Psychosis Treatment in Toronto Doctoral-Level Psychological Care
Psychosis treatment at Laksman Doell Psychology is delivered by doctoral-level registered psychologists, both in person at our office in the Annex neighbourhood of Toronto and virtually across Ontario.
What Psychosis Looks Like
In clinical contexts, when we use the word “psychosis”, we are often referring to a range of different experiences that may accompany a more tenuous sense of reality. These may include the experience of unusual beliefs or extreme paranoia (which are sometimes referred to as “delusions”), the experience of anomalous sensory experiences like hearing voices or seeing things that others don’t hear or see (which are sometimes referred to as “hallucinations”), or the experience of other forms of disorganized thinking or disorganized behaviour.
While many of these experiences are certainly atypical, it is also important to recognize that experience of psychosis is still a part of normal human experience. Close to 3% of the population may experience psychosis in the context of a mental health disorder, but it is also true that many more individuals may have anomalous sensory experiences following extreme circumstances (for example, following periods of sleep deprivation, sensory deprivation, social isolation or solitary confinement, or even in experience of grief following a significant loss). It is also true that living through difficult circumstances or surviving trauma can impact the way that we see ourselves, the world, and other people, and that sometimes this can lead to thoughts that other people might deem to be “irrational” or “paranoid”, but that tend to make a lot of sense when they are interpreted based on the lived experience of the person who is thinking them.
Individuals who have lived experience of psychosis may present to treatment at different points along their recovery journey, and may be looking for help with a wide range of different presenting issues. Some individuals are looking for help in reducing the distress associated with their psychosis, and are looking to understand their unusual beliefs, or to cope differently with their sensory experiences. Others are presenting following a first-episode of psychosis, and are looking for help navigating the early road to recovery, to not lose sight of what matters most to them, and to ensure that their experience of psychosis does not limit them or come to define who they are. Many others are looking for help with areas that either result from, or that contribute to, their experience of psychosis. This may include individuals who are struggling with the experience of internalized stigma, depression, anxiety, substance-use, or difficulties with motivation and social withdrawal.
What psychosis looks like in families and couples is also an important consideration. Behind each individual who is living with psychosis is someone who loves them. This could be a partner, a parent, a sibling, or a friend. These individuals also often find themselves feeling confused, misunderstood, scared, or angry and may even be experiencing guilt and shame.
Whatever the experiences, and whatever it looks like, it is important to know that there is help available for individuals who have been touched by psychosis, and that you don’t have to manage this alone.
You may not be sure what you need, but something brought you here…
- You had an episode of psychosis within the last year. You no longer have any unusual beliefs or anomalous sensory experiences, but you’re struggling to make sense of where those experiences came from, and you don’t want to lose sight of who you were before your episode.
- You have a psychiatrist who is helping to manage your medication, but you are looking for Cognitive Behavioural Therapy for Psychosis (CBTp), and want to find a psychologist who knows how to do this well.
- You are experiencing paranoia or distressing voices, and you are looking for help to both understand these experiences, and to respond to them in ways that enhance your coping and that diminish the distress that they cause. You don’t want these experiences to dictate the life that you live.
- Your partner recently experienced an episode of psychosis. Now that you’re both on the other side of it, they don’t want to talk about it, but you can’t stop thinking about it. The two of you need help finding your back to one another.
Experiences of psychosis that we treat:
At Laksman Doell Psychology, we provide compassionate, humanistic and evidence-based treatment for adult individuals and couples who have been living with experience of psychosis. Sometimes these experiences may have occurred in the context of a mental health diagnosis such as schizophrenia or schizoaffective disorder, bipolar affective disorder, brief psychotic disorder, delusional disorder, substance-induced psychotic disorder, or a major depressive disorder with psychotic features. However, sometimes these experiences also occur in the context of major life stressors, or in the aftermath of trauma.
Many individuals who are living with psychosis find that they are looking for an explanation or a diagnosis, but this is not the case for everyone. For many others, what they are seeking is a deeper understanding of their experiences: an explanation of where these experiences originated and the factors that are driving and maintaining them, and a more complete understanding of the things that may be helpful in reducing their distress, enhancing their coping, and getting back to the life that they want to be living. At Laksman Doell Psychology, we help individuals with all of the above. Our approach is grounded in both clinical rigour and in a deep and abiding respect for the identity, experience, and goals of the individuals that we work with.
Our doctoral-level psychologists provide treatment for a number of different areas where individuals and their loved ones have been affected by psychosis, including:
Unusual Beliefs (Delusions)
Even the most unusual beliefs that individuals may hold can usually be made sense of, particularly when we understand that individual’s learning history and life experiences. That said, we also know that human thinking is not infallible, and that the way that we perceive and interact with the world can serve to strengthen and maintain beliefs that may, or may not, be true. Taking the time to explore those thoughts that cause us distress or that interfere with our living the life that we want to live, can often be hard to do on our own.
Anomalous Sensory Experiences (Hallucinations)
We know that for individuals who are living with voices, visions, touch or smells that others don’t experience, it is often the things that we say to ourselves about these experiences that contribute most to how distressing they are. Developing a new understanding of the things that drive these experiences, and recognizing our own autonomy and control over how we respond to them, can be of the utmost importance in recovery.
Recovery from Psychosis
First-Episode Psychosis
Psychosis most often emerges for the first time in young adulthood, just when individuals are really discovering who they are and are finding their independence. An episode of psychosis can feel like it is the end of this journey towards independence, and can involve some very real setbacks in academics and career trajectories. Early intervention is often crucial, in order to ensure that these initial setbacks aren’t allowed to go unchallenged.
Supporting a Loved-One with Psychosis
Watching someone you love who is experiencing psychosis can be a scary, confusing and difficult experience. It is hard to know what to do or say, and it may be that even your best efforts seem to lead to the opposite of what was intended. The sense of helplessness that comes with these experiences is real. It is important to know that you are not alone, that others have walked a similar path, and that there are things that are helpful.
Couples Therapy for Relationships that Have Been Affected by Psychosis
Couples who are living with, or who have made it through, an episode of psychosis, often find themselves feeling as if they are losing part of one another. Difficulties in communication can breed fear, mistrust, misunderstanding and resentment. Finding your way back to one another is possible, but sometimes it requires help in processing emotional ruptures and in reestablishing communication, trust, and intimacy.
Treatment that starts with understanding you.
At Laksman Doell Psychology, our doctoral-level psychologists utilize evidence-based treatments to treat the different areas of distress and difficulty that may be a part of the experience of psychosis. While the treatment targets may differ from person to person, we always start with developing a collaborative and complex understanding of who you are as an individual, and what it is that you are looking for help with. Taking the time to develop a comprehensive formulation of each individual who presents for treatment allows us to understand the experiences that you have had that have shaped the way that you see yourself and the world around you, the circumstances surrounding the onset of your psychosis, the ways that you are currently responding to and making sense of any unusual beliefs or anomalous experiences, and your current strengths, struggles, goals and aspirations. It is this comprehensive formulation that helps us to present you with the different evidence-based options for therapy, and that allows us to collaboratively develop an individualized treatment plan to help you reach your goals.
Cognitive Behavioural Therapy for Psychosis (CBTp) is the foundation of much of the work that we do to treat individuals who are living with experience of distressing psychosis. It is the psychosocial treatment for psychosis with the strongest evidence-base in research, and it is rooted in the knowledge that it is often the ways that we make sense of and react to our experiences of psychosis that contribute to how much these experiences cause distress and interference in our lives. Thus, CBTp involves collaboratively understanding and exploring the thoughts that we have about our experiences and working to develop new, more adaptive, explanations while simultaneously working to further develop our repertoire of coping skills. CBTp may lead to reductions in distress or isolation, or improvements in daily functioning and quality of life.
Where it is appropriate, our psychologists will also speak with you about incorporating other evidence-based treatment modalities, for example Acceptance and Commitment Therapy (ACT), Dialectical Behaviour Therapy (DBT), Compassion-Focused Therapy (CFT), or Motivational Interviewing (MI). Each of these modalities has been shown to be helpful in the treatment of different aspects of the experience of psychosis, but may also be incorporated to address different treatment targets that may accompany psychosis. This includes areas such as internalized stigma, comorbid depression and anxiety, or issues related to ongoing substance-use.
In addition, we have specialized expertise in working with couples who have been affected by the experience of psychosis. Our doctoral-level psychologists who provide this service offer a rare combination of competency in CBTp along with expertise and training in evidence-based couples’ therapy modalities that include Emotion-Focused Couples Therapy. Couples who are navigating this often overlooked terrain deserve a well-trained clinician who holds expertise in both of these areas.
Specialist training.
Private practice access.
At Laksman Doell Psychology, we have several doctoral-level psychologists who have received extensive training in evidence-based psychosocial interventions for psychosis and who are not only dedicated to doing this work, but are dedicated to doing it well. We recognize the importance of showing up fully for individuals who are struggling to find the help that they need, and individuals who have been living with psychosis have historically had a very difficult time navigating the mental health system and finding help in private practices when they wanted it. Dr. Faye Doell, C.Psych., one of our Co-Founders and Clinical Directors, spent over a decade leading the CBT for Psychosis Service in the Complex Care and Recovery Program at CAMH, helped to shape the North American competency standards for CBTp, has trained psychologists across the country, and has been an invited expert on government-led mental health initiatives involving CBTp. She leads this area of our practice with an unparalleled dedication, and has worked to build a team of clinicians who share the same vision of recovery-oriented treatment as she does.
Every clinician at Laksman Doell Psychology is a doctoral-level psychologist who is registered with, or working toward registration with, the College of Psychologists and Behaviour Analysts of Ontario (CPBAO). Sessions are available in person at 27 Prince Arthur Avenue in the Annex neighbourhood of Toronto, or virtually across Ontario via PHIPA-compliant video. All services are available virtually to any Ontario resident. No referral required.
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Frequently Asked Questions
Can a psychologist help with psychosis?
Yes. Some psychologists seek out extensive training in the assessment, diagnosis, and treatment of psychosis and psychotic-spectrum disorders. At Laksman Doell Psychology, we have a number of psychologists who provide treatment for psychosis using both Cognitive Behavioural Therapy for Psychosis (CBTp), and other evidence-based psychosocial treatments.
Is psychosis permanent? Can people recover?
Many people can and do recover significantly, especially with early intervention. That said, recovery can mean different things for different people. Some individuals define recovery as an absence of symptoms, whereas for other individuals recovery is defined more by a reduction in distress, a better understanding of themselves and their experiences, and as living a life with real meaning and connection. However you define recovery, it is important to know that help is available if you feel stuck at any point on your recovery journey.
Do I need medication if I am experiencing psychosis?
Medication is the first-line treatment for many individuals who are experiencing distressing psychosis. In Ontario, medication is prescribed by a psychiatrist or a physician. Psychologists work alongside psychiatry when medication is part of the picture. It is often helpful to think of psychotherapeutic treatment and medication as complementary, rather than as competing, treatment modalities.
How do I talk to someone I love about getting help for psychosis?
Start with empathy and concern, rather than labels and judgement. Focus on what you are observing and what it is that is causing you concern, not on arguing about what is real. If there is any immediate safety concern, contact crisis services. If not, a consultation with a psychologist who works with psychosis can help you to figure out the right next steps, including how to have those conversations that currently feel daunting.
Do I need a referral for psychosis treatment in Toronto?
No. You can contact us directly. No referral from a physician or psychiatrist is required.
Is psychosis treatment covered by OHIP?
Private practice services are not covered by OHIP. Coverage may be available through extended health benefits, as many plans cover the services of a registered psychologist. We recommend confirming with your provider before commencing treatment.
Can I be seen virtually?
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The first step is a brief consultation to help understand what you are looking for.
Email us at [email protected] or complete our contact form online.