Frequently Asked Questions
Q: I have heard that you work with trauma more holistically. What does this mean?
A: I view trauma in a broader sense that looks at trauma to be more about the person's subjective experience versus the type of event. An experience can be traumatic for one person and not for another and vice versa. I see trauma to be a wound to the nervous system. Trauma can occur as a result of what did or didn't happen. I work with attachment and relational trauma and not just shock trauma or trauma that may result in an acute stress or PTSD response. Trauma has the ability to impact our brains, bodies, beliefs about ourselves, others and the world and the relationships we have in the here and now.
False refuges or maladaptive coping mechanisms can be a result of past trauma and a dysregulated nervous system. With this perspective, all coping makes sense, although it may not be serving you any longer. Trauma informed therapists tend to wonder "what happened to you?" versus "what is wrong with you?". Trauma is a normal response to an abnormal or unfathomable life experience. Trauma can be healed and there is hope. Here is a great video that provides an introduction into how I conceptualize trauma, attachment, stress and the body and brain. https://youtu.be/ZdIQRxwT1I0
Q: What is the difference between counselling and psychotherapy?
A: Often used interchangeably, there are differences that set counselling a part from psychotherapy. Counselling tends to focus on issues of the here and now and offers education and strategies to assist with the client's presenting issues. Psychotherapy tends to be a deeper form of treatment that can focus on a person's formative history, core beliefs and aspects of self that are contributing to a person's ongoing distress or impairment.
The controlled act of psychotherapy is defined in the RHPA as follows: Treating, 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 judgement, insight, behaviour, communication or social functioning.
Q: Who can practice psychotherapy in Ontario?
A: As of December 30, 2017, the controlled act of psychotherapy has been proclaimed in force, and becomes one of fourteen controlled acts defined in the RHPA. A controlled act is an activity thought to have the potential of posing a risk of serious harm to the client. Restricting the performance of controlled acts to certain regulated professionals who are legally authorized to perform them is the approach to protecting the public set out in the RHPA. As a result, as of December 31, 2019, performance of the controlled act of psychotherapy is restricted to members of the following regulatory colleges:
Q: What is the difference between a social work psychotherapist, psychotherapist, psychologist and psychiatrist?
A: Psychotherapists provide counselling and psychotherapy services but are unable to provide diagnoses or medication in Ontario. Professionals who practice psychotherapy typically have a Masters level degree (but may possess an undergraduate degree or college diploma) with varied training in therapeutic modalities or approaches.
Registered Social Workers are registered with the Ontario College of Social Workers and Social Service Workers and abide by the ethics and standards of practice dictated by this regulatory body. Social workers have foundational training in social issues which lays the ground work for understanding society, systems and how these pieces impact people. Social workers normally complete multiple placements in the field and usually work in the field for several years before entering into private practice which affords them unique experience in working with people, social services and mental health. Social workers have been practicing counselling and psychotherapy since the inception of the profession and historically have been the one of the most accessible counsellors/clinicians to communities. Registered Social Workers are able to work in systems such as hospitals, schools, children's aid societies, judicial system to name a few and are not just working in private practice. Not all social workers have a clinical orientation and some focus more in community development, policy and/or research.
Registered Psychotherapists are registered with the College of Registered Psychotherapists of Ontario. This regulatory body tends to be a "catch all" for professionals who are qualifying for or independently practicing the controlled act of psychotherapy that do not already belong to one of the other colleges listed above. "RPs" can possess varying degrees including but not limited to: Master of Education or Master of Arts in Counselling Psychology, Master of Divinity Studies or may be "grandfathered" into the college without a graduate degree but instead with an undergraduate degree or college diploma. RPs who are qualifying require supervision for a certain number of hours before they can enter into independent practice.
Psychologists hold a doctorate level degree and are able to provide diagnoses as related to the Diagnostic and Statistical Manual for Mental Health Disorders and are also able to provide psychotherapy services. Psychologists can also administer other types of psychological testing depending on their area of expertise such as psycho-educational assessments. Psychologists can provide psychotherapy as well and typically work at a higher hourly rate than RSWs or RPs given their scope and because they hold a doctorate level degree.
It is important to look into your therapist's experience (types of experience, years of experience) and clinical training and orientation. You may also want to ensure that the therapist who you want to work with is covered under your extended health benefits if you wish to use them. Clients may also be interested in the place in which their therapist obtained their formal education. It is important that you are informed and comfortable with who it is you are hiring for your services.
Psychiatrists are medical doctors who have attended medical school and went on to specialize in psychiatry. Psychiatrists typically engage more with the medical model as it relates to mental health and are able to provide diagnoses and medication to their patients. Psychiatrists can but don't often provide psychotherapy in Ontario. Psychiatrists are covered by OHIP in Ontario.