapy draws upon the material that surfaces in the relationship developed between therapist and patient to bring to life certain core conflicts or early injuries, some of which might reside outside a person’s conscious mind. This type of therapy can be of particular value when the presenting issue pertains to relationships. Insight-Oriented Therapy tends to be of a longer duration than other types of therapy.
Cognitive Behavioural Therapy (CBT)
Cognitive-behavioural therapy (CBT) is an umbrella term for a category of practical, shorter-term forms of psychotherapy. CBT focuses on the here-and-now problems that come up in day-to-day life. CBT helps people to examine how they perceive and think about their experiences, and how these perceptions and thoughts affect the way they behave and feel. It is a problem-focused, goal-oriented approach that teaches skills, provides tools, and often requires work to be done at home between sessions.
Emotion-Focused Therapy (EFT)
Emotion-Focused Therapy is based on the premise that human emotions are connected to human needs, and therefore emotions are the key to helping people change problematic emotional states and interpersonal relationships. The overarching goal of EFT is to help the patient develop an increased awareness of their emotional experience, an improved ability to tolerate and regulate emotions, and be better able to transform unhelpful emotions.
Solution-Focused Brief Therapy (SFBT)
Solution-Focused Brief Therapy (SFBT) is an approach to therapy that addresses the here-and-now, concentrating on present-day solutions, with little time spent on discussing the problems that have brought the person to therapy. It typically begins with identifying and clarifying goals and then working in collaboration with the patient to find solutions that can improve their quality of life. The method is rooted in the belief that people develop default patterns based on experiences, and these patterns dictate how they cope. By examining times when the patient’s problems were not present (for example, exceptions to the rule, or times when the problem was not an issue), the therapist and patient can map out a way forward. As the name suggests, SFBT tends to be briefer in duration than other approaches might be.
Communication Retraining is not so much an approach to therapy as it is a powerful therapeutic technique that can be added to any of the other approaches. Given its central importance, particularly in Couple Therapy, it has been included in this list. Communication Retraining focuses on helping patients put their thoughts and feelings into words in a way that maximizes the probability that they will be heard and understood. It also teaches them to really listen in conversation and convey to the speaker that they have heard them. While these may seem like basic skills, they tend to fail us when we need them most: in times of conflict. This makes Communication Retraining a requisite part of couple therapy. The basics of Communication Retraining can be relayed to a couple in one or two sessions; however, the work of practicing this is often taking place in the background on an ongoing basis throughout the course of couple therapy.
Cognitive Processing Therapy (CPT)
Cognitive processing therapy (CPT) is a specific type of Cognitive Behavioral Therapy (CBT) that helps patients learn how to challenge and modify unhelpful beliefs related to trauma. It has been effective in reducing symptoms of PTSD that have developed after experiencing a variety of traumatic events including child abuse, combat, rape and natural disasters. As with most types of CBT, CPT has a homework component that patients complete on their own between sessions. The goal of CPT is to help the patients process their traumatic experience rather than avoid it, and create a new understanding and conceptualization of the traumatic event, thereby reducing its ongoing negative effects on their current life.
Relaxation Training is more a therapeutic technique than an approach to therapy, but it has been included here because of its enormous potential to support patients in both individual and couple therapy, and its central role in all sorts of therapies. Relaxation Training equips patients with the ability to change their state from one of tension and constriction (fear, anger, hypervigilance) to one of relaxation and openness (safety, equanimity, groundedness). This ability is invaluable in helping patients cope with anxiety, anger, depression, insomnia, chronic pain, trauma, and relational conflict. Skills are taught and practiced in session as well as at home.
Dialectical Behaviour Therapy (DBT)
DBT is a type of CBT that helps people live in the moment, cope better with stress, regulate their emotions, and relate better to others. It seeks to help people find a balance between accepting themselves and the world around on the one hand, and at the same time effecting change in order to replace unhealthy methods of coping and relating with healthy ones. DBT can be particularly helpful to people who struggle with emotion regulation and self-destructive behaviour.
Motivational Interviewing (MI)
MI is an approach to therapy that is both directive and goal-oriented, and tends to be shorter term. The term ‘directive’ does not imply that the therapist tells you what you change and why; it’s just the opposite. The therapist is directive in their inquiry in order to help you uncover what you want and why. MI is used to help people explore their ambivalence about adopting a new behavioural pattern, as well as their reasons for wanting to change. This approach is designed specifically to help people get in touch with their own intrinsic desire to do things differently. It can be very useful when a person feels stuck in an old behavioural pattern and cannot seem to get past the inertia associated with change.
As with Relaxation Training and Communication Training, we employ Mindfulness Training less an approach to therapy and more as a technique that can be incorporated into any therapy in order to augment its effects. Mindfulness refers to the practice of being present; that is, being aware of one’s physical, emotional, and mental state in the present moment, without judgement. It is the process of bringing one’s attention to all that can be sensed in the here-and-now, and committing to noticing the now as opposed to thinking about the past, present, or future. It has been shown to be a very effective part of treatment for chronic pain, insomnia, depression and anxiety, and stress management.
Acceptance and Commitment Therapy (ACT)
ACT is an approach to therapy that relies heavily on mindfulness. ACT helps people learn to accept the full range of their inner world (thoughts, emotions, sensations, needs), and to use mindfulness skills to be flexible and not get caught up in their experience. It helps people to get clarity about their own values and desired actions, and to commit to moving their life in this direction.