Thoughts on Record: Podcast of the Ottawa Institute of Cognitive Behavioural Therapy

Comments or feedback? Send us a text! Eating disorders such as anorexia nervosa can reflect among the most severe and debilitating forms of mental illness.  In fact, anorexia nervosa has the highest mortality rate of any form of mental illness and unfortunately for a subset of clients, all current "gold standard" treatments can prove ineffective.  Dr. Blake Woodside, MD, a pioneer in the revolutionary use of deep brain stimulation for treatment resistant eating disorders joins us to discuss: the history and development of DBS how Dr. Woodside  personally became interested in DBS for eating disordersa description of the clinical presentation and prognosis of severe anorexia nervosa the brain areas are typically targeted in DBS and possible mechanism of actioninclusion/exclusion criteria for a client being considered as a candidate for DBSinformed consent in the context of DBS how the DBS procedure is undertaken (client preparation, client experience during surgery, recovery etc.)combining DBS combined with psychotherapy and medication a review of the typical response rate to DBTphilosophical considerations around DBS with respect to free will, ethics, human performance etc.  future developments and technological advances in DBS and associated techniquesDr. Blake Woodside’s specialty in psychiatry is the treatment of eating disorders in adults, and family therapy of adolescent anorexia nervosa. He is Medical Director Emeritus, Program for Eating Disorders at the Toronto General Hospital, where he led the inpatient service for 25 years, and Professor in the Department of Psychiatry at the University of Toronto.  Dr. Woodside is actively involved in research, presently focusing on novel treatments in eating disorders, including Deep Brain Stimulation, Repetitive Transcranial Magnetic Stimulation, and Family-Based Therapy. He has also served in various capacities for the Canadian Medical Association, and the Canadian Psychiatric Association.

Comments or feedback? Send us a text! Unraveling the mystery of consciousness, including experiences nested within consciousness such as emotions reflects the leading edge of inquiry in a variety of fields including neuroscience, psychology and philosophy.   Preeminent neuroscientist, author & musician Joseph LeDoux, PhD., a pioneer in the field of brain mechanisms of memory and emotion joins host Dr. Pete Kelly, C.Psych to discuss: Dr. LeDoux's model of emotions, including a comprehensive tracing of the perception of a stimulus through the central nervous system all the way through to the construction of the conscious experience of an emotion.  the importance of a sense of self to the experience of emotions.the universality of the need to navigate threat contrasted with the very individual or even culturally bound experience of the emotion of fearconstruction of emotional schemas a brief review of the different forms and layers of consciousnessimplications of Dr. LeDoux's model for improving the effectiveness of psychotherapy, particularly exposure based-therapy.consideration of how subcortical, unconscious processes interact to produce conscious states from a therapeutic lens.  advantages and disadvantages of the evolution of consciousness with a consideration of the implications for the fate of humanity.  Dr. Joseph LeDoux is the Henry and Lucy Moses Professor of Science at NYU in the Center for Neural Science, and he directs the Emotional Brain Institute of NYU and the Nathan Kline Institute. He is also a Professor of Psychiatry and Child and Adolescent Psychiatry at NYU Langone Medical School. His work is focused on the brain mechanisms of memory and emotion and he is the author of The Emotional Brain, Synaptic Self, Anxious and The Deep History of Ourselves. LeDoux has received a number of awards, including William James Award from the Association for Psychological Science, the Karl Spencer Lashley Award from the American Philosophical Society, the Fyssen International Prize in Cognitive Science and the American Psychological Association Distinguished Scientific Contributions Award among many, many others.  His book Anxious received the 2016 William James Book Award from the American Psychological Association. LeDoux is a Fellow of the American Academy of Arts and Sciences, the New York Academy of Sciences, and the American Association for the Advancement of Science, and a member of the National Academy of Sciences. He is also the lead singer and songwriter in the rock band, The Amygdaloids and performs with Colin Dempsey as the acoustic duo So We Are.https://joseph-ledoux.comhttps://www.amygdaloids.com/http://www.soweare.net

Comments or feedback? Send us a text! Many psychotherapists have a number of clients who are taking psychotropic medications to address symptoms of mental illness; however, focused and in-depth didactic training in psychopharmacology as well as how to conceptualize the use of pharmacological strategies in the context of psychotherapy is not a core component of many graduate psychotherapy programs.  Dr. Cary Kogan, C.Psych, a clinical psychologist with a Post-Doctoral Master's degree in clinical psychopharmacology, shares his insights around:the value in training in pharmacology for psychologiststhe current prescribing environment for psychologists in Canada & the United Statescurrent nomenclature/classification around psychotropic medicationsconsiderations around the use of psychotropic medication e.g., method of administration, side-effects, brand vs. generic etc. current evidence & risks around medications with antidepressant effectsbrief consideration of psychedelic compounds as therapeutic agentsinformed consent around the use of psychotropic medicationconsiderations around combining psychotherapy & pharmacological strategiesthe complex relationship between diagnostic systems, prescription practices and conceptualization of mental illnessEpisode Disclaimer:  Any discussion of medical treatment is intended as information only and should not be used as a basis for making treatment decisions without consulting with a licensed professional.Cary Kogan earned his Ph.D. in clinical psychology from McGill University and Post-Doctoral Master’s degree in clinical psychopharmacology from Fairleigh Dickinson University in the USA. He is currently Professor of Clinical Psychology in the School of Psychology at the University of Ottawa where he also serves as Director of the Centre for Psychological Services and Research, a community-based mental health training centre. Dr. Kogan teaches at the undergraduate and graduate levels including courses on psychopathology and psychopharmacology. His research interests include classification of psychopathology and translational neuroscience with a special focus on neurodevelopmental disorders. Dr. Kogan is a consultant to the World Health Organization, Department of Mental Health and Substance Abuse, for the revision of the Mental, Behavioural and Neurodevelopmental Disorders chapter of the International Classification of Diseases (ICD). He has contributed to the development, testing, and international implementation of the clinical descriptions and diagnostic guidelines for mental health professionals.

Comments or feedback? Send us a text! Although emotions comprise among the most profound and meaningful of human experiences, they can likewise evoke intense discomfort, avoidance or even phobic reactions.  Effectively matching one's emotional reaction to  the demands of the environment is a central task of every individual - a task which is increasingly difficult in an emotionally avoidant society with an increasing number of "virtual" interactions and cues.  In our discussion today, OICBT clinician Stacey Kosmerly, Ph.D., sits down with host Dr. Pete Kelly, C.Psych to discuss:the definition of emotion from a psychotherapeutic/neurobiological lensmyths around "good vs. bad" emotionsthe  evolutionary purpose of a number of specific emotions (e.g., sadness, fear, jealousy etc.)how humans develop challenges around emotion dysregulation & emotional inhibitiontips for parents/loved ones for understanding and managing the difficult emotional reactions of children, partners etc. the central role of vulnerability in gaining confidence managing strong emotionsshame as a particularly difficult emotion to address clinically/interpersonallymanaging emotional reactions to our emotional reactions how clinicians can leverage their emotional reactions to improve their effectiveness as clinicians the role social media may be playing in emotional difficultiesStacey Kosmerly, Ph.D. is clinician at the Ottawa Institute of Cognitive Behavioural Therapy.  She has a PhD. in Clinical Psychology from the University of Ottawa and an Masters in Applied Psychology from Laurentian University.  Ms. Kosmerly is highly involved in the Dialectic Behavioural Therapy (DBT) Program and the Adult Attention Deficit/Hyperactivity Disorder (ADHD) Programs at the OICBT. She uses primarily DBT and CBT approaches to therapy, integrating her past training in emotion focused therapy (EFT) and  acceptance and commitment therapy (ACT) when appropriate. During her Master’s degree, Ms.Kosmerly worked closely with Dr. Adele Lafrance, one of the developers of Emotion Focused Family Therapy, and was involved in community outreach related to this. Since 2013, she has been involved in delivering workshops on Emotion Coaching, that is, skills for parents and caregivers to respond effectively to their children’s/loved one’s emotions, in community settings. 

Comments or feedback? Send us a text! Many mental health clinicians and consumers operate under the assumption that mental illness results from chemical imbalances in the brain. However, a close examination of the evidence strongly suggests that this is not the case. In fact, there is some suggestion that psychotropic medications such as antipsychotics and antidepressants used to treat mental illness may themselves perturb normal neurochemical functioning.  Importantly, pharmacologically inducted alterations in the functioning of core neurochemical systems may have important implications for the maintenance of symptoms and long-term outcomes.  Author & journalist, Mr. Robert Whitaker joins us to discuss the core themes of his 2010 (updated in 2014) book Anatomy of an Epidemic which seeks to not only put the development and use of psychotropic medications in historical context, but also critically examines the long-term impact of these compounds from a data-driven lens.  In this discussion we cover the evidence around neurochemical "imbalances" in the brain,  findings around the the long-term outcome data around the use of antipsychotics & antidepressants  including the possibility of these compounds contributing to relapse and chronicity of illness, a brief consideration of problems associated with anxiolytics like benzodiazepines and finally, a discussion of the kinds of shift in narrative required around mental illness to move our understanding and treatment strategies forward.  Host note: the information discussed in the podcast today should not be taken as medical advice around the use of psychotropic medications and is for general information only.  If you have questions around the pharmacological management of your symptoms, please consult with your medical provider.      Robert Whitaker is an American journalist and author who has won numerous awards as a journalist covering medicine and science, including the George Polk Award for Medical Writing and a National Association for Science Writers’ Award for best magazine article. In 1998, he co-wrote a series on psychiatric research for the Boston Globe that was a finalist for the Pulitzer Prize for Public Service. His first book, Mad in America, was named by Discover magazine as one of the best science books of 2002. Anatomy of an Epidemic won the 2010 Investigative Reporters and Editors book award for best investigative journalism. He is the publisher of madinamerica.com.https://www.madinamerica.com

Comments or feedback? Send us a text! Despite widespread acknowledgment that self-care is an essential component of sustainable practice for mental health professionals, it is an area where many clinicians struggle to implement consistent healthy habits or necessary behavioural change.  In 2019, Drs. Karen G. Dyck, C.Psych and Melissa Tiessen, C.Psych became the co-founders of the website Intentional Therapist and since then, have been actively engaged in efforts to help female mental health professionals find convenient, intentional, creative, and playful ways to incorporate self-care into their lives.  On the podcast  we explore: their motivation to create the Intentional Therapist initiative and how they define self-carewhy they place an emphasis on female mental health professionals specifically & relevant gender differences when it comes to self-carekey components/messages shared through their newsletteraspects of their messaging that have been especially relevant to them personallythe upcoming Intentional Therapist retreat shifts in their own thinking about self-care since starting the Intentional Therapista broader discussion of self-care beyond the Intentional TherapistDr. Karen G. Dyck completed her Master’s Degree in Developmental Psychology at the University of Manitoba and her Doctoral Degree in Clinical Psychology at the University of South Dakota.  She was an Associate Professor in the Department of Clinical Health Psychology at the University of Manitoba for 17 years, 4 of which she served as the Director of the Rural and Northern Psychology Programme.  Within this position Karen had the opportunity to work collaboratively with a range of healthcare providers and administrators and to regularly consult with other mental health professionals.  It is within that context that Karen became interested in the topics of healthy workplaces, employee wellness, and self-care.  Karen left her university position in 2014 to pursue private practice and explore other, less traditional, opportunities where she could draw from her training and experience.  Karen has two wonderful bonus children and lives in Anola, MB, with her supportive husband and 18 year old cat, Kittie Pie. OICBT Psychologist Dr. Melissa Tiessen completed her Doctoral Degree in Clinical Psychology at McGill University. She completed a post-doctoral residency in the Department of Clinical Health Psychology at the University of Manitoba within the Rural and Northern Program, where she had the fortunate opportunity to work under Dr. Karen Dyck.  Melissa went on to work as an Assistant Professor in the Department for 2 years, and then moved to Ottawa where she worked for 1 year within the Cardiac Rehabilitation Program of The Ottawa Hospital/University of Ottawa Heart Institute.  This led to a unique opportunity as the Director of the Education Directorate of the Canadian Psychological Association, where Melissa served for 4 years, overseeing the association’s national accreditation and continuing education programs.  Working in the field of accreditation highlighted for Melissa the incredible importance of quality training experiences for psychology students and the necessity of good work-life balance and self-care.  Melissa also had the opportunity to spend some time living abroad, where she was involved with multiple non-profit organizations dedicated to supporting the health and well-being of women and children.  Since 2018 Melissa has worked in private practice.  Melissa lives in Ottawa, ON, with her supportive husband and young son. 

Comments or feedback? Send us a text! While Irritable Bowel Syndrome (IBS) is a common experience, it is not a challenge that many individuals - quite understandably - like to talk about or admit to struggling with.  Unfortunately, many sufferers simply “learn to live with it”, but at the expense of flexibility and enjoyment in their lives around travel, commuting, sports, outdoor activities & relationships.  Ottawa Institute of Cognitive Behavioural Therapy psychologist Dr. Kathryn Sexton joins host and colleague Dr. Pete Kelly to discuss IBS.  Topics covered include current conceptualizations around the causes of IBS (with a special emphasis on stress), stigma as a maintaining and exacerbating factor, the prevalence, symptoms and diagnosis of IBS, differences between IBS and inflammatory bowel disorder (IBD), treatment of IBS from a CBT perspective, the role of acceptance in coping with IBS and finally, medical and alternative treatments for IBS.    Dr. Kathryn Sexton is registered as a Psychologist (Interim Autonomous Practice) with the College of Psychologists of Ontario and a registered Psychologist with the Psychological Association of Manitoba, practicing in the areas of both Clinical and Health Psychology.  She specializes in cognitive behavioural treatments for anxiety and mood disorders and chronic stress.  Her areas of special interest and experience are in the assessment and treatment of worry/generalized anxiety disorder, health anxiety, and insomnia, and in chronic stress and pain management related to irritable bowel syndrome (IBS) or to immune-mediated inflammatory diseases such as IBD.  Dr. Sexton received her Ph.D. in Clinical Psychology from Concordia University in Montreal, training in the Anxiety Disorders Laboratory.  She completed her Pre-doctoral Residency at the Clinical Health Psychology Program within the College of Medicine at the University of Manitoba in Winnipeg.  She conducted further postdoctoral training in the Inflammatory Bowel Disease Clinical and Research Centre at the University of Manitoba and Health Sciences Centre in Winnipeg.  Dr. Sexton currently sits on the Board of the Canadian Association of Cognitive-Behavioural Therapies - L’Association Canadienne des thérapies cognitives et comportementales (CACBT – ACTCC).  Dr. Sexton is also an active researcher and has published several scientific articles and book chapters on cognitions and behaviours influencing worry/generalized anxiety disorder, health anxiety, and stress in chronic gastrointestinal diseases. https://www.ottawacbt.ca/dr-kathryn-sexton

Comments or feedback? Send us a text! Despite Canadian group insurance plans managing upwards of 35 billion dollars a year, mental health clinicians frequently experience significant frustration with respect to accessing the funds required to effectively treat their clients - especially those with more severe presentations.  Co-founder of Cubic Health Inc., Mr. Mike Sullivan RPh, BSP, MBA joins Dr. Pete Kelly, C.Psych for an in-depth discussion of how innovations in the management and allocation of funds held in large self-funded insurance plans could hold the key to revolutionizing the treatment of mental illness.  In this fascinating discussion, Mike and Pete discuss the market gaps that led to the development of Cubic Health, the basic organization and components of the insurance industry in Canada, Mike's observations around where the insurance industry has stagnated, especially around the provision of mental health services, the use of analytics in analyzing and optimizing the provision of insurance benefits, trends in psychotropic medication in Canada, innovations in large group plans that could free up millions in financial resources for the effective treatment of mental illness, the responsibilities of clinicians within the insurance system to foster innovation, and finally, consideration of dynamics around short and long-term disability with respect to mental illness.  Mike also shares personal reflections on the stressors (and opportunities) of running a growing business, observations on leadership and some of his favourite books related to leadership, interpersonal effectiveness and growth.  Mr. Mike Sullivan, co-founded Cubic Heath Inc. in 2003 in an era when start-ups venturing into the mix of technology and healthcare, especially in the world of employee benefits, had limited access to capital. Fast forward 17 years later, there still is not another company in Canada in Cubic’s space, which for those of us concerned with mental health is concerning because it underlines how slow to change the group insurance industry has been traditionally, although as we will discuss, things are really beginning to change.  Cubic has built a proprietary clinical and analytics infrastructure focused on making employee health benefit plans more efficient and sustainable. Cubic's focus as an independent benefit plan analytics and clinical solutions company is the intersection of Mike’s background as a Pharmacist and his post-graduate studies in Finance. Cubic has evolved into the largest clinical team in the employee benefits industry in Canada, supported by a team of talented Data Scientists, Business Intelligence experts, Developers and Information Systems professionals. Cubic’s clients are primarily large single- and multi-employer benefit plans ranging size from 500 to 650,000 employee lives.   A frequent speaker across North America on benefit plan design and management, Mike has also appeared on CBC, BNN, and in the Globe & Mail. He is a regular columnist for Benefits Canada magazine and serves as an Adjunct Professor at the University of Toronto.www.cubichealth.ca

Comments or feedback? Send us a text! Sports psychology is strongly recognized as an indispensable tool to help athletes achieve maximum performance in high-stakes situations.  However, in addition to facilitating sport-based outcomes, psychotherapy can also help athletes manage the demands and rigours of sport from a mental health perspective.  Former Olympic coach (Canadian Women's Curling) and Clinical Psychologist (Supervised Practice), Dr. Adam Kingsbury outlines his journey into sports psychology, the definition of sports psychology and the kinds of activities undertaken under the rubric of sports psychology, the unique challenges (both ethical & technical) of delivering psychological services in the context of sport, the line between coaching vs. providing psychological services, the potential role for core-belief work/schema therapy in the context of sport psychology and an in-depth consideration of Dr. Kingsbury's Olympic Coaching experience at the PyeongChang 2018 Winter Olympics.  Dr. Adam Kingsbury, Ph.D., a clinical psychologist in supervised practice, is a graduate of the doctoral program in clinical psychology (Ph.D.) at the University of Ottawa.  He is a former Olympic coach (PyeongChang 2018), and a Chartered Professional Coach in the sport of curling. He provides assessment and psychotherapy services with a special interest in assessment, diagnosis, and treatment of ADHD, as well as providing services for high performance athletes, physicians, and those in the creative arts (musicians, actors, visual artists, etc.).https://twitter.com/adskahttp://ottawariverpsychology.com/team/adamdoctoral-associate/

Comments or feedback? Send us a text! While it is common to hear that we are in the midst of a mental health crisis, a closer examination of the available data strongly suggests that so-called diagnostic inflation may actually be a key contributor to the apparent increase in mental illness.  Dr. Allen Frances, MD, author of Saving Normal: An Insider's Revolt Against Out-of-Control Psychiatric Diagnosis, DSM-5, Big Pharma, and the Medicalization of Ordinary Life speaks with host Dr. Pete Kelly, C.Psych around why it's so hard to define "abnormal" in the context of mental health, a historical consideration of the origin and development of the Diagnostic and Statistical Manual of Mental Disorders (DSM) (including human factors - politics, pharma etc. - that have permeated the development of the DSM), how DSM-5 has strongly contributed to diagnostic inflation, challenges and caveats associated with the treatment of mental illness with pharmaceuticals, the importance of psychotherapy in the treatment of mental illness and whether (and how) the DSM might be reformed.  Dr. Frances also provides a psychiatrist's perspective on Trump and the psychological and societal factors that have allowed Trump to ascend to power.  Allen Frances, MD, is professor emeritus and former chair of the Department of Psychiatry and Behavioral Science at Duke University School of Medicine. Dr. Frances was the chairman of the DSM-IV Task Force and a member of the leadership group for DSM-III and DSM-III-R. He is the author of the award-winning international bestseller Saving Normal, as well as Twilight of American Sanity: A Psychiatrist Analyzes the Age of Trump and the reference work Essentials of Psychiatric Diagnosis. He lives in San Diego, California.https://twitter.com/AllenFrancesMD