Cognitive Therapy Basics

Counseling or psychotherapy is a form of treatment that can help you understand and resolve problems, modify your behavior for the better and make positive changes. There are several types of psychotherapy or counseling techniques and they use different approaches, techniques and interventions.

At times, a combination of different counseling approaches may be helpful, while, in some cases a combination of medication with counseling may be best.

Counseling techniques that work, include:

Cognitive Behavior Therapy (CBT)- This approach helps improve your mood and behavior by examining any confused or distorted patterns of thinking you may have. CBT emphasizes that thoughts cause your feelings and moods which, in turn, can influence your behavior.

For example, if you are experiencing unwanted feelings or behaviors, your therapist will work to identify the underlying thinking patterns that are causing them. He or she will then help you to replace your symptom-inducing thinking with thoughts that result in more appropriate feelings and behaviors. CBT can be very effective in treating both depression and anxiety.

Dialectical Behavior Therapy (DBT) can be used to treat you if you experience chronic suicidal feelings, are harming yourself or have the symptoms of borderline personality disorder. DBT emphasizes taking responsibility for your problems and will help you examine how you deal with your conflict and negative feelings. This can involve a combination of group and individual sessions.

Family Therapy focuses on helping your family to function in more positive and constructive ways. It explores your patterns of communication and provides support and necessary education.

These sessions can include any children along with parents, siblings or even grandparents that are involved. Couples therapy is a specific type of family therapy that focuses on how you and a spouse or other intimate partner communicate, interact or solve problems with each other.

Group Therapy uses the power of group dynamics and peer interactions to increase your understanding and improve your social skills. There are many different types of group counseling (e.g. psychodynamic, social skills, substance abuse, multi-family, parent support, etc.)

Interpersonal Therapy (IPT) is a brief treatment specifically developed and tested to treat depression. Its goals are to improve your functioning with others by decreasing any symptoms of depression that you may have. IPT has been shown to be effective in treating adolescents with depression as well.

Play Therapy involves the use of toys, blocks, dolls, puppets, drawings or games to help your child to recognize, identify, and verbalize feelings. The counselor observes how he or she uses play materials and identifies themes or patterns to better understand his or her issues. Through a combination of talk and play, your child has an opportunity to better understand and manage his or her conflicts, feelings, and behavior.

Psychodynamic Psychotherapy emphasizes the understanding of your historical and past family issues that motivate and influence you. It can help identify your typical behavior patterns, defenses and your responses to inner conflicts and struggles.

Psychoanalysis is a specialized, more intensive form of psychodynamically-oriented counseling which usually involves several consultations per week. Psychodynamic methods are based on the assumption that your behavior and feelings will improve once your inner subconscious and childhood struggles are brought to light.

Psychotherapy or counseling is not a quick fix or an easy answer. It is a complex and rich process that can reduce symptoms, provide insight, improve your functioning and enhance your quality of life.

Clinical psychologists and mental health counselors are trained in providing different forms of counseling and, if necessary, are able to arrange for you to receive medication, as well.



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There are three basic models for conceptualizing the process of psychotherapy:  implanting something new in the client that is missing (deficiency model), changing or removing something problematic that is already present (pathology model), or nurturing the unfolding of some potential wholeness that is inherent in each human (spiritual model).  While each model captures some of what might need to go on in psychotherapy at any given moment, the spiritual model is for me the most interesting and comprehensive.

Each of these three models of psychotherapy also suggests a particular role for the therapist.  In the deficiency model the therapist is something like a dietary supplement for the psyche, providing something not already present and not readily available in the usually daily intake of psychological experience.  The pathology model makes the therapist something between a mechanic and a surgeon, removing something dysfunctional and possibly replacing it with something new that can be expected to function better.  In the spiritual model the therapist works in manner of a midwife, seeking to eliminate obstacles to a natural process of the birthing of new awareness without claiming to create or control what emerges. 

Each of these three models of psychotherapy has parallels in religious and spiritual traditions.  The deficiency model corresponds to the belief that a person cannot be whole, spiritually mature, or loved by God unless he or she adopts a particular set of beliefs or joins a particular religious or spiritual group.  The pathology model corresponds to the concept of original sin.  The spiritual model addresses that Matthew Fox has lately been calling Original Blessing, and what Buddhists have for a long time referred to as Buddha Nature.  

While any person’s psychotherapy might legitimately work from any one of these three models at a given point in time, the deficiency and pathology models must eventually yield to the spiritual model in any long-term therapy.  It is not a question of nature versus nurture, but rather a question of how we nurture our clients’ inherent nature.  The most fundamental way in which we do this is through the ongoing nurturing of our own nature, through our own psychotherapy, spiritual practices, and anything else we can find.



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There are three basic models for conceptualizing the process of psychotherapy:  implanting something new in the client that is missing (deficiency model), changing or removing something problematic that is already present (pathology model), or nurturing the unfolding of some potential wholeness that is inherent in each human (spiritual model).  While each model captures some of what might need to go on in psychotherapy at any given moment, the spiritual model is for me the most interesting and comprehensive.

Each of these three models of psychotherapy also suggests a particular role for the therapist.  In the deficiency model the therapist is something like a dietary supplement for the psyche, providing something not already present and not readily available in the usually daily intake of psychological experience.  The pathology model makes the therapist something between a mechanic and a surgeon, removing something dysfunctional and possibly replacing it with something new that can be expected to function better.  In the spiritual model the therapist works in manner of a midwife, seeking to eliminate obstacles to a natural process of the birthing of new awareness without claiming to create or control what emerges. 

Each of these three models of psychotherapy has parallels in religious and spiritual traditions.  The deficiency model corresponds to the belief that a person cannot be whole, spiritually mature, or loved by God unless he or she adopts a particular set of beliefs or joins a particular religious or spiritual group.  The pathology model corresponds to the concept of original sin.  The spiritual model addresses that Matthew Fox has lately been calling Original Blessing, and what Buddhists have for a long time referred to as Buddha Nature.  

While any person’s psychotherapy might legitimately work from any one of these three models at a given point in time, the deficiency and pathology models must eventually yield to the spiritual model in any long-term therapy.  It is not a question of nature versus nurture, but rather a question of how we nurture our clients’ inherent nature.  The most fundamental way in which we do this is through the ongoing nurturing of our own nature, through our own psychotherapy, spiritual practices, and anything else we can find.



http://www.google.com

Psychologists and Applied Psychology

Psychologists are the most demanded professionals in the world today. Psychology as a branch of study became famous after Wilhelm Wundt; a German psychologist establishes the first laboratory for the formal study of Psychology in Leipzig in Germany in 1879. Toronto Psychologist are considered at par with doctors for the services they provide. Psychologists are regarded as clinicians or scientists and are highly proficient experts recognized today.

Psychology is the study of behavior and other cognitive process. It also studies emotions and personality apart from cognition. These psychologists apply psychological principles and research in everyday psychology and healing for their patients. Psychology comes in applied and pure form. Pure form may be a little theoretical but applied psychology is what professional psychologists use and apply. Some of the services that psychologists offer are psychotherapy, career and marriage counseling, psychoanalysis, supervision, etc.

Psychotherapy:

Psychotherapy is an important part of the job profile of Toronto clinical psychologists. This field is used extensively in healing people and families from emotional trauma. It comprises of catapulting an individuals well being by pulling him out from emotional stress or a miserable experience. This requires good interpersonal skills and is done confidentially. This is based on communication, empathy, dialogue, understanding and aims at behavioral change and improved health of an individual or to make amicable group or family relations. It also applies the basics of expressive theory in its operations. It may be a child therapy, family therapy or a group counseling too.

Psychoanalysis

Psychoanalysis is a method of Psychotherapy. Psychoanalysis examines the patient’s unconscious motives and tries to bring forth the link with those with the current actions. Once the link is formed, it aims at destroying the negative energy generated due to these unconscious mental processes and motives. It aims to comprehend your personality through interrelations between your unconscious thinking and transform your present self. This requires seating and consultation one on one with the expert counselor who makes you feel comfortable. It helps a person to break the shackles of the unconscious mind and transform himself or herself. People with neurotic tendency can be identified and groomed to be productive to the society.

Marriage counseling

Marriage counseling is an integral part of relationship counseling. It seeks to understand differences or conflicts between the partners, help the couple to respect and admire the uniqueness of each individual, and get intimate. It teaches the partners to accept each other and makes you able enough to communicate and resolve differences. A confidential treatment goes on at regular intervals and seeks to enhance a couples life and outlook individually and collectively.

Psychotherapists and psychologists can act as trainers for the new comers and spread the subject to a vast base of people interested in the field. They may help college students as well as established psychologists seeking to develop psychotherapeutic skills. This may take the form of supervision.

Supervision is a special course devised by some settled psychologists who have specialization in psychotherapy and applied sciences. It helps under confident psychotherapists more assertive and effective therapists. A practical hand on experience in this field is indispensable though this may require theoretical orientation too like regular psychology studies.

Author Bio

Dr. Sandra R Palef Toronto Psychologist and Psychoanalyst with over 25 years of experience offering Toronto psychotherapy, psychoanalysis and marriage counseling.




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Anyone in Ontario, with or without credentials, can hang up a shingle and call him/herself a psychotherapist. One group of psychotherapists belongs to a regulatory college, such as psychologists, psychiatrists, and social workers. They are required to adhere to certain standards of education and qualification, must demonstrate continuing competence, and are subject to a complaints and disciplinary process. However, even some regulated professionals, such as GP psychotherapists, can practice psychotherapy without formal training. A second group of Toronto psychotherapists has one or more university degrees and specialized training in psychotherapy but belongs to an unregulated association, such as art or music therapists, marriage and family therapists, pastoral counselors, and addiction counselors. A third group is made up of unregulated practitioners who are in private practice without formal training, professional affiliation or accountability.

This situation is about to change. In order to protect the public from the risk of harm from psychotherapists who are unqualified, the Ontario Government recently passed the Psychotherapy Act, a section of the Health System Improvements Act. Under Royal Assent (June 4, 2007), the name of the new College of Psychotherapists was proclaimed, as well as a transition period before the other provisions come into law. One of the provisions not yet proclaimed is the “Authorized Act”, which is defined, in part, as the authorization “to treat, by means of psychotherapy technique delivered through a therapeutic relationship, an individual’s serious disorder of thought, cognition, mood, emotional regulation, perception or memory that may seriously impair the individual’s judgment, insight, behavior, communication or social functioning.” Another provision not yet proclaimed is the “Restricted Titles” provision, which restricts the title of “psychotherapist” to members of the new College of Psychotherapists.

If the “Restricted Titles” provision is proclaimed, psychologists, psychiatrists and social workers who have been authorized to provide psychotherapy by their regulatory colleges will no longer be able to call themselves psychotherapists. According to Mr. Gilbert Sharpe, a partner at the law firm of Fasken Martineau DuMoulin, and someone who has played a major role in the development of health law in Ontario for over 30 years, it would have been too confusing to require psychotherapists who were already a member of a profession to be part of the new College of Psychotherapists. The new college was aimed at those who were unregulated but were calling themselves psychotherapists. However, the original intent was that such professionals should be able to use the restricted title in addition to those who were going to be part of the new college. He believes that was an oversight that should be addressed and corrected in the next round of amendments to the legislation. Many psychotherapists agree with him. If psychologists will be allowed to refer to themselves only as “psychologists who provide psychotherapy services” and not simply as “psychotherapists”, the public will only be more confused. The new legislation is essential to protect the public from unregulated psychotherapists, but it requires some adjustments to offer people a full and clear range of options when seeking a competent psychotherapist in Toronto.



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“I am successful,” “I am a wonderful person,” “I will find love again,” and many other similar phrases that students, the broken-hearted and unfulfilled employees may repeat to themselves over and over again, hoping to change their lives. Self-help books through the ages, from Norman Vincent Peale’s The Power of Positive Thinking all the way to the latest, The Secret, have encouraged people with low self-esteem to make positive self-statements or affirmations.

New research suggests it may do more harm than good to many people.

Canadian researcher, Dr. Joanne Wood at the University of Waterloo and her colleagues at the University of New Brunswick who have recently published their research in the Journal of Psychological Science, concluded “repeating positive self-statements may benefit certain people, such as individuals with high self-esteem, but backfire for the very people who need them the most.”

The researchers asked people with and low self-esteem to say “I am a lovable person.” They then measured the participants’ moods and their feelings about themselves. The low-esteem group felt worse afterwards compared with others who did not. However, people with high self-esteem felt better after repeating the positive affirmation–but only slightly. The psychologists then asked the participants to list negative and positive thoughts about themselves. They found, paradoxically, those with low self-esteem were in a better mood when they were allowed to have negative thoughts than when they were asked to focus exclusively on affirmative thoughts.

The researchers suggest that, like overly positive praise, unreasonably positive self-statements, such as “I accept myself completely” can provoke contradictory thoughts in individuals in individuals with low self-esteem. When positive self-statements strong conflict with self-perception, the researchers argue, there is not mere resistance but a reinforcing of self-perception. People who view themselves as unlovable, for example, find that saying that are so unbelievable that it strengthens their own negative view rather than reversing it.

These findings were supported by previous research published in 1994 in the Journal of Social Psychology, showing that when people get feedback that they believe is overly positive, they actually feel worse, not better.

Dr. Wood goes even further. In her Psychology Today blog, she says that most self-help books advocating positive affirmations may be based on good intentions or personal experience, but they are rarely based on even one iota of scientific evidence. She cites psychologist Sonja Lyubomirsky’s The How of Happiness as an exception.

Does that mean positive affirmations are of absolutely no value. Not according to Dr. Wood and her co-researchers. They say they positive affirmations can help when they are part of a broader program of intervention. That intervention can take place in a number of forms such as cognitive psychotherapy or working with a coach who has expertise in the behavioral sciences.

What kind of intervention is best to use to make positive affirmations most effective?

That’s where we encounter even more controversy.

Traditional cognitive psychotherapy may not be the best intervention according to Dr. Steven Hayes, a renowned psychotherapist, and author of Getting Out of Your Mind and Into Your Life. Hayes has been setting the world of psychotherapy on its ear by advocating a totally different approach.

In an article in Time magazine, John Cloud describes Hayes’ work. Hayes and researchers Marsha Linehan and Robert Kohlenberg at the University of Washington, and Zindel Segal at the University of Toronto, what we could call “Third Wave Psychologists” are focusing less on how to manipulate the content of our thoughts (a focus on cognitive psychotherapy) and more on how to change their context–to modify the way we see thoughts and feelings so they can’t control our behavior. Whereas cognitive therapists speak of “cognitive errors” and “distorted interpretation,” Hayes and his colleagues encourage mindfulness, the meditation-inspired practice of observing thoughts without getting entangled by them–imagine the thoughts being a leaf or canoe floating down the stream.

These Third Wave Psychologists would argue that trying to correct negative thoughts can paradoxically actually intensify them. As NLP trained coaches would say, telling someone to “not think about a blue tree,” actually focuses their mind on a blue tree. The Third Wave Psychologists methodology is called ACT (Acceptance and Commitment Therapy), which says that we should acknowledge that negative thoughts recur throughout our life and instead of challenging or fighting with them, we should concentrate on identifying and committing to our values in life. Hayes would argue that once we are willing to feel our negative emotions, we’ll find it easier to commit ourselves to what we want in life.

This approach may come as a surprise to many, because the traditional cognitive model permeates our culture and the media as reflected in the Dr. Phil show. The essence of the conflict between traditional cognitive psychologists and psychotherapists is to engage in a process of analyzing your way out your problems, or the Third Wave approach which says, accept that you have negative beliefs, thinking and problems and focus on what you want. Third Wave psychologists acknowledge that we have pain, but rather than trying to push it away, they say trying to push it away or deny it just gives it more energy and strength.

Third Wave Psychologists focus on acceptance and commitment comes with a variety of strategies to help people including such things as writing your epitaph (what’s going to be your legacy), clarifying your values and committing your behavior to them.

It’s interesting that that The Third Wave Psychologists approach comes along at a time when more and more people are looking for answer outside of the traditional medical model (which psychiatry and traditional psychotherapy represent). Just look at a 2002 study in Prevention and Treatment, which found that 80% people tested who took the six most popular antidepressants of the 1990’s got the same results when they took a sugar pill placebo.

The Third Wave Psychologists approaches are very consistent with much of the training and approach that many life coaches receive, inclusive of Neuro-Linguistic Programming (NLP), and many spiritual approaches to behavioral changes reflected in ancient Buddhist teachings and the more modern version exemplified by Eckhart Tolle (The Power of Now). The focus of those approaches reinforces the concepts of acceptance of negative emotions and thoughts, and rather than giving them energy and fighting with them, focus on mindfulness, and a commitment to an alignment of values and behavior.

So what can we learn from all this? Two things–first, just engaging in positive affirmations by themselves, can do harm to people with low self-esteem, and provide only little benefit for those with high-esteem, if those affirmations are not part of a comprehensive program of self-growth, preferably with a knowledgeable professional; and second, the traditional cognitive psychotherapeutic approach at trying to change people’s negative thinking through logical processes may actually be counterproductive, compared to an approach that has people accept their thoughts, not resist them and give more energy to them by thinking about them, but rather engage in positive behaviors and thinking.

On the next post, I’ll be interviewing Stephanie Frank, President of Success IQ University, a Master NLP Coach and Certified Hypnotherapist, who has worked with hundreds of individuals practicing the concepts and ideas in this blog, and achieved huge success with her clients. She’ll tell us how.

 



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Abuse & Violence in the Family

(Dr. Samson Omotosho, PhD, APRN/PMHN)

Introduction: Abuse and violence in the family refer to physically and emotionally harmful behaviors that occur between family and household members. It includes child abuse, child neglect, intimate partners abuse and violence, marital rape, and elder abuse. It could be a learned behavior that can be unlearned through therapy. Perpetrators try to isolate the family to keep it secret and avoid sanctions. They usually have some power and control over the other members of the family. They may rationalize the violence with their drug use. The use of cocaine, PCP, amphetamine etc may increase violent behavior.

Forms of Abuse: Physical abuse includes hitting, punching, shoving, stabbing, shooting, kicking, and withholding medication, wheelchair, food, and fluids. Sexual abuse includes coercion, marital rape, and withholding sex. Psychological abuse includes threat, harassment, and blackmail. Emotional abuse includes name-calling, insults, and ridicule. Economic abuse includes total control over finance, running up bills, forbidding school or work.

Myths and Reality About Violence: Family violence occurs at all levels of society. Separation or divorce may not end violence. Abuser does not need to be provoked. Some survivors wrongly tend to blame self. Treat the violence but also the alcohol, drug, stress, and mental health problems if any. Violence occurs between gays and lesbians too. Abused women are discouraged from disclosure by threats, fear, denial and disbelief expressed by ‘confidants’.

Models of Intervention: The Paternalistic model assumes that the clinician has more knowledge than the patient; that the survivor is responsible for ending the violence; that the clinician should give advice and sympathy; and see the patient as a victim. Whereas, the Empowerment model, which is better, assumes that the clinician should mutually share knowledge with the patient, plan strategies with the patient, respect patient’s competence, experience and strengths, and see the patient as survivor.

Response of Survivors to Violence: Physical signs include injuries at multiple sites in various stages of healing (head, neck, face, throat, sexual organs), headache, insomnia, and stress. Behavioral sign is that the individual does not leave the abuser or leaves and returns before making a final break. Psychological signs include delayed reaction, depression, lowered self esteem, attributions e.g. self-blame, impaired school or work performance and conduct, poor concentration and poor problem solving.

Why Individual Does Not Leave the Abuser? Abused individuals do not leave the abuser for any of many reasons, which include fear of being stalked and killed (which is a realistic fear), strong emotional attachment to the abuser, determination to end the abuse, sanctions present in the couple’s culture, fear of stigma, lack of resources to live away from the abuser, and consideration of what will happen to her children if she leaves. She may leave and return, thinking, “Maybe he will change”.

Child Abuse & Neglect: In every state, child abuse and neglect are must be reported. Types of abuse include child sexual abuse, child physical abuse, child emotional abuse, and child neglect. Child that witnesses family violence may also suffer abuse.

Child Sexual Abuse: This is the involvement of children in sexual activities that they do not fully comprehend and to which they do not or cannot freely give consent. This violates child’s trust in the adult that is supposed to protect him/her. Threat to the child, pet, and others keeps the child quiet. It results in confusion, shame, and helplessness. Its effect may last a lifetime and affect mental health. It may be guarded as a family secret.  

Observable Signs of Sexual Abuse: The observable signs of child sexual abuse include physical aggression, excessive masturbation, social withdrawal, low self esteem, impaired school performance, sleep disturbance, STD’s, bleeding, soreness, itching, UTI, pregnancy, bruises, swelling, redness, fracture, burns, and unkempt appearance.

School Violence: School violence is usually due to child drug use, child’s access to guns, antisocial and impulsive behaviors, family dysfunction, community unresponsiveness, interpersonal disputes, and bullying and harassment by peers.

Child Abduction: Most abduction is done by a parent. 70% are by fathers, 25% by their mothers. Parents that are likely to abduct include those that have threatened or attempted it in the past, suspect abuse by the other parent, may be paranoid, may intend to use it as revenge, punishment, trophy, or one that strongly believes that child be raised in his or her home country.

Child Abuse Assessment and Intervention: Explore and be aware of your own attitude to abuse survivors so as not to be judgmental. Do a thorough history & physical assessment. Use private, quiet uninterrupted environment. Honestly state the purpose of the interview. Inform victim of the pending physical assessment. Use a calm and supportive approach

If possible, interview child separately first before joint interview with parent or guardian. Pay attention to child’s affect (look) and behavior, mother’s understanding of the problem, discrepancies in their stories, and parent’s emotional responses. Document your assessment fully. Report suspected abuse to CPS. Coordinate services such as further assessment, psychological testing, individual psychotherapy, family psychotherapy, and group psychotherapy.

Intimate Partner Violence (IPV): IPV is a pattern of coercive and assaultive behavior between intimate and dating partners. Abuse of female partners is the more prevalent IPV. Female violence is more often in self-defense. Many IPV end in homicide or homicide-suicide. Leaving or an attempt to leave by the victim increases homicide risk. There is a higher homicide risk with handgun, history of suicidal ideation or attempt, battering during pregnancy, sexual abuse, substance use, extreme jealousy, and controlling behavior (“if I can’t have you, no one can”). Few women kill their abusers if there is no intervention. Assessment of IPV should be part of mental health assessment. Ask partners about history of conflicts, “pushing and shoving”, and quality of relationship. Observe for hesitation, looking away, and unease. Be supportive, let victim know she is not alone. Describe and map the extent of injuries. Assess for attribution e.g. self-blame. Assess for depression, PTSD, and anxiety. If patient is the abuser, assess potential for further violence. Consult legal advisor for “Duty to Warn”. Courts have made it mandatory abusers (happens to be mostly men) to be treated. Treatment includes confronting the violence, affirming that responsibility lies with the abuser, behavior therapy, anger control, attitude change to women, couple counseling, and cognitive behavior therapy (CBT). Empower the woman, using laws, community resources, support groups, and safe shelters. Mutually set goals with the victim. Mutually consider and choose from options. Help mobilize natural, social and professional supports.

Rape and Sexual Assault: This affects men, women and children, especially women and children. Sexual assault is a forced act of sexual contact without consent. It is usually done to humiliate, defile or dominate the victim. Rape is a felony, yet majority is unreported. Survivors of marital rape do not seek care because of embarrassment and humiliation. Careful assessment and questioning is needed. In caring for the victim, listen, be nonjudgmental, and provide emotional support. Document your observation and assessment fully. Help collect evidence if patient chooses to litigate. In the acute stage, assess for fear, disorganization, shock, and restlessness. In the second stage, assess for flashbacks, phobias to places and people, and sexual difficulties. Encourage the victim to discuss feelings. Explore options e.g. changing phone number. Explore available community services and support groups. Refer for physical treatment and psychotherapy. Plan for a follow-up phone contact in a few days.

Elder Abuse: There are about 5 million abused elderly persons in the US annually. Spouse abuse overlaps with elder abuse

The abused does not report for fear of being abandoned to a nursing home or being isolated. Signs include bruises on arms, wrists, ankles, face lacerations, vaginal lacerations, fractures, malnutrition, poor hygiene, dehydration, flinching and shrinking away in the presence of abuser. Help and care include reporting a suspected abuse to the Adult Protective Services (APS), counseling, psychotherapy, substance abuse and treatment of the abuser, if necessary.

Reference: Stuart, G. W. & Laraia, M. T. (2005). Principles and practice of psychiatric nursing (8th ed.). St. Louis, MO: Elsevier Mosby.

 



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Anyone in Ontario, with or without credentials, can hang up a shingle and call him/herself a psychotherapist. One group of psychotherapists belongs to a regulatory college, such as psychologists, psychiatrists, and social workers. They are required to adhere to certain standards of education and qualification, must demonstrate continuing competence, and are subject to a complaints and disciplinary process. However, even some regulated professionals, such as GP psychotherapists, can practice psychotherapy without formal training. A second group of Toronto psychotherapists has one or more university degrees and specialized training in psychotherapy but belongs to an unregulated association, such as art or music therapists, marriage and family therapists, pastoral counselors, and addiction counselors. A third group is made up of unregulated practitioners who are in private practice without formal training, professional affiliation or accountability.

This situation is about to change. In order to protect the public from the risk of harm from psychotherapists who are unqualified, the Ontario Government recently passed the Psychotherapy Act, a section of the Health System Improvements Act. Under Royal Assent (June 4, 2007), the name of the new College of Psychotherapists was proclaimed, as well as a transition period before the other provisions come into law. One of the provisions not yet proclaimed is the “Authorized Act”, which is defined, in part, as the authorization “to treat, by means of psychotherapy technique delivered through a therapeutic relationship, an individual’s serious disorder of thought, cognition, mood, emotional regulation, perception or memory that may seriously impair the individual’s judgment, insight, behavior, communication or social functioning.” Another provision not yet proclaimed is the “Restricted Titles” provision, which restricts the title of “psychotherapist” to members of the new College of Psychotherapists.

If the “Restricted Titles” provision is proclaimed, psychologists, psychiatrists and social workers who have been authorized to provide psychotherapy by their regulatory colleges will no longer be able to call themselves psychotherapists. According to Mr. Gilbert Sharpe, a partner at the law firm of Fasken Martineau DuMoulin, and someone who has played a major role in the development of health law in Ontario for over 30 years, it would have been too confusing to require psychotherapists who were already a member of a profession to be part of the new College of Psychotherapists. The new college was aimed at those who were unregulated but were calling themselves psychotherapists. However, the original intent was that such professionals should be able to use the restricted title in addition to those who were going to be part of the new college. He believes that was an oversight that should be addressed and corrected in the next round of amendments to the legislation. Many psychotherapists agree with him. If psychologists will be allowed to refer to themselves only as “psychologists who provide psychotherapy services” and not simply as “psychotherapists”, the public will only be more confused. The new legislation is essential to protect the public from unregulated psychotherapists, but it requires some adjustments to offer people a full and clear range of options when seeking a competent psychotherapist in Toronto.



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Psychologists and Applied Psychology

Psychologists are the most demanded professionals in the world today. Psychology as a branch of study became famous after Wilhelm Wundt; a German psychologist establishes the first laboratory for the formal study of Psychology in Leipzig in Germany in 1879. Toronto Psychologist are considered at par with doctors for the services they provide. Psychologists are regarded as clinicians or scientists and are highly proficient experts recognized today.

Psychology is the study of behavior and other cognitive process. It also studies emotions and personality apart from cognition. These psychologists apply psychological principles and research in everyday psychology and healing for their patients. Psychology comes in applied and pure form. Pure form may be a little theoretical but applied psychology is what professional psychologists use and apply. Some of the services that psychologists offer are psychotherapy, career and marriage counseling, psychoanalysis, supervision, etc.

Psychotherapy:

Psychotherapy is an important part of the job profile of Toronto clinical psychologists. This field is used extensively in healing people and families from emotional trauma. It comprises of catapulting an individuals well being by pulling him out from emotional stress or a miserable experience. This requires good interpersonal skills and is done confidentially. This is based on communication, empathy, dialogue, understanding and aims at behavioral change and improved health of an individual or to make amicable group or family relations. It also applies the basics of expressive theory in its operations. It may be a child therapy, family therapy or a group counseling too.

Psychoanalysis

Psychoanalysis is a method of Psychotherapy. Psychoanalysis examines the patient’s unconscious motives and tries to bring forth the link with those with the current actions. Once the link is formed, it aims at destroying the negative energy generated due to these unconscious mental processes and motives. It aims to comprehend your personality through interrelations between your unconscious thinking and transform your present self. This requires seating and consultation one on one with the expert counselor who makes you feel comfortable. It helps a person to break the shackles of the unconscious mind and transform himself or herself. People with neurotic tendency can be identified and groomed to be productive to the society.

Marriage counseling

Marriage counseling is an integral part of relationship counseling. It seeks to understand differences or conflicts between the partners, help the couple to respect and admire the uniqueness of each individual, and get intimate. It teaches the partners to accept each other and makes you able enough to communicate and resolve differences. A confidential treatment goes on at regular intervals and seeks to enhance a couples life and outlook individually and collectively.

Psychotherapists and psychologists can act as trainers for the new comers and spread the subject to a vast base of people interested in the field. They may help college students as well as established psychologists seeking to develop psychotherapeutic skills. This may take the form of supervision.

Supervision is a special course devised by some settled psychologists who have specialization in psychotherapy and applied sciences. It helps under confident psychotherapists more assertive and effective therapists. A practical hand on experience in this field is indispensable though this may require theoretical orientation too like regular psychology studies.

Author Bio

Dr. Sandra R Palef Toronto Psychologist and Psychoanalyst with over 25 years of experience offering Toronto psychotherapy, psychoanalysis and marriage counseling.




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Depression is a mental disorder that affects a person’s moods. It affects millions of people around the world. People with depression may feel sad, angry, irritable, tired, confused, guilty, hopeless or worthless. When a person is diagnosed with depression, it’s bad news for himself and his family. It’s painful for the person and can also be difficult for the person’s family. Depression if left untreated could get worse. It will affect a person’s ability to function in daily life and work. Worst still, depression even may lead a person to suicide.

A serious disease depression may be, it is treatable. Proper treatment can help people with depression get back to normal daily activities.

Main treatments for depression are antidepressants and psychotherapy. Antidepressants are medicines that help to relieve depression so that a person suffering from depression can function more normally. There are mainly four types of antidepressants:

1. Selective Serotonin Reuptake Inhibitors (SSRIs) – Celexa (citalopram), Lexapro (escitalopram oxalate), Luvox (fluvoxamine), Paxil (paroxetine), Prozac (fluoxetine), Zoloft (sertraline). These antidepressants help the brain absorb the chemical serotonin.

2. Tricyclics antidepressants (TCAs) – Adapin (doxepin), Anafranil,(clomipramine), Elavil (amitriptyline), Endep (amitriptyline), Ludiomil (maprotiline), Norpramin (desipramine), Pamelor (nortryptyline), Pertofrane (desipramine), Sinequan (doxepin), Surmontil (trimipramine), Tofranil (imipramine), Vivactil (protriptyline)

3. Monoamine Oxidase Inhibitors (MAOIs) – Nardil (phenelzine), Parnate (tranylcypromine)

4. Serotonin/norepinephrine reuptake inhibitors (SNRIs) – venlafaxine (tradenames Effexor XR®, Efexor®), nefazodone (tradename Serzone®), milnacipran (tradename Dalcipran®/ Portugal; Ixel®/ France), desipramine (tradenames Norpramine®, Pertofraneis®), duloxetine (tradename Cymbalta®)

In the market, there are also antidepressants that don’t fall in the above categories available such as buproprion (Wellbutrin), nefazodone (Serzone), trazodone (Desyrel), venlafaxine (Effexor), and mirtazapine (Remeron).

Certain antidepressants cause side effects. In most cases, side effect disappears once a person’s body has adjusted to the medicines. Sometimes people on antidepressants may feel worse before feeling better. It takes time for depression medication to work correctly.

Besides taking medications, psychotherapy or talk therapy can be also of help to depressed individuals. It includes short-term therapy sessions, usually from ten to twenty weeks. Positive results for the depression patients will generally be showing up after one or more sessions of psychotherapy. This type of depression treatment actually helps the individuals by slowly making them open up about their feelings, the root of their problems, most important of all, the root of their depression. Healthy verbal exchanges between the cognitive behavior therapist and the depression patient is great depression treatment that’ll positively affect the depression patients by helping them discuss and talk about whatever they’ve been keeping inside.

Even though either medication or psychotherapy works independently all by itself, many experts feel combination of both medication and psychotherapy can work more effectively to help depressed individuals overcome depression and become mentally healthy.



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