What We Do

What We Do

There have been many approaches developed to help people struggling with physical, emotional and psychological difficulties.  How do you find the best fit for your needs and concerns?  While there are no guarantees that a specific approach will work for you, we do know that certain approaches work for many people experiencing a specific type of concern (e.g. chronic pain, depressed mood, anxiety, substance abuse, post-traumatic stress disorder, etc.).  These types of approaches are termed “evidence-based”.  An evidence-based approach is one that has been scientifically investigated and been shown to effectively address a particular concern or problem.  Evidence-based counselling can increase the chance that a problem is identified accurately and handled effectively.  This can prevent the problem from being drawn out unnecessarily and decrease the chances of it coming back (i.e. relapsing).

At JMA, we focus on providing compassionate and evidence-based rehabilitation counselling to help people create purposeful and fulfilling lives.

To give you a sense of the types of counselling that we do at JMA, below are the therapies and approaches that we practice and that have been shown through research to be effective.

Functional Activation and Physical Conditioning

Individuals who suffer with chronic physical and mental health problems frequently become deconditioned due to disuse and inactivity.  With input from your health care providers regarding any medical contraindications, our Rehabilitation Counsellors will develop both an individualized exercise routine as well as a gradually progressed plan for increasing family, social, recreational and vocational activities.

We encourage individuals to start all new activities well within their current baseline.  For example, if an individual is starting a walking exercise we will ask them to walk only for as long as they can comfortably, and then set a starting point at 50% of that baseline with a carefully graduated progress.  In addition to fixing the amount of activity, we also ask our clients to plan in advance the time that they are doing activity.

It is important that planned activities be realistic and not tied to the clients’ level of symptomology.  It is also important to recognize that symptoms, or flare-ups of symptoms, do not represent signals of health or life-threatening warning.  The scientific literature clearly establishes that such careful planning and quota-based activities assist in improving function in spite of ongoing symptomology and also appears to contribute to the symptoms gradually receding into the background.

You will learn not to overdo activities when you are feeling well or feeling like you have extra energy and not avoid planned activities when you are feeling unwell.  Ultimately, this places you in control of what you plan to do, when you are going to do it and how much you are going to do.  It prevents your symptoms from acquiring control by determining how much or how little you do.

Cognitive Behavioural Therapy

Cognitive Behavioural Therapy, also referred to as CBT, is an evidence-based psychological treatment proven to be effective through rigorous scientific research.  This means that CBT treatment is not based on what people think might work, but what has been proven to work.

Research has shown that CBT is an effective treatment for a wide range of problems including psychological disorders (i.e. anxiety, depressed mood, phobias, stress, physical health problems (i.e. chronic pain or fatigue) and other behavioural disorders (i.e. anger, low self-esteem, grief).  Individuals tend to function better and stay that way!!!!!

Being committed and doing the assignments set for you is an integral part of CBT.  While the sessions offer support and space to explore your concerns, it is the work you do outside of your sessions that is likely to have the most impact.  By staying focused and completing assignments, you will help yourself progress quicker.  This way, you will hopefully start to develop a stronger sense of self-confidence and self-belief.

Return to Work Coordination

It is our experience that many of our clients experience an increase in symptoms, of all types, as we begin the planning and implementation phase of a return to work.  We understand that this is a difficult time for our clients and that the increased symptoms do not signal an increase in pathology, but rather a very understandable increase in anxiety and fear about returning to the workplace.  It is a very common for individuals who are returning to work after a prolonged absence to experience both fear and anxiety.  For some individuals, this leads them to either delay or abort the return to work process in order to avoid the discomfort.  Sustaining avoidance often requires effort and energy and limits one’s focus at the expense of fully experiencing what is going on in the present.  Avoidance may get in the way of other important, valued aspects of life.

Unfortunately, delaying or aborting the return to work is a solution that has the short term benefit of reducing the discomfort.  However, in the long term this strategy actually results in increasing the fear and anxiety resulting in unnecessary avoidance and a shrinking of the individual’s meaningful life[1].

The role of the Rehabilitation Counsellor is to develop a plan for a graduated return to work in conjunction with you, your insurer and your employer.  Typically, the graduated return to work extends over the course of 4 to 8 weeks, depending on the situation.  The involvement of our Counsellor does not end with the beginning of the return to work.  We continue to meet with you until you are working full time in order to provide ongoing support, problem solving and reminders about how to best utilize the strategies and skills learned during your involvement with us.  We have had considerable experience at managing a successful return to employment for our clients.

[1] See: Grillon, C. (2008). Models and mechanisms of anxiety: Evidence from startle studies. Psychopharmacology, 199(3): 421-437 and Barlow, D. H. (2002). Anxiety and its disorders: The nature and treatment of anxiety and panic (2nd ed.). New York: Guilford Press.


6 CBT Therapies That Work

  • Acceptance and Commitment Therapy (ACT)
  • Behavioural Activation (BA)
  • Prolonged Exposure (PE) Therapy for Post-traumatic Stress Disorder
  • Behaviour Therapy (BT)
  • Cognitive Therapy (CT)
  • Dialectical Behaviour Therapy (DBT)
Acceptance and Commitment Therapy (ACT)

A basic assumption of ACT is that suffering is a normal and unavoidable part of human experience and that it is actually people’s attempts to control or avoid their own painful experiences that lead to much long-term suffering.  ACT helps people learn ways to let go of the struggle with pain, be more mindful, get clarity on what really matters to them, and to commit to living full, vibrant lives.

ACT uses mindfulness practices to help people become aware of and develop an attitude of acceptance and compassion toward painful thoughts and feelings. Additionally, ACT heavily emphasizes the role of values to help people create meaningful lives.  ACT is centered on such questions as “What do you really want your life to be about?” or “If you lived in a world where you could have your life be about anything, what would it be?”

ACT has also been adapted to create a non-therapy version of the same processes, called Acceptance and Commitment Training.  This training process, oriented toward the development of mindfulness, acceptance, and values skills in nonclinical settings, such as businesses or schools, has also been investigated in a handful of research studies with good preliminary results.

Behavioural Activation (BA)

BA is designed to manage the consequences often seen with someone who is suffering from depressed mood.  BA focuses on the depressed person’s behaviours that keep him or her stuck in depression.  The behavioural counsellor helps the client examine their triggers for depression-related behaviours, as well as the effects of depressive behaviour on mood and pursuit of important activities (e.g. attending work).  Acting as a coach, the behavioural counsellor encourages the client to engage in behaviours that disrupt the cycle of depression.  Clients who participate in BA learn how to examine the interactions among their behaviours and moods, how to stop the cycle of depression, and how to prevent future depressive episodes.

Prolonged Exposure (PE) Therapy for Post-traumatic Stress Disorder

PE is specifically designed to address the symptoms of Post-traumatic Stress Disorder (PTSD).  Early in counselling, the client creates a list of situations that are safe, but typically avoided because they cause anxiety.  Together with the psychotherapist, the client learns to approach each situation on the list, starting with the easiest ones, and stay in each situation for a specific amount of time.  By staying in previously avoided situations, the client develops new skills for handling anxiety, learns how to re-evaluate their perceptions of danger, and increases their self-confidence.  Additionally, PE includes processing the traumatic event by talking about it in a safe and supportive atmosphere. Because approaching avoided situations and reimagining traumatic events can be very difficult, our psychotherapists work in a compassionate and collaborative manner to help people achieve success with PE.

Behaviour Therapy (BT)

Behaviour Therapy (BT) focuses on an individual’s learnt, or conditioned, behaviour and how this can be changed.  The approach assumes that if a behaviour can be learnt, then it can be unlearnt (or reconditioned), therefore, it is useful for dealing with issues such as phobias or addictions.

Behaviour therapy helps a person understand how changing his or her behaviour can lead to positive changes in his/her life.  Often, the focus is on helping the person engage in positive or value-consistent behaviours.  The behavioural counsellor works with the client to examine the barriers to or difficulties in engaging in these types of behaviours. The behavioural counsellor also teaches the client to analyze their own behaviour, as well as the effects their behaviours have on mood and other areas of life.  This approach tends to be more time-limited and focused on a specific problem that the person is encountering.

Cognitive Therapy (CT)

Cognitive Therapy (CT) deals with thoughts and perceptions, and how these can affect feelings and behaviour.  By reassessing negative thoughts, an individual can learn more flexible, positive ways of thinking, which can ultimately affect their feelings and behaviour towards those thoughts.

Dialectical Behaviour Therapy (DBT)

Dialectical Behaviour Therapy (DBT) is a cognitive behavioural treatment that was originally developed to treat chronically suicidal individuals diagnosed with borderline personality disorder (BPD) and it is now recognized as the gold standard of psychological treatment for this population.  In addition, research has shown that it is effective in addressing a wide range of other disorders such as substance dependence, depression, post-traumatic stress disorder (PTSD), and eating disorders.

What Does Counselling Involve?

  • You will usually meet with a rehabilitation counsellor on a weekly basis either in person or by videoconferencing or phone, depending on where you live.
  • Sessions vary in length depending on the specific service that you are referred to.
  • You will work with the rehabilitation counsellor to identify what things are most important to you in your life.
  • Then you will establish specific, time-targeted goals that will move you in the direction of those identified values.
  • If you have been referred by someone else, they may also contribute to the counselling goals.
  • Most sessions will involve some form of “homework” which you will bring back to review with the Rehabilitation Counsellor.

Acceptance & Commitment Therapy (ACT)

ACT uses mindfulness practices to help people become aware of and develop an attitude of acceptance and compassion toward painful thoughts and feelings.

Behavioural Activation (BA)

BA is designed to treat depression. BA focuses on the depressed person’s behaviors that keep him or her stuck in depression.

Prolonged Exposure (PE)

PE is specifically designed to treat the symptoms of Posttraumatic Stress Disorder (PTSD).

Behaviour Therapy (BT)

BT focuses on an individual’s learnt, or conditioned, behaviour and how this can be changed.

Cognitive Therapy (CT)

CT deals with thoughts and perceptions, and how these can affect feelings and behaviour.

Dialectical Behaviour Therapy (DBT)

DBT is now recognized as the gold standard of psychological treatment for this population.


J Marlin and Associates Inc. offers Cognitive Behavioural Therapy services to help individuals increase their sense of vitality, well-being, and fulfillment.

Head Office1100 Burloak Drive, Suite 602 Burlington, ON L7L 6B2

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