Thanks to one entrepreneur, Cognitive Behavioural Therapy (CBT) is breaking out of offices and onto screens across Ontario.

The online service, Tranqool, allows clients to receive online video therapy from the comfort of their own home. The therapy offered—Cognitive Behavioural Therapy (CBT)—focuses on challenging patterns of thought that lead to unwanted behaviour and negative feelings. CEO and founder, Chakameh Shafii came up with the idea after she heard a report on the radio about the large number of Canadians suffering from mental health issues. For Shafii, who once turned to CBT for her anxiety, that moment was a tipping point.

She called a friend who was having trouble finding a therapist outside of work hours. They agreed that there had to be a way to make therapy more accessible. For her, it was only logical to use modern communication technology—something traditionalists have not yet embraced. "We're disrupting the industry to an extent but we're disrupting it with something people are already used to," Shafii explains.

Familiarity with tools like Skype and Facetime stretch across several generations, and Shafii says TranQool's interface is just as easy. All you need is a computer with Internet access and a couple minutes to register. It also provides the luxury of choosing your therapist from a list of mental health professionals, each with a detailed profile. After you've matched with a service provider, you're brought to a page where you can book an appointment. When it's time for your session, you simply log back in and click "Start Your Session."

Dawn Zivanovich, a clinical social worker who's been with Tranqool from the start, says age isn't necessarily a disadvantage when it comes to navigating technology. "If you're 88 you've seen a lot of changes in your life," she says. "Older people can learn whatever they need to."

Tranqool's success also hinges on the effectiveness of online CBT. Initially, there was concern that therapists would have difficulty making that all-important connection with their patients. Zivanovich, however, calls the jump to online therapy "seamless." Research on the topic seems to confirm that assertion. According to an evidence-based review in the Canadian Medical Association Journal, patients who used Internet-delivered CBT had equal or better outcomes than those who received traditional in-person therapy.

Shafii says the service also lessens the effect of the stigma surrounding mental illness, which often prevents people from seeking service. Clients who are too embarrassed about seeking help no longer have to talk to a long list of strangers before they receive therapy. Instead they're provided a direct line to their therapist from the privacy of their own homes.

The symptoms of mental health issues, like depression, can also become a barrier to the service. "A lot of times, our clients don't have as much energy to physically get up and go to a clinic to see a therapist," Shafii explains. "So for them it makes a lot of sense to do it in the comfort of their own home."

For many older clients with mobility issues, video therapy is less of a convenience and more of a necessity. Shaffi says that senior clients often feel like a burden when they have to rely on family members to drive them to appointments. With TranQool they're able to seek and receive service independently.

Zivanovich says that seniors often have difficulty with the transition into retirement. "People automatically think 'this is going to be great, I'm going to love it,' and then after about three months they don't know what to do with themselves," she says. To ease the transition she helps them to establish a plan going forward, involving a new set of goals.

And, with regards to fixed incomes, Shafii has also made therapy more accessible financially. TranQool only charges $80 per session for a social worker and $120 for a psychologist, which is about $100 dollars less than what you might pay for in-person therapy.

For her, everything from the platform she chose to the pricing was driven by her hope that others could experience what she had in therapy. "The impact of having someone to talk to and to teach me skills was really significant," Shafii says. "It was just life changing."

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CBT tips

Record your thoughts
You have a lot more control over how you feel than you might think. When you're at your worst, make a list of your thoughts. Often you'll find self-defeating statements that may be driving the way you feel and behave. Replace these negative thoughts with statements that are more realistic and goal-oriented. For example, you might replace "I want to get out of bed, but I'm too tired" with "I'm tired, but let's get up and see how I feel." While this is a simplistic example, it demonstrates how thoughts often impact our mood and behaviour. Changing thoughts that steer us down the wrong path begins with becoming more aware of them.

Practise mindfulness
And we do mean practise. "You can't become mindful overnight," Zivanovich says. "It takes a deliberate commitment." But she also says practising can be as simple as looking around and noticing what you see. On a deeper level, you can become more mindful of your emotions. So the next time someone cuts you off on the way to work, you might detach yourself from your anger. When you become aware of your emotional reaction, you can gain control over the resulting behaviour. Mindfulness can also help with anxiety as focusing on things around you can ground you in the present.

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