Let’s talk therapy in Toronto with Kate Scowen

What are the gaps you’ve seen in the therapy landscape here? How has that affected the way you’ve shaped Hard Feelings?

There needs to be more oversight in terms of who’s offering private practice. You know, private practice therapy was originally something you did later in your career. It wasn't that you went to school, graduated and opened a private practice. You went to school, you graduated, you worked in the sector, you developed your skills in a supervised environment — in a work setting — and then maybe 10 years down the road, you'd open private practice. Now, with the proliferation of online therapy programs, people are graduating with very little experience and opening a private practice, and there's not a lot of oversight in terms of the quality of therapy and that's a problem.

I think one negative interaction can really impede seeking help. People say, “I tried therapy once — it was terrible.” And it's like, “Was it? Or was it that you had the wrong therapist?” So, I think there's a real problem there. How do you know if your therapist is a good therapist? What is a good therapist?

That’s why the therapists of Hard Feelings are highly skilled. To join the practice, it’s not an easy pathway, and we have expectations in terms of years of experience and skill. So, it's low cost therapy and highly skilled therapists.

What are some common misconceptions you’ve seen about therapy from your five years working at Hard Feelings?

The pandemic has shown us that there's a real need for navigation support. People don't know where to go for help. They don't know how to connect with a counsellor. It’s confusing. What's a social worker? What's a psychotherapist? What's a psychiatrist? There's so much general education that's missing for folks. We get a lot of referrals that are actually not appropriate for Hard Feelings, so how can we help people navigate? We get so many requests, you know, “Hi, I'm struggling. I need to connect with a counsellor. Can you please tell me how to do this?” So whether it’s folks who don't have enough capacity, or they couldn't afford Hard Feelings, how do we help them?

And I think people need to understand what therapy is, right? I think sometimes people think: I'm gonna go there and everything will get fixed and everything will be better — and it's not. Therapy is a process. It's about making change. It’s a lot of work; it's not easy.

Now I can say it's not until the fourth session that your client is really your client because it's not until then you've created the therapeutic relationship. Once you have a solid therapeutic relationship where you feel somewhat safe and comfortable in the room, and you feel like you're being heard and you have a rapport with your therapist — that takes about three sessions. That's why we say to people, “Give it at least three times.” Like, if you buy a new pair of shoes, you know they're gonna hurt the first couple of times you wear them; but hopefully by the third, fourth time, they're going to start to feel comfortable, right? So, you do have to take time. I think we live in a culture at a time where it's like, “Oh, it doesn't work for me. I'm walking away,” and therapy is not like that. It takes time — it really does.

This interview was edited and condensed for clarity.