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Frequently Asked Questions

 

What is your cancellation policy?

Please note I have a strict no show/late cancellation fee of the regular session fee should there not be 24 hours notice.

How do I book or change a session time?

Sessions can be scheduled, changed, or cancelled by clicking the "Book Appointment" button at the top of this web page. You will need to use your email to create a password to log in. You can also send me an email at HelmanKrista@gmail.com. Please give me at least 24 hours notice to cancel or reschedule to avoid you having to pay a late cancellation/no show fee.

How do I attend an online session via video e-counselling?

Shortly before the start of your online session you will receive an email with instructions and the link for your online session.

What Training do you Have?

I completed my Master of Social Worker with Carleton University and am a Registered Social Worker with the Ontario College of Social Workers and Social Service Workers (OCSWSSW). I continue to expand my knowledge with professional development in areas such as, EMDR, DBT, CBT, positive psychology, working with children, abandonment, Ego State Therapy, eating disorders, Structural Dissociation, and complex trauma.

What modalities do you use?

My toolbox includes elements of Polyvagal Theory, Adaptive Information Processing (AIP) model, Attachment, and Structural Dissociation Theory. I'm primarily an Eye Movement Desensitization and Reprocessing (EMDR) therapist, and use aspects of therapies such as Cognitive Behavioural Therapy (CBT), Narrative Therapy, Dialectical Behaviour Therapy (DBT), positive psychology, Ego State Therapy, and the Safe & Sound Protocol (SSP).

What is it like in a therapy session?

Therapy will involve preparation before addressing the tough stuff, and everyone is different with how long they need. First you'll dip your toe in the lake, then we'll make sure you're ready with floaties before you decide to jump in! Preparation can include SSP music for all or part of the session or exploring other life factors to ensure you have practiced feeling stable, supported, and calm, before we move forward. This might include guided meditation, imaginative parts work, drawing, and creating a coping toolbox with grounding techniques such a breath work and homework.

When all of you is ready and willing, we shift to process lingering unhelpful thoughts, feelings, or body sensations related to a past, present, or future events. This is often done with EMDR but at times parts work, the coping toolbox, or just talking can help someone move through their feelings and heal.

Can I join my child's session?

Yes and no. My approach to therapy is individualized based on needs and developmental state. With child clients I invite caregivers only to participate with the initial intake session, then ongoing sessions are typically with the child only. I've found that children tend to make faster gains in therapy when they feel they have a space of their own to explore feelings, whether or not the issues are related to parental relationships.


My goal is always to bring caregivers into the solution when the child feels safe with doing so. Sometimes parents are invited to join the end of a session so their child can show a new skill, share sessions details, or ask for support. Parent sessions may be requested at anytime however, unless the child grants me permission or I feel there is a safety issue, discussion will be guided around how to support the child instead of details of therapy sessions.

There is a possibility I may start working with a child and then determine parenting sessions with or without the child are in the best interest of the child. Work with caregivers is child focused, informative, and supportive.

Can you make a suggestion about where my child lives or the other parent's behaviour?

I do not have the expertise to perform parenting assessments and it is not my practice to provide parents with reports. I do not get involved regarding anything related to custody matters, unless it concerns a safety matter in which I'm obligated to report child abuse. 

Except for rare circumstances, in order for me to accept your child as a client I ask that both parents with decision making rights agree to my services and attend the intake session. This avoids conflict for the child and sets expectations. I expect caregivers to communicate with each other on their own without needing me to share relevant therapeutic details with more than one party. I ask parents to view their role as part of a team for their child, with the child's needs prioritized during and after sessions.

Trauma

Trauma is subjective meaning, you can experience trauma without falling under a diagnosable label. In fact, I believe we've all experienced trauma at some point and it is the individual experience and the loneliness in that experience that defines trauma, not the type of event. For example, a child falls and no one is there to scoop them up and say it is going to be okay, being bullied by other children or family members regularly, or never feeling allowed to have personal needs. Our biological temperament, what we experience, our age and how often we experience the threat contribute to unprocessed events and future perceived threats.

Clients do not need to have a trauma diagnosis to benefit from EMDR and parts work, and I use aspects of EMDR and parts work.

SSP

Safe & Sound Protocol (SSP) is a research-based mind/body therapy that enhances social engagement & resilience by reducing stress & auditory sensitivity. It uses filtered music to train the middle ear muscles to focus on certain frequencies, using this acoustic channel as portal to neural regulation and sense of safety at the autonomic nervous system level. It have been shown to benefit with clients living with Autism Spectrum Disorder, Sensory Processing Disorder, Traumatic Brain Injury, speech, developmental, or learning difficulties, trauma, anxiety, and social engagement struggles. I like to think of it as a tool that can turn down volume to promote a sense of internal calm.

Clients listen to music using over the ear headphones either in office or at home, depending on where they are at with therapy and needs. The SSP requires a minimum of 6 sessions which includes an intake and information session plus the 5 hours of the core program. Some clients can only tolerate short sets of music during a session and others can complete a full hour to music in one session. This therapy cannot be rushed in order for the effects to be beneficial. There are no negative long term side effects however, some clients experience short term symptoms or worsening of symptoms as their system regulates.

After they listen to the music program clients have ongoing access to similar music at home for maintenance, to be used as needed. Some clients may need to redo the original program in therapy after 3 months time.

Those with the following features might benefit from using the SSP:

  • Social and emotional difficulties

  • Auditory and other sensory sensitivities

  • Auditory processing difficulties

  • Anxiety and trauma-related challenges

  • Inattention

  • Reactivity

  • Stressors that impact social engagement

  • Difficulties in regulating physiological and emotional state

  • Chronic pain and fatigue

  • Depression

  • Difficulty sleeping

  • Gut issues

  • Low resilience

SSP Video

Case Studies

EMDR

Eye Movement Desensitization & Reprocessing (EMDR) supports recalling memories with lower emotional impact & reprocessing them with gained insight. It involves the use of eye movements, tapping, or hand buzzers while focusing on a specific thought/feeling/body memory sensation to transform the event on an emotional level and create adaptive neural network connections.

EMDR is an evidence-based therapy approach which is thought to activate the problem solving process, and enhance a client's ability to make links between experiences. Desensitization and processing occurs, eventually allowing the client to think about the upsetting event with no or little disturbance, as well as form new insight into the situation. EMDR can help memories process and have freedom to evolve in the future.

More info: ottawaemdr.com

Parts work and AIP Model

We all have parts! Parts work is based on Structural Dissociation Theory and Ego State Therapy. Have you ever or someone you know struggle to order form a menu and say something like "part of me wants to order salad because I'm trying to watch what I eat, but it's been a long day so another part of me really wants poutine even though I know I'll be up all night with heartburn"? Parts want the best outcome but sometimes our parts cannot agree, might not be fully aware of consequences, or they might not have been updated with present information due to trauma. 

Think of the brain as a computer system having many folders and apps. They are created from experiences and contain information of how we think, feel, and sense the world around us. They work together and sometimes an app is launched to direct the system.

Imagine that each folder holds information for survival of the species and daily life actions. Daily life folders help us navigate activities such as play, sleep, house cleaning, attachment, socializing, reproduction, and taking care of others. This is much needed for mental and behavioural functioning! Folders are categorized so the brain knows how to respond the next time an even slightly similar situation happens. These folders essentially form our worldview. 

Apps are initiated when there is a perceived threat, and run specific defence instructions on how to react based on a perceived threat such as an injury to the body, social rejection, and attachment loss. They hold information such as survival of the individual, and are involved with fight, flight, freeze, collapse, social submission, attachment cry, and recuperation. Apps also encode and store all pieces of events that are not completely processed.

From the time we are born, our thoughts, feelings, and body sensations, as well as how we perceived others to behave and the meanings that go with those experiences are recorded and contained in these folders and apps. As we get older and add to our experiences, folders and apps evolve as they are reassessed and updated. 

When folders and apps cooperate, communicate, and work together, adaptive information is integrated and apps are updated. The person experiences positive mental health. ​When trauma happens, the app cannot be updated and it keeps repeating instructions related to past circumstances. The brain does not process the past experience and app instructions might not be appropriate for present circumstances. Think about unhealthy behaviour. It is likely that at one time the related thought/feeling/body sensation served a purpose to protect the self but when not updated, the behaviour can become socially, physically, or emotionally harmful.


Parts work can help the system work collaboratively so the system and move towards positive mental health.