Your first scheduled session will serve as an intake session, during which we will delve into your
background and life experiences. This session plays a crucial role in establishing the therapeutic
relationship, which is fundamental to the success of therapy. Together we will set individual
goals for therapy, which will serve as the foundation for your ongoing sessions.
The scheduling of sessions is designed to accommodate your pace and availability, ensuring that
they are tailored to meet your specific needs and goals.

Try a few sessions and provide feedback.

Try a few sessions before deciding if it is working. Change does not occur with one session.
If therapy isn’t working, let the therapist know so different techniques may be implemented
during sessions. Research shows that therapy improves when feedback is provided.

Individual therapy sessions range between $175 to $225 per 60- to 90-minute session.

Couples and family therapy sessions range between $185 to $225 per 60-minute session.

Private psychotherapy services are covered by most extended health insurance, workers
compensation, or auto insurance companies. Most insurance companies cover the cost of therapy
sessions provided by Registered Social Workers. Please connect with your insurance company to
discuss your coverage limitations, if any. It is your responsibility to verify coverage for the
service provided and it is your responsibility to submit your paid receipt to your insurer to obtain
reimbursement.

Fees must be paid before each session regardless of insurance coverage.

If you are asking an insurance company to pay for psychotherapy or other benefits – your
insurance company may ask for a copy of your health records or ask for verification of services
provided. Your insurer reserves the right to examine documents related to any claim to
administer eligible benefits and services.

HARM – If your therapist has reason to believe you are in danger of harming yourself or that
you may harm another person, your therapist may contact your listed emergency contact,
emergency services, or the police, and attempt to warn that other person of your intentions.

CHILDREN AND THE ELDERLY – If your therapist has reason to believe a) a minor (under
age 18) needs protection due to neglect, physical, sexual, or emotional abuse caused by
yourself or another person, your therapist must inform Children’s Aid Society (CAS); or b) an
elderly person has, is, or may be in danger of neglect or abuse, your therapist will contact
emergency services or the police.

LEGAL AND PROFESSIONAL – Your therapist must comply with court orders for records.
Your therapist has a duty to report when a regulated health professional has sexually abused a
patient. Your therapist will consult with a supervisor or colleague when required for training
and to improve treatment, and your therapist will comply with any regulatory requirement for a
practice audit.

We have all felt sad or blue, and said something like, “I feel depressed!” Does that mean you are
clinically depressed?

It is normal to feel sad or low, sometimes. Feeling down is within the normal range of human
emotions. During the course of a day, your mood can shift in intensity activation
(alarmed/astonished) to deactivation (fatigued/tired); and can shift from pleasant
(happy/contented) to unpleasant (distressed/sad). Being in a deactivated and unpleasant mood
state does not necessarily qualify as “depression.” However, depression may be present when
you stay stuck in this low deactivated unpleasant state. Someone struggling with depression is
stuck not just for a few minutes or an hour or two, but is stuck in this mood state for most of day
almost everyday, for weeks at a time, being unable to shake it, and being unable to return to the
usual range of human emotions, and thus creating problems in relationships, school, and/or work.

• feeling useless, hopeless, or excessive guilt
• being irritable and/or struggling with persistent sadness
• loss of interest or pleasure/withdrawal from activities/people, and resulting loneliness
• changes in appetite and weight
• lack of sleep or excessive sleep and fatigue
• feeling slow or lethargic
• trouble concentrating or making decisions
• crying easily or feeling like crying

More acute symptoms to watch for include thoughts of suicide and/or a loss of touch with reality,
such as hearing voices or having strange thoughts (delusions).

A qualified doctor or a psychiatrist is needed to formally diagnose clinical depression, including
clarification of the type of depression you are experiencing.

Depressive disorders, also known as mood disorders, are commonly described or diagnosed as:

• Major Depressive Disorder
• Bipolar Disorder (sometimes referred to as manic depression)
• Postpartum Depression
• Seasonal Affective Disorder (or seasonal depression)
• Dysthymia (a persistent low-grade depression persisting over years)
• Adjustment Disorder with Depressed Mood (depressive symptoms may be a more pronounced reaction to an external stressor)

Depression is Associated with Impairment

Unfortunately, persistent depression can negatively affect your work and/or school, your relationships, and pursuit of your life goals, and robs you of your ability to enjoy life. Practically, you should seek help if you are stuck in this place and it is stopping you from getting to do the things you want to do in your life.

Depression is Relatively Common

Depression is quite common. You are not alone if you are struggling with depression. In Canada, depression is present in about five percent (5%) of the population at any particular time, and just over 10 percent (+10%) of adults experience depression at some point over the course of their lifetime. So look around – you are not the only one wrestling with this and looking for help!

There is no simple answer to this question. You may hear people state that depression is caused by a “chemical imbalance” in the brain. However, this is an insufficient answer when it comes to considering other potential cause. There is usually no one clear cause and there are many suspected causes. These are referred to as risk factors. The following factors are believed to play a role in depression:

• Genetic/biological causes (does it “run in the family”?)
• Personality (your “style” of interacting with the world around you)
• Stressful life events (e.g., childhood abuse or adult trauma, job loss, end of a close relationship, death of a loved one – not just grief, )
• Medical conditions (e.g., diabetes, thyroid condition, chronic pain, weight issues, cardiac problems, and others)

These are common risk factors for depression. Even knowing these risk factors, it is difficult to know which causes which. For example, does pain cause depression, or depression cause pain? Or do they simply exacerbate one another, and there is an underlying third “cause”? Remarkably, there are many people with these risk factors who don’t suffer from depression. And for those that do struggle with depression, it is challenging to identify the causal factor.

The good news, regardless of cause, there are effective treatment options for depression (discussed below).

Protective Factors

Some people are less likely to struggle with depression than others. We don’t know exactly why. However, research has identified several protective factors.

The following are some of the factors associated with less depression:

• A Healthy Diet, Reduced Alcohol, and Regular Aerobic Exercise
• Coping and Decision-Making Skills
• Social Support from Family and Friends
• Self-Esteem and Resilience (ability to adapt to stressful circumstances)
• Existential/Spiritual Orientation (adhering to values, sense of purpose, future-oriented)

These protective factors are associated with daily habits, lifestyle, and perspective. Focusing on these factors can lead to practical steps you can take to reduce your risk of depression.

• Antidepressant Medication – needs to be prescribed by a psychiatrist by a general physician (family doctor) with knowledge/experience in prescribing psychotropics.

This is a very brief overview and is not an exhaustive list. Of course, at Advance Health, we focus on providing effective psychotherapy.

Looking for Hope!

Most people struggling with depression ultimately recover. The discussion above is intended to provide a definition for depression, with common signs and symptoms, help you understand that there are multiple causes and protective factors for depression, and finally to present the common treatment options.

Most people experience anxiety to some degree at some point in their lives. In fact, anxiety is within the normal range of human emotions. For, example, worrying you might be late for the bus is not a problem. That is normal and in fact is helpful ! What makes anxiety problematic is its severity, and how persistent or pervasive it is.

Anxiety is an emotional response to a perceived threat. Fear, in contrast, is the emotional response to an actual threat. Anxious thoughts and responses are future-focused: ‘What if I fail this exam?” “What if I have another panic attack today?” “What if my mother gets into a car accident?” The anxious response to these thoughts, whether we are conscious of that response or not, is something like “I couldn’t handle it.” Which gives rise to the perceived threat.

The anxiety one feels is the emotional response to that threat.

At moderate or severe levels, anxiety can manifest as any one of or a combination of the following:

• chronic worry,
• physical tension,
• panic attacks, or
• obsessive-compulsive patterns.

Anxious thoughts can manifest in any number of different themes in different people, such as worrying about your health or becoming ill, how one is perceived by others, having another panic attack, or harm coming to oneself or loved one if a compulsion is not completed.

Anxiety can result in concentration difficulties, low energy, changes in appetite, and poor sleep. It can result in avoidant behaviour, that is, avoiding situations that trigger the anxious response; or in safety behaviours – a behaviour that in the short term quells the anxiety but in the long term only maintains it.

When anxiety is negatively impacting your job, relationships, or your personal quality of life, it has become problematic.

This is a brief introduction to the topic of anxiety, with the goal to help you start to recognize the symptoms.