Bibliographic record
Abstract
The importance of effective and timely psychotherapy treatment for Canadians in need has received increased attention in recent years. Additionally, there has been a call to better understand the current practices of the psychology workforce, to first understand where we stand as a field and further, to gain insight into how to best utilize psychology experts in the provision of mental health services. As the need for increased accessibility to psychotherapy treatment has come to the forefront of concerns in mental health care service delivery, initiatives to understand how best to implement programs aimed at increasing access have begun to be explored. The following dissertation has two aims in line with these recent trends: (a) to document the perspectives of psychology practitioners regarding increasing access to psychotherapy and the implementation of a future government-funded psychotherapy model in a local Canadian context, and (b) in order to inform these future initiatives to increase access to psychotherapy, documentation of current routine psychotherapy treatment is needed; therefore the second aim is to document current psychotherapy treatment in the private sector, as there is a dearth of knowledge concerning service delivery in this sector. To achieve these aims, first a survey study of psychologists and psychotherapists working in the private sector in Quebec (N = 671) was conducted focusing on themes such as psychotherapy format, age groups being served, collaboration with other health professionals, referral sources, fees for services, clinical tools used, wait-times, and use of supervision. Results indicated that the most served age population is adults (age 31-64); individual therapy is most commonly offered; and anxiety and mood disorders were reported to be the most frequently treated mental health disorders. It was not common for practitioners to have a wait-list longer than one week; and the average fee charged for individual therapy was $95.10 (SD = 16.69). To gain a more detailed understanding of private practice, a second study was conducted to examine the differences in practice characteristics among those of different levels of education, years of experience and theoretical orientation. To achieve the second aim, a survey study was conducted of licensed psychologists and psychotherapists in both public and private practice in Quebec concerning accessibility to psychotherapy treatment and the favourable components of a future government-funded model of psychotherapy (N = 1462). Results indicated that 77% of the sample 'strongly agreed' that accessibility to psychotherapy should be increased. Diagnosable mental health disorders, particularly mood disorders, anxiety disorders, and schizophrenia and other psychotic disorders, as well as psychological functioning related to health, injury and illness, and family difficulties were identified as the problems to be prioritized. There was stronger agreement for clinicians in a future government-funded model of psychotherapy to be paid on a session-to-session basis as opposed to receiving a yearly salary; to be able to set their own fee; and to have freedom to choose the appropriate psychotherapeutic approach. To again gain a nuanced understanding of the perspectives of these practitioners, a second study sought to examine the differences in perspectives regarding a government-funded model of psychotherapy between those of different levels of education, years of experience, and work setting (public vs. private). Important differences were found concerning fees and hiring structure, the use of validated measures to track treatment progress, as well as the central role of the treating clinician. Finally, a summary of the current characteristics of psychotherapy practice is presented in conjunction with information concerning the future of government-funded psychotherapy.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.010 | 0.003 |
| Scholarly communication | 0.004 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.018 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".