For my resourse guide to anxiety and depression, click HERE.

Therapy and Counselling Services
In addition to my work in assessment I have over 30 years experience as a therapist / counsellor. My initial license was as a Licensed Professional Mental Health Counsellor. I then completed two more years of supervised experience and became a License Marriage and Family Therapist and Clinical Member and now Fellow of the American Association for Marriage and Family Therapists. This experience included working in my own private practice, in a community health center, as a school counsellor and in a psychiatric hospital as a clinician and department chair. I have also taught at several colleges and universities in both Canada and the United States, including being the Clinical Director of the Forensic Internship program at Bellevue Hospital/Kirby Psychiatric Center where I was a member of the Psychiatry Faculty. My initial training was in Behaviour Therapy, then I completed an advanced certificate in Cognitive Behaviour Therapy at the Albert Ellis Institute. My initial training during internship was in systems therapy. Most recently I have completed training in the Gottman Couple's Therapy methods. 

Anxiety and Stress (Depression is discussed below)
For both Anxiety Disorders and Stress Related Symptoms I offer individual counseling and therapy in my Vancouver and Burnaby offices (serving Coquitlam, New Westminster, Port Moody and Maple Ridge). In most cases we use Cognitive Behavioural Therapy (CBT) which is an evidence based, scientifically supported method for teaching individuals the skills and tools they need to overcome anxiety and stress related disorders. In addition to Cognitive Behavioral Therapy (CBT) I often also teach skills commonly called “Mindfullness.” Mindfulness is a set of behavioural and cognitive skills designed specifically to help reduce daily stress and anxiety and address the problem of relapse, often associated with anxiety or stress disorders. Mindfulness is usually not appropriate for the initial phase of therapy.

Frequently Asked Questions (FAQ)
Isn’t anxiety or stress normal?  Why am I having trouble with it now?
People often call asking just this question about therapy or counseling for anxiety. Anxiety and stress are actually normal parts of everyone’s life. They are normal reactions to stressful situations, for example, feeling anxious about a test. Anxiety is actually a helpful and necessary warning system we wouldn’t do well without. In some cases we might actually enjoy some level of anxiety, such as when watching a scary movie, reading a suspenseful book or riding a roller coaster. If there were no anxiety during these activities we wouldn’t be doing them! Sometimes, however, anxiety levels can grow to a point when it is hard to control, it might interfere with our thinking and mental processing, make it difficult to make decisions, and last much longer that the incident itself. In this way both anxiety and stress can cause significant difficulties in our daily functioning. We can also, over a period of time, begin to react with anxiety to things that should not be causing anxiety at all. The anxiety seems to spread to new areas of concern. When anxiety rises to this level it is likely that you have developed one of several types of Anxiety Disorder. Anxiety, luckily, is something we can provide both medical and psychological treatment for.

You should know that anxiety disorders are common, affecting approximately 40 million adults per year in North America alone. And most people are treated effectively with therapy, sometimes medication, or a combination of the two. Cognitve Behavioural Therapy (CBT) and Mindfulness have been found to be highly effective in most situations to avoid relapse. (CBT and Mindfulness Training are offered in both my Vancouver and Burnaby offices serving Burnaby, New Westminster, Coquitlam and Maple Ridge.)
 
Are There Different Types or Kinds of Anxiety Disorder?
While the term Anxiety Disorder is often used, it actually refers to a family of anxiety problems which including the following: Generalized Anxiety Disorder, Obsessive Compulsive Disorder, Panic Disorder, Post-Traumatic Stress Disorder and Social Phobias.

Do You Treat Children with Anxiety Disorders?
Yes. We have new and highly effective means of teaching children as young as 5 the techniques of Cognitive Behavioural Therapy and often suggest texts and stories such as “When My Troubles Get Too Big,” and “The Incredible Five Point Scale.” Treating children and teens often involves the entire family and the school staff. I provide parent education, teacher training and school based consultations on stress, anxiety and related disorders. Most of the materials I use are available for classroom wide programs and are commonly found in school settings. Specialized programs addressing anxiety for children and teens with Autism Spectrum (ASD) and Asperger’s Disorder are also available. Children and adolescents are seen in both my Vancouver and Burnaby locations.)

Anxiety Disorders and Stress are treatable and often respond to medication as well as counselling and therapy, especially Cognitive Behavioural Therapy (CBT). CBT  is an evidence-based form of psychotherapy that emphasizes the important role that our thoughts, beliefs (cognitions) and behaviors play in determining how we feel and behave. CBT has been shown to be effective in treating Anxiety Disorders. Again, as a psychologist I have received specialized training in Cognitive Behavioural Therapy at the Albert Ellis Institute in New York, including over one year of clinical supervision in providing CBT and obtaining an advanced certificate in CBT from The Albert Ellis Institute.

LINK: Self-Help Tips for Generalized Anxiety Disorders (click here)

Depression
 
Depression is one of the most common mental health problems in North America with over 20 million people suffering from symptoms of depression. Symptoms of Depression are very similar to normal feelings and moods we have all have. Everyone feels sad, blue or down on occasion. Individuals suffering from depression experience these feelings more intensely and for longer periods of time. They also might experience tiredness or fatigue, irritability, difficulty focusing, concentrating and planning, as well as changes in appetite or sleep patterns. These symptoms are reviewed during out initial meeting.

For those suffering from Depression which is causing difficulties in their day-to-day lives I offer two primary forms of therapy: Cognitive Behavioural Therapy (CBT) to help you address, control and change specific symptoms, and Mindfulness Training, which has beed found to be effective in avoiding relapse. Both of these therapeutic techniques are Evidence Based Therapies (EBT), meaning they have been scientifically shown to be effective.

Frequently Asked Questions (FAQs)
Are there Different Types of Depression? Some People Seem to Have Few Symptoms, and others I Know Have Real Trouble Functioning?
There actually are several forms of depressive disorders. They differ in nature and severity and include the following (among others): Major Depressive Disorder, Dysthymic Disorder, Postpartum Depression, Seasonal Affective Disorder and Bipolar Disorder. These symptoms can vary greatly in severity. A comprehensive assessment is usually called for in order to understand the nature of the problems you may be having.

Can you Tell Me About Counselling for Depression?
The most frequent used therapy for Depression is Cognitive Behavioural Therapy, or CBT. CBT was started by two important psychologist, Albert Ellis, and Aaron Beck. Beck’s theory states that depressed people think the way they do because their thinking is biased towards negative interpretations. According to this theory, depressed people acquire a negative schema of the world in childhood and adolescence as an effect of stressful life events. When the person with such schemata encounters a situation that in some way resembles the conditions in which the original schema was learned, the negative schemata of the person are activated. Cognitive Behavioural Therapy for Depression helps a client understand this pattern of thinking, and teaches specific tools and skills to address it. These include learning to approach problems differently, to understand your biased thinking, and some very specific skills such as “thought Stopping” to deal with intrusive thoughts.

Cognitive Behavioural Therapy has been shown as an effective treatment for clinical depression. Recently some CBT practitioners have returned to more behavioral approaches to the treatment of depression such as behavioral activation. A large-scale treatment study found behavioral activation to be more effective than cognitive therapy and on a par with medication for treating depression. In my practice in Burnaby and Vancouver I use both Cognitive Behavioural Therapy for Depression as well as techniques derived from more behavioural approaches, such as behavioural activation for Depression.

Is CBT Effect for Depression with Children and Adolescents?
The use of CBT has been extended to children and adolescents with positive results. CBT is one of the few empirically-supported psychosocial treatments for young people “CBT for Children and Adolescents”. It is often used to treat major depressive disorder, anxiety disorders, and symptoms related to trauma and posttraumatic stress disorder. Significant work has been done in this area. CBT is also used as a treatment modality for children who have experienced complex post-traumatic stress disorder and chronic maltreatment.

Can You Tell Me More About CBT for Depression?
Cognitive and Behavioral Therapies for children and adolescents usually are short-term treatments (i.e., often between 6-20 sessions) that focus on teaching young people and their parents specific skills. CBT is different from many other therapy approaches by focusing on the ways that a person’s cognitions (i.e., thoughts), emotions, and behaviors are connected and how they affect one another. Because emotions, thoughts, and behaviors are all linked, CBT approaches allow for therapists to intervene at different points in the cycle. Though approaches can differ somewhat, they have the following in common:
The therapist and child or adolescent client develop goals for therapy together, often in close collaboration with parents, and track progress toward goals throughout the course of treatment. The therapist and client work together with a mutual understanding that the therapist has theoretical and technical expertise, but the client is the expert on him- or herself. The therapist seeks to help the client discover that he/she is powerful and capable of choosing positive thoughts and behaviors.
Treatment is often short-term. Clients actively participate in treatment in and out of session. Homework assignments often are included in therapy. The skills that are taught in these therapies require practice.

Treatment is goal-oriented to resolve present-day problems. Therapy involves working step-by-step to learn skills and achieve goals.

Do you provide services to GLBT individuals?

Please see my webpage here (click)

Summary
Treatment for Severe Depression (or any of these “Mood Disorders”) is often most effective when clients receive a combination of counseling (Cognitive Behavioural Therapy) and medication treatment. For many forms of Depression CBT has been shown to be as effective as medication, and is often used alone.

Cognitive Behavioural Therapy, or CBT, is an evidence-based therapy that has been shown to be highly effective with many mood disorders, from depression to bipolar disorder. Cognitive Behavioural Therapy for depression or mood disorders can range in length from a few sessions to several months of sessions. A treatment plan is developed between you and your doctor/therapist which matches your needs. Often times self-help books, videos and audio programs are suggested to suppliment the work we do in the office. Cognitive Behavioural Therapy teaches you about the nature of your mood disorder, how your thinking patterns effect how you feel, and teaches you specific skills that you may use to help control these patterns. Often meditation (reflective practice), relaxation (MindfulnessTraining), behavioural interventions and thought stopping techniques are used in combination to control the many different symptoms that make up your mood disorder.

Resources for Depression
One excellent resource found on line here in British Columbia is “Here to Help.” (www.heretohelp.ca) This web page has several workbooks and on-line activities for those with depression. Most of these are evidence-based programs, either behavioural interventions of  Cognitive Behavioural Therapy (CBT) based.  Here are some, more to be added:

Help to the Prevention of Relapse: http://heretohelp.bc.ca/skills/managing-depression/relapse