World Mental Health Special: How can we work our interventions better

The World Mental Health on October 10 is a recognition of the global importance of mental health. What is the relevance for Canada?

First: The slogan ‘1 in 5’ is not enough

We need to move beyond this oversimplification. Imagine saying to people with heart problems that they have a ‘physical health problem’ in common with people who have joint problems.
People who are burdened by social anxiety disorder have different needs from people who suffer from schizophrenia. None of the popular mental health campaigns in Canada or Ottawa recognise this vital fact. However, the World Health Organisation is clearly working to define the different needs.

Being specific about mental health disorders is important

There are different types of mental problems. At present we have diagnoses as in DSM 5 (Diagnostic and Statistical Manual Version 5) or ICD 10 (International Classification of Diseases Version 10) which define these. Many professionals and clients may not prefer diagnoses, but this is just a way of communicating and specifying the nature of the problem in brief. Each individual has different needs the best evidence is for individualised treatments.

Talking about the right intervention is important

We often hear people say that they want to see a psychologist, psychiatrist, psychotherapist, counsellor et cetera. This is understandable but we need to further specify the type of intervention or treatment that would provide solutions to the specific mental health conditions. For example, only 5 therapies are recommended in treatment guidelines for PTSD (post-traumatic stress disorder) and these are: Prolonged Exposure Therapy, Cognitive Therapy, Cognitive Processing Therapy, EMDR (eye movement Desensitisation and Reprocessing) and Narrative Exposure Therapy. Only Cognitive Behavior Therapy is recommended for the treatment of social anxiety disorder. The evidence for these is clearly established and in England these are national recommendations from the government.

Access is important

Having access to mental health assessments and treatments is important. They should be based on carefully designed and navigable care pathways for each mental health problem. A pathway for access to care in ADHD (Attention Deficit Hyperactivity Disorder) would be different from a pathway for generalised anxiety disorder (or excessive worrying).
Walk-in centres and emergency rooms are should not be the default options even though they serve their purposes.

The IAPT (Improving access to Psychological Therapies) services in England showed that self-referral for therapy was associated with good outcomes.

Speed of access is important

Access for therapy within 6 weeks of referral is also associated with good outcomes (see IAPT England). In our team’s clinical work, we strive to meet these standards.

Training and supervision are associated with good outcomes in psychotherapy

We want to clearly differentiate the training for licenses to practice, which is regulated by various colleges (e.g. Social Work, Psychology, Physicians, Psychotherapists) from the actual training in specific psychotherapies. The largest implementation of evidence-based psychological therapy (IAPT, England) which receives a million referrals each year has shown that over and above the professional training, therapists need to train specifically in the different types of therapy. The duration of such training should be at least one year and be associated with weekly supervision using the therapist’s audio recorded work.
All our therapists and trainers have gone through this and continue to attend weekly training and supervision as learning and competence are a part of ongoing quality management.

Measuring outcomes every session must be the gold standard

All too often clients attend therapy with no measurement of outcomes. Not doing these overestimates the overall therapy outcomes. We partner with greenspace, a Canadian company based in Ontario, to measure client’s outcomes using carefully selected questionnaires. These can be completed weekly online or in therapy sessions so both the therapist and the client can keep track of their progress and work constructively towards the client’s goals.

Happy Mental Health Day!


About the Author:

Dr Sanjay Rao is an experienced teacher and Associate Professor of Psychiatry at the University of Ottawa In 2018 he was awarded a Fellowship of the Canadian Association of Cognitive Behavioural therapy for his contribution to CBT in Canada. He has received an award from the Department of Health, UK for CBT development. He is the Director of Unified CBT training.

Learn more about our programs
Enter your email address and we'll reach out to you with more information!

Learn more

Unified CBT for Social Anxiety
17/10/2019 | 12:00 pm - 6:00 pm EDT

Get an insightful understanding of experiential cognitive and exposure-based exposure treatment of social anxiety. Enhance your confidence in providing therapy by following a step by step specific protocol rather than all too common generic ‘thought mood’ stereotypes of CBT formulation. 

Bookings are closed for this event.


Unified Experiential CBT for Generalised Anxiety Disorder
03/10/2019 | 12:00 pm - 6:00 pm EDT

Get an insightful understanding of experiential cognitive and exposure-based exposure treatment of social anxiety. Enhance your confidence in providing therapy by following a step by step specific protocol rather than all too common generic ‘thought mood’ stereotypes of CBT formulation. 

Bookings are closed for this event.


Behavioural Activation Treatment For Depression
10/10/2019 | All Day EDT

The course covers the theory and model for diagnosing and treating depression. Approach BAT through the functional analysis of avoidance and loss of rewards in depression. By understanding the skilled use of the activity diary, you will learn to identify ‘stuck’ points and effective treatment strategies to get clients unstuck. 

Bookings are closed for this event.


Post-Traumatic Stress Disorder: Unified CBT Approach
23/11/2019 - 24/11/2019 | 9:00 am EDT




Unified Experiential CBT for Obsessive Compulsive Disorder
07/11/2019 | 12:00 pm EDT

Cognitive Behavioural Therapy (CBT) is a first line evidence-based treatment for Obsessive Compulsive Disorder (OCD). 

Bookings are closed for this event.


Rumination Focused Cognitive Behavioural Therapy
14/11/2019 | 9:00 am EDT

Rumination is a common phenomenon across a range of conditions like posttraumatic stress disorder and social anxiety disorder. It can be a challenge for therapists as it is associated with poor clinical outcomes. Rumination may go undetected and derail therapy.



STAR Centre’s Structured Psychotherapies Conference
15/11/2019 | 8:00 am EDT

This 1-day event is packed with learning opportunities for practicing clinicians with a diverse array of topics on structured psychotherapies delivered by recognized experts. The conference consists of state of the art presentations and workshops, focused on key skills for practice.


Unified Experiential CBT Skin Picking & Hair pulling
21/11/2019 | 12:00 pm EDT

Trichotillomania (hair pulling disorder) and Excoriation Disorders (Skin Picking Disorder) are included in the obsessive-compulsive related disorder section of the DSM-5 and are present in about 1-2% of the population. They are more common in females, often co-morbid with other conditions.



Unified Experiential CBT for ADHD
28/11/2019 | 12:00 pm EDT

Attention Deficit Hyperactivity Disorder is a common presentation in adult mental health. It is often co-morbid mood and anxiety disorders. Adult ADHD (AADHD) is frequently missed in presentations. There is also the danger of overdiagnosis in presence of other conditions which disrupt attention and concentration.