It all started in 1972 with a small clinic: four rooms, a faculty compliment that wasn’t much larger, and a traditional approach to treatment where clients were seen over two or three years. To record sessions for supervisory purposes, a video camera attached to a VCR rattled on a cart from room to room, often needing its settings adjusted.
The University of Waterloo was one of the first in Canada to have its own in-house training centre for its clinical psychology PhD program – but a lot has changed since the 1970s. With years of planning and the backing of president David Johnston and vice-president, Academic & Provost Amit Chakma, in 2008 a new vision for the Psychology Clinic took shape.
Now, the Centre for Mental Health Research and Treatment (CMHRT)—its name recently updated to emphasize the services it provides — celebrates 10 years in operation.
Evidence and treatment work together
The CMHRT isn’t just about advancing research on mental health: it’s committed to providing affordable and effective mental health services to the community, while also training the next generation of clinicians.
But these goals don’t operate in silos – in fact, the goals of the centre are so integrated it’s impossible to talk about one without another, especially when it comes to research and treatment.
“Clinical psychology at Waterloo is very much committed to a scientist-practitioner approach. Science informs clinical practice, and clinical practice informs science,” says Dr. Christine Purdon, Professor of Psychology, Director of Clinical Training, and past Executive Director of the Centre.
The CMHRT provides service to over 250 clients per year from the community and from campus. CMHRT assessment and therapy services include the use of standardized questionnaires and measures to enable Centre clinicians to use client feedback and outcome data to inform the delivery of therapy for the individual client and improve Centre service delivery for all.
“Ideas for research come from careful clinical observations, and new clinical breakthroughs come from meticulous theory-driven research,” says Dr. David Moscovitch, Professor of Psychology and current Executive Director of CMHRT.
“The Centre is set up perfectly to promote this reciprocal relationship between research and practice, which leads to discovery and innovation in both.”
A recent example of the combined impact of research, training and treatment is a new imagery-enhanced cognitive behavioural therapy for adults struggling with social anxiety, previously only offered in Australia where it was developed. Clients who participate in these groups experience significant mental health benefits from a cutting-edge therapy, with results contributing to a growing body of evidence about its effectiveness. Notably, the group is led by doctoral students and residents in clinical psychology who are trained to deliver the treatment under the supervision of Dr. Moscovitch.
Embracing new technology
The CHMRT’s growth goes beyond its larger physical space and new faculty and staff positions.
A secure – and discrete – method of capturing and sharing video recordings of assessment and therapy sessions has allowed the program to bring in more adjunct supervisors from broader backgrounds and in centres of excellence in southwestern Ontario.
“We currently have a wide range of adjunct faculty from across Ontario,” says Dr. Marjory Phillips, Director of the CMHRT and an alumna of Waterloo’s program. “All are hand-picked, highly talented psychologists. With our state-of-the-art video system, our off-campus supervisors can log in from their own offices to securely access and watch students conducting assessment and treatment.
“The video system enables us to offer a gold standard model of clinical training, in which the supervisor observes every session and then meets with the student to review it, thus providing valuable feedback that enhances students’ experiential learning. Our program is one of the few in Canada to offer clinical supervision of this kind.”
Working with our community
In addition to providing affordable evidence-based psychological services in both individual and group formats, the Centre extends into the community by collaborating with other health care professionals and organizations to provide much-needed services for children, families, and adults – services that also help to extend the breadth of learning opportunities for CMHRT clinicians in training.
For example, in 2016, the Centre partnered with the Parkwood Institute’s Operational Stress Injury Clinic in London, Ontario to provide a specialized mental health assessment service for veterans, members of the Canadian Armed Forces and RCMP. The assessment is a vital first step in identifying and planning treatment for operational stress injuries such as post-traumatic stress disorder (PTSD).
Another partnership with Sanctuary Refugee Health Centre helps some of the most vulnerable and diverse newcomers to Canada. Many refugees have lived through unimaginable circumstances, and may be suffering from severe anxiety, mood issues or PTSD. The formal mental health assessment and report from the CMHRT offers evidence to support their refugee status claims as well as help them secure the social services they need. Students learn to work with translators to support these clients in a culturally-sensitive manner.
More recently, the CMHRT launched Positive Parenting Program (Triple P) therapy groups, implementing an internationally recognized program to provide parents with skills and confidence to parent children and teens with challenging behaviours and to build stronger family relationships. Based on research, Triple P has helped an estimated four million children and their families in 25 countries around the world.
The CMHRT is also part of the Child and Youth Planning Table of Waterloo Region. “It’s an important opportunity for us to learn and connect,” says Dr. Phillips.
“We want people to be aware of our services and to share information, and we want to be part of something bigger in the community.”
The future of treatment
“We’re always trying to think ahead about what the field of clinical psychology needs, and how we can train our students to meet that need,” says Dr. Purdon.
For example, internet-assisted treatments could provide vital care to people who don’t have easy access to mental health services.
“There are people all over Northern Ontario, for instance, who have very limited access to mental health services, and not necessarily evidence-based mental health services. We want our students to learn to deliver these treatments.”
“When I think about what has impressed me most, it’s dedication and hard work of our CMHRT students, staff, and core and adjunct faculty,” says Dr. Moscovitch. “The vision and capacity of our Centre have grown and evolved in wonderful ways, but it would not have been possible without a full team effort. Everyone has a real sense of unity and pride around our mission of achieving excellence in clinical training, practice, and research.”