Insights and Take-Aways From The Polyvagal Theory for Trauma Clients

Posted by: Andrea Cashman on September 25, 2015 8:49 am

I recently attended Stephen Porgues workshop in Ottawa called Social Connectedness as a Biological Imperative: Understanding Trauma through the eyes of Polyvagal Theory. If anyone is interested in pursuing a specialization in trauma or expanding their trauma learning repertoire, I highly recommend attending a workshop with Stephen Porgues. He is a great speaker that can break down the science of Polyvagal Theory so that you can apply this knowledge to helping your trauma clients. It was a very informative and even inspiring workshop to attend. I cannot say all workshops in the past have given me more fuel for the passionate work that I feel I am doing. I thought I would share some insights and learning points that I took away from this workshop. By all means, it would be wise to look into Polyvagal Theory in its entirety to full understand its scope and application for treatment. I will not be going into it in full as that would take up a lot of blog space and it is not the purpose I intend on in my blog. I recommend either attending a workshop or purchasing Stephen Porgues book on Polyvagal Theory.

First of all, Polyvagal Theory specifies two functionally distinct brances of the vagus nerve, the tenth cranial nerve, that serve different evolutionary stress in mammals, including us humans. The less evolved vagus nerve branch serves as a more primitive branch that illicits immobilization behaviors (ie feigning death) whereas the more evolved vagus branch is linked to social communication and self soothing behaviors (wikipedia). You can check out YouTube for more explanations on Polyvagal Theory – here’s another brief definition in relation to trauma https://www.youtube.com/watch?v=8RKC3Ga6shs Polyvagal Theory claims that the nervous system employs a hierarchy of strategies to both regulate itself and to keep us safe in the face of danger. In fact, it’s all about staying safe. Our highest Strategy involves social engagement which is regulated by the myelinated vagus nerve. Our next strategy is fight or flight, regulated by the sympathetic nervous system when social engagement is not an option. Our last option is to freeze, to immobilize when fight/flight is not an option in the face of trauma(Garland, 2013). Continue reading →

*The views expressed by our authors are personal opinions and do not necessarily reflect the views of the CCPA

Helping Clients See Past Their Diagnosis:

Posted by: Andrea Cashman on September 8, 2015 9:01 am

As psychotherapists, we use diagnoses to categorize mental illness to assist us in developing and implementing treatment plans based on current up-to-date research. A diagnosis serves as a guiding tool for treatment purposes. It is imperative for us psychotherapists to see our clients for who they are – genuine and unique human beings struggling to stay afloat in the midst of their personal storms. Clients come in struggling with issues pertaining to their mental illness with impacted relationships and consequently the burden of stigma that many endure with their diagnosis. It is helpful to unpack stigma to help you and your client understand it fully. The World Health Organization in 2001 also recognized that it is the largest barrier to treatment engagement.

Jones and colleagues outlined stigma, in it’s full scope, to have 6 dimensions that include:

Peril – Otherwise known as dangerousness. Clients can be perceived as frightening, unpredictable and strange.
Conceal-ability – The visibility of a mental illness which parallels with controllability. Mental illnesses that are harder to conceal are more stigmatized.
Course – How likely the person is to recover and/or benefit from treatment
Disruptiveness – Measures how much a mental illness effects relationships or success in society. If the mental illness is seen as less disruptive, more stable, it is less stigmatized.
Origin – Mental illness can be either biological or genetic in origin.
Aesthetics – Or the displeasing nature of mental illness in its social cues and perceived behaviours that fall out of the norm.

Continue reading →

*The views expressed by our authors are personal opinions and do not necessarily reflect the views of the CCPA

Starting Anew

Posted by: Jennifer Morrison on September 4, 2015 12:15 pm

I have very recently began a new position as a guidance counsellor in three schools, all of which have never had a guidance counsellor before. Although all schools are extremely grateful to have me, there are still some challenges surrounding the creation of a brand new position. Where are they going to locate me, will there be a private space, private phone line, filing cabinet to store confidential files, a space that is suitable for counselling? How will staff, parents and students react to this new role? Some of this is out of my control and I must live with that. However, there is still a lot I can do to make this an easier transition for everyone.

At this point in the game I am simply trying to allow students and staff to see me in the school. I am walking around before school, talking to students, going into the staff room to meet teachers. Overall, I want them to know that I am here. Now is not the time to come into their classrooms and start pulling out students. They have only been back to class for two days and I am unfamiliar to everyone. I feel that staff must first get to know me and what it is I do, before they will be willing to send their students to see me. I think that is reasonable. I feel it will be a while before they are comfortable enough to send students my way, and that is OK. Continue reading →

*The views expressed by our authors are personal opinions and do not necessarily reflect the views of the CCPA

Helping Young Clients Transition From Post-Secondary School

Posted by: Andrea Cashman on August 26, 2015 5:00 am

Many of the young clients that come into my office seem to be struggling with making the transition from post-secondary school into the real world. They are the young adults who have just successfully graduated from their College or University programs but struggle to make the next step. The reason behind their hesitation is not what you may think it is initially. Many of them struggle to even get past putting in applications for job postings. The job search terrifies them not because there is a lack of jobs necessarily but because they do not feel good enough or they completely feel lost on what career is for them. Struggling with self-identity or self-esteem issues is what holds them back. I’ve even seen clients who have entered into programs that their parents have picked out for them. These young adults feel trapped in a world that doesn’t hold true to themselves. Regardless, the question remains the same: why are these young adults suffering a transitional crisis so early on? We mostly hear jokes and passings about mid-life crises. We hear frequently about empty nest transition crises. However, we rarely hear about young people suffering a crisis in their 20’s. This is often referred to as a quarter life crisis. Continue reading →

*The views expressed by our authors are personal opinions and do not necessarily reflect the views of the CCPA

Focus on the Positive

Posted by: Jennifer Morrison on August 25, 2015 3:30 pm

As the summer winds down I am beginning to think of all I must do to prepare myself for a new school year and a new job. We all go through those transitions where we must get to know our new clientele, our communities and our colleagues. These tasks are a new and exciting challenge for me and ones I look forward to. However that excitement comes with some anxiety. We all know what the fear of the unknown can do to one’s mental health. Lack of sleep, restlessness, stomach issues along with a whole host of other symptoms often prevent people from making transitions in their lives. Perhaps they feel that dealing with the status quo is easier than dealing with change. Continue reading →

*The views expressed by our authors are personal opinions and do not necessarily reflect the views of the CCPA

Presence

Posted by: Sherry Law on August 25, 2015 5:00 am

In one of my previous posts I mentioned a phenomenon called presence, which is a potent experience capable of convincing a person that they occupy a place which they do not exist physically. This experience is difficult to describe but is the quintessential point I, and other researchers in the field of virtual reality, believe the technological and the therapeutic intersect. This post will attempt to explain how presence is achieved and how it can be therapeutic.

Presence, in terms of artistic experience, is also called immersion, explained by philosopher, Samuel Coleridge, as a “suspension of disbelief”. This experience can occur in any medium, such as a good book, or a tv show. If you can imagine a quiet evening with a book where an exciting story can make you forget that you have been turning the page for hours. This is an example of immersion. You feel as though you are a visitor to the story, or a witness to the events unfolding in your minds eye. What virtual reality (VR) accomplishes is immersion but replacing the minds eye with direct visual input. Continue reading →

*The views expressed by our authors are personal opinions and do not necessarily reflect the views of the CCPA

Choosing a university program

Posted by: Mike Peirce on August 24, 2015 3:10 pm

Over the past month, I have spent a great deal of time reviewing Canadian university programs as I updated the material for the 2015-16 edition of “For Grads Only”. This publication is near and dear to my heart as I believe it is a useful tool for students beginning their search for their ideal university and program. During my research, the program searches on the University Canada website made me think about what a student goes through as they decide their course of action for university application. Did you know that if you simply search for Bachelor degree programs taught in English in Canada, there are almost 6,400 possibilities to consider? There is no wonder students are often overwhelmed by deciding what to study. The importance of this decision can never be underestimated as a student needs to know what the program they will enroll in before they can decide which university to apply to. After all, if the university doesn’t teach the program, no sense in going there. Over the years, I have realised that students researching undergraduate university degree programs fall into one of three groups: 1) those who know what they want to study, 2) those who have some idea and 3) those who haven’t a clue. The neat thing is I believe there is no problem being in any one of these three categories. The process of choosing just needs to be adjusted a little. Continue reading →

*The views expressed by our authors are personal opinions and do not necessarily reflect the views of the CCPA

Is goal-setting essential for a good marketing and learning plan?

Posted by: Andrea Cashman on August 20, 2015 5:00 am

It’s important to establish goals and goal-setting in your private practice to maintain a marketing and competency plan in order to grow or maintain your practice. Without goals, it’s easy to fall within a rut or status quo and this lack of growth will affect your practice in minor or major ways. Goals allow you to achieve certain objectives to fulfil your practice vision or dreams. These visions or dreams can include building your clientele or advancing yourself through specialization or expertise in the psychotherapy field. Sit back and ask yourself – What do I see when I envision my dream practice? Then ask yourself – How can I get there? What goals do I need to make?

Examples of some goals related to competencies may include ones that centre on delivering effective client care and establishing trust in the therapeutic relationship (which may be examined in client feedback and supervision etc.,), developing more sound knowledge of medical and psychiatric illnesses (through courses and reading), developing a learning plan that includes specialization or furthering your competency level based on the client population you counsel, developing your communication skills through learning basic counselling skills (if you are a new psychotherapist), or goals centred on professionalism or referral networking. Each of these goals listed above can be broken down into specifics and tailored to meet your preferences and desired outcomes. It’s important to list your goals as either short term or long term goals and to be easy on yourself if you do not meet a deadline in time. Goals can always be altered. Continue reading →

*The views expressed by our authors are personal opinions and do not necessarily reflect the views of the CCPA

Payment Options for Counsellors

Posted by: Shelley Skelton on August 2, 2015 3:30 pm

How do you plan to receive payment from your clients? Are you collecting payment yourself or will there be a receptionist doing that for you? Do you have third party payment? Will you be mobile or in one location? Will any of your counselling be online? All of these answers will help determine which option is best for you. I will share what I have learned about payment options and how I made my decisions. Two very useful online articles are listed at the bottom.

So, there seems to be four basic payment options: cash, cheque, credit, or debit. Each have benefits and disadvantages, depending on your answers from above. These are my thoughts based on my single person, mobile, face-to-face private practice.

Considering how much a counselling session can cost, cash does not seem like the best option because I am the holder of the payment and I wouldn’t want to have a lot of cash in the office. If the client is not paying the full amount, however, this could be a hassle-free way to be paid.
Cheques seem like a good option assuming they don’t bounce but the bank usually holds them for a few days before they can be accessed. Also, I don’t know how many people use cheques anymore. I wouldn’t make this the only option, but I see few disadvantages to accepting cheques.
Debit does not cost anything to accept, so in that way it is preferable to credit, although some online payment systems such as Paypal do not include debit. I like debit, although I could not find any debit options that did not also include credit.
Credit costs the counsellor money (somewhere around 2.75%), however, it is very convenient for everyone. Also, there are a number of ways to receive payment through credit: a point of sale system like the square, a mobile card processor, a credit card terminal if you are in one location, and online payment like Paypal. I like this option because the fee transfer happens right away.

My plan is to accept cheques and cash while encouraging credit or debit. For credit options, I narrowed my top two choices to the Square or Moneris because I wanted the transaction to be face to face (rather than e-transfers or Paypal). Even though Moneris has a monthly fee, I chose it over the Square for a few reasons. First, Moneris has been around longer and has a strong track record for customer service. Second, this service has a relationship with my bank (RBC) and a person in my city who has already talked to me on the phone – how often does that happen these days? , Third, I can accept debit or credit with Moneris. The Square only takes credit. If you are curious about online payment systems, you can visit the two articles I listed below; I found both very informative.

This decision about payment options is an important one to make and you would be wise to do so before opening your business bank account because there are a number of different types of accounts based on how your receive payment. I found it very helpful to speak with a business account manager at my bank in order to sort out all of these options. If anyone has opinions or insights about payment options, please leave a comment and share with our readers.

Lindzon , J. (2014, Nov. 14). Top five online payment systems for your small business. Globe and Mail. Retrieved from http://www.theglobeandmail.com/report-on-business/small-business/sb-money/cash-flow/top-five-online-payment-systems-for-your-small-business/article21553705/

Purch. (2015, June 11). Square Review: Best Mobile Credit Card Processing Solution. Business News Daily. Retrieved from http://www.businessnewsdaily.com/8064-best-mobile-credit-card-processor.html

*The views expressed by our authors are personal opinions and do not necessarily reflect the views of the CCPA

Technology is Expanding a Counsellor’s Toolbox

Posted by: Sherry Law on July 22, 2015 9:37 am

I recently spent some time with a colleague and the idea of video conference counselling came up. Both being technology buffs, we dove right into the idea without hesitation. As we discussed, it became clear to me that there were real ethical arguments to support the idea of integrating technology with therapy. Unfortunately, the fears around the little known realm of technology in counselling creates a demanding barrier of entry, stifling enthusiasm to attempt online therapeutic practice. Hoping to fan some burning embers of excitement, I present three ethical considerations for the use of technology in counselling:

Financial Access

Cost has always been a struggle for people who need mental health assistance. Both the direct cost per session as well as indirect costs can affect people’s budgets, adding pressures to the decline of one’s mental health. For example, taking time off work or out of the day may not always be feasible for people, especially if you have children to take care of, and during a contracting economy where every day matters in the eyes of your employer. The struggle to balance self care, and life responsibilities is very real. Online counselling could reduce the cost of office space rental, parking space rental, and utilities in the office. The savings from such a transition could help to increase access for some clients.

Physical Access

Physical access can be limited due to a person’s living arrangements, or life circumstance. Many people cannot afford a convenient mode of transportation to attend a counselling session. For example, in rural areas, the problem can worsen with some people having to depend on the therapist’s mode of transportation into their area before they can acquire mental health services. The dependency could lead to spotty access at best, and an inconsistent therapeutic relationship at worst. For counsellors working within a rural area, a plethora of other ethical concerns can arise, such as multiple relationships, limits on resources, isolation, and community expectations. Online counselling could not only offer larger variety of therapists for the rural clientele who can specialize, but can subdue altogether some of the ethical issues around rural therapeutic practices.

Continue reading →

*The views expressed by our authors are personal opinions and do not necessarily reflect the views of the CCPA