For those who
serve, guard and save

About Us

A breakwater is a wall that stands between the calm of the harbour and the chaos and violence of the open sea. Some people are willing to take on “breakwater” occupations: as their life work they choose to stand facing outward toward danger, so that those behind them can enjoy security and peace. They take on the physical and psychological risks of confronting violence, disorder, and suffering, when most others would choose to look away.

Their work is vital, but it can take a heavy toll. They can find themselves feeling worn out, angry, high-strung, or depressed. It can get harder and harder for them to leave the stress of their job behind when a shift is over. They can struggle with evils they’ve seen, or with the consequences of their own split-second decisions. Sometimes they’ve seen so much that it sours their view of the world and human nature. They can wind up feeling isolated and alone, like no one can possibly understand what they’ve been through.

We created Breakwater for these people. Led by clinical psychologists with extensive scientific and clinical experience, Breakwater’s team uses research-based methods to help those who serve, guard, and save.

Here's How We Do It

By priding ourselves on being familiar with the unique work done by first responders, armed forces members, and those in related jobs
By addressing both the psychological and biological aspects of stress, anxiety and depression through innovative treatments aimed at both mind and brain
By focusing our efforts not only on intervention, but also on building resilience, keeping people functioning on the job and preventing stress injuries like PTSD and depression
By making sure that our clients’ privacy and confidentiality are always closely guarded, and that they’re treated with dignity and respect at every step in the process


► Assessment
Our team is led by clinical psychologists, the assessment experts of the mental health world. We’re able to:
  • Establish or rule out diagnoses of depression, PTSD, or other conditions
  • Give an up-to-date picture of how well an individual is coping with stress, relative to his or her individual baseline
  • Measure relevant aspects of personality such as resilience and vulnerability to stress
  • Assess mental capacities that can degrade after injury or chronic stress, such as problem-solving, attention, and memory
  • Directly measure the functioning of the brain and autonomic nervous system through innovative research-based tools such as quantitative electroencephalography and heart-rate variability
► Consultation
Our team is available for training and consultation to officers, management, and peer support team leaders and members. We can provide training on topics related to prevention, early intervention, and treatment of operational stress injuries - including PTSD, depression, and anxiety disorders - as well as related issues like general wellness and stress management, substance abuse, and relationships.
► Rapid Response Capability
Response time is critical. Under arrangement with first-responder organizations, we maintain rapid-response capability to help manage situations involving acute operational stress--such as “bad calls” or other crisis situations--so that help is always close at hand for acute incident management. We can also arrange with organizations to ensure we’re available to see service members for a fast consult, within a day or two of a request.
► Psychotherapy and Counselling
We stay on top of the scientific literature and provide expert psychotherapy and counselling that are based solidly on research conducted among first responders, military service members, or veterans. We understand that what works for other people may not necessarily be effective for those in high-stress professions, and our guiding principle is that the services we provide should be matched to the unique needs of the people we serve. Our approach is respectful, informed, no-nonsense, and tailored to the individual.
► Neuromodulation
In keeping with our conviction that there are both psychological and biological components to stress and mental health, we provide cutting-edge, research-driven interventions that directly modify the functioning of the brain. These include:

EEG biofeedback (neurofeedback), a brain-training procedure in which the individual learns to control his or her brain activity through moment-to-moment measurement of EEG (brain waves). As the brain’s electrical activity is recorded and analyzed, signals are provided to the brain when it shifts its activity in the direction of better regulation, promoting further, similar shifts. Neurofeedback is tailored to the individual’s own physiology using an initial norm-based assessment of brain function called a quantitative electroencephalogram (QEEG).

Heart-Rate Variability (HRV) biofeedback, a procedure that increases the brain’s ability to adapt its response to stress by challenging the autonomic nervous system. HRV biofeedback is effective at promoting relaxation, decreasing anxiety, and contributing to better coping with stress. Research has also shown that it can reduce PTSD symptoms.

Some of these interventions are done in the office, while others can be managed from home through the use of apps, wearables, and hand-held devices. All have been shown in scientific research to increase the brain’s capacity for self-regulation.

Our Team

Dr. Nicole Ethier earned her Ph.D. in Clinical Psychology from the University of Waterloo, where she currently holds a clinical adjunct faculty position. As part of her training, Dr. Ethier worked at the Operational Stress Injury Clinic in London, Ontario, where she worked with military veterans and RCMP officers. She has continued to develop this area of expertise, focusing on occupational stress injuries, such as PTSD, anxiety, and depression. In addition to providing assessment and therapy to first responders, Dr. Ethier is passionate about mental health prevention. She is involved with various first responder services throughout Ontario, providing consultation to peer support teams and pre-employment psychological screening of new hires.
Dr. Shannon Gifford earned her Ph.D. in clinical psychology from the University of Waterloo. She worked at the Parkwood Institute Operational Stress Injury (OSI) Clinic in London, Ontario for more than ten years, where she provided assessment and treatment services to currently serving and veteran members of the Canadian Armed Forces and the RCMP. Dr. Gifford has been a clinical adjunct faculty member with UW’s clinical psychology Ph.D. program since 2008.
Dr. Philip Toman has practised clinical psychology since 2004. He completed his Ph.D. in Clinical Psychology at the University of Waterloo, where he now also has an adjunct faculty posting. His interests lie in predicting who will be resilient to the impact of operational stress, monitoring the early onset of symptoms, and developing early interventions to keep people on the job. His area of clinical specialty within Breakwater is the use of brain-based techniques for assessment and intervention, bringing psychology and physiology together.
Dr. Beth Keleher earned her Ph.D. in clinical psychology from the University of Waterloo. During her graduate and residency training, she provided assessment and treatment for RCMP and Canadian Armed Forces members via rotations at the Parkwood Institute Operational Stress Injury (OSI) Clinic, the Calgary OSI Clinic, as well as for first responders at Breakwater Institute. She uses an integrative approach for treatment, drawing on a number of therapeutic techniques (e.g., cognitive-behavioural, interpersonal, and emotion-focused therapies) to address clients’ distinct needs and goals.
Kevin Capobianco is nearing the completion of his PhD in Clinical Psychology at the University of Waterloo where he has researched factors contributing to psychotherapy effectiveness. He has returned to Breakwater Institute after completing the University of Manitoba’s Predoctoral Clinical Health Psychology Residency where he gained further experience assessing and treating PTSD and other mental health challenges through hospital inpatient and outpatient work, and through the Deer Lodge Centre OSI Clinic for Canadian Armed Forces members. Kevin integrates various psychotherapeutic techniques in his clinical work and strives to tailor his approach to best fit with each client.
Carla Kane earned her Master of Social Work (MSW) from Wilfrid Laurier University in Waterloo. She focused her graduate studies on trauma, with a particular interest in the effects of operational stress injuries on individuals and family members including spouses and children. Prior to earning her MSW, Ms. Kane was a police officer for nine years having spent time in patrol and detectives. As a former first responder, Ms. Kane has intimate knowledge of the operational stressors that can impact individuals and families. At Breakwater, she offers services to individuals, couples, and families, using a trauma- informed approach to collaboratively identify coping skills and build resiliency.
Tali Barclay earned her Master of Social Work from the University of Toronto. Her training included modern approaches to psychotherapy over the life course. Her area of interest at Breakwater includes examining and treating the impact of occupational stress on family structures. Tali provides therapy services to individuals, couples and families.
Nick Zabara is completing his Ph.D. in clinical psychology at the University of Waterloo. His clinical experience has included working at the Parkwood Institute Operational Stress Injury (OSI) Clinic in London, assessing veterans of the Canadian Armed Forces and the RCMP for post-traumatic stress and related concerns. He has also worked with anxiety, depression, and PTSD in outpatient and inpatient populations at St. Joseph’s Healthcare in Hamilton. He will be completing his clinical residency at the Centre for Addiction and Mental Health (CAMH) in Toronto, providing assessments and treatment through the Workplace Safety and Insurance Board (WSIB).
Terri Currie earned a Bachelor’s Degree in Psychology and Social Work from the University of Waterloo and is a registered social worker. She has administered aptitude tests for police and special constable applicants across the province for Ontario Police Services, governed by the Ontario Association of Chiefs of Police, and has clinical experience working with children, youth, adults, and families. At Breakwater, she is a neuromodulation administrator, providing repetitive transcranial magnetic stimulation (rTMS) and neurofeedback treatment for anxiety and depression. Ms. Currie also works alongside Breakwater’s clinical psychologists to facilitate peer support and employment screening activities.
Shianna Hofstetter assists both clients and the Breakwater team in her role as administrative assistant. She has years of client service experience in both private and non-profit sectors and an educational background in mental health. Ms. Hofstetter is a registered social worker, having earned her Bachelor’s Degree in Social Work from the University of Waterloo.

“Those who can truly be accounted brave are those who best know the meaning of what is sweet in life and what is terrible, and then go out, undeterred, to meet what is to come.”
~ Pericles ~

Common Questions

► How are services paid for?
If you’re currently working:
You can use your employer’s extended health benefit plan to cover the cost of our services. Some employers also have dedicated funds set aside to pay for needed mental health services.

If you’re currently off work:
Your disability insurer or WSIB might have funds available to pay for services that are geared toward getting you back to your job.

If you’re an active military service member:
Please talk to your base medical officer about receiving services from us.

If you're a first responder:
There are funding options through WSIB's Community Mental Health Program, which you can access even if you plan to remain at work.

If you’re a veteran:
Please talk to your Veterans Affairs Canada Case Manager. If you haven’t got one, see the VAC website or call their contact line - 1 800 522 2122 - to explore your eligibility for services.

If you’re an organization:
We can work on a contractual or a fee-for-service basis, depending on your organization’s needs.
► Do you prescribe medications?
No, we don’t prescribe medications, because we don’t currently have medical doctors on staff (see the next question and its answer).
► What’s the difference between a psychologist and a psychiatrist?
A psychologist holds the Ph.D. degree and has training as a scientist as well as a clinician. Psychologists are experts in the science of psychology, and tend to be involved in research, assessment, consultation, and therapy. A psychiatrist holds the M.D. degree and has specific training as a medical doctor. Psychiatrists typically specialize in prescribing medication, because it’s an activity that’s exclusively reserved to medical doctors.
► Do you do cognitive-behavioural therapy, or CBT?
We are well trained in CBT, and apply its techniques frequently. We find that CBT principles and techniques are more applicable to some of our clients’ needs than to others, and we use them accordingly.
► How much will my employer know about the work that I do with you?
That’s up to you. Our self-referring clients are under no obligation to tell their employer that they’re getting services, who’s providing them, or what the services are. In the event that there is some information-sharing arrangement in place with an employer, we go over that with the client prior to beginning services so there’s no confusion.

Sometimes disability insurance companies require that we send them periodic updates on progress, but they themselves have policies to prevent your personal information from falling into the wrong hands.
► Do you see people with substance abuse problems?
We do, but we don’t consider ourselves specialists in addiction or substance abuse, and we’ll steer you to other programs if we believe you need to do extra work in that area. In general, we don’t insist that our clients have all their substance use issues worked out, but we won’t continue seeing clients for whom substance use--whether prescribed or non-prescribed--is interfering with our work.
► Do you see people who take medical cannabis?
Yes, we do. Many of our clients take cannabis or cannabis-derived products for sleep, anxiety, and/or chronic pain. This only becomes an issue in cases when the drug interferes with the usefulness of what we’re trying to do. As non-medical doctors, we don’t prescribe either cannabis or other medications.
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