Angela Stern Retiring May 8, 2020

 

After 23 years of dedication to PPC and outstanding service to many, many clients (and a 30+ year career as a school counselor with the GSCS), Angela Stern has made the exciting decision to retire from private practice, effective May 8, 2020.

We thank her so much for all she has done, and wish her nothing but happiness and fulfilment in this next chapter!

Minor Children Protocol

We have recently updated our session policies and Joint Custody Consent Form for minor children.

PPC has different protocols for children 14 or younger, and for teens 15+. For children 14 & under, the first session is with the parents/caregivers only. Parents of teens 15+ are encouraged to attend the first part of the first session together and determine with the therapist what is the best process to follow going forward.

By law, we must also be aware of the custody arrangement between the biological parents, and have signed documents on file before sessions with a child can take place.

Please see our Resources section for the updated policy and consent form HERE.

Biofeedback Now Offered at PPC

BIOFEEDBACK

Offered by Ryan Dielschneider at PPC

If your counsellor asked you to slow down your breathing and take a series of deep breaths, you probably wouldn’t have much difficulty. But what if your counsellor asked you to reduce the activation of your sympathetic nervous system? Or, to increase the mean amplitude of low beta brain waves at your sensorimotor cortex? Chances are, you wouldn’t even know where to begin. That’s where biofeedback comes in. (And, if you were wondering: yes, we actually can have some direct control over our brain-waves!)

Biofeedback is a specialized technique used in psychology, physiotherapy, medicine, and related fields to help individuals learn self-regulation. The essence of biofeedback is right in the word – you get moment-to-moment information provided to you (feedback) about a physiological process in your body (bio). By getting to instantaneously see what’s going on in your body, you can learn better control over yourself and, subsequently, optimize your functioning and live a better life.

Biofeedback services are now being offered at PPC by Counsellor Ryan Dielschneider who has completed training accredited by the Biofeedback Certification International Alliance (BCIA).

What kinds of self-regulation can biofeedback teach you?

First, biofeedback can help you learn to Relax your Body by training muscle tension and stress responses in your skin.

Second, biofeedback can help you learn to Calm your Mind by training heart-rate patterns related to resiliency and brain-wave patterns related to a ‘busy brain.’

Third, biofeedback can help you learn to Focus your Attention by training brain-wave patterns related to maintaining a broad, open, alert awareness.

Put all together, biofeedback can ultimately help you to Optimize your Performance. Research has demonstrated it can be helpful for symptoms related to a wide variety of concerns, including but not limited to ADHD, anxiety, depression, trauma, chronic pain, headaches, substance use, and athletic performance.

What should I expect?

Biofeedback is safe, non-invasive, and painless. Initially, your therapist will complete a physiological profile assessment in order to get a baseline. Then, in a typical biofeedback session, your therapist will attach one or more sensors to you and then adjust the parameters of biofeedback software to optimize the training for you. The sensors simply measure something, such as brain-waves (EEG) or your level of anxiety (SC); they do not alter or impact you directly. While training, you will practice relaxing your body, calming your mind, and maintaining a focused mental state while the computer gives you feedback in the form of an animation, video, or game. (You can even train while watching almost any video on YouTube!)

It is a little bit like going to the gym, but you are improving your mind and exercising your nervous system. As you train, you consciously learn what the ideal physiological state feels like so you can bring it up at will – for example, when an anxiety attack is starting or when you need to concentrate on a task. In addition, your body passively learns to regulate and balance itself simply through the feedback rewards the computer provides, naturally moving toward healthier functioning.

Biofeedback training for as little as 15 to 20 minutes can create positive, permanent changes to clients’ nervous systems. The types of biofeedback and number of training sessions required to reach an individual’s goals are unique for every person. However, since biofeedback involves a steady process of learning, research suggests that gains will add up over time:

• Sessions 1 to 4: you should begin to notice positive changes in your attention, clarity, and ability to relax;
• Sessions 5 to 12: you should achieve moderate improvements in the areas you are working on;
• After 20 sessions: you should achieve significant improvements; and,
• Completing 40 sessions is typically the optimal “magic” number for obtaining the best results

To book an appointment and try biofeedback training for yourself, please call PPC at (306) 664-0000.

Insurance

Choosing between yes or no to be insured

We have discussed the different disciplines in the mental health field in the first two articles (What is the Difference Between a Counsellor, Social Worker, Psychologist and Psychiatrist, Parts 1 and 2) So, what is a consumer to do? It’s all a bit overwhelming.

First, coverage. If you have a national Employee Family Assistance Program (EFAP), keep in mind that most Psychologists and veteran therapists do not work for the lower paying national EFAP. As well, you are generally not able to choose a specific therapist or a specific discipline with these EFAP’s, and you may only have access to sessions by telephone or email.

Alternatively, if you have access to insurance or extended health benefits (where you may have to pay up front and be reimbursed), many of these plans will only cover a Registered Psychologist. While insurance companies are slowly becoming more inclusive to disciplines other than Psychology, check your plan first. Remember, the actual registering body of the professional is the key here. Registered Psychologist or Registered Social Worker are often the only two mental health disciplines covered.  However, some employers have taken steps to include Certified Counsellors as well.  Every individual policy will have their own definition of what will be covered. As well, some require a doctor’s referral to be submitted along with your receipt, and others do not.  Again, refer to your policy details.

Getting a word of mouth therapist recommendation is a very good idea. Personally, I would be reluctant to see a therapist without a recommendation by a trusted friend. Most therapists don’t mind a brief telephone interview. Tell the therapist what you are doing and ask them questions suiting your concerns and values, beyond their profile on a website.

Remember, the purpose of your first appointment is to tell your story and further rate them. I tell my clients they need to give me at least an 80% satisfactory rating before returning. If I am seeing a couple, they each need to give an 80% grade. Couple’s counselling will fail if one gives 50% and the other gives 100%.

You will need to establish whether you are looking for a “process-” or “outcome-” based therapist. Process-based therapists are nice, kind, warm and interested in the relationship where your self-evolved insight will be helpful. Outcome-based therapists on the other hand, may have these characteristics as well, but more importantly focus on the outcome – the goal. They focus on fewer sessions with maximum outcome. Generally, it is the veteran therapists that practice the more direct approach.

Costs vary amongst disciplines. Psychiatrists and Psychiatric nurses are generally covered under medical care (as are all other public practitioners). Those of us in private practice have wide ranging rates, from under $80 per hour to $180+ per hour. The costs are generally based on 1) the therapist’s qualifications (a PhD for example, generally demands a higher hourly rate), 2) the therapist’s experience (therapists with less than 5 years’ experience generally charges a lower rate), 3) the location (therapists operating out of their homes have no little to no expenses.  An interview question for these therapists might be, where will my file be securely and safely stored until it is destroyed) and 4) the size of the practicing group (sole practitioners with no Administrative staff or overhead charge the lowest hourly rates).

You can always discontinue with a therapist if you find the relationship match (which is the most important factor of all) is not working. Admittedly, if you have seen 3 or 4 therapists and were dissatisfied with all of them, you may be looking in the wrong direction.

Best of luck with your search!

Dennis

Why Do Apologies Fail?

“I am sorry”. Three very powerful words, all three wisely and commonly recommended. They can be difficult to say but nice to hear. But the well-intended apology is not fail-proof. In fact, it rarely gets the desired results of a huge genuine thank you, a hug, a “oh that was so nice of you, Excellent! good, let’s move on”. No, it is more common to be followed by a passive silence, LONG silence. Leaving you wondering if they were awestruck or just hemorrhaged. The apology can also be followed by an aggressive “What! You think those cheap three words that you always use will satisfy me, well you are CRAZY!’ It could also be followed by them stomping off, crying or the passive cold, hard stare.

“What went wrong? How can I fix this? I meant well” … Here are some tips. First your intention and sincerity, even if it was 100 percent, has absolutely nothing to do with it. Offering a peace offering to someone who is psychologically charged is largely doomed to failure. The physiology or arousal will require a minimum of 45 minutes to settle, doing it perfectly before the offended can be “rational” enough to receive, process, file and respond appropriately. Again, that is if all the stars and planets line up (hunger, thirst, sleep, hormones, pre-stress factors, circumstances, the sender having perfect body language, blood sugar levels, prior experience with apologies – and many more factors).

So why Bother? It is still the right thing to do. It is wise, however, to eliminate any expectation of a favorable response. Besides, your apology is to be UNconditional – regardless of how it is received.
Second reason it failed? There is a reasonable chance you ended the “I’m sorry” with a “but”. Qualified apologies just don’t cut it. Even saying “I’m sorry I did X but I thought you Y. Y has no value, perhaps in the debrief the day later but in that moment of the apology it has no bearing.

Third reason is you may have made a more grievous error of saying, “I’m sorry you feel this way. You took it wrong; you just didn’t X”. The worst is “I’m sorry, but you did the same last week”. The genuine apology can only refer to you not them. Remember “I” statements.

Lastly, there is an inverse relationship between being convinced you are right or faultless and the effectiveness of the apology. If people estimate that you think you are still right, the apology will be rejected. The more you think you were right, the more your apology will be regarded as synthetic – “faux leather”. And this air of “right” will be detected, guaranteed.

Part 2 of 2: What is the difference between a Counsellor, Social Worker, Psychologist, and a Psychiatrist?

In Part I, we distinguished Psychiatry – the medical model of the helping professions. In Part II, we will attempt to differentiate Psychologists, Social Workers, and Counsellors.

First, to be fully accurate, the research shows no difference in outcome for any of the disciplines or the model, philosophy or approach used by the practitioner. In other words, the Psychologist may be held in higher regard than a Social Worker or Counsellors but there is no research to support their greater effectiveness.

Admittedly, Psychologists are arguably held to a higher standard of care than the titles Social Worker and Counsellors. Using the title of Psychologist requires considerably more training and arduous comprehensive exams, plus an oral examination. The Social Work title can be used with a two-year diploma, an undergraduate or graduate degree. The title “Counsellor” is generic. As such, anyone can use the title with no training at all. A Canadian Certified Counsellor (CCC) status does require a minimum of a Masters Degree and the Association does have the right to certify, advise and discipline its members. So, a CCC may well have more training than a Registered Social Worker (RSW).

As with most disciplines, there are different types of Social Workers and Psychologists. A community Social Worker or an Administrative Social Worker would have no counselling training. Similarly, an Assessment Psychologist may have little counselling training.

So, indeed, it is buyer beware. First, ensure the person you are seeing is registered with any of these three bodies: Saskatchewan College of Psychologists, Saskatchewan Association of Social Workers or the Canadian Counselling and Psychotherapy Association. If not, you may be advised to continue looking for an accredited therapist. Second, check both the level of degree and the type of experience the therapist has before booking that initial appointment. A minimum of a Master’s Degree is recommended. Now, the question of the actual difference between the two disciplines is that Social Workers (like the name implies) have a broad social vision of the client. The Social Worker considers both the person and the environment to understand and treat the client. They cast a wider net to include family, family of origin, work, community and all variables in a person’s suffering. It is not that the Psychologist or Certified Counsellor neglects to consider these areas but it would be a matter of weighting. They may think that these external influences are factors but the weight of the responsibility rests largely/exclusively with the client. The Social Worker would regard the 5 factors worth 20% each in the foundations and functioning of the individual.

There can be considerable tension between the disciplines. The Psychiatrist who argues in the value of Pharmacology, the Psychologist who argues the value of individual responsibility, the Social Worker who argues the impact of an entire system, and the Certified Counsellor who may be more general.

The truth is, all four are correct and valuable depending on the case itself.

What is the difference between a Counsellor, Social Worker, Psychologist, and a Psychiatrist? (Part 1 of 2)

Good question! Most people cannot distinguish between these disciplines. Regulatory bodies require each discipline to carefully represent themselves accurately.

First, let’s distinguish Psychiatry from counsellors, Social Workers or Psychologists.   A Psychiatrist is a medical physician who is a specialist in the treatments and medicines for the mind. This is the only discipline (of those referenced here) that can prescribe medication. A General Practitioner/Physician/Doctor must make a referral for you to see a Psychiatrist.   Only a Psychiatrist/GP/Physician or other medical Physician can prescribe medications. Their training largely follows a medical treatment model.  As such, Psychiatry appointments are generally shorter in length, as they listen for symptoms that would give them cause to prescribe or adjust a medication. Your Pharmacist may know more about the drug in question so you should consult with that discipline if your Psychiatrist prescribes a medication.

There are relatively few Psychiatrists in Canada who see patients for a full hour for what is basically called “talk therapy” (involving no medication). In other words, the Hollywood version of a Psychiatrist is a bit misleading.

Now to confuse matters further, a Registered Psychiatric Nurse (who would have 2-4 years of academic training) may also be involved.  The nurse monitors the symptoms and medication, offers some general talk therapy and works in concert (as a team member) with the Psychiatrist in a public practice setting (hospital or outpatient clinic).

Wait times are generally several months, though most times your Physician may have already started some pharmaceutical intervention for the Psychiatrist to adjust.

This leaves the non-medical/Pharmacological disciplines of Psychology, Social Work and generic “Counsellor”. In Saskatchewan, anyone can use the title of counsellor, therapist, mental health worker or a host of other labels. No training, licensing, or regulation is required.  Occasionally you may see an allied degree (like a nurse or teacher) use the title of counsellor and represent a degree other than Social Work or Psychology.   It is generally a good idea to look carefully into these services. The greatest issue (besides the obvious) is that they may not be accountable to any regulating body if you were to have a claim against them.  In addition, the counsellor may not be insured at all, or their insurance may be very limited (and prohibitive).  This is not to say they are not good at what they do.  Some people with little to no training or allied training have a gift.