About Counselling and Therapy Services (Burnaby/Vancouver)

As a Registered Psychologist I provide individual therapy and counselling services using the evidence based techniques of Cognitive Behaviour Therapy (CBT) and Rational Emotive Behaviour Therapy (REBT). Individuals are seen in both my Burnaby and Vancouver offices for a variety of issues including chronic pain, depression, anxiety, stress, panic, anger management, ADHD and work or relationship issues. 

I hold an Advanced Certificate in Cognitive Therapy from the Albert Ellis Institute in New York. If you are looking for a cognitive therapist you should ask what training they have in CBT, as many individuals claim they practice CBT after completing only a workshop or reading a book. The Advanced Certificate Program at the Albert Ellis Institute included extensive CBT readings, group and individual training and supervised practice of Cognitive Behaviour Therapy/Rationale Emotive Behaviour Therapy under the supervision of a licensed mental health practitioner. In addition to my practicum at the Ellis Institute I also focused on CBT during my graduate studies and post doctoral internship. Registered Psychologists undergo one year of of full time supervised practicum experience, as well as a year of post doctoral experience. Since graduation I have practiced counselling and therapy for over 20 years and have served as the program director and practicum supervisor in several hospitals, universities and community mental health centres.

FAQs:

Could you tell me more about Cognitive Behaviour Therapy (CBT)?

My primary mode of practice is rational-emotive/cognitive therapy. Cognitive Behaviour Therapy or CBT (including Rational Emotive Therapy) is a highly effective, research driven approach that helps people to combat and overcome such difficulties as high anxiety/stress, panic attacks, depression, anger, relationship problems, phobias, worry, obsessions, compulsions, addictions (food or drugs), social anxiety, sexual problems, ADHD and low self-esteem. The course of treatment is typically short-term (approximately 8-12 sessions), and people often enjoy rapid and enduring relief from their symptoms. I am also trained in other counselling and therapy techniques, and use these when and where appropriate. Overall I try to match  the skills and techniques to your needs. My office provides a supportive, caring and safe environment to work on change and focus on growth and future success.

I have heard about "Schema Therapy," what's that?

Schema-Focused Cognitive Therapy goes further, to help people address and break long-standing or particularly stubborn patterns of thinking, feeling and behaving that arise from deep-seated beliefs, such as “I’m unlovable,” “I’m a failure,” “People don’t care about me,” “I’m not important,” “Something bad is going to happen,” “People will leave me,” “I will never get my needs met,” “I will never be good enough,” etc. Remarkable results have been achieved via the Schema-Focused approach, even for people who have previously found other therapies to be ineffective. Results of course cannot be guaranteed, however, compared with other types of therapeutic intervention research has shown Cognitive Therapy to be effective.

Schema-Focused and Rational Emotive and Cognitive Behaviour Therapy do more than address symptoms, they address a way of thinking that causes you problems in life, work and relationships. In addition to individual therapy I often recommend readings which emphasize the personal growth aspects of cognitive behaviour therapy as well as those that focus on symptom relief.

Do you do any "Mindfulness" work?

In collaboration with other health related professionals I have recently (the past two to three years) begun to offer a longer and more intensive form of Cognitive Behaviour Therapy called Mindfulness Based Cognitive Therapy (MBCT). This method of therapy blends together features of two disciplines: Cognitive Behaviour Therapy (CBT), which aims to identify and alter cognitive distortions (irrational or inaccurate thoughts) and Mindfulness, which is a meditative (mental focusing) practice taken from Buddhism which aims to help people identify their thoughts, moment by moment, but without passing judgement on the thoughts. As with other medically based meditative interventions, this is not a religious oriented practice, but a scientifically supported methodology used in many medical and mental health centers throughout the world. This particular intervention is based upon Mindfulness-Based Stress Reduction (MBSR), an eight week program developed by Jon Kabat-Zinn in 1979 at the University of Massachusetts Medical Center. MBSR research has shown that this combined intervention method is enormously empowering for patients with chronic pain, hypertension, heart disease, gastrointestinal disorders, ADHD, as well as psychological problems such as anxiety, panic and depression.

More about Cognitive Behaviour Therapy

Albert Ellis and the Institute for Rational Emotive Behaviour Therapy

In 1955 Dr. Albert Ellis developed  Rational Emotive Behaviour Therapy or “REBT”  which is an action-oriented therapeutic approach that stimulates emotional growth by teaching people to replace their self-defeating thoughts, feelings and actions with new and more effective ones. REBT teaches individuals to be responsible for their own emotions and gives them the power to change and overcome their unhealthy behaviors that interfere with their ability to function and enjoy life.

Today the Albert Ellis Institute is a world center of research, training, and practice of REBT, its founder Dr. Albert Ellis remains one of the most influential psychologists of our time, and authored more than 70 books and 700 articles all designed to help people overcome destructive, self-defeating emotions and improve their lives.  Later Dr. Aaron Beck developed what is commonly called Cognitive Behaviour Therapy (CBT) along the same lines as REBT. Today these two cognitive based therapies are very similar, although some specific techniques may differ in the two schools of practice. Both are referred to as Cognitive Behaviour Therapy. I have received both my Basic and Advanced Certificates in Cognitive and Rational Emotive Therapy through the Albert Ellis Institute in New York City. For more information you can click here:

http://www.rebt.org Albert Ellis Institute in New York City

What will I be learning in Cognitive Behaviour Therapy (REBT/CBT)

and Schema-Focused Therapy?

You will learn to:

1. Identify the themes and patterns in your thoughts, feelings and behavior that cause you emotional wear and tear;

2. Learn how to handle your thoughts and manage your emotions so that you feel better and cope more effectively;

3. Learn how to handle problematic situations to maximize positive outcomes and experiences;

4. Prevent maladaptive cycles of thinking, feeling and behaving from repeating over and over again;

5. Find ways to reach your goals and get your needs met rather than running up against the proverbial brick wall.

Could you say more about Schema-Focused Cognitive Therapy?

Schema-Focused Cognitive Therapy is the approach developed by Jeffrey E. Young, Ph.D., who was a protégée of Dr. Aaron Beck. Prior to his founding the Cognitive Therapy Centers of NY and Connecticut, as well as the Schema Therapy Institute, Dr. Young served as the Director of Research and Training at the Center for Cognitive Therapy at U. Penn with Dr. Beck, where he trained many clinicians in the application of CBT. In working with clients, however, Dr. Young and his colleagues found a significant segment of people who came for treatment but had perplexing difficulty in benefiting from the standard approach. He discovered that these people typically had long-standing patterns or themes in thinking and feeling—and consequently in behaving or coping—that required a different means of intervention. Dr. Young’s attention turned to ways of helping patients to address and modify these deeper patterns or themes, also known as “schemas” or “lifetraps.”

The schemas (listed below) that are targeted in treatment are enduring and self-defeating patterns that typically begin early in life, get repeated and elaborated upon, cause negative/dysfunctional thoughts and feelings, and pose obstacles for accomplishing one’s goals and getting one’s needs met. Although schemas are usually developed early in life (during childhood or adolescence), they can also form later, in adulthood. These schemas are perpetuated behaviorally through the coping styles of schema maintenance, schema avoidance, and schema compensation. Dr. Young’s model centers on helping the person to break these patterns of thinking, feeling and behaving, which are often very tenacious.

In formulating the Schema-Focused approach, Young combined the best aspects of cognitive-behavioral, experiential, interpersonal and psychoanalytic therapies into one unified model of treatment. Through Young’s work and the efforts of those trained by him, Schema-Focused Therapy has shown remarkable results in helping people to change patterns which they have lived with for a long time, even when other methods and efforts they have tried before have been largely unsuccessful.

Schema’s that REBT / Cognitive and Schema Focused Therapy Focus on:

Emotional Deprivation: The belief and expectation that your primary needs will never be met. The sense that no one will nurture, care for, guide, protect or empathize with you.

Abandonment: The belief and expectation that others will leave, that others are unreliable, that relationships are fragile, that loss is inevitable, and that you will ultimately wind up alone.

Mistrust/Abuse: The belief that others are abusive, manipulative, selfish, or looking to hurt or use you. Others are not to be trusted.

Defectiveness: The belief that you are flawed, damaged or unlovable, and you will thereby be rejected.

Social Isolation: The pervasive sense of aloneness, coupled with a feeling of alienation.

Vulnerability: The sense that the world is a dangerous place, that disaster can happen at any time, and that you will be overwhelmed by the challenges that lie ahead.

Dependence/Incompetence: The belief that you are unable to effectively make your own decisions, that your judgment is questionable, and that you need to rely on others to help get you through day-to-day responsibilities.

Enmeshment/Undeveloped Self: The sense that you do not have an identity or “individuated self” that is separate from one or more significant others.

Failure: The expectation that you will fail, or belief that you cannot perform well enough.

Subjugation: The belief that you must submit to the control of others, or else punishment or rejection will be forthcoming.

Self-Sacrifice: The belief that you should voluntarily give up of your own needs for the sake of others, usually to a point which is excessive.

Approval-Seeking/Recognition-Seeking: The sense that approval, attention and recognition are far more important than genuine self-expression and being true to oneself.

Emotional Inhibition: The belief that you must control your self-expression or others will reject or criticize you.

Negativity/Pessimism: The pervasive belief that the negative aspects of life outweigh the positive, along with negative expectations for the future.

Unrelenting Standards: The belief that you need to be the best, always striving for perfection or to avoid mistakes.

Punitiveness: The belief that people should be harshly punished for their mistakes or shortcomings.

Entitlement/Grandiosity: The sense that you are special or more important than others, and that you do not have to follow the rules like other people even though it may have a negative effect on others. Also can manifest in an exaggerated focus on superiority for the purpose of having power or control.

Insufficient Self-Control/Self-Discipline: The sense that you cannot accomplish your goals, especially if the process contains boring, repetitive, or frustrating aspects. Also, that you cannot resist acting upon impulses that lead to detrimental results.

Reference: "A Client's Guide to Schema-Focused Cognitive Therapy" by David C. Bricker, Ph.D. and Jeffrey E. Young, Ph.D.,

Cognitive Therapy Center of New York. 1999

Summary

I hope you have found this very brief introduction to Cognitive Behaviour Therapy useful. In the office we discuss these issues, practice understanding our “automatic” and often irrational thinking, and learn to apply cognitive behaviour techniques to stop and change these debilitating thoughts. Progress is made through a combination of in-office counselling/therapy, readings and homework during which you apply what you have learned and practiced in the real world. While CBT may often be the primary therapy technique we use I often also involve psycho-education (direct teaching about your mental health issues), behavioural techniques and sometimes use my skills in Systemic and Family Therapy to address issues you may have with relationships, family or at work.

Fees

EAP and EFAP consignment, crime victims assistance program as well as extended insurance and self-pay are accepted. Session fees are $175.00 per hour. There is a sliding scale available to those will lower incomes. I also accept credit cards through on-line PayPal.

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Psychological services (including assessment, testing and therapy) provided in my offices include (covered by most extended health care insurance):

ADHD (click here: http://www.relatedminds.com/adhd-attention-deficit-hyperactivity-disorder/

Anxiety and Stress (click here:) http://www.relatedminds.com/anxiety-stress/">http://www.relatedminds.com/anxiety-stress/

Autism and Asperger's Disorder (Click here:)  http://www.relatedminds.com/autism/

Individual Counselling (click here: ) http://www.relatedminds.com/individual-therapy/

Child Counselling / Therapy (click here: ) http://www.relatedminds.com/child-therapy/

Couples Counselling / Therapy (click here:)  http://www.relatedminds.com/couples-therapy/

About Dr. Roche

I am a Registered Psychologist and a Registered Marriage and Family Therapist (RMFT) in British Columbia. In addition to my doctorate in clinical Psychology (The Union of Experimenting Universities), I hold a master's degree in family therapy from Goddard college, a certificate of advanced graduate studies (CAGS) in school and educational psychology from Norwich University, and have completed two years of post doctoral studies in neuro-psychology at The Fielding Institute in Santa Barbara, California. I am also a certified school psychologist, certified teacher of special education (New York and California), and a Clinical Member of the American Association of Marriage and Family Therapists (AAMFT). Finally, I hold a doctoral degree in law (JD) with an emphasis in medical malpractice and education law. Beyond my academic credentials, I have completed two years of supervised clinical experience in both hospital and community based clinics and two years of post doctoral training in neuropsychology. I have served as director of behaviour programming for several school districts, as a consultant on autism for the province, and have held numerous academic positions including Clinical Instructor in Psychiatry at New York University and Bellevue Hospital in New York as well as being a faculty member at NYU, Brooklyn College, SUNY New Paltz, and Norwich University.

My offices in Burnaby and Vancouver serve Burnaby, Vancouver, Coquitlam, Port Moody, Port Coquitlam, New Westminster and Maple Ridge. Clients often come to my Vancouver office from North Vancouver, West Vancouver and even as far as the Sunshine Coast. For more information on the location of my Burnaby and Vancouver offices, please see my "Office Location" page, which contains a Google map.

Key words

ADHD | Anxiety and Stress | Autism and Asperger's Disorder | Individual Counselling | Child Therapy | Testing and Assessments and Learning Disabilities | Couples Counselling | Depression | The Angry Child | Anger Management | Pain Management and PTSD | Forensic Services | Attention Deficit Hyperactivity Disorder | Vancouver | Burnaby | Coquitlam | New Westminster | Maple Ridge | Port Moody | Child Psychologist | Psychologist | Learning Disability | Assessment | Testing | Psycho-educational Assessment | Neuropsychological Assessment

http://www.relatedminds.com

http://Therapists.PsychologyToday.com/rms/70682

http://www.therapistlocator.net/member?183420

http://www.bcpsychologist.org/users/jimroche

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

What is Different about Gottman Therapy?

Gottman Family Therapy is a science based form of couple's therapy. Information about Gottman Therapy, along with books, DVDs and audio books can be found at the Gottman Institute's website. Gottman Family Therapy is offered by both Registered Psychologists and Registered Marriage and Family Therapists in British Columbia. Please visit my website for more information on relational therapy that I offer: http://www.relatedminds.com

New Definition of Autism May Exclude Many

Usually, once a week, I teach a graduate class in diagnostics at a local college. Students are surprised to hear that the definitions of different mental health conditions such as ADHD or autism spectrum disorder can change. Any every few years, when the new edition of the DSM (Diagnostic and Statistical Manual of Mental Disorders) there are often changes. Most of these are brought about by new science, new understanding, experiments and research that helps re-define and make more specific how we make a diagnosis. This time around, as we prepare for the 5th edition, some people are concerned about the effects of many of the changes, especially those for Attention Deficit Hyperactivity Disorder (ADHD or ADD as it was once known) and autism spectrum disorder (ASD).

The proposed changes in the DSM for autism would, according to many, sharply reduce the skyrocketing rate at which this disorder has been diagnosed. And honestly, some days almost all of the calls to my office are from individuals who talked with a friend, read a newspaper article or saw something on the web that made them think they might possibly have autism. After talking with their family doctor, who usually has no idea how to make such diagnosis, they call me. Many want, more than anything, to get a diagnosis so they know what is wrong. But this is exactly where the new DSM is struggling. As a recent article in the New york Times puts it, "where to draw the line between the unusual and abnormal..." The new proposed guidelines are most likely going to exclude many people from the diagnosis who are "higher functioning" and move them from that the "category" of abnormal- or "diagnosable" to "unusual." Many people who are currently diagnosed as having Aspeger's disorder will most likely be left out.

currently at least a million children and adults have a diagnosis of Asperger syndrome (or disorder) or "pervasive developmental disorder-not otherwise specified- PDD-NOS - and endure many of the same social struggles and deficits that people with autism have, but they do not meet the criteria for ASD - autism spectrum disorder. The proposed changes to the DSM would put all three of these categories -PDD (Pervasive Developmental Disorder), Asperger's Syndrome, and Autism Spectrum Disorder (ASD) together, eliminating PDD-NOS and Asperger's from the manual entirely. Under the current criteria for a diagnosis a person can qualify for the diagnosis by exhibiting 6 or more of the 12 required observed or reported behaviours; under the new proposed definition a person would be required to exhibit 3 3 deficits in social interaction and communication and at least 2 repetitive behaviours, a much narrower definition for diagnosis. The problem is, especially in places like BC where a strict diagnostic procedure is enforced, kids may no longer qualify for a diagnosis of ASD (autism spectrum disorder) even though they have fairly significant behavioural and social deficits.  Some services are always driven strictly by a persons diagnosis.

Research shows that the new definition seems to have more of an effect on the "cognitively able" rather than the "classically autistic" child. Currently several studies are looking at how the new definition would effect diagnostic decisions. But if a diagnosis is suppose to guide treatment interventions, the real purpose of a diagnosis, then some changes really do need to be made. We will have to wait to see what the outcome is. No matter what happens, we do know the end result will be that some children (and adults) who currently qualify for a diagnosis will no longer qualify. Effort will need to be made to expand the criteria for getting help that even the "cognitively able" and "unusual" child needs to be successful.