Comments or feedback? Send us a text!While a number of empirically supported, disorder-specific treatment protocols exist, it is frequently the experience of clinicians that clients present with co-morbid symptoms - that is, symptoms of a number of mental disorders at the same time.  This can present challenges around treating concurrent symptoms and/or what to prioritize in treatment.  Dr. Kristen Ellard, Clinical Psychologist, Professor & co-developer/co-author of the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders, a cognitive behavioral treatment designed to target emotion dysregulation across mood and anxiety disorders, joins us for a fascinating discussion in which we cover:   the origin story and philosophical underpinnings of the Unified Protocolhow the Unified Protocol model proposes that normally adaptive emotional & behavioral processes are translated into psychopathology  the basic structure of Unified Protocol including core interventionsthe proposed mechanism of changes within the Unified Protocol's modelwhether commonly employed theoretical models in psychology (e.g., CBT, psychoanalytic, ACT, EFT etc) actually match the way in which the brain actually works  how to leverage knowledge of how the brain processes information to maximize the effective deployment of psychotherapythe critical role of somatic (interoceptive) sensations in the construction of emotional experienceshow subcortical or “unconscious” areas of the brain might make calculations with respect to threat, attraction, preferences etc. what we can learn about brain function and the importance of sense of self in the context of mental disorders from emergent data around the therapeutic benefits of psychedelicsComments or Feedback?  Email the podcast: oicbtpodcast@gmail.comKristen Ellard, Ph.D. is Assistant Professor in Psychology at Harvard Medical School and Director of Dimensional Neuroimaging Research at the Massachusetts General Hospital Division of Neuropsychiatry. She completed her PhD in clinical psychology at Boston University under the mentorship of Dr. David Barlow, and completed her clinical internship and postdoctoral fellowship at Massachusetts General Hospital/Harvard Medical School. She was co-developer and co-author of the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders, a cognitive behavioral treatment designed to target emotion dysregulation across mood and anxiety disorders, which has now been translated into six languages. Dr. Ellard’s research uses transdiagnostic, dimension-based neuroscience and behavioral approaches to understand the roots of severe cognitive and affective dysregulation in neuropsychiatric disorders, and to find more efficient and effective means to address this dysregulation through combined behavioral and neuromodulatory approaches such as transcranial magnetic stimulation (TMS) and deep brain stimulation (DBS). She has received several foundation awards and two NIH National Research Service Awards for her research program (F31/F32), including most recently a Fellowship Award through the MGH and Brown University Joint Training Program in Recovery and Restoration of CNS Health and Function (T32) and a Mentored Patient-Oriented Career Development Award (K23) from the NIMH.https://dnn.mgh.harvard.edu/member/kristen-k-ellard-phd/

Comments or feedback? Send us a text!Rumination in the context of OCD, anxiety & depression is often conceptualized as an automatic & intrusive psychological experience for which there is little relief beyond distraction, mindfulness etc.  Dr. Michael Greenberg, clinical psychologist and Director of OCD Associates, has re-framed rumination as a compulsion which is amenable to treatment via a number of specific techniques.  In this conversation we cover:how Dr. Greenberg's conceptualization of OCD differs from traditional conceptualizations of OCDthe unique contribution and value that psychodynamic models can bring to the conceptualization and treatment of OCDthe concept of the "core-fear" in OCDwhy rumination is so often thought of as an intrusive thought and the case for re-conceptualizing rumination as a compulsionthe importance of differentiating between awareness and attention with respect to mental eventsa brief summary of Dr. Greenberg's critiques of Acceptance & Commitment Therapy (ACT), particularly in the context of OCDthe form and function of rumination for most clients and the principles that need to be taught to clients in order to teach them to stop ruminatingdifferentiating between constant intrusive, automatic thoughts & ruminationa consideration of whether rumination in OCD is functionally or qualitatively different than in depression, generalized anxiety disorder etc. reflective pondering vs. brooding in the context of effective problem solvingexamples of response prevention in the context of rumination and Dr. Greenberg's conceptualization of ERP more generally integration of core belief work/psychodynamic principles for examining stuck points in OCD therapy.Comments or Feedback?  Email the show: oicbtpodcast@gmail.comHost note: We will be offering a 6 week essentials of CBT workshop that I will be facilitating beginning March 24, 2023.  For more information and registration, please visit: https://www.ottawacbt.ca/news.  Dr. Michael Greenberg is a licensed clinical psychologist and the director of OCD Associates, a national telehealth practice specializing in Rumination-Focused ERP.  He holds a PhD in clinical psychology from Fairleigh Dickinson University, where he trained in both Cognitive-Behavioral Therapy (CBT) and psychodynamic psychotherapy. He completed specialized training in CBT for anxiety disorders and OCD at Mount Sinai Hospital, and in the treatment of personality disorders and serious mental illness at Nassau University Medical Center. He completed post-doctoral training at Terrap, one of the oldest and best established CBT centers on Long Island. He is licensed in New York, California, and Virginia.https://drmichaeljgreenberg.com/ocdassociates/

Comments or feedback? Send us a text!While low mood & sadness are very frequently adaptive responses to life's challenges, there are times where this normally adaptive mechanism is applied for too long, at the wrong time, or at the wrong intensity in the form of major depressive disorder.  In our 2nd annual Fireside Chat geared for mental health clinicians and consumers alike, host of Thoughts on Record, Dr. Pete Kelly, C.Psych provides an in-depth overview of depression from a variety of perspectives including:  the cognitive, behavioral, physiological & emotional symptoms of depressionhow depression is diagnoseddepressive episode specifiers/subtypesrisk factors and warnings signs related to suicidea brief description of bipolar disorderthe evolutionary & functional significance of symptoms of depressionwhen and how depression goes from being adaptive to a problem of clinical significancethe critical role of loss in depressionrisk factors and vulnerability factors for depressionthe central relationship between anxiety & depressionconceptualizing the mechanics of depression from a CBT perspective (e.g., mood loops, cognitive distortions, TRAP-TRAC model, rumination, values, core beliefs, perfectionism, pain vs. suffering, etc)evidence based psychotherapy for depressiona brief overview of CBT interventions for depression (e.g., behavioural activation, cognitive restructuring, behavioural experiments)the case for proactive treatment of depressionsome thoughts on selecting a psychotherapistgeneral thoughts on integrating medication into treatment for depressionrecommended self-help resourcesComments or feedback?  Email us at oicbtpodcast@gmail.comIf you are experiencing thoughts of self-harm or suicide please go to your local emergency room.  In addition, the following resources are available:  Canada Suicide Prevention Service: 1-833-456-4566 (24/7)National Suicide Prevention Lifeline (United States): 1-800-273-8255For a list of International Crisis Lines please visit: https://www.opencounseling.com/suicide-hotlines

Comments or feedback? Send us a text!Clinical presentations characterized by "overcontrol" of emotions (e.g., OCPD, chronic depression, eating disorders) can present a very unique set of challenges & opportunities within the therapeutic setting.  Psychotherapist, supervisor and trainer, Hope Arnold, LCSW, MA, joins us for a discussion of the promise of Radically Open Dialetcial Behavior Therapy (RO DBT) for assisting these clients.  In this discussion we cover:a overview of RO DBT & how Hope became interested in this therapeutic modalityhow RO DBT differs from traditional DBT a brief review of core tenants of RO DBTthe typical format & delivery of RO DBTan overview of "overcontrol"the typical clinical presentations associated with overcontrol with a special emphasis on OCPDconceptualizing overcontrol including contributions of developmental history, temperament & personality structurewhy traditional therapies may not be poised to provide benefit to clients affected by overcontroltypical presentation of clients affected by over overcontrol in sessionhow clinicians can build empathy for clients with overcontrol even though it may be difficult to access a client's actual internal experiencetips for building awareness of one's own proclivity for overcontrol and deactivating the threat system to foster social connectednessHope Arnold, LCSW, MA is a Supervisor and Trainer in Radically Open DBT (RO DBT). She began her RO DBT training with Dr. Tom Lynch, treatment developer, in 2016. Hope continues to attend intensive trainings throughout the country and receives regular supervision from Dr. Lynch.  Hope is a co-creator of the RO DBT App for electronic diary cards and skills.  ​In her clinical work, Hope is the founder of RO DBT Denver in Denver, Colorado, a center dedicated to evidence-based care and treating disorders of overcontrol. She specializes in personality disorders (Obsessive Compulsive PD, Paranoid PD, Dependent PD, Avoidant PD), eating disorders, autism spectrum disorders (special interest in female autism), and treatment-resistant disorders (depression and anxiety).  ​Prior to opening RO DBT Denver, Hope was in private practice at the DBT Center of Houston and was the RO DBT Lead Clinician.  She led a team of six clinicians intensively trained in RO DBT and supervised the team member’s skill development. Hope completed her Intensive Training in DBT and Prolonged Exposure Therapy through Behavioral Tech.  Hope is also trained in Jungian Therapy, Cognitive Behavioral Therapy, and Cognitive Processing Therapy  ​Hope graduated Summa Cum Laude from Loyola University in New Orleans with a BBA in marketing. She worked for two of the largest private financial and consulting firms in the world before transitioning to being a clinician.  She has master’s degrees in social work from the University of Houston and psychology from Saybrook University with a concentration in Jungian studies.  ​Hope has presented at the local, national, and international level on topics related to DBT, RO DBT, and Jungian Theory. www.radicallyopen.net - International RO DBT organization & trainingwww.rodbtdenver.com - Free Loving-Kindness Meditation download on Client resources pagehttps://apps.apple.com/us/app/ro-dbt/id1526204265 - RO DBT Diary Card and Skills App Comments or feedback?  Email the show: oicbtpodcast@gmail.com

Comments or feedback? Send us a text!Clients with both an intellectual disability and mental health diagnosis are among the most vulnerable members of our society; however, these clients often face significant barriers with respect to accessing services for a number of complex reasons.  Dr. Philip Grandia, C. Psych joins us for an in-depth discussion of working with clients with an intellectual disability in a mental health context.  In this episode we cover:  a general overview and description of intellectual disability (ID) including diagnostic criteriaimportant considerations around differential diagnosis in the context of IDmental illness in the context of ID including frequently observed patterns of comorbiditythe very special concern of trauma & exploitation of clients with IDhow anxiety and depression presents in clients with IDthe role and caveats around the use of medication in clients with IDassessing one's own competency to deliver psychotherapy to clients with IDaddressing issues of capacity and consent when initiating treatmentassessing safety effectively in clients with IDclinician perceptions of clients with ID that reflect a barrier to accessing servicesthe types of CBT interventions that can be effective and helpful in clients with IDrewarding aspects of working with this populationDr. Philip Grandia is a Clinical Psychologist at The Royal Ottawa Mental Health Centre. Following his first career as an infantry officer in the Canadian Armed Forces, Philip underwent his PhD in Clinical Psychology at the University of Ottawa. He completed his residency and supervised practice at The Royal and subsequently joined the hospital as staff. In addition to his clinical work, Philip is actively engaged in program evaluation initiatives and Psychology training. He currently works on The Royal’s three dual diagnosis teams in the Community Mental Health Program.Have feedback or comments? Email the show: oicbtpodcast@gmail.comPlease note that while all emails are read, we are not able to reply to all messages that are sent. Emailing Thoughts on Record does not establish a clinician-patient relationship with the Ottawa Institute of Cognitive Behavioral Therapy (OICBT).  Moreover, we are not able to provide any comment or advice with respect to either general or specific clinical or personal situations. If you live in Ontario, Canada and wish to seek clinical services from the OICBT please visit www.ottawacbt.ca. If you are experiencing a mental health emergency, please contact your health care provider and/or proceed to the nearest emergency department.  The following resources are also available:  Canada Suicide Prevention Service: 1-833-456-4566 (24/7)National Suicide Prevention Lifeline (United States): 1-800-273-8255For a list of International Crisis Lines please visit: https://www.opencounseling.com/suicide-hotlines

Comments or feedback? Send us a text!Conversations around the conceptualization, development & implementation of diagnostic frameworks around mental illness often generate more questions than answers, but are endlessly fascinating in their ability to pull on a number of diverse & interesting threads of inquiry.  Clinical psychologist, professor & former president of the Canadian Association for Cognitive & Behavioural Therapies (CACBT), Dr. Andrea Ashbaugh, C.Psych returns to Thoughts on Record for a discussion of diagnostic frameworks for mental illness.  In this conversation we cover:thoughts on the conceptualization of mental illnessthe functional utility/evolutionary significance of mental health "symptoms" - even when frequent and/or intensecultural expectations around the experience of psychological pain advantages and challenges of current diagnostic symptoms (e.g., DSM 5, ICD-11)mental health consumer expecations around receiving a diagnosispotential benefits and harm that can come with a diagnosisthe emergence of potential dimensional models of diagnosis (e.g., The Hierarchical Taxonomy of Psychopathology (HiTOP))  transdiagnostic treatment of psychopathology, with a special focus on managing comorbidityconsideration of some common diagnostic conundrums e.g., severe symptoms in high functioning clientsAndrea Ashbaugh is an associate professor in the School of Psychology at the University of Ottawa, Director of the Centre for Psychological Services and Research, and is a licensed clinical psychologist in the province of Ontario, Canada. She obtained her master's and Ph.D. in Clinical Psychology from Concordia University in Montreal, Quebec, Canada and completed a post-doctoral fellowship in the Department of Psychiatry at McGill University and the Douglas Mental Health University Institute, in Montreal, Quebec, Canada.She is director of the Cognition and Anxiety Studies Laboratory (CASL) and the Sex and Anxiety Research Group (SAX-RG). Her research interests as part of CASL centre around understanding the causes and developing treatments for anxiety and fear-related problems. She has recently started a program of research to understand the causes and psychological effects of experiencing traumatic and non-traumatic events that transgress one’s moral beliefs (Moral Injury) in military personnel and veterans. Her research in the context of the SAX-RG centres around the impact of beliefs about arousal sensations and context on the interpretation of arousal, and its impact on sexual interest and functioning. She has received funding for her research broadly including from Natural Sciences and Engineering Research Council of Canada and the Social Sciences and Humanities Research Council of Canada.Dr. Ashbaugh regularly supervises CBT training and teaches courses on psychopathology and clinical psychology at both the graduate and undergraduate level. She has served on the Editorial Boards of Psychological Assessment. She is currently an Associate Editor for the Journal of Behavior Therapy and Experimental Psychiatry and editorial board member for Behaviour Research and Therapy. She is a former president of the Canadian Association for Cognitive and Behavioural Therapies (CACBT) and was seminal in the development of national CBT training guidelines that were released by CACBT in May 2019.

Comments or feedback? Send us a text!While most psychotherapists identify with one predominant theoretical orientation, in practice it is common for clinicians to adopt an "eclectic" approach that aligns with the varied lens/interests a clinician might hold as well as to meet the varied needs of clients.  Consultant, coach, author and podcast host, Imi Lo, joins host Dr. Pete Kelly for a very wide-ranging discussion of a variety of topics related to psychotherapy including:   Imi's preferred theoretical orientation, conceptual framework and why she has chosen to focus on work with emotionally intense and highly sensitive peopleblending psychodynamic and CBT principlesa brief discussion of the schema therapy model, with a focus on mode workthe judgment that can be inherent in the conceptualization of personality disorderscurrent conceptualizations of mental illness and the functional utility of "symptoms"the inner lives of highly sensitive, intense peoplethe notion of emotional "over-control" and a brief consideration of the utility of RO-DBT in this contextnavigating & integrating the ongoing tension between champions of "vulnerability" vs "radical self-responsibility"Imi's reflection on process-related aspects of therapymanaging emotional depletion to avoid burnoutreflections on principles of acceptance, and not resisting one's experience (for clinician and client, alike)description of, and navigation of the so-called "midlife passage" some overall thoughts on current areas of interest and growth in psychotherapyImi Lo is a consultant for emotionally intense and highly sensitive people. She is the author of Emotional Sensitivity and Intensity, available in multiple languages, and The Gift of Intensity. Imi is the founder of Eggshell Therapy and Coaching, working with intense people from around the world.  Imi has practised as a social worker and therapist in London (U.K). She has trained in mental health, psychotherapy, art therapy, philosophical counseling, and mindfulness-based modalities. She works holistically, combining psychological insights with Eastern and Western philosophies such as Buddhism.  Imi’s credentials include a Master in Mental Health, Master of Buddhist Studies, Graduate Diploma in Psychology, Bachelor of Social Science in Social Work, Certificate in Logic-based Therapy, and an Advanced Diploma in Contemporary Psychotherapy. She has received multiple scholarships and awards including the Endeavour Award by the Australian Government. She has been consulted by and appeared in publications such as The Psychologies Magazine, The Telegraph, Marie Claire, and The Daily Mail.eggshelltherapy.com

Comments or feedback? Send us a text!Dreams have long been a source of fascination, mystery & intrigue, yet there is now an abundance of scientific evidence to shed light on the origins, nature, and purpose of this captivating aspect of the human experience.  Sleep neuroscientist Dr. Sidarta Ribeiro, joins host Dr. Pete Kelly, C.Psych for an in-depth consideration of many of the themes explored in his book The Oracle of Night: The History & Science of Dreaming.  In this discussion they cover:      what led Dr. Ribeiro to write The Oracle of Night and the meaning behind the titlethe definition of a "dreaming" and the functions dreaming may servethe underlying neuroscience of dreaming parallels between dreams and what is experienced during psychedelic experienceswhy emotions in dreams can feel so incredibly intense compared to that which is experienced when awakethe science behind lucid dreaming and tips on how to become proficient in lucid dreamingthe symbolic meaning and utility of dreams, both individually and collectively the evolutionary significance of dreaming and why has it created an adaptive advantagethe negative impact of modernity on the quality and nature of dreams and our ability to recall/utilize dream contenthow to better remember dreams and become attuned to dream content how acute sleep deprivation can act as an "anti-depressant" in the context of severe depressionthe importance of REM sleep for emotion regulationDr. Ribeiro's thoughts on the biggest unanswered questions in the field of dream study, including how dream content is selected by the brain Dr. Sidarta Ribeiro is a founder and vice director of the Brain Institute at Universidade Federal do Rio Grande do Norte in Brazil, where he is also a professor of neuroscience. He received a PhD in animal behavior from The Rockefeller University. Sidarta is the author of The Oracle of Night: The History and Science of Dreaming, his fifth book, and a contributor for Folha de S.Paulo, Brazil´s largest newspaper.  He is a Member of the Latin American Academy of Sciences (ACAL) since 2016, he is associate editor of the journals PLoS One, Frontiers in Integrative Neuroscience and Frontiers In Psychology - Language Sciences. He is a member of the Steering Committee of the Latin American School for Educational, Cognitive and Neural Sciences and the Center for Research, Innovation and Education in Neuromathematics (NeuroMat). He served as secretary of the Brazilian Society of Neuroscience and Behavior (SBNeC) from 2009-2011 and was a member of the Brazilian committee of the Pew Latin American Fellows Program in the Biomedical Sciences between 2011 and 2015.

Comments or feedback? Send us a text!While many parenting books and websites emphasize the critical role of the parent in influencing a child's behaviour, it is frequently overlooked that all children possess a genetically driven temperament which exerts a powerful influence not only on the child's behaviour, but on the behaviour of their parents.  Dr. Danielle Dick, joins us for a discussion of some of the core ideas contained in her new book The Child Code: Understanding Your Child's Unique Nature for Happier, More Effective Parenting.  In this discussion we consider: Dr. Dick's motivation for writing The Child Code despite the current wealth of parenting books availablea definitive description of the influence of genes on our behaviour, along with a consideration of the actual ability of parents to influence life outcomeshow the heritability of the traits actually goes up over the lifespan owing to self-selection into environments that resonate with our traits.introduction to the "Big Three" dimensions of temperament: Extraversion, Emotionality & Effortful Controlexamples of how to leverage understanding of a child's temperament to optimize the parenting approach to promote "goodness of fit"the surprising consequences of parent and child being "over matched" on certain dimensions of temperament tips for parents to manage guilt & distress arising from challenges around fit with one's child, despite an abundance of unconditional lovethe difference between temperament and disorder and when parents should consult a mental health professionalDr. Dick's suggestions for managing the complex task of parenting across independent households in the wake of a separation or divorce - especially where  different parenting styles are presentstrategies for helping parents to understand the impact of their own temperament on perceptions of their childDanielle M. Dick, Ph.D., is the distinguished Commonwealth Professor of Psychology and Human and Molecular Genetics at Virginia Commonwealth University, where she directs a research institute on behavioral and emotional health. She is an internationally recognized and award-winning expert on genetic and environmental influences on human behavior. Dr. Dick has received grant funding totaling in excess of $25 million from the National Institutes of Health, the National Science Foundation, and private foundations. She has more than 300 peer-reviewed publications, and has won numerous national and international awards for her work.https://www.danielledick.com

Comments or feedback? Send us a text!At the beginning of the COVID-19 pandemic, thousands of psychotherapists were forced to migrate their practice to teletherapy or secure video.  While many have embraced this new mode of practice and have even found enhancements to their delivery of therapy, others are eager to return to the office or adopt a hybrid model.  Dr. Hannah Zeavin, author of the The Distance Cure: A History Teletherapy, joins us for a conversation around the history of teletherapy as well as systems-level implications for the wide adoption of teletherapy. In this conversation we cover:     the biggest misconceptions that psychotherapists are likely to labouring under with respect to the history and deployment of teletherapya discussion of the reality of every therapeutic exchange - whether virtual, in the office or otherwise - being mediated in some respect and existing within a "frame"the evidence-base around teletherapy3rd party payers stance towards teletherapy and whether a distinction between in-office therapy and teletherapy remains relevantthe dysfunctional focus on "activities" vs "outcomes" in an insurance-driven mental health system and how teletherapy could unwittingly accentuate this dynamicconsideration of therapy-process related factors in the context of teletherapy (e.g., client seeing the clinician within their home environment & vice versa)implications of the the appification/commodification of mental health services via digital platformsthe dangers of "batch processing" and "gamification" in the provision of therapy within a commodified mental health systemthe potential for the digital distribution of services to create “winner takes all” outcomes and the danger of a cost leader further commodifying mental health via call-center models or similarPotential unintended consequences of national licensure around the commodification of mental health services Dr. Zeavin's thoughts on the questions clinicians and practices should be grappling with right now in the context of tele therapyHannah Zeavin is a Lecturer in the Departments of English and History at the University of California, Berkeley and is on the Executive Committee of the University of California at Berkeley Center for Science, Technology, Medicine, and Society and on the Executive Committee of the Berkeley Center for New Media. Additionally, she is a visiting fellow at the Columbia University Center for the Study of Social Difference. Dr. Zeavin’s first book, The Distance Cure: A History of Teletherapy is now out from MIT Press, with a Foreword by John Durham Peters. She is at work on her second book, Mother’s Little Helpers: Technology in the American Family (MIT Press, 2023).  Dr. Zeavin serves as an Editorial Associate for The Journal of the American Psychoanalytic Association and is a co-founder of The STS Futures Initiative. Other work has appeared in or is forthcoming from American Imago, differences: A Journal of Feminist Cultural Studies, The Guardian, The Los Angeles Review of Books, Real Life Magazine, Slate, The Washington Post, Logic Magazine, and beyond. Dr. Zeavin received her B.A. from Yale University in 2012 and her Ph.D. from the Department of Media, Culture, and Communication