Psychotherapy
You don't have to keep carrying this alone. Work with a therapist to understand what's keeping you stuck and start moving forward with confidence.

Psychotherapy is a working relationship with a regulated therapist that helps you understand what keeps you stuck and start to change it. Trillium's therapists draw on evidence-based approaches such as cognitive behavioural therapy (CBT), EMDR, acceptance and commitment therapy (ACT) and dialectical behaviour therapy (DBT) to work through anxiety, depression, trauma, stress and life transitions. Decades of research show its effects are significant and lasting across most conditions — for many people, the hardest part is simply starting.
Last updated: September 2026
What is Psychotherapy?
Psychotherapy is a series of conversations with a purpose: you and a trained therapist use proven psychological methods to shift the patterns of thinking, feeling and behaving that are holding you back (American Psychological Association, 2012). It is not venting, and it is not advice. You bring what is getting in the way. Your therapist brings a steady outside perspective, training in specific approaches, and a plan the two of you build together — then adjust as you go.
In Ontario, psychotherapy is also a regulated health service. Treating serious difficulties with mood, thinking, emotions, perception or memory through psychotherapy is a controlled act, which means only members of an authorized regulatory college — including Registered Social Workers and Registered Psychotherapists — can provide it (College of Registered Psychotherapists of Ontario).
To put it plainly, your therapist answers to a regulator, follows a code of ethics, and uses methods that have been tested. That is the real line between psychotherapy and coaching or a good talk with a friend. If you are weighing those options, we have written guides and deep dives on psychotherapist or life coach, why therapy is different from talking to friends, and how psychotherapists, psychologists and psychiatrists differ.
What can Psychotherapy help with?
Psychotherapy helps with the everyday struggles that wear people down — anxiety, stress and burnout, low mood, self-doubt, the after-effects of difficult experiences, and relationship patterns that keep repeating — as well as with formally diagnosed conditions such as depression, anxiety disorders, PTSD and OCD. Most people who contact us are not in crisis. They have been coping for a long time and want something to change.
You have read the articles, talked it through with friends and tried to think your way out of it. Most days you function. Some days it takes everything you have to look like you are.
Anxiety that won't switch off
Worry that runs in the background all day, a body that stays on alert, and situations you have started to avoid because the anticipation is worse than the event.
Burnout and stress overload
You are doing everything you are supposed to and still feel behind. Rest does not restore you, small tasks feel heavy, and your patience is gone by mid-afternoon.
Low mood, feeling flat or stuck
Less interest in things you used to enjoy, trouble getting going, and a sense that life is happening to you rather than being lived by you.
Not feeling good enough
A harsh inner voice that says you are not doing enough, comparing yourself to where you "should" be by now, and feeling like a failure no matter what you achieve.
Past experiences that still weigh on you
Something that happened years ago still shapes how you react today — in relationships, at work, or in how safe you feel in your own body.
Reacting, then feeling guilty
Snapping at the people you love and then replaying it for hours, or saying yes to everyone else until there is nothing left for you.
Wondering whether what you are carrying is "enough" to bring to therapy? Read our resource article on the 12 signs it may be time to book a session.
Many of these concerns have their own page with a dedicated team and a deeper explanation of how we work: anxiety counselling, depression counselling, stress and burnout therapy, trauma therapy, childhood trauma and attachment, grief counselling, OCD therapy, body image, couples counselling, prenatal and postpartum counselling and teen counselling. If your concern is not listed, ask at the consult — the list above is where we most often start, not a limit.
How does psychotherapy help?
Psychotherapy helps by giving you a structured place to notice the patterns that keep a problem going, learn specific skills for changing them, and practise those skills between sessions until they hold up in real life. The relationship matters too: feeling understood by someone who is steady, honest and on your side is part of what makes the work possible.
The evidence is strong. The general effects of psychotherapy are widely accepted to be significant and large, and they hold across most diagnoses — outcomes vary more with how long a problem has lasted, how complex it is and how much support you have than with the particular "brand" of therapy used (American Psychological Association, Recognition of Psychotherapy Effectiveness, 2012). Psychotherapy also teaches skills that last beyond the course of treatment, and its results tend to hold up longer than medication alone while rarely producing harmful side effects (American Psychological Association, 2012).
Therapy and medication are not either/or. Many people do both, and if medication is part of your care it is prescribed and monitored by your physician or psychiatrist while your therapist focuses on the skills, patterns and history that medication cannot reach. Feeling better also has a way of showing up outside your head — in sleep, in how you handle a hard conversation, in how much of the day you actually enjoy.
In practice
People may reach out feeling that they are not good enough, are not doing enough, or are falling behind. They may describe anxiety that is difficult to switch off, exhaustion that does not ease with rest, or snapping at people they love and feeling guilty afterward. Some want to work through something from the past; others are looking for practical ways to manage anxiety, stress or low mood, or to change patterns of people-pleasing and avoidance.
Each person’s circumstances are different. In our practice, these concerns can come with a sense of having carried too much alone and a wish for more ease, connection and enjoyment in everyday life.
Observation shared September 2026. General patterns only — not a description of any individual client.
Which types of psychotherapy do we use?
Our therapists work with several evidence-based approaches and choose the one that fits your goals rather than fitting you to a single method. The approaches below are the ones we use most, and each has its own page if you want the detail.
- Cognitive behavioural therapy (CBT) — identifies the thinking and behaviour loops that keep anxiety, low mood or stress going, and gives you structured, practical tools to interrupt them.
- EMDR therapy — a structured approach for processing distressing memories so they stop driving present-day reactions; used for trauma, PTSD and some anxiety presentations.
- Acceptance and commitment therapy (ACT) — builds psychological flexibility: making room for difficult feelings while acting on what matters to you.
- Dialectical behaviour therapy (DBT) skills — concrete skills for emotion regulation, distress tolerance and relationships, useful when feelings escalate fast or spill onto the people around you.
- Emotionally focused therapy (EFT) — works with attachment needs and the emotional cycles underneath conflict, for individuals and couples.
- Solution-focused brief therapy, narrative therapy and mindfulness-based approaches — shorter or more reflective options that focus on strengths, the stories you hold about yourself, and steadier attention.
Most of our therapists are trained in more than one of these and blend them as your needs change. Different structured psychotherapies tend to produce broadly similar results; the fit between you and your therapist, and your engagement between sessions, matter more than the label on the method.
Who provides psychotherapy at Trillium?
Psychotherapy at Trillium Counselling is provided by Registered Social Workers (MSW, RSW), regulated by the Ontario College of Social Workers and Social Service Workers, and by Registered Psychotherapists (RP), regulated by the College of Registered Psychotherapists of Ontario. Both colleges authorize their members to perform the controlled act of psychotherapy once they have completed the additional training the college requires (Ontario College of Social Workers and Social Service Workers, 2024). We do not have psychologists or psychiatrists on staff; a formal diagnosis, if you ever want one, comes from a physician, psychiatrist, nurse practitioner or psychologist, and our therapists work with the pattern whether or not you pursue that step.
Every therapist here holds their own registration with one of these colleges and is accountable to its standards of practice, so you can look them up on the public register before you ever book. If the alphabet soup of titles is confusing, our explainer on psychotherapists, psychologists and psychiatrists walks through who does what in Ontario.
Most of our team provides individual psychotherapy. Below are a few of the therapists at Trillium Counselling who support clients through psychotherapy, in Kitchener-Waterloo and online across Ontario. During your free consultation, we'll match you with the therapist who's the best fit for your needs, schedule, and goals — including team members not pictured here.
How do we match you with the right therapist?
We match you with a therapist based on what you want to work on, the approach that tends to suit it, and the practical details that make therapy sustainable — your schedule, whether you prefer online or in person, and the kind of person you are likely to open up to. Every therapist on our team works from their own areas of focus and training, so the match is deliberate rather than whoever happens to have an opening.
If you would rather talk it through first, we offer an optional free 20-minute matching consultation. You tell us what has been going on and what you would like to be different, and we suggest the therapist we think fits — no assessment, no obligation to book afterwards. Fit matters because the working relationship is a strong predictor of how therapy goes, so if it does not feel right after a few sessions, tell us; switching therapists within Trillium is straightforward and nobody takes it personally. Before you start, you may find these useful: how to find the right therapist, questions to ask a therapist before you begin, signs your therapist is a good fit, the different personality types of therapists and when it might be time to change therapists.
What happens in your first few sessions?
Your first psychotherapy session is a 50-minute conversation about what brought you in, what you have already tried and what you would like to be different — not a test, and not a session where you must tell your whole story. Before it, you complete a short online intake form so your therapist arrives with the background and you can spend the hour on what matters instead of paperwork.
Over the first two or three sessions your therapist gets a fuller picture, explains how they work and agrees goals with you, so you both know what "better" would look like. Most people start weekly or every two weeks and space sessions out as things improve. Some concerns settle in a handful of sessions; longstanding patterns and trauma take longer, and your therapist will check in on progress rather than assume. You set the pace, and you can pause or stop at any time. A few practical habits can make a real difference — we have collected them in nine things you can do to get the most out of therapy, and if opening up is the hard part, this piece on why sharing how you feel is so hard may help.
Online or in person — which should you choose?
Choose whichever you will actually show up for: the evidence shows video psychotherapy and in-person psychotherapy produce comparable results for anxiety, depression and PTSD, so the practical fit — commute, privacy at home, childcare, how you focus — is the deciding factor. A meta-analysis of randomized trials found telemedicine psychotherapy no less effective than face-to-face care, with a difference in outcomes the authors described as negligible (Fernandez et al., Clinical Psychology & Psychotherapy, 2021), and a 2023 review of 17 trials reached the same conclusion across PTSD, mood and anxiety disorders (JMIR Mental Health, 2023).
At Trillium you can do either, or mix them — some clients start in person at our Waterloo office and move online once the relationship is established; others live in Ottawa, London, Sudbury or Thunder Bay and work with us entirely by video. Our online counselling across Ontario page explains how video sessions work, what you need, and how privacy is handled.
Can psychotherapy help during a life transition?
Yes — psychotherapy is often most useful at the turning points that are not a "disorder" at all: leaving home or finishing school, a new job or a lost one, a move, a breakup or divorce, becoming a parent, a health change, retirement. Transitions unsettle the routines and roles that held your sense of self in place, which is why questions about identity and purpose tend to surface right when everything else is also changing.
What usually gets in the way is not the transition itself but the patterns it stirs up: putting things off, doubting yourself, or trying to keep everyone else happy while your own footing slips. Therapy gives you a place to name those patterns, decide which ones you want to change, and build the practical scaffolding — a support system, small realistic goals, steadier attention — that lets you move forward with confidence rather than waiting until you feel certain. If you are in your late teens or twenties and this sounds familiar, our guide to adulting and life transitions includes a short self-discovery quiz, and students in Waterloo can read about counselling for UW and Laurier students.
Psychotherapy in Waterloo Region and across Ontario
Trillium Counselling provides psychotherapy in person in our uptown Waterloo office, a short drive from Kitchener, Cambridge, Guelph and the surrounding townships, and online by secure video to clients anywhere in Ontario. Evening appointments run until 9 p.m. Monday to Thursday and 8 p.m. on Friday, with Saturday mornings available, because most of the people we work with are fitting therapy around work, school or a family. If that is you our guide on five ways to fit therapy into a busy life is worth two minutes.
Individual sessions are typically $175 to $185 per 50 minutes depending on the therapist and therapy type (individual work, couples work etc), and most extended health plans reimburse sessions with a Registered Social Worker or Registered Psychotherapist; we can bill many major insurers directly. Current fees, hours and insurance details are kept up to date on our hours and rates page. In 2022, more than five million Canadians met the criteria for a mood, anxiety or substance-use disorder, and counselling was the most common form of care those who reached out received (Statistics Canada, Mental Health and Access to Care Survey, 2023). If guilt about "taking up a spot" is what is stopping you, we wrote about why guilt is often the first barrier to getting help.
Psychotherapy FAQs
+What is the difference between psychotherapy and counselling?
What is the difference between psychotherapy and counselling?
In everyday use the words overlap, and at Trillium the same therapists provide both. Counselling usually refers to shorter-term, present-focused support around a specific situation, while psychotherapy tends to go deeper into longstanding patterns, emotions and history. In Ontario, psychotherapy is also a legally controlled act that may only be performed by members of authorized regulated colleges, such as Registered Social Workers and Registered Psychotherapists.
+How do you match me with a therapist at Trillium Counselling?
How do you match me with a therapist at Trillium Counselling?
Through a free 20-minute phone consultation. You tell us what has been going on, what you would like to be different, and any preferences about schedule, format or therapist style. Our intake team then suggests a therapist whose training and availability fit. There is no obligation to book afterwards, and if the first match does not feel right after a few sessions, we will help you switch.
+What happens in my first psychotherapy session?
What happens in my first psychotherapy session?
Your first session is 50 minutes. Before it, you complete a short online intake form so your therapist has the basics. In the session you talk about what brought you in, what you have already tried and what you want to change. Your therapist explains how they work, what privacy protections apply and the specific situations in which Ontario law requires information to be shared, such as a risk of serious harm or a child-protection concern, and how you will set goals together. You do not have to share everything on day one.
+How many sessions will I need, and how often will we meet?
How many sessions will I need, and how often will we meet?
It depends on what you are working on. Most people begin weekly or every two weeks, then space sessions out as things improve. Some concerns settle in a handful of sessions; longstanding patterns or trauma usually take longer. Your therapist will review progress with you regularly, and you decide the pace. There is no fixed program length, and you can pause or stop at any time.
+What does a psychotherapy session cost at Trillium Counselling?
What does a psychotherapy session cost at Trillium Counselling?
Individual psychotherapy sessions are $175 to $185 per 50-minute session, depending on the therapist. Couples sessions are about 80 minutes and billed at 1.5 times the individual rate. We ask for 48 hours' notice to change or cancel an appointment. The matching consultation is free. Current fees are always listed on our hours and rates page.
+Is psychotherapy covered by my extended health benefits or OHIP?
Is psychotherapy covered by my extended health benefits or OHIP?
Psychotherapy with a Registered Social Worker or Registered Psychotherapist is not covered directly by OHIP, but most extended health plans reimburse sessions with one or both designations. Check your plan for the covered provider types and your annual maximum. We provide a receipt you can submit to your insurer for every session and can bill many major insurers directly so you pay only the difference.
+Can I do psychotherapy online from anywhere in Ontario?
Can I do psychotherapy online from anywhere in Ontario?
Yes. Our therapists provide psychotherapy by secure video to clients anywhere in Ontario, and in person at our Waterloo office. The College of Registered Psychotherapists of Ontario treats a video session with a client located in Ontario as psychotherapy delivered in Ontario, so the same professional standards and protections apply. Research comparing video and in-person psychotherapy has found the two produce similar results for anxiety, depression and PTSD.
+Do I need a referral from my doctor to start psychotherapy?
Do I need a referral from my doctor to start psychotherapy?
No. You can book directly with Trillium Counselling without a physician referral. Some extended health plans do require a doctor's note before they will reimburse psychotherapy, so it is worth checking your plan before your first session.
+Do I need a diagnosis to start psychotherapy?
Do I need a diagnosis to start psychotherapy?
No. Most people who come to us do not have a formal diagnosis and never pursue one. In Ontario a diagnosis can only be communicated by a physician, psychiatrist, nurse practitioner or psychologist; Registered Social Workers and Registered Psychotherapists do not diagnose. Our therapists work with the pattern in front of you, whether that is anxiety, low mood, stress or the weight of past experiences, whether or not a diagnosis is ever part of your care.
+Can I switch therapists if it isn't a good fit?
Can I switch therapists if it isn't a good fit?
Yes, at any time. Fit is a strong predictor of how therapy goes, and a mismatch is not anyone's failure. Tell your therapist or our intake team what is not working and we will suggest another therapist on the team and help you rebook without starting the matching process from scratch. Your therapist will not take it personally.
+Do you offer evening or weekend psychotherapy appointments?
Do you offer evening or weekend psychotherapy appointments?
Yes. Our Waterloo office and online calendar run Monday, Wednesday and Thursday from 9 a.m. to 9 p.m., Tuesday from 10 a.m. to 9 p.m., Friday from 9 a.m. to 8 p.m., and Saturday from 9 a.m. to 1 p.m. Evening and Saturday spots are the most requested, so mention your preferred times at the consult and we will match you with a therapist who has that availability.
+Can I do psychotherapy while taking medication?
Can I do psychotherapy while taking medication?
Yes. Psychotherapy and medication are often used together, and many clients do both. Medication is prescribed and monitored by your family physician, psychiatrist or nurse practitioner; your therapist does not prescribe or adjust it, but can help you notice how you are responding and, with your consent, share relevant observations with your prescriber. Psychotherapy also teaches skills that continue to help after treatment ends.
Related Resources on Psychotherapy
Plain-language answers to the questions people ask before their first session.
How do I know if I need therapy? 12 signs it's time to book
You do not need to be in crisis. The twelve everyday signs people usually notice first, and what to do next.
ChoosingFinding the right therapist: tips to help you choose
Credentials, approach, fit and practicalities — how to compare therapists without getting lost in the alphabet soup.
Who's whoPsychotherapist, psychologist or psychiatrist: what's the actual difference?
Who can diagnose, who can prescribe, who provides talk therapy, and what OHIP does and does not cover in Ontario.
PrivacyWhat does confidentiality mean in therapy?
What stays between you and your therapist, the specific exceptions Ontario law requires, and how your records are handled.
Ongoing supportWhy therapy isn't just for a crisis
How ongoing support works when nothing is "wrong" — maintenance, growth and catching patterns early.
ServiceOnline counselling across Ontario
Secure video psychotherapy from anywhere in the province — how it works, what you need, and how sessions are kept private.
Not sure yet? Let’s talk it through.
If you’d like to ask questions or explore your options first, book a free 20-minute matching consult or give us a call (226-752-8857) . One of our team members will help you find the right therapist and next steps that feel comfortable for you.
About the reviewer
Devon Jorge, MSW, RSW, Registered Social Worker, Psychotherapist is the Clinical Director and Therapist at Trillium Counselling with specialized training in complex trauma, EMDR, and attachment-based, marriage and family therapy. This page was reviewed by Devon for accuracy. Last reviewed September 2026.
If you need help right now
Call or text 9-8-8, Canada’s Suicide Crisis Helpline. It is free, confidential and open 24 hours a day, every day. In Waterloo Wellington, Here 24/7 answers around the clock at 1-844-437-3247. If someone is in immediate physical danger, call 9-1-1.
Trillium Counselling does not provide crisis services. For non-urgent support, book a free consultation or call 226-752-8857.
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