Ontario government demos CBT for mental wellness

Diane Landry has participated in CBT therapy several times, both individually and in a group setting. Photo credit: Courtesy of Diane Landry

At 19 years-old, Diane Landry has received cognitive behavioural therapy (CBT) several times in her life. A few days at the hospital in grade 10 began her long road of psychotherapy treatments, including CBT.

CBT focuses on the here-and-now—on the problems that come up in day-to-day life. CBT helps people examine how they make sense of what is happening around them and how these perceptions affect the way they feel, according to CAMH.

Landry has done both group and individual CBT therapy. She says she found the group very helpful in one specific round of therapy, adding the group would bond during breaks between sessions, which made therapy easier.

“It was easier to open up in the group at that point, because it was like okay these people, they’re not judging me, you know, we’re here to help each other, we’re here to listen to each other and give off our own strategies,” says Landry.

Dr. Nicole Elliott, a psychologist at Ontario Shores working out of Durham College, says it’s good to have services available for people when they need them.

“A lot of times it’s either they have to go to inpatient programs, or it’s through private practice as well, and it can be quite expensive,” says Dr. Elliott. “Being able to have that [psychotherapy] available for people to get it when they need it, rather than waiting until it’s in a crisis or through other things as well, it’s good to have.”

This would have been good for Landry.

The provincial government has a plan to make this therapy more accessible on an outpatient basis.

In October 2017, the government of Ontario launched a demonstration project to increase access to mental health services across the province. The project is similar to a psychotherapy program started in 2008 in England.

Anyone looking for therapy can go to a community partner or their doctor based on the service area they’re in, and get a referral. The referrals go through the hospital heading their area and everything will get set up through it.

Then the therapy will take place out of the community partner location. So, someone doesn’t have to visit the hospital just to receive therapy.

Beth Brannon is the director of the Integrated Community Access Program at Ontario Shores, one of the project’s community partners. Brannon says the demonstration project improves access to therapy because it is provided at no cost.

“The important part to this is that it’s all publicly-funded. So, people aren’t having to pay, which has been a huge barrier for many, many people in terms of accessing the therapy that they need,” Brannon says.

The Increasing Access to Structured Psychotherapy (IASP) program is headed by the specialty mental health hospitals — CAMH, Ontario Shores Centre for Mental Health Sciences, The Royal Ottawa Mental Health Centre, and Waypoint Centre for Mental Health Care. The four hospitals work with community partners in their service areas to provide CBT.

Diane Landry first received access to CBT when she was an inpatient at Ontario Shores.

“While you are an inpatient somewhere, you are required to attend every day, they will, like, drag you there if they have to,” Landry says. “It’s a group thing if you’re an inpatient.”

Group CBT is essentially CBT therapy, but done with others who are struggling and in a setting where everyone can support one another. CBT can take place in individual settings or group settings.

Ontario Shores has over 30 sites for the demo based out of various community organizations, institutions and family practices across the Central and Central East Local Health Integration Network (LHIN). The Central and Central East LHIN cover a large area including the Durham Region, Kawartha, Northumberland, Haliburton, and parts of Toronto.

“We have some in Peterborough and some in York Region,” says Brannon. “We have a couple of positions that are in our indigenous communities.” They also have “non-traditional” partners such as Grandview Children’s Centre.

There are two sites on campus: at Durham College, in the Campus Health Centre, and UOIT, in the Student Life Building.

Dr. Elliot says the presence of these clinics makes therapy more accessible to students.

According to facts and statistics from CAMH, 34 per cent of Ontario high school students reported moderate to serious levels of mental distress, with 14 per cent reporting serious levels. CAMH also says people 15-to-24 years-old are more likely to experience mental health issues than any other age group.

Landry says access to CBT wasn’t as difficult for her as it can be for others.

“It [accessing CBT] was a lot easier since I had pre-existing services, but it can take months to get on a list,” says Landry, who participated in individual and group CBT therapy.

Upon discharge from Ontario Shores, Landry continued receiving CBT on an outpatient basis as well as receiving dialectical behaviour therapy (DBT), a specific type of therapy derived from CBT.

CBT involves becoming aware of behaviours and thoughts, unlearning them, and then developing strategies to stop the behaviours and thoughts from happening, Landry says.

Photo credit: Meagan Secord

It’s a goal-oriented type of therapy where the focus is on building skills to cope with situations and change thought patterns, says Dr. Elliott.

“So, it’s really helping us focus on building in better ways of coping when we are feeling distressed, but also identifying what certain thought patterns we might have or ways we interpret situations can affect how we feel and being able to catch those thoughts when they’re happening,” Dr. Elliott says, adding CBT is more effective for treating mental illnesses like depression and anxiety.

Landry says journaling was most helpful when she received CBT. It allowed her to record what was happening in her crisis moments, and then reflect on it after and know what to do the next time.

As of Sept. 2018, Ontario Shores has received over 12 hundred referrals for the whole project, according to Brannon.

“I think that speaks to the need,” says Brannon. She hopes the IASP program can demonstrate the need for publicly funded psychotherapy and show the positive impact it has on people’s lives.

Landry made a friend during CBT therapy, one she credits with helping her succeed.

“And like one person, like, stuck with me. Like I’m still best friends with them now, to this day. And they were the one person that kind of showed me in the group, like you can do this, don’t worry.”