Ben Gane

Mindfest 2023: Psychiatrist Saadia Sediqzadah offers tips on how to find the right psychotherapist

siddiq22 — Wed, 26 Apr 2023 20:08:09 +0000

Mindfest 2023: Psychiatrist Saadia Sediqzadah offers tips on how to find the right psychotherapist

siddiq22 Wed, 04/26/2023 - 16:08

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Psychiatrist and lecturer Saadia Sediqzadah will speak at U of T's Mindfest mental health fair on May 5 about cultural competence in psychotherapy (supplied image)

Ben Gane

Topic

Our Community

Temerty Faculty of Medicine

Unity Health

Diversity and Inclusion

Faculty & Staff

Mental Health

Mindfest

Psychiatry

In her work as a psychiatrist, Saadia Sediqzadah focuses on mental illness in youth and marginalized populations.

The daughter of Afghan refugees, Sediqzadah is a clinician-investigator at Unity Health Toronto and lecturer in the University of Toronto's department of psychiatry in the Temerty Faculty of Medicine who specializes in early psychosis intervention and supporting marginalized adolescents.

Her clinical practice is primarily outreach-oriented, providing psychiatric care to patients who are homeless, in the shelter system or in Toronto Community Housing. She is also the psychiatrist lead for the Starting Treatment Early in Psychosis Service (STEPS) program, which serves transitional-aged youth with psychotic illnesses, and she provides psychiatric care to youth shelters in Toronto via Inner City Health Associates.

Sediqzadah is one of several speakers scheduled for U of T’s Mindfest event – a community fair for conversations on mental health – on May 5 at Hart House. She will talk about finding a psychotherapist who is a good match in terms of clinical approach but also cultural competence and affordability.

In advance of Mindfest, Sediqzadah spoke with writer Ben Gane from U of T's department of psychiatry about how those considering therapy can find a psychotherapist who is the right fit.

Why is finding a therapist who is a good match important?

Studies have shown that the success of psychotherapy has more to do with the therapeutic relationship between you and your psychotherapist than the type of psychotherapy you pursue. That’s the key and compelling reason.

What should you consider before starting your search for a therapist?

Ask yourself what brings you to psychotherapy: Are you seeking help for specific mental health symptoms such as anxiety or depressed mood, or for a specific mental health diagnosis? Are you seeking help for a situation in your life or life event (e.g., school or work-related stress, relationship issues, death of a loved one)? Do you want to explore the past or process past traumas? Or are you simply looking for an empathic listener (as you are lacking that in your life)?

Once you know what your needs or goals are, how can you decide if a potential therapist is equipped to help with them?

If you are searching for a registered psychotherapist, social worker, or a psychologist, they will often have a website or an online profile in a registry that can give you a feel of who they are, the type of psychotherapy they offer, what they might specialize in and elements of their background or identity that might resonate with you.

What if the first therapist you meet isn’t a good match?

Sometimes finding a therapist you feel safe and comfortable with requires meeting with a few therapists till you find the right fit.

Many private psychotherapists offer a free or discounted introductory session where you can get to know each other – you can ask them questions and discuss logistics including prices, scheduling, and location. “Shopping around” is not so easy if you need a medical doctor like a psychiatrist, as waitlists can be long.

What is “cultural competence,” and what role does it play in finding a therapist who’s a good match for you?

Cultural competence starts with challenging the assumption that our own cultural values are normal and anything outside of them is “other.” It’s important for us to recognize and check that assumption before we try to become competent in another person’s culture.

I consider cultural competence to be an interest and willingness to learn about another person’s cultural practices and worldview. It is openness, curiosity and a genuine wish to understand another culture to be better equipped to help others.

Cultural competence may or may not be important to you as you begin your search for a therapist. It is important to remember that while things are changing, psychotherapy continues to be a predominantly white, cis-heteronormative space in Toronto and North America. If you are a member of cultural, ethnic, racial and/or sexual minority, it may be difficult to find a therapist of a similar background – if that is important to you.

Are there tools to help find a therapist psychotherapist who shares your cultural identity?

I recommend searching registries for psychotherapists who self-identify as such or indicate experience or an interest in working with populations that you identify with. In Canada, I highly recommend Healing in Colour, a nationwide registry of psychotherapists who identify as Black, Indigenous and/or other people of colour (BIPOC) who support BIPOC populations and any of their intersecting identities including LGBTQIA2S+ and religion.

What are some barriers to accessing effective psychotherapy in Ontario that people may encounter?

Cost is probably the top barrier to accessing psychotherapy. In Ontario most psychotherapy providers are private, and depending on the client’s situation, paid for by private medical insurance or out of pocket. Only those with a medical degree (psychiatrists and family doctors who provide psychotherapy) are covered by OHIP. Unfortunately, almost anything in health care that is covered by OHIP will have a waitlist.

There are psychotherapists from a variety of different backgrounds who work at certain allied health organizations or not-for-profits that offer free psychotherapy. You can check out a list here. Once again, these will have long waitlists and are mostly time-limited.

Any other advice for those looking for a psychotherapist?

I’m glad they're prioritizing your mental health and seeking help from a professional – everyone can benefit from psychotherapy.

Visitors attend the 2022 Mindfest fair at Hart House (photo by Felix Chan)

With a focus on mental health, U of T’s Mindfest event aims to educate and inspire

Christopher.Sorensen — Mon, 28 Feb 2022 14:58:19 +0000

With a focus on mental health, U of T’s Mindfest event aims to educate and inspire

Christopher.Sorensen Mon, 02/28/2022 - 09:58

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Nikhita Singhal, a resident physician in psychiatry at U of T, is among the participants in this year's Mindfest event, which aims to build awareness about mental health and promote mental wellness (photo courtesy of Singhal)

Ben Gane

Topic

Our Community

Temerty Faculty of Medicine

Mental Health

Mindfest

Psychiatry

The University of Toronto will host its ninth annual Mindfest event in early March to build awareness of mental health and provide strategies to promote mental wellness.

This year’s event, which will take place virtually from March 5 to 8, provides a virtual venue for honest conversations about mental health, and features experts from U of T’s department of psychiatry in the Temerty Faculty of Medicine, among others, in partnership with Jack.org.

The keynote speaker is sports broadcaster Michael Landsberg, who has experience with mood disorders and stigma. His organization, Sick Not Weak, has changed how Canadians think about mental illness and started new conversations about mental health in sports.

Psychiatry resident physician Chika Stacy Oriuwa will present about her experience as a Black woman in medicine, and how racial marginalization and mental health can intersect.

Associate Professors Daphne Korczak and Jennifer Crosbie will discuss impacts of the pandemic on the mental health of children and young people, and Kierston Drier will speak about self-care when resources are inaccessible from her perspective as founder of the Bathroom-Stall Project.

Mindfest amplifies unique perspectives on mental health.

Nikhita Singhal, also a resident physician in psychiatry at U of T, will talk about how treatments for an eating disorder when she was a youth motivated her to pursue psychiatry as a career – and how those experiences have informed her approach to providing care.

Singhal was hospitalized for the first time at age eight and underwent a care program focused on weight gain and nutrition.

“It felt like a revolving door – a metaphor initially shared with me by a nurse who had worked on the unit for over a decade and repeatedly watched the same patients come in after being ‘weight-restored,’ then relapsing as soon as they left the hospital,” says Singhal. “I saw the same pattern for myself and many of my co-patients, as each encounter with the system pushed me further into illness and instilled a deep sense of distrust and frustration with treatment itself.”

Singhal says her experiences show that eating disorders are poorly understood, with treatments frequently centred on symptoms rather than underlying causes.

“I believe a greater focus on healing one’s relationship with the body and exploring the underlying issues would be beneficial,” says Singhal. “Current approaches often do include some element of therapy, yet the emphasis remains first and foremost on food and weight gain.”

The pandemic has seen a marked increase in the number of young people diagnosed with eating disorders, underlining the importance of identifying the most effective forms of treatment.

Singhal says tailoring treatments to the individual rather than taking a ‘one-size-fits-all’ approach would greatly benefit patients. As someone who has been both a patient and care provider, Singhal says we often divide these two groups into distinct categories and lose sight of their common humanity.

“Recognizing patients as the experts in their own experiences and appreciating the vast wealth of insight they bring to the table is crucial,” she says. “My hope is that we can bridge the gap between ‘us’ and ‘them’ in the health-care system – we are all human beings who may fall ill ourselves at some point, and this is not a weakness or flaw on our part.”

Singhal says people who want to help promote patient voices can openly discuss these topics with health-care providers and seek opportunities to add their voices to the conversation on a broader level.

The message reflects Mindfest’s core mission: include all voices in the mental health conversation. Singhal hopes her presentation will help others feel empowered, combat stigma and demonstrate what’s possible.

“We are not weak because we have struggled; the challenges we have faced and the experiences which have shaped our paths can make us stronger,” she says. “I believe there are multitudes of resilient, courageous individuals with their own stories to share who have a tremendous amount to offer to the health-care system.”

U of T's Mindfest event to explore diversity and the impact of COVID-19 on mental health

Christopher.Sorensen — Wed, 03 Mar 2021 16:18:15 +0000

U of T's Mindfest event to explore diversity and the impact of COVID-19 on mental health

Christopher.Sorensen Wed, 03/03/2021 - 11:18

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(Photos courtesy of Kenneth Fung and Lisa Andermann)

Ben Gane

Topic

Our Community

Temerty Faculty of Medicine

The University of Toronto is gearing up to host its fourth-annual Mindfest event next week to build awareness of mental health and provide tips, resources and strategies for promoting mental wellness.

The event – happening virtually from March 8 to 12 – will explore implicit bias and diversity and the impact of the pandemic on student mental health, as well the tools and resources that people can use to practise self-care during difficult times. It is free for ��οstudents and faculty to attend.

Mindfest co-founder Kenneth Fung, an associate professor in the Temerty Faculty of Medicine’s department of psychiatry, recommends a number of ways to build resilience, ranging from connecting with our families, friends and communities in safe ways to joining a social movement.

He and fellow co-founder Lisa Andermann, also an associate professor of psychiatry, recently shared their thoughts with writer Ben Gane on how people can boost their mental wellness during the COVID-19 pandemic.

What impacts has COVID-19 had on people’s mental health?

Fung: As the pandemic drags on, it is quite normal to experience a wide variety of emotions, including anxiety, frustration and sadness.

People who initially coped well with the pandemic, and the resulting social isolation, may feel worn down.

Vulnerable, disadvantaged groups may face greater impacts, including discrimination, financial and housing concerns, as well as worsened mental or physical health.

All of this can increase the risk of mental health issues, from burnout to clinical depression, and even the potential contemplation of suicide.

What can people do to build resilience?

Fung: Resilience comes from both internal and external sources. We can build up our internal resilience by getting better sleep, exercising, meditating and engaging in meaningful and rewarding activities.

To build up our external resilience, we can connect with our families, friends and communities in safe ways. We can reach out for help from community and health-care services if we need it, and join in with various social movements to advocate for change together.

While there is undeniable big picture adversity, there is also opportunity for big picture healing.

We're not all experiencing the same pandemic. What advice can you give people facing anti-Asian racism, anti-Black racism or other prejudice?

Fung: When you encounter racism, discrimination, harassment, or potential assault, put your safety first.

You may need to remove yourself from the situation immediately and get help. Such incidents may evoke various emotions, such as anger, shame, or powerlessness. We must remember that racism and xenophobia of any kind is never acceptable.

Covert, subtle, and overt racism are all traumatic and damaging. Get support from your friends, family, and community. We all share in our collective responsibility to combat stigma and discrimination.

When you witness racism, speak up and confront it in a safe manner, report it, or join a community action initiative. Collective voices are louder than individual voices, and together, we can all do our part in making our society safer and more equitable.

Can we bring growth and progress into our lives despite the pandemic?

Andermann: Time at home during the pandemic has certainly made it feel as though life is on hold. It has been hard for everyone, but especially for those who cannot visit family or who have experienced milestones that they would typically celebrate with others.

However, the pandemic has also given us a break from the pressure to be in multiple places at once.

There has been an opportunity to try new things – being challenged to turn an in-person event into an online format and being pleasantly surprised when it works out; taking courses or watching webinars from around the world and supporting local neighbourhood restaurants and shops when possible.

What tips do you have for finding joy during the pandemic?

Andermann: I’m focusing on meaningful, small moments appreciated in solitude or shared with others, with pets, in nature or outdoors, or comfortably indoors, can brighten one’s day. It could be a mindfully drinking a cup of tea, a walk around the block, in a park, or exploring a new part of the city.

Experience new things by trying new recipes or taking an online class. For me, a new puppy has been a great source of joy in the past months – although, I have to note, this comes with early mornings and making sure nothing chewable is left on the floor.

U of T-led international research reveals common foundation for six psychiatric disorders

Christopher.Sorensen — Mon, 31 Aug 2020 22:24:07 +0000

U of T-led international research reveals common foundation for six psychiatric disorders

Christopher.Sorensen Mon, 08/31/2020 - 18:24

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Tomas Paus, a professor in the department of psychiatry, used international databases to study more than 12,000 patients and found that genes that affect cortical thickness may play a role in six major psychiatric disorders (photo courtesy of Tomas Paus)

Ben Gane

Topic

Breaking Research

Faculty of Arts & Science

Research & Innovation

New work by a University of Toronto researcher shows that genes that affect cortical thickness may play a role in the development of six major psychiatric disorders.

A paper by Tomas Paus, a professor in the Faculty of Medicine’s department of psychiatry, used international databases to study more than 12,000 patients with attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), bipolar disorder (BD), major depressive disorder (MDD), obsessive-compulsive disorder (OCD) and schizophrenia.

Paus says the research paper published in JAMA Psychiatry is an important step towards understanding the origins and development of these disorders, and may help with the development of new methods to treat and prevent them.

“Previous studies have shown commonalities in brain structure of people with these disorders, particularly cortical thickness,” says Paus, who is the senior lead author on the paper and also a professor in the department of psychology in the Faculty of Arts & Science. “But no one has brought together data and modelling from all six of these disorders before.”

Cortical thickness is a measurement describing the density of the outer layer of the brain, called the cortex. The cortex plays an important role in consciousness.

Prior studies have shown that the cortex tends to be thinner than average in people with the disorders, according to Paus.

In his research, Paus and graduate student Yash Patel used a technique called virtual histology.

Invented by Paus’s lab, the method uses gene expression to estimate the number of cells in different regions of the brain. Some genes act as markers, indicating the presence of a certain type of cell. If a region of the brain has more expression of these markers, it will have more of the matching type of cell.

Using virtual histology, the team was able to profile gene expression across 34 regions of the brain. They found that the difference in cortical thickness between patients corresponded to the difference in the number of pyramidal cells in the brain (indexed through gene expression).

Pyramidal cells are vital agents of communication within the brain, involved in processing information from the senses, controlling movement, generating emotions and making decisions, says Paus.

He adds that the number of pyramidal cells that develop in an individual is influenced by prenatal and postnatal processes, which take place before and after birth.

“The commonalties we’ve identified across these six disorders tell us that we need to look for common factors shaping the brain both before and after birth,” says Paus. “The presence of postnatal factors suggests that psychosocial influences may also be involved. It tells us that brain structure is not fixed and can be changed through experience.”

The research was made possible by the ENIGMA Consortium, an international network of researchers from around the world. The paper has 299 co-authors from more than 20 countries.

The consortium allowed Paus and his team to access datasets encompassing all six of the disorders they wished to study.

“This type of international collaboration is very powerful,” says Paus.

“Not only does it allow us to pool data and perform research at a scale that would have previously been impossible, it also provides an ideal environment to train students, giving them an opportunity to learn from teachers who are highly diverse and come from all over the world.”

Patel, the paper’s first author, highlights the educational benefits offered by working with an international research network.

“Usually with research, you read a lot of papers and study the methods used by previous researchers that way,” says Patel, who is a fourth-year graduate student at U of T’s Institute of Medical Sciences. “But through the consortium, we had access to the minds behind the papers.”

“I hope that others reading these papers will find inspiration in what we’ve discovered,” says Paus. “We’re building a foundational understanding of these disorders that could open paths to treatment and prevention.”

Individual cohorts within this research project have been funded by multiple national agencies. The ENIGMA Consortium is funded by the U.S. National Institutes of Health, while Patel is supported by the Natural Sciences and Engineering Research Council of Canada.

US$13-million trial aims to expand access to talk therapy for new and soon-to-be moms

noreen.rasbach — Thu, 25 Jul 2019 17:32:09 +0000

US$13-million trial aims to expand access to talk therapy for new and soon-to-be moms

noreen.rasbach Thu, 07/25/2019 - 13:32

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Daisy Singla, an assistant professor of psychiatry, will lead research into whether nurses can provide talk therapy for new and expecting mothers as effectively as psychiatrists and other specialists (photo by Jim Oldfield)

Research & Innovation

The University of Toronto's Daisy Singla is leading a study in Canada and the U.S. that will test whether nurses can provide talk therapy for new and expecting mothers as effectively as psychiatrists and other specialists. The study could provide evidence to expand access to evidence-based therapy for pre- and postpartum anxiety and depression.

Singla is an assistant professor of psychiatry at ��οand a clinician scientist at the Lunenfeld Tanenbaum Research Institute, part of Sinai Health System. She and her collaborators – Dr. Samantha Meltzer-Brody from the University of North Carolina at Chapel Hill and Dr. Richard Silver at the University of Chicago — are supported by US$13.2 million from the Patient-Centered Outcomes Research Institute (PCORI).

About 80 per cent of women who need care for pre- and postpartum anxiety and depression do not have access to it, often due to a shortage of specialists. The trial will target women’s mental health through behavioural activation (BA), a talk therapy that aims to increase enjoyable and fulfilling activities that can be delivered weekly in as few as six sessions.

Singla recently spoke with writer Ben Gane about the trial, which will start enrolling 1,300 participants in early 2020.

What are the driving ideas behind this study?

The key idea is increasing access to evidence-based talk therapies. We want to compare two innovative approaches (non-specialists and telemedicine) to treatment as usual (specialists and in-person treatment). Non-specialists include anyone without formal training in mental health – a peer, a teacher, or a nurse. We’re training nurses to provide weekly behavioural activation (BA) talk therapy and then comparing patient outcomes to specialists delivering the same treatment. We will also examine whether BA delivered via telemedicine will be as effective as it is in-person.

Why is behavioural activation a good fit for this study?

Multiple studies have demonstrated the comparable effectiveness of BA to longer courses of treatment and medications in targeting depression. BA is relatively easy to learn and easy to teach; that’s important when training non-specialists.

Why do you think care provided by non-specialists will be effective?

Research on the effectiveness of non-specialist delivered treatments for mental health dates back to the 1950s. I’ve had the good fortune of being mentored by global mental health pioneer Dr. Vikram Patel; he and others have tackled the issue of access in low-resource settings for years, and they found that training non-specialists to provide patient-centred care can be an extremely effective way to deliver talk therapies. This includes providing care in settings convenient for the patient, reducing the number of treatment sessions to as few as eight and involving key family members. In this study, we have the opportunity to reverse engineer some of the very innovative and effective delivery strategies from the Global South to the Global North.

You’re also exploring the effectiveness of using telemedicine to provide deliver therapy remotely. What’s the significance of providing care remotely?

Telemedicine is a particularly valuable tool when providing care for pregnant and postpartum moms. Whether you’re having a baby soon, or you’ve recently given birth and you’re caring for an infant, it can be a challenge to get out of the house and attend a session. Using telemedicine, you can deliver care at home. At Sinai, our perinatal psychiatrists led by Dr. Ariel Dalfen have done a terrific job of using telemedicine to provide care to mothers across Ontario. But we do not know if BA delivered remotely is as effective as BA delivered in-person.

You’re one of the youngest applicants to ever receive a PCORI grant of this size. What does this mean to you?

To be honest, I am beyond words. I am so grateful for PCORI’s vote of confidence in our ideas and our team. PCORI’s mission is to further research that will directly benefit patients and improve their lives in real ways; I am fortunate to be working with a funder whose pragmatic and person-centred values align with my own. In addition, both Dr. Jim Woodgett (director of the Lunenfeld-Tanenbaum Research Institute) and Dr. Lesley Wiesenfeld (psychiatrist-in-chief at Sinai Health System) have been relentlessly supportive in this initiative.

I hope this award encourages other early career researchers – especially young women – to explore their passions while building a diverse team of experienced colleagues. I also hope it inspires Canadian funders to take a chance on young people and their ideas. Too often, we are told to wait our turn and by the time that happens, individuals are too tired or too disgruntled to explore innovations that are so essential to existing health-care systems. The ongoing status quo needs to change if we want to achieve our shared goal of improving access to mental health care.

What long-term impact do you hope this study will have?

This research has the potential to increase the accessibility, scalability and cost-effectiveness of evidence-based psychological treatments for perinatal women worldwide. In short, we’re exploring practical and efficient solutions to get the treatments that we know work to those that could benefit the most.