Our Services

Clinical psychology and behavioural sleep medicine services


Psychotherapy is a treatment relying on your own capacity to bring about changes in your life. The therapist's role is to guide and support you to get new insight into your health problems and to teach you skills of how to fight your illness.

  • Insomnia
  • Cognitive behavioural therapy is the first line, recommended treatment for chronic insomnia. Cognitive behavioural therapy for insomnia (CBT-I) is provided on an individual basis and typically consists of 4 treatment sessions. The treatment works fast and has a long term effect.

  • Nightmares
  • Nightmare treatment is a short, imagery based treatment that can be combined with cognitive behavioural treatment for insomnia

  • Depression
  • Clinical depression is an illness characterized by overwhelming sadness or decreased ability to enjoy everyday activities of life, including work, recreation or sex. Sleep problems are very common in depression. Psychotherapy can treat your depression and sleep difficulties at the same time. The treatment is time limited (about 15 sessions) and is often of long-term benefit.

  • Anxiety
  • Worry during the day or in the evening may prevent you from having a good night sleep. Psychotherapy teaches you how to live with healthy, adaptive anxiety and how to reduce the non-helpful, stressful worry in your everyday life.  The length of treatment – depending on the type of anxiety problem – is estimated to be between 5 and 20 sessions.

  • Chronic Fatigue
  • Lifestyle factors, sleep problems, sleep habits, and chronic medical conditions often triggers or maintain chronic fatigue. Cognitive behavioral fatigue management and mindfulness improves quality of life and fatigue in chronic fatigue conditions, including chronic fatigue syndrome and fibromyalgia.

Dora Zalai graduated in medicine sum cum laude in Hungary and focused on pediatric neurology. After immigrating to Canada she completed a research fellowship in the health and disease psychiatry program at the University of Toronto and then worked in the sleep program at the University Health Network. Dora's passion for behavioural sleep medicine inspired her to pursue a doctoral degree in clinical psychology at Ryerson University where her focus is to study the psychological aspects of fatigue in chronic medical conditions and sleep problems following traumatic brain injury. Dora has a long standing experience in providing cognitive behavioural treatment for individuals who have a combination of sleep difficulties and medical/mental health problems. She has an aptitude in conveying complex health information in an easily digestible form; to this end she has contributed to an internet based program on insomnia and four booklets for patients on topics ranging from insomnia and sleep apnea treatment to cultural aspects of psychiatry.

  • It is effective. Psychotherapy in most cases is as at least as effective treatment of the above conditions as medication, or provides the most effective solution in combination with medication.
  • It is a long-term solution. Research studies have consistently shown that people experience further improvement even a year after they finish psychotherapy and its effect carries on.
  • It is about you. Psychotherapy is about your individual life situation, your emotions, your family situation, goals and needs. In psychotherapy you will be listened to and be respected for who you are and as such, you will feel empowered.
  • It does not have chemical side effects.
  • You may start to feel the effects of psychotherapy later than those of medication (but it often is effective long after you finish the psychotherapy treatment).
  • It requires time commitment (sessions are usually 50 - 60 minutes long)
  • It requires your active contribution (you need to talk about your experiences and may need to complete homework)
  • It may require payment, but it is cheaper than medication in the long run.

Sleep & Psychiatric Assessment

  • Semi-structured sleep and psychiatric interviews (e.g. Structured Clinical Interview for DSM 5 – SCID 5 and Anxiety Diagnostic Interview Schedule- ADIS)
  • Actigraphy
  • Circadian sleep disorder assessment (including sleep diary, actigraphy, and DLMO assessment and interpretation)
  • Ambulatory, home PSG assessment (for patients not eligible for OHIP covered sleep studies)

Insomnia Treatment

  • Cognitive behavioural therapy for insomnia (CBT-I)
    • patients can be on/off medications during treatment
    • CBT-I can be used to help patients discontinue hypnotic medications

Nightmare Treatment

  • Imagery rehearsal therapy (IRT)

Sleep Apnea Treatment

  • Psychoeducation about sleep apnea and treatment options
  • Motivational interviewing (MI) to facilitate commitment to treatment
  • Cognitive behavioural therapy for claustrophobia

Depression Treatment

  • Behavioural activation (stand-alone or in combination with CBT-I)
  • Cognitive behavioural therapy for depression (stand-alone or in combination with CBT-I)
  • Mindfulness-based cognitive therapy for patients with chronic and recurrent depression (group treatment; offered only if there are enough patients to form a group and if there is space for group treatment)

Anxiety Disorder Treatment

  • Cognitive behavioural therapy specifically for generalized anxiety disorder, social anxiety disorder & specific phobia

Obsessive- Compulsive Disorder Treatment

  • Cognitive behavioural therapy for OCD
  • Mindfulness-based cognitive therapy

Fatigue Management

  • Cognitive behavioural fatigue management

Circadian Sleep Disorder Treatment

  • Behavioural treatment
  • Melatonin treatment
  • Bright light therapy
  • Stand-alone or in combination with CBT-I

Mindfulness program & Mindfulness based Cognitive Therapy for patients with depression, anxiety, chronic pain, or fatigue. This is provided in a group format and is only available if there are enough applicants.

Support Group for Individuals with Sleep Problems and Obesity

  • Provides support for individuals with obesity and sleep problems and after bariatric surgery
  • It is not a weight loss group but participants are supported if they decide to lose weight

Support Group for Individuals with Chronic Insomnia

  • This is not a treatment group but it provides support for individuals with chronic insomnia who are not ready for or not interested in cognitive behavioural therapy and for whom medication treatment did not work
 
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