Question 1

1. Do you do both assessment and treatment work?

Accepted Answer

Yes. I do both.

Regarding assessment, historically, for some 25-30 years, I did mostly IME (Independent Medical Legal, or Psychological Legal) assessment work and typically for the court, lawyers, and/or insurance companies. These were lengthy assessments, resulting in 20-to-25-page reports. I no longer do this type of assessment or report; however, I am happy to do shorter comprehensive “clinical” assessments that result in 2 to 6-page reports. These assessments and reports would be mostly diagnostic in nature, followed by treatment recommendations. They may also be designed to help opine upon and manage workplace injury and disability. They can be used in the context of litigation. They may address psychologically-based workplace limitations and restrictions. They may be used for pension purposes, as with Veterans Affairs Canada – involving Veterans, members of the Canadian Armed Forces (CAF), and RCMP members. They can involve written reports and/or completed insurance forms. They may relate to those injured in motor vehicle accidents, as with ICBC. They will follow DSM-5TR diagnostic criteria.

Additional details regarding treatment are found in the questions and answers, below.

I am well-practiced and steeped in both psychological assessment and treatment work.

Question 2

2. Do you offer both in-person and online assessments and treatment?

Accepted Answer

Yes and no. For the most part, my services are online and conducted by phone or within a secure videoconferencing platform. I find this to be most the convenient approach, as do most of those who seek my assistance. This methodology yields both reliable and valid clinical data, as has been supported by many controlled studies that have compared in-person versus online treatment.

Many recognized protocols and guidelines are also available for online assessments.

On the rare occasion, I will provide in-person assessments and treatment. This practice would be determined on a case-by-case basis.

Question 3

3. What is the cost of your services?

Accepted Answer

The present cost of my services is $250 per hour. I offer direct billing with ICBC without a surcharge. Work that is “forensic” in nature and for the court is at a higher rate. The current BCPA (British Columbia Psychological Association) suggested rate is $235 per session (usually 50 minutes). Many extended benefits plans reimburse at this rate or more. It is best to check with your insurance carrier for clarification regarding hourly and total third-party psychological coverage.

Psychological services are not covered by MSP. Psychological fees, paid out of pocket, are generally income tax deductible as medical expenses; however, confirmation by a tax specialist is recommended. Fees, payment, source and method of payment, receipts, and related details are discussed and agreed upon at time of booking of services. Fee levels and other payment variables are subject to change over the course of time.

Question 4

4. What is your cancellation policy?

Accepted Answer

If you need to cancel or reschedule, and by way of courtesy, I would like as much notice as possible. That way, I can plan my schedule and insert others into my calendar who are waiting to see me. For the most part, I would like 24 to 48 hours of notice. If you cannot provide this, as in cases of severe illness or an emergency, this will be acknowledged and understood.

Question 5

5. How will I know if therapy is right for me?

Accepted Answer

Before beginning any service (assessment or treatment), we will arrange a 15-minute complimentary telephone call. By this time, you will likely have answered 3 questions as part of the sign-up process on this website. This will give me a sense of what you are looking for (regarding assessment and/or treatment). I will be looking for an assessment or treatment match – that is, a match between what you seek and what I can confidently deliver. I will not, for instance, take on any task that is not within my area of expertise.

Regarding therapy, once we are engaged in the treatment process, in my view, it is our combined job, so to speak, to create and foster a therapeutic setting and treatment focus that is “helpful” for you, the client. I will ask you, on a periodic basis, about “how we are doing,” and if what we are doing is “helpful.” If not, and if your therapeutic goals are not being met, we will decide to change course, and if this is not possible, we will discuss a referral elsewhere.

Question 6

6. Regarding treatment, whom do you work with, and what type of therapy do you practice?

Accepted Answer

I work with people from all walks of life and with a multitude of different issues and/or concerns. These can include any of, or any combination of: anxiety (GAD, social, health anxiety), fears/phobias, anger, panic, trauma and stressor-related disorders (Adjustment Disorders, ASD, PTSD, Complex PTSD), OCD, insomnia, depression, bipolar illness, grief/bereavement, issues with substance use/abuse, chronic illness, chronic pain, cognitive issues, ADHD, workplace concerns and/or disability, couples and marital issues, problematic family relations, and so on. As well, I routinely treat those injured in motor vehicle and recreational accidents, and RCMP members and other First Responders suffering from traumatic exposure in the workplace. In addition, I enjoy working with couples and families on relationship issues.

Regarding therapeutic orientation, I am strongly informed by a bio-psycho-social understanding of physical and psychological health. Primary treatment modalities include CBT (Cognitive-Behavioral Therapy), ACT (Acceptance and Commitment Therapy), MBSR (Mindfulness-Based Stress Reduction), and MI (Motivational Interviewing). I am also well-versed in couples/marital therapy (CBT, ACT, and Gottman Method) and Family Systems Theory.

Further, my practice is trauma-informed, meaning that I am knowledgeable, experienced, and comfortable in assessing and treating individuals suffering from injury and trauma from multiple earlier and later sources, resulting in many different forms of psychological impairment and distress.

See Resources link in the menu, above.

Question 7

7. What happens during a typical therapy session?

Accepted Answer

At the start of the first session, we review the purpose of the session and the limits of confidentiality. We review presenting complaints/symptoms and related impairments. We do a brief history, and we may complete some limited screening questionnaires having to do with anxiety, depression, cognitions, physical pain and disability, etcetera. This is an introductory, exploratory session. At the end of the session and at the end of each subsequent session, we do “take homes” – wherein the client articulates a few learnings, thoughts, and/or realizations from the session. These take-homes often help solidify any gains and/or cognitive shifts made as a result of our session.

Subsequent sessions often begin with a review of the “take homes” from the previous session. Then, we continue to explore the issues at hand, and those that are most important for the client. By addressing the biggest issues, so to speak, the thought is that the smaller concerns “will take care of themselves.” The content and amount of client sharing, however, is fully decided/determined by the client.

Question 8

8. How often do I need to attend therapy, and how long does it take?

Accepted Answer

The frequency of treatment attendance is usually determined by financial matters/means, the severity or acuteness of the problem, the time availability of the client and/or this writer, and client satisfaction. Some clients attend weekly, some attend bi-weekly, and some attend monthly. Some attend on an as needed basis and only once every 3-6 months, and only for a particular stressor at the time. Typically, therapy sessions are more frequent in the early stages when symptoms and impairments are more acute.

The duration (or length of treatment) is influenced by the same factors. Treatment duration, in my experience, can range from one session to more than a year.

Question 9

9. What about confidentiality? Will everything I share be confidential?

Accepted Answer

Limits of confidentiality are reviewed at the start of any assessment or at the beginning of the first treatment or therapy session. Essentially, I advise that I am required by my practice guidelines to keep a record of our meeting and the content. Depending upon the nature and purpose of the session, the content that is kept can be more or less detailed. I advise that regardless of the setting, there will be no release of records without client or legal counsel written consent, or a court order. Even with written consent, records are carefully reviewed before release, with several considerations in mind. These are set out, for instance, in the CPBC (College of Psychologists of BC) Code of Conduct.

I also advise that I have a duty to warn and/or a duty to report, and a legal obligation to do so, if I have a reasonable suspicion of child, dependent, or elder abuse or neglect, or when a client presents a significant danger to self or to others.

Question 10

10. Is psychological therapy only for people with serious mental health issues?

Accepted Answer

No. Some individuals come to a psychologist with serious mental health issues such as a Major Depression or PTSD; whereas, others may present with mild or subclinical depression or anxiety symptomatology and only wanting to address workplace, couples, or family relationship issues, life transition difficulties, and so on. There would not be a serious mental health issue – this person or these people may just wish for and benefit from some extra support in dealing with regular life events. This choice, in my opinion, is perfectly reasonable and one that can lead to overall better health.

Question 11

11. What is the difference between a psychologist, psychiatrist, and counsellor?

Accepted Answer

A psychologist in BC typically has an advanced university degree such as a Ph.D. or Psych. D. This is often 3 or 4 years of study (and clinical internship experience) beyond a master’s degree. A psychologist with a Ph.D. is a doctor, though not a medical doctor. A psychologist cannot prescribe medication. A psychologist can and is licensed to diagnose mental health conditions (typically using the DSM-5-TR).

A psychiatrist is first trained as a medical doctor and then completes a specialty in psychiatry. A psychiatrist can both diagnose mental health conditions and prescribe medication. A psychiatrist is most likely to focus on the medical aspects of mental illness/disorders, and with a biological or neurological focus.

A counsellor generally has a master’s degree in counselling or a related area. A counsellor cannot diagnose mental health conditions and cannot prescribe medication.

A psychiatrist in BC will most likely bill through MSP. Psychologists and counsellors are not able to do so. For the most part, a psychologist invoices at a higher rate than a counsellor.

Essentially, and in the simplest of terms, the differences come down to the extent and type of training, the capacity to diagnose, the capacity to prescribe medication, and matters of “regulation.” Importantly, psychology and psychiatry in BC are “licensed” and “regulated” healthcare practices. Their practices are overseen, regulated, and held accountable to and by their respective Colleges. To date, it is my understanding that counsellors within BC are not regulated or “licensed” under any BC Healthcare College, or as healthcare practitioners. Regulation and licensing are designed to assure a high standard of training, a high standard of care, and to protect the public. The CPA (Canadian Psychological Association) offers some additional information regarding psychological practice regulation, as follows:

https://cpa.ca/public/decidingtoseeapsychologist/

Psychological services in BC are now regulated under the College of Health and Care Professionals of British Columbia (CHCPBC).

https://www2.gov.bc.ca/gov/content/health/practitioner-professional-resources/professional-regulation/psychology (https://www2.gov.bc.ca/gov/content/health/practitioner-professional-resources/professional-regulation/psychology)