Improving Access to Anxiety Therapy for English-Speaking Communities in Québec

Title: Improving Access to Cognitive-Behavioural Therapy for Anxiety Disorders and Related Problems for English-Speaking Communities in Quebec: A Scoping Review of Adaptations and Delivery Models in Linguistic Minority Contexts

Anxiety disorders are the most common mental health condition in Québec and Canada, affecting one in three people during their lifetime. If left untreated, anxiety can interfere with work, school, relationships, and physical health. Cognitive-behavioural therapy (CBT) is an effective, evidence-based treatment for anxiety, but many English-speaking Quebecers face language barriers that limit access to these services, especially outside major urban centres.

This project will examine how CBT for anxiety has been adapted in different countries to better support people who speak a minority language within their healthcare system. Researchers will conduct a scoping review to identify strategies such as translated materials, culturally adapted resources, bilingual therapists, and telehealth services.

The findings will help identify practical approaches that could improve access to quality mental health care for English-speaking communities in Québec, particularly in regions with limited English-language services. Results will be shared through a scientific publication, an infographic, and a policy brief.

Outputs:

Coming soon…

Remotely-Delivered CBT for English-Speaking Psychiatric Outpatients across Quebec: An Evaluation of Treatment Effectiveness, Treatment Acceptability and Barriers to Accessing Care

Cognitive behavioural therapy (CBT) is the ‘gold standard’ psychological intervention for most mental health problems, however, access to CBT is often challenging due to long clinic waitlists and limited availability of trained professionals in all communities. In Quebec, English-speaking Quebecers are faced with additional challenges in accessing care due to their status as a linguistic minority. One method of increasing access to CBT is using a model of remote service delivery whereby clinics that specialize in CBT can provide services in English to patients located anywhere in the province. Using a non-randomized design, we aim to examine whether providing remotely-delivered CBT to English-speaking Quebecers from across the province will lead to similar improvements in symptoms and functioning compared to patients receiving in-person treatment. We will also examine questionnaire results and identify themes in patients’ written feedback to assess their treatment satisfaction and to better understand their experiences of receiving remotely-delivered CBT. This study will be conducted in the Centre for CBT Research, Training and Intervention (Centre for CBT-RTI), a clinic located in the McGill University Health Centre. The Centre for CBT-RTI is a non-sectorized clinic staffed by bilingual mental health professionals with expertise in CBT who provide in person and remotely-delivered CBT for patients from across Quebec. The findings from this research are anticipated to increase awareness among mental health professionals and key stakeholders in government and hospital administration about the benefits of remote-delivered CBT and patient preferences for service-delivery.

Outputs:

• Project completion: Data collection and analysis finalized. Results shared with mental health professionals locally at McGill University and the McGill University Health Centre, and nationally through the Canadian Association of Cognitive and Behavioural Therapies. An additional submission was made to the Douglas Research Centre / McGill Psychiatry Research Day.

• Conference presentations:

  • April 2025 – Poster at the 3rd Annual MUHC Mental Health Mission Research Day (Montréal).

  • May 2025 – Poster at the Canadian Association of Cognitive and Behavioural Therapies 15th Annual Conference (Banff).

  • Submitted – Poster to the Annual Research Day of the Douglas Research Centre and McGill Department of Psychiatry.

• Student training and outputs: MSc student is preparing a master’s thesis (submission planned August 2025), including a manuscript to be submitted to a peer-reviewed journal in Fall 2025.

Virtual Reality Exposure Therapy for Severe Anxiety Disorders: Effectiveness and Acceptability in English-Speaking Quebeckers

Exposure therapy consists in approaching one’s fears without avoidance. It is known to be the best psychological intervention for anxiety disorders, which are some of the most common, debilitating mental health problems in Quebec. Recently, virtual reality exposure therapy (VRET) has been developed to address some of the accessibility and acceptability concerns of traditional exposure therapy conducted in “real life”—one of these being the need for consistently clear communication between therapists and patients. Through computer-generated, language-free environments, VRET helps individuals confront the virtual counterparts of their fears, without extensive therapeutic discussions. VRET’s potential to increase access to a first-line anxiety treatment for English-speaking Quebec residents is thus promising. Although the efficacy of VRET has been shown to be comparable to traditional exposure therapy, most of this research has been conducted in well-controlled laboratories focusing on subclinical anxiety. This project aims to examine the effectiveness and acceptability of VRET for severe symptoms of anxiety disorders in a non-sectorized mental health clinic, accessible to all Quebec residents. English-speaking Quebeckers with an anxiety disorder will receive twelve sessions of VRET and will complete symptom measures pre- and post-intervention. Results will be compared to symptoms of individuals who have already undergone traditional exposure therapy at the clinic. Demonstrating that VRET is as effective as traditional exposure therapy in a real-life and language minority context will help increase access to a gold standard intervention, using approachable, language-free technology. Lastly, themes will be extracted from participants’ feedback to compare the treatments’ perceived accessibility and acceptability

Outputs

• Pilot and early results dissemination: Pilot data (2 participants) and preliminary analyses (8 participants) were presented at the McGill University Health Centre Research Days (2023 and 2025) as part of research dissemination and recruitment efforts.

• Conference presentations: The project was presented at the First Annual Conference in Digital Mental Health (Québec), showcasing the technology and its clinical applications to researchers and healthcare professionals.

• Future outputs planned: In line with the original proposal, the project is expected to produce two peer-reviewed publications, two out-of-province conference presentations, and one clinical workshop on integrating virtual reality into exposure therapy practice.

• Knowledge mobilization and media coverage: The project has been featured in multiple media outlets, including La Presse, 98.5 FM Radio Textos, CBC Radio Noon Quebec, CBC Daybreak Montreal, and Y’a du monde à messe (Télé-Québec) (broadcast scheduled June 6, 2025).