Assessment and Treatment Services
What kind of services do you offer?
Dr. Kathy Smolewka, C.Psych & Associates offer neuropsychological and psychological assessment services as well as mental health treatment (e.g., CBT, DBT-skills, ACT, EMDR), occupational therapy, and cognitive rehabilitation (i.e., Goal Management Training™) options. Our assessment services include psychoeducational assessments, neuropsychological assessments and other assessments, such as NMT, psychodiagnostic assessments and neurocognitive baseline testing and repeat neurocognitive screening. Please view our Home page for more details about each type of assessment. Our treatment services are provided by Dr. Kathy Smolewska and Clinical Associates who are Registered Social Workers and an Occupational Therapist.
What should I expect at my first appointment?
During your first appointment, you can expect to discuss the issues for which you are seeking treatment as well as some other information about your life and family history. You may also be asked to fill out some questionnaires.
What is treatment/therapy?
Therapy is a collaborative treatment for emotional/behavioural/psychological problems based on the relationship between an individual and a professional –psychologist, social worker, occupational therapist or licenced counselor. It is a form of treatment aimed at relieving emotional distress and mental health problems through structured meetings between the professional and client with the goal of improving a certain aspect of their life and overall wellbeing by identifying and changing thought and behaviour patterns that are causing distress. These sessions provide an environment in which the client can talk openly with an objective, neutral and non-judgemental professional. Therapy aims to teach new skills sets so that you can better cope with whatever challenges arise in the future.
When should you consider therapy?
Everyone can benefit from therapy, and there are many reasons why one might seek it. Everyone has trouble coping with certain problems and unproductive behaviour patterns that hold us back from being our best selves. Some people seek therapy because they may feel sad, anxious, overwhelmed, or irritable more often than not, which interferes with their everyday functioning. People who are struggling with relationship challenges, feeling stuck in their career, or feeling disconnected from the people around them, may also find therapy beneficial. Additional signs that you could benefit from therapy include feeling an overwhelming sense of helplessness and sadness, finding it difficult to concentrate and carry out everyday activities, excessive worry, and your behaviour negatively impacting those around you.
What are the different kinds of therapy?
There are many different approaches to therapy, and therapists usually draw on at least one. Each perspective helps the therapist understand their clients with their problems and come up with solutions. Cognitive behavioural therapy (CBT) involves a practical approach to treatment. Your therapist might ask you to complete certain tasks designed to help you develop more effective coping skills. They may ask you to log your reactions to a particular situation, or practice new skills between sessions. In contrast, psychoanalytic and humanistic approaches typically focus more on talking. Your sessions may consist of discussing your early life experiences to help you and your therapist better understand the causes of your current difficulties. Your therapist may also combine elements from different types of therapy. In fact, most therapists blend elements from different approaches, rather than stick to just one approach.
Do you offer therapy to children?
Yes, we offer treatment services to individuals of any age.
How are psychoeducational assessments useful?
A psychoeducational assessment is an evaluation of a child’s, adolescent’s, or young adult’s cognitive and academic strengths and weaknesses. Attention, memory and some aspects of executive functioning are also typically assessed. Individuals are usually referred for these assessments when they are having problems at school, or they are doing very well at school and may require enriched programming. During this assessment, the student is interviewed and undergoes cognitive and academic testing. Information is also gathered from the family and the school. Once all of the information is collected, recommendations are provided for the individual, family, and the school in the form of a report. If the child, adolescent, or young adult has a complex developmental history (e.g., perinatal complications, neurological condition, concussions), a neuropsychological assessment would be recommended.
What is a psychologist and how does it differ from a psychiatrist?
Psychologists are trained professionals who are skilled at assessing, diagnosing and treating behavioral dysfunctions and psychological issues. Psychologists go through advanced training and have earned a PhD or PsyD, which is different from the medical degree that a psychiatrist receives. Psychologists have completed an undergraduate degree prior to going to graduate school, where they earn an MA or PhD, or even both, in the area of psychology, which is the study of human thoughts, feelings and behaviour. They then receive specialty training through a residency/internship program and supervised practice to get practical experience required to begin effectively working with patients. Those who have completed a PhD can be referred to as “Dr.”, while Psychological Associates have terminated their training after obtaining an MA. All psychologists and psychological associates must be registered with the College of Psychologists of Ontario and must declare their areas of specialized training, detailing the type of psychology they practice as well as the age groups they serve.
Psychiatrists are medical doctors who specialize in mental health and can prescribe medication and diagnose illnesses. Psychiatrists generally focus more on the biological aspects of mental health, rather than the psychotherapeutic aspects. Psychiatrists have completed an undergraduate degree, gone to medical school, and have completed a fellowship in which they specialize in a specific area of mental health. Psychiatrists are registered with the College of Physicians and Surgeons of Ontario. Both psychiatrists and psychologists use types of therapy as the foundation of their treatment process, however psychiatrists’ treatment plans often use medication.
What is the difference between Neuropsychology and Psychology?
Neuropsychology is a sub-field of psychology that focuses on neurodevelopmental and neurological brain disorders. A neuropsychologist is a psychologist specializing in concerns with cognitive functions, especially those that are impeded by a disease, condition or injury that affects the brain. Neuropsychologists will administer computerized and hands-on tests to their clients to assess their cognitive ability, and will use this information to measure the advancement of an illness and offer therapy to help manage their conditions. Neuropsychologists may also use the information gathered from working with their patients to write up clinical reports to help the medical and scientific community better understand cognitive disorders. Examples of conditions neuropsychologists assess and treat are ADHD, Autism, Alzheimer’s disease, Dementia, OCD, concussions and Traumatic Brain Injuries (TBIs).
What is a neuropsychologist?
A neuropsychologist is a clinical psychologist whose area of expertise deals with the relationship between the brain and behaviour. A neuropsychologist’s practice involves assessment, diagnosis, treatment planning and, in some cases, therapy and/or rehabilitation of individuals who have sustained any type of injury (or suspected injury) to the brain. In order to declare competency as a neuropsychologist, practitioners much have earned a PhD in psychology from an accredited university program, completed a minimum two years of training and supervision in a neuropsychological practice, completed an accredited internship placement (or the equivalent), and passed all mandatory examinations to become licensed for independent practice in their state or province.
Common reasons for a neuropsychological assessment
A neuropsychological assessment can be conducted for several reasons and in the context of many neurodevelopmental/neurological/psychiatric problems and conditions. The following are a few examples:
(1) Autism-Spectrum Disorder
(2) Attention-Deficit Hyperactivity Disorder (ADHD)
(3) Prematurity and perinatal complications
(5) Learning Disorders
(6) Traumatic Brain Injury
What does a neuropsychological assessment involve?
A neuropsychological assessment evaluates multiple areas of functioning that have an impact on performance in daily life, academics, occupational and social functioning. Assessments may examine the following:
•Auditory and visual processing
•Visual perception, visual-constructional and spatial abilities
•Learning & Memory
•Concept formation and problem-solving
•Planning and organization
•Sensory perceptual and motor functions
•Behaviours, emotions and personality
How do I know if my child needs a neuropsychological assessment?
A neuropsychological evaluation may be beneficial if your child has:
•Medical problems such as prematurity, diabetes, chronic heart or breathing problems, certain genetic disorders, or treatment for childhood cancer
•A brain injury from a trauma to the head, stroke, lack of oxygen, or an infection
•A neurological disorder such as spina bifida, hydrocephalus, cerebral palsy, epilepsy, neurofibromatosis, tuberous sclerosis, or a brain tumor
•Been exposed to lead, street drugs, or inhalants such as carbon monoxide
•Experienced early deprivation or maltreatment
•Been exposed to alcohol, smoking, or certain drugs prior to birth
•A developmental or school problem such as a learning disability, attention-deficit/hyperactivity disorder, or autism spectrum disorder/pervasive developmental disorder
•Had an evaluation by a psychologist or the school, but the treatment following that evaluation has not helped
Your physician may recommend a neuropsychological assessment to help make or confirm a diagnosis, get a record of your child’s functioning prior to treatment with medicine or surgery, and/or record a change in your child after a medical treatment.
How long do neuropsychology assessments take?
A neuropsychological assessment takes between 18-22 hours to complete and includes both in-person and virtual components (e.g., interviews via a video platform or by phone). The number of hours required depends on the client, the complexity of the history, the number of testing sessions required, the amount of documentation that needs to be reviewed, and the number of collateral interviews. Scoring, interpretation, report writing and the feedback sessions are included in the 18-22 hours.
What should I expect during an assessment?
Initial interview (approximately 1-2 hours)
•We will meet to discuss your symptom complaints and their current impact on your functioning. You are welcome to bring a significant other to the interview though this is not required.
•It may be helpful to collect information from others who know you well, such as family members, teachers, and/or employers. These people will be contacted only with your permission.
•You will be asked to complete questionnaires related to your emotional well-being and psychological status.
Cognitive/neurocognitive tests (6-8 hours)
•You will be asked to complete a series of tasks such as providing word definitions, naming objects, and figuring out solutions to problems. Some of the tests are easier than others. This is normal as we all have different strengths and weaknesses.
•All of the tests are well-established and widely used measures of cognitive functioning. The length and content of the test battery vary depending on the presenting symptom complaints.
Additional Interviews and Collateral Interviews (duration varies)
•Whether or not additional interviews and collateral interviews are required depends on the referral question
Feedback session (1-2 hours)
•We will review the results of testing and discuss their functional implications and treatment recommendations.