therapy questions

  • Much of the information below has been adapted from Dawn’s Ethical Model and her work on Relational Charting.

    • In an effort to provide trauma-informed and ethically sound care, I aim to align with her recommendations for relational charting and informed consent.

    • Dawn McBride/Dawn Psychological Services (DPS) 2025. https://www.dawn-mcbride.com/

  • Going to a therapist is nerve-racking for many people. Before you consider seeing me as a therapist, I want to make sure you know what your rights are and how I would work to protect you throughout this process.

    It’s important that during the therapeutic process, you take the lead. That means that at any time within our time together, you know you can change your mind (consent is continuous), and you can leave or say any of the following:

    • Yes OR No

    • Skip OR Pass

    • Stop OR Pause

    • I don’t know OR I can’t remember

    As a client, you have rights to see your file, know what’s in it, how it’s stored, and what happens to the information if you or I die. To learn more, see below in section on “Your File.”

  • Your privacy and safety are important to me. I will not tell people you are my client or share information about you unless I have your permission. There are some exceptions to this. It is my responsibility to reduce the risk of harm to yourself and others.

    • I may need to share some information about you to access help to reduce this danger (e.g., calling 911, contacting your emergency person)

    Exceptions to your privacy

    • If I am very worried you: If I feel you cannot keep yourself safe from harm and/or learn there is a risk to your safety or to the safety of person(s)/animal(s).

    • Judge (Subpoena) or Legal Issues: If a judge or the law requires me to disclose information about you, or if we become involved in a legal dispute over the care I provided and my lawyer needs access to my files.

    • Health insurance: If health insurance (e.g., blue cross) requires information to process your claim.

    • Consultation: I need to consult with other professionals for their expertise to ensure ethical care.

    • Supervision: I am required to undergo supervision to ensure that the care I provide you is ethical. Supervisor: Chelsey Stang.

    • Next of kin: If you die, executors can order counselling notes be released to your next of kin, unless this is specified in your personal will.

    • Death & closure of company: If I die, am unable to work, or close my company, your file may be transferred to/held by another registered professional of the same regulatory body (e.g., nutrition notes with a dietitian; psychotherapy notes with a psychologist).

    • If I sell my practice, the person who buys it will have access to your files.

  • The most important part of therapy is liking your therapist.

    If at any point in your journey that you or I decide it’s not a good fit, I can refer you to another therapist. This is also why we start with a free 15-minute consultation to make sure it seems like a good fit.

  • This question depends on whether you are seeking nutrition only or a service that includes psychotherapy.

    nutrition for ADHD & chronic pain

    • Clients who are seeking this service are interested in practical tips, meal and snack ideas and nutrition education specific to ADHD and chronic pain.

    • In general, its best practice to obtain this information from a person outside of your social circle as I can only have one role with you as a healthcare professional.

    • If you are unable to obtain the necessary information and support on nutrition for adhd & chronic pain, I am able to provide this service to distant members of my social circle for a limited number of sessions. In this situation, if you required additional support on sensitive topics, that required a more intensive assessment of psychosocial factors, it would be best for you to see another dietitian and a referral would be provided.

    psychotherapy

    • For both “nutrition & psychotherapy” and “psychotherapy” clients, I can only have one role with you as your health care professional.

    • This means I can’t be your friend, business partner, or client.

    • If we end up in the same social circles or we know similar people, to maintain professional boundaries, I will refer you to another mental health therapist and/or dietitian.

  • If I see you in public, to ensure your privacy and safety, I will try to:

    • not acknowledge you unless you initiate.

    Please note that it can be natural to smile and wave to someone you know.

    • If my instincts kick in and I smile, I will aim to keep our interaction brief and carry on. 

  • There are a variety of ways to support your mental health in addition to or instead of psychotherapy.

    • support groups (e.g., grief groups, AA)

    • movement and sport (e.g., pilates classes, gym, recreation league)

    • Religion, spirituality, and energy work (e.g., prayer, reiki)

    • allied health professions (e.g., occupational therapy, naturopathy, acupuncture)

    • health workshops: There are a number of workshops from the Primary Care Network (PCN) that aim to tackle topics like mental health, happiness, and chronic pain from a variety of disciplines.

  • It depends on the service and the province or territory you reside in.

    Nutrition

    • Only accessible for clients that are in Alberta at the time of their appointment.

    Nutrition & Psychotherapy

    • Only accessible for clients that are in Alberta at the time of their appointment.

    Psychotherapy (CCC)

    • Available to clients across Canada that are located in a province or territory where counselling is unregulated.

    • In unregulated provinces, CCC is recognized as the national standard.

    • Unregulated provinces or territories: British Columbia, Alberta, Saskatchewan, Manitoba, Newfoundland, Yukon, Northwest Territories, and Nunavut

  • When possible, please text (587) 674-4100, to set up discovery call, as I am often unable to answer my phone.

    Alternatively, book a discovery call through JANE. You will be directed to JANE by clicking ‘book now’.

  • Not at this time.

  • A person’s mental health can be affected by a medical issue (e.g., low iron, hormones, etc). If you are noticing a change in your mental health, make an appointment with your doctor to get a physical assessment with a full panel of blood work done.

    If you don’t have a family doctor and are residing in Alberta, check out the link below:

your file

  • Every client gets an electronic file that is in a password protected computer in an online software database designed for helping professionals (e.g., JANE)

    My chart notes tend to include:

    • Your strengths, coping resources, goals, risks, safety information, and themes.

    • Any emails, texts, or letters involving you (i.e., from you/to you/about you) are kept in your file (then will be deleted from the server).

    • Please note that communication regarding setting up or cancelling appointments, is not recorded or kept in your file.

    • Any recordings (of me, of a client) are required to be stored in the client file, unless the recording is for supervision.

    Whenever possible, I try to avoid:

    • Recording “evidence,” a historical or current list of your wrongdoings.

  • I am legally required to:

    • Save closed files for a minimum of 10 +1 years for adult files (and even longer for youth files)

    • Keep a client file indefinitely if I record in your file that you have a permanent physical disability or history of sexual violence.

  • To comply with ethical standards for both professions, your information will be kept separately in discipline-specific chart notes. In the event that I am unable to continue working, my nutrition notes will be transferred to another dietitian and my psychotherapy notes will be transferred to a psychologist.

  • To get started with the ‘nutrition & psychotherapy’ sessions, book a 60 minute initial psychotherapy assessment. After this appointment, you have two options:

    1. Book a ‘60 minute initial nutrition assessment’ and continue with ‘nutrition & psychotherapy’ sessions.

    2. OR, continue with psychotherapy sessions until you are ready to add nutrition in to your sessions. At this point in time, you can book a ‘60 minute initial nutrition assessment’.

  • Yes, at any point in time you are able to switch from booking nutrition and psychotherapy sessions to psychotherapy sessions.

    Likewise, if you start with psychotherapy sessions (and you are residing in Alberta), you just need to book a 60 - minute initial nutrition assessment to get started with nutrition & psychotherapy sessions.

  • To comply with ethical standards for both professions, your information will be kept separately in discipline specific chart notes.

    In the event that I am unable to continue working, my nutrition notes will be transferred to another dietitian and my psychotherapy notes will be transferred to a psychologist.

  • ‘nutrition and psychotherapy’ sessions involve two separate professions (dietetics) and (psychotherapy).

    To meet ethical requirements of both professions and for your health benefits, billing will be separated by the discipline (nutrition vs. psychotherapy) for time spent in 15 - minute increments.

    For example:

    A 60-minute ‘nutrition & psychotherapy’ session could be billed in the following ways (based on time spent):

    • 45-minutes psychotherapy & 15-minutes nutrition OR vice versa.

    • 30-minutes psychotherapy & 30-minutes nutrition

    • 60-minutes psychotherapy & 0-minutes nutrition OR vice versa

  • There are a number of workshops from the Primary Care Network (PCN) that aim to tackle topics like mental health, happiness, and chronic pain from a variety of disciplines.

  • Given my dual role, I limit the nutrition services that I offer to reduce the risk of stepping into my role as a therapist without consent.

    Therapy services tend to go deeper into a person’s history and require a much more in depth consent process. Stepping into my role as a therapist in a nutrition session would be unethical.

    This is why, I am only offering nutrition sessions for people with ADHD and chronic pain, as ADHD comes with many practical barriers to eating well.

    When possible, I recommend choosing “nutrition with psychotherapy” so that we can explore the mental and emotional barriers to behaviour change.

    As my nutrition sessions focused on ADHD and chronic pain are unable to address these aspects of a person’s experience, as it is difficult to know when behaviour change interventions would not fit within the role of a dietitian.

    To protect my licenses, I need to ensure that I have appropriate consent and clear distinctions between when I am acting as a therapist or a dietitian.

  • Not at this time.

  • In an effort to promote a healthier relationship with food & our bodies, I focus more on changing behaviour & attitudes than on outcomes.

  • As a dietitian, I lack competency in addressing most eating disorders like anorexia nervosa or bulimia nervosa. If you are looking for a dietitian that specializes in eating disorders check out:

    • The Nourish Collective in Edmonton: https://www.thenourishcollective.ca/

    • OR, get a referral from your doctor for a dietitian that focuses on ‘mental health’ or ‘eating disorders’.

nutrition & psychotherapy

dual role

  • A dual role occurs when a therapist or dietitian, has more than one relationship with the client. For example:

    • the therapist is the clients friend and therapist.

    • the therapist is the client’s business partner and therapist.

    • the therapist is a client of the client and their therapist.

    • this also applies when the therapist is apart of your social circle, a friend of your parent, partner or friend.

    Generally, the second role is non-professional but even when both roles are professional (dietitian & a therapist), dual roles are complicated.

  • Even when both roles are professional (dietitian & a therapist), dual roles are not recommended.

    This is because:

    • It can interfere with a therapist’s ability to make ethical decisions as advised by their regulatory body.

    • If I am your therapist and I refer you to see me as a dietitian, I may be trying to take advantage of you financially.

    • If I see you as both a dietitian and a therapist, how do you know if I am speaking from my expertise as a therapist or as a dietitian?

  • Dual roles are complicated, even when both roles abide by a code of ethics.

    The reasons it’s important to combine these roles:

    • Research shows that nutrition affects mental health and vice versa.

    • Each profession has a deficit in knowledge or skill to address the intersection between nutrition and mental health.

    • In my experiences as a dietitian, I noticed a gap in care. As I lacked the skill and knowledge to address the mental and emotional barriers that come with changing your diet. And therapists lacked an understanding of nutrition to provide suitable recommendations.

  • In the process of creating my services, I took several steps to see if it was possible to offer nutrition with psychotherapy. These steps included:

    • Consultation with College of Dietitians of Alberta.

    • Consultation with Canadian Counselling and Psychotherapy Association.

    • Consultation with my supervisor, Chelsey Stang, R. Psych.

    • Consultation with a lawyer.

    To reduce the risk of harm, I:

    • created a transparent process

    • listed the risks, benefits and alternatives

    • aim to separate my roles in session with clear language, seeking permission to step into the other role and by using a metaphorical hat to go between roles (e.g., “speaking from my dietitian hat”)