FAQs About Therapy With Dr. Selles

I am based in Vancouver, BC; however, I am registered to provide psychology services virtually to individuals living anywhere in British Columbia. Due to regulatory restrictions, I am unable to provide psychology services to individuals living outside BC. Back to Top.

How are your services provided?

I provide the majority of my services virtually via a secure telehealth platform. In-office services can be arranged if they are preferred, although there may less flexibility in scheduling and a longer wait to be seen.

If beneficial or important to targeting symptoms, other options include public/outdoor (e.g., walk-and-talk) or home-based sessions, although these services are generally associated with additional costs. Back to Top.

When do you offer appointments?

I primarily offer appointments on Tuesday-Thursday afternoons/early evenings (e.g., 3-7 PM); however, other options may be possible if these times are not feasible for your schedule. To reserve any specific date/time appointments must be formally scheduled. Back to Top.

What happens if I'm late, cancel, or forget to attend an appointment?

You are responsible for being on time and prepared for sessions. If late, no refunds or extra time will be provided. Forty-eight hours’ notice is required for cancellation except in extenuating circumstances. Late cancellations and no-show appointments will be charged as if the session was attended. Back to Top.

What are your fees?

Fees for services are currently set at $235/50-minute hour (the final portion is reserved for other necessary activities such as documentation, scheduling, email). All other activities (e.g., telephone calls, travel time, report/letter writing, consultations, court appearances) will be pro-rated at the same hourly rate and charged accordingly. Fees may increase in the future; however, at least four weeks’ notice will be provided.

How do I pay?

Payment is accepted via credit/debit or e-transfer; however, a credit/debit card will be kept on file to ensure timely payment. If payment via credit/debit card is preferred, the card on file will be automatically charged at the end of each session. If e-transfer payments are preferred, payment must be received within one week, after which the balance will be charged to the card on file.

Receipts are issued following each payment. Some extended health plans will cover a set amount of psychological services. You are responsible for submitting any claims for reimbursement with your insurance carrier. If eligible and pre-arranged, payment via government programs may be accepted (e.g., Ministry of Child and Family Development; Jordan’s Principle). Back to Top.

How do you handle my personal health information?

Personal health information is collected only for use in care and treatment. I use Jane App: a secure (encrypted) online system for charting, appointment scheduling, and virtual appointments. You have the right to access your health information and will be provided with copies for a minimal fee. You always have a right to ask questions about the way the privacy of your personal health information is being handled. Back to Top.

How do you handle my personal health information?

Do you keep the information we discuss confidential?

As a psychologist, I keep the information you share with me just between us (i.e., confidential) unless you directly provide me with permission to share it with others or if I have a legal obligation to disclose that information (e.g., to ensure safety, in response to a court order). If you are the parent of a child or mature minor, there are also unique aspects to what may or may not be kept confidential. Detailed information regarding these limits to confidentiality will be provided to you prior to the first appointment. Back to Top.

What if I’m unhappy with something?

My intention is for us to work together as members of the same team, but it's definitely possible that I'll make a mistake or do something that upsets you. If something like this happens, the best thing you can do is discuss it with me. This way I can understand where I went wrong and we can address and resolve the issue together. If you feel you cannot address the issue with me or are unsatisfied with my response, you do not need to continue working with me.

As a Registered Psychologist, I am also subject to rules and regulations of the College of Psychologists of British Columbia. If desired, you can review information about their mandates, functions, and complaints process. Back to Top.

Scope of Practice

Can I talk to you about anything?

In general, there are no topics that are off limits in therapy and if something is of concern to you, I will do my best to help you explore ways of managing it that are consistent with who you want to be. That said, I am not an expert in everything and I may suggest that you seek alternate or additional support for concerns that fall outside of my areas of practice. In addition, it is important to understand that I provide an active form of therapy, which means that, rather than just listening and being supportive, I will also try to direct our conversations towards topics that are of relevance to your concerns and introduce skills that may be of benefit to you. Back to Top.

How do I know if you are a good fit for my or my family's needs?

Choosing a psychologist or therapist that you like and trust increases the likelihood that you will benefit from treatment. Read through the website and ask yourself:

Are my concerns similar to those that are described?

Does Dr. Selles’ approach to treatment appeal to me and seem like it could be helpful?

Does Dr. Selles seem like someone I would feel comfortable and confident talking to?

Am I okay with the way Dr. Selles practices and his policies?

What age clients do you work with?

My primary focus is on working with older teenagers and young adults (e.g., between 15-40 years old); however, I am open to working with younger and older clients. I have extensive experience working with children, youth, and their parents; however, virtual services may not be the best fit for many youth/families and in-person services would be recommended. I also work with older adults who are primarily seeking therapy for obsessive-compulsive disorder (OCD) as I have particular expertise in this area. Back to Top.

Do you involve parents, partners, and/or other family members?

The level of involvement from family members typically reflects the level of dependence the individual has on those family members and, for older clients, the extent to which they feel open to including those individuals in treatment.

For example, parents are typically primary participants in therapy for children. For teens, if family accommodation is extensive, parental inclusion may be substantial; however, for independent teens, parental inclusion may be minimal. For adult clients, the inclusion of partners or family members is generally at the discretion of the client. Back to Top.

Can you provide a diagnosis?

Psychological diagnoses are generally assessed and assigned based on observable symptoms, self- and observer-reported experiences, and the extent to which these challenges impact well-being. As a registered psychologist, I have the background, training, and capacity to assess for, and diagnose, most psychological disorders. That said, although I will provide feedback regarding the nature of the concerns, I generally do not emphasize diagnoses in therapy, preferring instead a transdiagnostic approach.

If formal assessment and verification of a diagnosis of importance to you (e.g., in order to obtain accommodations), this can generally be arranged; however, due to the additional time required for conducting a structured assessment, obtaining information from multiple perspectives, and writing reports, this will be associated with additional costs.

Please note I do not provide psychoeducational assessments. Back to Top.

Will you consult with my doctor, teacher, psychiatrist, past therapist, etc.?

As it relates to sharing information and ensuring consistent care, with your permission, I am happy to briefly connect with others who may be, or have been, involved in your care for no charge. If ongoing consultation or training is required (e.g., providing guidance to teachers), these sessions will be charged to you at the standard rate. Back to Top.

How are you different from a psychiatrist? What about a counsellor, therapist, or coach?

Psychiatrists are medical doctors who then go on to specialize in mental health conditions. This means that they can prescribe medication and provide medical interventions. In contrast, I hold a doctoral degree in psychology where training focused primarily on psycho-social and behavioral aspects of mental health. This allows me to offer evidence-based interpersonal interventions (e.g., CBT, ACT) but not prescribe medications.

Registered Clinical Counsellors (RCCs/CCCs) are also mental health professionals and can provide therapy; however, they have undergone less training, particularly as it relates to the science that underlies psychological problems and their treatments. As a result, counsellors tend to provide less specialized care and are not able to provide a diagnosis.

Unfortunately, anyone can call themselves a counsellor, therapist, or coach, even if they don't have specific educational or training experiences. I would encourage you to be wary of non-registered providers, as they are not held accountable by professional standards. Back to Top.

Reaching Out

What happens after I contact you?

I will look over your form within 1-2 business days and, if you appear to be a good fit, contact you to let you know about next steps. If you do not appear to be a good fit, I may decline to offer an appointment. When possible, I will offer suggestions for alternative services that may be more suitable for your needs.

Can I speak to you before committing to an appointment?

If you have questions about fit or services, or if you'd like to connect with me before scheduling an appointment, I'm happy to have a brief 10-minute phone call. Please note that the call is not an opportunity to discuss, evaluate, or get support for, your specific symptoms or concerns. To set up a call, please reach out to me via the contact form. Back to Top.

How quickly can you see me? How long is your wait list?

I currently have a minimal waiting list and will do my best to schedule you in efficiently; however, how quickly I can see you may also depend on your flexibility to meet at times I have available. Back to Top.

What should I do while wait for my first appointment?

While waiting, it is recommended that you monitor your concerns. You might do this by reflecting on, and keeping track of, things such as:

What thoughts, feelings, or behaviors are causing me the most difficulties in my life?

When and why do they occur (e.g., what triggers them)?

How do they get in the way?

How do I respond to these difficulties and what happens as a result?

If I didn’t have these difficulties, how would I be living my life?

The articles and resources pages also contain ideas on places to start in the interim. Back to Top.

What if I’m not sure I want to proceed? Can I back out?

Prior to your first appointment, you will be provided with detailed information to review that will help you make an informed decision about if you would like to proceed with your appointment. This includes an overview of my practice policies, what meeting with a psychologist involves, risks and benefits, what information is kept confidential and when information may need to be shared with others, and alternative options available to you. It is important that you read this information carefully and raise any questions or concerns you may have.

After reading this information you may decide that you do not wish to proceed with services and are free to cancel the appointment. You may also decide that you would like to discuss some concerns at the outset of the initial meeting. If through this discussion you decide you would not like to proceed with services, the appointment will end and you will not be charged. In contrast, if you indicate understanding of the information, agree to proceed, and participate in the assessment process, you will be charged for that time; however, you are under no obligation to schedule additional appointments or continue working with me.

Can I invite others to my session?

While I welcome the participation of loved ones (e.g., parents, partners, etc.) in treatment when relevant, it is important that session time is utilized in a way that is most helpful for you. In addition, all participants need to understand what it means to meet with a psychologist (e.g., risks and benefits, limits to confidentiality). Therefore, additional parties may only join or observe sessions with prior discussion and consent. Back to Top.

Therapy Process

What happens in a first appointment/during assessment?

After a review of the information provided ahead of the session and the chance to resolve any questions or concerns, in the first appointment we'll work together to develop a map of you and your life. We’ll talk about how you got here, where you see yourself now, where you’re getting lost or stuck, and where you want to go in the future. We’ll consider the world around you (e.g., relationships, situations) and the world within you (e.g., thoughts, feelings). Following this discussion, I’ll be able to provide feedback about why you may be in this position and suggest possible pathways we could explore to help you get to where you want to go.

In order to be able to gather enough information and provide some amount of feedback, I generally recommend scheduling a 75-minute initial appointment, although standard 50-minute appointments are also an option. Depending on what’s happening for you, this assessment phase could take more than one appointment.

For children, it is common that parents are the primary participants in the first appointment, while for teens, parents may be partially involved based on individual preference and level of involvement in the concerns. Read more about how I approach including loved ones or family members here.

Due to the importance of ensuring appropriate support, completing an assessment does not guarantee further services. If I feel I cannot adequately support you, I will do my best to point you towards other services that may be a better fit. Back to Top.

What is a transdiagnostic approach and why do you prefer it?

The use of diagnosis emerges from the application of a medical model to mental health. However, psychological problems are not solely medical problems. The mind is highly complex and difficulties emerge from a combination of genetic risks, personality traits, biological factors, past experiences, environmental challenges, ongoing stressors, lifestyle choices, and psychological processes (e.g., ways of responding to thoughts and feelings).

While diagnoses can help identify risks, common patterns, and potential solutions, there are many limitations to placing emphasis on them in therapy. People commonly experience challenges that overlap with multiple diagnoses and trying to apply rigid labels or treatments to these dynamic experiences can be very limiting. I also explore the downsides of over-identifying with a diagnosis in this article.

In contrast, a transdiagnostic approach focuses on shared factors and processes that underlie and contribute to challenges. This allows for the learning and application of skills that are not limited to a single area and provides for a treatment experience that can be adjusted to each individual’s unique needs. Back to Top.

What does therapy involve?

Therapy is a process that we work through together. Generally, therapy involves exploring, understanding and adjusting the ways you respond to your experiences in order to help you move toward the life you want for yourself and the person you want to be. This can include learning strategies to manage your thoughts, beliefs, sensations, emotions, attention, behavior, health, relationships, and/or environment.

Each time we meet we’ll first review how things have been going for you. We’ll then spend time exploring a topic, learning a new strategy and/or practicing something that will help. We’ll finish by identify things you’ll work on between sessions so that you keep making progress. Since we only have a limited time together, it is essential that you dedicate time to applying your learning in your daily life. Back to Top.

How often will we have therapy sessions?

Ultimately this is up to you and dependent on your circumstances; however, most commonly, people participate in one 50-minute session/week when first starting therapy. This provides a consistent opportunity to check-in, learn new skills, apply them to daily life, and then problem-solve difficulties. Once you have more skills and you begin to improve, it is common to gradually increase the time between sessions to allow for additional practice and increasing independence.

For individuals who are struggling and want more immediate support, longer or more frequent sessions are also possible. Evidence suggests that engaging in this type of intensive approach to therapy can lead to more rapid improvements.

Is therapy difficult or unpleasant?

Like any activity that requires developing new skills, therapy can definitely be difficult or unpleasant. Our work together will likely require discussing private experiences and exploring beyond your comfort zone, where uncomfortable sensations, upsetting thoughts, or painful emotions may arise.

However, if you are struggling, you are likely already frequently in contact with these same difficult experiences. In this way, therapy can also be interesting, rewarding, and enjoyable. As you engage in the tools and practice them, you may discover new ways on handling things that offer new experiences of insight, freedom, control, enjoyment, or satisfaction. Ultimately, therapy is intended to help you more effectively navigate through difficult experiences towards the life you want. Back to Top.

Will I be forced to do anything in therapy?

In therapy we work together as a team. You will not be forced you to do anything (even if it’s something other people want). At the same time, we will explore reasons you might want to change and I will offer you opportunities and encouragement to try out new strategies that we’ve figured out will be helpful for you.

How long does therapy last?

Therapy does not seek to “cure” difficulties, but typically ends when you feel you have the strategies to manage challenges as they arise and you can live well. Your goals and preferences for treatment will determine what that looks like for you and you are free to stop at any time.

A number of things can influence how quickly therapy works and how many sessions you complete. Some of these things are outside of your control, such as:

Younger people tend to benefit from treatment more quickly than older people
Small, simple problems resolve faster than big, complex problems
Therapy is easier if your life is stable and you have good support systems

However, you can increase the likelihood that you benefit from therapy by:

Taking Ownership: Approaching treatment as your opportunity to improve your life
Practicing Openness: Trusting the process and trying things, even if they are scary or hard
Acting Consistent: Showing up, giving your best, and applying the strategies regularly

People commonly participate in anywhere between 5-30 sessions. Sometimes people start therapy focused on one area, but transition to focus on another area as they improve or as their priorities shift. Sometimes people end treatment and manage things independently for a while, but come back when something new or difficult arises. Back to Top.

How does therapy end? Can I come back at a later time?

When you’re ready to discontinue, we’ll review all the things we learned together and develop a plan for how you’re going to continue on your journey independently so that you feel prepared to cope even if things become more difficult in the future. If you need help again at a later time, you will be welcome to reach back out for support. How quickly you can be seen again will depend on my availability at the time. Back to Top.

Will I get better in therapy? Do you have any guarantees?

Due to the complex nature of psychological problems, I cannot guarantee that the services I provide will be effective for you and, to be honest, you should be skeptical of any provider who does guarantee their services will work.

That said, we have lots of evidence that demonstrates how therapy can have a significant positive impact. Talking with someone who listens and understands can help you feel less alone, confused, or frustrated. You may begin to understand yourself and your experiences better and gain skills that help you manage things more effectively. Knowing that you have someone to talk with can also be helpful in managing tough moments and staying committed to making positive changes.

The approaches to therapy we will use are based on clear and well-established scientific principles and have been found to be safe, well-tolerated and, for most people, beneficial. For example, people typically report less unpleasant experiences, more success in daily tasks, and greater satisfaction with life following these types of therapy. However, it is important to keep in mind that therapy is not an immediate or straight-forward process, it can take time to improve and problems may get worse before they get better.

Despite all this research, I still can’t say it will definitely work for you. Some people do not benefit and you could be one of those people. If you do not benefit from treatment, it is possible you will feel more frustrated with your challenges than you do now. The only thing I can guarantee is that I will do my best to help you in the ways that I know how. Ultimately, you will have to decide what is better for you: to keep managing things the way that you are or to take a risk and try something new. Back to Top.