Psychotherapy

What is psychotherapy?  - a description for patients of different types of psychotherapy

CANMAT 2023 guidelines recommend the following:

1. First-line psychological treatments for acute  major depressive disorder (MDD) include:
   • cognitive-behavioural therapy (CBT)
   • interpersonal therapy (IPT) and
   • behavioural activation (BA)
2. Second-line psychological treatment for acute MDD include:
   • problem-solving therapy
   • mindfulness-based cognitive therapy
   • cognitive behavioural analysis system (CBASP)
   • short-term psychodynamic psychotherapy (STPP)
3. Combining antidepressant and psychological treatment (CBT and IPT) where feasible as combined treatment is superior to either treatment alone
4. First-line psychological treatments for maintenance include:
   • CBT and 
   • mindfulness-based cognitive therapy (MBCT)  

Note: If no or partial response to psychotherapy consider adding an antidepressant

• Click here for psychotherapy follow-up table
• click here for medication table

Resources

For those with work benefits for psychological treatment options include accessing their Employment Assistance Program (EAP) or using benefits for

• Psychologists (on eMentalHealth.ca)
• Social workers (on eMentalHealth.ca)
• Registered psychotherapists  (on eMentalHealth.ca)
• Psychology today - online resource which helps find a therapist based on location, cost, type of therapy and insurance coverage
• AbilitiCBT -  internet-based CBT with a registered therapist 
• MindBeacon- internet-based CBT with a registered therapist 

For those without work benefits or funds to self-finance psychotherapy go to:

• Psychotherapy in your area (on eMentalHealth.ca)
• BounceBack (free telephone-guided CBT)
• Ontario 
• BC
• Manitoba

Consider working with your patient using the Antidepressant Skills Workbook (ASW):

• ASW website 
• Patient info about ASW pdf
• Physician info about ASW pdf

Ottawa resources

• AccessMHA.ca -service to help navigate mental health resources including psychotherapy and counselling in Eastern Ontario
• Ontario Structured Psychotherapy  - free individual CBT
• Ottawa Mental Health Community Resource Directory.pdf
  • includes information on various services including counselling, finances, immigrant services, legal services etc.
• Counselling Connect - same day or next day phone or video counselling session
• TOH/Bruyere FHT social work vs. Shared Care referral guideliines
  • TOH pdf
  • Bruyere pdf