‘Tis the (Exam) Season!



by: Dr. Marisa Murray, C.Psych.(Supervised Practice)

You’ve prepared for weeks. Or maybe you haven’t? Your social life--at this point, is non-existent! Whether you’ve studied to the brink of reciting the material in your sleep or if your total exam prep has consisted of overnight cramming, when exam day arrives, the same thing often happens. Thoughts of uncertainty begin to kick in, leaving you feeling overwhelmed and anxious.

It’s natural to feel some butterflies in your stomach before an exam. It’s similar to the way you might feel before playing in the big game, performing on stage, or engaging in public speaking. Pre-exam jitters can be channeled to help motivate us to perform at our best. This is known as a helpful kind of anxiety. It helps us view the exam as an exciting challenge!

It’s the unhelpful kind of anxiety–the one that causes us to fear the exam, to have difficulty concentrating, to second guess ourselves or to have physical symptoms, like a headache or a racing heart--that interferes with our performance.

With exam season fast approaching, here are some helpful tips for managing your pre-exam anxiety:

  1. Use your time effectively: No matter how hard you try, it can feel like there is ‘never enough time’ around exam season. Fine-tuning your time-management skills can include: using a calendar or a checklist to set goals, avoiding potential distractions (e.g., phone, your guilty pleasure on television) during study time, and keeping a consistent yet flexible study routine while rewarding yourself for meeting your study goals.
  2. Engage in self-care: Take care of yourself to manage your stress levels. Getting a good night’s sleep, taking breaks (typically ones that allow for stretching, moving around, replenishing food and water intake), engaging in social interactions, and/or practicing a relaxation activity are examples of how you can release some of the pre-exam stress. Just as you schedule your study time, schedule time for yourself!
  3. Develop a study plan: Consider putting together a realistic study plan that allows for flexibility. In developing your study plan, figure out which exams require more prep time. Also, try to factor in some wiggle room for potential obstacles that might interfere with the study plan (e.g., coming down with the flu!). Most importantly, figure out what helps you reach your optimal studying – do you study better alone? Or do you better achieve your studying goals in a group setting? Do you like to study in the comfort of your own home? Or do you prefer the silence of the library? Do you learn better visually? Auditorily? What time of day do you retain information best? Try to answer these questions and incorporate the answers into your study plan.
  4. Monitor your negative thoughts: Telling yourself, “I’m going to fail this exam,” can be very convincing to the powerful mind and, yes, exacerbate anxiety! Keep in mind that there will be questions you know and others you don’t. You cannot learn everything! Try to view your upcoming exam as a new experience. Perhaps the midterm didn’t go as well as you wanted – this is a new exam. Work on convincing your mind that you will “try your best.”
  5. Make use of available resources: Many schools offer workshops and presentations related to stress management, test-taking strategies, and time-management. Look into what’s available on campus. Also, make use of your professors’ and teaching assistants’ office hours to get a better grasp on challenging course material. Finally, consider reaching out to a mental health professional for assistance in managing unhelpful exam anxiety.

Dr. Marisa Murray, C.Psych. (Supervised Practice) is a psychologist in supervised practice at the Centre for Interpersonal Relationships (CFIR) in Toronto, Canada, under the supervision of Dr. Cassandra Pasiak, C.Psych. Dr. Murray supports children, adolescents, and adults with psychological treatment and assessment services, including psychoeducational assessments and treatment for eating disorders and body image-related issues.







Relationship Therapy for LGBTQ+


by: Dr. Dino Zuccarini, C.Psych.

Living and loving in the social margins of a heteronormative world can create complexity in the relationships of individuals from the LGBTQ+ community.  In our early years, recognition of being different than members of your family of origin and peers can create significant attachment and self fears. We all need a sense of acceptance, emotional validation, approval, and admiration if we are to develop a strong sense of self and connection to others. Individuals from LGBTQ+, in many instances, may face abandonment, rejection, punishment, and abuse just for being different. These types of traumatic experiences create fears and distrust in others, mainly when early attachment figures are the individuals who are the source of rejection, punishment, and abandonment. Rejection also fills individuals with a deep sense of shame that comes with deep feelings of unlovability, insignificance, and worthlessness.  

The internalization of these experiences can create difficulties when fears, shame, and past hurts limit the capacity to trust and connect others. The clinicians at CFIR work to build more secure, resilient identities and strengthen interpersonal relationships in the LGBTQ+.  They support you to unpack the emotional residue of early distress in attachment and/or with pears and the impact of this residue on your attachments.




The Best Gift this Holiday Season – Self-Care



By: Dr. Brianna Jaris, C.Psych.

The holiday season is an incredibly stressful time for many people. There are some things that we may not be able to avoid – congested malls, traffic and travel, holiday gatherings and parties, buying gifts, etc… but, throughout it all, the best thing that we can do is to give ourselves the gift of self-care. Here are a few things that we can do to make the best out of this holiday season:

1) Make a plan – Be prepared by making a plan. For example, make a grocery list or plan out when you can do your holiday shopping. Having a plan is the first step in preventing the added stress of forgetting something or having to do things last minute. 

2) Be proactive – Don’t wait until the last minute to shop for groceries for a holiday dinner or shop for gifts. Getting things done ahead of time can give you a great sense of accomplishment and can help avoid the stress of overwhelming yourself with having to do too much at once. 

3) Be realistic – For example, plan for there to be traffic or for the shopping centres to be busy. Also, set a budget and don’t go overboard. It’s important to realize that you may not be able to do it all yourself, so don’t be afraid to enlist help if you need to as well.

4) Set up appropriate boundaries – Establish a timeline for visitation - don’t let guests overstay their welcome. Do certain topics of conversation need to be set as “off-limits”? Don’t forget that setting up healthy boundaries also means being able to say “no” to people or demands. Remember that in order to be healthy, sometimes you have to risk disappointing other people.

5) Build time in for yourself – The most important thing of all this holiday season is to take care of you. Take breaks and build in time to relax as necessary. Self-Care is the best gift you can give.

Stay ahead of stress this holiday season by sticking to a plan, recognizing your limits, and not letting others dictate your holiday. We all want to make the holiday season special for the ones we love, but don’t forget to take care of YOU this holiday season!

Dr. Brianna Jaris, C.Psych. is a clinical psychologist at CFIR.  She has extensive experience in psychological assessment and diagnosis and the treatment of a wide range of psychological issues, including trauma, depression, anxiety.  She is currently the head of CFIR’s Trauma and PTSD service. You can visit www.cfir.ca to find out more about Dr. Jaris.

Attachment Style and Couple Sexual Issues


According to attachment theory, as a result of early year interactions with caregivers, we either become securely attached or insecurely attached—either anxiously or avoidantly attached.  Attachment style then influences sexuality in complex ways. Anxiously attached partners in the bedroom might be seeking out sex for reassurance of self or attachment fears.  For example, they may feel less positive about themselves (e.g., undesirable or unattractive), and/or have worries about the availability, accessibility, and responsiveness of their partner.  Strong sexual desire is fuelled by the need for self and attachment reassurance. Avoidantly attached partners are not motivated sexually in the same way.  These partners are more likely to focus on the pleasure-oriented aspects of sex only and have difficulties with feelings of closeness.  Some avoidantly attached partners will have sex for duty's sake. Arousal and desire problems arise when anxiously or avoidantly attached partners are unable to fulfill these goals.  

The clinicians at CFIR support couple partners to discover the multiple ways in which securely attached partners experience and explore sexuality. The couple and sex therapy clinicians at CFIR use a wide variety of strategies to support couple partners to build more confidence in their sexuality, greater eroticism, and desire.




Evidence-based Treatment at CFIR




Over the past 35 years, there has been a substantial amount of research conducted to identify psychotherapy treatments that work. Research suggests that many different types of treatment approaches might be beneficial for a wide variety of disorders. It is vital that a clinician who is providing you treatment is trained in empirically-supported treatment interventions so that you know that you are getting the most scientifically investigated treatment interventions.

Recently, evidence-based practice has come to mean more than empirically-supported treatment (Canadian Psychological Association, 2012). Evidence-based practice involves the thoughtful and informed use of the psychological research base to inform clinical treatment practice. It’s also essential that your clinician be able to attend to a wide range of individual differences and personal client factors (e.g., attachment style, coping styles, cultural factors) in treatment, as well as consideration and use of research in supporting clients in their healing process.

The clinicians at CFIR are invested in providing empirically-supported treatments, tailoring treatment to individuals based on their needs and individual differences, and ensuring that we are kept abreast of leading-edge research related to your presenting issues.




Forgiveness and Reconciliation for Couples Post Affairs



Forgiveness and reconciliation after an extramarital affair is a complex process. Forgiveness occurs when there is an experiential shift in the injured partner toward the betraying partner— a movement toward softer feelings. This experiential shift requires an unpacking of different types of emotional reactions associated with these types of relationship traumas. The shattering of one’s sense of self, the other, and one’s sense of future identity in the aftermath of an affair can create instability and insecurity in one’s self and the relationship. These types of injuries result in complex emotional reactions that require resolution. Reconciliation, the next step in recovery, occurs when steps are taken to rebuild trust and restore the relationship after a forgiveness process. These steps are essential for the restoration of security.

The team of psychologists, psychotherapists, and counsellors at CFIR employ evidence-based interventions to support relationship partners beleaguered by emotional injuries in the aftermath of an affair. Steps to forgiveness and reconciliation and the interventions required for successful resolution of an extramarital affair have been delineated in research conducted by Dr. Zuccarini, C.Psych., co-founder of the Centre for Interpersonal Relationships. (Zuccarini et al., 2013). Clinicians at CFIR are prepared to support you in promoting healing in your relationship.



Navigating the Teenage Years




We were all teenagers once, yet sometimes trying to understand what's on your teen's mind is harder than advanced high school calculus. What can make matters worse is when, in your parental quest to figure out your teen's thoughts, feelings and motivations, both you and your child end up having a conflict and/or experiencing feelings of confusion, frustration, and at times, ultimate helplessness. 

While teenagers sometimes aren't as vocal and open with their parents, a crucial step in a parent confronting a teenager's psychological challenges is helping them identify the source and then exploring options to address it.

"My teen is withdrawing from the family."  

"You're not the boss of me." Or "You just don't get it!" How many times did you say this to your parents as a teen? How many times have you been on the receiving end of those words? One of the most widespread challenges of adolescence is the parent-teen relationship. Parents often grapple with a balance between providing support while allowing teens to make their own decisions and life choices. Here are some things you can do:  

  • Accept: Your teenager is exploring an unfamiliar life stage - - one in which friends and classmates are considered the most influential. You can continue to play a very prominent role in their lives often by merely letting them know that they can reach out to you when they need to. 

  • Avoid why questions: Checking-in with your child is essential. But try to avoid "WHY" questions. What you believe to be a simple question of curiosity might be interpreted by your teen as the 'Third Degree' leaving both of you equally frustrated. Instead of saying, "Why on earth did you do that?" maybe try rephrasing the question as "What did you hope would happen?

  • Plan activities: Shared interests (or maybe not…) Venturing into your teen's world to learn about a new videogame might be an opportunity for him or her to teach YOU something new. Or maybe you can offer to teach your teen a new skill. Whether it's teaching your teen a new recipe or how to change a tire - that might be another way to connect - - but remember: DON'T FORCE IT!   

  • Share your own experience:  Often times, teens appreciate hearing about their parents' own teenage experiences. Feel comfortable sharing your own adolescent experiences and give your teen the opportunity to ask you questions. Most importantly, try to make connections between your skills and your teen's current ones. 

  • Monitor screen time: Like it or not, screens - - whether they are smartphones, tablets, portable games, video game consoles, computers, and TVs - - have become an integral part of teenagers' daily lives. If you're hoping it's a stage, I have news for you - - this is unlikely to change soon. As such, setting limits on screen time use for the entire family (e.g., dinner time, movie nights) will encourage face-to-face communication among family members, without teens feeling singled-out.

"My teen experienced a traumatic event. How do I offer support?" 

Talking about a traumatic event, at any age, can be overwhelming. Teenagers might not know who they should talk to, how to talk to someone, how much is appropriate to share, or where to start. Some teens might feel more comfortable talking to a friend, a sibling, or a mental health professional. Meeting your teen at a level where he or she feels comfortable is KEY! If your teen has reached out to you for support, it's important to consider the following:

  • Try to stay calm/composed: Although you, as a parent, are also experiencing heightened levels of emotions, it's vital for you to remain calm for your teen when talking about his or her traumatic experience so you can foster feelings of safety and security. 

  • Avoid judgment: Traumatic experiences often lead to feelings of self-blame and guilt. It's crucial to listen openly and empathically, and, most importantly, convey the message that this was NOT the teen's fault. 

  • Show openness to questions: Allow your teen to ask questions and try your best to answer these questions openly and honestly. 

  • Know your limits: if your teen is having difficulty talking about the experience with you, don't take it personally. It's not uncommon for a teenager to "not want to share" with a parent (at least initially). What's most important is that your teen receives appropriate support. Consider reaching out to a mental health professional for guidance. 

"My teen can't seem to meet school deadlines or focus in class." 

High school has never been easy. At some point or another, many teens experience difficulty in school - whether it's their ability to focus in a particular class, study for an exam, or find the motivation to do homework. For some teens, these daily difficulties pose challenges to their overall learning experience and impact their overall functioning.  
As teenagers advance in school, academic demands increase, and challenges sometimes become more apparent. As a result, it is essential to understand when these challenges might be a sign of a learning disorder or Attention Deficit Hyperactivity Disorder (or more commonly referred to as ADHD):
  • Has your teen experienced changes in attitude toward school/school attendance? For example, a teenager who previously enjoyed school now demonstrates resistance or a negative attitude toward school. 
  • Has your teen expressed emotional concerns like feeling anxious or overwhelmed about completing school work or writing exams? 
  • Has your teen complained about difficulty keeping up with school work/devoting an excessive amount of time to homework compared to other classmates? 
  • Has the school expressed concern regarding challenges (e.g., applying skills and knowledge, impulsive and disruptive behaviours, difficulty with focus) that are interfering with your teen's ability to reach his/her academic potential?
  • Is your teen experiencing consistent difficulty with planning and organization, remembering details, and time-management? 

If you answered "YES" to any one of those questions, a psychoeducational assessment might provide a clear understanding of your teenager's cognitive and academic strengths and challenges. In addition, an assessment might also inform you and your teen of appropriate accommodations that can be made at both the secondary and post-secondary level to ensure that your teen performs at an academic level reflective of his or her abilities.



7 Tips to Put the Brakes on Road Rage



In our modern commuting lives, there may be nothing less infuriating than traffic and congestion. No doubt, in recent years there has been a notable jump in commute times across most Canadian cities and as a result a more significant presence of “road rage”. You might be all too familiar with the trademark experiences of road rage: the honking horns, the screams from passing cars, or the casual use of the middle finger. However, we’re less likely to have ways to help deal with the stress caused by traffic and congestion.

Here are some great tips to put the brakes on road rage: 

1. Listen to audiobooks - Find and explore new subjects of interest to you that will both expand your mind as well as allow you to focus on something other than the cars around you.

2. Take Deep Breaths - This simple strategy can be quite effective in reducing stress. Try this: Get comfortable in your car seat, take in a deep breath in for four seconds, then hold this breath for seven seconds, and slowly breath out for another eight seconds. Try to relax your body as you slowly release this breath. 

3. Get out of your head and into your body -  Sometimes we get so wrapped up in our heads we forget about the rest of our experiences. Try this: While paying attention to traffic get comfortable in your car seat, start to notice where your body is making contact with the car, focus on a particular sensation, try to hold your concentration on the feeling, note any distractions, and then try to move your attention back to the sensation. To deepen this exercise, include deep breaths. 

4. Be curious about the experiences of those in the cars around you - When we are face-to-face with someone, we can more easily experience empathy for others – but when they’re a car-length away, understanding can sometimes become difficult. When driving, try to imagine the lives and faces of the individuals in the cars around you. Like you, they’re bound to make mistakes. This empathy technique can help reduce feelings of anger and frustration.

5. Explore your musical tastes - Music can be an excellent way to decompress and bring feelings of happiness to commuting. However, it’s best to take notice of what type of music you’re playing. Is it aggressive or angry? It might not be the best time to explore this type of music when you’re behind the wheel. Try something more uplifting, relaxing, or neutral to keep calm and avoid anger. 

6. Take the scenic route - Though not always possible, occasionally adding a few minutes onto your commute may be worth it to avoid congestion. Sometimes an extra ten minutes down a picturesque tree-lined street is ideal in comparison to a gloomy and congested highway. 

7. Make congestion part of your decompression - This cognitive shuffle can help turnaround the way you feel about your commute home. Try looking at this period as a time you can leverage. Shift this time from being lost to instead being a valuable part of your day to disconnect, explore, or grow using some of the other strategies discussed in this article. 


These tips should help you lessen some of the effects of road rage and traffic congestion. However, if you feel like your anger still feels out of control, it might be time to seek help. Skilled clinicians at CFIR can help you understand your experiences of anger and support you to build a more resilient and healthy self. Click here to book your free consultation now.




7 Signs Your Relationship May Need Help






Relationships have never been easy and now it seems we’re in a space and time where technology and the way we connect are continuously growing and changing. The intimacy we have with someone can mean so much, yet it seems we consistently struggle to maintain the bond. How can we know if we are “getting it right” in our partnerships?

In speaking about the complexity of our relationships, famed relationship expert, Esther Perel notes that “companionship, family, children, economic support, a best friend, a passionate lover, a trusted confidante, an intellectual equal [...] we are asking from one person what an entire village once provided.” In this paradigm, it can be hard to understand when our partners and our relationships maybe failing us. 

Here are some signs that indicate your relationship may need some work:

1. Lack of Communication 

In a world bursting with ways to communicate, it may be surprising to learn that ineffective communication remains a common issue in relationships. It’s impossible for your partner to know all your needs, feelings, and thoughts without talking about them. Communication is essential in overcoming relationship wounds, and very few relationships can survive without it.

2. Arguing with No Repair

Though constant arguing can sometimes be indicative of relationship distress – unrepaired conflict may be the real culprit. Arguments, when done sympathetically, are an essential part of relationship satisfaction. Repairing from a dispute allows partners to accept each ones’ differences and re-establish their love for one another. 

3. Loss of Curiosity

We are continually growing and changing as individuals and it crucial we remember to remain curious about our partners as they grow. The experience of curiosity and surprise is one of the essential processes in maintaining long-term desire. Partners in healthy relationships are happy to explore their partner’s unique perspective of the world.

4. Mind Reading

This familiar refrain, “Look, I know you're angry…” exposes a common misstep in many relationships. Often experienced in conjunction with a loss of curiosity, partners start assuming they are always in each other’s “bad books” even before a problem is revealed. Stay tentative about your perceived experience of your partner, especially in times of distress. You might be surprised by the difference between how they feel and how you thought the feel!

5. Loss of Priority

It can be hard to find a balance between work, children, friends, and family in today’s busy world. How you prioritize your relationship may look different to you, so it’s crucial that you discuss this with your partner. Failure to explore this in a discussion could leave your partner feeling unloved and unimportant. 

6. No Hurt – Only Anger

When we’re most distressed it may feel instinctive to get angry. Though anger is an important emotion in that it tells us something isn’t working, it isn’t usually helpful in resolving conflict. Instead, opting to express our more vulnerable and hurt emotions allows our partner to understand and ultimately care for us when necessary. 

7. Blaming your partner

It takes two to tango! Though one partner may sometimes be experiencing more distress, it’s beneficial to recognize that your relationship is co-created by both of you. Take note of how you may be contributing to the dynamic between you and your partner.


Couples experiencing any of these relationship difficulties at heightened levels may feel like they are insurmountable problems. However, exploring these issues can provide a needed check-in for your relationship. Moreover, what you discover can inspire you and your partner to reimage what your relationship could become. Couples therapy offers an excellent opportunity to explore these struggles and move towards growth. The skilled clinicians at CFIR can help you and your partner better understands your current distress and support you to build a more resilient and healthy relationship.




Three Key Tips All Women Need to Apply Now in Their Professional Lives



As the saying goes “Natural Born Leader” women have been supporting organizations in leading roles across many diverse industries globally. 

CFIR Associate of CFIR's Career & Workplace Service, Erin Leslie, share three essential tips all women need to apply now in their professional lives and when seeking that next level role: 

1. When looking for key roles make sure to take into account lifestyle preferences and balances that give time for you to look after yourself and your loved ones. Don’t just accept the next leadership role because it means you will have the title and responsibility. You need time to be mindful of your own needs and healthy approach to re-energizing.

2. Do you hear yourself saying “I can’t apply on that job” because you think you don’t fill 80% of the job posting criteria? Stop self-doubt now! Do you like the position description? Great! Now, look at how your past experience can contribute and build the narrative around how your experience makes you the ideal candidate for the job. 

3. Be mindful about negative energy and the impacts it has on your stress levels and body. There are times when we catch ourselves judging a project or adverse performance/outcomes without having all the facts. Remember that you never know what people are genuinely going through in their lives that would cause professional impacts on their work. Be supportive and an active listener. You may uncover some key insights to help move the situation back onto a successful pathway. 

Thank someone today for their professional services and happy International Women’s Day.

Are you ready to expand on your journey into professional leadership? Request to meet with Erin through CFIR's Career and Workplace Service now: 


 Book Your Initial Appointment




Six Reasons to Book Your Appointment at CFIR Toronto Today




Did you know that Centre for Interpersonal Relationships (Toronto) recently moved? We opened the doors to our new, spacious office located at 790 Bay St. in June! Our relocation is an exciting chapter in the story of CFIR as we continue to provide accessible and flexible mental health services for children, adolescents, adults, couples, families & groups. There are a lot of good reasons to consider coming to CFIR’s Toronto location for an appointment. Here are six that immediately come to mind:

1. Vast Clinical Experience – Psychologists at CFIR are skilled professionals ready to address the cognitive, emotional, behavioural, interpersonal and socio-cultural dimensions of your concerns. 

2. Location790 Bay Street is a medical office building located in the heart of downtown Toronto. CFIR is now just steps from major downtown hospitals including Women’s College Hospital, Mount Sinai Hospital, Sick Kids Hosptial. We're also in very close proximity to College Subway Station, and buses as well as the PATH (our underground walkway through the business district). On-site and underground paid parking is available.

3. Broad and Flexible Treatment Options - We believe it is crucial for your clinician to be able to be flexible in offering a variety of scientific, evidence-based treatments to address the various facets of your concerns. No one treatment fits all, so we provide you with different possibilities.  At CFIR, we take an integrative approach to treatment, to ensure we tailor them to each client's needs. 

4. One Stop for All Mental Health Issues - CFIR provides a wide-range of specialized services to support you:

TREATMENT SERVICES
  • Adolescent Psychology
  • Adoption
  • Anger & Emotion Regulation
  • Anxiety & Stress
  • Attention Deficit & Learning Challenges
  • Career & Workplace
  • Child Psychology
  • Couples Therapy
  • Depression Mood & Grief
  • Eating Weight & Body Image
  • Family Psychology
  • Fertility Counselling
  • Forensic Treatment
  • Health Psychology
  • Interpersonal Relationships 
  • Multicultural
  • Neuropsychology
  • Obsessive-Compulsive
  • Personality
  • Rehabilitation Psychology
  • Self-Growth & Self-Esteem
  • Sex Therapy
  • Sexual Addiction
  • Sexuality Gender & Relationship Diversity
  • Substance Use
  • Trauma Psychology & PTSD
ASSESSMENT SERVICES
  • Adoption Assessment
  • Alcohol & Drug Evaluation
  • Attention Deficit & ADHD
  • Autism Spectrum & Developmental Disorder
  • Career & Vocational Couples & Pre-Marital
  • Disability Injury & Accident
  • Fertility & Third-Party Reproduction
  • Forensic Assessment
  • Immigration & Refugee
  • Neuropsychological Assessment
  • Personality & Interpersonal Functioning
  • Psychodiagnosis & Mental Health
  • Psychoeducation Assessment
  • Trauma & Dissociation

5. Remote Support that Can Come to You - We make it easier to address your concerns by offering you a secure, confidential and private way for you to get the care that you need via our optional SecureVideo Telepsychology Service.*

6. Coverage by Most Insurance Plans - Private extended insurance plans (as well as Medavie/BlueCross (RCMP, Veterans Affairs, Canadian Armed Forces) and CUPE) provide coverage for CFIR services.  Our Psychologists are approved providers of the Canadian Interim Federal Health Program (IFHP) for Refugees.  

CFIR clinicians will conduct a comprehensive assessment to identify the factors that have contributed to your concerns. The assessment is followed up with a treatment plan to address your issues and provide you with a sense of the treatment duration, and what type of progress and change you can expect over time.

There you have it, six solid reasons to book your initial appointment at CFIR - Toronto today. With offices in Toronto and Ottawa, we’ll get you started on your journey towards positive change.  Click here to request your session.


*SecureVideo Telepsychology Services are only available for Ontario residents. 



A Look at How Psychology Can Help and Support Refugees


by: Marcela Olavarria Turner, M.A., C.Psych. Assoc.

In recognition of World Refugee Day, we want to highlight how psychology can help and support refugees in their journey to building their lives in Canada. According to the UN Refugee Agency, as of 2016, there are 121,267 refugees and asylum seekers in Canada alone, and a sky rocking 67.75M refugees, asylum seekers, internally displaced persons, returnees, stateless and vulnerable persons worldwide. Before arriving at a receiving country, many refugees experience things such as war, violence (sexual, physical and psychological), torture, political repression, and multiple losses. They can also experience harsh conditions while transitioning to a safer place, such as more exposure to violence, separation from loved ones, uncertainty about their own and loved ones' safety, doubt about both their future and about the outcome of their migration. 

Despite these experiences, refugees show remarkable ability to adapt and cope with such adversity. Nonetheless, once refugees have arrived in safer places such as Canada, they can still experience temporary or enduring difficulties as a result of migratory experiences and stressors related to adapting to a new social, economic and cultural environment. These difficulties might be: 

  • Physical: difficulty sleeping or oversleeping, muscle tension, gastrointestinal problems, headaches, decreased or increased appetite, etc.
  • Emotional: intense fear and feeling of insecurity; mood swings; irritability; overwhelming emotions; anger and sadness
  • Changes in thoughts: changed sense of how you perceive yourself, the world, others, and how you relate to others; demoralization, disillusionment; helplessness and/or hopelessness;
  • Changes in behaviour: restlessness; moving or speaking very slowly; withdrawal; being easily startled;  


If you can relate to the portrait painted above, know that you are not alone. There are professionals and organizations that can (and want to) help. 

Psychology can help reduce the impact of some previously noted difficulties by using proven and effective treatment strategies that respect cultural background and the strengths present in each individual. Psychological services help people heal fostering psychological coping strategies, connections through a social support system and keeping active. Therapy is a safe place to learn about and explore one's mental health struggles while strengthening one’s capacity to adapt to challenging life events.

CFIR's refugee assessment services provide psychological and neuropsychological assessments for those individuals facing Immigration and Refugee Board (IRB) reviews. For more information, please visit our Immigration & Refugee Assessment Service page.
As a refugee, if you need additional support, consider also consulting the ‘Services for Refugee Claimants in Ottawa’ online document.

How We Approach Treatment Options at CFIR


Photo by Justin Veenema



At Centre for Interpersonal Relationships (CFIR), we believe it is important for your clinician to be flexible in offering a variety of scientific, evidence-based treatments to address the cognitive, emotional, behavioural and relational aspects of your concerns. Providing you with different possibilities for change is fundamental to us because we know that no one treatment fits all!

Different treatments focus on various aspects of your concerns, including behaviours, cognitions, emotions, perceptions, and relationships. We've compiled a list of a few scientific, evidence-based psychological treatments available at CFIR along with the focus of the treatment approach:

Acceptance and Commitment, Compassion & Mindfulness-based therapies (ACT, MBSR)

Acceptance and Commitment, Compassion & Mindfulness-based therapies (ACT, MBSR) are forms of psychotherapy that support an individual to learn how to observe, be less reactive, accept and be non-judgmental of internal thoughts or emotional reactions. ACT helps you to act from core values as opposed to being entangled in the thoughts and emotional responses that are at the root of your concerns. Developing a more compassionate outlook towards your self is also essential for remediation of various mental health concerns. Treatment focuses on developing the capacity to observe, adopt a non-judgmental stance toward thoughts and feelings, and diminish reactivity while anchoring the self in core values to promote clarity in thinking and action.

Cognitive-behavioural therapy (CBT)

Cognitive-behavioural therapy (CBT) is a form of psychotherapy that addresses psychological issues by focusing primarily on the cognitive and behavioural dimensions of your emotional and behavioural concerns (i.e., the way that your thoughts, beliefs or thinking influences your emotional and behavioural responses). CBT also focuses on problem-solving, finding solutions, improving coping, helping you to challenge distorted cognitions (e.g., thoughts, beliefs) and change problematic behaviours. Your emotional or behavioural responses transform through exposure to specific situations, cues, narratives or places that trigger distress and maladaptive responses. Homework is often assigned.

Eye Movement Desensitization and Reprocessing

Eye Movement Desensitization and Reprocessing is a form of treatment that came to be from a context of treating patients to deal with and process distressing memories of past traumatic experiences. It's currently used to treat a broader range of psychological issues. Treatment involves visual or auditory bilateral stimulation with a primary focus on the integration of distressing aspects of past, and present experiences and increasing adaptation and resilience by building inner resources to address these experiences.

Motivational Interviewing

Motivational interviewing is a form of counseling that helps individuals achieve changes by increasing their motivation to change difficult behaviours. Treatment targets ambivalences about changing, and becoming increasingly aware of the problems, consequences, and risks of these behaviours. Motivation is increased to create a better future consistent with an individual’s values and principles.

Psychodynamic, Attachment-based, Mentalization therapies

Psychodynamic, attachment-based, mentalization therapies focus on how past and current relationship experiences have influenced a person’s present patterns (i.e., thoughts, thinking about self and other, emotional reactions toward self and others, and behaviours) and relationships. Psychoanalytic-oriented approaches have a rich, historical tradition beginning with Freud and Jung to present-day scientifically validated psychodynamic approaches. The goals of psychodynamic-mentalization and attachment-based therapies are to increase an individual’s self-awareness about these patterns to promote change in the present-day.

Concerns flow from internal conflicts, dynamics, and patterns that create difficulties for our self and block us from building meaningful lives and relationships. Defenses and self-protective strategies that prevent access to earlier emotionally overwhelming experiences are diminished over time to promote more adaptive functioning, self-growth, and change. Treatment focuses on cognition, emotion, and interpersonal dimensions of your difficulties. Your interpersonal relationships, both with your therapist and others, are explored to understand and change how one experiences oneself and relates to others in interpersonal relationships. These approaches tend to focus on the self and relational issues underlying your symptoms and distress, as opposed to targeting symptoms directly.

Systemic therapy

Systemic therapy is a form of psychotherapy that understands problems evolving in interactions and interaction patterns with other individuals and systems. Treatment focuses on the impact of your couple partner, children, family, work and socio-cultural system on your self and your relationship with others.

CFIR clinicians can help you or someone you care about address the concerns, issues or struggles that life may occasionally present.

Most private extended insurance plans, as well as Medavie/BlueCross (RCMP, Veterans Affairs, Canadian Armed Forces) and CUPE, cover CFIR services.

Contact us today. Help is available right now for you and your loved ones! We also offer video-based appointments.

8 Questions You Might Want to Ask Your Therapist Before Starting Your Sessions



1. “Are you trained in scientific, evidence-based treatments that are proven to be effective?”


Over the past few decades, numerous psychological treatments have undergone intensive, scientific investigation to examine their effectiveness in helping individuals with a wide range of psychological disorders. To-date, many empirically-supported therapies have been identified. It is important that your therapist is well-versed in what treatments are most beneficial for you based on scientific evidence. Application of these treatments alone, or in combination, provide you with optimal treatment options.

The registered psychologists at Centre for Interpersonal Relationships (CFIR) have received 3000-4000 hours of clinical training in evidence-based treatments before graduation, and supervise psychotherapists and social workers in the implementation of these treatments.


2. “Do you only offer one type of treatment (e.g., CBT) or do you provide different types of treatment options? What happens if your preferred approach doesn’t fit well with me?”


Not all approaches work for everyone. Not all treatments will fit your concerns and needs!

Research study after research study demonstrates that, while psychological treatments do work, not all treatments work for everyone.  Some individuals drop out of treatment, some do not fare well, and some don’t achieve any significant change. It’s unclear whether one particular brand of therapy fits better with any specific child, adolescent, adult, couple or family. From a practical viewpoint, however, some clients may want a shorter therapy option that targets their symptoms without going into a lot of depth, while others wish to have an in-depth exploration and understanding of their challenges. Sometimes symptoms are addressed first, and then a closer investigation of underlying self and relational causes are explored to acquire more profound change.

Many psychologists and psychotherapists will combine a variety of strategies to help you achieve your treatment goals. At CFIR, our psychologists, psychotherapists, and counsellors may use a variety of cognitive-behavioural, dialectical-behavioural, or mindfulness-based strategies to help you diminish your emotional distress and symptoms.  They may then turn to various experiential or psychodynamic approaches to help you to become more aware of your self and your self in relationship with others to create change at a more in-depth level. 

It is essential to find a therapist that can respond to your needs and concerns by offering a variety of treatment approaches in both a short and longer-term format. CFIR mental health professionals are skilled in various types of evidence-based treatment models and short and long-term treatment. They can help you reduce your immediate distress and diminish your symptoms, as well as help you to understand and change deeper self or relational issues underlying your difficulties. 


3. Will you provide a comprehensive assessment of my condition (i.e., interview and questionnaires)? 


Assessment is vital to understand the nature of your difficulties and can help guide treatment and inform the direction of your recovery process. A medical doctor might use interviews and ask that you complete a variety of tests (e.g., blood pressure, blood, and urine tests, ultrasounds, and other technologies) to understand the nature of your health issues. Similarly, psychologists conduct extensive interviews and administer questionnaires to help with their understanding of your difficulties. Numerous factors can contribute to your current problems. A combination of clinical interview and scientific, evidence-based measures will assist your mental health practitioner to understand the unique circumstances underlying your present concern. 

A clinical interview and questionnaires can also save you money, hours and treatment sessions since a lot of information is ascertained all at once and used to identify contributing factors to your distress and concerns early on in treatment. Reliable and valid questionnaires can save a lot of in-session time by gathering valuable information about factors underlying your condition promptly.

A thorough assessment can also provide relevant information about what to expect regarding the duration of your treatment. CFIR’s comprehensive assessments help us to identify contributing factors underlying your concerns. Realistic timelines for your recovery from your condition can then be determined based on the assessment outcomes.


4. “Are you well-trained? Are you a provincially registered care provider or supervised by a registered clinical psychologist?”


It’s essential that you seek treatment from a practitioner who has been well-trained and a member of a professional college in Ontario such as (but not limited to) College of Psychologists, College of Psychotherapists or College of Social Workers. Registration with a College denotes that your practitioner has completed education and training that has met the standards of practice for the profession. 

Registered psychologists have the most training in evidence-based psychological treatments. The registered psychologists working at CFIR supervise psychotherapists and social workers in the application of evidence-based therapies in their practice with their clients.


5. “Is there a way for us to connect before starting therapy sessions to ensure you’re a good fit for me?”


The relationship with your therapist is a vital aspect of your treatment and recovery from your symptoms and distress. Research studies suggest that the single most significant factor in whether a client changes during a course of therapy is the nature of his or her relationship with a therapist—whereas the treatment itself accounts for a less amount of your development. Make sure you are comfortable with your therapist and how they will work with you to address your concerns. 

Relationships are significant to us! CFIR offers a free initial 30-minute consultation to help determine if he or she will be a good fit for you! Meeting a therapist in-person will give you a sense of whether you feel comfortable with them or in the physical office surroundings. The 30-minute consultation gives you a chance to learn if the therapist is flexible in providing different treatment options. There’s nothing more frustrating, and costly, for you and your loved ones than to start with one therapist, spend numerous sessions working in one treatment approach, only to find it’s not working or fitting well with you. If your therapist primarily works in one treatment modality (e.g., CBT, or EFT, or Psychodynamic), it’s good to know whether he or she will be able to switch treatment direction if therapy is not working for you. 

Ask whether or not your therapist can provide different types of treatment. If your treatment is not working for you, your clinician should ideally provide you with other options or refer you to someone else who may be able to meet your needs for a different type of treatment. CFIR clinicians are skilled in employing different treatment models and often integrate different treatment approaches to offer you the best treatment possible.

At CFIR, we work collaboratively with you to identify your treatment goals and offer different types of treatment options to ensure that you get the help that you need. We are flexible and can change our treatment approach if you find that significant progress isn’t happening by using one method.


6. “How many sessions are required for treatment of my condition? What constitutes change or ‘recovery’? Are there quick, short-term treatments for conditions like mine?”


Receiving sufficient treatment to recover from your mental health concern is crucial! Your therapist should have some sense of the treatment dosage (i.e., number of sessions required) to reduce your symptoms or to recover from your mental health issue. Typically, 50% of clients feel better after about 7-8 sessions, and 75% report marked improvement after 20 sessions. There is, however, a significant body of research that points to the expected duration of treatment for a wide range of psychological issues (i.e., number of sessions required for symptom reduction or recovery from your condition). Your treatment provider needs to know the research to provide some sense of what you can expect regarding your treatment duration. 

When it comes to creating meaningful and significant change, there are no quick, short-term treatments. If you solely want to acquire information or education on a condition or topic, one or two sessions may suffice. Diminishing symptoms and recovery from your condition will, however, require more sessions and commitment to change. Typically, short-term treatment requires between 8-20 sessions to ensure significant symptom reduction and recovery for most conditions. However, some conditions need upwards of 12-14 months of consistent treatment for recovery.


7. “Is your service covered by my workplace insurance? How do I verify if I can afford the number of required sessions either using my insurance coverage or paying ‘out of pocket’?”


Workplace insurance programs cover not all mental health care practitioners. Clients who don’t review their workplace insurance before receiving psychological services can find themselves very disappointed, and out of a lot of money, when they find out that they're insurance won't cover the duration of their sessions. Research how much coverage you have available and figure out how much ‘out of pocket’ money you’ll need (if necessary) to attend sessions consistently until significant change is realized. 

Registered psychologists tend to be covered by most workplace insurance programs. However, if you are seeing a psychotherapist or social worker, you’ll want to verify whether your plan includes their services. At CFIR,  a registered clinical psychologist supervises psychotherapists and social workers, and receipts are issued under the supervising psychologist as well. Some insurance companies will accept these circumstances, while others will not. It’s up to you to verify with your insurer whether your insurer will cover your sessions.

Since most individuals will require more sessions than their insurance covers, you need to evaluate whether you can afford to pay for sessions ‘out of pocket’ once your insurance has run out. Have this discussion with your therapist to ensure that lack of financial resources does not disrupt your treatment. Based on your insurance, and ability to ‘pay out of pocket,’ your therapist may determine given your presenting concerns, that other treatment options may be better for you (i.e., workshops or group therapy, or seeing a psychotherapist or joining our Reduced Cost Services program). Referral to our counsellors is seamless and ensures continuity of your treatment with minimal disruptions.

If you find yourself out of insurance dollars, and your ability to pay ‘out of pocket’ reduced, you may want to modify the number of your sessions per month or take a break from therapy until which point your workplace insurance coverage is available to access again.


8. “What is your fee? Do you offer a range of fee options (i.e., sliding scales) or services in different formats (i.e., individual, couple, family, group therapy, workshops) to ensure accessibility and affordability of psychological services? 


Your therapist’s fees should be known to you and agreed upon before therapy commences. Also, depending on your payment method, you might also want to ask about whether your therapist has a sliding scale (i.e., able to offer a lower fee to ensure accessibility and affordability).  Services in different formats (i.e., individual, couple, family, group therapy, workshops) may also be an option to ensure accessibility and affordability of psychological services. We'll be happy to answer your question regarding cost for a session through CFIR when booking a Free Consultation.