Frequently Asked Questions

The most common questions about our services are listed below, categorized as administrative or clinical in focus. Have a question that isn’t answered here? Feel free to contact us directly.

ADMINISTRATIVE QUESTIONS


How does your clinic operate?

The Refuge is the operating name of the Schlote Psychotherapy Professional Corporation, owned by Sarah Schlote, MA, RP, CCC, SEP. Sarah is a Registered Psychotherapist in good standing with the College of Registered Psychotherapists of Ontario, and the corporation has an active certificate of authorization from the CRPO.

Each practitioner at The Refuge operates their own independent business from the premises. As a result, it is important to know that Sarah Schlote has a business relationship with each of them as sub-tenants.

The therapists operating at The Refuge are specialized in working with trauma and attachment-related issues and have been invited to operate here because of the specialized nature of the clinic. Often, clients may see more than one therapist at The Refuge at once, such as attending individual counselling with one therapist and couples counselling with another. Seeing therapists who share theoretical perspectives and use similar approaches can help streamline your overall experience and facilitate treatment planning and coordination with your various providers. It is for this reason that The Refuge was created, and many of our clients appreciate the “one stop shop”, integrative wraparound care they receive here, in terms of the ease of effort it provides them.

However, there is no obligation for you to work with other therapists on the team, and you are more than welcome to work with other therapists in the community for other aspects of your care. We are also happy to coordinate care with your existing therapist if you have one, or refer you to someone offsite who might be a better fit for whatever reason should you require additional support. This will not affect your care with your therapist here in any way. We value your choice, voice and empowerment, and strive to embody these principles of trauma-informed care by upholding and respecting your right to self-determination in making decisions that are right for you. Thank you for your trust in us.


How do I make an appointment?

There are a number of ways to approach us to access services at The Refuge. The first is to call the toll free number to do an intake call for the purposes of answering any questions you might have and work sort out which practitioner(s) will be following up with you. The direct therapist will contact you directly so you can have an initial phone consultation (ranging from 10-30 minutes) to make sure it feels like a good fit before booking a first session.

Alternately, you may call any of the practitioners here directly, whose numbers are available on their page on the website. If contacting a therapist directly, please let them know how you found out about us.


Do you offer a free initial session?

New clients typically obtain a free intake call (10-30 minutes) prior to booking a first session in person, in order to make sure it feels like a good fit and to answer any questions you might have. Due to demand for services, we are usually unable to provide free initial sessions in person at this time.


Are your services covered by OHIP?

The only services covered by OHIP are medical doctors (whether general practitioners, psychiatrists or other specialist MDs).


Are your services covered by insurance?

It depends on what is covered by your extended health benefits, as each plan and insurance company is different. The most common ways our services are covered are as follows. Please ask your insurance company if any of the following apply:

  • Registered Psychotherapist (College of Registered Psychotherapists of Ontario – applies to 3 of our practitioners)
  • Master’s-level therapist (applies to 4 of our practitioners)
  • Clinical Counsellor (Sarah Schlote and Angela Herzog are certified counsellors through the Canadian Counselling and Psychotherapy Association)
  • Registered Marriage and Family Therapist (Kristina Baré de Vos)
  • Registered Social Worker (Kari Kokko)
  • Registered Occupational Therapist (Melody Lynden)
  • Services under supervision of a Registered Psychologist (Sarah Schlote, Angela Herzog and Kristina Baré de Vos work as associates of Dr. Shari Geller of the Centre for MindBody Health)
  • Health spending account (applies to all our practitioners)

Prior to booking, please confirm with your insurance provider what coverage you have available, how much per calendar year, whether you need a referral from a medical doctor, etc. Typically, clients pay therapists for their services and submit receipts for reimbursement.

Advocating for RP Coverage: Since the College of Registered Psychotherapists of Ontario is still relatively new, many insurance companies, such as SunLife, have not updated their policies to include Registered Psychotherapists (RPs). However, some have begun doing so – Manulife is one of them. Also, some insurance companies are willing to consider approving individual practitioners on a case by case basis, even if a particular designation is not formally listed in a particular benefits plan. We’ve had some success with certain insurance companies who have approved our practitioners on an exception basis once they review our qualifications and specializations, which is something you could inquire about. For instance, Sarah Schlote is a registered provider with Green Shield, which occurred after a client submitted her credentials to their insurance company.


Are you registered with an EAP (Employee Assistance Plan)?

Our practitioners are not registered with any EAPs, but we do accept clients who have been awarded support via Victim Services or the Criminal Injuries Compensation Board.


Do you take credit card payments or have a sliding scale?

Each of our practitioners has their own payment policies, rates and scale. Please contact the practitioner you are interested in working with or visit their personal website to find out more information.


What are your office hours?

Each of our practitioners has their own schedule, and visiting the office to meet with us is by appointment only. However, you are welcome to visit the grounds, walk the trails or the labyrinth, or find a sit spot for quiet contemplation surrounded by nature without an appointment.


What do I need to do to prepare for my first session?

Each of our practitioners operates their independent business at The Refuge, and has their own intake forms and policies. Please visit the website of each practitioner to learn more about how to prepare for your first session if this has not already been discussed with you by phone. Be sure to review the directions to our offices on our Contact page.


What are your rates?

Each of the practitioners operating at The Refuge has their own rates. Some have to charge HST, others do not. For more information about each person’s rate scale, please click on their page under Our Practitioners, and then click on their informed consent form under the Policies and Forms tab. The hourly rate for direct services is in the $120-$150/hr range, and each therapist offers a sliding scale based on financial need at their own discretion. If you are accessing services here as a client of Dr. Shari Geller, registered psychologist, a different rate scale applies. Feel free to discuss this with Dr. Geller or your treating therapist.


Do you work with children and teens?

Yes we do. The Refuge currently has a family therapist who offers services for younger clients as well as their caregivers. For more information, please click here or see Tiffany Burtch‘s page for more information.

Please note that equine-facilitated therapy services through The Refuge are only offered to individuals aged 16 and up at the present time.

CLINICAL QUESTIONS


I want to try to resolve what is going on for me without medications. Will you support me in that?

Absolutely. We work with people in a wide variety of situations, ranging from those who are on medications (and find them helpful), to people who are wanting to wean off, to people who are not on any at all and refuse to go that route. While we believe that medications are in many cases over-prescribed and that healing can come from within when working with the mind-body connection in psychotherapy, we also recognize there may be instances in which medications can be helpful for emotional stabilization temporarily until you have developed the internal capacity, resources and resiliency to cope without them.


I don’t know if I have trauma, but I do struggle with chronic stress, grief and loss, relationships, anxiety, anger, etc. Can you still help me?

Absolutely. Trauma is not the only explanation or reason for many mental health and addictions challenges, although it is a common one. Usually by the end of the first couple of sessions, we are able to get a sense about how your experiences or that of your ancestors may have shaped you and be contributing to the emotional, physical, relational and spiritual challenges you are facing today, and come up with a plan and goals. Some people are hesitant to acknowledge trauma because they associate that word with victimhood or weakness and they do not feel victimized, or their definition of trauma is limited to the narrow range represented by PTSD. At The Refuge, we use a broader definition of the term that does not imply failure, defectiveness or pathology and is not limited to shock trauma. We don’t look at what is wrong with you, but instead what has happened to you and how you’ve adapted to survive, and how we can support you to heal and move forward. Sometimes, especially in the case of pre-verbal experiences that may have happened before conscious memory was laid down, we don’t get a full picture of the “cause” of a particular symptom. However, we don’t always need to know the “why” to be able to help you with the “what”.


I’ve been to lots of therapists and have had to tell my story over and over again and nothing’s really changing. I’m also concerned about doing body-focused trauma work and that it will be overwhelming. What makes you different?

Your experience and concerns are very common and make sense. Trauma and body-oriented work are a specialization that requires great sensitivity and skillfulness to be done safely and effectively. Many traditional or talk-based therapists or counsellors will encourage talking about a traumatic event to “face it”, but talking about something is not the same thing as processing it and, in fact, may do more harm than good in some cases. Some may focus on trying to cognitively address your symptoms, even though those symptoms are in the body and nervous system and may be addressed more effectively using other methods. Others will ask you to focus internally on your body or breath too quickly before you are ready, which may also be harmful. In either case, you may have found yourself flooded, overwhelmed, triggered, and having to override or disconnect in order to cope with therapy, which defeats the purpose.

At The Refuge, our practitioners are committed to ongoing professional training in the area of trauma and attachment, obtaining clinical consultation/supervision and to doing their own personal work to ensure the highest standard of therapeutic care.

Our practitioners are also committed to supporting your safety, choice, voice and empowerment. Know that you can always refuse body-oriented approaches in your work with us, and that we have many other modalities at our disposal that we can use in our work together. Or you may be curious about body-focused work but want to proceed slowly – and we agree with this too. The first step is always building trust and rapport with one another, and working in a titrated way from where you are at, regardless of what approach we use. Titration implies doing a little bit at a time, respecting your limits and comfort level, to help you develop the internal capacity and self-confidence to gradually tolerate more, so that you don’t need to put so much effort into managing things all the time (“using your energy to control your energy”). It’s like learning to drive a car – you need to know how to work the brake pedal before being able to press down on the gas and enjoy the freedom of driving. Similarly, we don’t want to toss you into the deep end of the pool before you know how to swim.

This involves learning the internal self-regulation skills to ground yourself and help you modulate your emotions and physical arousal, so that feelings, sensations and being in your body are not as overwhelming or scary. It can be a pleasant surprise to feel your emotions or sensations without fear, bracing, worrying, panic or avoidance and ride them out until they dissipate and still be ok. This is especially important if your feelings have felt out of control or you have kept things tightly guarded or controlled, or learned to disconnect or dissociate in order to cope. You may struggle with hyper-arousal (a high amount of anxiety/panic/hypervigilance, anger/rage, or speedy energy and difficulty settling) or hypo-arousal (flat, disconnected, numb, tired, foggy), or caught between extremes, and so finding a more flexible mid-range that isn’t so stuck, rigid or exhausting is an important step.

Working with trauma for some people may then involve the renegotiation of a traumatic or stressful experience to release, discharge or complete it in an embodied way in the present (also known as “unwinding” in certain circles). This is not the same as catharsis, re-enactment or re-living it, which are rarely useful. Renegotiating means being able to work through the leftover charge from difficult experiences differently. This often involves gradually thawing out of freeze/fear and into feeling more empowered to move physically or respond emotionally in the way you need to in order to self-protect (or would have wanted to in the past but were prevented from doing – mobilizing fight/flight responses). Our goal is to help you feel a sense of joy, mastery, embodied empowerment and triumph in your life experiences and sense of self, as opposed to re-enacting a familiar sense of fear, anxiety, overwhelm and defeat. You may be ready to do this work off the get-go, or this can be the culmination of a process of careful preparation at your own pace.


Do I need to tell you the details of my story in order for you to work with me?

Telling the details of your story over and over again can be exhausting and triggering. Having at least a general sense of some of the experiences you’ve had without going into specific details of events is often enough for us to begin working together towards your goals. You always have choice about how much you disclose in your therapy and what your goals are – at The Refuge, therapy is not “done to you”, but is a collaborative process that respects your integrity and right to self-determination. And if you are one of the many people who has kept silent for a long time and do want to share your story, or if in our work together you feel more confident and ready to process a particular memory, know that we are here to bear witness to your experience and will help you work through in a way that is emotionally safer, with the aim of renegotiating and completing it.


Do we need to drag up old memories in order for me to heal?

Like we mentioned above, simply talking about past experiences and memories is rarely useful if we are not helping you work through and clear the residual charge attached to those experiences. Rest assured that our goal is not to go on a witch hunt to open up repressed memories directly just for the sake of it without your consent. There’s a good reason you’ve been keeping certain emotions and sensations buried, and that’s a sign that we can do some good work together on helping you build the skills to feel less victimized by your internal experience so you’re not living in fear of what’s inside and hidden away.

There are ways we can support your healing process to a certain degree without delving too deeply into the past. For example, the body holds memory and sometimes a physical response can arise and be worked through that doesn’t seem connected to any particular conscious experience. We can also work together in the present moment to build skills that will helpful for you to move forward, without any deeper processing of past events. However, if a spontaneous memory or connection to past experiences does arise in our work, or if you have a specific goal of wanting to work on a particular memory or experience, our focus will again be to help you work through that in a way that is less overwhelming. Instead of feeling isolated or left to flounder alone helplessly in it, which may be familiar and what you went through at some point in the past and want to avoid, we aim to offer you the support, attunement and presence you need emotionally and physically to get through what is coming up for you in a more empowered and transformative way. As Dr. Peter Levine says, “trauma is a fact of life, but it doesn’t have to be a life sentence.” Things can be different.

PROFESSIONAL INQUIRIES


Do you have time to talk to me or offer advice as I start my career?

We often get inquiries from students or new therapists who are enthusiastic about embarking on their professional paths. Feel free to reach out to any of the practitioners at The Refuge to inquire about consultation in this area. The regular hourly rate usually applies. Please keep in mind that this is a busy clinic, and our schedules are dedicated to client sessions and post-session follow up, so pro bono career consulting or free business advice is not typically possible. Investing in consulting, coaching or mentoring is usually possible to write off as a business expense for tax purposes, so be sure to inquire with your bookkeeper or accountant for more information.


Do you take practicum students?

This is a common question, and we wish we could support the growth of future therapists in this way! However, because we are so specialized in what we do, clients who seek out our services are looking for advanced level practitioners, so we wouldn’t be able to provide students with the required hours of direct client contact (providing therapy) required for practicum programs. We do encourage you to look into the topics on our website further, and explore additional training in these areas. Specializing is a lifelong process of continuing education that doesn’t end with a master’s degree, and we are glad that our work is inspiring to others.

EquuSpirit The Refuge Trauma Trainings

© 2013 –   Sarah Schlote.

The Refuge and EquuSpirit are registered trade names of the Schlote Psychotherapy Professional Corporation