Frequently Asked Questions
Psychotherapy is a collaborative process in which you, the client, with the help of a mental health professional trained in psychotherapy, are able to increase insight into distressing thoughts, emotions and behaviors that may be reducing your quality of life, interfering with your ability to engage effectively with others and preventing you from pursuing your goals. More importantly, psychotherapy enables you to develop increased coping skills that allow you to make real changes in your mood, express emotions in a healthy manner and more fully engage with what you most value in life.
I use the term “counselling” in the name of my practice to refer to the range of services in my practice including individual psychotherapy, caregiver counselling and case management. Some definitions of these terms also suggest that counselling is a form of talk-therapy that is usually short-term, more behaviorally and goal- focussed and deals with immediate issues in your life.
While all psychotherapists provide counselling not all counsellors are psychotherapists. Psychotherapy addresses deeper issues related to your psychological history and relationships (e.g., early family life with your parents, peer groups, school and work) and how they inform your current coping strategies and the issues that bring you to counselling.
Psychotherapists are usually trained in one or more therapeutic approaches (e.g., Cognitive Behavioral Therapy, Acceptance Commitment Therapy, Attachment Theory and Emotionally Focussed Therapy) and use this training to work with you in specific ways to address your problems (see below for definitions of the therapeutic approaches I practice).
The most important aspect of psychotherapy is the rapport or relationship that is established between you and the psychotherapist. Good psychotherapy provides a warm, empathetic space, one in which you feel that trust and a solid working relationship can be established. I will mindfully attend to this aspect of our work together from our first session and will check-in regularly with you to ensure that you feel heard and validated in your experience.
In terms of the interactions that take place in therapy, psychotherapists use their education, practice experience and skills to create structured conversations in which healing can occur. This means that the psychotherapist asks questions, listens actively, suggests alternative perspectives, and uses different tools to help you establish new ways of coping and living a more fulfilling life. You will also become more involved over time in setting the agenda, goals and flow of psychotherapy sessions as effective psychotherapy places you as the key person to determine what is most important to work on.
Common goals for psychotherapy include the following:
Feeling less anxious;
Have more energy and interest for what’s important to me;
Work through and let go of difficult or “sticky” emotions (e.g., a depressed mood, sadness, grief, anger);
Connect with my feelings/emotions;
Express myself more authentically;
Improve communication at home, at work, with people who matter to me;
Improve my ability to make big decisions;
Adjust to a significant diagnosis (mine or a loved one’s);
Find meaning and re-engage with my life after a significant loss;
Navigate the health care system more effectively and plan effectively for my future or that of my loved one.
You are the most important change-agent in psychotherapy! That means I will communicate to you early on and throughout the duration of your psychotherapy that it is the empathetic and effective working relationship we establish, with you in the driver’s seat, that creates the context for you to reach your therapy goals. It also means that we will start where you are and with what is workable and attainable in terms of making changes in how you relate to your emotions, challenging thoughts and behaviors in your life.
I mostly use Cognitive Behavioral Therapy (CBT), an evidence-based form of therapy, that helps you become aware of and change your distressing thoughts and behaviors in a way that is more adaptive and helpful. CBT mostly uses a type of rational questioning process, called Socratic Questioning, to help you take a more balanced and rational approach to your thoughts while helping you problem-solve and choose behaviors that support your therapy and life goals. CBT is particularly good at helping you identify the inner-critic or self-critical voice and change the messages you give yourself.
I also use principles from Acceptance, Commitment Therapy (ACT) and mindfulness to help you become less stuck or caught up in your thinking and more mentally flexible to make choices about what ideas, perspectives and actions will move you towards what you most value and find purpose in. ACT emphasizes, to loosely quote the book title from ACT founder Steven C. Hayes, getting out of your mind and into your life.
Finally, I use a compassion approach to help you become more accepting and gentler with emotions and experiences that trouble you. Many clients tell me that it is hard to not struggle with their thoughts or that they have a negative, self-critical voice and that “I don’t know how to love myself”. Learning to be compassionate with your thoughts, emotions and habits is a powerful way to let go of negative self-talk and create a more open, kind and resilient mindset.
While I teach mindfulness principles, you DO NOT have to learn or practice meditation. Instead, I provide information and exercises based on the principles of mindfulness for you to practice and benefit from.
Mindfulness is the skill of intentionally and non-judgementally paying attention to present-moment experience (which includes thoughts, feelings, behaviors and external events).
This is a skill that can be developed without learning to meditate, though meditation can help you to anchor this skill. The key to learning mindfulness is learning to stay with what is happening and clearly discern the components of present moment experience.
For example, a client may come into a therapy session and say the following: “I feel horrible. My life is going down the tubes this week”.
As you learn to apply mindfulness techniques, like noting (and not getting caught by) your thoughts, you’ll be able to take what seems like a big, negative thought/feeling like the above and re-frame it like this:
“I’m having a heavy pressure feeling in my chest now”.
“I’m noticing how I’m feeling tired, a bit lethargic”.
“there’s a thought that life is bleak”
If you choose to become more practiced with mindfulness you can learn to shorten the above noting practice and simply acknowledge your thoughts and feelings by quietly saying to yourself: “feeling” or “thinking”, or as one of my client’s playfully referred to one of her negative messages, “there’s thought number two”.
As you develop mindful awareness you learn, as Steven Hayes describes, to look at thought, not from thought. Taken together, mindfulness, CBT and compassion gives you a more flexible and kind way of being aware of your internal experience, and a genuine knowing that you are much bigger than and not defined by your thoughts, feelings or habits.
I provide both short- and long-term psychotherapy. Some client’s come to psychotherapy with a time-limited issue where a little support with problem-solving and some ideas for improved coping or stress-relief is sufficient. These clients may only need 4-8 sessions, sometimes less or a little more. Other client’s benefit from a longer-term commitment to therapy to deal with more extensive issues but the main determining factor for length of time in therapy is how able you’re feeling to manage what initially brought you to therapy.
As your insight and coping skills grow you will find that you’re more able to manage troubling emotions and experiences. In effect, you become your own therapist with a developed tool kit with which to deal with whatever comes along and challenges you. Some client’s return for “tune-up” sessions, check-ins or if a new and challenging issue arises. The key is that you’ll know when you are ready to take the ball and run with it.