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Anxiety & Mood Clinic

We use strategies grounded in cognitive-behaviour therapy (CBT) to help you to get well and stay well. We work with adults up to approximately 70 years of age. For younger ages you can visit our Child & Adolescent Program for more information on anxiety and mood problems.

CURRENT AVAILABILITY:
February 2023

Types Of anxiety & MOOD PROBLEMS that respond well with CBT

Click on a term below to learn more.

Generalized anxiety

Generalized anxiety disorder is characterized by excessive and uncontrollable worry. Among other symptoms, individuals may experience restlessness, irritability and muscle tension.

Alice describes herself as a “worry wort”. She worries incessantly about bad things that might happen. Worrying interferes with her sleep as she finds it difficult turning off her thoughts at night. During the day she often feels edgy and irritable. She likes to plan ahead for any potential problems. She’s not comfortable with uncertainty. Her anxiety is often triggered by a simple “what if…?” question.

HEalth anxiety

Health anxiety (hypochondriasis) is characterized by a preoccupation with the idea or thought that they are currently ill, or may become ill in the future. The worry is typically accompanied by checking the body and seeking reassurance from medical specialists.

Isabella often visits her doctor’s office for headaches and tingling in her hands. Each time her doctor sends her for tests, but nothing is ever found. Although these negative results make her feel better, the reassurance tends to be short-lived, as new concerns quickly arise. Isabella finds it difficult to relax until she is certain that she is not critically or terminally ill. Whenever she returns home from the doctor’s office she notices something new, and the cycle begins again.

PANIC ATTACKS

Panic disorder is characterized by recurring panic attacks and may be accompanied by Agoraphobia (anxiety about being in places or situations from which escape might be difficult or embarrassing).

Fatima describes her panic attacks as a “sudden wave of anxiety”. At first these anxiety episodes happened out of the blue, but soon enough she started to notice them happening in the shopping mall, parking garages and sometimes when she’s driving in rush hour.  Her anxiety flares up when she feels she might become trapped, or might not be able to get help if she needs it. She can't go anywhere without her cell phone and always carries a water bottle in case she has a panic attack. Now she only travels a limited distance from her home, and as a result she recently missed her niece's wedding.

Social Anxiety

Social anxiety (also known as social phobia) is characterized by excessive shyness and/or a fear of being judged by others.

Mark was a particularly shy boy growing up. He managed to get through university, although participating in class was difficult. He’s now in his first job, and he tends to keep himself to himself and avoids the lunchroom. Turning down extra work from his boss is virtually impossible for Mark, and he has recently begun to resent his job. Outside of work his social life is limited and he feels quite lonely. His fear of negative judgement and rejection contributes to his social isolation. He would like to have more meaningful connections with people, although the idea initiating conversations is terrifying.

Phobias

Specific phobia is characterized by an excessive fear of an object or a situation which, when avoided, significantly impairs one’s life in some way.

Amelie has always had a fear of vomiting. Although she has only vomited a couple of times in her life, she becomes very anxious if she feels remotely nauseous. She has started to avoid certain foods in case they do not agree with her. She is nervous at public events where people are eating and drinking. Up until recently her fear has not significantly interfered with her life. Now she would like to start a family, but she doesn’t know how she will handle morning sickness.

Depression

A major depressive episode is more than just feeling sad or depressed. Among other symptoms, individuals can experience lack of motivation, fatigue, poor concentration, low sex drive, sleep and appetite changes. Feelings of persistent depression can present as a general feeling of sadness, emptiness and aimlessness.

Brian is usually on top of his work but lately feels everything is taking longer than usual. He frequently loses his keys and is often reminded by his boss to finish tasks. From the moment he wakes up he feels more sluggish and even though he is sleeping more, he feels exhausted. Before he knows it this has been going on for two weeks and his irritability is starting to affect his relationships. He feels stuck in a rut.

Bipolar Disorder

Bipolar disorder is characterized by extreme mood swings: feeling high (mania or hypomania) and feeling low (depression). When mood shifts from depression to mania, individuals feel euphoric, full of energy, and often irritable. This mood state can lead to poor judgement, interpersonal problems, and ultimately is followed by another bout of depression.

Andrea is a gradutate student in science who experiences drastic mood changes. Sometimes she feels invincble, as if she can do anything and during during these times, she is able to work on her thesis for hours on end until late at night with only a few hours of sleep. This can be helpful, however her mania leads to impulsive behaviours, including gambling and online shopping. After a week or so she finds herself unable to get out of bed, feeling unmotivated, and has difficulty focussing. During this depressive state, she finds it hard to work on her thesis, she calls in sick to work, and avoids spending time with friends and family.

Frequently Asked Questions

What can I expect from CBT sessions?

If you and your psychologist agree to work together, then therapy can begin. The direction of treatment will largely depend upon the difficulties you are having. In therapy we will focus on how you think (cognitions) and what you do (behaviours). Although therapy sessions are far less structured than the assessment phase, sessions may feel somewhat structured in that each one will attempt to address the following:

  • Review of homework (e.g. questionnaires, monitoring forms, behavioural exposures etc.)
  • Check-in to see if any major new developments have occurred (e.g. significant stressors, or major changes)
  • General discussion of the issues on which you have been working
  • Introduction of new material/strategies
  • Plan of action (collaborative discussion of homework for the week)

View more information about Cognitive Behaviour Therapy.

How much does it cost?

Our standard rate/fee is $225.00 per session (45-50 minutes). This is the fee recommended by the Ontario Psychological Association for individual psychotherapy sessions. Ontario Health Insurance Plan (OHIP) does not cover treatment with private psychologists. However, there are a number of ways to have your treatment costs reimbursed. You can find out more details on our Fees page.

What happens in the first appointment?

Therapy always starts with an assessment. This may last between 1-3 sessions. We need to have a clear understanding of what your difficulties are before we can make any treatment recommendations. The goals of the assessment, from the point of view of the psychologist, are to:

  • Discuss confidentiality
  • Gather relevant background information (e.g. family of origin, past history of difficulties)
  • Hear a description of the difficulties in your own words (especially important if you have been referred by a doctor or family member)
  • Determine if your presenting difficulties fit within the psychologist’s scope of practice (if not, a referral will be made to another clinician or clinic)
  • Set some preliminary treatment goals
  • Explain CBT and how it applies to your specific difficulties
  • Answer any concerns you have about the therapy process

The assessment phase is a little more structured than subsequent therapy sessions. It is the psychologist’s role to guide you through it, so you do not need to worry about what to say.

How long does treatment take?

The answer depends on a number of variables: the nature of the problem, financial limitations, your availability, your own preferences about the pace of the work, and your therapy goals. Using these variables, we can tailor a CBT program specific to your needs. Typically we see individuals anywhere from 4 to 20 sessions. The standard length of a session is 45-50 minutes long. We usually refer to the appointment as an hour, with the final 10-15 mins used for the psychologist to write his or her notes and copy materials that will be useful for subsequent sessions.

Do I need a referral?

You do not need a referral to make an appointment with us. If you are planning on using your extended health benefits plan, you may wish to check with your insurance company as sometimes they require that you be referred.

Can I choose which psychologist to work with?

Once you have made contact with us, you will have a brief confidential conversation with our clinic administrator. She will find out from you what you are hoping to talk about with the therapist, and if you have a preference for a male or female therapist. She will also find out when you are available to come in for an appointment. Based on this initial conversation you will be paired with a therapist. If you have a specific preference on who you would like to meet with, we will do our best to accommodate your wishes.

Anxiety & Mood Clinic Staff:

Suffering from anxiety?