Common Challenges

Common Challenges


Have you ever wondered what types of problems or challenges might typically bring people to rehabilitation counselling? If you’re taking cues from movies or TV, you probably think therapy is for people who’ve run out of options or for people who have been given a diagnosis of some form of mental illness.

The truth is that almost any problem that stands between you and the values, goals, priorities, and commitments of your life may be improved with the help of a skilled, experienced counsellor.  Quite often, someone suffering with a physical or mental health problem over a period of time understandably responds by avoiding situations that are believed to trigger increased discomfort.  This leads to both physical deconditioning and social withdrawal.  The role of a rehabilitation counsellor is to assist you to improve not only your level of physical activation and mobilization, but also to address the physical and emotional withdrawal which often results in diminished meaningful interactions or activities that a person would find rewarding or vital in life.

According to data from the Canadian Mental Health Association (CMHA), mental and physical health are linked (CMHA, 2017).  People with a long-term medical condition such as chronic pain are much more likely to also experience mood disorders.  Conversely, people with a mood disorder are at much higher risk of developing a long-term medical condition.  Our rehabilitation counsellors are not here to provide a diagnosis or first line treatment for your condition.  That remains in the hands of your health care providers.  Our role is to collaborate with your health care providers by addressing the secondary suffering that has resulted from your response to your physical and/or mental health problem.  The result is an improvement in your overall level of physical conditioning and day to day functioning and resumption of meaningful activities.

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Chronic Mental Health Disorders


Mental health problems can cover a broad range of conditions, but the common characteristic is that there is a pattern of behavioural or psychological symptoms that impact multiple life areas and create distress for the person experiencing these symptoms.

The following are some of the mental health conditions that we see at JMA.

  • Anxiety
  • Depression
  • Grief and Loss
  • Anger Management
  • Addictive Behaviours (food, sex, drug, alcohol, work)
  • Stress
  • Phobias

In situations of chronic physical or mental health conditions, it is often the secondary suffering that makes matters worse.  Both can lead to some common problems over time such as fatigue, sleeplessness, withdrawal from physical activity, work disability and reduced social, recreational and family activities.

And, although the symptoms of chronic physical and mental health conditions may not be readily palliated, the issues of secondary suffering can be dealt with effectively.  Individuals can lead a valued and fulfilling life in spite of their chronic condition.

The following are some of the mental health disorders that we see at JMA.

  • Anxiety Disorders
  • Mood Disorders
  • Eating Disorders
  • Other Mental Health Disorders
Anxiety Disorders

Anxiety is a normal reaction that many people experience. An anxiety disorder, however, is diagnosed when various symptoms of anxiety create significant distress and some degree of functional impairment in daily living. A person with an anxiety disorder may find it difficult to function in areas of life such as social interactions, family relationships, work or school.
• Panic Disorder
• Agoraphobia
• Social Anxiety Disorder
• Specific Phobia
• Post-Traumatic Stress Disorder
• Obsessive Compulsive Disorder
• Generalized Anxiety Disorder

Mood Disorders

Mood disorders affect about 10% of the population. Everyone experiences “highs” and “lows” in life, but people with mood disorders experience them with greater intensity and for longer periods of time than most people.

Depressed mood is the most common mood disorder; a person with depression feels “very low”. Symptoms may include: feelings of hopelessness, changes in eating patterns, disturbed sleep, constant tiredness, an inability to have fun, and thoughts of death or suicide.

People with bipolar disorder have periods of depression and periods of feeling unusually “high” or elated. The “highs” get out of hand, and the manic person can behave in a reckless manner, sometimes to the point of financial ruin or getting in trouble with the law.

Eating Disorders

Eating disorders are mental disorders defined by abnormal eating habits that negatively affect a person’s physical or mental health.
• Anorexia Nervosa
• Binge Eating Disorder
• Bulimia Nervosa

Other Mental Health Disorders

• Grief and Loss
• Anger Management
• Addictive Behaviours (food, sex, drug, alcohol, work)
• Stress
• Phobias

Chronic Physical Health Conditions


What Is Chronic Pain?

Chronic pain is typically described as pain that persists long after normal healing should have occurred, usually at least three to six months.  It can also be described as pain that has lost its purpose.

Chronic pain may originate with an initial trauma/injury or infection, or there may be an ongoing cause of pain.  Some people suffer chronic pain in the absence of any past injury or evidence of body damage.

One in five Canadian adults suffer from chronic pain (Moulin, Clark et al 2002, Schopflocher, Jovey et al 2011).  Chronic pain can be mild or excruciating, episodic or continuous, merely inconvenient or totally incapacitating.

The following are some of the chronic physical health conditions that we see at JMA.

  • Chronic Pain (back, headache, Fibromyalgia, repetitive strain injury, irritable bowel syndrome)
  • Chronic Fatigue Syndrome or Systemic Exertion Intolerance Disease
  • Chemical sensitivities
  • Vertigo

Canadian Mental Health Association (CMHA). 2017.  The Relationship between Mental Health, Mental Illness and Chronic Physical Conditions.  Retrieved from https://ontario.cmha.ca/documents/the-relationship-between-mental-health-mental-illness-and-chronic-physical-conditions/

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 behaviours that keep him or her stuck in depression.


Cognitive & Behavioural Therapy (CT & BT)

CT deals with thoughts and perceptions, and how these can affect feelings and behaviour. BT focuses on an individual’s learnt, or conditioned, behaviour and how this can be changed.

Quota Based Physical Conditioning

This can include graduated cardiovascular training and/or progressive resistance training to assist the individual to gradually resume their pre-disability level of functioning.


Rebuilding Social, Recreational & Family Activities

JMA guides clients through a graduated return to meaningful activity while assisting them to incorporate recommended strategies for pain management.


Work Hardening

Our work hardening process uses cognitive and physical work hardening strategies designed to utilize real or simulated work activities to restore physical, behavioural and vocational functions.


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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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