Psychotherapy Services Hamilton

What is the difference between psychotherapy and counselling?

Dr. Barbera C. Psych and her associates provide both counselling and psychotherapy services In Hamilton and online to individuals and couples in Ontario. All clinicians are either registered with the College of Psychologists of Ontario, the College of Registered Psychotherapists of Ontario or are completing their post-masters work to register as a psychological associate with the College of Psychologists of Ontario.

What is Psychotherapy?

Psychotherapy is a specialized therapy delivered primarily through talking that is focused on helping a person improve their well-being and ease emotional and psychological concerns. The concerns that psychotherapy addresses can include mood, anxiety, PTSD, low self-worth or low self-confidence, grief, adjustment difficulties, distress tolerance, disruptive behaviours and more.

Psychotherapy can be delivered to individuals, couples, families and groups. 

Dr.  Jennifer  Barbera  C.  Psych  and  her  associates  focus  on  providing  psychotherapy  services  to  individuals  and  couples.  We  do  not  provide  family  therapy  or  work  with  children.

How is psychotherapy different from counselling?

Psychotherapy focuses on assisting individuals who have significant concerns related to their mood, emotions, behaviour, thinking or social functioning. Psychotherapy is a regulated procedure, that only certain regulated health professionals are authorized to perform after meeting a comprehensive list of requirements.

Counselling is not a regulated procedure, used with people who generally have less severe concerns and are not experiencing any disruption to their functioning. For instance, someone might pursue counselling when they want to help overcome a break-up. In contrast, another person might seek psychotherapy when a recent relationship break-up has lead to significant sleep disruption and changes in mood and or an inability to attend work. 

The Controlled Act of 'Psychotherapy'

Psychotherapy is considered a 'controlled act' and is regulated in Ontario by the College of Registered psychotherapists of Ontario. In Ontario, the act of counselling is not regulated. 

Psychotherapy regulation means that there is better protection for people seeking psychotherapy services because:

-registered psychotherapists must demonstrate proof of specific education requirements (e.g. a masters degree).

-registered psychotherapists must complete some exams to be licensed.

-registered psychotherapists must receive and provide evidence of extensive clinical practice and of having received supervision on their cases from a registered  psychologist  or psychotherapist.. 

-registered psychotherapists must complete ongoing continuing education requirements. 

-the College of Registered Psychotherapists of Ontario is available to respond to complaints made by the public and has the authority to investigate and apply sanctions and make decisions regarding continued licensing. 

According the Regulated Health Professional Act, only regulated and approved health professional can perform a controlled act. 

Only the following professionals may apply to become regulated and authorized to perform the controlled act of psychotherapy. These health professional include:

Registered Psychologists, 

Registered Social Workers, 

Registered Social Service Workers,

Registered Nurses, 

Registered Occupational Therapists,

Registered psychotherapists, and

Physicians

To perform  the  act  of  Psychotherapy,  a  clinican  must  be  either  registered  with  one  of  the  above  regulatory  colleges,  or  they  must  be  in  the  process  of  fulfilling  their  requirements  and  working  under  the  direct  supervision  of  a  regulated  health  professional  who  is  permitted  to  provide  psychotherapy.

As defined in the Regulated Health Professions Act, the controlled act of Psychotherapy is defined as:

i)  Treating

ii)  by means of psychotherapy technique

iii)  delivered through a therapeutic relationship

iv)  an individual's serious disorder of thought, cognition, mood, emotional regulation, perception or memory that

v)  may seriously impair the individual's judgement, insight, behaviour, communication, or social functioning (RHPA 1991).

All 5 elements of this definition must be present for an intervention to be considered the controlled act of 'psychotherapy'. 

According to the College of Registered Psychotherapists of Ontario, when you work with a psychotherapist you should expect:

-To have the risks, benefits and expected outcome of the therapeutic intervention explained to you during the initial consent procedures, referred to as 'informed consent'.

-A clear and mutually established set of goals or plan for therapy.

-Each and every session has a clear beginning and end to the session, during which problems or concerns are discussed, and possible solutions or outcomes are explored.

-That the Registered Psychotherapist demonstrates clear and appropriate professional boundaries and provides a safe and confidential environment. 

What are other ways to identify a competent and professional psychotherapist?

When looking  for  psychotherapy  services  we suggest looking for:

-A psychotherapist who works in a professional office with other mental health clinicians, such as other psychotherapists and psychologists. This usually helps to ensure that they have a professional practice established and that they seek out ongoing consultation as opposed to only working out of their home in isolation from other professionals.

-A psychotherapist who has experience and training in the specific area you are seeking services for. In particular, ask how often they assist other individuals with the same concern. Ask what type of training they have. 

Ask what issues they don't assist with. A professional psychotherapist should only work in their areas of competencies and should be able to identify issues they don't assist with and populations that they don't work with. Be cautious about a  therapist who works with any age and any issue.

-A psychotherapist who has a breadth of training is suggested. This means that the clinician is trained in more than one therapeutic modality such as CBT, DBT, ACT, EFT, IFS etc. Be cautious about clinicians who only provide one therapeutic modality because not everyone responds to the same approach, and having a range of options and combining approaches is often beneficial. Ask the clinician what their main theoretical orientation is and why. Also, ask how they became trained in the approaches they use and when.

-A psychotherapist who is continually attending additional clinical training, including clinical practicums or intensives, is recommended. Ask the psychotherapist what trainings they have taken in the last year and look for someone who has taken at least a few trainings in the last year.  

-A psychotherapist who has a professional website and online reviews is recommended. Online reviews can help you gain insights into the experiences that others have had with the particular psychotherapist you are considering. 

Expect that there could be the occasional negative review even with an excellent clinician because sometimes individuals become upset with clinicians when they don't comply with unreasonable requests made of them, such as changing names on receipts or simultaneously providing services to a significant other- both practices are unethical. Individuals may also write negative reviews when an assessment is completed for the WSIB, and inconsistent information was presented. Seek out reviews to have as much information available as possible, but remember to take reviews in balance. 

Aside from explicitly looking for the characteristics mentioned above, it may also help to know what red flags to look for  in  psychotherapy or how to know when a psychotherapist may not be as professional or competent as expected. 

When  looking  for  a  psychotherapist,  we suggest being cautious about the following:

-A psychotherapist who does not establish informed consent and make a point of directly answering any questions you might have before commencing  psychotherapy  services. A reputable psychotherapist should directly address issues such as confidentiality, the costs of services, their cancellation policy, risks and benefits of services etc. Consent forms that cover all key points are lengthy but responsible.

-A psychotherapist who schedules multiple psychotherapy appointments back-to-back or many appointments (e.g., more than 4-5) in one day. Particularly for trauma-related work, a reputable clinician should avoid scheduling back-to-back appointments because its essential to take time to ensure proper grounding and closure before sending people on their way after trauma work. Ask the psychotherapist you are considering whether they schedule back-to-back and how many appointments do they schedule in one day? 

Dr. Jennifer Barbera and her associates do not schedule psychotherapy  appointments back-to-back to ensure that people do not feel rushed out the door and to help make sure people do not wait for their appointment to start. We also usually avoid scheduling more than 4 appointments a day, with occasional exceptions of 5 appointments when needed to accommodate someone's needs. 

Many practices schedule back-to-back, and it's not uncommon for clinicians to schedule 7-8 appointments in one day. This  does  not  allow for  a  buffer  in  case  needed,  or  time  to  review  and  prepare  for  each  session.  Ask  to  help  make  sure  you are  getting  better  quality  services!

-A psychotherapist who talks about themselves during your appointment. Occasionally for the clear purpose of helping to normalize your experience, it may be appropriate to use brief and intentional self-disclosure; however, a reputable psychotherapist should never shift the focus of a session away from you and onto themselves. 

-A psychotherapist who tells you what you should or need to do. A reputable psychotherapist should not pretend to be the expert on your own life or give you direct advice (unless you are at risk of serious harm). A reputable psychotherapist should help you explore and identify what course of action is best for you. They should be able to set aside their own opinions and values so that you do not feel judged. They should be explicit if their own values could at all influence the way they are guiding you or responding to you.

-A psychotherapist who either writes continuously throughout the entire appointment or never writes anything down. A reputable psychotherapist should take some notes to help inform their clinical work and note-taking; however, they should also be attentive and focused on you. 

-A psychotherapist who allows you to talk openly early on about your trauma history, without getting you to pause and check-in about how you are feeling inside before proceeding. Psychotherapists who are not trauma-informed can unknowingly aggravate a person's trauma-related symptoms. 

A reputable trauma-informed therapist is aware that although parts of you certainly want to talk about what happened, there may be other parts of you that feel differently and could feel distressed and more anxious afterwards, which can lead to increased numbing, dissociation, anger and self-harm.

For other suggestions on how to locate a reputable therapist visit our Therapy 101 page.

Resources:

The College of Registered Psychotherapists of Ontario

https://www.crpo.ca

Peter  (Thomson),  thank  you  for  taking  the  time  to  describe  yourself  and  the  work  that  you  do  as  a  registered  psychotherapist  and  Social  worker.  You  have  worked  with  Dr.  Barbera  c.  Psych  since  2013  and  continue  to  provide  some  supervised  psychological  services  for  trauma  (particularly  first-responder  PTSD)  using  EMDR.

Can you briefly describe your educational background and training in therapy & psychology?

Yes, I hold a Social Service Worker diploma, Bachelor Degree in Psychology, Masters in Mental Heath Counselling and undergraduate courses in Social Work. My training in therapy lies in CBT, Self Compassion, Trauma and PTSD, IFS and EMDR.

Can you tell me more about what made you go into psychology and psychotherapy and/or social work as a career?

I was interested in studying the human mind and how that relates to people functioning in difficult and precarious situations. 

How long have you been practicing as a Psychotherapist, and what types of clients have you worked with during your career?

I have been working as a therapist since 2008. I provide individual psychotherapy to adolescents and adults in areas of trauma, PTSD, depression, anxiety, stress and low self-esteem.

What specific psychotherapy approaches or modalities are you trained in, and do you have any specialized certifications or areas of focus?

I am trained in Cognitive Behaviour Therapy, IFS and EMDR. At this point in time, I am completing the certification process for EMDR.

What qualities do you think are most important in a therapist? 

Being able to establish a therapeutic rapport, providing empathy and understanding and providing psychodynamic therapy in areas that are still unresolved.

How do you ensure that you provide client-centered care and maintain a non-judgmental and empathetic stance with your clients?

I provide a Rogerian and humanistic approach where I spend much time connecting with the client on different areas of their life. I very much incorporate self compassion and self care in order for the client to be more compassionate and understanding towards themselves.

How do you feel about receiving supervision, and how often do you seek supervision for your cases?

Receiving supervision is a necessary part of my role as a therapist  providing  psychotherapy. It helps me with professional development and growth. On an annual basis, I seek supervision 10-12 times for cases that are in question.

What methods do you use to assess the needs and goals of your clients at the beginning of therapy?

I establish a treatment plan within the first three sessions that consists of direct questioning of why the client has come to therapy and what changes they would like to see. I also use mental health measurements to help identify certain areas of concern.

How do you prioritize self-care to prevent burnout and maintain your own emotional well-being?

I prioritize self care by running regularly throughout the week, spend quality time with my wife and two children and socialize with friends on a monthly basis.

What is your favourite thing about being a therapist?

Seeing a client be less judgemental and critical of themselves and show more self compassion and understanding. See a clinet’s level of functioning improve when unresolved targets become resolved through EMDR treatment.

What is your least favourite thing about being a therapist?

First charging a client for a missed session after they have received multiple reminders. Recommending to a client that they are not ready for therapy or should seek another provider based on poor attendance, inconsistent effort, being argumentative.

What do you think are some of the most important factors that determine how much someone benefits from psychotherapy?

Level of functioning pertaining to mood, cognition, fulfillment, relationships.

Where do you see your career as a therapist heading in the next few years?

Becoming certified with EMDR treatment, delivering workshops and continuing to supervise graduate level students.