I offer three main areas of support:

• Mindfulness-based psychotherapy for emotional support and coping

• Healthcare decision-making and planning (including advance care planning)

• Therapeutic groups focused on shared experiences and mindfulness skill-building to support mental health

My work integrates:

• clinical nursing experience

• serious illness communication

• mindfulness-based psychotherapy

• healthcare system navigation

This allows me to support both the emotional and practical aspects of serious illness and healthcare decision-making.

Some services may be covered by extended health benefits, depending on your plan and the type of service.

• Psychotherapy is more commonly covered

• Healthcare planning and navigation may not be covered, but can sometimes be reimbursed under health spending accounts or nursing services.

I recommend checking with your provider directly. Receipts are provided for all services.

In some cases, services may be considered a medical expense for tax purposes, particularly when provided by a regulated health professional such as myself. I recommend confirming with your accountant or the CRA.

No. Many people reach out before a crisis to plan ahead, reflect on their values, or prepare. Others come during active illness or caregiving.

This work can be helpful at many stages, including:

• early planning and reflection

• new diagnoses

• caregiving transitions

• periods of uncertainty or change

You don’t need to be in crisis to begin.

Mindfulness-based therapy combines evidence-informed psychotherapy approaches with mindfulness practices, helping you:

• Notice thoughts and emotions without becoming overwhelmed

• Respond rather than react in difficult situations

• Build clarity, resilience, and self-awareness

It is practical, grounded, and adaptable to your comfort level. No prior experience is required.

Mindfulness supports decision-making by helping you:

• Slow down in moments of pressure or uncertainty

• Distinguish between fear, urgency, and what truly matters

• Stay connected to your values

• Approach complex choices with greater clarity and steadiness

This is especially helpful in healthcare situations where emotions and information can feel overwhelming.

Yes. I work with both individuals and families, particularly when:

• decisions need to be made together

• roles (like substitute decision-makers) are being clarified

• communication or alignment is needed

Privacy Statement

Present at the end – Psychotherapy Services
Effective Date: January 1, 2026

1. Our Commitment to Privacy

Present at the end is committed to protecting the privacy and confidentiality of your personal health information (PHI). As a health information custodian under Ontario’s Personal Health Information Protection Act, 2004 (PHIPA), we collect, use, store, and disclose personal health information in compliance with PHIPA and other applicable laws.

2. What Is Personal Health Information?

Personal Health Information (PHI) includes identifying information about your physical or mental health, healthcare history, treatment plans, and payment for care.

3. Information We Collect

We may collect:

• Name, address, phone number, and email

• Date of birth and emergency contact information

• Health and mental health history

• Session notes and clinical records

• Billing and payment information

We collect only the information necessary to provide safe, ethical, and effective psychotherapy services.

4. How We Use and Disclose Your Information

Your information may be used to:

• Provide psychotherapy services

• Maintain clinical records

• Communicate with you regarding appointments or services

• Process billing and insurance claims

• Comply with legal and regulatory requirements

Your PHI will not be disclosed without your consent except where required or permitted by law, including:

• Risk of serious harm to yourself or others

• Suspected child abuse or neglect

• Court orders or subpoenas

• Regulatory audits or investigations

5. Use of Microsoft 365

Our practice uses Microsoft 365 for email communication, scheduling, and secure document storage. Microsoft 365 employs encryption and industry-standard security safeguards. Access to your information is protected through password controls and multi-factor authentication.

While reasonable safeguards are in place, electronic communication (including email) carries inherent risks. By choosing to communicate via email, you acknowledge and accept these risks.

6. Safeguards

We protect your personal health information through:

• Password-protected and encrypted devices

• Multi-factor authentication

• Secure cloud storage

• Restricted access to authorized individuals only

• Secure record retention and destruction practices

7. Retention of Records

Clinical records are retained in accordance with professional regulatory standards in Ontario. Records are securely destroyed after the required retention period has expired.

8. Your Rights Under PHIPA

Under PHIPA, you have the right to:

• Access your personal health information

• Request corrections to your records

• Withdraw consent to the collection, use, or disclosure of your information (subject to legal and clinical limitations)

• File a complaint with the Information and Privacy Commissioner of Ontario

9. Questions or Concerns

If you have questions about this Privacy Statement or your personal health information, please contact:

Celina Carter PhD, MN, RN, Present at the end, Toronto, ON info@presentattheend.com

If your concerns are not resolved, you may contact the Information and Privacy Commissioner of Ontario.