Our Services

Services We Offer:

(click on each service for more info)

Psychiatric Assessment

Duration: 2 hours with nurse; 1 to 1.5 hours with a psychiatrist 

Cost: $750

Medical referral required for psychiatry

This assessment is a comprehensive evaluation, conducted by a licensed psychiatrist, to assess an individual’s mental health, emotional well-being, and psychological functioning. It involves gathering information about the person’s symptoms, medical history, psychosocial background, and any relevant factors that may contribute to their mental health concerns. The assessment aims to establish an accurate diagnosis and develop an appropriate treatment plan. 

psychiatry-and-neuropsychology-

Here are the key components typically involved in a psychiatric assessment: 

  • Clinical Interview: The mental health professional will conduct a structured or semi-structured interview with the individual to gather information about their current symptoms, past mental health history, family history, medical history, psychosocial stressors, and any other relevant factors. The interview may cover a wide range of topics, including mood, thoughts, behaviors, relationships, and daily functioning. 
  • Mental Status Examination: A mental status examination involves assessing the individual’s current mental state and functioning. It includes evaluating their appearance, behavior, speech, mood, affect, thought processes, cognition, and insight. This examination provides insights into their immediate mental state and helps guide the diagnostic process. 
  • Psychiatric Rating Scales and Questionnaires: Standardized rating scales or questionnaires may be used to assess specific symptoms, severity, and the impact of mental health conditions. These measures can include self-report questionnaires completed by the individual and observer-rated scales completed by family members or other caregivers. 
  • Medical Evaluation: A medical evaluation may be conducted to rule out any underlying medical conditions or physical health issues that could be contributing to the individual’s mental health symptoms. This may involve reviewing medical records, conducting physical examinations, or ordering laboratory tests.
  • Psychosocial Assessment: Understanding the individual’s psychosocial context is essential for a comprehensive assessment. This assessment may involve exploring the person’s social support network, family dynamics, work, or school environment, living situation, and any significant life events or stressors that may be impacting their mental health.
  • Diagnostic Formulation and Treatment Planning: Based on the assessment findings, the mental health professional will make a diagnosis or provide a diagnostic formulation, which involves identifying the specific mental health condition or conditions that best explain the individual’s symptoms and experiences. 

A treatment plan will be developed, which may include medication, therapy (such as cognitive-behavioral therapy or psychodynamic therapy), lifestyle modifications, rTMS, Ketamine, neurofeedback, Electroconvulsive Therapy (ECT) and other interventions tailored to the individual’s needs. 

It is important to note that the specific components of a psychiatric assessment may vary depending on the individual’s presenting concerns, the setting, and the mental health professional’s approach. The goal is to gain a comprehensive understanding of the person’s mental health and develop an appropriate treatment plan to support their well-being and recovery. 

It is at the psychiatrist’s discretion whether you will have further follow-up appointments. 

Adult Assessment of Attention-Deficit-Disorder (ADD)

Duration:  One visit, 4-5 hours (in-person); One follow-up visit, 1 hour (in-person or virtual) 

Cost: $2,295 

Medical referral not required. 

Also known as Attention-Deficit/Hyperactivity Disorder (ADHD), in adults this evaluation involves a comprehensive evaluation of their symptoms, medical history, and functional impairments. It aims to determine if the individual meets the diagnostic criteria for ADHD and to understand the impact of symptoms on their daily life. 

Here are the key aspects of the assessment process: 

  • Clinical Interview: One of our neuropsychologists, will conduct a detailed interview with the adult to gather information about their symptoms, developmental history, medical history, family history, educational background, work performance, and any other relevant factors. The interview may also involve discussions with close family members or partners who can provide additional insights into the individual’s behavior and functioning. 
  • ADHD Rating Scales: Standardized rating scales and questionnaires are used to assess ADHD symptoms and their impact. These measures typically involve self-report and may also include informant ratings from family members, partners, or colleagues. They assess symptoms related to inattention, hyperactivity, impulsivity, and associated impairments in various domains of functioning. 
  • A brain-based assessment for a more complete diagnostic! 
  • Interview and history taking 
  • Questionnaires and behavior checklists 
  • Continuous Performance Test (CPT) 
  • Conners Scale for Assessing ADHD 
  • Tests of attention: visual & auditory, selective attention, vigilance, memory, verbal working memory 
  • Tests for executive functions: figural fluency, interference, cognitive flexibility, response inhibition, task switching  
  • Tests for processing speed 
  • Medical questionnaires 
  • Lab tests, if needed

Treatment recommendations will be provided. 

Documentation for special services from schools or employer available upon request. 

ADHD Assessment of Children Aged 6-13

Duration: One visit, 5-6 hours; one visit with parents, 1-2 hours 

Cost: From $2,600 to $2,995 

Medical referral not required.  

This assessment involves a comprehensive evaluation of their cognitive, behavioral, and emotional functioning. It aims to identify strengths, weaknesses, and potential areas of difficulty in various domains of functioning. 

Here are the key aspects of the assessment process: 

  • Clinical Interview: The neuropsychologist will conduct an interview with the child and their parents or caregivers to gather information about the child’s developmental history, medical history, educational background, and any specific concerns or areas of difficulty.  
  • Cognitive Testing: A variety of standardized neuropsychological tests are administered to assess different cognitive abilities, such as intelligence, attention, memory, executive functions, language skills, visual-spatial abilities, and academic skills (e.g., reading, writing, math). These tests are age-appropriate and specifically designed to assess the cognitive functioning of children. 
  • Behavioral and Emotional Assessment: Rating scales and questionnaires may be used to gather information about the child’s behavior and emotional well-being. These measures help assess aspects such as attention problems, hyperactivity, impulsivity, social skills, anxiety, depression, and behavioral difficulties. 
  • Assessment of Academic Skills: Academic achievement tests, such as reading comprehension, spelling, and math tests, may be administered to evaluate the child’s academic skills and compare them to age and grade-level expectations. 
  • Observation: The neuropsychologist may observe the child during the assessment to gather additional information about their behavior, social interactions, attention span, and emotional regulation. 
  • Collaboration with School: Collaboration with the child’s school and teachers may be sought to gather information about the child’s performance in the classroom, behavior, and any concerns raised by the school staff. 
  • Feedback and Recommendations: Following the assessment, the neuropsychologist will provide feedback to the parents or caregivers, discussing the results and explaining the implications for the child’s functioning. They will also provide recommendations for interventions, accommodations, and strategies to support the child’s academic, social, and emotional needs.

The results of the neuropsychological assessment help in understanding the child’s cognitive strengths and weaknesses, identifying any areas of concern or specific learning disabilities, and informing educational planning and interventions. It can guide the development of tailored interventions, educational accommodations, and support services to address the child’s individual needs. Treatment recommendations will be discussed with the parents. 

Assessment of Post-Concussion Symptoms

Duration: 6 hours 

Cost: $1,695 

Medical referral required for physiatry.   

This assessment involves a comprehensive evaluation of an individual’s symptoms, medical history, and functional impact following a concussion or mild traumatic brain injury (TBI). The goal is to assess the presence, severity, and persistence of symptoms related to the injury.  Here are the key aspects of the assessment process: 

The assessment is divided into five parts:

  • Cognitive testing (COGBAT), lasting approximately 55 minutes
  • Complete evaluation with a nurse, lasting an hour
  • Evaluation by Simon Tinawi MD, FRCPC, Physiatrist (about 1h)
  • Evaluation with Alain Ptito, PHD, Neuropsychologist (about 45-60 min)
  • Evaluation by a physical therapist (1h)
post-concussion-symptoms

Following these visits, the multidisciplinary team will meet to discuss your case and develop a personalized treatment plan. They may suggest additional testing. The nurse will contact you within the next few days for a follow-up visit or call. During the meeting, she will discuss with you the team’s conclusions and, if applicable, recommendations for follow-up visits and treatments. She will be able to share with you each of the individual specialists’ reports.

  • Clinical History and Interview: A healthcare professional will conduct a detailed interview to gather information about the individual’s medical history, including the occurrence and circumstances of the head injury, the symptoms experienced since the injury, and any previous history of concussions or brain injuries.
  • Symptom Assessment: The healthcare professional will assess the individual’s post-concussion symptoms using standardized symptom checklists or questionnaires. These assessments typically cover a range of symptoms commonly associated with concussions, such as headaches, dizziness, nausea, cognitive difficulties (e.g., memory problems, difficulty concentrating), sleep disturbances, mood changes (e.g., irritability, anxiety, depression), and sensitivity to light or noise.
  • Cognitive Assessment: A cognitive assessment may be conducted to evaluate the individual’s cognitive functioning, including attention, memory, processing speed, and executive functions. This assessment helps determine if there are any specific cognitive impairments related to concussion.
  • Physical Examination: A physical examination may be performed to assess any physical signs or abnormalities associated with the concussion, such as balance issues, coordination problems, or visual disturbances.
  • Neurological Evaluation: A neurological examination is conducted to assess the functioning of the nervous system, including sensory and motor responses, reflexes, coordination, and cranial nerve functions. This evaluation helps identify any neurological deficits or abnormalities related to concussion.
  • Imaging and Neurodiagnostic Tests: In some cases, imaging tests like computed tomography (CT) scans or magnetic resonance imaging (MRI) may be ordered to rule out any structural brain abnormalities or complications. Neurodiagnostic tests, such as electroencephalography (EEG), may also be conducted to evaluate brainwave activity.
  • Psychological Assessment: Emotional and psychological factors can often be affected following a concussion. A healthcare professional may assess the individual’s emotional well-being, mood, and psychological symptoms using standardized questionnaires or interviews.

The results of the assessment help in formulating a diagnosis of post-concussion syndrome or related conditions and developing an appropriate treatment plan. Treatment may involve a multidisciplinary approach that addresses the individual’s specific symptoms and needs. This can include physical rest, cognitive rest, symptom management strategies, gradual return to activities, rehabilitation therapies (e.g., physical therapy, occupational therapy), cognitive rehabilitation, and psychological interventions (e.g., counseling, cognitive-behavioral therapy).

It is important to consult with a healthcare professional specializing in concussions or traumatic brain injuries for an accurate assessment and appropriate management of post-concussion symptoms. They can guide you through the assessment process, provide necessary interventions, and monitor your progress to ensure optimal recovery.

Assessment of Pain Disorders

Duration: 1 to 2 hours 

Cost: $400

Medical referral not required in most cases.   

This assessment typically involves a comprehensive evaluation of an individual’s pain symptoms, medical history, psychological factors, and functional impact. The goal is to determine the nature, severity, and underlying causes of the pain disorder.

pain-disorders

Here are the key aspects of the assessment process: 

  • Clinical History and Interview: A healthcare professional will conduct an in-depth interview to gather information about the individual’s pain symptoms, including the location, intensity, duration, and characteristics of the pain. They will also inquire about any triggering factors, exacerbating or relieving factors, and the impact of pain on daily activities and quality of life. Additionally, they will explore the individual’s medical history, previous treatments, and any psychological or psychosocial factors that may contribute to the pain.
  • Pain Assessment Tools: Various standardized pain assessment tools may be used to quantify and evaluate the individual’s pain experience. These tools often involve self-report questionnaires, numerical pain scales, visual analog scales, or multidimensional pain inventories. They help assess the intensity, quality, and impact of pain on various aspects of life.
  • Physical Examination: A physical examination may be conducted to assess the affected areas and identify any physical signs or abnormalities related to the pain. The healthcare professional may evaluate muscle strength, range of motion, joint stability, and perform specific tests to identify potential sources of pain.
  • Diagnostic Tests: Depending on the suspected underlying cause of the pain, diagnostic tests such as X-rays, magnetic resonance imaging (MRI), computed tomography (CT) scans, nerve conduction studies, or laboratory tests may be ordered to further evaluate the condition and rule out other potential causes.
  • Psychological Evaluation: Psychological factors can significantly influence the experience and perception of pain. A healthcare professional may conduct a psychological evaluation or refer the individual to a psychologist or psychiatrist for further assessment. This may involve evaluating emotional well-being, stress levels, anxiety, depression, coping mechanisms, and any past trauma or psychological conditions that may contribute to or exacerbate the pain.
  • Functional Assessment: Assessing the impact of pain on an individual’s functional abilities and daily activities is important. This may involve evaluating activities of daily living, work-related tasks, recreational activities, and overall quality of life. Functional assessments help determine the impact of pain on a person’s ability to function and guide treatment planning.

The results of the assessment help in formulating a diagnosis, understanding the underlying causes, and contributing factors, and developing an appropriate treatment plan for the pain disorder. Treatment may involve a multimodal approach, which can include medications, physical therapy, psychological interventions (e.g., cognitive-behavioral therapy), lifestyle modifications, and other interventions tailored to the individual’s specific needs. 

Assessment of Sleep Disorders

Duration: 1 hour 

Cost: $225

Medical referral not required.   

This assessment typically involves a comprehensive evaluation of an individual’s sleep patterns, behaviors, and related symptoms. It is performed by a neuropsychologist specialized in sleep disorders.

It aims to identify the presence, type, and underlying causes of the sleep disorder.

sleep-disorders

Here are the key aspects of the assessment process: 

  • Clinical History and Interview: A healthcare professional will conduct an in-depth interview to gather information about the individual’s sleep habits, sleep-related symptoms, medical history, medications, lifestyle factors, and any factors that may contribute to sleep disturbances.
  • Sleep Diary: Keeping a sleep diary or log for a specified period can provide valuable information about sleep patterns and routines. It typically includes information about bedtime, wake time, total sleep duration, sleep quality, and any notable events or symptoms.
  • Sleep Questionnaires: Various standardized questionnaires may be used to assess specific sleep disorders or symptoms. Examples include the Epworth Sleepiness Scale (ESS) for excessive daytime sleepiness, the Pittsburgh Sleep Quality Index (PSQI) for overall sleep quality, or specific questionnaires for conditions like insomnia or restless leg syndrome.

Polysomnography (PSG)

Duration: One night

Cost: $1,500

Medical referral required.   

This is a diagnostic test used to evaluate and diagnose sleep disorders. It involves the simultaneous recording of various physiological parameters during sleep, including brain waves, eye movements, muscle activity, heart rate, breathing patterns, and oxygen levels. Polysomnography is typically conducted in our sleep laboratories.

The patient spends a night at the facility while multiple sensors and electrodes are attached to various parts of the body. These sensors record and monitor different physiological activities during sleep.

polysomnography

Here are the key aspects of polysomnography: 

  • Electroencephalography (EEG): EEG electrodes are placed on the scalp to measure brain wave activity. This helps determine the various stages of sleep (e.g., deep sleep, REM sleep) and identify abnormalities such as sleep apnea, narcolepsy, or parasomnia.
  • Electromyography (EMG): EMG electrodes are usually placed on the chin or limbs to measure muscle tone and activity. This helps identify muscle movements, such as leg movements during sleep, which can be indicative of restless leg syndrome or periodic limb movement disorder.
  • Electrooculography (EOG): EOG electrodes are placed around the eyes to monitor eye movements. This helps determine the presence of rapid eye movements during REM sleep, which is a characteristic feature of normal sleep.
  • Other Measurements: Additional sensors and electrodes may be used to monitor respiratory effort, airflow, heart rate, oxygen levels, and other parameters. These measurements help identify and assess sleep-related breathing disorders, such as sleep apnea, as well as other sleep-related conditions.
  • Data Analysis: The collected data is analyzed by sleep technologists and sleep specialists. They review the recordings, assess sleep architecture, identify abnormal patterns, and make a diagnosis based on established criteria for sleep disorders.

Polysomnography is a comprehensive and informative test that allows healthcare professionals to evaluate various aspects of sleep and diagnose sleep disorders accurately. It helps in the assessment of conditions such as sleep apnea, narcolepsy, insomnia, parasomnia, and other sleep-related disorders. Based on the results, appropriate treatment options can be recommended to improve sleep quality and overall well-being.

Cardiorespiratory Polygraphy

Duration: One night

Cost: $400

Medical referral required.   

This is a diagnostic test used to assess and monitor the functioning of the cardiovascular and respiratory systems during sleep. It is a simplified version of polysomnography focusing on cardiovascular and respiratory parameters.

Cardiorespiratory polygraphy is typically conducted at home, allowing the individual to sleep in their own environment. The test involves portable monitoring devices less complex than those used in a sleep laboratory.

cardiorespiratory-polygraphy

Here are the key aspects of cardiorespiratory polygraphy: 

  • Parameters Measured: Cardiorespiratory polygraphy monitors various physiological signals related to the cardiovascular and respiratory systems. It commonly measures parameters such as heart rate, blood oxygen levels (pulse oximetry), breathing effort, airflow, and snoring.
  • Sleep-Related Breathing Disorders: Cardiorespiratory polygraphy is useful in assessing sleep-related breathing disorders, such as obstructive sleep apnea (OSA). It can detect and evaluate abnormal breathing patterns, including episodes of apnea (temporary cessation of breathing) and hypopnea (partial reduction in airflow). These measurements help in diagnosing and determining the severity of sleep apnea.
  • Assessment of Oxygen Desaturation: The measurement of blood oxygen levels (pulse oximetry) during sleep provides information about the extent of oxygen desaturation that occurs during apnea or hypopnea events. This helps assess the impact of sleep-related breathing disorders on oxygenation.
  • Portable Monitoring Devices: Cardiorespiratory polygraphy typically uses portable devices that are easy to use and comfortable to wear during sleep. These devices are designed to record the required physiological signals and are equipped with sensors or probes that are applied to specific body areas.
  • Data Analysis and Interpretation: The recorded data from cardiorespiratory polygraphy is analyzed by healthcare professionals, such as sleep technologists or sleep specialists. They review the data to assess the presence and severity of sleep-related breathing disorders and provide a diagnosis based on established diagnostic criteria.

Cardiorespiratory polygraphy offers a more accessible and convenient alternative to polysomnography for the evaluation of sleep-related breathing disorders. While it provides valuable information about cardiovascular and respiratory parameters during sleep, it is important to note that it does not capture other aspects of sleep architecture or neurological activity, which are assessed in full polysomnography.

It is recommended to consult with a healthcare professional experienced in sleep medicine to determine the most appropriate diagnostic test based on individual symptoms, clinical history, and suspected sleep disorders.

Assessment of Cognitive Functions

Duration: 2 hours

Cost: $650 

Medical referral not required.   

This assessment typically involves a comprehensive evaluation of an individual’s cognitive abilities and functioning. It aims to determine the presence, severity, and potential causes of cognitive impairment or decline.  

assessment-of-cognitive-functions

Here are the key aspects of the assessment process: 

  • Clinical History and Interview: The healthcare professional will conduct a thorough interview to gather information about the individual’s medical history, current symptoms, functional abilities, and any factors that may contribute to cognitive decline (e.g., medical conditions, medications, lifestyle factors).
  • Cognitive Screening Tools: Various standardized cognitive screening tools are available to quickly assess cognitive functioning. Examples include the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA). These tests provide a brief overview of cognitive domains, such as memory, attention, language, and executive function.

If you or someone you know is experiencing cognitive decline or concerns about cognitive function, it is recommended to consult with a healthcare professional who specializes in cognitive assessment and can guide you through the evaluation process. 

Quantitative Electroencephalogram (qEEG)

Duration: 1 hour

Cost: $450

Medical referral not required.   

A quantitative electroencephalogram (qEEG) is a specialized type of electroencephalogram (EEG) that measures and analyzes the electrical activity of the brain in a quantitative manner. An EEG is a non-invasive test that records the electrical patterns and rhythms of the brain using electrodes placed on the scalp.

While a standard EEG provides visual representations of brain wave patterns, a qEEG goes a step further by applying mathematical algorithms and statistical analysis to extract specific information from the EEG data. The EEG data of the recorded person is compared to a normative EEG database of thousands of age-matched control subjects with normal brain function (Z-score). This quantitative analysis allows for a more detailed assessment of brain activity and can provide insights into brain function, connectivity, and abnormalities.

quantitative-electroencephalogram-qeeg

Here are some key features and applications of qEEG: 

  • Brain Wave Analysis: qEEG measures and quantifies diverse types of brain waves, such as alpha, beta, theta, and delta waves. It provides information about the distribution, amplitude, and frequency of these waves, helping to identify patterns associated with specific brain states or conditions.
  • Brain Mapping: By analyzing the spatial distribution of brain wave activity, qEEG can generate topographic maps or brain maps. These maps provide a visual representation of the relative activity levels in different brain regions and can assist in identifying areas of abnormal activity or imbalances and the degree of deviation from the normative EEG database.
  • Diagnostic Aid: qEEG can be used as a diagnostic tool in assessing various neurological and psychiatric conditions, including epilepsy, attention-deficit/hyperactivity disorder (ADHD), Emotional-related disorders (e.g., anxiety, depression, PTSD…), sleep disorders, traumatic brain injury (TBI), and neurodevelopmental disorders. It can help identify specific patterns or markers associated with these conditions, aiding in diagnosis and treatment planning.
  • Treatment Planning and Monitoring: qEEG analysis can guide treatment decisions, particularly in the field of neurofeedback or transcranial magnetic stimulation (TMS). Neurofeedback is a type of therapy that uses real-time feedback of brain wave activity to help individuals self-regulate their brain function. qEEG data can help identify specific areas or patterns for targeted neurofeedback training and can be used to monitor progress over time.

It is important to note that while qEEG provides valuable information, its interpretation requires expertise and clinical judgment. It is typically performed and analyzed by qualified healthcare professionals, such as neurologists, neuropsychiatrists, or neurofeedback practitioners, who have specialized training in EEG and qEEG interpretation.

Overall, qEEG enhances the analysis of brain wave activity by applying quantitative methods and statistical analysis to EEG data. It provides valuable insights into brain function, connectivity, and abnormalities, aiding in diagnosis, treatment planning, and monitoring of various neurological and psychiatric conditions.

Psychophysiological Assessment of Stress

Duration: 2 hours

Cost: $650 

Medical referral not required.

The psychophysiological assessment is used to observe the physiological state at rest, during periods of stress and during recovery.

Overreacting to stressful situations and taking a long period of time to return to an initial baseline may be associated with physical and psychological disorders, as well as decreased performance in personal and professional activities.

stress-

During the psychophysiological assessment we measure heart rate and variability (HRV), respiration, skin conductivity, peripheral skin temperature and muscle activity.

We examine physiological functioning at rest and its changes in response to stressors and during periods of recovery, to find atypical patterns that may cause problems.

This assessment determines precisely how and to what extent individuals react to stress as well as their ability to recover afterwards.

With the person’s self-reported comments on their past and current functioning, this assessment allows us to identify strengths and weaknesses, and to develop a training program to optimize health.

Neurofeedback

Duration: 1 hour per session

Cost: $140 per session

Medical referral not required.   

Neurofeedback is a therapeutic technique that aims to train and regulate brain activity using real-time feedback provided to an individual about their own brainwave patterns. It is a form of biofeedback that focuses specifically on monitoring and modifying brainwave activity.

To optimize the success of the neurofeedback training, each individual protocol is always guided by the results of the patient’s qEEG.

The process typically involves placing electrodes or sensors on the scalp to measure electrical activity in the brain, known as electroencephalography (EEG). This data is then processed by a computer, which provides visual or auditory feedback to the individual in real time. The feedback usually takes the form of a game, a movie, or some other interactive display that responds to changes in the individual’s brainwave patterns.

neurofeedback

During a neurofeedback session, the individual learns to control their brainwave activity by observing the feedback and making conscious efforts to modify their mental state. The underlying principle is that by receiving immediate feedback about their brain activity, individuals can learn to self-regulate and optimize their brain functioning. For example, if the goal is to increase a specific brainwave frequency associated with focused attention, the individual may be instructed to concentrate or relax to achieve the desired brainwave pattern. As they successfully generate the target brainwave activity, they might see their avatar move forward in a game or hear a pleasant tone.

The individual’s progress is continuously monitored throughout the session, and the feedback is adjusted accordingly. The aim is to train the individual to recognize and modulate their own brainwave activity, promoting self-regulation and improved brain functioning.

Neurofeedback sessions typically last around 60 minutes, although the duration can vary depending on the individual’s needs and treatment plan. The number of sessions required can also vary, with some individuals benefiting from a few sessions, while others may require more extensive training over a longer period. It is worth noting that the specific protocols and techniques used in neurofeedback can differ depending on the practitioner, the individual’s goals, and the targeted conditions. A trained professional, such as a neurofeedback therapist or clinician, guides and oversees the session to ensure its effectiveness and safety.

There are two methods to practice neurofeedback:

  • 1-Channel Neurofeedback: This technique consists in placing 1 or 2 electrodes on the brain region(s) where the brainwaves are the most deviating based on the original qEEG. The goal is to increase or decrease specific brainwave frequency on the targeted brain area. This technique is highly effective in children with ADHD.
  • 19 Channel-Z score Neurofeedback. Unlike one or two electrode(s) neurofeedback method, where we concentrate on lowering the power in one specific region of the brain, 19 channel neurofeedback (also known as Z-score neurofeedback) can train many variables (up to 5700) at one time (e.g., EEG frequency power, coherence, phase shift and asymmetry). 19- channel neurofeedback trains brainwaves using z-scores. This means that the brainwaves are consistently trained to be within normal limits as defined by a normative database.

Neurofeedback has been used to address various conditions and improve cognitive and emotional functioning. It has been applied in the treatment of attention-deficit/hyperactivity disorder (ADHD), anxiety, depression, post-traumatic stress disorder (PTSD), traumatic brain injury (TBI), and other neurological and psychological disorders. Additionally, it is sometimes used by athletes and performers to enhance focus, attention, and performance. 

It is important to note that while neurofeedback shows promise and has been used in clinical settings, it may not be a universally recognized or scientifically proven treatment for all conditions. As with any therapeutic intervention, it is advisable to consult with a qualified healthcare professional or a licensed practitioner experienced in neurofeedback before pursuing this approach.  

Biofeedback

Duration per session: 1 hour 

Cost: $120 per session

Medical referral not required.   

Biofeedback involves electronic devices to monitor and provide real-time feedback about certain physiological processes within the body. The goal of biofeedback is to help individuals learn how to consciously control and regulate these processes, leading to improvements in physical and mental health.

biofeedback

Here are some key aspects of biofeedback:

  • Process: During a biofeedback session, sensors or electrodes are attached to the individual’s body to measure specific physiological functions. These functions can include heart rate, blood pressure, muscle tension, skin temperature, respiratory rate, brainwave activity (electroencephalography or EEG), or sweat gland activity (electrodermal activity). The sensors send signals to a monitoring device that converts the physiological data into visual, auditory, or tactile feedback.
  • Real-Time Feedback: The feedback provided by the biofeedback device allows individuals to observe and understand how their physiological processes respond to different situations, thoughts, or emotions. This real-time information helps them become aware of subtle changes in their body and learn to control these processes consciously.
  • Training and Techniques: With the help of a trained healthcare professional or biofeedback therapist, individuals learn specific techniques to modify their physiological responses. These techniques may include relaxation exercises, deep breathing, guided imagery, meditation, cognitive-behavioral techniques, or muscle relaxation exercises.
  • Applications: Biofeedback has been used to manage various conditions and promote overall well-being. It can be helpful in stress management, anxiety disorders, chronic pain, headaches, high blood pressure, digestive disorders, and musculoskeletal disorders. It is also used in sports performance training and to enhance focus and attention in cognitive tasks.
  • Benefits: Biofeedback aims to improve self-regulation and enhance self-awareness, empowering individuals to actively participate in their own health and well-being. By learning to control physiological responses, individuals may experience reduced symptoms, improved emotional well-being, better stress management, enhanced performance, and an overall sense of control over their body’s responses.
  • Professional Guidance: Biofeedback is typically conducted under the guidance of a trained healthcare professional or biofeedback therapist. These professionals can help individuals understand the data, interpret the feedback, teach appropriate techniques, and provide support throughout the process.

It is important to note that while biofeedback can be a beneficial tool for many individuals, it may not be suitable for everyone or as a standalone treatment for certain medical conditions. It is recommended to consult with a healthcare professional to determine if biofeedback is appropriate for your specific needs and to ensure proper guidance and supervision during the training process.

Repetitive Transcranial Magnetic Stimulation (rTMS)

Duration: 3 min to 30 min per session 

Cost: $130 to $200 per session

Medical referral required from psychiatrist or for psychiatry. 

Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive neurostimulation technique that uses magnetic fields to stimulate specific regions of the brain. It involves placing a magnetic coil on the scalp, which generates brief and focused magnetic pulses that pass through the skull and induce electrical currents in targeted areas of the brain.

repetitive-transcranial-magnetic-stimulation-rtms

Here are key aspects of transcranial magnetic stimulation (TMS):

  • Procedure: During a TMS session, the individual sits comfortably in a chair while a healthcare professional positions the magnetic coil on the scalp, targeting specific regions associated with the condition being treated. The coil is connected to a TMS device, which controls the intensity, duration, and frequency of the magnetic pulses. The individual may feel a tapping or knocking sensation on the scalp during the procedure.
  • Mechanism of Action: TMS works by creating rapidly changing magnetic fields that penetrate the skull and induce small electrical currents in the underlying brain tissue. These electrical currents can modulate the activity of the targeted brain regions, promoting or inhibiting neural activity depending on the stimulation parameters used. The precise mechanisms by which TMS produces its therapeutic effects are still being investigated but are thought to involve changes in neuronal excitability, synaptic plasticity, and neural network connectivity.
  • Applications: TMS has been used as a therapeutic tool in various psychiatric conditions since 2003 in Canada and 2008 in the United States. It is used for major depressive disorder (MDD) when other treatments have not been effective. TMS has also shown promise in the treatment of other conditions, including anxiety disorders, bipolar disorder, chronic pain, addiction, migraine, and certain neurological disorders such as Parkinson’s disease and epilepsy. Ongoing research is exploring the potential benefits of TMS in other mental health and neurological rehabilitation areas.
  • Safety and Side Effects: TMS is considered safe when performed by trained healthcare professionals. It is non-invasive and does not require anesthesia. Common side effects are mild and transient, such as headache, scalp discomfort or pain at the stimulation site, light-headedness, or muscle twitching. Serious side effects are extremely rare but can include seizures, hearing loss if appropriate ear protection is not used, and mania or hypomania in individuals with bipolar disorder.

It is worth noting that there are different rTMS protocols 1Hz (inhibition),10Hz (activation), iTBS, cTBS, and SNT. The various protocols have specific uses and considerations depending on the condition being treated. It should be administered under the guidance of a trained healthcare professional who can assess the individual’s suitability for the treatment, determine the appropriate stimulation parameters, and monitor the progress and any potential side effects.

Please consult with a healthcare professional or specialist in TMS for more detailed information on the procedure, its potential benefits, and its suitability for specific conditions.

Electroconvulsive Therapy

Duration: 3-4 hours (including pre and post treatment care)

Cost: $1,500/session

Medical referral required from psychiatrist or for psychiatry.

What is ECT treatment?

ECT, also called sismotherapy, electroconvulsive therapy, or electroshock therapy, is a medical treatment known to be effective for many mental disorders and certain serious medical conditions. After general anesthesia, electrical current is delivered into the skull through electrodes for a few seconds. This current induces a short brain seizure but does not cause any pain.

How does ECT work?

Studies suggest that ECT leads to the same changes in the brain as antidepressants, but more quickly. The way ECT works is not yet completely understood and is still the subject of scientific research.

electroconvulsive-therapy

Who can receive ECT?

The physician does a comprehensive assessment of the advantages and disadvantages of this therapy for the user in comparison to other available treatments. Today, ECT is mostly given to people suffering from severe major depression, certain bipolar disorders, catatonia, or schizophrenia, where such conditions are resistant to conventional treatments (e.g., medication and psychotherapy). ECT is used in the following cases:

  • Conventional therapies have failed.
  • Conventional therapies are not tolerated or are contraindicated.
  • The user’s life is threatened in the short term and this treatment is necessary to rapidly improve his condition.
  • The user has responded well to ECT in the past and prefers this treatment.

How is ECT administered?

ECT is often administered in the morning, up to three times a week. Before the first treatment and, if necessary, afterward, the general condition of the user is assessed during a consultation with the physician through a physical exam and laboratory tests. Any medical condition is monitored very closely.

  • The day before the ECT, the usual medication may be modified by the physician.
  • The day of the ECT,
    • Due to general anesthesia, the user needs to fast (no eating or drinking) at least eight hours before the ECT. However, if the physician allows it, some medications can be taken with water. Additional instructions may be given, if necessary.
    • In the treatment room, intravenous (IV) fluid is introduced into a vein in the user’s arm or hand to administer medications. The patient is connected to various monitoring devices.
    • The user falls asleep for five to 10 minutes, with an anesthetic drug injected through an IV. Then, a muscle relaxant is given to relax the muscles and reduce movements. As a result, the user will not feel the treatment.
    • ECT starts when the user is completely sedated, his muscles relaxed. At this point, a brief current is delivered for a few seconds by the electrodes, inducing the seizure.
    • Throughout the procedure, the user receives oxygen through a ventilation mask placed over his mouth and nose.
    • At the end of treatment, the user wakes up in the recovery room where is vitals are monitored and he is supervised.
    • Due to the use of anesthesia, the user should not drive and must be accompanied home by someone.

Ketamine Treatment

Duration: 1.5 to 2 hours

Cost: $300 for a sublingual treatment (SL); $450 for an intramuscular injection (IM);  $700 for an IV treatment

Medical referral required.

Ketamine treatment for depression is an emerging therapeutic approach that involves the use of ketamine, a dissociative anesthetic and NMDA receptor antagonist, to alleviate symptoms of depression in individuals who have not responded to traditional antidepressant medications. At the Braxia Health we treat Major Depressive Disorder, and Bipolar Depression. Individuals Post Traumatic Stress Disorder (PTSD) or obsessive-compulsive disorder (OCD) will be considered on a case-by-case basis for potential investigational use of intravenous ketamine.

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Here are some key aspects of ketamine treatment for depression:

  • Mechanism of Action: Ketamine’s antidepressant effects are not yet fully understood. It is thought to work by rapidly increasing synaptic connectivity and promoting the release of certain neurotransmitters, particularly glutamate, which plays a role in mood regulation. Ketamine also interacts with other molecular targets in the brain, leading to a cascade of effects that can have antidepressant properties.
  • Administration: Ketamine for depression is typically administered via intravenous (IV) infusion. The dose and duration of the treatment vary depending on the individual’s protocol. A single session of ketamine infusion lasts between 40 and 50 minutes, plus a 20-minute recovery time. An acute course consists of six treatments in the span of three to four weeks.
  • Efficacy: Ketamine has shown promising results in rapidly reducing depressive symptoms, including feelings of sadness, hopelessness, and suicidal thoughts, in individuals with treatment-resistant depression. Studies have reported significant improvements within hours or days following ketamine infusion. However, the effects are often temporary, and maintenance or repeated treatments may be necessary for sustained benefits. Ketamine treatment for depression has shown promising results, particularly in individuals who have not responded to traditional antidepressant medications. However, it is still considered a new and evolving treatment. It is crucial to work closely with a healthcare provider who can assess individual suitability, monitor progress, and provide appropriate guidance throughout the treatment process.

Ketamine Assisted Therapy (KAT)

Individual sessions: $180 (cost of ketamine treatment not included)
Group Sessions: $100/hour (cost of ketamine treatment not included)

Neurotherapy Montreal is proud to offer Ketamine-Assisted Therapy, a cutting-edge treatment modality that combines the benefits of ketamine with therapy to provide relief for individuals struggling with depression, anxiety, and PTSD. Our experienced team of healthcare professionals is dedicated to helping our patients achieve mental well-being and a better quality of life.

What is Ketamine-Assisted Therapy?

Ketamine-Assisted Therapy involves the administration of ketamine, a dissociative anesthetic, in a controlled and therapeutic environment. It is typically combined with psychotherapy or counseling sessions to enhance the therapeutic process. Ketamine has shown promising results in rapidly reducing depressive symptoms, managing anxiety, and facilitating breakthroughs in therapy.

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Our Approach

At Neurotherapy Montreal, we prioritize the safety and well-being of our patients. Our approach to Ketamine-Assisted Therapy involves:

  • Comprehensive Assessment: Our team conducts a thorough evaluation to understand each patient’s unique needs, medical history, and mental health condition. This assessment helps us determine the suitability of Ketamine-Assisted Therapy for each individual.
  • Personalized Treatment Plan: We create a personalized treatment plan that combines ketamine sessions with therapy or counseling. Our experienced therapists work closely with patients to address their specific concerns and goals.
  • Expert Guidance: Our healthcare professionals are trained in administering ketamine and closely monitor patients throughout the treatment sessions. We provide a supportive and comfortable environment to ensure a positive experience.
  • Integration with Therapy: Ketamine-Assisted Therapy is not a standalone treatment. It is integrated into a comprehensive therapeutic approach, combining ketamine sessions with regular therapy or counseling. This integration enhances the effectiveness of the treatment.

Benefits of Ketamine-Assisted Therapy

  • Rapid relief of depressive symptoms
  • Reduction in anxiety and distress
  • Potential breakthroughs in therapy
  • Enhanced mood and overall well-being
  • Improved motivation and focus

Is Ketamine-Assisted Therapy Right for You?

Ketamine-Assisted Therapy may be suitable for individuals who have not responded well to traditional treatments for depression, anxiety, or PTSD. However, it is important to undergo a thorough assessment to determine eligibility. Our team at Neurotherapy Montreal will guide you through the process and help you make an informed decision about your treatment options.

Get Started Today

If you or a loved one could benefit from Ketamine-Assisted Therapy, we encourage you to contact our clinic to schedule a consultation. Our compassionate team is here to answer your questions, address your concerns, and guide you on your journey towards improved mental health.

Note: Ketamine-Assisted Therapy should only be administered under the guidance of qualified healthcare professionals. Individual results may vary, and it is important to consult with a healthcare provider to determine the most appropriate treatment for your specific needs.

Perfusion

Duration: 2 hours

Cost: $250 to $900

Medical referral not required in most cases.

Intravenous (IV) treatment, also known as intravenous therapy or IV infusion, refers to the administration of fluids, medications, or nutrients directly into a person’s vein. It involves inserting a sterile plastic tube called an intravenous catheter into a vein, typically in the arm or hand, allowing for the direct delivery of substances into the bloodstream.

We administer many medications intravenously to achieve immediate and precise effects. IV administration allows medications to bypass the digestive system, enabling faster absorption and distribution throughout the body.

Common examples of medications include antibiotics, pain medications (ketamine, lidocaine, magnesium, etc.), vitamins and supplements.

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The specific type, duration, and frequency of IV treatment depend on the individual’s medical condition and treatment goals. Our IV therapies are administered by trained registered nurses under the supervision of a Physician.

Ultrasound-guided Infiltration

Duration: 1 hour

Cost: $250 and up

Medical referral not required in most cases.

This procedure refers to a technique where ultrasound imaging is used to assist in the precise placement of medication or local anesthesia into specific target tissues or structures. This technique helps improve accuracy, safety, and effectiveness of the infiltration procedure.

During ultrasound-guided infiltration, a healthcare professional, typically a radiologist, a physiatrist, an orthopedist, or an anesthesiologist, uses an ultrasound machine to visualize the internal structures of the body in real time. The ultrasound device emits high-frequency sound waves that bounce off the tissues and organs, creating a detailed image on a monitor. The ultrasound image provides valuable information about the location, depth, and size of the target area, such as a specific nerve, joint, or a collection of fluid. This information helps guide the healthcare professional in accurately placing the needle or catheter for the infiltration procedure.

ultrasound-guided-infiltration

The process of ultrasound-guided infiltration typically involves the following steps:

  • Preparation: The patient is positioned to provide optimal access to the target area. The skin is cleaned and sterilized to reduce the risk of infection.
  • Ultrasound Imaging: The healthcare professional applies a gel to the skin over the target area and moves the ultrasound probe over the gel. This allows the ultrasound waves to pass through the gel and into the body, producing a real-time image on the monitor.
  • Needle Placement: Using the ultrasound image as a guide, the healthcare professional directs a needle or catheter toward the target area, ensuring precise placement. The medication or local anesthetic is then injected into the target tissue or space.
  • Confirmation: After the injection, the healthcare professional may use ultrasound imaging again to confirm the distribution of the medication or anesthesia and ensure it has reached the desired location.

Ultrasound-guided infiltration can be used in various medical procedures we offer including the following categories:

  • Neuraxial: intra-articular facet blocks or medial branch nerve blocks, epidural injections (selective nerve root block, interlaminar, transforaminal, caudal)
  • Joints: knee, wrist, elbow, shoulder (glenohumeral or acromioclavicular), hip (intra-articular and greater trochanteric bursa), sacroiliac joint, intercostal nerve, lateral femoral cutaneous nerve, suprascapular nerve, ilioinguinal nerve, ilio-hypogastric nerve, genitofemoral nerve
  • Peripheral/other: stellate ganglion bock, greater occipital nerve, branches of the brachial plexus (i.e., median, ulnar, or radial nerves), branches of the lumbosacral plexus (i.e., obturator, peroneal nerves)

Infiltration under fluoroscopy

Duration: 1 hour

Cost: $450

Medical referral not required in most cases.

This refers to a medical procedure where medication or local anesthetic is injected into a specific target area under the guidance of fluoroscopic imaging. Fluoroscopy is a real-time X-ray imaging technique that allows healthcare professionals to visualize internal structures and monitor the injection procedure as it happens.

Fluoroscopy is used for the following treatments: 

  • Intra-articular infiltration 
  • Facet blocks 
  • Foraminal (or selective epidural) blocks 
infiltration-under-fluoroscopy

Here is an overview of the process of infiltration under fluoroscopy:

  • Preparation: The patient is positioned appropriately for the procedure, ensuring access to the target area. The skin is cleaned and sterilized to reduce the risk of infection.
  • Fluoroscopic Imaging: A fluoroscope, which is a specialized X-ray machine, is used to generate real-time images. The machine emits a continuous X-ray beam, which passes through the body and creates a moving image on a monitor.
  • Needle Placement: Using the fluoroscopic image as guidance, the healthcare professional inserts a needle or catheter into the target area, such as a joint, space, or specific tissue. The needle is carefully advanced while continuously monitoring its position on the fluoroscopic screen.
  • Injection: Once the needle is properly positioned, the medication or local anesthetic is injected into the target area. The healthcare professional observes the distribution of the injected substance in real time using fluoroscopy, ensuring it reaches the desired location.
  • Confirmation: After the injection, the healthcare professional may perform additional fluoroscopic imaging to verify the spread of the medication or anesthetic.

Infiltration under fluoroscopy is commonly used for procedures such as joint injections, nerve blocks, epidural injections, and other interventions that require precise needle placement and visualization of the procedure in real time. The use of fluoroscopy helps guide the healthcare professional, ensuring accurate placement and minimizing the risk of complications.

It is important to note that fluoroscopy involves the use of X-ray radiation, so necessary precautions are taken to minimize exposure to both the patient and healthcare professionals involved. The benefits of accurate needle placement and real-time visualization provided by fluoroscopy outweigh the associated radiation risks when used appropriately and with proper radiation safety measures.

Osteopathy

Duration: 45 minutes

Cost: $100 per session

Medical referral not required for treatment.

Osteopathy is a form of manual medicine where the osteopath effectively treats many health conditions: back pain, muscle tension, pain due to osteoarthritis, certain ENT (ear-nose-throat) and digestive diseases.

Here is a non-exhaustive list of conditions for which our osteopathic treatments are successful:

  • arthritis
  • foot, ankle, hip, and knee pain
  • back pain, neck pain, and sciatica
  • hand, shoulder, and elbow pain
  • headaches
  • tennis and golfer’s elbow
  • postural problems due to pregnancy
  • sports injury
  • digestive issues
  • neuralgia
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Cognitive-Behavioral Therapy for Insomnia (CBT-I)

Individual and group services offered. 

Duration for individual session: 1 hour

Cost: $150.00 per session

Duration for group sessions: 2 hours

Cost: $1,750 for the program

Medical referral not required.

Nature and modality of services:

Cognitive-behavioral therapy for insomnia (CBT-I) is scientifically recognized as the most effective and long-lasting modality of therapeutic intervention for the treatment of insomnia. The services offered to you are part of a structured group psychotherapy program focused on sleep difficulties and problem solving.

cognitive-behavioral-therapy-for-insomnia

This program does the following:

  • Emphasizes the chronobiological, psychological and behavioral factors involved in the maintenance of insomnia.
  • Provides for the development of an individualized sleep reorganization plan adapted to your needs and particularities.
  • Advocates the acquisition of essential skills for the consolidation of regular and quality sleep.
  • Encourages the exchange and support of peers in your efforts to solve your difficulties. In short, you will benefit from a learning experience combining theory, practice, and mutual assistance, to help you adopt better habits of waking and sleeping.

This program, spread over 10 to 12 weeks, provides for 8 clinical meetings distributed as follows:

  • Individual initial evaluation session of 30 to 45 minutes,
  • 6 group sessions of 2h30 each
  • An individual assessment session of 30 to 45 minutes.

Sessions are conducted by a neuropsychologist trained in sleep disorders.

Cognitive-Behavioral Therapy (CBT) for ADHD

Service offered in a group setting. 

Duration: 1h30 hour per session

Cost: $200 per participant per session (1h30 + 15 minutes coaching call between sessions)

Medical referral not required.

This program is offered in the form of weekly group meetings (8 to 10 people), lasting 1h30, and spread over 12 consecutive weeks. Individual follow-ups can also be offered.

CBT intervenes to improve the difficulties of daily living – procrastination, time management and other common difficulties – and not to treat the fundamental symptoms of inattention, hyperactivity, and impulsivity.

cognitive-behavioral-therapy-cbt-for-adhd

CBT sessions aim to identify situations where lack of planning, disorganization, and poor time and task management pose problems in the patient’s daily life. Sessions can help an individual cope with obligations such as paying bills or getting a job done on time, and encourage activities that provide fulfillment and well-being, such as sleep, exercise physical or leisure. Learning about ADHD is always a good place to start, as it reinforces the message that ADHD is not a character flaw and demonstrates the neurological underpinnings of everyday challenges.

The goals and agenda of CBT sessions are centered around scenarios and challenges that the patient has encountered and, more importantly, expects to encounter, particularly between sessions. The therapist uses take-home reminders, follow-up check-ins, and other means to apply new coping skills for use outside of the counseling room. How an ADHD patient functions in day-to-day life is the best way to measure the effectiveness of therapy.

Cognitive-Behavioral Therapy (CBT) for Anxiety and Depression

Individual and group services offered. 

Duration for individual session: 1 hour

Cost: $150 and up

Duration for group sessions: 2 hours

Cost: $100 per session

Medical referral not required.

This program is offered in the form of individual or weekly group sessions (5-to 12 participants), lasting 2 hours, and spanning over 10 consecutive weeks. Individual follow-ups may also be provided.

cognitive-behavioral-therapy-cbt-for-anxiety-and-depression

Cognitive-behavioral therapy (CBT) is one of the most effective psychological interventions for treating various psychiatric disorders such as depression, anxiety disorders, somatoform disorders, and substance-related disorders. Its use has recently expanded to include psychotic disorders, behavioral medicine, marital disorders, stress-related conditions, and many other clinical conditions.

CBT is an effective treatment strategy for depression, and combined treatment with pharmacotherapy is significantly more effective than pharmacotherapy alone. Data also suggest that the relapse rate for patients treated with CBT is lower than for patients treated with pharmacotherapy alone. Guidelines for the treatment of depression suggest that psychological interventions are an effective and acceptable treatment strategy, especially for mild to moderate depressive episodes.

FINANCING OPTIONS ARE AVAILABLE