HomeMedicine By SpecialtyMental HealthMental health therapy beyond the hospital

Mental health therapy beyond the hospital

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’s (TSH) department is taking mental health therapy beyond the bricks and mortar of the hospital, becoming the first and only hospital in Canada to deliver Internet-Assisted Cognitive Behavioural Therapy (iCBT) (as part of its Adult Outpatient Program) and a one-of-a-kind Mental Health App Library.

Individuals in need of cognitive behavioural therapy typically face challenges like long wait lists, a shortage of therapists, and a lack of access to a therapist outside of regular business hours. Now, adult outpatients of TSH’s Mental Health department can access treatment for anxiety and depression wherever and whenever it is most convenient for them.

“By offering this therapy through the Internet, along with our recommended mental health apps to support the process, patients are empowered to get the care they need on their terms and on their schedule,” says Dr. David Gratzer, Psychiatrist, TSH. “It means that more people will get access to evidence-based therapy.”


TSH recently launched iCBT2, a revamped version of iCBT that was originally developed through a partnership with Queen’s University. It uses traditional (face-to-face) CBT modules adapted for email and was recently redeveloped to make it more flexible, engaging, and patient-tailored.

Here’s how it works: A TSH therapist (who is dedicated to providing online services) emails outpatients one module per week. Patients can complete them on their own time, and then email them back to the therapist. The therapist blocks off time to review the work and provide written feedback to the patient.

Available through a physician’s referral, iCBT2 includes more substantive content, interaction, and videos, as well as aesthetic improvements, and takes only six weeks to complete (instead of the previous eight). The retention rate for iCBT2 has increased to approximately 80 per cent – an impressive improvement from its previous rate of approximately 10 per cent.

“Our iCBT clients have indicated that the program has been beneficial,” says Shawnna Balasingham, Therapist and Social Worker at TSH.

“Most report that the skills they learned through the program have helped them to effectively manage their distressing moods. Overall, those who have completed the program show significant reductions in their symptoms of depression, anxiety, and stress.”


For Ashley King, who has suffered from anxiety and depression for many years, iCBT2 was a game-changer.

“It helped me understand why I was experiencing certain symptoms, and taught me strategies about managing my anxiety,” she says. “There’s a weekly activity sheet, which is useful in encouraging me to try things out of my comfort zone.”

In addition to providing online therapy, TSH now offers a Mental Health App Library. While many patients already use mental health apps and websites, not all of them are created equally. With this in mind, the Adult Outpatient Program curated a Mental Health App Library consisting of 18 TSH physician- and therapist-approved apps for Android and Apple operating systems.

The free apps are designed to help improve mental health. They are meant to complement prescribed treatment plans, and are not intended to replace professional treatment.

“For example, a patient could use a relaxation app while taking transit to a mental health appointment,” explains Faiza Khalid-Khan, Director, Mental Health, TSH. “In this example, the app walks the patient through relaxation exercises, and the patient arrives at their appointment already prepared with thoughts and questions, helping them to get the most out of their therapy session.”

With the Mental Health App Library, patients can access trusted apps for support with anxiety, relaxation, depression, sleep, and post-traumatic stress disorder.

TSH is a leading provider of individual and group programming for those living with a major mental illness in Scarborough, Ontario. For more information, visit www.tsh.to.



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