Psychological

Treatment

Dr. Meghan Rossi

 Today
Dates Topic Chapter Pages

March 7th The Stress Response 13 120-122

March 12th Mike Lake Presentation: Autism

March 14th Stress & the Immune Response 13 123-124

March 19th Diagnosing Psychological Conditions, 14 130-133

Diathesis-Stress Model
March 21st Neurodiversity & Schizophrenia 14 134-135

March 26th Mood and Anxiety Disorders, 14 136-139

Obsessive Compulsive Disorder, Post-
Traumatic Stress Disorder
March 28th Personality Disorders, 14 141-142
Neurodegenerative Conditions
April 2nd Psychological Treatments 15 149-150

April 4th Biological Treatments/Review 15 151

 Outline for Today

01 What is therapy?

02 What is evidence-based practice?

03 How to implement evidence-based practice

04 How to choose a mental health clinician

01
What is
therapy?
 Therapy Modalities
Individual Group

Family Couples
 Identifying, changing, and/or
responding differently to unhelpful
ways of thinking, feeling, & behaving

1) Determining present day maintaining factors

2) Identifying treatment goals
3) Learning new skills
4) Understanding yourself
5) Processing the past
Assessment Case Treatment Treatment
Formulation Planning
and Diagnosis

Progress Monitoring

Termination

Therapeutic relationship
02
What is
‘evidence-based’
practice (EBP)?
 Best Available
Research
Evidence

EBP
Client
Characteristics, Clinical
Culture, & Expertise
Preferences
STRONGEST
Best
Available
Research
Systematic knowledge synthesizing Evidence
research with high internal and
external validity (meta-analyses,
Cochrane reviews, NICE guidelines) Treatment decisions/planning

Primary research studies with high

internal and external validity

Primary research studies with Treatment

limited internal and external validity

Unpublished data, professional

opinion, prior experience

Monitoring treatment
WEAKEST
How do I find strong evidence?
 Client
Characteristics, Important to consider:
Culture, &
Preferences ■ Variations in presenting problems or disorders, etiology,
concurrent symptoms/syndromes, behavior

■ Age, developmental status, developmental history and life stage

■ Sociocultural and familial factors

■ Current environmental context and stressors

■ Personal choices, values and preferences relevant to treatment

The ability to integrate knowledge, experience, technical, Clinical
and relational skill, critical thinking, prediction, decision- Expertise
making and self-assessment within a fluid situation that
is often uncertain and ambiguous

Where do we see clinical expertise?

● Therapeutic relationship, assessment & case
formulation, treatment planning/goal setting,
selection and application of interventions, monitoring
progress, attending to context (individual, cultural,
etc.), seeking consultation/additional resources as
needed, etc.
 Therapeutic Relationship
Components:
Empathy
Genuineness
Positive Regard
Goal Alignment

Skills:
Active listening
Reflecting
Validation
Summarizing
 Therapeutic Relationship
Active listening à eye contact, avoid interrupting

Reflecting à “I can tell you are feeling frustrated and upset.”

Validation à “I would be surprised if you didn’t feel this way”

Summarizing à “I am hearing you say that you have been

feeling low for quite some time now and it has limited you
from doing the things you love, like spending time with
friends. Did I get that right?”
YOUR TURN!
 Yara is a 25-year-old cisgender Muslim woman that emigrated to Canada from Dubai a year
ago to pursue graduate school education in Business. She has always been a reserved and
introspective person, and although she has a couple of very close friends back home, she
has often found it difficult to talk to new people and open up to them. Yara reports that

Yara when she is around people she doesn’t know, her mind starts racing with thoughts and
that she feels like she could explode with tension and fear. When she feels like this, she
often finds it helpful to leave the situation and be alone for awhile.

Since starting this new program, she has found it even more difficult to engage in class
discussions or approach peers for group projects. She would hate to get the wrong answer
or have people judge her for not being smart enough. She wants to introduce herself to her
professors, but she worries that she will make a fool of herself. As a result, she has been
missing classes and declining invitations to go to various events in her department.

In her personal life, Yara worries about being misunderstood, rejected, or judged because of
her cultural background. She will often see people stare at her or look away as she
approaches, so she finds herself mostly spending her evenings and weekends alone, apart
from the occasional video call from her family and friends back home. When Yara strikes up
enough courage to go to a school function, she finds she feels a bit less anxious when she
stands in the back, doesn’t look people directly in the eye, and has something in her hand
she can grip onto. It has been a really difficult year for Yara and she is finding it more and
more isolating and exhausting to keep up with her mind.
Yara
1) What are the symptoms Yara presents with? What
psychological condition best represents her concerns?

2) What do the NICE guidelines for this condition

recommend for treatment of this condition?

3) What are aspects about Yara’s life that you would need to
know that would help inform treatment with her?

4) What are examples of statements that are a) reflecting, b)

validating, and c) summarizing as applied to Yara’s
presenting concerns? What would you not say?
1) Symptoms and
Yara is a 25-year-old cisgender Muslim woman that emigrated to Canada from Dubai a
disorder
year ago to pursue graduate school education in Business. She has always been a
2) NICE guidelines reserved and introspective person, and although she has a couple of very close friends
back home, she has often found it difficult to talk to new people and open up to them.
3) Additional info? Yara reports that when she is around people she doesn’t know, her mind starts racing
with thoughts and that she feels like she could explode with tension and fear. When she
4) Examples of
feels like this, she often finds it helpful to leave the situation and be alone for awhile.
statements to say and
not say in therapy
Since starting this new program, she has found it even more difficult to engage in class
discussions or approach peers for group projects. She would hate to get the wrong
answer or have people judge her for not being smart enough. She wants to introduce
herself to her professors, but she worries that she will make a fool of herself. As a result,
she has been missing classes and declining invitations to go to various events in her
department.

In her personal life, Yara worries about being misunderstood, rejected, or judged because
of her cultural background. She will often see people stare at her or look away as she
approaches, so she finds herself mostly spending her evenings and weekends alone,
apart from the occasional video call from her family and friends back home. When Yara
strikes up enough courage to go to a school function, she finds she feels a bit less anxious
when she stands in the back, doesn’t look people directly in the eye, and has something
in her hand she can grip onto. It has been a really difficult year for Yara and she is finding
it more and more isolating and exhausting to keep up with her mind.
Looking for mental
health services?
When Looking for a Clinician…

01 02 03 04

Uses evidence- Has credentials Specializes in No goals in

based practice and is registered dozens of treatment and/or
with a regulatory different does not work
body therapies and with you
mental health collaboratively
concerns
 Questions?
meghan.rossi@dal.ca
Office Hours: 2pm-3pm Tuesdays
(masks required for in-person)
LSC2325 or virtual

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**masks will be provided to those without them

 Last
Class:
Biological Treatments and Review

Read pages 149-150