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An Argument for In-Person Mental Health Treatment over Online Therapy

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By Rob at AERCs 

One of the many biproducts of the Covid-19 pandemic, which we all lived through, was the rise of online therapy providers. The recent health crisis will forever be remembered because of our governments’ stay-at-home orders, social distancing, masking, increased hospitalizations, and the deaths of millions of people worldwide. These challenges also created uncertainty in the marketplace, contributing to increased unemployment, housing insecurity, and loneliness. These stressors have helped create a mental health crises in our general population.   

How do people generally react to life-changing government mandates?

Evidence suggests thousands of Canadians adopted unhealthy coping mechanisms to deal with increased stress, anxiety, sadness, and uncertainty the epidemic brought. Increased rates of eating disorders, depression, substance use, suicide, and domestic violence have all been attributed to the coronavirus pandemic. Additionally, there are dozens more online mental health service providers who offer therapy over virtual meeting platforms.

Is in-person therapy better than virtual counselling?

Are the two treatment formats even the same thing? AERCs Therapy offers both but takes the position that in-person meetings are more comfortable, personalized, and meaningful.

AERCs Therapy offers in-person therapy at any of three different locations across the greater Toronto area with one being downtown at Yonge and Davisville. In person treatment has many advantages over online therapy and some factors include the ability to accommodate individual preferences regarding the specific issues being addressed, and the level of comfort the patient may have with technology, and most importantly, the patient’s ability to form a meaningful connection with the therapist. Therapy is an emotional exchange, and the screen is a barrier.

Advantages of In-Person Psychotherapy and Social Work

There are plenty of reasons why people should choose to meet in-person with mental health workers.

Nonverbal Cues: Therapists and counsellors at AERCs read body language, tone of voice, and facial expressions in real-time during their in-person sessions. How patients sit in their chairs and what they do with their hands and feet can offer clues to their thought processes. This extra layer of information can paint a more complete picture of a patient’s emotional state and can assist in more accurate diagnosis and treatment planning.

Personal Connection: Some people find it easier to establish a therapeutic relationship when interacting with someone face-to-face, as opposed to through a screen.

Focus and Attention: In-person sessions may offer fewer distractions, making it easier for both the client and therapist to concentrate on the conversation.

Technical Issues: With in-person therapy, there’s no need to worry about internet connectivity problems, software issues, or other technical glitches that can interrupt online sessions.

Privacy: In a dedicated office setting, you may have a greater assurance of privacy and confidentiality than in an online format, where the security of the connection may be uncertain.

Access to Tools and Techniques: Certain therapeutic techniques, such as art therapy and play therapy may be more readily available or effective in an in-person setting.

Immediate Response: In case of a crisis or a significant emotional breakdown, an in-person therapist can respond more quickly and has more resources at hand to manage the situation.

 

Argument for Online Therapy

To be fair, online therapy also has some merits.

Accessibility: Online therapy is available to those who may have difficulty attending in-person sessions due to geographic location, physical disabilities, or other logistical challenges.

Convenience: Online sessions can be more easily scheduled and attended, offering greater flexibility.

Comfort: Some people find it easier to open up when they are in the comfort of their own home.

Anonymity: The perceived distance that comes with online interaction may allow some people to discuss stigmatized or embarrassing issues more freely.

Ultimately, the choice between in-person and online therapy will depend on individual circumstances, treatment goals, and personal preferences. AERCs Therapy like others in the marketplace offers a hybrid model where they provide both in-person and online sessions to accommodate the diverse needs and preferences of their clients.

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Your Health

Ecosystem biodiversity important to human health and nutrition

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Photo Credit: Mikhail Nilov

BY W. GIFFORD- JONES MD & DIANA GIFFORD-JONES

The routine of modern-day life for most of us involves regular trips to the grocery store and three meals a day. The regular patterns of our diet can be a source of comfort or a rushed necessity, but is eating the same familiar foods – often the same recipes, products, brands, over and over, day by day – good for us?

As nutritious as a “well-balanced” diet may be, there are good reasons to strive for a more diverse diet.

Chimamanda Ngozi Adichie, the acclaimed Nigerian writer, was not referring to plant and animal ecosystems when she wrote, “Diversity is not about feeling included, it’s about feeling valued.” Yet, she’d surely agree. Unless biodiversity is valued, it will lose ground, quite literally.

Now, new research is showing that valuing diversity in the natural world has important implications for human health.

A study in the journal PNAS examines the relationship between aquatic biodiversity and human health. Researchers found that aquatic ecosystems, such as: rivers, lakes, and oceans, provide a wide range of nutritional benefits to human populations.

According to the study, consuming a diet that includes a variety of fish, seaweed, and other aquatic foods can help prevent chronic diseases such as heart disease and diabetes. Additionally, these foods are rich in important nutrients such as: omega-3 fatty acids, iodine, and iron, which are essential for human health.

The researchers also found that consuming a diverse range of aquatic foods can have positive impacts on the environment. By promoting the consumption of a wider range of fish and other aquatic foods, fisheries and aquaculture can diversify their operations and reduce pressure on overfished species.

Protecting the biodiversity of aquatic ecosystems is essential for continued access to nutritional benefits. Yet, climate change and human activities have already impacted the health of the world’s water. Conservation and sustainable use simply haven’t been the priority.

Land surfaces, where humans live, haven’t fared any better. Scientists are concerned about the health of the: soil, grasses, and forbs that many animal species depend on for their dietary nutrition.

Dr. Forest Isbell, professor of ecology at the University of Minnesota, notes, “Land use changes and overexploitation are driving changes in biodiversity and ecosystems in many parts of the world.”

Isbell has closely read the research published in PNAS and thinks the findings are likely to be replicated in other ecosystems. He’s involved in studies that test the effects of biodiversity in grasslands that provide essential forage for grazing livestock. “It’s an important question,” he says. “Due to widespread farming and overgrazing by livestock, we have seen significant biodiversity loss in many grasslands. Just as people benefit from a diverse diet, so too do our livestock. By studying how biodiversity of grasses affects nutritional content of forage for herd animals, for example, we will be better able to inform policies and practices designed to protect land-based ecosystems.”

Human health depends on a diverse diet that delivers vitamins, minerals, protein, fats, water, and carbohydrates. It’s essential to place high value on the availability and quality of these components, as demonstrated by growing evidence of a vital relationship between ecosystem biodiversity and human health.

Sadly, a study by the Food and Agriculture Organization of the United Nations reports that 95% of the calories consumed worldwide come from a mere 30 species. Farmers cultivate only about 150 of the 30,000 edible plant species, and 90% of the food from domesticated livestock comes from only 14 animals.

What can health-conscious consumers do? On the next trip to the grocery store, think about the choices and try picking out a diverse range of foods, including from aquatic sources.

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Your Health

Don’t let food safety in the kitchen lapse: 10 ways to ensure you are eating safely

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Photo Credit: Wendy Wei

BY W. GIFFORD- JONES MD & DIANA GIFFORD-JONES

It’s an age-old problem, but not one that should come with age. Yet, compared to younger culinary novices, elderly people may be more prone to making mistakes in food preparation that can lead to food poisoning.

Kitchens can be a dangerous place. So there is no harm in having a refresher to make sure food safety in the kitchen doesn’t lapse. You know why? Recall that occasion when it seemed like a good meal – until later, when cramps, nausea and diarrhea had you vowing never to eat again.  Unless you’ve been visiting uncared for places or you are a victim to an outbreak of foodborne illness, there’s no excuse for food poisoning other than an unfortunate mistake.

Unfortunately, mistakes happen, and with some frequency in the kitchens of seniors. For example, a study published in the Journal of Food Protection found that older adults were less likely to use food thermometers when cooking meat, increasing the risk of undercooked meat.

Another study found that elderly people were more likely to store food at unsafe temperatures, such as leaving perishable foods out at room temperature for too long or storing them in the refrigerator at temperatures above 40°F (4°C). This could increase the risk of bacterial growth.

The Centers for Disease Control and Prevention (CDC) reports that older adults are more likely to develop severe complications from foodborne illnesses, such as kidney failure or sepsis, due to age-related changes in the immune system and underlying health conditions.

The World Health Organization (WHO) claims that contaminated food is one of the most serious health problems in the world. It’s usually due to an organism called E. coli, and for: infants, pregnant women and the elderly the consequences of consuming it can be fatal.

The good news is that food safety in the kitchen is straightforward and largely unchanging.

  • Wash your hands repeatedly. Your fingers are excellent at transmitting infection.
  • Keep kitchen surfaces meticulously clean. Bacteria always win if you become careless.
  • Protect food from insects and rodents in cupboards and drawers. Animals often carry pathogenic organisms that cause foodborne disease. Store food in closed containers.
  • Many foods such as fruits and vegetables are better in their natural state. But others are not safe unless they’re processed. For instance, lettuce needs thorough washing and pasteurized milk is safer than raw milk.
  • Cook food thoroughly. Many raw foods such as poultry, meats and eggs may be contaminated with disease causing organisms. Thorough cooking will kill the pathogens, so if cooked chicken is raw near the bone put it back in the oven until it’s done.
  • Eat cooked foods immediately. When cooked foods cool to room temperature, bacteria begin to multiply; the longer the wait the greater the risk.
  • Store cooked foods carefully. A common error is putting too large a quantity of warm food in the refrigerator. In an overburdened refrigerator, food remains warm too long allowing bacteria to proliferate.
  • Reheat cooked foods thoroughly. This is your best protection against bacteria that may have developed during storage.
  • Avoid contact between raw foods and cooked foods. For instance, safely cooked foods can become contaminated by even the slightest contact with raw food. So don’t prepare a raw chicken and then use the same unwashed cutting board and knife to carve a cooked bird.
  • Add a pinch of common sense. If something seems “off,” don’t eat it. If food is past its expiry date, throw it out.

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Despite the importance of Vitamin D, many people are deficient in this essential nutrient

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BY W. GIFFORD- JONES MD & DIANA GIFFORD-JONES

Vitamin D is often referred to as the “sunshine vitamin”. This is because it is synthesized in our skin in response to sunlight. The beauty of Vitamin D is that it’s free – a great model for “all things in moderation” too.

There are two main forms of vitamin D: vitamin D2 and vitamin D3. Vitamin D3 is the form that is synthesized in the skin, while vitamin D2 is found in some plant-based foods and supplements.

Vitamin D plays a crucial role in maintaining bone health by promoting the absorption of calcium and phosphorus from the diet. It also helps to regulate the immune system and may reduce the risk of certain types of cancer, such as colon, breast, and prostate cancer.

Despite the importance of vitamin D, many people are deficient in this essential nutrient. In fact, studies suggest that up to 50% of the global population may have insufficient or deficient levels of vitamin D!

Symptoms of deficiency can vary, including fatigue, depression, cognitive decline and dementia. Bone density loss increases the risk of fractures and falls in older people. Low levels of vitamin D have been associated with increased risk of heart disease and diabetes.

Why does a deficiency develop? It can be difficult to get enough vitamin D from sunlight, especially during the winter months. Additionally, vitamin D is found in relatively few foods, so it can be challenging to get enough vitamin D from the diet.

Scientific studies have found income, gender and ethnicity differences in vitamin D status globally. One study looked at the vitamin D status of over 1,000 healthy Japanese adults and found that 40% of women and 26% of men had vitamin D deficiency, and that individuals of non-Japanese ethnicity were more likely to have vitamin D deficiency than those of Japanese ethnicity. A study in the US found that people with higher incomes were more likely to be using supplements, and therefore less likely to suffer deficiencies. Consumer choices and food prices may also be important. Studies have found that consumption of fortified milk and milk products has a major effect on likelihood of deficiency.

If you need to know your vitamin D level, a blood test will determine it, but as the philosopher Voltaire once said, “The best is the enemy of the good.” Getting regular intake of vitamin D should be the goal, not trying to measure daily levels.

Make it a habit to get some vitamin D every day. The most effective way is to get sunlight directly on your skin. Spending 10-15 minutes outside in the sun each day with your arms and legs exposed will help your vitamin D levels, plus sunshine is a “feel good” prescription in general. Be sure to protect your skin with sunscreen if enjoying longer exposure.

But getting outside without layers of clothes can be difficult during the winter months, especially in northern latitudes, so don’t forget you also get vitamin D from certain foods. Include: fatty fish (such as salmon, tuna, and mackerel), egg yolks, and fortified foods (such as milk, orange juice, and cereal).

If you are concerned that the vitamin D in your diet is insufficient, a daily supplement can help. The recommended daily intake of vitamin D varies depending on: age, sex, and other factors, but in general, adults need between 600 and 800 international units (IU) per day.

The upper limit for vitamin D intake is 4,000 IU per day for adults, and it’s important not to exceed this amount unless under medical supervision.

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