CACBT-ACTCC 2024 Fellows

Tuesday , July 02, 2024

We were very pleased to recently announce our three 2024 Fellows: Dr. Stephanie Cassin, Dr. Peter Farvolden, and Dr. Noah Lazar. Each of our new fellows gave a brief set of remarks at our Annual General Meeting in May, offering an inspiring glimpse into the work of these esteemed members. We are posting their remarks here in the form of a blog post, so that they can reach a wider audience. Please enjoy!

Dr. Stephanie Cassin: Promoting access to CBT via Project ECHO Ontario Mental Health 

Access to CBT can be a significant challenge, particularly in underserved communities that have limited access to specialized mental health services. Project ECHO® is a virtual professional development training model that has potential to build capacity in CBT across Canada and beyond. The ECHO model was originally developed at the University of New Mexico and has since been expanded to many geographical areas to develop capacity in a wide range of healthcare domains.

Project ECHO Ontario Mental Health (ECHO-ONMH) is funded by the Ministry of Health and supports healthcare providers in delivering high quality, evidence-based mental healthcare in their local communities. Through multipoint videoconferencing (Zoom), ECHO-ONMH links expert inter-disciplinary teams with front line care providers in order to share best practices, jointly discuss practical recommendations for client care, and build sustainable communities of practice.

In 2019, ECHO-ONMH launched a CBT Psychotherapy Program to increase healthcare providers’ foundational knowledge and skills in CBT. The inter-disciplinary team includes 2 psychologists, a psychiatrist, a social worker, and 2 people with lived experience of CBT.  Each of the 12 ECHO sessions begins with a didactic presentation on topics such as the CBT model, collaborative goal setting, behavioural activation, exposure therapy, identifying and challenging maladaptive thoughts, problem solving, mindfulness-based CBT, and relapse prevention.  A case-based learning approach is then used to support knowledge development and application of CBT theory into practice.  During this portion of the ECHO session, one of the participants delivers a brief de-identified case presentation and poses a few consultation questions to the group. The group members ask clarifying questions regarding the case presentation and then provide treatment recommendations that are summarized in a report and shared with the case presenter.

In the first 5 cycles of the program, ECHO Ontario Psychotherapy CBT has provided CBT training to 471 health care providers across 341 different organizations. The healthcare providers include MDs (family physicians and specialists), nurses and nurse practitioners, occupational therapists, psychologists, psychotherapists, social workers, case workers, and addictions counsellors employed across Ontario, with an overrepresentation of health care providers in rural communities. The program evaluation data demonstrates high levels of participant engagement and satisfaction, and increased self-efficacy in CBT. ECHO Ontario Psychotherapy also has programs to build capacity in Dialectical Behaviour Therapy and Developmental Trauma & Resilience.

For more information about Project ECHO®, see https://projectecho.unm.edu/

For more information about Project ECHO-ONMH, including the Psychotherapy Program, see https://camh.echoontario.ca/

Stephanie Cassin, PhD, CPsych

Professor and Director of Clinical Training

Department of Psychology, Toronto Metropolitan University

Co-Lead, ECHO Ontario CBT Psychotherapy

Fellow, CACBT

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Dr. Peter Farvolden: Remarks on Becoming a Fellow of CACBT

I would like to thank my long-time distinguished colleagues for nominating me and I would like to thank the Nomination Committee and Board for appointing me. It is a true honour and I really appreciate it.

I want to talk about the future of CBT, but I’ll start by talking about why CBT appealed to me very early on in my journey as a psychotherapist.

My first undergraduate degree was in Philosophy at the University of Waterloo, where I became fascinated with what was happening at the intersection of philosophy and cognitive science. At some point while completing that degree I decided that I wanted to understand more about how the brain works so I did a BSc in psychology that was heavy on biology and neuroscience. My ambition at the time was to be a neurosurgeon, like the next Wilder Penfield or something. Then, in my second year, I got a job working as a counsellor in a residential treatment centre for adolescents and I became fascinated with the process of psychotherapy, and that was that. I sometimes call it the “other kind of brain surgeon.”

I think great psychoanalysts and great Jungian analysts can provide great transformative psychotherapeutic experiences. However, I practice CBT because I think that the causes of a lot of common mental health problems include cognitive and emotional processes that are “features” of our system rather than bugs.

For example, I was re-reading Daniel Khanemans’ Thinking, Fast and Slow when he died a few months ago. I have been reading Khaneman and Tversky for 40 years and re-reading it always blows me away. If you are a CBT therapist and you haven’t read it, please do yourself and your patients a favour. There is a seed of an idea for an intervention on almost every page. A five-point summary of the book is that:

- The brain thinks in two ways. There is a fast system and a slow system;

- The “fast system” is a machine built for quickly and easily jumping to conclusions based on emotions and intuitions;

- This fast process can be easily hacked by people who want to manipulate us;

- The slow system, a.k.a. reasoning, is relatively slow and effortful, so people mostly avoid it because we are lazy; and

- People can be taught to slow down, exert effort and employ reason. Easy to say but not easy to do, actually quite challenging, but it can be done.

And what is CBT if not a model and methods employed to help people slow down, exert effort and engage in reasoning?

It is clear that behavioural scientists and software engineers know how to work together to exploit the “fast thinking” features of our operating system towards great evil, with devastating effects on global mental health. Just take a look around you.

The CBT community is in an excellent position to use the very same knowledge to do great good, to help people recognize the dangers of thinking fast and learn techniques that will promote thinking slow.

So, I believe that the world now needs you all more than ever, especially to the degree that your research and practice is informed by current behavioural and cognitive science over emotion and intuition. You know, The Enlightenment. Science!

Thank you,

Peter Farvolden, PhD, CPsych

Fellow, CACBT

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Dr. Noah Lazar: Reflections on the importance of CACBT

First, I want to extend my sincerest appreciation to CACBT for this honour and want to extend my congratulations to the other fellows who were named today.  As some of you may know, I served on the board of CACBT for seven years, and I wanted to use my time today to reflect on the organization, and the wonderful work that it has been doing.

In my professional life, I’m involved in clinical practice, supervision and teaching, and my sense sometimes is that CBT can have “bad rap”. I might hear from a client that they tried CBT, but it didn’t work, only to find out the clinician gave them a list of cognitive distortions and talked about their childhood.  I’ve heard from other mental health professionals that CBT is just a collection of worksheets and doesn’t go in depth, only to surprise them when we discuss an in-depth cognitive case conceptualization.  I’ve heard from therapists in training that CBT is harmful, as challenging one’s thoughts or perceptions invalidates the client’s experience, only for them to see that engaging in Socratic questioning isn’t invalidating at all.   

When I hear these comments, it seems that there’s a lot of “fake news” about CBT out there, and it really becomes clear why CACBT is such an important organization right now. 

• CACBT certifies clinicians to ensure that they have the knowledge and experience to deliver appropriate evidence-based CBT.
  

• CACBT provides continued education on how we can adapt our skills to best serve our clients.
  

• CACBT advocates for the use and benefits of CBT and plays an important role in combatting some of the misinformation that is out there.
  

• As we have more clinicians from training programs that may not emphasize or value evidence-based techniques, I think the importance of CACBT has never been clearer.

Personally, I found my time on the CACBT board to be an extremely rewarding experience, and I would encourage all of you to consider becoming active on the board or on committees.  Apart from the important work that CACBT does, I can also say that it afforded me the chance to work with some of most dedicated people in the CBT world. I think we only have to look at who is on this Zoom meeting to see the incredible breadth of talent and experience that CACBT has been able to bring together.  It was really a treat for me to be a part of.

Thank you everyone for this honour, it genuinely means a lot to me, especially coming from this organization and community.

Noah Lazar, Ph.D., C.Psych.

Clinical Director | Psychologist

The Downtown Psychology Clinic

Fellow, CACBT