Creative Transitions Psychotherapy - Blog

Would You Have a Relationship with a Robot? AI isn’t Therapy

Sat, 09 May 2026 19:48:48 GMT

Shirley Katz, Ph.D., RP, CCC, Clinic Director

Use of AI is rapidly growing and working its way into conversations about mental health. Clients often tell us they use chatbots to support their work in therapy or compare it to their therapy. At our practice, we do not use AI to generate ideas or treatment suggestions. Some therapists may use it with client permission to write their notes, but only a confidential, legally compliant health related system. Most of us prefer to use the writing process to reflect on our therapeutic relationship, goals and progress and to make plans for follow up sessions. This also consolidates memory. Its how we spend more time processing a case even when we are not client facing. Overall, we discourage the use of AI tools to substitute or compare psychotherapy experience. This is not based on fear of technology but more so about ethics, regulatory responsibility and what the science actually shows about the topic. There are good reasons.
Psychotherapy is a regulated health profession, not a wellness or self-help tool like a workbook. Therapy is relational and interactive. It is also controlled by the College of Registered Psychotherapists of Ontario (CRPO) and also has standards related to client safety, informed consent, confidentiality and privacy, competence, scope of practice and limits, crisis and risk assessment and intervention, accountability and professional liability. AI systems are not regulated professionals. These systems cannot hold licensure, be held accountable for competency, or be disciplined for ethical or privacy breaches. They are not human and do not offer attuned health attachment-based experiences. Therapeutic relationships are the cornerstone of mental health treatment.
Research on the topic has shown that when AI systems take on therapist‑type roles, they operate outside existing health‑care regulation demonstrating serious gaps in protection for clients. Studies further found that even when AI was asked to follow evidence-based models it violated core ethical standards showing problems with boundaries, inappropriate reassurance and failures in handling potential risk or crisis. Licensed clinicians are required to practice in ways that protect the public. Offering or endorsing tools that have known ethical problems does not meet that obligation. Therapists at our clinic would likely ask clients to refrain in using these tools.
Another issue that comes up with the use of AI actually pre-dates it. Historically, there has always been concern about clients seeking therapy from multiple, non coordinated sources. This emerged from an ethical principle called nonmaleficence (do no harm) and supported by ethics of fidelity, integrity and responsibility. When client care is uncoordinated, they can get conflicting input leading to potential confusion or overwhelm which can undermine the effectiveness of treatment. At the very least, if clients are seeking input from AI they should be discussing how it is impacting them and ensure that it is coordinated information, which supports reflection or skills practice in line with the treatment goals of therapy and not harmful, confusing or contradictory.
It is essential to remember that AI systems do not do well at identifying and managing risk. Crisis care requires human accountability and judgement. AI is inconsistent and unreliable in this regard and does not escalate proper supports. Conversely, a trained therapist knows how to assess risk over time, due to the emphasis on alliance and an ongoing therapy relationship, noting any subtle shifts or incongruence for example. They are obligated to respond and accountable if harm occurs and was mismanaged. For example, therapists have a duty‑to‑warn when there is impending harm, a duty‑to‑protect, a duty to report. Emergency response protocols are not optional.
Therapy happens by a real human relationship that requires tuning in, building rapport, assessment, repair of rapport if there has been a rift, reflection on that relationship strength, embodied presence over time, genuineness, etc. It’s a central mechanism of change. Most clients have experienced their hurts in the context of relationships, and healing and relearning happens in the context of a human relationship. The relationship is central to the treatment in all modes of therapy. This is evidence based. Conversely, research has demonstrated that AI’s empathy is not relational, it’s performance. Clients can feel comforted in the moment or reassured, while being misunderstood or misguided in meaningful ways that impact how they cope or respond in human circumstances. This can further create a problem if people do not access real care or if they have trauma, as they can mistake an AI response as a replacement for real human relational witnessing and safety.
Further problems include how these systems are based on data generated by humans and reflect bias, such as demonstrating greater stigma towards certain diagnoses. For clients who are marginalized this can be harmful. In regulated practice ethics emphasize justice, equity, inclusion and cultural safety.
Overall, the evidence base for the utility of AI in mental health is very limited and large, peer reviewed studies conclude that it is not supported as a replacement or adjust for professional, human relationship-based therapy. It is also not confidential. AI systems do not meet Canadian consent and privacy standards for mental health data use and storage.
Our position on AI is that it may have some use in administrative support when used cautiously and with human oversight. Psychotherapy is human, relational, ethical and regulated. AI systems currently do not offer that.   Choose therapy not AI. Human healing happens in a relationship with all its potential imperfections. Change that happens in such relationships reflects what it is to be human. If you want to discuss how your use of AI may fit into your mental health plan or progress please ask your therapist. You are not a robot, and neither are we.

Building Self Esteem Through Connection and Community

Sat, 25 Apr 2026 18:54:24 GMT

By Shirley Katz, Ph.D., RP, CCC
There is a well known connection between self-esteem and mental health. Some early Psychologists saw it as moderated by our connections to things outside of ourselves, a sense of belonging. Alfred Adler (1958) viewed people as having a natural propensity towards growth and creativity. He believed that all people have a need to belong and find meaning through contributing to society. From an Adlerian perspective, human development is guided by an inherent striving to do one’s best and to become healthiest and happy (Watts, 2013). Adler (1958) also believed that feelings of inferiority, though painful, can motivate a person towards betterment.
Adler (1958) saw people as having certain lifestyles based on their sense of inferiority or superiority in relation to others. These lifestyles can be seen as a kind of behavioral interaction pattern used to overcome difficult emotions. Some people become dominant and try to control others, or getting things from them, others avoid social interaction to reduce vulnerability, white some become socially useful to be valued to society and others. A lifestyle orientation focused on getting things from others is the most common pattern, though being socially inclined is most beneficial to society (Schultz & Schultz, 2013). Notably, being socially useful through empathy and community involvement is related to individual mental health, benefitting the self as well as others, enhancing a person’s life satisfaction and wellbeing (Leak & Leak, 2006).
Central to Adler’s theory is the importance of social connection and community. He saw people as social by nature, needing to be a part of something larger than themselves. Research supports this view. In a large and recent study, there was strong evidence for the interactive relationship between self esteem and social relationships (Harris and Orth, 2019). People suffer from low self worth when they do not feel a part of something or struggle to make connections - but then feeling a sense of low self worth, people may not make efforts to connect or contribute. This cycle gets people stuck and suffering.Some people over-compensate for feelings of low worth by people-pleasing, reassurance seeking or “approval dependence” which can lead to lower self esteem (Saruhan & Çınar, 2022). People with low self worth may keep connections or contributions that are not growth oriented, or not serving them, out of fear of rejection or isolation. They may invest time and energy that does not align with their own needs or values.
So how does one connect to the community and make valuable contributions towards a sense of belonging, without over doing it? Since belonging is a well-known social need (Leary and Baumeister, 2000), we all need to make connections and starting out is not always easy. It is important to start small and in alignment with one’s true self. Further to this, a history of focusing on monitoring and fulfilling other people’s needs in order to seek approval may be related to not having a clear sense of self. Therapy can help identify and strengthen a sense of self through exploration of traits, personality and values.
With or without therapy, the first step prior to choosing groups, activities or causes to take up, is to develop a stronger sense of self with identification of your values and interests. What is most important to you? What would you be willing to put time and effort into? Why? Once you know your values it is easier to choose activities that align with them.
Next, ensure the activity is truly in line with your sense of self and not just something that will offer approval or acceptance. Ask yourself if you are doing something because it is fulfilling and aligned with your values, or because it leads to external validation. You may create connections that do not fulfill you at all. If someone’s sense of self is not well developed because of a history of people pleasing or approval seeking, this can also be a bit of a process – differentiating what is in alignment with the true self versus validation seeking.
When involved in a new group, community or activity, it is important to monitor the reciprocity and balance and set boundaries. Is the activity also providing support and connection or is it one sided giving? If it drains you, it is not fulfilling your needs. Take a pause and re-evaluate. Set limits and only offer the amount of time, energy and commitment that you can or want to share. It is important to contribute to something that grows in value or supports your growth.
Finally, respect your own contributions. Self esteem sometimes grows by also treating yourself like your time, energy and commitment is valuable. Self compassion is key. It contributes and offers benefits beyond self esteem (Neff, 2023) fostering resilience and emotional stability. Self compassion is about being supportive towards the self when going through difficulties. It can involve the gentle self talk that one might offer a friend. It can be considered a way to connect with the self.
In sum, compassionate connection with oneself and identification of values and interests, followed by time and effort spent on making connections and contributions in the community that align with these interests and values – is the best way to feel a stronger sense of self worth and to develop strength and stability. If someone has a history of betrayal of themselves and a pattern of people pleasing, a therapist can help to strengthen the sense of self and teach assertiveness and boundaries so choices align with better mental health and life satisfaction.

Adler, A. (1958). What life should mean to you. New York, NY: Capricorn Books. (Original work published 1931)
Harris, M. A., & Orth, U. (2019, September 26). The Link Between Self-Esteem and Social Relationships: A Meta-Analysis of Longitudinal Studies. Journal of Personality and Social Psychology. Advance online publication. http://dx.doi.org/10.1037/pspp0000265
Leak, G. K., & Leak, K. S. (2006). The relationship of social interest and self-actualization: A canonical analysis. Journal of Individual Psychology, 62(2), 136–145.

Leary, M. R., & Baumeister, R. F. (2000). The need to belong: Desire for interpersonal attachments as a fundamental human motivation. Psychological Bulletin, 117(3), 497–529.
Neff, K. D. (2023). Self-compassion: Theory, method, research, and intervention. Annual Review of Psychology, 74, 193–218. https://doi.org/10.1146/annurev-psych-032420-031047
Saruhan, N., & Çınar, M. (2022). The relationship between self-esteem and approval dependence: The mediating role of interaction anxiety and self-insight. Current Psychology, 41(10), 7318–7328. https://doi.org/10.1007/s12144-020-01268-1
Schultz, D. P., & Schultz, S. E. (2013). Theories of Personality (10th ed.). Belmont, CA: Wadsworth Cengage Learning.
Watts, R. E. (2013). Adlerian counseling. In R. E. Watts (Ed.), The Handbook of Educational Theories (pp. 459–472). Information Age Publishing

Self-Reflection in Supervision: Why it Matters

Mon, 05 Jan 2026 23:31:43 GMT

Self-Reflection in Supervision: Why it Matters

by Shirley Katz, Ph.D., RP, CCC (Clinical Supervisor)

Reflection is not just a buzzword. It is a well-known essential pedagogy in many fields, recognized as an effective way to deepen learning (Fernández‐Balboa, 1998). It is common in experiential learning, which is effective in skills development overall (Veine, et al., 2020). Self-reflection is crucial in developing new clinical skills (e.g. Cooper & Weickowski, 2017; Knapp et al. 2017; Prasko et al. 2012) and in ongoing development and effective practice (de Stefano, Overington and Bradley, 2014, Rodolfa et al. 2005).

What is Self-Reflection?
Effective reflection is a learned skill that is not always taught in schools or practiced regularly. Many are unfamiliar with how to integrate it and make it effective. Therapists and their supervisors may benefit from guidance to help make their interaction and learning more meaningful, and for Supervision to be more than just venting and direction.

Self-reflection has been described as the capacity to inspect one’s ongoing experience to develop professional knowledge, solving problems by thinking while doing (Schön, 1983). In therapy, it is about developing awareness and insight into one’s own patterns to practice safely within the therapy relationship. Prasco et. al., (2023) describe it as an analytical process of deep examination of a therapist’s own thoughts, biases, past experiences or feelings aimed at understanding how these may influence their practice.

Benefits of Enhanced Self-Reflection
The College of Registered Psychotherapists of Ontario (CRPO) recognizes self reflection as an essential competency towards entering the field and necessary for quality assurance in ongoing professional development, especially regarding the Safe and Effective Use of Self (SEUS).

In training therapists who used effective self reflection enhanced therapy outcomes,
making more effective and ethical decisions and were able to differentiate their own needs from client’s needs (Prasco, et.al., 2023). It further helps to bridge theory into practice, particularly if it is purposeful and directed. In a recent review of the literature on self-reflection Aprilia, et al., (2024) found that this activity was linked to enhanced empathy, better management of countertransference, stronger integration of theory to practice and more ethical behavior as well as fostering personal and professional growth.

Effective self-reflection is an important tool in clinical supervision particularly in Constructivist models of Supervision, which encourage and empower supervisees to find their own answers rather than following their supervisor’s approach (Guiffrida, 2015). Supervisors who support self-reflection arguably strengthen their therapists’ capacity to model it to their clients, who in turn could grow in their own self awareness. Using reflection models, a supervisor can help a therapists explore and develop.

Reflection Frameworks

Aprilia et al., (2024) argue that self-reflection should be a supported continuous process in the development of therapy skills. They suggest that supervisors use structured exercises to enhance competency.

Here are two reflection frameworks that are great for developing reflective skills. One common one is called the What? So What? Now What? model (Borton, 1970)

What? Asks the learner or, in this case, the therapist to describe the nature of their experience, their role, observations and reactions. The supervisor might cue the therapist to think about what happened, what they thought, felt, or expected, and what they learned about themselves or the client.

So What? Explains the significance or the relevance of the experience and interpretations. The supervisor may ask what it is that makes the issue or incident matter or stick out to the therapist, or, what might be the meaning, result or consequence of the issue. The supervisee may be asked to think about connections to their theory or practice, or their overall development and learning goals.

Now What? Here, one would explore the impact of the experience, and the interpretations made may have on future actions and thinking. A Supervisor might ask the therapist to think about what they are planning to do because of the discussion or experience discussed. How might they approach the client or similar situations differently, or how they want to apply what came up in supervision and what they learned overall.

Another helpful model for reflection is called the ICE model, developed by Fostaty, Young and Wilson (2020) for students. It can easily be adapted for supervision. It stands for Ideas, Connection and Extensions. These stages are inter-connected and recursive, not linear.

Ideas. In this part, learners identify basic facts like what happened, what processes were involved, what skills were needed and what questions emerged. Supervisees can be prompted to describe basic but important factors in a case, and to formulate a question for supervision-based learning.

Connections. In the Connections part of the model, learners might be cued to think about tying in prior learning to current experience. In Supervision, a therapist can be prompted to tie the question to their own working theory, or to themes in their professional development goals, for example.

Extensions. At this higher level, learners hypothesize, extrapolate, apply knowledge to new contexts, and understand implications. In therapy this might be represented by being able to effectively bridge theory, reflection or supervision-based learning into practice.

Overall Benefits of Reflection in Supervision
Overall, integrating self-reflection into Clinical Supervision is important. It makes learning deeper and more meaningful. It can also optimize therapy for clients as the therapist becomes more aware. A supervisor should emphasize the importance of these self-reflection skills and set an example by using reflection in Supervision as this activity differentiates "great therapists" from "average therapists" (Prasko, 2021). Safe and effective use of self depends on strong self-reflective skills which can and should be practiced in supervision.

Sources
Aprilia, N., Ramadhin, N., Wulandari, T., & Asbi, A. (2024). Self-awareness and self-reflection on the counselor’s personal development. Journal of Psychology, Counseling and Education, 2(2), 154–161. https://doi.org/10.58355/psy.v2i2.38

Borton, T. (1970). Reach, Touch and Teach. London: Hutchinson

Cooper, L. D., & Wieckowski, A. T. (2017). A structured approach to reflective practice training in a clinical practicum. Training and Education in Professional Psychology, 11(4), 252–259. https://doi.org/10.1037/tep0000170

Fernández‐Balboa, J. (1998). The Practice of Critical Pedagogy: Critical Self‐Reflection as Praxis. Teaching Education, 9(2), 47–53. https://doi.org/10.1080/10476210.1998.10335494

Fostaty Young, S., & Wilson, R. J. (2000). Assessment and Learning: The ICE Approach. Winnipeg, MB: Portage & Main Press

De Stefano, J., Overington, L., & Bradley, S. (2014). Developing Repertoire: A Qualitative Study of Trainees’ Self-Reflection on Clinical Practice. Canadian Journal of Counselling and Psychotherapy, 48(4). Retrieved from https://jmss.org/index.php/rcc/article/view/60969

Guiffrida, D. (2015). A Constructive Approach to Counseling and Psychotherapy Supervision. Journal of Constructivist Psychology, 28(1), 40–52. https://doi.org/10.1080/10720537.2014.922911

Knapp, S., Gottlieb, M. C., & Handelsman, M. M. (2017). Enhancing professionalism through self-reflection. Professional Psychology, Research and Practice, 48(3), 167–174. https://doi.org/10.1037/pro0000135

Prasko, J., Mozny, P., Novotny, M., Slepecky, M., & Vyskocilova, J. (2012). Self-reflection in cognitive behavioural therapy and supervision. Biomedical Papers of the Medical Faculty of the University Palacky, Olomouc, Czechoslovakia, 156(4), 377–384. https://doi.org/10.5507/bp.2012.027

Prasko, Jan & Abeltina, Marija & Vanek, Jakub & Dicevicius, Darius & Ociskova, Marie & Krone, Ilona & Kantor, Krystof & Burkauskas, Julius & Juskiene, Alicja & Slepecky, Milos & Bagdonaviciene, Lina. (2021). How to use self-reflection in cognitive behavioral supervision. Activitas Nervosa Superior Rediviva. 63. 68-83.

Prasko J, Ociskova M, Abeltina M, Krone I, Kantor K, Vanek J, Slepecky M, Minarikova K, Mozny P, Piliarova M, Bite I. (2023). The importance of self-experience and self-reflection in training of cognitive behavioral therapy. Neuro Endocrinol Lett., Jun 14; 44(3), 52-163. PMID: 37392442.

Rodolfa, E., Bent, R., Eisman, E., Nelson, P., Rehm, L., & Ritchie, P. (2005). A cube model for competency development: Implications for psychology educators and regulators. Professional Psychology, Research and Practice, 36(4), 347–354. https://doi.org/10.1037/0735-7028.36.4.347

Schön, Donald A. The Reflective Practitioner: How Professionals Think in Action. New York: Basic Books, 1983

Veine, S., Anderson, M. K., Andersen, N. H., Espenes, T. C., Søyland, T. B., Wallin, P., & Reams, J. (2020). Reflection as a core student learning activity in higher education - Insights from nearly two decades of academic development. International Journal for Academic Development, 25(2), 147–161. https://doi.org/10.1080/1360144X.2019.1659797

Slow is Safe: The Liberating Power of Slowing Down and Noticing in Therapy by Maria Ahmed, RP

Fri, 02 Jan 2026 23:20:12 GMT

Why Slowing Down Matters in Trauma-Informed Therapy
In trauma-informed therapy, real progress often begins not by doing more, but by slowing down enough to listen and notice—especially to the wisdom of the body and emotions. These signals may have been ignored for years in the name of survival.
In a fast-paced world, healing requires slowing down. The usual pressure to be productive, fix things, and hurry is about survival, not recovery. That’s why therapy can feel unfamiliar, even frustrating. It may feel like two steps forward, one step back—and that’s okay.

Why Slowing Down Feels Uncomfortable
When clients are invited to check in with their bodies, common reactions include:

“Why can’t I feel anything?”
“I should be able to name my emotions.”
“Why is this so hard?”

Behind these judgments is a protective part of the self, trying to avoid discomfort or push feelings away. These instincts aren’t failures; they’re survival strategies.

Honoring Protective Parts with Internal Family Systems (IFS)
One approach we use is Internal Family Systems (IFS) therapy, which teaches us to recognize and honor these protective parts. Instead of ignoring or running away, we notice and acknowledge them with gratitude. Slowing down and feeling might not have been safe in the past—therapy creates new experiences where we respond to the present, not react to old wounds.

For Trauma Survivors: Safety First
For those with trauma histories, being present in the body can feel scary. The body may have been a place of tension, betrayal, or pain. So we go slowly, using trauma-informed protocols that build safety and trust. Noticing sensations—tightness in the chest, a lump in the throat—can stir up old patterns. Our goal is to grow capacity for awareness and acceptance, consciously and collaboratively.

Somatic Awareness: Listening to the Body
We often use gentle, guided noticing called Somatic Awareness, asking:

Where is your breath right now?
Is there an area that feels more activated or more at ease?
What words describe the sensation—tight, pulsing, dull, warm?

Instead of analyzing, we listen and accept. We heal the relationship between sensations and thoughts by letting go of the need to fix or run away.

Building Emotional Vocabulary
Sometimes we use metaphors:
Does it feel like a storm? A cage? A whisper?
Curiosity replaces criticism, helping rewire old survival-based patterns.

The Quiet Signs of Progress
Progress isn’t always dramatic. It might look like:

A deeper breath
A softened jaw
Tears that finally come
Laughter that breaks tension
The realization:
“I’m allowed to feel this.”
“I don’t have to rush through my pain.”
“My body feels like mine again.”

Clients move from confusion to clarity, from self-judgment to self-compassion. Emotions become manageable signals, not overwhelming storms. Peace, joy, and wholeness emerge.

The Bottom Line - Therapy is not a race.
It’s a return to the truth of the body—our nature and capacity to be whole and held.
And it begins by slowing down.

Is Therapy Helpful? Why? How?

Thu, 01 Jan 2026 21:52:32 GMT

Understanding Theories

Psychotherapy is about helping people grow and change. When clients come for help, therapists gather information and make decisions about how to intervene or proceed to best helping clients to make the changes they seek by using theories to organize and simplify the information clients share. A therapists’ theory is a kind of map and includes knowledge of human development. The theory leads to the type of techniques and tools a therapist may use, though some draw from other theories when it fits. A theory should fit with the way a therapist views mental health, but also fit the client issue and personality, as well as their resources. Overall, the theory is not as important as a good fit with the therapist.

Is Therapy Effective?

Research consistently suggests the effectiveness of therapy with between 75% and 80% of clients benefitting after 10 to 20 sessions, with lasting benefits.
What makes therapy effective? Outcomes depend largely on how effective the therapist is using what is called “Common Factors”. That is, factors common to all therapeutic approaches. It is about their ability to develop a good therapeutic alliance, with real and genuine empathy, as well as both the clients’ and the therapist’s positive expectations for change, and the hope that clients experience at the beginning of therapy. Clients need to feel heard, understood, accepted and hopeful for therapy to be effective.

Clients themselves actually attribute 40% of the change they experience in therapy to external factors such as their own resources or supports and opportunities. About 30% of outcomes are tied to the therapist–client relationship, and only 15% to techniques.
Though differences in positive outcomes of therapy from different theoretical approaches are not strong, the approach still should fit a clients’ needs. The therapeutic alliance is of great importance but the tools they use may be in part responsible for the development of the therapeutic alliance. The therapist’s confidence and competence in their method influences their ability to create hope and positive expectations. These factors are inter-related. Overall, the methods should be a good fit for the therapist and the client.

Common Factors

A common set of variables are important, regardless of the differences in approach.
Some of the factors that are important towards effective therapy outcomes are:

A therapy relationship of trust, genuine compassion, emotional safety, positive regard for the client, support for autonomy, empowerment, spirit of collaboration.
A shared understanding of the nature of the problem or concerns.
Clear goals and therapy plans.
An understanding of what interventions are being used and how they will help a person make progress on their goals.
A belief in clients’ ability to create change/positive expectations.
Understanding of client motivation and resources or challenges.
Client willingness and readiness to do the work needed.
Openness to feedback.

Effective Therapists

The quality of the therapy relationship is the most important aspect of the therapy process. A therapist should be friendly, patient, warm and genuine. They should be able to make appropriate and helpful self disclosures not sharing distracting stories because of over-relating. They should be encouraging, honest, and flexible with respect for differences without losing sight of what they believe to be healthy, based on in-depth knowledge of human development and wellbeing. They should be ethical, objective and fair with good communication skills that demonstrate enthusiasm and hope. Good therapists are self aware, up to date on relevant issues and research, dedicated to life-long learning, aware of their own limitations and open to feedback from clients.

How to Get Started

Sometimes clients are unclear about their goals. That is ok. It can take time to feel safe, heard and understood about what feels “wrong” and what the problems really are, before deciding what change would look like. Still, it is important to collaborate and come up with somewhat measurable goals in order to be able to track if therapy is helping. It is important to feel safe to ask questions and to give feedback to the therapist about client experience. Therapists are usually very well intentioned but not always effective at judging if the rapport is intact, or when there has been a rupture. Clients can feel just a little bit less understood one day and not return to therapy. At our clinic we value feedback and understand the importance of effective alliance building skills. Our therapists possess the personal qualities that make for effective therapy. We make it our ethical obligation to try to fit the client to the therapist and prefer to refer to another practice if we cannot meet the needs of a client rather than keeping them with us. Feel free to reach out by email, clicking here for a consultation about which therapist could best fit your needs.

Coping with Food and Body Image

Thu, 01 Jan 2026 19:31:36 GMT

Clients with eating and body image concerns come to therapy after years of suffering in silence, and some after years of ineffective interventions. Our Clinic Director has had success in this area in part from research and personal experience suffering, extensive reading on this subject and have an approach that is personal, direct, honest and integrative. It is often different than what they are used to.

Shirley Katz, Ph.D., RP, our Clinic Director has written about her beliefs on this topic and supervises therapists who work in this area. She believes that any compulsive behavior, defined as that which is repetitive, unhealthy, unwanted, mindless - is avoidance of Self which is made up and informed by emotion. Most have learned for some reason or another that there was no room for the emotions. Trauma, childhood neglect or abuse, growing up with someone whose emotions were out of control - these are just some of the reasons people learn to sweep their feelings and opinions under the rug. People learn overt and not-so-conscious ways of controlling themselves and interpersonal relationships only to find that painful patterns keep coming back and they are out of control of their harmful behaviors despite so much effort.

Without addressing underlying social learning about emotion, teaching new ways of coping with feelings, and changing the way people think about themselves and others, there can be no real healing from eating disorders. Whether it is body hate, counting calories, denying the self nutrition - its all the same. These obsessions take us away from healthy relationships with our Selves, with food, with out bodies and with others. The therapists in our clinic work with this model, including Audette, Chantel and Carolina.

Therapy for eating disorders tends to be a bit difficult and long term. It takes more time to feel understood and to be understood when emotions and vulnerability are repressed. Out therapists understand the difficulty for our eating disorders clients to feel vulnerable, to trust and allow their feelings to emerge. They work patiently to build the therapeutic relationship and help clients feel respected, heard and understood so they can feel safe to explore and make valuable changes. This sometimes goes along with the process of learning to trust one's self and effectively manage emotional experiences.

Audette is a Registered Social Worker therapist who is also a Registered Nurse with training and special interests in this area of work. Chantel also has special interests and training in working with this issue. She was a varsity athlete and understands how the role of competitive career areas interact with this issue. Carolina has experience in working with Eating Disorders including a past role as a hospital based Psychologist in Brasil.

How Does Therapy Help with Relationships?

Thu, 01 Jan 2026 19:16:23 GMT

What shapes who we are and brings meaning and purpose to our lives if not our relationships? Many times the way we relate to other adults has roots in the way we were treated as children. Our personalities and experience in life also shapes how we interact in relationships. Do we trust others? Do we feel love worthy? Are we too needy of reassurance or hyper independent?

Significant experiences in different stages of life can have a huge impact on how we function in future relationships. Trauma can make it hard to feel seen, heard and supported in a relationship or to ask for what we need. Sometimes what we need is too complex and difficult or even triggering for a partner and therapy is needed either individually, in couples' counselling or both.

What is relationship wellbeing? While there are some evidence based factors that help contribute to a healthy relationship, each person has to determine for themselves how satisfied they are. What is the meaning of the relationship you are in? What is its purpose? Does it nurture and nourish those who are committed to enhancing it? Are those who are committed to one another committed to nurturing the relationship in an equal manner? Or do you have to alter who you are and hide your feelings and needs to be accepted? Does your need to feel secure make you act in ways that interfere with your needs or your partners' comfort? Are there relationships in your life that you want to change or let go of, or struggle to hold on to? Therapy can help you and/or the other person work through those questions and function in ways that feel more helpful or meaningful and to change unhelpful pattern of thinking or reacting. Therapy can also help you understand why or how you may attract a type of person that does not enhance your wellbeing.

Wherever you are at with significant people in your life, therapy can help you hear and speak to one another through a new lens or make choices for yourself that are more in line with your own wellbeing. Our approach draws from attachment theory, emotional focused therapy and other neurobiology informed methods. Some of us have special training in Attachment related issues and a few of us are specially trained to work with couples and families.

Shirley is the Clinic Director and has training and experience working with relationships from her Doctoral program at UBC and experience working in the past as a Psychologist for the Ministry of Children and Families in BC. She consults, supervises and mentors therapists who want to work in the area of relationships as many Masters' level therapists do not have formal training in working with couples and families. Several of the associates in this practice trained under her and we are happy to provide potential clients with information about their training and background to help determine fit and suitability. Most counsellors and therapists abide by ethical codes that include something called "Limits to Competency" in that they will not take on client issues that they do not have the training to support. Unfortunately some will accept clients they have not the background to help effectively. Please ask questions about training and experience before making a decision. You do not invest money and energy in therapy to be discouraged.

Shirley Katz, PhD., RP, our Clinic Director wrote a few articles for Marriage.com. Note that there are internal links to courses that were not part of the original articles and that the external site may include those without the author's permission.

Feel free to read: https://www.marriage.com/experts/shirley-katz

If you want to be matched with a clinician who works with couples or family members together, please contact us by email through this link.

Therapy for Depression

Thu, 01 Jan 2026 19:07:16 GMT

Many people suffer from sadness, loneliness and grief or normal fluctuations in mood due to events in life or even their physiology. Without sadness when we experience lack, or loss, we would have no attachments, no motivation to seek out betterment. Grief and loss, loneliness and frustration need to be heard and supported. This does not always require therapy.

Depression is not sadness. It’s a mood state that sometimes plagues a person like a dark cloud and often is marked by a state of apathy and a loss of interest in things that used to make a person happy.

There is often a negative outlook on things that impacts choices and behavior. It can impact sleep, appetite, bonding, motivation, focus, and more. The very things that make a person feel alive and well tend to feel like too much of a burden to engage in and sometimes others are pushed away or stay away because they do not know how to be helpful, making depression potentially more severe. Poor physical health can worsen depressed mood, and depressed mood can worsen physical health.

Therapy that takes a mind-body approach to depression is imperative. Empathy and support together with gentle behavioral activation, is helpful to bring back enough vitality to help a person work to enhance their own mood and wellbeing. Pacing is important. Enhancement of motivation needs to happen in the context of understanding the whole person, not their depression. People who struggle for a long time with depression tend to forget their true self and over identify with their depression.

Our Psychotherapists are trained in Cognitive Behavioral Therapy and Acceptance Based Therapies like ACT and Mindfulness to treat depressions. Some of us have special skills in understanding how medication can interact with therapy and how fitness or time in nature can help.

Most of us also understand how to draw from Self Psychology – enhancement of sense of self and self worth. Choose a therapist you feel can understand and connect with who you are as a person, but who also knows how to help you change your thoughts and behaviors in a respectful manner towards a more positive life. Make sure you are addressing mind-body wellness with attention to potential health factors that might relate to low mood and/or poor self care. Please ask us to match you with a therapist that helps with Depression, Low Mood or Grief by emailing us here.

Gender Non-Conformity

Thu, 01 Jan 2026 18:55:07 GMT

Most people addressing gender issues for the first time in therapy have kept it buried for so long...they feel shame and fear to disclose. A good therapy alliance is essential.

We are fully aware of how important the therapy relationship is. Trust that we are not judging and will make you as comfortable talking as you let us, and relief will come in addressing things you may have hidden from even your self.

Clients dealing with gender issues may be in various places in their journey of self understanding, self acceptance, and potentially transition. There may be self esteem related issues, interpersonal or family history issues, lack of acceptance or self acceptance and sometimes a people pleasing problem.

We have supported many clients in varying stages of awareness, identification and coming out as well as transitioning. We are aware of the research on this issue and am partial to the notion that being able to live as much as possible as who you genuinely are, finding acceptance and support for this Self- is the holy grail of well being.

Happiness is a fleeting emotion. Satisfaction with life, dignity, and self-worth cannot be denied. Finding and expressing your truth is important as are healthy relationships that are reciprocal and adaptive with appropriate boundaries.

We are also available to help friends and family who are learning how to support someone who is coming out or transitioning. When relationships are problematic, we work with clients to learn how to assert healthy boundaries.

Clients experiencing gender dysphoria or going through transition often need support that is not standard Psychotherapy but may be related to wellbeing.

We maintain a small referral and support net of helping professionals, and keep up to date on services available that are relevant and can be helpful. If letters are required, we can often write them, collaboratively, when suitable.

There are a few therapists at the clinic with a background in helping with gender issues. Please email and ask to be directed by clicking here.

Treatment for Anxiety and PTSD

Thu, 01 Jan 2026 18:49:11 GMT

Did you know anxiety is considered to be one of the most treatable conditions in therapy?

Many clients present with concerns about anxiety. Each person is unique and there are many ways anxiety can be experienced and expressed, ranging from mild stress responses in adjusting to new or difficult circumstances to extreme physiological patterned responses to earlier trauma(s).

We take a trauma informed approach, assessing the nature of the concern thoroughly before making a therapy plan with you. We are trained to understand how thoughts, emotion, physiology and neurobiology, and environment or systems interact to create issues people bring to therapy.  Maria, Chantel and Carolina work with trauma from different methods but with gentle and caring awareness.

When anxiety is present there is some focus on a cognitive behavioral intervention to help alleviate distress, teach new coping responses to stress however we also pay attention to systemic or environmental issues, historic experiences and lifestyle variables that may be part of the problem or challenge a persons' efforts to change. Victoria takes a Cognitive Behavioral approach to reduce symptoms.  Chantel is trained in Yoga and Relaxation and also works on new coping to manage symptoms.  Maria is trauma trained and may use many methods including skill from DBT to help reduce symptoms.  Elissa might help understand how to be more assertive and self aware to identify and deal with interpersonal triggers. Audette may take a look at past learning, triggers and new ways of coping.  Ella might explore the early roots of distress and help a client heal through the relationship with the therapist. Carolina, who worked in hospital settings as a Psychologist in Brasil, does a thorough assessment and may work with other professionals on your care team if needed, using herself both a CBT approach and integrating expressive therapies if helpful. The method is not as important as feeling that the therapist is a good fit - please reach out to the Clinic Director to be matched.

A common form of anxiety that causes a lot of distress is Obsessional Anxiety. Being obsessional can be a factor of personality, a response to traumatic events, or a diagnosable anxiety condition.  Being obsessional and hypervigilant can also be a symptom of trauma. A good therapist can do a thorough intake and help a person determine this. Depending on the history/source and nature of the problem, treatment also varies. When there is a genetic predisposition to diagnosable OCD people can often recall that their parent did a lot of what is called “checking behavior”.  While it may not have interfered directly with their lives, they may have been plagued with constant worry that led them to check and re-check things like locks, bank accounts, cleanliness, etc.

The checking behavior provides some kind of short term relief of the fear but research shows that it also creates long term pain, in creating more and more obsessions and fears.  Sometimes avoidance is used to not feeling the anxiety, rather than washing or checking for example. When there is a genetic predisposition, sometimes medication can help along side therapy. This is well known in the mental health field.

If trauma triggers OCD type symptoms, then trauma needs to be delicately addressed before working on the symptoms that may be in place to cope with unbearable feelings.

Choose a therapist that you feel can really understand you when you are dealing with these kinds of repetitive thoughts, feelings and behaviors. A few of our therapists can provide CBT or ACT to help, and one of our therapists Audette is also a nurse, well trained in a hospital setting with a good understanding of the impact and interaction of medication and therapy. Please ask. Email us by clicking here for an intake.