Our Therapy Approaches
We use primarily five evidence-based therapy approaches: Dialectical Behaviour Therapy, Emotion-Focused Therapy, Cognitive Behaviour Therapy, Mindfulness-Based, and Solution Focused Therapy. See below for descriptions of each.
Dialectical Behaviour Therapy (DBT)
In DBT, the early work is often to get a handle on ‘problem behaviours’ such as self-harm, suicidal ideation, substance use, impulsive spending or sexual activities, or more general tendencies to ‘avoid’ life, whether that is through school refusal, poor work attendance, or minimal social engagement. We believe clients engage in these behaviours for a variety of reasons, not least of which is to avoid big feelings (sadness, anxiety, guilt, shame, etc…) as well as their own internal ‘critic’. Clients often come in experiencing a tendency towards either under-regulation or over-regulation of their emotions. Effective management of anger and other big emotions can at times be a part of the work. A mixture of skills building (i.e., distress tolerance, emotion regulation, interpersonal, mindfulness skills) and exploratory therapy to understand the function of these ‘problem behaviours’ can be effective.
Our experience with the timeline of DBT work is between 6 months to a year or more - this really depends on the individual, their environment, their level of emotional awareness and control, the skills they already bring to the table and other factors.
Emotion-Focused Therapy (EFT)
In EFT, clients typically do not struggle with 'problem behaviours’ or at least not as acutely as with DBT clients. Clients are often interested in EFT work because of their own desire to ‘get more in touch’ with their emotional and/or internal self. They often have the sense that they are circling around, like on a merry-go-round with their own self-awareness but have difficulty getting deeper into their own experience. It’s a useful treatment (like DBT and CBT) for people struggling with depression, anxiety disorders, relationship challenges and complex trauma. The work can feel more ‘active’ at times as we consciously seek to experience and express your emotions in session, for the purpose of helping enhance emotion regulation and ultimately changing less adaptive emotions with more adaptive emotions.
Note: A common experience we have had with DBT clients is that as we progress from more initial ‘Stage 1’ type work, the focus in ‘Stage 2’ often resembles EFT work - where sessions revolve more around emotional processing, trauma processing, and ‘self’ work, as well as heavier questions around meaning, purpose, identity and freedom.
With EFT work, short-term is considered roughly between 10-20 weekly sessions, and of course can go for longer periods as needed.
Cognitive Behaviour Therapy (CBT)
In CBT, a primary assumption is that what is creating challenges for you is ultimately what you tell yourself, or the beliefs you have about yourself, others, the world and the future. Similar to DBT, this treatment can have some ‘homework’ where you might track your thoughts related to a specific emotion or behaviour you are struggling with. For anxiety, we often use a version of exposure work - where we would explore what you are problematically anxious about, and if it makes sense, to develop an exposure hierarchy to gradually and predictably approach the feared stimulus. For depression, we often use a version of behavioural activation - where we will attempt to have you ultimately re-engage in the life that depression has caused you to move away from (including those activities and relationships that provide meaning and balance for you). We will do work around identifying ‘thinking traps’ and we will do worksheets around thought appraisal and reframing.
Similar to EFT, the course of CBT can be as short as 10 sessions, or longer depending on the level of ‘stuckness’ you might be experiencing with your own automatic thoughts/criticisms/core-beliefs, as well as factors related to your environment, skills, self-awareness and other elements.
A related leg of CBT is what is called Cognitive Processing Therapy (CPT). This is a 12 week protocol for Post Traumatic Stress Disorder (PTSD). Early sessions of CPT provide education on PTSD and related issues, with a focus on exploring the impact of the trauma on you and your relationship to the world in general. Later sessions cover topics around intimacy, trust, esteem, power, safety and meaning as trauma can have such a significant impact in all of these areas. We find this a useful protocol for people who appreciate more structure in treatment, and for those able to tolerate spending time with the impact of their trauma not only in session but also when home by themselves.
Mindfulness-Based Therapy and Mindful Self-Compassion
Mindfulness is the practice of anchoring your awareness of thoughts, feelings and bodily sensations to the present moment. There is evidence to suggest that symptoms of depression are intensified by focused attention on the past, while symptoms of anxiety are exacerbated by focused attention on the future. In mindfulness-based therapy, you will learn to direct your attention to what is rather than what has been or what could be. Mindfulness therapy will help you develop the skills to encounter your present experience with an attitude of nonjudgement and self-compassion, which will help reduce suffering.
Mindful self-compassion therapy employs mindfulness-based principles to help clients establish a healthier and more balanced self-regard. So often in life we are kind, generous and compassionate toward other people, but harsh and self-critical towards ourselves. This destructive tendency can lead us to develop issues with mood regulation, self-confidence, and motivation. The self-compassion approach encourages you to treat yourself with the same care and consideration as you would a treasured friend.
Mindfulness incorporates tools like meditation, breathing exercises, and relaxation training, and may also be used in conjunction with other therapeutic modalities like Cognitive Behavioural Therapy depending on your needs. Timeframes for therapy are highly dependent on symptom severity and commitment to the therapeutic process. We are deeply committed to working with you to measure progress and determine an appropriate path forward if you do not feel satisfied with your experience in therapy.
Solution-Focused Therapy and Brief Coaching
We believe you come into therapy already equipped with valuable insight about your life. The solution-focused approach aims to utilize your existing strengths and knowledge base to find solutions to your presenting concerns. Unlike other therapeutic approaches that focus on analyzing problems, solution-focused therapy has a positive orientation, helping clients recognize their own inner resources to establish and achieve specific, measurable goals. This approach can be utilized on it’s own or in conjunction with other therapeutic interventions.
Brief coaching is an extension of the solution-focused approach. The objective of this practical intervention is to use focused discussions to draw attention to your strengths and past victories to help map out a pathway your preferred future. Each session is goal-directed to help you make changes quickly and effectively.
Solution-focused therapy is designed to be a short-term intervention, with the recommended number of total sessions ranging from 4-8. It is therefore not well suited to be used on its own with clients facing multiple or complex difficulties.
If you have any questions about these approaches or would like to book an intake appointment, please contact us.