What can I expect my first appointment?
Your first session will vary depending upon the type of therapy you are seeking. Currently, we offer RO DBT, DBT, FBT, trauma therapy, and integrated models. Generally, regardless of your presenting concerns, you will be asked to complete some questionnaires that help your psychologist determine what symptoms you are experiencing, and which therapy would best fit. You will also participate in an assessment interview where you are asked a range of questions about your life, including mental health symptoms, and you have an opportunity to ask questions too. Generally, the assessment process will take one to three sessions. After that, a diagnosis will be discussed if appropriate, and recommendations for treatment will be made. If you are an adolescent seeking services, the first session will likely involve some time where the psychologist meets with you independently and some time where the psychologist meets with you and a parent.
How do I know what the right treatment is for me?
This is both an individual choice, and your psychologist can make recommendations based upon your presenting concerns. Research into the effectiveness of various therapies recommends specific therapies based upon your presenting concerns. It is also important to take into account whether you’ve had therapy before and how you responded to that therapy. Others may have specific preferences for certain types of therapy based upon your own beliefs.
What is Radically Open Dialectical Behaviour Therapy (RO DBT)?
Radically Open Dialectical Behaviour Therapy is an evidence-based transdiagnostic treatment model developed by Dr. Thomas Lynch to address excessive self-control, known as overcontrol. This includes things like maladaptive perfectionism, chronic depression, Anorexia Nervosa, Obsessive-Compulsive Personality Disorder, Avoidant Personality Disorder, treatment-resistant anxiety, and Autism Spectrum Disorders. It is the product of over 25 years of research and builds on concepts including standard Dialectical Behaviour Therapy, brain-based research, and Malamati Sufism.
Overcontrolled (OC) individuals can be said to have too much of a good thing! Being able to tolerate distress in order to achieve goals allows us to be successful at school and work, but can make connecting to others and having fun difficult! OC Individuals with maladaptive overcontrol typically express emotions less than others, are sensitive to threat, have low sensitivity to rewards, have high expectations of themselves and others, tend to follow the rules and expect things to be done just right, have difficulty with intimate relationships, and experience high social comparisons, including feelings of envy and bitterness.
RO DBT is structured to incorporate individual therapy, skills class, and phone coaching over a period of 30 weeks. The weekly skills class helps individuals learn the skills to treat overcontrol, and individual therapy helps with additional practice of skills and application to your life. RO DBT is a novel intervention in that it directly targets social connectedness and how we socially signal to others.
What is the evidence that RO DBT is effective?
The efficacy of RO DBT has been informed by experimental, longitudinal, and correlational research. The evidence is growing all the time It includes two randomized controlled trials (RCTs) of refractory depression with comorbid OC personality dysfunction that provided the foundation of the development of the RO DBT treatment manual (Lynch et al., 2007; Lynch, Morse, Mendelson, & Robins, 2003), one non-controlled trial with adult anorexia nervosa inpatients (Lynch et al., 2013), a case series open-trial applying Radical Openness skills alone plus standard DBT with adult AN outpatients (Chen et al., 2015), and one non-randomized trial targeting treatment resistant overcontrolled adults (Keogh et al, 2016), while the mechanisms of change and efficacy for treatment of refractory depression and comorbid OC personality disorders are being investigated via the large multi-site RCT ‘REFRAMED’ (for more info click here).
What is Family Based Therapy (FBT) for eating disorders?
Family Based Therapy is the method for treating Anorexia, Other Specified Feeding and Eating Disorders, and Bulimia with the most evidence of effectiveness. It is a method of treating adolescent eating disorders that occurs across three phases. In the first phase of treatment, the young person’s parents take full responsibility for their eating and supervises all meals and snacks. In the second phase of treatment, responsibility for eating is slowly given back to the adolescent. In the third phase of treatment, attention is given to helping the young person and family return focus to normal tasks related to adolescent develop. In many mental health conditions, the condition is inherently distressing for the individual experiencing it, and they are thus motivated to seek treatment. With eating disorders, there is more of an internal conflict for the person experiencing the disorder. While they may be aware of some negative effects of the eating disorder, there are often many perceived benefits to remaining sick. As a result, having external individuals taking control of eating assists the young person in overcoming their ambivalence.