FREQUENTLY ASKED QUESTIONS
Are the fees covered by OHIP (Ontario Health Insurance Plan)?
Fees for psychological services are not covered by OHIP. However, most private insurance plans cover at least some of the fees for the services provided by psychologists. The amount of coverage available may vary from one insurance policy to another. If you have an insurance plan (e.g., through your employer), we suggest that you review your policy with your insurance company to find out how much coverage is available for psychological services. Some insurance companies require a referral (usually from a family physician or a psychiatrist) before they will reimburse the costs of psychological services.
How much does a session with a therapist cost?
The Ontario Psychological Association sets out general guidelines around fees for psychological services. A typical hourly rate to see an practitioner at our clinic ranges from $175 to $210 per hour. The rate to see students, residents and behavioural therapists under supervision is approximately $70 to $120 per hour. Do not hesitate to ask fee-related questions when you speak to your potential therapist over the phone, including questions about the hourly rate, missed or canceled session policy, and type of payment accepted.
What happens during the first meeting?
The overall purpose of the first meeting is for your therapist to get to know you better. You will be asked to complete questionnaires, describe the difficulties you are experiencing, and provide information about the strategies you have used to cope with these difficulties so far. You will also be asked questions about your lifestyle, your background (including questions about your past), and your goals. Your therapist will also ask you very specific questions based on criteria for various psychological disorders. The information obtained by your therapist during this meeting will allow him or her to determine if he or she can help you and the best way to do so.
What will happen during therapy?
At the most basic level, therapy entails a guided conversation with your therapist. The role of your therapist is to guide the conversion and teach the skills and information that will help you reach your goals. Often, CBT therapists follow an agenda for each session, as opposed to having a "free flowing" conversation. This is to ensure that the skills and information that have been shown to be effective in research are adequately communicated. In addition to structured conversation with your therapist, your therapist may guide you through specific mental or behavioural exercises that either help you understand your difficulties or help you practice the new skills you have learned.
How do I choose a therapist?
It is a good idea to ensure that the person you are considering to work with is a regulated professional. In Ontario, psychologists are registered with the College of Psychologists of Ontario and must follow the Regulated Health Professions Act (RHPA) as set by the Government of Ontario. At our clinic, we also supervise and work with social workers who are being supervised by registered psychologists. That being said, each psychologist has his or her own style. A potential therapist should be willing to speak to you over the phone for a few minutes to answer your questions before your first appointment. Do not hesitate to ask questions about the therapist's experience and his or her therapeutic approach.
How do I choose the type of treatment I need?
If you are unsure as to what type of treatment you need, we recommend that you review the list of services we provide or contact our clinic (613-820-9931) to get more information. Depending on your individual characteristics, the unique components of the difficulties you are experiencing, and your preference for learning, one evidence-based approach may be preferred over another.
Should I choose individual or group therapy?
Individual and group therapy have been shown to produce similar results for a number of mental health problems (e.g., social anxiety). However, individual and group therapy do differ and each has advantages and disadvantages. In individual therapy, a client and therapist determine how often and when they want to meet based on factors like the client's needs and the therapist's availability. Sessions usually last 50 minutes, and the focus of the session revolves around the client's needs and difficulties. Group therapy, on the other hand, usually consists of weekly sessions that last between 1.5-3 hours. Session times are pre-determined and if a client misses a session that session usually cannot be offered again. Individual therapy may allow therapists to know their clients in greater detail and to adjust treatment based on the progress and unexpected issues that can arise during therapy. Clients who choose to see a therapist individually often do so because they feel they can share more personal information and because it offers greater flexibility around appointment scheduling. Clients who opt for group therapy often report that meeting and hearing from other individuals who struggle with similar difficulties makes them feel less alone and more optimistic that their situation can improve. Group therapy is also less expensive than individual therapy. It is also possible to be involved in both group and individual therapy.
What if I need something more intensive or more frequent contact?
In some cases, the standard frequency of appointments in outpatient treatment (one appointment per week) is not the best approach. In some cases, more frequent contact with a therapist is indicated through best practice guidelines. The intensity of treatment needed is usually determined by the severity and impact of the problem for each individual. The treatment of OCD is one area of treatment, for example, where more intensive treatment may be needed. At the OICBT, we offer an intensive OCD day treatment program where clients come in every day for three hours over a 5 day period. This may mean that you have the same number of appointments as you otherwise would, but just in a more compressed time-span (i.e, months of treatment instead of weekly appointments over years). Treatment response will also likely be improved.
Is the Home- and Community-Based Program Right for me?
Individuals with anxiety (e.g., panic disorder, agoraphobia) and depression may have great difficulty leaving their home to attend appointments. In addition, treatment outside the therapists’ office (e.g., going to a busy shopping mall, taking public transportation) is often indicated as the therapist can then directly help his or her client implement and practice strategies introduced in treatment. Because few therapists provide off-site services, we have initiated a program focused on increasing access to mental health services in the community. The overall goal of our home- and community-based program is to provide evidence-based treatment to individuals who will benefit from accessing services within their homes and/or receiving treatment within relevant community settings. Click here more information about the home- and community-based program.
When should I consider a more comprehensive assessment and diagnosis?
In some cases, clients choose to complete more comprehensive and detailed assessments and diagnostic differentials. For example, if you are seeking a detailed diagnostic report, we may suggest our intensive assessment stream in which we provide a highly detailed and tailored assessment that spans several weeks and usually includes 4-5 assessment sessions.
What is a psychologist?
Psychologists are regulated health care professionals who generally hold a doctoral degree in psychology. Training to become a psychologist involves between 6- to 10-years of university study, and usually requires additional post-graduation training and examinations. Psychologists do not prescribe medication. They are trained to assess, diagnose and treat a wide range of mental health issues (e.g., depression, anxiety, relationship problems, addictions, stress, anger, adjustment to chronic illness).
What are the differences between a psychologist and a psychiatrist?
Psychiatrists are physicians with a specialty in the treatment of mental health disorders. Like psychologists, psychiatrists are allowed to diagnose mental health problems. They are also licensed to prescribe medications, something psychologists in Ontario are not allowed to do. Psychiatrists' main treatment approach is through the use of medications to treat or manage their patients' mental health problems, although some also use psychotherapy. We currently do not have a psychiatrist at the OICBT.
What is a supervised practice psychologist?
A supervised practice psychologist is someone who has completed all course and training requirements of a doctoral program in clinical psychology and who is in the process of finalizing their registration with the College of Psychologists of Ontario. In Ontario, this generally means that they have completed at least 6 years of graduate training. The clinical work of supervised practice psychologists is supervised by a fully licensed member of the College of Psychologists of Ontario.
What is a psychology resident?
A psychology resident is a therapist who is in the final year of their training in a doctoral program in clinical psychology. They have generally completed at least 5 years of course and clinical work prior to their residency. Their residency is a critical requirement of their training and involves a full-time, one-year placement.
What is a practicum student?
At the OICBT, practicum students are graduate students who are taking part in a doctoral program in clinical psychology, such as the University of Ottawa's Clinical Psychology PhD program. These students have between 2-5 years of graduate training in the delivery of therapy. Because of their status as trainees, they are able to offer services at a reduced rate.
What is a social worker?
Social workers explore problems within the context of their families, workplace and communities, and consider the connection between personal problems and larger social issues. Social workers do not diagnose; they can be certified in CBT and follow evidence-based protocols. In fact, social workers provide the majority of counselling and psychotherapy services in the province of Ontario and are licensed by the The Ontario College of Social Workers and Social Service Workers.
What is a behavioural therapist?
Different organizations sometimes have varying descriptions of the behavioural therapist role. At the OICBT, behavioural therapists work as part of the care team under the supervision of psychologists. They work directly with clients, often as part of the home- and community-based program to guide clients in making specific behaviour changes. Our behavioural therapists have completed post-secondary programs related to psychology, behaviour, and mental health.
On your website you refer to CBT as evidence-based treatment. What does that mean?
Evidence-based treatment is treatment that has been shown through research studies to produce improvement in clients. Research conducted on more than 40 years of research has shown that the evidence in support of CBT is very strong (e.g. Hoffmann et al., 2012). These studies have been replicated with different populations, by different research teams, in different countries and cultures.
Should I be taking medication?
It is not uncommon for clients who begin cognitive-behavioural therapy to also take medication. Ultimately, the decision to take medications or not is yours. But it is best to discuss this with your family physician and/or your psychiatrist. Some clients who seek help at our clinic are determined to go off all medications, whereas other clients want to learn new skills to deal with their difficulties but express a desire to continue to take medications. Either way, your therapist can help you. Sometimes the severity of the symptoms is such that little progress can be made in psychotherapy. In such cases, a course of medications might be necessary to decrease the symptoms to a level where clients can start engaging in - and benefit from - cognitive-behavioural therapy. In other cases such as schizophrenia or bipolar disorder the recommended treatment very often includes medications. But as stated above, we encourage our clients to discuss all issues related to medication with their family physician and/or psychiatrist.
How do people develop mental health problems?
Mental health problems are common. It is estimated that in any given year 1 in 5 individuals (20% of the population) will experience a mental health problem (click here for more information on the prevalence of mental health problems). Many factors can play a role in the development of mental health problems. Many mental health problems have a genetic component. People with a first-degree relative with schizophrenia, for example, are at greater risk of developing a similar illness. Some traits may also be passed on from one generation to another through learning. Children of very anxious parents may, through observation, learn that social situations are anxiety-provoking or that bad things may happen at any time, which would in turn make them feel more anxious. We also know that stressful events (e.g., job loss, divorce, death of a loved one, car accident) can trigger mental health problems. Similarly, a person's lack of coping abilities, or a reliance on unhelpful coping strategies, can contribute to increased difficulties.
Whether your problems are due to genetics, learning, stressful situations, or poor coping skills, and whether your problems go back several decades or are quite recent, you can learn strategies that have been shown to significantly reduce symptoms and help individuals improve their quality of life.