Depression Screening and Diagnosis in BC

I am often asked about on-line depression, anxiety, ADHD and autism screening tools, and usually warn against their use. The reasons are simple: A diagnosis of depression, anxiety, ADHD or Autism is a difficult thing. In the popular press you read about the problems with "misdiagnosis" all the time, and that is usually because a physician or psychologist haven't taken the time to do a comprehensive differential diagnosis - that is, they haven't attempted to "rule out" other disorders. What looks like depression can be any number of things, including something as simple as the need for a change in sleep habits or diet. But to determine that takes time and a comprehensive history. That takes time and expertise. So I always urge patients to "see your doctor." That being said there is still a cry for some sort of quick screen, and I have found one provided by "heretohelp" in BC to be especially useful, as it allows to to take the information you have put into the screener, print it, and take it with you to the doctor.  Here is the website to use the screener:

http://www.heretohelp.bc.ca/screening/online/?screen=depression

Heretohelp (or here to help's) online screener for depression is first of all anonymous. It doesn't record anything that can identify you as the person completing the form. It takes you through several steps: 1) You provide some information about you , such as gender and age, that are important because it will compare your answers to other questions with norms for gender and age, which change, 2) It then directs you to a type of screener based upon this information - there are different depression screeners for different groups, 3) You will answer questions about your symptoms, and depending upon how you answer these it may direct you to other questions you were not expecting about, for instance, mood disorders or mania, which are important to help with the "rule out" we just discussed, 4) Your results will be shown on the screen and you can print this out and take it to your medical provider.  Remember - an accurate diagnosis for depression or any other psychiatric disorder can only be made by a qualified medical doctor or psychologist! You need a medical examination to rule out many possible causes of your symptoms, but bringing this printout along with you can be very helpful for your physician to know what exams or tests he or she you administer.

Don't diagnose yourself. Don't let your friends diagnoses you because they "know someone with depression" or have had a psychiatric disorder themselves. See your licensed or registered medical professional.

For information about my services as a registered and licensed psychologist please visit my weebsite at www.relatedminds.com  I provide both diagnostic services and treatment interventions for depression, anxiety, ADHD and related disorders.


Dr. Jim Roche
Registered Psychologist

Couple Counselling and Marriage Counselling: Beginning with Gottman Couples Therapy

Where to start with Gottman Couples Therapy? I often suggest at our first couples/marriage therapy session that both members take a look through John Gottman's YouTube page and view several videos. Reading a book, especially while having relational problems, isn't easy.  And sometimes when we are reading about about behaviour, and we are reading it because of problems we are having with our spouse, we read and do little more than find what's wrong with them! - watching these videos, together - can be helpful.

Having trouble in a relationship means examining both yourself and the relationship. A difficult thing to do. And it means making some behavioural changes NOW, because our partners expect us to make some effort...right away. And they are watching. And trying to make changes themselves. All of this can be difficult and usually calls for the coaching and guidance of a professional training in couple and marriage therapy.

Still, watching the video of John Gottman and his wife working through these issues with others can be very helpful, and you will feel the support of having others in the same place as you...moving forward.

This video is only one of several on the internet. There are also videos that are more comprehensive and come in a "marriage and family workshop" format that formally walk you through the important steps of therapy. As a marriage and family therapist it is my goal to help you find resource and skills you can use on your own to address problems not only now, but in the future, and I work as quickly as possible at moving you from weekly sessions to a more informal coaching relationship were you can work on your relationship or marriage on your own. These videos are a great place to start.



In marriage or couples therapy sessions we work through many of the issues you will hear about on these videos. We also focus, intensely, on changing they way you interact and communicate in yor relationship.

Other books and videos I suggest about Marriage and Couples counselling can be found at my Amazon.ca Book List. Click here Dr. Roche Book Suggestions

Finally, for more information about my services, not only as a Registered Psychologist but also as a Registered Marriage and Family Therapist you can visit my web site directly at this link: Dr. Jim Roche at RelatedMinds  My American Association for Marriage and Family Therapy site is located at this link: AAMFT.

For those viewing the videos I also share an outline to help you understand the terms and components of what Dr. Gottman is speaking about.

Feel free to contact me for more information.

Dr. Jim Roche

Marriage and Couple Therapy: Burnaby / Vancouver

Marriage and Family Therapists: The Friendly Mental Health Professionals

I am often called and asked if I will see someone, or a couple, for "couple's therapy," or "marriage counselling."  Most of these calls are because I am a psychologist, and there is an assumption that every mental health professional has the same training and experience and can see anyone. This isn't necessarily so, as marriage and family therapy is a separate field of study and every US State and most Canadian provinces actually license or registered therapists in the field of marriage and family therapy.

Luckily , in addition to my license as a psychologist I am also a Registered Marriage and Family Therapist in British Columbia, and a Fellow and Clinical Member of the American Association of Marriage and Family Therapists (BCAMFT and AAMFT).  

A marriage therapist usually holds a graduate degree in marriage and family therapy, and has completed one or two years of full time supervised clinical internship in marriage and family therapy.  This includes60 semester hours of work focused on marriage and family therapy. Most "clinical counsellors" and psychologists have taken one or two courses in this area, and would not qualify to registration in marriage and family therapy.  This doesn't mean they don't have the clinical ability or experience to do marriage and family therapy, but it good to know that there are specially certified experts in the field, many of whom ARE psychologists.

To find a listing of Registered / Licensed Marriage and Family Therapists near you, including those who are additionally Registered / Licensed Psychologist, go to the "Find a Therapist" website of the American Association for Marriage and Family Therapists by clicking here: http://www.therapistlocator.net/iMIS15/therapistlocator/

To find out more about the differences between the various mental health professionals you can also visit this page, which explains what marriage and family therapists are in comparison to other mental health professionals. Click here: http://www.therapistlocator.net/IMIS15/Content/Consumer_Updates/Marriage_and_Family_Therapists.aspx

Briefly, from that page, you will see that: "Marriage and family therapists are mental health professionals with a minimum of a master’s degree and two years supervised clinical experience. Marriage and family therapists (commonly referred to as MFTs or family therapists) are trained and licensed to independently diagnose and treat mental health and substance abuse problems. Marriage and family therapy is one of the core mental health disciplines and is based on the research and theory that mental illness and family problems are best treated in a family context. Trained in psychotherapy and family systems, marriage and family therapists focus on understanding their clients’ symptoms and interaction patterns within their existing environment. MFTs treat predominantly individuals, but also provide couples, family and group therapy. Whomever the client, Family Therapists treat from a relationship perspective that incorporates family systems."

For more information about my practice as a Registered Marriage and Family Therapist and Fellow of the American Association of Marriage and Family Therapists you can visit my web page here: http://www.relatedminds.com/couple-family-therapy/ or my home page at http:www.relatedminds.com

I can also be reached at my office by calling 778.998-7975

About Couple Counselling and Marriage Therapy

I am often asked about the differences between a Psychologist and a Marriage and Family Therapist ( I am licensed | Registered in both fields). You can find this information on the web page of the American Association for Marriage and Family Therapists here:

http://www.aamft.org/imis15/Content/About_AAMFT/Qualifications.aspx

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What are the qualifications to be a Marriage and Family Therapist?

Marriage and family therapy is a distinct professional discipline with graduate and post graduate programs. Three options are available for those interested in becoming a marriage and family therapist: master's degree (2-3 years), doctoral program (3-5 years), or post-graduate clinical training programs (3-4 years). Historically, marriage and family therapists have come from a wide variety of educational backgrounds including psychology, psychiatry, social work, nursing, pastoral counseling and education. 

The Federal government has designated marriage and family therapy as a core mental health profession along with psychiatry, psychology, social work and psychiatric nursing. Currently all 50 states support and regulate the profession by licensing marriage and family therapists with the remaining states in the process of obtaining licensure laws.

The regulatory requirements in most states are substantially equivalent to the American Association of Marriage and Family Therapists Clinical Membership standards. After graduation from an accredited program, a period - usually two years - of post-degree supervised clinical experience is necessary before licensure or certification. When the supervision period is completed, the therapist can take a state licensing exam, or the national examination for marriage and family therapists conducted by the AAMFT Regulatory Boards. This exam is used as a licensure requirement in most states and provinces.

Who are Marriage and Family Therapists?

Marriage and Family Therapists (MFTs) are mental health professionals trained in psychotherapy and family systems, and licensed to diagnose and treat mental and emotional disorders within the context of marriage, couples and family systems.

Marriage and family therapists are a highly experienced group of practitioners, with an average of 13 years of clinical practice in the field of marriage and family therapy. They evaluate and treat mental and emotional disorders, other health and behavioral problems, and address a wide array of relationship issues within the context of the family system. 

Marriage and Family Therapists broaden the traditional emphasis on the individual to attend to the nature and role of individuals in primary relationship networks such as marriage and the family.  MFTs take a holistic perspective to health care; they are concerned with the overall, long-term well-being of individuals and their families. 

MFTs have graduate training (a Master's or Doctoral degree) in marriage and family therapy and at least two years of clinical experience. Marriage and family therapists are recognized as a "core" mental health profession, along with psychiatry, psychology, social work and psychiatric nursing. 

Since 1970 there has been a 50-fold increase in the number of marriage and family therapists. At any given time they are treating over 1.8 million people.

What is Marriage and Family Therapy? 
A family's patterns of behavior influences the individual and therefore may need to be a part of the treatment plan. In marriage and family therapy, the unit of treatment isn't just the person - even if only a single person is interviewed - it is the set of relationships in which the person is imbedded. 

Marriage and family therapy is:

• brief
• solution-focused
• specific, with attainable therapeutic goals
• designed with the "end in mind."

Marriage and family therapists treat a wide range of serious clinical problems including: depression, marital problems, anxiety, individual psychological problems, and child-parent problems. 

Research indicates that marriage and family therapy is as effective, and in some cases more effective than standard and/or individual treatments for many mental health problems such as: adult schizophrenia, affective (mood) disorders, adult alcoholism and drug abuse, children's conduct disorders, adolescent drug abuse, anorexia in young adult women, childhood autism, chronic physical illness in adults and children, and marital distress and conflict. 

Marriage and family therapists regularly practice short-term therapy; 12 sessions on average. Nearly 65.6% of the cases are completed within 20 sessions, 87.9% within 50 sessions. Marital/couples therapy (11.5 sessions) and family therapy (9 sessions) both require less time than the average individuated treatment (13 sessions). About half of the treatment provided by marriage and family therapists is one-on-one with the other half divided between marital/couple and family therapy, or a combination of treatments. 

Why use a Marriage and Family Therapist?

Research studies repeatedly demonstrate the effectiveness of marriage and family therapy in treating the full range of mental and emotional disorders and health problems. Adolescent drug abuse, depression, alcoholism, obesity and dementia in the elderly -- as well as marital distress and conflict -- are just some of the conditions Marriage and Family Therapists effectively treat.

Studies also show that clients are highly satisfied with services of Marriage and Family Therapists. Clients report marked improvement in work productivity, co-worker relationships, family relationships, partner relationships, emotional health, overall health, social life, and community involvement.

In a recent study, consumers report that marriage and family therapists are the mental health professionals they would most likely recommend to friends. Over 98 percent of clients of marriage and family therapists report therapy services as good or excellent.

After receiving treatment, almost 90% of clients report an improvement in their emotional health, and nearly two-thirds report an improvement in their overall physical health. A majority of clients report an improvement in their functioning at work, and over three-fourths of those receiving marital/couples or family therapy report an improvement in the couple relationship. When a child is the identified patient, parents report that their child's behavior improved in 73.7% of the cases, their ability to get along with other children significantly improved and there was improved performance in school. Marriage and family therapy's prominence in the mental health field has increased due to its brief, solution-focused treatment, its family-centered approach, and its demonstrated effectiveness. Marriage and family therapists are licensed in 46 states and are recognized by the federal government as members of a distinct mental health discipline.

Today more than 50,000 marriage and family therapists treat individuals, couples, and families nationwide. Membership in the American Association for Marriage and Family Therapy (AAMFT) has grown from 237 members in 1960 to more than 23,000 in 1996. This growth is a result, in part, of renewed public awareness of the value of family life and concern about the increased stresses on families in a rapidly changing world. 

How can I find a Marriage and Family Therapist?

AAMFT Clinical Members meet stringent training and education requirements that qualify them for the independent practice of marriage and family therapy.  AAMFT requires Clinical Members to abide by the AAMFT Code of Ethics, the most stringent ethical code in the marriage and family therapy profession. This code delineates specific ethical behavior and guidelines for members to follow to ensure the ethical treatment of clients. Clinical Membership in the AAMFT signifies an MFT's dedication to his or her ongoing professional development. Each month, AAMFT Clinical Members receive important updates on current clinical and research developments in the field, as well as numerous opportunities throughout the year to attend professional development conferences.

Click here to find a Marriage and Family Therapist today!

I have been practicing in the field of Marriage and Family Therapy, providing couple, individual and family therapy for over 25 years. Visit my web site for information about my qualifications and services at: www.relatedminds.com​

Marriage and Family Therapy: What's a Registered Marriage and Family Therapist?

Today I got another email asking for a psychologist who does "marriage therapy." I get these all the time and I try to redirect couples or families to the British Columbia Association of Marriage and Family Therapists where they will find a psychologist whio is also a marriage and family therapist. Why do I do this? Because marriage and family therapy is a distict profession. It's different than social work, counselling or psychology - although any of these individuals might have expertise in counselling couples or families. Here is what the Canadian Association of Marriage and Family Therapy says on their web page:

"Marriage and Family Therapy (MFT) is a distinct mental health discipline which utilizes family systems theories and intervention techniques, and is one of the five core mental health professions: marriage and family therapy, psychiatry, psychology, social work and psychiatric nursing."

It's not just a course or workshop another counselling professional has taken, it is a separate and distinct field of practice. The Canadian site goes on to say:

"Registered Marriage and Family Therapists (RMFT) are family-focused psychotherapists. They are relationship specialists and mental health generalists, and are trained to help individuals, couples, and families resolve personal and work related problems. Members have training in the development stages of personal, family and relationship growth. RMFT’s are held to the demanding Code of Ethics of The American Association for Marriage and Family Therapy (AAMFT) and are Clinical Fellows of the AAMFT and the Registry of Marriage and Family Therapists in Canada."

That means they have a separate graduate degree focused on the theories and skills of marriage therapy. This is usually a two or three year graduate program leading to an MA or MS degree in Marriage and Family Therapy. In addition to that they have one or two full time years of supervised experience practicing marriage and family therapy. Many other professionals providing counselling to couples and families have completed a few courses or workshop, and worked with a few couples during their internship. A marriage and family therapist -here in BC called a Registered Marriage and Family Therapist, have one or two years of focused work in coupoles and family therapy. That's a big difference.

To find a Registered Marriage or Family Therapist here in BC go to the web site of the British Columbia Associate or Marriage and Family Therapists at: http://www.bcamft.bc.ca/ohana/website/index.cfm?p=95575656796  

You will find the "Therapist Locator" on that page. Many BCAMFT members are not only family therapists but Registered Psychologists as well. If your insurance will only pay for a registered psychologist (something you may find they are flexible about if you call) you can get the benefits of seeing a fully trained marriage and family therapist and a Registered Psychologist all at once! 

For information about my services as a Registered Marriage and Family Therapist, as well as a Registered Psychologist, please visit my website at www.relatedminds.com or http://www.relatedminds.com/couple-family-therapy/

 More information from the Canadian Association of Marriage and Family Therapists:

Services provided by Marriage & Family Therapists include;

Assessment and treatment of mental and emotional health, and family health Individual psychotherapy Relationship counselling Couple and Marriage Therapy Family Therapy Group psychotherapy Premarital education   marital enrichment Locate a therapist anywhere in Canada or the USA click here.

Psychotherapy for Children and Adolescents

The terms "psychotherapy" or therapy" refer to a number of different techniques used to help children and adolescents (teens) who are experiencing difficulty with behaviour or emotions. Although there are many different types of therapy all of them (art therapy, cognitive therapy, talk therapy, supportive therapy) rely on communications as first tool in bringing about changes. This means that the child or adolescent who is engaging in therapy needs to have a good relationship, rapport, with their therapist. He or she needs to feel safe, and unpressured in the therapeutic relationship.Building this kind of relationship can take time.

Psychotherapy / counselling might involve just sitting and talking, it might involve talking while the therapist and child/adolescent talk, it might involve more listening than talking and it might involve playing games, building things, reading something together, drawing, painting or many other activities that help the child / adolescent feel calm, safe and listened to.

Usually therapy starts with an initial evaluation involving the parents and the child. Some goals will be set, a problem picked out or an issue focused upon. A history is usually taken and a formal mental status examination should take place.  Child and adolescent psychotherapy often involves involving others in therapy beside the child or adolescent. That might include professionals from the school, other family members or a medical doctor if there is a need for medical intervention.

Child and adolescent therapy can help in a number of ways. It can help the child or adolescent receive emotional support they need, the therapist can model behaviours and emotional responses, they can learn skills to resolve conflicts with others. New solutions to old problems can be tried and tested in therapy. Therapy can serve as a bridge between the child/adolescent and his or her parents when their is a distance between them Goals might be very specific, a skill to learn and master, a behaviour to change, or more general such as reducing anxiety or depression (although these usually involve learning very specific skills as well).

Child therapy can be short or long term, and for those seeing me long term there is a sliding scale if costs restrict participation. In my own practice I offer you and your child not only my more than 30 years experience as a child and adolescent therapist, but also my experience as a classroom teacher, school psychologist and counsellor, administrator and as a parent.

For more information about obtaining child and adolescent counselling or psychotherapy services please visit my web page listed below, or contact me directly by phone at 1.778.998-7975

More information can be found about my services, which include comprehensive psychoeducational, neurodevelopmental and neuropsychological assessments for the diagnosis of ADHD, Learning Disorders, Aspergers and Autism Spectrum Disorder at my web site: www.relatedminds.comOthers sites include:

http://www.relatedminds.com/assessment​http://therapists.psychologytoday.com/rms/70682
​http://psychologists.bc.ca/users/jimroche
​http://psyris.com/drjimroche​​http://www.actcommunity.net/jim-roche.html

What is Gottman Method Couples Therapy?

What is Gottman Method Couples Therapy?

Gottman Method Couples Therapy is a form of couple therapy, sometimes called relational therapy of marriage therapy (although you don’t need to be married) which combines more than three decades of Gottman research and clinical practice.

Through research-based interventions and exercises, Gottman Therapy helps couples break through barriers to achieve “greater understanding, connection and intimacy” in their relationships. 

This form of therapy is a structured, goal-oriented, scientifically-based. Intervention strategies are based upon empirical data from Dr. Gottman’s three decades of research with more than 3,000 couples. This research shows us what actually works to help couples achieve a long-term healthy relationship, and what doesn’t (which includes some things we have previously suggested). Gottman Method Couples Therapy was developed out of this research to help couples to do four things:

• Increase respect, affection, and closeness 
• Break through and resolve conflict when they feel stuck
• Generate greater understanding between partners 
• And keep conflict discussions calm 

After becoming a licensed and registered Marriage and Family Therapist I started training in the Gottman method.  Gottman based Couple’s Therapy is now my first recommendation whenever it is an appropriate method. There are times couples may need individual therapy to augment couple therapy, or may need to address specific behavioural or mental health needs. But Gottman Couple Therapy provides an excellent scaffold around which to build an individualized approach to therapy.

Gottman therapy – couple therapy, marriage therapy, family therapy, “plays well” with other techniques, but for the most part addresses most areas of concern a couple may have. Couples come to therapy and can additionally make use of Dr. Gottman’s books, manuals and training DVD’s. If you are considering seeing a marriage and family therapist I would suggest you visit Dr. Gottman’s website, or the Gottman Institute’s YouTube channel and start by looking at the video’s there. It’s a good place to make a start, and make a decision on what kind of therapy would be best for you.

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This post is not meant to provide medical or psychological diagnosis. If you are suffering from symptoms that cause you distress, see your medical doctor or psychologist for help.

More information can be found about my services, which include individual therapy, couples counselling, comprehensive assessments for the diagnosis of ADHD, Learning Disorders, Aspergers and Autism Spectrum Disorder at my web site: www.relatedminds.com

Others sites include:

 http://therapists.psychologytoday.com/rms/70682
 http://psychologists.bc.ca/users/jimroche
 http://psyris.com/drjimroche

 http://www.actcommunity.net/jim-roche.html

Offices are located in Burnaby (serving Coquitlam, New Westminster, Maple Ridge and Surrey) as well as in Vancouver. Call 778.998-7975 for more information.