What is a psychologist?

Just like other health care providers such as family physicians, medical specialists and nurses, psychologists are regulated health professionals. They see people of all ages, working with them as individuals, in couples or in families. Psychologists also work with groups, organizations, companies and government agencies.

Although many psychologists both assess and treat psychological problems, some provide only specialized assessment services. When working with individuals, psychologists use psychological tests and informed discussion to help clients and patients identify problems or issues and to work on solutions. They also work with groups and organizations to assess individuals and foster behaviour change. Most psychologists work in their own offices or in clinics, schools, or institutional settings such as hospitals, prisons or places of business (From the Ontario Psychological Association)

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What is the difference between psychologists and psychiatrists?

Psychologists and psychiatrists both undertake about the same number of years of education and training. Some of the training is similar (e.g., diagnosis) and some is quite different.

Psychologists have doctoral degrees in psychology and specialize in the assessment, diagnosis and treatment of human emotion, thought and behaviour. They have advanced training in psychotherapy and the science of behaviour change. Although they may be trained in the use of medication to treat mental illness, in Ontario they are not as yet licensed to prescribe medications.

Psychologists are the only professionals qualified to use certain kinds of psychological tests to assess intelligence as well as emotional and behavioural problems and neuropsychological dysfunction.

The fees of psychologists in Ontario are covered by private payment, extended medical plans, employee assistance programs, and/or government services and agencies or other special programs. They are licensed by the College of Psychologists of Ontario.

When you choose a psychologist, you can be assured that this professional has received extensive formal training and supervision in her or his area of expertise, will adhere to a strict code of ethics and professional standards, and is governed and regulated by the College of Psychologists.

Psychiatrists, like your family physician, have degrees in medicine which is quite different than degrees in psychology, with additional specialized training in the diagnosis and treatment of mental illness.

In Ontario, psychiatrists tend to focus on the biological aspects of mental health while psychologists tend to focus on the cognitive, emotional and behavioural.

Psychiatrists are licensed by the Government to prescribe medication. The practice of most psychiatrists in Ontario is focused on prescribing medications and consulting with family physicians, psychologists and other health professionals. In fact, psychologists and psychiatrists are colleagues and often work closely together.

In Ontario, the fees of psychiatrists are covered by the Ontario Health Insurance Plan (OHIP). Like psychologists, you can be assured that psychiatrists have received extensive formal training and supervision in her or his area of expertise and will adhere to a strict code of ethics and professional standards.

Psychiatrists are governed and regulated by the College of Physicians and Surgeons of Ontario.

Psychologists and psychiatrists are regulated health professionals. Other mental and behavioural health professionals might not be regulated and might not be trained in the assessment, diagnosis, and treatment of mental health issues. (From the Ontario Psychological Association)

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Why should I see a regulated professional?

Psychologists are regulated health service providers, registered with the College of Psychologists of Ontario to practice psychology within the framework of the Regulated Health Professions Act (RHPA).

The College is given the responsibility by the Government of Ontario of setting the standards psychologists must follow when providing psychological services in the province. The purpose of regulation is to ensure the public receives high-quality services and is protected from unprofessional and unethical conduct. Only those registered by the College are allowed by law to call themselves psychologists or to offer psychological services.

Regulation protects the public by ensuring that psychologists:

• are well trained
• stay well trained through continuing education
• obey provincial laws, regulations and a code of ethics to ensure patients are safe and receive excellent services
• are answerable to consumer complaints to the College of Psychologists of Ontario

Regulated health professionals also protect the public by ensuring that their personal information remains private.

People who call themselves counselors or family therapists, unless they are licensed psychologists, are not currently regulated health professionals covered by the Regulated Health Professions Act (From the Ontario Psychological Association)

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How long will it take to get better?

For most problems, the evidence-based treatments that EBT3 uses takes 8-20 individual, couple, family, or group sessions. Therapy sessions are typically scheduled weekly and last 50 minutes in the clinic. However, your EBT3 therapist may suggest longer sessions, on a more frequent basis, or outside of the office, dependent on your particular problems.

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How do I choose a therapist?

The following are things you need to know about a prospective clinician:

Registration and Special Expertise.

You should find out whether your potential clinician registered in your province. If the person is not registered in your province, you may want to ask whether the person is being supervised by another mental health professional. Some clinicians will be certified in evidence-based psychological practices, like cognitive-behavioral therapy. Therapists with a strong foundation in these practices will not mind being asked questions about their qualifications and will freely give you any professional information that you request. If a therapist does not answer your questions to your satisfaction, or refuses to answer your questions, you should consult another clinician.

Fees.

You may feel uncomfortable asking about fees. However, it is important information that a good clinician will be willing to give a potential client. The following are financial questions you might ask over the phone or during your first visit:

• How much does the clinician charge per hour?
• Is there a policy concerning missed or canceled sessions?
• Is there a charge?
• Will the clinician want you to pay after each session, or will you be billed periodically?
• Does the clinician or practice accept debit or credit cards?

Other questions you may want to ask a therapist.

• How many times and how frequently will the clinician want to see you?
• How long will each session last?
• How long does the therapist expect treatment to last?
• What are some of the treatment approaches likely to be used?

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Once initial goals are decided upon, you can expect a good clinician to discuss one or more approaches for helping you reach your goals. If you are not progressing, or if progress is too slow, your clinician should suggest modifying or changing the treatment approach. At each of these points you may want to ask yourself the following questions:

• Do you understand what the clinician has asked you to do?
• Do the clinician’s instructions seem relevant to your goals?
• Do you believe that following these instructions is likely to help you make significant progress?
• Has the clinician given you a choice of alternative therapy approaches?
• Has the clinician explained possible side effects of the therapy?

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What do I do if I am dissatisfied with my therapist?

Talk With Your Therapist. People can feel angry or frustrated at times during therapy. If you do, you should discuss these concerns with your clinician. A good clinician will be open to hearing them and discuss your dissatisfaction with you.

Get a Second Opinion. If you feel that the issues and problems you have raised with your clinician are not being resolved, you may want to consider asking for a consultation with another professional. Usually the clinician you are seeing can suggest someone you can consult. If your clinician objects to you consulting another professional, you should change to another clinician who will not object.

Consider Changing Therapists. Many people feel that it is never acceptable to change clinicians once therapy has begun. This is simply not true. Good clinicians realize that they might not be appropriate for every person. The most important thing you need to ask yourself when deciding to continue with a particular therapist is, "Am I changing in the direction I want to change?" If you do not feel that you're improving, and if, after discussing this with your clinician, it doesn't appear likely, you should consider another therapist.

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How will I know if CBT is for me?

Most people know within 2-4 sessions whether or not they are comfortable with their therapist and whether or not CBT is an approach that is likely to be helpful. It usually takes longer than 2-4 sessions to experience any significant change in symptoms or distress. We encourage everyone to discuss their progress with their therapist after 4-6 weeks of treatment.

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Why do I have this problem?

Not enough is known about the causes of depression and anxiety. Each person’s circumstances and experiences are different and complex. As a result, we often can't be sure why a person is experiencing these issues. More importantly, it's been demonstrated that simply understanding why someone has problems is not sufficient: in order to overcome them, people must move from understanding to action, by challenging and changing their thoughts, assumptions, beliefs, and behaviours. Fortunately, although we know less than we would like to about the causes of anxiety and depression, we do know what works to help people get better and stay well. Thus, rather than looking back, the focus of CBT is on solving problems in the present and looking forward.

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What about medication?

For most mood and anxiety problems, short-term, evidence-based psychotherapy is at least as effective as medication. In addition, these therapies are more effective than medication in the long-run in preventing a return of symptoms. That said, some people benefit from a combination of therapy and medication, while some medications may actually interfere with the effectiveness of therapy. You should discuss what the current research says about medication for your specific circumstances when you meet with your EBT3 therapist.

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