Bringing accessible psychotherapy to more Ontarians

Access to care remains one of the biggest challenges for those living with mental illness. Dr. Judith Laposa, an Assistant Professor in the Department of Psychiatry, is working to change that through her role in a province-wide initiative focused on providing accessible care to Ontarians with anxiety and depression and training more caregivers to provide psychotherapy.

In 2017, the Ontario government dedicated $16 million to improve access to psychotherapy for Ontarians. The result was the creation of the Increasing Access to Structured Psychotherapy (IASP) demonstration project.

A collaborative effort between the Mental Health Partners (The Centre for Addiction and Mental Health, Ontario Shores Centre for Mental Health Sciences, The Royal Ottawa Health Care Group and Waypoint Centre for Mental Health Care), IASP provides face-to-face (or OTN) Cognitive-Behavioural Therapy (CBT) for Ontarians struggling with anxiety or depression.

Laposa has played an important role in the program, and is currently working on clinical and training programs. The end goal of the IASP program is to provide CBT to thousands of Ontarians, and training staff to provide evidence-based psychotherapy.

There’s a shortage of qualified care providers in Ontario, so one of IASP’s goals is to train thousands of therapists in the next five years. Laposa developed on-site assessment and CBT training for CAMH. She also co-wrote half of the foundation CBT fundamentals online blended learning course, and is currently co-writing two additional online courses, all of which will be mandatory throughout the province for IASP staff. The IASP includes options for off-site virtual training that will make training easily accessible for therapists across Ontario.

The other side of IASP’s work is clinical, providing OHIP-covered CBT for Ontarians struggling with anxiety or depression. Laposa and her team have been providing high-intensity group CBT sessions. Each patient attends sessions for thirteen to fifteen weeks.

“We’re holding fifty-six therapy groups a week, that’s a very high volume,” said Laposa, “We’re getting a lot of interest, and some people are travelling from outside the city to see us. It’s clear the need is there.”

One key aspect of IASP’s approach is the use of weekly symptom measurement. Studies have shown that monitoring symptoms as therapy progresses leads to better outcomes. It’s a strategy that fits well with IASP’s focus on providing care that is evidence-based and prioritizes patient outcomes.

IASP is modelled after Improving Access to Psychological Therapies (IAPT), a program that has been implemented in the United Kingdom. The proposal for IASP emphasized the economics of the issue, demonstrating that the economic benefits of keeping Ontarians mentally healthy outweighed the costs of supporting the program.

Laposa hopes that the program will lead to a further funding for psychotherapy and other forms of mental healthcare in Ontario. “Ultimately,” she says, “It’s all about getting high quality treatment to people who need it, without long wait times. It’s something that can make a very real difference in peoples’ lives.”