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CBT and attachment-based strategies for challenging psychotherapy cases: Navigating puzzling and complex clinical scenarios

November 12, 2026


Facilitator(s): Rana Pishva, PhD, C.Psych.


Description: Strategies for addressing challenging and complex psychotherapy: Navigating puzzling clinical scenarios is designed for clinicians seeking practical strategies to navigate complex and often puzzling situations in therapy. 


Even the most skilled clinicians face moments of uncertainty in therapy. In this immersive, interactive session, you’ll learn how to apply CBT and attachment-based interventions to address challenging client scenarios—from stuck cases to complex relational dynamics—so you can move forward with clarity and confidence. 


Through a combination of lectures, case studies, facilitated discussion, and group exercises, this session integrates evidence-based practices and real-world experience to help clinicians confidently address challenging scenarios. All strategies presented are informed by research-backed principles from cognitive behavioural therapy and attachment-based interventions.


Themes covered include dispelling common myths and misconceptions clients bring from social media; addressing relational issues when the source of client distress is a third party (e.g., parent, partner, or child); challenges and clinical pitfalls when clients seek the therapist’s personal opinion or decision-making; and working with a client who feels “stuck”, or a client “over-identifies” with a self-made diagnosis. When time permits, participants can also ask about their own challenging situations for discussion.

 

Examples of topics covered: 

  • Responding to “pop psychology” and misinformation
  • Working with the “Person not in the room”
  • Navigating requests for therapist advice
  • Clients feeling “stuck” or experiencing ambivalence, avoidance, and stagnation
  • Managing rupture and fostering repair in the therapeutic relationship
  • Client self-diagnosis

"This targeted training is for clinicians seeking practical, research-informed strategies to navigate common complex situations in psychotherapy.” – Dr. Rana Pishva


Learning objectives:

  • Implement strategies to overcome barriers to therapeutic progress.
  • Enhance skills in case conceptualization by effectively integrating cognitive behavioural and attachment-based theories. 
  • Recognize and manage ruptures in the therapeutic relationship. 
  • Effectively use practical strategies for working with relational issues when the client's distress involves a third party. 
  • Develop advanced listening skills by learning to notice and interpret discursive markers in client speech. 

Register now to strengthen your clinical insight and expand your therapeutic toolkit with strategies designed for today’s most challenging therapy moments.


SickKids Centre for Community Mental Health Learning Institute provides continuing education designed to help mental health professionals strengthen clinical knowledge, refine therapeutic skills and apply evidence-informed approaches in practice. Explore upcoming training at www.sickkidscmhlearning.ca. Ontario Psychological Association members can use code OPA20 to save 20% on eligible registrations.