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

Hope Arnold, LCSW, MA, a supervisor and trainer in Radically Open DBT (RO DBT), discusses how this unique therapy approach targets overcontrol disorders like OCPD. She explores how RO DBT differs from traditional DBT, focusing on emotional expressiveness and social connectedness. Arnold shares insights into the biology and development of overcontrol, the importance of addressing perfectionism, and the need for clinicians to recognize their own tendencies towards overcontrol. Practical tips for clients and therapists are provided, emphasizing the journey toward adaptive connectedness.

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

Comments or feedback? Send us a text! While trauma perpetuated by traumatic loss or imminent threat to one’s life is familiar and salient to most psychotherapists, the pervasiveness & severity of trauma precipitated by "moral injury" experienced during and/or after a trauma is frequently underestimated and overlooked as a factor that can exacerbate and/or maintain PTSD.  Internationally recognized expert in PTSD, psychologist, researcher & author, Dr. Brett Litz, joins us for an interview around the Adaptive Disclosure (AD) psychotherapy protocol.  In this episode we cover:  the nuances involved with conceptualizing and treating operational stress injuries among military personnel, including a review of the biggest misconceptions that clinicians unfamiliar with this population might harbour and how this could impact treatmentthe definition of a moral injury and an overview of the two major types of moral injury (i.e., moral injury "self" & moral injury "other")consideration of the "moral" emotions of shame & anger in the context of moral injurychallenges of treating moral injury as well as subtle or overt signs that a client might be affected by a moral injurythe origin of Adaptive Disclosure (AD) and where it departs from other CBT-based trauma therapies such as Prolonged Exposure Therapy or Cognitive Processing Therapythe basic theoretical framework/some of the core assumptions of Adaptive Disclosuredescriptions of some of the core therapeutic interventions in Adaptive Disclosurethe unique challenges of delivering any psychotherapy - including Adaptive Disclosure - within the context of a military population (e.g., over control, overregulation)  a brief outline of the next iteration of Adaptive Disclosure - Adaptive Disclosure Enhanced (ADE), which emphasizes to an even great extent increased flexibility in provision of therapy, an emphasis on functioning (as opposed to symptoms) and integration of compassion trainingDr. Litz is a clinical psychologist and Professor in the Departments of Psychiatry and Psychological and Brain Sciences and is also the Director of the Mental Health Core of the Massachusetts Veterans Epidemiological Research and Information Center at the VA Boston Healthcare System. Dr. Litz is internationally recognized as an expert on PTSD, military trauma, and the early intervention and treatment of trauma, traumatic loss, and moral injury.  Dr. Litz recent work entails the development and validation of a new measure of moral injury as a multidimensional outcome (the Moral Injury Outcome Scale; a public domain scale available by emailing Dr. Litz) and conducting a VA funded multi site clinical trial testing an expanded version of Adaptive Disclosure on Veterans with PTSD. Adaptive Disclosure is a flexible multidimensional psychotherapy that employs different strategies to target threat-based, loss-related, and moral injury-related trauma. Dr. Litz has over 370 peer reviewed publications and is a fellow of the Association of Behavioral and Cognitive Therapies, the American Psychopathological Association, and the Association for Psychological Science.https://www.bu.edu/psych/people/litzb/http://www.guilford.com/books/Adaptive-Disclosure/Litz-Lebowitz-Gray-Nash/9781462523290

Comments or feedback? Send us a text! While self-care is widely acknowledged as being critical to effective and sustainable engagement in the provision of mental health services, it is an area of focus that is frequently neglected by mental health professionals for a variety of complex reasons.  Co-founders of the website Intentional Therapist, Drs. Karen Dyck & Melissa Tieseen, return to Thoughts on Record to discuss workplace hazards that mental health professionals must navigate.  We also review fundamental aspects of self-care necessary to effectively navigate these hazards.  In this discussion we cover:    General 'workplace hazards' that must be navigated by mental health professionals including:Patient behavioursWorking conditionsEmotional depletionPsychic/interpersonal isolationComplexity of therapeutic relationshipsPersonal disruptionsImpact of the pandemic on therapists and their practice:The need for continuous adjustments/managing uncertainty over the past 1.5 yearsTeletherapy-specific impacts on clinician well-being (but also considering emergent opportunties)Overall impact on therapists' well-beingCombatting the hazards (especially within the context of the current pandemic) - The 4 C’s of Self-Care:Community/ConnectionCompassionCourageCreativityDr. Karen Dyck completed her doctoral degree in clinical psychology at the University of South Dakota and currently works in private practice in Oakbank, Manitoba.  She is also presently the Executive Director of the Manitoba Psychological Society.  Before shifting to private practice, Karen spent the bulk of her career working within the Rural and Northern Psychology Program at the University of Manitoba’s Department of Clinical Health Psychology, and is a former chair of the Rural and Northern Psychology Section of the Canadian Psychological Association.  Dr. Melissa Tiessen completed her doctoral degree in clinical psychology at McGill University and currently works in private practice in Ottawa, Ontario.  Melissa also previously worked in the Rural and Northern Psychology Program at the University of Manitoba, as well as has served as the Education Director for the CPA, overseeing the organization’s accreditation and continuing education activities.  Karen and Melissa both have a longstanding interest in self-care and workplace wellness initiatives.  Recognizing that there are so many female mental health professionals, like themselves, who are trying to balance careers with additional caregiving roles, in 2019 Karen and Melissa co-founded Intentional Therapist.  Their mission is to help female mental health professionals stay healthy and happy through intentional, creative, and playful self-care.  https://www.intentionaltherapist.ca

Comments or feedback? Send us a text! In many contexts - both in-person and online - it can often feel like reasonable behaviour, the ability to constructively disagree, and basic kindness are in short supply.  Award-winning science journalist and author, Melissa Wenner Moyer, joins us to discuss some of the themes in her new book How to Raise Kids Who Aren't Assholes.  In this discussion we cover:a consideration of the evidence that parenting is failing children and creating an increase in bad behaviour  features of the current environment that could be selecting for/promoting bad behaviour among childrenMelinda's reflection on what has changed the most for children growing up in the 70s or 80s vs those who have been raised in the last 10 to 15 years  the critical link between generosity and successimpulse control & emotion vs. self-esteem as the primary driver of a child's sense of self-worth and contentednessthe key role of bearing responsibility and managing adversity (in reasonable doses) in creating tolerable adultsthe value of providing children with frank, direct feedback while remaining attuned to the overall attachment with your childhow to talk about lying with children and to work through contradictions that children may notice in their parent's behaviour around lying on a near-daily basis Melinda's thoughts and words of encouragement for parents who are worried that they are not living up to their ideal as parentsMelinda Wenner Moyer is a contributing editor at Scientific Americanmagazine and a regular contributor to The New York Times, Washington Post, and other national magazines and newspapers. She is a faculty member in the Science, Health & Environmental Reporting program at NYU’s Arthur L. Carter Journalism Institute. Her first book, How To Raise Kids Who Aren’t Assholes, was published in July 2021 by J.P. Putnam’s Sons. Melinda was the recipient of the 2019 Bricker Award for Science Writing in Medicine, and her work was featured in the 2020 Best American Science and Nature Writing anthology. She was also awarded a 2018 Alicia Patterson Foundation fellowship. Moyer’s work has won first place prizes in the Awards for Excellence in Health Care Journalism, the Folio Eddie Awards and the Annual Writing Awards of the American Society of Journalists and Authors. It has also been shortlisted for a James Beard Journalism Award, a National Academy of Sciences Communication Award and a National Magazine Award. She has a master’s in Science, Health & Environmental Reporting from NYU and a background in cell and molecular biology. She lives in New York’s Hudson Valley with her husband, two children, and her dog.https://www.melindawennermoyer.comMelindawmoyer.substack.com