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Mental health therapy is not 'one size fits all': Expert on how to find the right treatment


As Canadians emerge from the pandemic, more are dealing with mental health problems. To treat the conditions, one expert says, therapy is not a "one size fits all" approach.

One-in-four Canadians have experienced high levels of anxiety, a study by Mental Health Research Canada says.

As more people interact with mental illness, options on the best way to treat conditions can become overwhelming.

Candice Monson, a professor at Toronto Metropolitan University and CEO of Nellie Health, says each illness and person need to be treated differently.

"I think we're in a phase, fortunately, in mental health, where we really are … thinking more about personalized health," she said in an interview with

Monson started her career as a clinical psychologist, and now works at a Toronto-based for-profit clinic specializing in mental health care. She has studied the psychology behind mental illness and has tried to figure out which types of psychotherapy work best for patients.

The Canadian Psychological Association and Canadian Psychiatric Association compile research on illnesses and treatments that are most effective, and give guidelines to health professionals.

"So if I have depression, for example, one of the best treatments for depression is something called behavioural activation, which is a fancy term for getting active and moving," she said.

For anxiety, the best type of treatment, according to Monson, is to "face your fear" through exposure therapy.

"I think a lot of people go to therapy thinking it's a little bit like one-size-fits-all, and we're going to talk about past and my problems," Monson said, referring to cognitive behavioural therapy. "But the treatments that work actually are based on theory about why you even have this problem."

If you've never sought mental health treatment before, here's an overview of what to expect, and what to ask.


What type of therapy is best for you? An important first step in getting the right treatment, Monson said, is to understand the illness and choose a provider that is working with you.

"I think as a consumer, it's really important to educate yourself just like you would for any health condition," Monson said. "But also to feel like your provider is in it with you, (to say) these are the options."

Mental health is often referred to as a journey, one that could take more than a few appointments to make progress. Monson says treatment should be "active" work.

"I think it is really important to know what you're getting yourself into and that it makes sense to you," she said. "It's something you can commit to and join with your provider in actually doing in order to get the outcomes."

Finding the right therapist and provider is also crucial to achieving the correct treatment. Monson said there are questions people should be asking to make sure the therapist is the right fit for them:

1. How are you going to assess what I have?

2. What type of therapy are you qualified to use?

3. How do you know if I'm going to get better?

4. What is going to happen in therapy?

Therapists are generally trained in a number of different types of treatment, but some may specialize in specific techniques and prefer to focus on one or a few over others.

"If I'm a CBT (cognitive behavioural therapy) therapist, and I'm heavy on the (cognitive), little (behaviour), then we're going to spend a lot of time having you do what are called thought records," Monson said. "Then we're going to try to systematically be curious about how it is you're taking in information that may not be good for you."

This form of treatment would not be compatible, Monson said, with people who have obsessive-compulsive disorder (OCD), for example.


In addition to the type of treatment, the best type of provider is not one-size-fits-all.

A therapist is just one of many mental health professionals that people can turn to. This professional typically holds a master's degree and is licensed, the Nellie Health website reads.

Clinical social workers are trained in the assessment and treatment of mental health.

Psychologists specialize in the assessment, diagnosis and treatment of psychological disorders and problems, and holds a master's or a doctorate degree.

Psychiatrists are medical doctors and specialize in the assessment and medical management of mental health problems, including prescribing medication, says Nellie Health.

It’s important to know "what you're committing to so that you can fully commit to that alongside your provider, in order to get the optimal best outcome in your case," Monson said.


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