Depression Counselling in Vancouver — Depression Therapy with a Registered Clinical Counsellor - Dr. Samuel

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Depression counselling in Vancouver built on the largest evidence base in psychotherapy

Talk to Samuel directly. No receptionist, no intake forms. Call 604-721-0604 · Text what is going on · Book a free 20-minute call. In-person in downtown Vancouver or by video across BC; evenings available.

Depression responds to treatment, and the type of therapy matters less than starting

Major depressive episodes have become more common in Canada: Statistics Canada reports the 12-month prevalence was “up from 4.7% in 2012 to 7.6% in 2022” (Statistics Canada, 2023, para. 3). The same study found that among Canadians meeting criteria for a mood, anxiety or substance use disorder, only “about half (48.8%) reported that they had talked to a health professional about their mental health in the previous year” (Statistics Canada, 2023, para. 10).

The research on psychotherapy for depression is unusually large. A network meta-analysis of 331 trials found that “all therapies were more efficacious than care-as-usual and waiting list control conditions, and all therapies – except non-directive supportive counseling and psychodynamic therapy – were more efficacious than pill placebo” (Cuijpers et al., 2021, p. 283). Its authors concluded that “the most important types of psychotherapy are efficacious and acceptable in the acute treatment of adult depression, with few significant differences between them. Patient preference and availability of each treatment type may play a larger role in the choice between types of psychotherapy” (Cuijpers et al., 2021, p. 283).

What depression counselling in Vancouver looks like here

Session one. The first session separates what kind of depression this is: a first episode or a recurrence, a reaction to loss or a relationship, a low mood that rides on untreated ADHD or chronic poor sleep, or a long-standing pattern. Safety is assessed directly and respectfully.

The method. Cognitive behavioural therapy and behavioural activation form the spine of treatment because they carry the largest evidence base. The largest meta-analysis of a single psychotherapy ever conducted found that “CBT had moderate to large effects compared to control conditions such as care as usual and waitlist (g=0.79; 95% CI: 0.70-0.89), which remained similar in sensitivity analyses and were still significant at 6-12 month follow-up” (Cuijpers et al., 2023, p. 105). Where depression is rooted in early experience or self-criticism, Samuel integrates schema therapy and Internal Family Systems; where the relationship is the driver, couples work is offered alongside. Neurofeedback is available as an adjunct for low energy and poor concentration.

Therapy, medication, or both. The Canadian guidelines (CANMAT) adopt “a personalized care approach that emphasizes shared decision-making that reflects the values, preferences, and treatment history of the patient” (Lam et al., 2024, p. 641). On the comparison itself, Cuijpers et al. (2023) found that “CBT appears to be as effective as pharmacotherapies at the short term, but more effective at the longer term” (p. 105), and that combined treatment “was not more effective than CBT alone at either time point” (p. 105). Samuel does not prescribe; when medication is on the table he coordinates with your family doctor or psychiatrist.

Common reasons people come

Low mood that has lasted weeks or months; loss of interest and energy; waking early and not getting back to sleep; irritability that is straining a marriage; burnout that has tipped into hopelessness; depression after an injury or a crash (ICBC and CVAP sessions are funded, see ICBC counselling); depression that sits with anxiety (see anxiety counselling).

Your depression counsellor

Samuel Ezzatilord, PhD, RCC, CCC, LMCC, is a Registered Clinical Counsellor (BCACC #23405) and Canadian Certified Counsellor with more than 25 years of clinical experience. His doctorate in health sciences means sleep, medication and physical-health questions are part of the plan. He works to the CANMAT standard of “a collaborative, personalized, and systematic management approach” (Lam et al., 2024, p. 641).

Frequently asked questions

Does counselling work for depression?

Yes. Across 409 trials, “the efficacy of CBT in depression is documented across different formats, ages, target groups, and settings” (Cuijpers et al., 2023, p. 105), and across all major therapy types “all therapies were more efficacious than care-as-usual and waiting list control conditions” (Cuijpers et al., 2021, p. 283).

Is therapy as good as antidepressants?

The evidence says comparable short term and better long term for CBT: it “appears to be as effective as pharmacotherapies at the short term, but more effective at the longer term” (Cuijpers et al., 2023, p. 105). The right choice is personal; CANMAT recommends “shared decision-making that reflects the values, preferences, and treatment history of the patient” (Lam et al., 2024, p. 641).

Which type of therapy is best for depression?

Differences between the main therapies are small. Cuijpers et al. (2021) found “few significant differences between them” and that “patient preference and availability of each treatment type may play a larger role” (p. 283). Samuel starts with CBT and behavioural activation and adds schema therapy or IFS where the history calls for it.

How long does depression counselling take?

It depends on severity and history; the free 20-minute call gives you a realistic estimate. Trials report that CBT effects “were still significant at 6-12 month follow-up” (Cuijpers et al., 2023, p. 105), which is the kind of durable change treatment aims for.

Do I need a diagnosis or referral first?

No. You can book directly. If a formal diagnosis or medication review is useful, Samuel will say so and coordinate with your doctor. CANMAT guidelines “map a patient care journey from assessment to selection of evidence-based treatments” (Lam et al., 2024, p. 641).

Is depression counselling covered in BC?

Fees and expenses are covered by ICBC, CVAP, FNHA, IFHP, RCMP, VAC, and most other insurers, and direct billing is available. Most extended-health plans reimburse RCC sessions.

Can I do it online?

Yes. In person in downtown Vancouver or by secure video across BC. CBT was found effective in multiple formats, including as “unguided self-help intervention (g=0.45; 95% CI: 0.31-0.60)” (Cuijpers et al., 2023, p. 105); therapist-led sessions remain the standard of care.

What if I’m not sure it’s depression?

That is a good reason to call. Statistics Canada found that “counselling (43.8%) topped the list of the most common form of mental health care received by people with a mental disorder” (Statistics Canada, 2023, para. 12). The first conversation is free and sorts out whether this is the right place.

What happens when you call

The first conversation is a free 20-minute phone call with Samuel Ezzatilord, PhD, RCC, CCC, LMCC (RCC #23405). You describe what is going on; he tells you plainly whether what he offers fits and what a first session would involve. Sessions are available in English and Farsi, in person at Suite 1300, 1500 West Georgia St, Vancouver, or by secure video anywhere in BC. Fees and expenses are covered by ICBC, CVAP, FNHA, IFHP, RCMP, VAC, and most other insurers, and direct billing is available.

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References

Cuijpers, P., Quero, S., Noma, H., Ciharova, M., Miguel, C., Karyotaki, E., Cipriani, A., Cristea, I. A., & Furukawa, T. A. (2021). Psychotherapies for depression: A network meta-analysis covering efficacy, acceptability and long-term outcomes of all main treatment types. World Psychiatry, 20(2), 283–293. https://doi.org/10.1002/wps.20860

Cuijpers, P., Miguel, C., Harrer, M., Plessen, C. Y., Ciharova, M., Ebert, D., & Karyotaki, E. (2023). Cognitive behavior therapy vs. control conditions, other psychotherapies, pharmacotherapies and combined treatment for depression: A comprehensive meta-analysis including 409 trials with 52,702 patients. World Psychiatry, 22(1), 105–115. https://doi.org/10.1002/wps.21069

Lam, R. W., Kennedy, S. H., Adams, C., Bahji, A., Beaulieu, S., Bhat, V., Blier, P., Blumberger, D. M., Brietzke, E., Chakrabarty, T., Do, A., Frey, B. N., Giacobbe, P., Gratzer, D., Grigoriadis, S., Habert, J., Husain, M. I., Ismail, Z., McGirr, A., … Milev, R. V. (2024). Canadian Network for Mood and Anxiety Treatments (CANMAT) 2023 update on clinical guidelines for management of major depressive disorder in adults. The Canadian Journal of Psychiatry, 69(9), 641–687. https://doi.org/10.1177/07067437241245384

Statistics Canada. (2023, September 22). Study: Mental disorders and access to mental health care. The Daily. https://www150.statcan.gc.ca/n1/daily-quotidien/230922/dq230922b-eng.htm