Anxiety and Depression Counselling

You might be here because

• You are worrying constantly and cannot switch it off
• Getting through an ordinary day is taking more than it used to
• You have stopped doing things you used to enjoy
• Sleep has become unreliable, or the mornings are the hardest part
• People keep telling you that you seem fine

None of that has to apply exactly. People often arrive unable to name what is wrong, and that is a perfectly good place to start from.

What the work looks like

We start by looking at what is actually happening — when it began, what makes it heavier, and what you have already tried. From there the work is usually a mix of Cognitive Behavioural Therapy, which examines the thinking patterns underneath the feeling, and mindfulness-based techniques for the moments when it becomes physical. You leave with things you can use, not just things you have discussed.

Approaches most often used

• Cognitive Behavioural Therapy

  CBT is a short-term, goal-oriented, practical approach to problem-solving. I use it to change the patterns of thinking or behaviour sitting behind a difficulty, and so change the way you feel. It is used for everything from sleep problems and relationship difficulties to substance use, anxiety and depression.

  More on CBT →

• Mindfulness-Based Psychotherapy

  Mindfulness-based psychotherapy brings meditation techniques into therapy to cultivate warmth, compassion and self-awareness. Through focused attention and open monitoring you develop the ability to observe your own thoughts and feelings without judgment. You do not need to become a dedicated meditator for it to work.

  More on Mindfulness →

• Solution-Focused Therapy

  A brief, forward-looking approach that starts from what you want to be different rather than from an account of how the problem began. It works with the exceptions — the times the difficulty is already smaller — and builds from there. Useful when you have limited sessions, or when re-telling the history is more than you want to do right now.

  More on SFT →

• Exposure and Response Prevention

  ERP is the established treatment for obsessive-compulsive disorder, and is also used for phobias and severe anxiety. You approach what triggers the obsession, in a graded order you agree in advance, while gradually dropping the compulsion or reassurance that usually follows. It is structured and paced deliberately — nothing happens that you have not consented to first.

  More on ERP →

Further reading

• Before you book

  What actually happens in a first counselling session

  A first session is mostly you talking and me listening, with no obligation to tell the worst of it straight away. Here is what the hour is actually spent on, what I will ask, and what you are free not to answer.

• Fees and funding

  What counselling costs in British Columbia, and when someone else pays for it

  Counselling in BC is not covered by MSP, but it is not always paid out of pocket either. Extended health benefits, ICBC, WorkSafeBC and the Crime Victim Assistance Program each cover it under different rules. Here is how to work out which one applies to you before you book anything.