The ABCs of Psychotherapy

A psychologist is familiar with interview techniques, has completed supervised internships in psychotherapy and is able to use psychological tests to evaluate clients' intellectual abilities, aptitudes or aspects of their personality. At this time in Quebec, the title "psychologist" is protected, which means that all psychologists must be listed on the membership roll of the Ordre des psychologues du Québec.

• The difference between a psychologist and a psychiatrist or a psychotherapist

  A psychiatrist is a medical specialist, like a cardiologist or a surgeon. To benefit from the services of this doctor specializing in mental health, a client must be referred by a physician. The psychiatrist's training prepares him or her to treat major mental disorders, which usually require the use of medications. Because psychiatrists are doctors, they can prescribe drugs. They may also use interview techniques and psychotherapy to treat their patients. In Quebec, the practice of psychiatry is protected, which means that all psychiatrists must be medical specialists who are members of the Collège des médecins du Québec.

  A psychotherapist can be defined as someone who provides psychotherapy services. The title "psychotherapist" is not controlled in Quebec, which means that there are no specific regulations governing the practice of psychotherapy, and no university program awards a degree in psychotherapy. The title "psychotherapist" can be used by any person, who may or may not have adequate training. To be certain of obtaining quality services, it is preferable to ascertain that the psychotherapist has received appropriate training and is a member of a professional order. Bill 21, which was adopted by the National Assembly of Quebec in June 2009, will change this situation as soon as it goes into effect.

• Why undertake psychotherapy?

  At some point or other, anyone can experience personal or professional problems of a psychological nature. According to the Ordre des Psychologues du Québec, the most common reasons for seeking psychological help are:

  • Dissatisfaction with your life currently and the desire to find new meaning in life;
  • Experiencing distress: anxiety, depression, mourning, separation, illness or job loss;
  • Relationship problems: establishing new relationships, separations, lack of communication;
  • Family problems: child constantly breaking rules, a spouse not being responsible;
  • Sex problems: low sexual drive, erection problems, premature ejaculation;
  • Lack of control over behaviours: overeating, drinking problems, smoking, drug problems or gambling;
  • Lack of work-life balance: burnout, abuse of power, work conflicts, no priorities.

• When should one consult a psychologist?

  According to the Ordre des Psychologues du Québec, when one feels a little down or depressed, when life seems difficult and happy moments seem rare, we naturally try to solve our own problems and turn to our family and friends for advice. Often it doesn't take much — a vacation, a heart-to-heart talk with a spouse, starting an exercise program — to regain our sense of balance and move on. Sometimes, however, after having tried various solutions and the situation does not seem to improve, it may then be time to consider seeking professional help to evaluate the problem and find solutions to make things better.

  Here are a few situations where you might consider consulting a psychologist without delay:

  • When you are no longer able to carry out the tasks of daily living such as going to work or taking care of yourself, your children or your home;
  • When you have the feeling that no one understands you, that people avoid you or that their advice is useless;
  • When you cannot overcome your feelings of distress or a traumatic event and find that the solutions you try are not working out;
  • When you are feeling depressed, anxious, tense, angry or irritated more often than usual;
  • If you are finding it increasingly difficult to sleep;
  • If you are afraid of dealing with situations that seem ordinary to others;
  • If you have a lump in your throat or cry often;
  • If you feel your life is meaningless, with no hope of change.

• The process

  According to the Ordre des Psychologues du Québec, psychotherapy helps people who are experiencing personal problems to change their thoughts, feelings and behaviours in order to reduce their suffering and lead a more satisfying life. In many ways, psychotherapy will provide people with new and more effective ways of dealing with the obstacles that life presents. Psychotherapy has proven to be one of the most effective and accepted means of helping individuals resolve their problems.

  Psychotherapy is a process of change that requires collaboration with a psychologist. While psychotherapy is rewarding it can also be demanding. Clients may be encouraged to do exercises outside of the sessions or to examine situations, emotions and thoughts that worry them. You may talk about things you have never discussed before. You may also realize that certain thoughts and behaviours need to be modified. The first step in psychotherapy is an evaluation, during which the psychologist evaluates your problems, perhaps using tests and questionnaires or perhaps simply through an interview, in order to fully understand them and determine the best treatment plan for you. The first session is also an opportunity for you to break the ice and ask any questions that may be bothering you.

  The duration of the psychotherapy will depend on many factors such as the seriousness of the problem, the objectives one wishes to attain, the frequency of the sessions, the type of therapeutic approach used, the client's reactions, the client's motivation to change and commitment to the process. Psychotherapy can therefore last anywhere from a few weeks to a year or more.

• What types of psychotherapy are offered at Y2CP?

  There are different schools of thought in the field of psychology, leading to a variety of psychotherapeutic approaches that differ from one another in terms of the theories on which they are based, the way in which they conceptualize psychological problems, the techniques used and their view of the therapeutic relationship. Although many different approaches exist, the most commonly encountered are: cognitive-behavioural; existential-humanistic; psychodynamic-analytical and systemic-interactional. Many psychologists do not limit themselves to only one approach in their practice. In fact, many psychologists use ideas and techniques from a variety of approaches, depending on the problems that client present.

  At Y2CP, the cognitive-behavioural approach is most commonly used with our clients. The cognitive-behavioural therapy (CBT) is based on the principle that if maladaptive behaviour can be learned, it can also be unlearned. According to this school of thought, attitudes, habits and negative thoughts are learned responses and the best way to eliminate them is to learn new, more constructive ones. Emphasis is placed on the present, the here-and-now. During therapy, the psychologist will help his/her client to become aware of his/her own thoughts and beliefs, and to replace them with more realistic evaluations and judgements.

• What happens in the first few sessions?

  According to the Ordre des Psychologues du Québec, the first session is an opportunity not only for the client and the psychologist to meet but also to obtain information and evaluate, if necessary, the need to start psychotherapy. During the first session, client and psychologist must get to know the other and establish the foundation for a mutually trusting relationship. The client can also openly describe the difficulties he/she is facing, enabling the psychologist to evaluate the ways in which he/she can offer professional help. This step of the evaluation may last two or three sessions, in some cases may include the use of psychometric tests (evaluating, for instance, different aspects of the client's personality, his/her interests, or the extent of his symptoms). It is also an opportunity for the client to evaluate the psychologist and ask any questions that may be on his/her mind. It is important for the client to take the time to inform himself/herself. The psychologist will then explain the main aspects of the proposed psychotherapy so that the client can give his/her consent in a free and enlightened manner. An individual should not hesitate to ask the psychologist about his/her education and training, the type of therapy he/she typically uses, his/her approach, his/her usual way of working with clients, what sessions will be like and so on.

  During the first session, it is appropriate to ask questions about the practical aspects of psychotherapy. For instance:

  • What are the fees for each session, and when should they be paid?
  • How long is each session?
  • How frequent will sessions be? (Once a week, twice a week, etc.)
  • What happens when a client misses a session?
  • When are official receipts for tax or insurance purposes issued?
  • What happens in the case of an emergency?
  • Are the sessions completely confidential?
  • Will there be a file about me? What will be in the file? Will I have access to it?

  This discussion will eliminate unpleasant misunderstandings and enable the client to begin psychotherapy with clear and accurate information.

  During these first few sessions, the psychologist will be able to develop a plan with the client — in accordance with the client's needs, resources and the difficulties he/she may be experiencing — a mandate, some goals, a process and a way of working. The more explicit and open this discussion, the more beneficial therapy will be. It must be remembered, however, that this mandate is not firm: it will be useful to periodically review the progress being made in psychotherapy, to re-evaluate the process and, if necessary, to modify the objectives.

• Your rights are protected

  When dealing with a licensed professional, you have rights. The Ordre des Psychologues du Québec is required by law to oversee the exercise of the profession by determining the training that psychologists must receive, ensuring their competence, establishing the ethical standards to which psychologists must conform and receiving complaints from the public, which are considered to be requests for an investigation.

  Complaints from the public about services provided by psychologists are received and handled by the Order's syndic, or trustee, whose mandate is, first and foremost, to protect the public.

  The syndic studies the complaints and may initiate one of the following procedures:

  • With respect to questions regarding professional fees, the syndic, at the client's request, may initiate a procedure called a conciliation of accounts between the psychologist and the client with the aim of arriving at a mutually satisfactory arrangement. If an agreement cannot be reached, the client may request a procedure called an arbitration of accounts in which an independent arbitrator will decide the amount of the fees.
  • If the complaint concerns another subject such as the professional conduct of a psychologist, his/her competence or his/her respect of confidentiality, the syndic may, after his/her investigation, lodge a complaint with the Order's Disciplinary Committee, which will render a decision with regard to the complaint and, if appropriate, invoke sanctions against the psychologist as provided by law.

  As the Order's syndic cannot handle complaints involving therapists who are not psychologists, it is very important to make sure that the person you have consulted or wish to consult is in fact a psychologist licensed with the Ordre des Psychologues du Québec. This is the best way to guarantee that your rights are protected.

Source: www.ordrepsy.qc.ca