Psychotherapy/Counselling
We like to view psychotherapy as “physiotherapy for the mind”. Much the way physiotherapy can be used to address minor physical issues like a strained rotator cuff or a major issue such as a significant back injury, psychotherapy can be used to address a host of psychological issues. These issues can range from minor challenges such as dealing with worry and feelings of unhappiness to more significant mental health issues such as debilitating anxiety attacks or severe depression. We have included the word “counselling” beside “psychotherapy” throughout our website, as it is a term that people are often more comfortable and familiar with when referring to psychological treatment.
What Is Psychotherapy/Counselling?
Psychotherapy/counselling refers to different psychological treatment methods that help individuals to address a particular issue. With the psychotherapies we use at Sullivan + Associates, this process typically involves examining the relationship between thoughts, behaviours and feelings and how these areas impact psychological functioning. Once the problematic issue is identified and understood, a treatment plan is developed which typically involves learning psychological skills and strategies to help clients achieve the result they want.
If you wish to learn about what to expect at an initial psychotherapy/counselling session or future psychotherapy/counselling sessions, please click the appropriate link for more information.
4 Key Components of Psychotherapy/Counselling Treatment?
We believe that in order for psychotherapy/counselling treatment to be effective, there are 4 key components that must be present during treatment. That is, treatment must be collaborative, goal-oriented, efficient and evidence-based.
Collaborative
Studies show that collaboration between the client and the therapist is critical for success in psychotherapy/counselling. With psychotherapy/counselling, collaboration always begins with establishing rapport. It is critical that clients feel relaxed and comfortable with their clinician, as this will make it easier to freely provide information and commit to engaging in the therapeutic process. If there isn’t a good clinical match between the client and therapist, and the process isn’t collaborative, it’s very difficult to achieve a successful outcome.
Efficient
With psychotherapy/counselling, there can be the misperception that making change and achieving a specific goal has to take a long period of time. According to the College of Psychologists of Ontario, many psychological issues can be treated effectively within 8 – 20 psychotherapy/counselling sessions. At our clinic, we find that clients typically average anywhere between 4 – 12 sessions based on complexity of the issue (or issues) and how long the issue has been difficult for the client to manage. For instance, treatment for issues such as posttraumatic stress disorder (PTSD) can take longer to treat effectively based on the number and severity of traumatic incidents.
Goal-Oriented
When clients begin attending psychotherapy/counselling sessions, it is important that the client and therapist collaborate to outline specific goals and establish a plan to achieve these goals in the proper order. Our objective is not to have clients attend sessions to simply provide an update about their life since the previous session. Rather, there is a quick update about how the client has been functioning since the previous session, and unless there is a very pressing issue that needs to be addressed, the focus will return to learning and adapting skills and strategies to help clients better manage a challenging mental health issue or pursue a particular goal.
Evidence-Based
An evidence-based approach to psychotherapy/counselling is crucial, as it dramatically increases the chance that an issue will be identified correctly and treated effectively. An evidence-based approach can also help to prevent someone who is struggling with a mental health issue from suffering unnecessarily when the problem can be treated effectively and efficiently. Another advantage of participating in evidence-based treatment is that the risk of relapse decreases notably.
In psychotherapy/counselling, most evidence-based treatment approaches focus on the relationship between thoughts, feelings and behaviours and the development of a systematic plan to bring change to each of these areas to overcome an issue.
What Types of Psychotherapy/Counselling Are Used At Sullivan + Associates?
There are many different types of psychotherapy/counselling; however, clinical studies generally show that Cognitive Behavioural Therapy (CBT) is the most effective form of treatment for most psychological issues (e.g., anxiety, depression, self-esteem, chronic pain, addiction, etc.). As such, CBT often provides the framework for much of our treatment planning. However, we do use other evidence-based treatment approaches where appropriate and ultimately select the approach that is most comfortable and effective for the client. These approaches include but are not limited to: Dialectical Behaviour Therapy (DBT), Exposure and Response Prevention, Eye movement Desensitization and Reprocessing (EMDR), Mindfulness and Therapeutic Play with children.
CBT focuses on managing problems by changing how people think (cognitive) and how they act (behavioural).
The goal of CBT is to change patterns of thinking or behaving that contribute to problems or are ineffective in helping you to overcome an issue. When patterns of thinking and behaving have been improved, people feel better.
For example, if someone is experiencing anxiety attacks, the cognitive portion of therapy would help someone to challenge negative, inaccurate thoughts about their feelings of anxiety (e.g., “My anxiety will never go away.”, “Anxiety is physically hurting me.”).
The behavioural aspect of treatment would focus on training the person to relax their body by using techniques such as deep breathing, progressive muscle relaxation, etc.
When you combine changing how you think (i.e., challenging negative and inaccurate thoughts) and changing how you act (i.e., use relaxation techniques), it helps to change you how you feel (i.e., anxiety attacks occur with less frequently and with decreased intensity).
Dialectical means bringing two opposites in therapy together: acceptance and change. This form of treatment can be particularly helpful for people who struggle with managing emotions (i.e., rapid shifts in mood, sudden outbursts of anger, etc.).
Exposure therapy was developed to help people confront feared objects, activities or situations. Generally speaking, people are naturally-inclined to avoid things they fear in order to reduce feelings of distress. Avoiding anxiety-provoking situations in the short-term but feelings of anxiety increase in the long-term.
Cognitive Processing Therapy (CPT) is a psychotherapy used to treat Posttraumatic Stress Disorder (PTSD) and other related conditions. It borrows heavily from Cognitive Behavioural Therapy (CBT) and it has become more widely used in recent years.
The theory behind CPT is that the person’s beliefs about the causes and consequences of the traumatic events produces negative emotions, which prevent accurate processing of the traumatic memory and emotions resulting from the event. Because traumatic memories can be negative and distressing, there can be a tendency to avoid trauma triggers, which can interfere with the natural recovery process.
CPT utilizes cognitive techniques to help individuals struggling with trauma to address “stuck points” which persist from the traumatic event, so progress can be made towards recovery.
Mindfulness skills are a cornerstone of Dialectical Behaviour Therapy (DBT); however, it is also commonly used in with Cognitive Behavioural Therapy (CBT) and as a stand-alone therapy as well.
Mindfulness involves establishing a moment-by-moment awareness of our thoughts, feelings, bodily sensations and surrounding environment. Individuals are instructed to pay attention to their thoughts and feelings without judging or believing there is a right or wrong way to think or feel. This treatment approach can be highly effective with helping people to maintain a sense of calm, even while managing difficult emotions.
Acceptance & Commitment Therapy (ACT) is an evidence-based psychotherapy that uses acceptance and mindfulness strategies along with commitment and behaviour-change strategies to increase psychological flexibility.
The goal of ACT is not to eliminate difficult feelings but to be present with what life brings and to move toward valued behaviour. Acceptance & Commitment Therapy invites people to open up to unpleasant feelings, not to overreact to them, and not to avoid situations that cause them.
The therapeutic goal of ACT is to be more understanding of one’s emotions, which can lead to a better understanding of the truth. In ACT, the “truth” is measured through the concept of “workability” or what works to take another step toward what matters (e.g., values, meaning, etc.).
EMDR is a treatment that was developed to reduce the effect of distressing memories by engaging the brain’s neural adaptive information processing mechanisms. This is accomplished by following an 8-step process that instructs people to recall a distressing memory while engaged in bilateral sensory movements (e.g., side-to-side eye movements, bilateral auditory, bilateral tapping on knees, etc.). Please note: this approach is not hypnosis and individuals remain consciously aware throughout the process.
Emotion-focused therapy is a psychotherapy commonly used with couples and it is based on the premise that human emotions are connected to human needs and therefore emotions have an innately adaptive potential. And when emotions are activated and worked through, it can help people to change and improve problematic emotional states and interpersonal relationships.
Therapeutic play is generally used at our clinic with children between the ages of 5 and 8 years old. With this form of treatment, children are encouraged to express their feelings through play, which is a natural self-guided process. For children, playing offers a way to express their knowledge and experiences in a fun and easy manner. In addition, the child’s play materials and interaction with the clinician can help provide insight into a child’s behaviour.
Common goals that can be achieved through therapeutic play include developing better social skills, improved emotion regulation skills, as well as processing traumatic incidents from the past.