Helping women help themselves: Brief Psychotherapy Centre for Women stands the test of time

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From the Brief Psychotherapy Centre for Women, Women’s College Hospital

“[Therapy gave me a] clearer understanding of my sense of powerlessness, when I am triggered by race/class…Confidence in my right to have and express feelings even when they are not mainstream or popular… I am now able to enter a situation [white middle class] without feeling “less than” or judged. When these fears do arise, they are less powerful and I am able to identify what is happening and recognize it as a historical trigger. As a result of this therapy, I feel I am able to move forward in [the] pursuit of [my career], which I did not feel equipped to do before.”

- Woman speaking about her experience at the Brief Psychotherapy Centre for Women in Toronto

A mental health centre based on feminist principles and geared specifically for women is a rarity in Canada, which makes Toronto’s Brief Psychotherapy Centre for Women a model that deserves our attention and support.

Using a feminist, community-based approach to mental health for women, the Centre, part of Women’s College Hospital in Toronto, has completed therapy with over 2,200 women since it opened its doors in 1988.  A self-managed team of women psychotherapists provides non-medical, time-limited psychotherapy by developing and implementing a “relational-cultural” mental health model designed specifically to meet the needs of women.

“Our philosophy and focus of therapy is the empowerment of women,” says Shirley Addison, psychotherapist. “Unfortunately, this is the only program of its kind in Canada, with its distinctive time-limited relational-cultural model of therapy at a centre for women.”

Brief feminist psychotherapy is a specific type of therapy. Focused and time-limited, it deals with particular problems or issues that women identify themselves. A woman refers herself to the Centre then works with a therapist to set goals that they will both work toward over the course of therapy.  “That structure reinforces that women can identify issues that are important to them, set goals, work toward them and have the power to create change,” says Joyce Curry, psychotherapist.

In the words of one former client: "[The therapist was] very empathically minded—not just toward me, but for the people I was having trouble with; I got a real sense of the humanity of all the people.”

Women may choose individual psychotherapy consisting of 50-minute sessions each week for 16 weeks or group psychotherapy consisting of 90-minute sessions each week for 20 weeks. Both options include assessment sessions to determine suitability of the program, and two follow-up sessions approximately three months and a year after therapy has concluded.  In addition, women who have completed individual therapy may refer themselves to a 12-week group at the Centre.

Brief Relational Cultural Therapy (BRCT) is based on Relational-Cultural Theory (RCT), which is a model of psychological development that considers gender, power and cultural factors within a relational context. The model evolved from the seminal work of Jean Baker Miller published in 1976 called Towards a New Psychology of Women. This approach locates the source of mental health difficulties, as well as their solutions, within both interpersonal relationships and societal structures. 

This therapy examines the ways in which gender and other sources of inequity (race, socio-economic status, cultural differences, education, sexual orientation, age, ability, immigration, etc.) create differences in power, status and privilege, which affect the dynamics and quality of relationships and, in turn, the mental health of individuals. Therapy works toward empowering women to shape their relationships toward increasing equity, mutuality, and authenticity, that is, to develop more complex, growth-fostering relationships based on mutual empathy and mutual empowerment. This includes paying special attention to the pressures a woman may face in different aspects of her life—as a partner, worker, mother, daughter and friend—and how these roles affect well-being and physical and mental health.

The time-limited psychotherapy program includes an integrated evaluation process that is also client-driven. Women measure their therapeutic outcomes on a goal attainment scale at the mid-point and end of therapy. They also evaluate the program in a structured written narrative and program evaluation questionnaire. A recent review of the Centre found that 87% of the women clients reported improvement beyond their stated goals, and 72% reported that they took better care of their health since participating in psychotherapy.

The success and longevity of the Centre makes it an important model for others to emulate. Two key factors in the Centre’s success are the evidence-based, feminist therapeutic approach and a firm community foundation—a combination that has clearly stood the test of time.

As for community input, the Community Advisory Committee consists of 12 members of local community agencies and other sectors, former clients and a board member from Women’s College Hospital—providing input and support to the Centre’s programming and operations.

The Brief Psychotherapy Centre for Women serves a diverse clientele in terms of: ethnicity, race, age, socio-economic status, sexual orientation, religion, educational level, employment, health status, reflecting the population served within Toronto’s Central Local Health Integration Network (LHIN). Service is provided in English only, although Francophone clients have used the services.

While self-referral is a requirement, women often hear about the Centre from healthcare practitioners, including family physicians, hospitals, community and mental health agencies and former clients, their families and friends. Clients arrive at the Centre with a broad range of mental health problems, both complex and usually longstanding. Issues include: relationship issues, impacts of sexual, physical, or emotional abuse, depression/anxiety, loss and isolation, health/illness, aging, self-esteem, body-image, parenting, employment, education, financial, and stress related to poverty, work, legal issues, discrimination/cultural adjustment, among others.  The Centre does not serve women with severe and active substance use problems or dependence, acute psychosis or those who require crisis intervention.

In recognition of the model’s effectiveness and the gaps in research, the Ontario Women’s Health Council funded a research project to study the Centre’s approach. According to Jane Pepino, the Council’s Chair at the time, “the assessments provided in the study contribute to meeting a vital need in women’s health research: models for best practice in women’s health. We need models such as these in order to develop a health care system that is equitable and accountable to the women it serves” (2004).

Through client interviews and psychometric questionnaires, the study found that clients at the Centre improved significantly on all outcome measures, and that these improvements were “virtually all maintained at three and six months following therapy.” Results indicated “outstanding client satisfaction with the model of therapy and clarity about their process of change.”

Part of the research process included the development of an adherence scale and a manual to measure the adherence to the Centre’s therapy model by therapists, which is in the process of being modified to create a BRCT training manual for publication. “The findings clearly showed that BPCW is an effective standardized psychotherapy practice in the treatment of women who present with diverse mental health issues,” says Anne Oakley, psychotherapist & Coordinator. “Given the waiting-list of 12-16 months, ideally the BPCW-BRCT model would be expanded and replicated in other settings.”

For more information, visit:

Brief Psychotherapy Centre for Women website