Year: 2020

Meeting with Minister of Health (May 2020)

Posted on by CPA Webmaster

As part of the Organizations for Health Action (HEAL), the CPA had an opportunity to meet with the Federal Minister of Health, The Honourable Patty Hajdu to discuss the role of the government in the context of COVID-19. The Minister indicated that the government is discussing what additional investments need to be made to support the mental health of Canadians.

“Psychology Works” Fact Sheet: Phobias

Posted on by CPA Webmaster

What is a phobia?

A phobia is an excessive and persistent fear of a situation (e.g., enclosed places, driving, flying, seeing blood, heights) or an object (e.g., animals such as rats, snakes, spiders, dogs, or birds).

The focus of an individual’s fear is generally anticipated harm or danger related to the situation or object (e.g., having an accident while driving, being bitten by a dog) or fear of losing control and having anxiety-related physical sensations (e.g., panicking in an enclosed place, fainting upon seeing blood).

The fear is considered excessive because it is out of proportion to the actual level of danger associated with the situation. When an individual with a phobia is exposed to the feared stimulus (the object or the situation) or related cues (things that remind us of the object or situation), an immediate anxiety response is triggered that can sometimes grow into a full-blown panic attack. Consequently, people with phobias either avoid the feared situations or objects or they endure them with a lot of distress.

For example, an individual with a phobia of snakes experiences an anxiety reaction in a number of situations including seeing a snake on television, being outside in grassy or wooded areas where snakes may live, and seeing things that resemble a snake such as a coiled garden hose in the yard.

Phobias are quite common and occur in almost one in every 10 Canadians. There are four main types of phobias: animal type (e.g., spiders, dogs, and rodents), natural environment type (e.g., storms, heights, and water), blood-injection-injury type (e.g., seeing blood, getting a needle, having a medical procedure), and situational type (e.g., enclosed places, flying, driving). Phobias that do not fit into these four categories fall into a fifth category referred to as “other type” (e.g., fears of choking or vomiting). The most common phobias are those of animals and heights.

Blood-injection-injury and animal phobias typically begin in early childhood whereas situational and natural environment phobias begin later, usually in the late teens and 20s. Approximately 75% of individuals with a blood-injection-injury phobia report a history of fainting in response to the phobic stimulus.

These features of phobias are outlined in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, (American Psychiatric Association, 2013):

  • Significant fear or anxiety about a specific object or situation (in children, this may be expressed through tearfulness, tantrums, clinging, or freezing);
  • The phobic stimulus nearly always triggers immediate fear or anxiety;
  • The phobic stimulus is avoided or endured with intense distress;
  • The fear or anxiety is excessive or out of proportion to the actual danger posed by the phobic stimulus;
  • The fear, anxiety, or related avoidance typically lasts for at least 6 months;
  • The fear, anxiety, or related avoidance causes significant distress to the individual or interferes with their daily social, occupational, and/or other important activities.

Phobias have a strong effect on a person’s life. They cause a lot of distress and can make it very difficult to function normally in social situations, at work, or in other domains.

For example, an individual with a snake phobia may avoid pleasant activities such as gardening, nature walks, camping or playing a game in a field. A person with a height phobia may not take a job in an office on a high floor of an office tower. A person with a flying phobia may turn down a promotion because the new position requires flying to meetings across the country. An individual with a phobia of needles or medical procedures may avoid necessary treatments or routine blood tests because of their phobia, putting their health at risk.

Although many phobias are triggered by experiencing a traumatic event in the phobic situation (e.g., getting stuck in an elevator or having a panic attack while flying), a number of individuals do not remember a specific time or event that caused their fear and report a more gradual development.

Thus, there are a number of ways to develop a phobia, including direct learning (having a traumatic experience with the phobic object or situation), vicarious learning (seeing someone else being frightened of the phobic object or situation ), and informational transmission (hearing about a scary event through the media or a family member or being told that a specific object or situation is dangerous).

We are more likely to develop fears of some objects and situations than others. For example, it is much easier to develop a fear of a snake than a flower. In fact, our fear of snakes may have helped us to survive over the centuries. Our own unique personality factors (such as a disgust reaction to certain stimuli) and our stress levels at the time of a traumatic event can also lead to the development of a phobia.

What psychological approaches are used to treat phobias?

The treatment of choice for specific phobias is cognitive behaviour therapy (CBT).

It focuses on slowly and safely exposing a person to their feared object or situation. This is called an exposure-based treatment because it involves repeatedly approaching the target of one’s fear until it no longer produces a strong fear reaction.

Many studies have shown that exposure-based CBT is highly effective for the treatment of specific phobias.

In fact, specific phobias are considered to be the most treatable of the anxiety disorders. Most people with a phobia can achieve significant improvement or full recovery in as few as one to five sessions. This form of treatment has been used for adults, adolescents, and children.

CBT has been found to be effective when administered in a self-help book format as well. Recent developments in treatment have used virtual reality to assist in exposure to situations that are difficult to replicate, such as flying and heights.

Generally, medications are not considered effective for the treatment of specific phobias. However, it is not uncommon for individuals with phobias to be prescribed low doses of benzodiazepines (anti-anxiety medication) to be taken in the phobic situation (e.g., when flying). Although this will not eliminate the fear, it allows the person to function in the situation.

Where do I go for more information?

For more information on phobias visit the following websites:

You can consult with a registered psychologist to find out if psychological interventions might be of help to you. Provincial, territorial and some municipal associations of psychology often maintain referral services. For the names and coordinates of provincial and territorial associations of psychology, click http://www.cpa.ca/public/whatisapsychologist/PTassociations/.

This fact sheet was prepared for the Canadian Psychological Association by Dr. Randi E. McCabe, Clinical Director of the Mood, Anxiety, and Seniors Mental Health Services at St. Joseph’s Healthcare Hamilton and Professor in the Department of Psychiatry and Behavioural Neurosciences at McMaster University, and updated by Dr. Irena Milosevic, Clinical Psychologist at St. Joseph’s Healthcare Hamilton and Assistant Professor in the Department of Psychiatry and Behavioural Neurosciences at McMaster University.

Revised: May 2020

Your opinion matters! Please contact us with any questions or comments about any of the Psychology Works Fact Sheets:  factsheets@cpa.ca

Canadian Psychological Association

Tel: 613-237-2144
Toll free (in Canada): 1-888-472-0657

CDC: Use of Cloth Face Coverings to Help Slow the Spread of COVID-19

Posted on by CPA Webmaster

CDC recommends wearing cloth face coverings in public settings where other social distancing measures are difficult to maintain (e.g., grocery stores and pharmacies), especially in areas of significant community-based transmission.

CDC also advises the use of simple cloth face coverings to slow the spread of the virus and help people who may have the virus and do not know it from transmitting it to others. Cloth face coverings fashioned from household items or made at home from common materials at low cost can be used as an additional, voluntary public health measure.

Use of Cloth Face Coverings during Pandemic: Wearing, Maintaining and Making Cloth Face Coverings

“Psychology Works” Fact Sheet: Grief, Bereavement and COVID-19

Posted on by CPA Webmaster

COVID-19 is an infectious disease that is not only posing significant risk to public health and the way we cope with our daily lives; it is also posing a significant challenge to how we are dying and how we are mourning loved ones.

Death and Dying

Physical distancing restrictions related to COVID-19 have meant that many individuals are dying – or facing the prospect of dying – without the presence of family and friends around them, causing them feelings of isolation and psychological distress. Due to the strains facing health care workers and facilities, individuals in palliative care may also not be having their advanced-care directives fully realised (e.g., preferred location of death, life-prolonging measures).[i] This can be particularly problematic and distressing for those who are cognitively aware that their directives are not being met.

Those same restrictions are also causing distress for family and friends who are not being permitted to  be with loved ones when they are ill or dying, thereby preventing the opportunity to hold someone’s hand, have a last meaningful conversation, affirm a bond, make amends, or simply say good-bye.[ii] Further causing distress is the haste with which some current provincial restrictions are forcing families to decide where to send a body within 1-3 hours of death, depending on whether the death occurred in hospital or in a long-term care facility.

Impacts on Mourning

Different cultures have their own customs and rituals for mourning.  Physical distancing restrictions are also making it hard for people to come together socially with other mourners to grieve, spend time with or pay their final respects to the deceased, provide support to one another, and/or find comfort in their cultural or secular traditions, thereby contributing to grieving challenges and feelings of isolation.[iii]

When loved ones do not have the opportunity to say good-bye and cannot come together to provide physical comfort, they may not have the necessary closure – also known as ambiguous loss – they need to properly grieve.[iv] They may feel anger at those that have put the restrictions in place; regret at not having a chance to hold someone’s hand or make amends; worry that a loved one may not be being given appropriate care or necessary pain relief; and guilt over one’s own powerlessness and inability to be with a loved one in their time of need.

It is unknown how long physical distancing measures will be in place; as such, it is important for people to find new ways to both recognize the dying process and cope with grief.  During the dying process, to the extent possible, video calling can connect patients with family members who are separated because of travel and/or visitor restrictions, offering some sense of comfort to patients in their last days and moments. Following death, friends and family can come together virtually, make use of online memorials, write more elaborate obituaries, and/or plan to hold services at a time when physical distancing restrictions are no longer in place.[v] While these measures are providing some means of honouring the deceased, they nonetheless cannot replace the physical comfort and connectedness one feels from a hug or hand-shake.

Disrupted, Complicated or Prolonged Grief

Although grief is a normal response to loss, “the grieving process itself is very individualized and personal such that everyone processes and experiences grief differently”.[vi]  For many, coming together for a funeral or other cultural ritual to honour the death of an individual is an essential – and normal – step in the bereavement process. Not being able to come together to mourn may not only lead to ambiguous loss, these circumstances may also increase the likelihood of one experiencing disrupted, complicated or prolonged grief.

When Psychological Distress Becomes Too Much

Individuals experiencing disrupted, complicated or prolonged grief are at increased risk of substance use, sleep disorders, impaired immune functioning and suicidal thoughts.[vii]

While spiritual leaders are themselves being restricted from being with individuals as they pass and performing any last rites of passage, they can be a source of comfort to loved ones to help them cope with the loss. Psychologists and other mental health providers can also help with disrupted, complicated or prolonged grieving.

If the following signs and symptoms increase or worsen over time and impair overall functioning, they might signal need for help to cope with one’s grief:

  • Sleeping poorly, too much or too little
  • Avoiding others, even within the confines of social distancing
  • Experiencing headaches, stomach problems, neck or back pain
  • Crying excessively and all the time
  • Talking less and being withdrawn
  • Feeling dazed or disconnected from self or the reality
  • Feeling anxious, depressed or having panic attacks
  • Feeling angry, guilty, helpless, numb, or confused
  • Not wanting to get out of bed
  • Having difficulties concentrating or focusing
  • Excessive eating for comfort
  • Drinking more alcohol or taking prescription drugs more than prescribed
  • Having little patience
  • Feeling overprotective of loved ones

It is important to remember that most of us have had some of the signs and symptoms listed above at one time or another, and that COVID-19 has led to increased stress for most people.  If you have a number of these signs and symptoms and they

  • persist beyond a couple of weeks
  • persist to the point where you are not able to carry out the home or work-related activities permitted by social distancing advisories
  • are accompanied by intense feelings of despair, hopelessness, helplessness or suicidal thoughts

you are well advised to consult a regulated health care professional such as a psychologist, your family physician, psychiatrist, or other mental health provider.

Resources:

Ontario Palliative Care Network, 2020. Planning for Palliative Care Delivery during the COVID-19 Pandemic. http://www.virtualhospice.ca/covid19/

Where do I go for more information?

To obtain  important and up to date information about COVID-19, visit the Public Health Agency of Canada (PHAC) website at https://www.canada.ca/en/public-health/services/diseases/2019-novel-coronavirus-infection.html

Provincial, territorial, and some municipal associations of psychology often maintain referral services. For the names and coordinates of provincial and territorial associations of psychology, please visit:  https://cpa.ca/public/whatisapsychologist/PTassociations

This fact sheet has been prepared for the Canadian Psychological Association by Dr. Lisa Votta-Bleeker, Deputy Chief Executive Officer, Canadian Psychological Association; Dr. Katy Kamkar, Clinical Psychologist, Centre for Addiction and Mental Health (CAMH) and Chair of the CPA’s Traumatic Stress Section; and Ms. Eva Sheppard-Perkins, Canadian Psychological Association.

Date: May 11, 2020

Your opinion matters! Please contact us with any questions or comments about any of the Psychology Works Fact Sheets:  factsheets@cpa.ca

Canadian Psychological Association

Tel: 613-237-2144
Toll free (in Canada): 1-888-472-0657

[i] Arya, A., Buchman, S., Gagnon, B. and Downar, J., 2020. Pandemic palliative care: beyond ventilators and saving lives. Canadian Medical Association Journal, 192(15), pp. E400-E404.

[ii] https://www.apa.org/topics/covid-19/grief-distance

[iii] Leong, I., Lee, A., Ng, T., Lee, L., Koh, N., Yap, E., Guay, S. and Ng, L., 2004. The challenge of providing holistic care in a viral epidemic: opportunities for palliative care. Palliative Medicine, 18(1), pp.12-18.

[iv] https://www.apa.org/topics/covid-19/grief-distance

[v] Wolfelt, A., 2020. Exploring the Natural Complications of the “Whys” of Funerals During the Coronavirus Pandemic – Center For Loss & Life Transition. [online] Center for Loss & Life Transition. Available at: https://www.centerforloss.com/2020/04/funeral-whys-during-coronavirus/.

[vi] https://weareunsinkable.com/when-struck-by-a-dark-cloud-grief-loss/

[vii] Shear, K.M. 2015. Complicated Grief, New England Journal of Medicine, Vol. 372, No. 2, pp: 153-160..

“Psychology Works” Fact Sheet: Research Funding Information as relates to COVID-19

Posted on by CPA Webmaster

Canada’s COVID-related Research Support

Public health emergencies such as COVID-19 affect the lives of people, families and communities. In early March, the Government of Canada announced an investment of more than $275 million in funding for research on measures to combat COVID-19. Of this investment, $27 million was allocated to research through the three federal research funding agencies―the Canadian Institutes of Health Research (CIHR), Natural Sciences and Engineering Research Council (NSERC), and the Social Sciences and Humanities Research Council of Canada (SSHRC) ―the Canada Research Coordinating Committee, through the New Frontiers in Research Fund, the International Development Research Centre and Genome Canada. The international research community, research funders and public health institutions are cooperating to look for novel solutions, from new vaccines to more effective communication about the pandemic. To date, over 95 projects led by Canadian researchers are focussed on developing and implementing measures to rapidly detect, manage, and reduce transmission of COVID-19, as well as assess its impacts.

Information from Canada’s Tri-Funding Agencies

If your research is funded by a federal agency such as CIHR, NSERC or SSHRC, review each agency’s websites for information on how your current and/or future research may or may not be impacted.

CIHR

CIHR is closely monitoring the evolution and impact of the novel coronavirus (COVID-19), and is taking action to support its grants, scholarship and awards recipients, as well applicants and peer reviewers. Visit this page regularly for messages from CIHR President, Dr. Michael Strong, and updated information for the research community: https://cihr-irsc.gc.ca/e/51917.html.

SSHRC

As the COVID-19 situation continues to evolve, SSHRC management is assessing additional measures that may be needed to support SSHRC-funded students, postdoctoral fellows and research personnel and address concerns. Visit this page regularly for updated information on the impacts of COVID-19 on SSHRC’s policies and programs: https://www.sshrc-crsh.gc.ca/news_room-salle_de_presse/covid-19-eng.aspx.

NSERC

NSERC continues to adjust its operations as it monitors the evolution and impact of COVID-19. Visit this page regularly for messages from CIHR President, Dr. Alejandro Adem, and updated NSERC program information in relation to COVID-19: https://www.nserc-crsng.gc.ca/Media-Media/NewsRelease-CommuniqueDePresse_eng.asp?ID=1139.

Other Funding Sources

Others may have funding from sources other than the tri-agencies (for example, provincial funding, associations, foundations, private industry, universities); in that case, check in with your funding provider to assess the impacts of COVID on your research funding and deadlines.

Where do I go for more information?

To obtain  important and up to date information about COVID-19, visit the Public Health Agency of Canada (PHAC) website at https://www.canada.ca/en/public-health/services/diseases/2019-novel-coronavirus-infection.html

Provincial, territorial, and some municipal associations of psychology often maintain referral services. For the names and coordinates of provincial and territorial associations of psychology, please visit:  https://cpa.ca/public/whatisapsychologist/PTassociations

This fact sheet has been prepared for the Canadian Psychological Association by Dr. Lisa Votta-Bleeker, Deputy Chief Executive Officer, Canadian Psychological Association.

Date: May 7, 2020

Your opinion matters! Please contact us with any questions or comments about any of the Psychology Works Fact Sheets:  factsheets@cpa.ca

Canadian Psychological Association

Tel: 613-237-2144
Toll free (in Canada): 1-888-472-0657

“Psychology Works” Fact Sheet: Guidance for Psychology Students as Relates to COVID-19

Posted on by CPA Webmaster

As the COVID-19 situation evolves around the globe, students’ day-to-day lives are being increasingly disrupted: courses have been moved from in-person settings to online formats; visits with friends and families have been prohibited; access to resources such as the on-campus library, student counselling services, or other campus spaces has been lost; some students have had to leave, quickly in some cases, their student residence; in-person conferences have been cancelled; competition and application deadlines have been delayed; internship, residency and co-op/practicum placements have been cancelled or altered; and for some, research projects have been interrupted.

This document provides an overview of Canada’s COVID-related student funding support, as well as resources to help psychology students deal with the impact of the coronavirus on their research, training, and academic work.

More detailed information specific to Canada’s research funding support and information from the funders can be found in the CPA’s Fact Sheet on Research Funding Information as Relates to COVID-19 (https://cpa.ca/corona-virus/cpa-covid-19-resources/).

Information from Canada’s Tri-Funding Agencies

Canada’s tri-funding agencies (Canadian Institutes for Health Research – CIHR; Social Science and Humanities Research Council of Canada – SSHRC; Natural Science and Engineering Research Council of Canada – NSERC) are closely monitoring the evolution and impact of COVID-19 and are taking necessary actions to support its grant, scholarship, fellowship, and awards recipients; support its applicants and peer reviewers; protect their staff; and modify their operations. Below are links to messages from the tri-agencies.

Each agency is also regularly updating their websites with messages from the presidents and updated information for the research community.

Student Support; Awards, Scholarship and Fellowship Competition Deadlines

The Government of Canada has announced significant emergency support for students and recent graduate impacted by COVID – expanded student and youth programming, enhanced student financial assistance for Fall 2020, Canada Emergency Student Benefit, Canada Student Service Grant, and International Students. Information on this support can be found here: https://www.canada.ca/en/department-finance/news/2020/04/support-for-students-and-recent-graduates-impacted-by-covid-19.html

In early May, the tri-agencies announced that training award recipients (master’s, doctoral, and postdoctoral) may defer the start date of their award, or request an unpaid interruption of up to four-months for reasons related to the COVID-19 situation (https://cihr-irsc.gc.ca/e/42405.html#05_04_2020). For master’s and doctoral award holders, this can be adjusted to align with the next available start date (May 1, 2020; September 1, 2020; or January 1, 2021). The agencies will continue to support training award holders who, given the challenges posed by the COVID-19 situation, can only devote part-time hours to their research. They may continue to hold their awards and will be paid at the full amount. The amount will not be prorated, and the end date of the award will remain unchanged.

Visit the program webpages listed below for additional information specific to the following student award, scholarship and fellowship competitions and what impact COVID may or may not be having on their deadlines:

Other Funding Sources

Students with funding from sources other than the tri-agencies (for example, provincial funding, associations, foundations, private industry, universities); in that case, check in with your funding provider to assess the impacts of COVID on your research funding and deadlines.

Studying from Home

Given the many weeks since physical distancing has been in place, and schools have transitioned to virtual learning, many students have already set up home workspace.  Nonetheless, below are a few things to keep in mind when studying from home:

  • Remember to have realistic expectations for your work and progress during a global pandemic. It is okay if you feel that you do not have the mental or emotional capacity to produce knowledge or undertake research during a global crisis.
  • If possible, set up a dedicated workspace where you can keep study materials and have virtual classes or group chats, so that you keep your studies separate from the rest of your life. Try to remember proper ergonomics when setting up your workspace.
  • Take some time to make sure you have all necessary resources at your disposal to effectively conduct your studies, as this could help mitigate potential stressors. For example, install any required software on your computer or order a headset and webcam for online classes. Reach out to your professor or students’ union if you need support and resources.
  • As much as possible, keep your study space quiet and free from distractions. If you have roommates, you could use headphones (ideally noise-cancelling headphones) to drown out noise. Make sure your space is inviting so you want to spend time there (you could sit by a window or add a plant or favourite trinket to your desk).
  • Contact your internet provider for free or low-cost internet options if you do not have Wi-Fi at home and are unable to access the online resources that can help you continue your education.

 

 

Setting a schedule for school and life

  • Maintain a consistent routine: This includes sleep-wake times, exercise, and work/school schedules. It can be easy to do schoolwork all day because it feels like there is nothing else to do. Establishing and maintaining a routine will help you maintain a sense of normalcy and keep your schoolwork and home life separate.
  • Take breaks: It’s important to take breaks to rest your eyes, your mind and your body. If it’s hard for you to remember to take breaks, you could set up a timer for 90 minutes and then take a 15-minute break.
  • Check in with supervisors/professors about expectations: Maintain good communication with your supervisors and professors. Have a clear understanding about whether moving to online classes changes expectations around assignments, exams, and other academic requirements. For example, you could ask for flexibility on timelines given your current time zone.
  • Stay connected to others: Develop a plan to keep in touch with friends, family, and colleagues. Schedule regular phone calls or facetime chats. Tap into social media and tech platforms that allow virtual group gatherings.

Impacts on Graduate Students, Student Research, and Professional Training

Graduate students and trainees have been particularly impacted during CVOID-19 due to stressors arising from financial uncertainty; pressure to graduate within a given time frame and before funding runs out; managing research and teaching responsibilities; and disruption in academic work and transition to remote learning. During these times, students would be benefit from:

  • Talking to one’s university’s research officer to understand what, if any, impacts COVID-19 will have on any student funding one may have (e.g., scholarships, bursaries, fellowships).
  • Assessing if one’s research can be conducted through online surveys or if one’s research protocol can be moved to an online experiment.
  • Talking to one’s supervisor/professor(s) about working on publications, while not losing sight of the mental and emotional resources required to cope with COVID-19.

Professional Training Impacts

Some graduate students and trainees have also been particularly impacted by disruption to practicum/co-op placements, internships, and other face-to-face skill building activities. Students should talk to their department head or co-op/practicum coordinate (if applicable) about the impacts of cancelled practicum placements and co-op work terms, as well as options for extending work terms with placement providers and finding new placements.

With respect to the impact on internships, the CPA, Canadian Council of Professional Psychology Programs (CCCPP), and the Association of Canadian Psychology Regulatory Organizations (ACPRO) issued a joint statement recognizing the impact COVID-19 is having on the operation of professional psychology training programmes and on their faculty, staff and students (https://cpa.ca/cpa-ccppp-acpro-statements-regarding-covid-19/).  It is important to understand that decisions about training will be made at several levels (https://ccppp.wildapricot.org/news). The first level is between the internship program and the university, as they jointly determine if the requirements for the internship have been met. The second level of decision making lies with the regulators, who will make independent decisions on a case-by-case basis about whether a candidate for licensure/registration/certification has met the provincial standards that are outlined in legislation and bylaws.

Conference Cancellations

The pandemic has also resulted in the cancellation of many in-person conference and knowledge mobilization activities, which is also impacting students and trainees in terms of lost opportunities to present at or attend conferences.  Until such time that in-person conferences can resume, students should seek opportunities to present and/or participate in virtual conferences. The CPA’s national convention will be offered virtually in July and August 2020; check the CPA’s website regularly for more information on how to participate and/or present at the virtual event.

If you had been accepted to submit at a conference and the conference was cancelled, contact the conference organizers regarding their policy about creating an abstract book or conference proceedings, noting the conference acceptance on your CV, and obtaining the word on how to do so. The CPA will be preparing an abstract book of all accepted presentations; below is information on how to cite your presentation if you were accepted to present at the CPA’s 2020 National Convention in May 2020.

Surname, Initial. & Surname, Initial. (2020, May 27-30).  Title of accepted submission. [specify type of presentation – poster, Gimme-5, 12-minute talk, etc.]. 81st Canadian Psychological Association Annual National Convention, Montréal, Quebec, Canada. (insert link to Abstract Book PDF when available) (Conference cancelled due to COVID-19)

Alternative Learning Opportunities

  • Register for online continuing education offerings, from the CPA as your national association or from one of the provincial psychological associations, many of which are presently free or significantly discounted.
  • Explore or deepen your learning of new research methods or statistical applications by downloading freely available software.
  • Learn more about Open Science(https://cos.io/)and the preregistration (https://cos.io/prereg/)
  • Source publishers that are providing free access to books and journals online.
  • Take in the APA webinar (https://www.apa.org/education/coping-webinar-students)in which psychologists Lynn Bufka and Vaile Wright discuss ways for undergraduate and graduate students to navigate the shifting COVID-19 crisis.

Self-Care and Student Wellness

During this time, it is important to take care of yourself and pay attention to your mental well-being.

Where do I go for more information?

To obtain  important and up to date information about COVID-19, visit the Public Health Agency of Canada (PHAC) website at https://www.canada.ca/en/public-health/services/diseases/2019-novel-coronavirus-infection.html

Provincial, territorial, and some municipal associations of psychology often maintain referral services. For the names and coordinates of provincial and territorial associations of psychology, please visit:  https://cpa.ca/public/whatisapsychologist/PTassociations

This fact sheet has been prepared for the Canadian Psychological Association by Dr. Lisa Votta-Bleeker, Deputy Chief Executive Officer, Canadian Psychological Association.

Date: May 7, 2020

Your opinion matters! Please contact us with any questions or comments about any of the Psychology Works Fact Sheets:  factsheets@cpa.ca

Canadian Psychological Association

Tel: 613-237-2144
Toll free (in Canada): 1-888-472-0657

“Psychology Works” Fact Sheet: Guidance for Psychology Faculty and Researchers as Relates to COVID-19

Posted on by CPA Webmaster

COVID-19 is not only impacting everyday life; it is also impacting faculty and research teams in many ways, from how to transition to online classes, how to work and best support students remotely, how to adapt current research projects while ensuring the welfare and safety of research subjects, and how to pay salaries/stipends and other costs that may be modifying or halting research.

With the transition to virtual education, researchers and faculty are working diligently to protect their research participants and animal subjects, their students, their scholarship, and in some cases, their careers. In the interim, below is some information that may provide helpful guidance in navigating these difficult times.

More detailed information specific to Canada’s research funding support and information from the funders can be found in the CPA’s Fact Sheet on Research Funding Information as Relates to COVID-19 (https://cpa.ca/corona-virus/cpa-covid-19-resources/).

Working Remotely

Since mid-late March, most people have been working remotely. This has required faculty, staff and researchers to ensure they had all mission critical information with them; they were using university-approved security protocols to analyze and store data off-site; and they had a laptop, charger, webcam, contact information for team members and access to any electronic materials that would have been needed.  Knowledge of Skype, Zoom, Hangouts/Google-Meet and other video-conference software has become a must to stay connected virtually.

Maintaining Research

Given COVID-19, research that brings people physically close together or in large gatherings has been most impacted. Policies regarding how to conduct research during emergencies are university specific, and you should follow your institution’s emergency or disaster-preparedness policies for guidance to deal with COVID-19’s impact on your research and career/degree-completion impacts.

Information from Canada’s Tri-Funding Agencies

Canada’s tri-funding agencies (Canadian Institutes for Health Research – CIHR; Social Science and Humanities Research Council of Canada – SSHRC; Natural Science and Engineering Research Council of Canada – NSERC) are closely monitoring the evolution and impact of COVID-19 and are taking necessary actions to support its grant, scholarship, fellowship, and awards recipients; support its applicants and peer reviewers; protect their staff; and modify their operations.

Each agency is also regularly updating their websites with messages from the presidents and updated information for the research community.

Check in with your program officer

While Canada’s funding agencies have extended deadlines, it is nonetheless important to think creatively about how to sustain your research over at least the next three to six months. Stay in regular touch with your university’s program officer and share how the crisis is affecting your work and how you plan to keep making progress.

Maintain communication with your research team

Frequent communication is important to sustaining research projects, assessing how your team members are coping, and maintaining social connectedness. Consider daily or weekly video-meetings to set goals and/or action items. Reassure your staff that it is okay to not be as productive during these challenging times. To the extent possible, cross-train staff, deploy them to work on other tasks, and if not already done, have calls forwarded to a project staff person’s cellphone.

Modify your research and analysis

With the stoppage of face-to-face human research or temporary closure of research labs, researchers who rely on face-to-face interaction or in-lab work to collect data have had to either pause their research or transition their research to online.  If you are shifting to remote data collection and storage, keep in mind that changing methodologies may you require that you notify your institution’s review or ethics board and potentially, updating consents to participate. Modifications to methodologies in the midst of a study will have to be accounted for in future analyses.

Supporting Students and Trainees

Students and trainees are most vulnerable right now due to stressors arising from financial uncertainty; pressure to graduate within a given time frame and before funding runs out; managing research and teaching responsibilities; disruption in academic work and transition to remote learning;  cancelled or altered co-op placements, internships, and residencies; and lost conference presentation/attendance opportunities. If you are able, help them progress toward their goals and be flexible about deadlines.

Encourage students to visit the Government of Canada’s website for information on its emergency support for students and recent graduate impacted by COVID: https://www.canada.ca/en/department-finance/news/2020/04/support-for-students-and-recent-graduates-impacted-by-covid-19.html.

Encourage them to visit the tri-agency’s websites for information on extensions for training award recipients and competition deadline information pertaining to the Canada Graduate Scholarships, Vanier Canada Graduate Scholarships, Banting Postdoctoral Fellowships, and NSERC’s Undergraduate Student Research Award – to name just a few.

If students have been awarded funding from sources other than the tri-agencies, direct them to contact the funding provider to obtain information on impacts to deadlines.

Stay in touch with your students and have conversations with them about how they plan to carry on their work during this new reality, while reminding them that it is okay to feel that they do not have the mental or emotional capacity to produce knowledge or continue their research during these challenging times.

More detailed information specific to COVID and psychology students can be found in the following CPA Fact Sheets: Guidance for Psychology Students as Relates to COVID-19 and Student Wellness during COVID-19 ((https://cpa.ca/corona-virus/cpa-covid-19-resources/).

Supporting Junior Colleagues

Junior colleagues are also particularly vulnerable right now. If possible, senior faculty may be able to offer data sets they can work with or provide opportunities to collaborate on existing research projects.

If you are an early career researcher yourself, document how the crisis is affecting your research and talk to your chair about potential impacts on your tenure path. With the cancellation of most in-person conferences, seek opportunities to network virtually, participate in the work of your national or provincial psychological association, or participate in other scholarship activities (e.g., online continuing education, serving as a peer reviewer).

Self-care

While this is a very challenging time for everyone, it is important to remember that all of your department colleagues and research peers are in the same position.  Eventually, research activities will resume, as will in-person classes. In the interim, it is important for faculty and researchers to take care of themselves.

During this time, some psychology faculty may have increased demands to provide mental health services and supports to their students in ways that might otherwise not have been expected to before COVID019. Check in with your department and your university’s counselling services for information on available resources for students, while ensuring you have the necessary supports for yourself.

Be cognizant of the impacts of too many virtual meetings and too many emails. With the transition to working remotely, there has been a vast increase in the number of virtual meetings; while virtual meetings are effective at maintaining connectedness and communication, many are feeling overly fatigued by the number of video-conference meetings that now are required to deal with issues that once would have been addressed via an in-person meeting or by walking to someone’s office.  The same can be said of email.

In addition to supporting students, research staff and transitioning to remote learning, many faculty and researchers are also juggling the responsibilities – and fatigue – of being educators to their children who may also be at home.

Conferences and COVID-19

Given the state of the pandemic globally, in-person knowledge mobilization and sharing events such as conferences are being cancelled or postponed; in some cases, in-person conferences are being transitioned to virtual events to enable both the delivery and sharing of research findings and continuing education activities.  This is the case for the CPA’s 2020 Annual National Convention which was scheduled for May 2020 in Montréal, QC, but will be delivered as a virtual event over the summer of 2020.

A poster or presentation that was peer reviewed and accepted to a conference can still be included in your CV, even if the conference was cancelled. The CPA has a recommended format for citing cancelled presentations; this information was sent to all individuals that had a presentation accepted for inclusion in the CPA’s national conference (see below).

For individuals OPTING TO participate in the CPA’s virtual event, the format is as follows:

Surname, Initial. & Surname, Initial. (2020, insert dates of virtual event).  Title of accepted submission. [specify type of presentation – poster, Gimme-5, 12-minute talk, etc.]. 81st Canadian Psychological Association Annual National Convention, Montréal, Quebec, Canada. [insert link to virtual event when available]

For individuals OPTING NOT TO participate in the CPA’s virtual event, the format is as follows:

Surname, Initial. & Surname, Initial. (2020, May 27-30).  Title of accepted submission. [specify type of presentation – poster, Gimme-5, 12-minute talk, etc.]. 81st Canadian Psychological Association Annual National Convention, Montréal, Quebec, Canada. [insert link to Abstract Book PDF when available] (Conference cancelled due to COVID-19)

If the conference at which you were scheduled to present is not being transitioned to a virtual event or you are unable to participate in the virtual event, you can consider sharing your poster and/or presentation through the Open Science Framework (OSF). For more information, see OSF meetings.

Making the Transition: Moving your Course to a Virtual Environment

The need for a rapid transition from in-person instruction to online platforms has necessitated a steep learning curve for many faculty. It is important to remember that although effective, there are significant differences between in-person and online delivery of education:

  • Most adult education research shows that the maximum length of an online session should be less than two hours: attention spans begin to wane after as little as 15 minutes and engagement is challenging through a computer screen. Longer lectures should be broken up into more digestible portions.
  • There are some techniques that can help keep learners engaged; for example, some webinar or e-learning platforms provide the ability to create polls that will encourage participants to pay attention and answer topical questions in real time.
  • In creating lesson plans, keep in mind that topics and learning objectives should be kept focused and self-contained in order to maintain clarity and continuity. Schedule time for a brief recap at the start of each session but keep the path well-defined and easy to follow.
  • Consider adding more self-directed elements if possible; short projects, additional readings, and putting students into small groups to discuss material virtually can add value between sessions and contribute to the overall goals of the course while placing the onus on students to engage with the material.
  • Most importantly, stay connected to your students. If this is the first time you are delivering material online, take this opportunity to learn from your students regarding what does – and does not – work. Maintain your goals, clarify your benchmarks, and be open to learn and experiment.

The following is a list of some valuable resources to assist you in your transition.

Resources Provided by the APA

Staying Professionally Active

Recognizing the emotional and mental toll that the pandemic may be taking on some individuals, others may want or need to stay professionally active during this time. Below are some ways in which individuals can stay professionally involved.

  • Take a Continuing Professional Development course from the CPA’s online offerings, from a provincial/territorial association, or from other relevant professional associations.
  • Create and/or review your individual professional learning plan.
  • Expand your learning of research methods – quantitative and/or qualitative – or statistical applications, particularly those offering downloadable software at no cost.
  • Take the opportunity to read new journal articles; the CPA’s three journals (Canadian Psychology, Canadian Journal of Behavioural Science, Canadian Journal of Experimental Psychology) are available to all CPA members via the CPA’s members only portal.
  • Subscribe to the APA PsychNet® Gold database through the CPA and have access to the following: PsycINFO, PsycARTICLES, PsycBOOKS, PsycEXTRA, and PsycCRITIQUES.
  • Submit articles for publication consideration.
  • Volunteer to serve as a reviewer for one of Canada’s funding agencies.
  • Start working on grant applications.
  • Attend virtual conferences.

 

Where do I go for more information?

To obtain  important and up to date information about COVID-19, visit the Public Health Agency of Canada (PHAC) website at https://www.canada.ca/en/public-health/services/diseases/2019-novel-coronavirus-infection.html

Provincial, territorial, and some municipal associations of psychology often maintain referral services. For the names and coordinates of provincial and territorial associations of psychology, please visit:  https://cpa.ca/public/whatisapsychologist/PTassociations

This fact sheet has been prepared for the Canadian Psychological Association by Dr. Lisa Votta-Bleeker, Deputy Chief Executive Officer, Canadian Psychological Association.

Date: May 7, 2020

Your opinion matters! Please contact us with any questions or comments about any of the Psychology Works Fact Sheets:  factsheets@cpa.ca

Canadian Psychological Association

Tel: 613-237-2144
Toll free (in Canada): 1-888-472-0657

“Psychology Works” Fact Sheet: Cognitive Disorders and Dementia

Posted on by CPA Webmaster

What Is Cognition?

Cognition is how people process information. It is the ability of your brain to register, consolidate, store and retrieve information to solve problems. Cognition depends on several mental functions including attention, perception, memory, language, and reasoning.

What Is Dementia?

Dementia is the advanced stage for a cluster of clinical neurodegenerative disorders involving deterioration of cognitive abilities with resulting changes in behaviors that interfere with the ability of an individual to function independently in everyday life. There are two major classifications of dementias: neurodegenerative disorders and vascular dementias. There may be as many as fifty different forms of dementias.

Dementia is usually defined as a change in two or more areas of cognition that results in the reduction of an individual’s ability to function independently. It is not a disease but a condition that results from any of several neurodegenerative or vascular disorders. The many dementia syndromes can progress slowly or in a stepwise fashion dependent on the underlying disorder.

Dementia can result from damage that affect the nerve cells (neurons) of the outer layer (cortex) or the inner structures (subcortex) of the brain. The symptoms vary according to the areas of the brain that are most affected.

For example, the Alzheimer neurodegenerative disorder affects mostly cortical areas of the brain that involve acquiring or learning new information (amnesia), ability to perform skilled acts or use tools (apraxia), use of language (aphasia), or ability to perceive objects or people (agnosia).

Parkinson is another neurodegenerative disorder that primarily affect subcortical regions and symptoms include movement disorders (tremor, stooped posture, initiation of movement), speech and voice abnormalities (slurring, stuttering), and attention. There are memory problems, but they primarily involve the ability to retrieve information and less so to acquire information.

How Common Is Dementia?

Approximately 6.4% of Canadians above the age of 65 have some form of dementia but the prevalence increases substantially as we get older. Dementia occurs in approximately 2% of individuals between the ages of 65 to 74 but increases to 30% over the age of 85.

What Conditions Result in Dementia?

Alzheimer’s syndrome accounts for about 50% of all cases. It involves gradual damage and ultimately the death of neurons. The most common early symptom is memory loss that involves rapid forgetting. Affected individuals cannot recall recent events such as conversations or significant personal events.

Another common early symptom is difficulty remembering the names of people, even family members, and difficulty thinking of the most appropriate word to use.

Alzheimer’s is slowly progressive and may go on for several years before the person dies. As the disease progresses, more areas of cognitive function become involved, including spatial orientation, language, and the ability to perform sequences of learned skills. The individual typically becomes bedridden in the end stage and death occurs due to secondary causes, such as falls or infections.

Vascular dementia involves repeated damage to areas of the brain caused by blockages in the blood vessels. It can occur after a stroke or several strokes or brief periods of disrupted blood flow to the brain (transient ischemic attacks or TIAs). The symptoms are variable and depend on where the strokes are located. Vascular dementia can progress as Alzheimer’s disease does, but the progress may not be as gradual. Sudden worsening of cognition, relating to the immediate effects of a stroke or TIA, can be followed by periods of slight improvement. As the individual has more strokes, however, the severity of cognitive dysfunction worsens in a stepwise fashion.

Lewy-body spectrum, along with vascular dementia, account for the second and third most common causes of neurodegenerative disorders. Individuals with Lewy-body spectrum have symptoms like those exhibited by individuals with Parkinson, including tremor, rigid and stiff movements, flat facial expressions, as well as cognitive symptoms, such as memory loss, fluctuating attention, difficulty reasoning and difficulty putting together a sequence of movements. Individuals with Lewy-body spectrum frequently experience visual hallucinations early on and, less frequently, auditory hallucinations. Like Alzheimer’s syndrome, it progresses slowly.

Other Conditions That Result in Dementia Include:

  • Parkinson’s neurodegenerative disorder;
  • Mixed Alzheimer’s-Vascular dementia;
  • Chronic traumatic encephalopathy;
  • Frontal-Temporal neurodegenerative disorders;
  • Limbic encephalitis;
  • Normal pressure hydrocephalus;
  • Progressive supranuclear palsy;
  • Jakob-Creutzfeldt disease;
  • Idiopathic basal ganglia calcification;
  • Corticobasal neurodegeneration;
  • Multi-system atrophy;
  • Amyotrophic lateral sclerosis;
  • Korsakoff neurodegeneration;
  • Huntington’s disease.

Are Some Dementias Reversible?

Yes, if the symptoms result from some of the following conditions:

  • depression;
  • drug polypharmacy;
  • metabolic and nutritional imbalance;
  • Vitamin B12 deficiency;
  • Normal pressure hydrocephalus
  • Hypothyroidism
  • cardiovascular disorders.

Do We Know What Causes Alzheimer’s Disease and Other Types of Dementia?

In the last 20 years, there has been promising but also frustrating research efforts to identify the neurological dysfunction that characterizes Alzheimer’s disease. The consensus is that there is probably more than one cause that will require combinations of therapeutic efforts including cognitive and behavioral ones.

A small proportion (2%) of Alzheimer’s syndrome is inherited but, for most cases, the exact causes are still unknown. There are genetic factors that predispose an individual to develop the disease. Not all individuals having the genetic factors however will develop Alzheimer’s syndrome, which has led scientists to believe that there are important interactions between a person’s environment and genetic makeup.

Are There Treatments for Dementia?

There are currently a few medications that have been shown to ease the symptoms of Alzheimer’s disease but do not stop or prevent the disease. Examples of medical treatments include donepezil (Aricept ®), memantine (Ebixa®) and rivastigmine (Exelon ®).

Cognitive and behavioral treatments are also used to help individuals and their care partners compensate for specific cognitive disorders. Individuals with memory loss can learn to use aids, such as a Day-Timer or other electronic assistance to help remember things. Well-designed and predictable environments can also help in reducing excessive disability. Sustained care partner support and training in the use of behavior management techniques are also very helpful.

What Is Mild Cognitive Impairment (MCI)?

MCI is a state characterized by impairment of one or more cognitive processes, but the impairment does not result in a significant impact on the individual’s ability to function independently. The causes can be as varied as the causes of neurodegenerative disorders.

In fact, some individuals with MCI will go on to develop neurogenerative disorders. It is estimated that, after 5 years, approximately 50% of individuals that were initially identified as MCI develop some type of neurodegenerative disorder, most commonly Alzheimer’s syndrome. MCI is difficult to diagnose however, up to 25% of individuals initially diagnosed with MCI will not be found to have the condition on follow-up assessment.

What Can Psychologists Do to Help People With Cognitive Disorders & Dementia?

The consequences of various neurodegenerative disorders are severe cognitive impairments like memory, perception, language, and executive functions.

Psychologists have much to offer in assessing spared and impaired cognitive functions, in doing clinical research, and in designing intervention programs to minimize the effects of cognitive impairments.

Some of the ways a psychologist can help include:

  • provide clinical neuropsychological evaluations which are efficient and sensitive tools when combined to various biomarkers for the diagnosis of various dementias;
  • providing education to help understand the cognitive impairments and how they relate to changes in the individuals’ behavior and the impact of cognitive impairments on everyday activities;
  • providing training to individuals to help them compensate for their cognitive impairments;
  • teaching family members, friends or care partners, means of helping the individual;
  • providing the family members, friends or care partners, with coping skills to deal with cognitive and challenging behaviors;
  • providing access to community support services.

 

Signs of Possible Cognitive Impairment That Warrant Further Investigations:

  • difficulty remembering names of people they have been introduced to recently;
  • needing the repetition to questions or comments due to the individual not being able to recall the information;
  • requiring reminders to ensure they remember appointments;
  • forgetting to take medications – this can involve either not taking their medications or “double-dosing” because they forgot they took them;
  • forgetting significant recent events such as vacations, birthdays, anniversaries, to pay bills on time;
  • misplacing or losing personal items;
  • getting lost in familiar surroundings, or not recognizing landmarks;
  • difficulty recollecting the name of a familiar person and marked difficulty recalling the most appropriate word to use.

Note: In order to be of significance, these problems should occur more frequently than the average person of the same age would experience.

Where Do I Go for More Information?

You can consult with a registered psychologist to find out if psychological interventions might be of help to you. Provincial, territorial and some municipal associations of psychology often maintain referral services. For the names and coordinates of provincial and territorial associations of psychology, visit . The Canadian Register of Health Service Providers in Psychology also has a listing service and can be reached through http://www.crhspp.ca.

This fact sheet has been prepared for the Canadian Psychological Association by Dr. Guy Proulx, Director, The Glendon Centre for Cognitive Health, Glendon College, York University. https://centerforcognitivehealth.ca

Revised: April 2020

Your opinion matters! Please contact us with any questions or comments about any of the Psychology Works Fact Sheets:  factsheets@cpa.ca

Canadian Psychological Association

Tel: 613-237-2144
Toll free (in Canada): 1-888-472-0657

CPA-CCPPP-ACPRO Statements regarding COVID-19

Posted on by CPA Webmaster

On behalf of the Association of Canadian Psychology Regulatory Organizations (ACPRO), the Canadian Council of Professional Psychology Programmes (CCPPP), and the Canadian Psychological Association Accreditation Panel (the CPA Panel): The global COVID-19 pandemic has had an unprecedented impact on individuals, communities, our health care systems and on health providers themselves.

We, ACPRO, CCPPP, and the CPA Accreditation Panel also recognize that this pandemic has had, and continues to have, a significant impact on the operation of professional psychology training programmes, and on their faculty, staff, and students.

Attached, you will find a statement from ACPRO containing their response to licensure concerns amid the COVID-19 pandemic, as well as a statement from the CCPPP and CPA Accreditation Panel regarding their responses to accreditation- and training-related concerns. With these statements, our organizations want to communicate our commitment – to the extent possible – to minimize the disruptions that the pandemic has on students’ training, on programme operations, and ultimately on the availability of competent practitioners to meet the public need for mental health services at this time, while also maintaining the highest levels of integrity in our training, licensing, and accreditation processes. We also want to reassure our stakeholders of our commitment to maintaining an open dialogue among our organizations as this situation unfolds to ensure that we continue to be responsive to all of your needs.

Should you have any questions about the content of these statements, please do not hesitate to contact us at the coordinates below.

Wishing you all good health.

Sara Hagstrom, President, CCPPP, hagstros@tbh.net
Catherine Costigan, CCPPP, costigan@uvic.ca
Karen Messer-Engel, Chair, ACPRO, registrar.skcp@sasktel.net
Stewart Madon, Registrar of Accreditation, CPA, smadon@cpa.ca

CCPPP CPA ACPRO Statements COVID-19.pdf

Information Fact Sheet: COVID-19 Government Support for Employees

Posted on by CPA Webmaster

During the current Covid-19 Pandemic, a number of Canadian Governments have announced programs designed to support employers, with the specific goal of mitigating some of the economic consequences of Canada’s response to small business.

As a result of social distancing and other policies, economic activity in Canada has dramatically slowed.  This has resulted in financial stress for those businesses that continue to operate, often resulting in the need lay off some or all of their employees

The government initiatives continue to evolve in real time, and this fact sheet will be updated on a regular basis to keep up with the changes.

While this Fact Sheet focusses on the Federal initiatives, the reader is encouraged to check with their provincial and municipal governments for additional support which may be available

Federal Government

Canada Emergency Response Benefit

What is it? This taxable benefit would provide $2,000 a month for up to four months for workers who lose their income as a result of the COVID-19 pandemic.

Please note: This benefit replaces the previously announced Emergency Care Benefit and the Emergency Support Benefit.

Who can apply? CERB will cover Canadians who have lost their jobs, are sick, quarantined, or taking care of someone who is sick with COVID-19, as well as working parents who must stay home without pay to care for children who are sick or at home because of school and daycare closures.

It will apply to wage earners, as well as contract workers and self-employed individuals, who would not otherwise be eligible for Employment Insurance (EI), and who have not worked for 14 days

How to apply: The federal government announced that an application portal will be available by the week of April 6th. Applicants will also be able to apply, via an automated telephone line, or via a toll-free number.

This information will be updated.

For more information: https://www.canada.ca/en/department-finance/economic-response-plan/covid19-individuals.html#new_canada_emergency_response_benefit

Employment Insurance – Sickness Benefit

What is it? Employment Insurance sickness benefits can provide you with up to 15 weeks of financial assistance if you cannot work for medical reasons. You could receive 55% of your earnings up to a maximum of $573 a week.

Who can apply? Those who are sick, quarantined or have been directed to self-isolate due to COVID-19.

How to apply: Complete an online application as soon as possible after you stop working. As part of the COVID-19 response, the government of Canada will waive the requirement to provide a medical certificate to access EI sickness benefits, as well as the one week waiting period.

For more information: https://www.canada.ca/en/services/benefits/ei/ei-sickness/apply.html

Employment Insurance – General Benefits

What is it? Employment Insurance (EI) provides regular benefits to individuals who lose their jobs through a shortage of work or lay-offs and are available for and able to work, but can’t find a job.

Who can apply? Employees who were employed in insurable employment, lost their job through no fault of their own, and have been without work for at least seven days, and have worked for the required number of insurable employment hours in the last 52 weeks.

How to apply: Review the requirements and collect the necessary information at the following link, and click on the “Apply” link to begin your application.  https://www.canada.ca/en/services/benefits/ei/ei-regular-benefit/apply.html

For more information: https://www.canada.ca/en/services/benefits/ei/ei-regular-benefit.html

Key Links:

Finance Canada – https://www.canada.ca/en/department-finance/economic-response-plan.html

Canada Revenue Agency (Income Tax Issues) – https://www.canada.ca/en/revenue-agency/campaigns/covid-19-update.html

Employment and Social Development Canada (Employment Insurance Issues) – https://www.canada.ca/en/employment-social-development/corporate/notices/coronavirus.html

Canadian Payroll Association – Frequently Asked Questions:  https://payroll.ca/PDF/Resources/Payroll-and-Covid19-Infoline.aspx

 

This fact sheet has been prepared for the Canadian Psychological Association

Date: April 15, 2020

Your opinion matters! Please contact us with any questions or comments about any of the CPA’s Fact Sheets: factsheets@cpa.ca

Canadian Psychological Association

Tel: 613-237-2144
Toll free (in Canada): 1-888-472-0657

Information Fact Sheet: COVID-19 Government Support for Employers

Posted on by CPA Webmaster

During the current COVID-19 Pandemic, a number of Federal, Provincial and Territorial  governments have announced programs designed to support employers, with the specific goal of mitigating some of the economic consequences on Canada’s  small businesses.

As a result of social distancing and other policies, economic activity in Canada has dramatically slowed.  This has resulted in financial stress for those businesses that continue to operate. 

The government initiatives continue to evolve in real time, and this fact sheet will be updated on regular basis to keep up with the changes.

While this Fact Sheet focusses on the Federal initiatives, the reader is encouraged to check with their provincial, territorial and municipal governments for additional support which may be available

Federal Government

Temporary Wage Subsidy for Employers

What is it? The Temporary Wage Subsidy for Employers is a three-month measure that will allow eligible employers to reduce the amount of payroll deductions required to be remitted to the Canada Revenue Agency (CRA).  There was an earlier version of this program that has been replaced.

The subsidy is equal to 10% of the remuneration you pay between March 15, 2020, and June 15, 2020, up to $1,375 per employee and to a maximum of $25,000 total per employer.

Who can apply? Eligible employers include non-profit organizations, registered charities, or Canadian-controlled private corporations (CCPC).

How to apply: This subsidy can be calculated to reduce the amount of current remittance of federal, provincial, or territorial income tax that you send to the CRA by the amount of the subsidy.

For More Information: https://www.canada.ca/en/revenue-agency/campaigns/covid-19-update/frequently-asked-questions-wage-subsidy-small-businesses.html

Canada Emergency Wage Subsidy (CEWS)

What is it?  The CEWS provides for reimbursement of up to 75% of an employee’s wages (maximum $847/week), for a 12 week period (March 15- June 6). Recently, the Federal Government announced that the program will be extended to the end of August 2020; more details are still forthcoming

Who can apply? Eligible employers which include individuals, public and private taxable corporations, partnerships consisting of eligible employers, registered charities and NPOs, who have a experienced a 15% or more year over year decline in revenue (comparing March 2020 to March 2019) or a 30% year over year decline (for April and May)

How to apply:  Businesses will be able to apply on-line through the My Business Account CRA portal or as a web-based application, expected to be open by end of April

For More Information: https://www.canada.ca/en/department-finance/news/2020/04/the-canada-emergency-wage-subsidy.html

Supplemental Unemployment Benefit Program (SUB)

What is it? Employers can use a Supplemental Unemployment Benefit (SUB) plan to top-up their employees’ weekly earnings when they are unemployed due to a temporary stoppage of work. Payments are not considered earnings and are not deducted from EI benefits.

Who can apply? Employers undergoing a temporary stoppage of work due to training, illness, injury or quarantine.

How to apply: SUB plans are registered by Service Canada. Plans must be registered before their effective date. Officers from the SUB program assess employers’ SUB plans against the requirements set out in the EI Regulations. SUB program Officers also help employers develop SUB plans that meet the requirements of the EI Regulations.

For More Information: https://www.canada.ca/en/employment-social-development/programs/ei/ei-list/ei-employers-supplemental-unemployment-benefit.html

Work-Sharing Program

What is it? Work-Sharing (WS) is a program that helps employers and employees avoid layoffs when there is a temporary decrease in business activity beyond the control of the employer. The program provides EI benefits to eligible employees who agree to reduce their normal working hours and share the available work while their employer recovers. Work-Sharing is an agreement between employers, employees and the Government of Canada.

The Government of Canada has put in place Work-Sharing (WS) temporary special measures for employers affected by the downturn in business due to COVID-19. This includes

Who can apply? Typically used for forestry and steel workers, this has program has been extended to all employers from March 15, 2020 to March 14, 2021, and the maximum possible duration of an agreement has been extended from 38 weeks to 76 weeks.

How to apply: Employers must submit an application to a work-sharing agreement and a Work-Sharing Unit Form to the relevant regional Service Canada office. (See more: https://www.canada.ca/en/employment-social-development/corporate/notices/coronavirus.html#h4.04)

For more information: https://www.canada.ca/en/employment-social-development/corporate/notices/coronavirus.html#h4.02

Business Resources

Support for Financing and Business cash flow

Canadian Emergency Business Account (CEBA)

What is it? The Canadian Emergency Business Account (“CEBA”) is intended to provide interest-free loans up to $40,000 to small businesses and not-for-profit organizations. Should 75% of the amount be repaid before December 31, 2022, the remaining balance can be forgiven

How to apply? Organizations should contact their financial institution to understand the specific details of how to apply.  Application deadline is June 30 2020.

For More Information:   https://ceba-cuec.ca/

Business Credit Availability Program (BCAP)

What is it? The Business Credit Availability Program (BCAP) is intended to help Canadian businesses obtain financing during the current period of significant uncertainty.

How to apply? Employers seeking support through BCAP should contact the financial institutions with whom they have a pre-existing relationship, so that the financial institutions can assess their case.

For More Information: https://www.canada.ca/en/department-finance/programs/financial-sector-policy/business-credit-availability-program.html

Other Programs

Research support – on May 15 2020, the Federal Government announced a new program to add $450m in new funding to support research in Canada.  The link for the announcement is here: https://pm.gc.ca/en/news/news-releases/2020/05/15/prime-minister-announces-support-research-staff-canada

This page will be updated as more details are forthcoming.

Flexibility for Businesses Filing Taxes

What is it? The deadline for businesses to pay any income tax amounts that become owing or due after March 18, 2020 and before September 1, 2020 has been extended to September 1, 2020. This means you will not be assessed any penalties or interest if your balance due is paid by September 1, 2020.

For more information: https://www.canada.ca/en/revenue-agency/campaigns/covid-19-update.html

This fact sheet has been prepared for the Canadian Psychological Association

Date: May 25, 2020
Your opinion matters! Please contact us with any questions or comments about any of the CPA’s Fact Sheets:  factsheets@cpa.ca

Canadian Psychological Association

Tel: 613-237-2144
Toll free (in Canada): 1-888-472-0657

 

Audio Update: Dr. Heather MacIntosh on ‘Big T’ vs. ‘little t’ trauma

Posted on by CPA Webmaster

Daily Audio Update: Dr. Heather MacIntosh on ‘Big T’ vs. ‘little t’ trauma
It’s something of a colloquialism, but the distinction between ‘Big T’ and ‘little t’ trauma is one that matters in the current context of COVID-19. Dr. Heather MacIntosh joins us to discuss that distinction.

CPA Panel Statement re; COVID 19

Posted on by CPA Webmaster

ACCREDITATION PANEL FOR DOCTORAL PROGRAMMES
AND
INTERNSHIIPS IN PROFESSIONAL PSYCHOLOGY

On Behalf of the CPA Accreditation Panel:

CPA and the Accreditation Panel understand that the management of COVID-19 has far reaching effects on individuals, communities, our health care systems and on health providers themselves. Its impact on the health care environment will also impact trainees of all health professions. Some may leave internships or residencies to return home. Most will find their clinical roles impacted and it is possible that their clinical activity will be significantly changed or suspended as health care environments respond to this unprecedented health emergency. The decisions and experiences of trainees may vary from university to university, health care setting to health care setting and jurisdiction to jurisdiction. The guidance and advisories in one province/territory to another may differ and consequently impact health care delivery and health care training differently.

We understand and anticipate the concerns of trainees that any disruption or suspension of their residencies and internships can impact their ability to meet program completion requirements and, ultimately, impact their progress towards graduation and licensure. We also understand that there is not a single authority who can decide how missing requirements will be dealt with. For example, CPA’s Accreditation Panel cannot require programs to extend their training years or decrease required clinical hours. Programs needs and options will vary in the kind of accommodation they can offer. Further, regulatory bodies have requirements about how many internship hours are required of candidates for licensure.

The purpose of this advisory, however, is to let programs – their faculty, supervisors and trainees – know that CPA will collaborate with programs on an individual basis as well as Canada’s regulatory bodies individually and collectively, to help them navigate the impact COVID-19 will have on the training of psychologists. We will all need to be understanding, nimble and flexible in finding solutions that work for each program and, ultimately, put the needs of clients and students front and centre. CPA has reached out to CCPPP and ACPRO to discuss this issue and come up with some collective guidance to programs. CPA has also been collaborating with APPIC, APA, and ASPPB on this issue as well for those of our students who train north and south of the border. We will keep you apprised of our progress.

In the interim, feel free to contact the Accreditation Office at any time. Even more importantly, stay well and stay safe.

Dr. Stewart Madon, C. Psych.
Registrar, Accreditation & Ethics Officer
Canadian Psychological Association

PDF version: CPA Panel Statement re; COVID 19

Audio Update: Dr. Karen Cohen on advocacy during COVID-19

Posted on by CPA Webmaster

Daily Audio Update: Dr. Karen Cohen on advocacy during COVID-19
Quick chat with CPA CEO Dr. Karen Cohen about advocacy during COVID-19. Calling for insurers to cover tele-psychology, and drop the requirements for a physician referral for psychological services.

Audio Update: Karen Cohen on the Psychology Practice Fact Sheet and Telehealth

Posted on by CPA Webmaster


Quick chat with CPA CEO Dr. Karen Cohen about the fact sheet Psychological Practice and the Coronavirus, as well as the future of psychological tele-health services.

Audio Update: Heather MacIntosh worried about domestic violence

Posted on by CPA Webmaster


Stories about increased domestic violence during isolation have Dr. Heather MacIntosh worried. An expert in couples therapy, anxiety, and trauma, Dr. MacIntosh wrote the blog post “Coupling and Trauma in the Context of COVID-19”. She joins us to talk about those worries.

Audio Update: Karen Cohen pro-bono initiative

Posted on by CPA Webmaster


Quick chat with CPA CEO Dr. Karen Cohen, who answers some questions we’ve received about the pro-bono initiative to provide psychological services to front line health care providers across Canada.

“Psychology Works” Fact Sheet:  Emotional and Psychological Challenges Faced by Frontline Health Care Providers During the COVID-19 Pandemic

Posted on by CPA Webmaster

This is a time of tremendous uncertainty and change as the world faces the challenges of the COVID-19 pandemic. While some stressors are universal, frontline health care providers also face unique challenges in terms of physical risk, as well as emotional and psychological toll during this time of heightened, prolonged medical demand.

The information that follows is intended to help frontline health care providers across professional disciplines to better recognize the challenges and stressors that may be impacting them during the COVID-19 pandemic. Increasing awareness of stress and strategies to cope with the demands of frontline healthcare may be helpful to better navigate coping during this difficult time. Coping may include accessing resources, whether that is drawing on personal resources and strengths, accessing support of friends, family, or colleagues, or reaching out to psychologists or other mental health professionals.

Challenges that frontline health care providers may experience at this time may include:

COVID-19 Information Overload

Many frontline health care providers would find it difficult to answer YES to the question, “Do you have any time in your day that is not filled with thinking about or talking about COVID-19?”  Given that addressing COVID-19 directly or indirectly is a necessary aspect of one’s work for frontline health care providers at this time, there may be diminishing returns from seeking out even more information. It is also a time when many of the rules for the general public don’t apply to frontline health care providers (e.g., staying home). This can be distressing or confusing in some ways and also make it less useful to be seeking out COVID-19 related information that does not apply personally.  Finding realistic ways to protect some time to think about, talk about or engage in activities unrelated to COVID-19 can have benefits in terms of emotional well being and fatigue, as well as ability to be present and engaged at work.

  • Many frontline health care providers are receiving lots of COVID-19 related questions and requests for information from friends and family members. For example, loved ones may be asking about what they should do to stay safe or what is happening in medical settings, and front line health care providers may feel an obligation to engage in such discussions.  This is a time when credible information is readily available to the general public.  Frontline health care providers may wish to consider making requests of loved ones to have some non-COVID-19 related conversations and explaining why that would be helpful for them. Friends and family may appreciate the opportunity to be supportive in this way and are likely unaware of the impact that focusing only on COVID-19 may be having on health care providers.
  • For health care providers whose social circles are made up mainly of other health professionals, it may be helpful to protect some time (e.g., 15 minutes) at the beginning of virtual gatherings to talk about anything other than COVID-19. This would also give participants the opportunity to opt out of later pandemic-related discussions if they so choose.
  • Being mindful of COVID-19 oversaturation, the start of the day is one opportunity to make some change. As opposed to waking up and checking one’s phone in bed, it can be helpful to make the mindful decision to get out of bed, go to the bathroom, brush one’s teeth, maybe take a shower before making the conscious decision with alert mind to check one’s messages. Though this is a time when much is urgent, things can wait until one has the chance to brush their teeth.
  • When possible, scheduling time to read news/emails/social media if that is something that someone needs or wants to do rather than checking throughout the day can be helpful. Social media is often used as a quick break in our days but at this time, the content may not feel like an escape. Identifying some alternative activities to do either during brief breaks at work or for longer periods at home can be helpful such as listening to music, engaging in movement, reading a book.
  • Working on the health care frontlines also likely means that one’s social media feeds and email inboxes are particularly bombarded with COVID-19 related content. This can give a skewed view of what is happening in non-medical settings, much of which is beautiful. For example, people engaged in physical/social distancing are finding new ways of connecting online (e.g., eating dinner together remotely via zoom or facetime, etc.), the act of speaking on the phone to friends and families has had a resurgence beyond short text communications, gyms and dance studios are offering free online classes, artists are giving free lessons online, museums/art galleries are offering free virtual tours, and across the country people are banging pots and pans together at 7:30pm each night to show their support for health care providers. Recognizing that there is a world beyond the hospital walls even during this pandemic can be reaffirming for frontline health care providers as can be the knowledge that outside of those walls, people are very grateful for the sacrifices that frontline health care providers are making for the safety of everyone.
  • While there are many online activities currently being offered, frontline health care providers may have very little time to research these activities. For example, there are now many online, interactive, fun, free activities for children of all ages. Reaching out to friends or family to request that they find and share such information may be helpful and lighten the load of frontline healthcare providers who are parents.

Fear and Uncertainty about Safety of Self and Others

Many frontline health care providers are understandably experiencing fear and anxiety related to their own safety and the possibility of putting others at risk. Keeping such fears to oneself and pushing on may work in the short term but are not sustainable strategies, particularly during this time of prolonged, chronic stress and physical and emotional demand without a clear end date. Identifying which of these fears are having an impact can be a start to identifying helpful strategies to cope, including considering when it may be helpful access support whether personal, professional, or from a health care provider such as your family physician or a psychologist or other mental health care professional.

  • Many frontline health care providers have been coping with fears related to not having enough or appropriate Personal Protective Equipment and perhaps even having to make decisions that feel unsafe at times but fit with current demands of working during this pandemic. In certain fields, individuals may be coping with a sense of “when” rather than “if” about contracting illness.
  • Health care providers who have to self-isolate, or who were already on a leave when the outbreak occurred, may experience feelings of discomfort or guilt about not doing their part for the public during this time of great need. Self-disclosing symptoms and isolating when mandated is a very important contribution. Given that that this situation may well continue for some time, there will be periods when others are unable to work. Finding ways to use time “off” to rest and replenish can have benefit both now and also in enhancing readiness and resilience when one returns to work. However, it may be challenging for some to know how to use time off to engage in healing, self care or fun activities rather than ruminating about not working or oversaturating with COVID-19 information.
  • Some frontline health care providers are making, or worrying about having to make, difficult decisions about separating from family in order to protect them. This is a time when thinking of creative ways to stay in contact with loved ones without making unreasonable demands on oneself may be helpful. For example, having zoom or facetime on briefly while children are eating, playing, or getting ready for bed with no expectations of meaningful conversation can help to maintain a sense of connection during this time of forced physical separation. Outside of work, virtually reading a story or asking a child about something fun that happened in their day may also maintain connection.
  • While taking care of and having compassion for others may come naturally to frontline health care providers, being compassionate to oneself may be more difficult. Often individuals who are very compassionate to others find it difficult to be self-compassionate and instead engage in harsh self-criticism in the face of challenge.  Without self compassion, the likelihood of burnout increases. During this time of requiring so much service to others, it can be helpful for health care providers to find ways to show warmth and caring for themselves. In the face of self-criticism and challenge, it can be helpful to ask oneself how you would speak to someone else in your situation, a colleague or a friend.  What tone of voice would you use? What words would you use to support them in a compassionate way?

Difficulty Staying Present and Attending to One’s Needs

Staying present and engaged in the face of stress and workload demands are important skills for frontline health care providers at all times, but perhaps even more relevant during a chronically stressful period with no known end date.

  • Anxiety can make it challenging to stay present as one ruminates about the past or worries about the future. Taking a few seconds at various points throughout one’s work shift to physically stretch, have a mindful sip of water, to take a few, slow breaths, or naming one’s emotions can be incredibly helpful in staying present and addressing one’s needs in the moment. Some health care providers regularly engage in these brief moments of presence (e.g., before moving onto a next clinical interaction, before or after charting, before entering one’s place of work) to help with clinical engagement and efficiency.
  • This may be a time when individuals are prone to engaging in overpreparation (see COVID-19 Information Overload) with diminishing or even negative impact. Trying to read enough, learn enough until one “feels” prepared can be problematic in a situation such as this in which there is much that cannot be predicted. It can be useful to ask oneself, am I reading this to lessen anxiety or because it is necessary for my work and will have direct impact on my work tomorrow or the next day?  Health care providers have lots of experience coping with things that are unexpected and reminding themselves that they will do so again now as needed may be reassuring.
  • Frontline health care providers may be coping with exacerbation of pre-existing health issues or develop new ones during this time of stress and physical demand that can make it harder to engage in the challenging work they are facing. Many important types of healthcare, physical and psychosocial, , are now being carried out remotely online or by phone with availability of flexible times at off peak hours. As frontline health care providers, it may be helpful to consider accessing care for yourself at this time such as booking an online appointment with a physiotherapist, for example, to address the considerable physical toll of your current work demands, or contact a psychologist or other mental health professional for support and to address new or existing issues that one faces. It may be beneficial to review, or ask a spouse to review, an extended health benefits available to you through work or other private insurance . Additionally, many initiatives across the country are being put in place to offer services to frontline health care providers. This is also a time to make sure that one’s own prescriptions are filled and maintaining adherence to self-care in as much as that is possible.
  • In addition to coping with fear and anxiety about larger, population-based health needs related to COVID-19, frontline health care providers may also be coping with a number of challenges associated with doing things in accordance with new processes and procedures. For example, using new Personal Protective Equipment and trying to maintain physical distance in certain circumstances may change how one communicates with one’s team members or adds to physical discomfort; working with new teams and in new settings due to redeployment can make even familiar procedures feel less familiar, more cumbersome, and more uncomfortable; working with colleagues who are also facing tremendous stress and workload can impact the emotional tone of work interactions.  Being cognizant of the cumulative impact of even seemingly small stressors can be helpful and make it more likely that individuals engage in helpful strategies to address (e.g., using strategies to be present, eating something in the morning rather than running on empty, stretching to relieve muscle tension regularly rather than wait for pain or discomfort to heighten).
  • During this pandemic, familiar activities and places of community that add meaning, enjoyment, and enhance health are not available in a physical sense. Being unable to attend one’s regular religious services, attend a favourite fitness class, go running with a running group, or join friends for brunch can make it harder to find balance in the face of tremendous work demands. This is a time to remember that “some” moves us forwards as opposed to engaging in “all or nothing” strategies. Being creative about how to interact virtually and take advantage of the many fun, free online led activities that are available can be helpful. If someone feels too depleted to research these options, they could consider reaching out to non-healthcare friends or family to ask for their help.
  • It can be valuable for front line health care providers to check in with themselves about their current alcohol or other substance use, particularly if such use is aimed at relieving stress or numbing discomfort or emotional pain, helping with sleep, or if frequency has increased. Some individuals may have had difficulties with substance use in the past and this new, significant period of stress and increased time spent alone outside of work may increase the likelihood of reinitiating problematic coping strategies.
  • In addition to considering strategies or accessing resources to address difficulties with sleep, it may be helpful to consider ways in which one might be restricting one’s own sleep even if not experiencing any difficulties falling or staying asleep. For example, some frontline health care providers may be going to bed later to engage in more reading about COVID-19 in social media posts or watching the news. Relatedly, checking one’s phone after waking up in the night can result in staying awake as opposed to falling back asleep. It is also important to consider how fatigue may be impacted by factors other than sleep such as nutrition, diet, and physical activity.
  • Attending to one’s needs for support from loved ones remains important during this time of stress, even for frontline health care providers. Health care providers may sometimes want to protect their loved ones from their worries or their stresses. Health care providers would benefit from considering how and when to ask for support from loved ones and also communicating what would not be helpful at this time. Being a health care provider does not make one immune to the worry and stress of COVID-19 and non-medical friends and family will understand this.

How Can Psychologists Help?

Relevant to the potential impact of working under the stress of the COVID-19 pandemic, psychologists are experienced in assessing and helping individuals cope with issues such as anxiety, fear, distress, trauma, and grief. Learning skills to tolerate and cope with uncertainty, addressing longstanding or new unhealthy habits, addressing sleep difficulties, finding support for stressed relationships, and finding ways to maintain resilience through difficult situations are just some examples of what one may choose to address with a psychologist in a supportive and confidential therapeutic relationship.

Where do I go for more information?

To obtain  important and up to date information about COVID-19, visit the Public Health Agency of Canada (PHAC) website at https://www.canada.ca/en/public-health/services/diseases/2019-novel-coronavirus-infection.html

The CPA maintains a regularly updated page of psychology-related COVID-19 resources https://cpa.ca/corona-virus/

Provincial, territorial, and some municipal associations of psychology often maintain referral services. For the names and coordinates of provincial and territorial associations of psychology, please visit:  https://cpa.ca/public/whatisapsychologist/PTassociations

This fact sheet has been prepared for the CPA by Anita Gupta, Ph.D., C.Psych., a clinical, health and rehabilitation psychologist whose clients are physicians working on the frontlines in Toronto, Ontario.

Date: March 29, 2020

Your opinion matters! Please contact us with any questions or comments about any of the Psychology Works Fact Sheets:  factsheets@cpa.ca

Canadian Psychological Association

Tel: 613-237-2144
Toll free (in Canada): 1-888-472-0657

Audio Update: Coping with COVID for people with existing anxieties or OCD with Dr. Christine Korol

Posted on by CPA Webmaster


COVID-19 can be especially difficult for people who already had anxiety, OCD, or another condition. We talk with Dr. Christine Korol about the challenges faced by those who were already experiencing mental health issues.

Audio Update: Fear of losing someone or dying yourself with Dr. Christine Korol

Posted on by CPA Webmaster


The number one fear people have during COVID-19 is losing someone they love. The number two fear is getting sick yourself. We talk to Dr. Christine Korol about both those fears, and how to approach them.

Audio Update: Being angry with people not taking COVID seriously with Dr. Christine Korol

Posted on by CPA Webmaster


It’s easy to get upset with people who are not taking COVID-19 seriously. We chat with Dr. Christine Korol about anger and convincing your parents or friends to be more careful.

Audio Update: Christine Korol quick chat therapy with front line workers

Posted on by CPA Webmaster


Dr. Christine Korol has been working with health care professionals for some time. Today she discusses the various issues facing front-line health care providers with the CPA.

“Psychology Works” Fact Sheet: Student Wellness and COVID-19

Posted on by CPA Webmaster

As the COVID-19 situation evolves around the globe, students’ day-to-day lives are being increasingly disrupted. From courses being moved from an in-person setting to online classes and not being able to visit friends and family, to not having access to the resources such as the library, the mental health clinic, or other spaces on campus, to having to leave residence, and conferences being cancelled, students’ lives are being affected in many ways.

As you deal with the impacts of COVID-19 on your life and the implications for your loved ones and the world at large, it is important to prioritize your mental health, as well as your physical well-being. The Canadian Federation of Students has partnered with the Canada Psychological Association to bring you resources in this unprecedented time of stress and help you cope with a changing world.

The information that follows is intended to help students cope psychologically in the face of health risks like COVID-19. It does not convey important information that you should know about how the virus is contracted, its signs and symptoms, how to decrease your risk of contracting the virus and how the virus is treated. For important and up to date information about COVID-19 visit  the Public Health Agency of Canada (PHAC) website at https://www.canada.ca/en/public-health/services/diseases/2019-novel-coronavirus-infection.html

Mental Health Risks Associated with COVID-19

It is important to remember that it is normal to be emotionally affected by events like wide-spread illnesses and that everyone will react differently to current world events. It is also important to remember that although these events may feel overwhelming, we are strong and resilient and have access to tools which can help us cope with stressors. Signs of stress can look like:

  • Fear and worry about your own health and the health of your loved ones
  • Changes in sleep or eating patterns
  • Difficulty sleeping or concentrating
  • Worsening of chronic health problems
  • Increased use of alcohol, tobacco, or other drugs

If you are experiencing any of these, remember to be patient with yourself as you are navigating a rapidly evolving situation and coping with many stressors and major changes.

Coping with Stress and Anxiety

During this time, it is really important to take care of yourself and pay attention to your mental well-being. Here are some tips to manage stress and anxiety:

  • Follow health and safety guidelines: Check credible sources such as the Public Health Agency of Canada and Health Canada to reduce the risk of contracting the virus. Remember that the media reports things that go wrong more often than things that go right. We hear about and pay more attention to the few people who might have been made very sick or who have died from an illness than we do about the many more people who have successfully recovered from an illness.
  • Take breaks from the news: While it’s important to stay informed and take guidance from health experts, hearing about the pandemic repeatedly can be upsetting. Make sure to take breaks from the news, including social media. If you want to stay informed but are becoming overwhelmed, set aside a set amount of time to check the news every day or sign up for a daily newsletter from a reputable news source.
  • Take care of your body: Take deep breaths, stretch, or meditate. Try to eat healthy, well-balanced meals, exercise regularly, get plenty of sleep, and do not increase your consumption of alcohol and drugs. YouTube can be a great place to find at-home workouts, guided meditations, or tips and tricks on cooking nutritious meals.
  • Take care of your mind: To cope with times of uncertainty, it can be easy to dive into a series, watch movies endlessly or jump on board with other mindless distractions for long periods of time. While this does help us escape current realities, it can feel unproductive and potentially unhealthy to disengage for too long. Consider, instead, choosing distraction activities that keep your mind thoughtful and stimulated. Is there a list of books you would like to read? Are there some podcasts that were suggested by like-minded friends? Consider listening to audiobooks while completing chores or other projects to keep yourself active throughout the day. Try to consciously choose the information you take in, such as historical or biographical reads, and watch out for those distractions that are engaged in out of convenience.
  • Connect with others: Your community is there for you in times of physical distancing. Connect with your loved ones and people you trust about your concerns and how you are feeling. Apps like Skype, FaceTime and Whatsapp allow you to call your friends and family through an internet connection so you don’t have to use your phone plan minutes.
  • Ask for help: Call a health care provider such as a psychologist, social worker, counsellor, family physician, or psychiatrist, if stress gets in the way of your daily activities for several days in a row.

International Students can have a harder time connecting with family abroad due to possible unstable internet communication. Here are other ways to stay connected with your community:

  • Reach out to a classmate: Chatting with peers can open doors to deeper connections and friendships. At this moment, a lot of people understand the need for connection and are open to making new friends!
  • Join an online group for international students: You are not alone. There are many international students in Canada going through similar experiences and coming together. Check out these Facebook groups: International Student Network and Migrant Students United!

Studying from Home

You might be used to going to the library or getting together with friends at a coffee shop to study, and the line between classes and everyday life can become more and more blurred as you are respecting physical distancing measures. Here are some tips to help you get set up for continuing your studies from home:

Your study environment

  • Dedicated study or workspace: If possible, set up a dedicated workspace where you can keep study materials and have virtual classes or group chats, so that you keep your studies separate from the rest of your life. Try to remember proper ergonomics when setting up your workspace.
  • Having resources at your disposal: Take some time to make sure you have everything you need at your disposal to effectively conduct your studies, as this could help mitigate potential stressors. For example, install any required software on your computer or order a headset and webcam for online classes. Reach out to your professor or students’ union if you need support and resources.
  • Comfort and quiet: As much as possible, keep your study space quiet and free from distractions. If you have roommates, you could use headphones (ideally noise-cancelling headphones) to drown out noise. Make sure your space is inviting so you want to spend time there (you could sit by a window or add a plant or favourite trinket to your desk).

Setting a schedule for school and life

  • Maintain a consistent routine: This includes sleep-wake times, exercise, and work/school schedules. It can be easy to do schoolwork all day because it feels like there is nothing else to do. Establishing and maintaining a routine will help you maintain a sense of normalcy and keep your schoolwork and home life separate.
  • Take breaks: It’s important to take breaks to rest your eyes, your mind and your body. If it’s hard for you to remember to take breaks, you could set up a timer for 90 minutes and then take a 15-minute break.
  • Check in with professors about expectations: Maintain good communication with your professors. Have a clear understanding from your professor about whether moving to online classes changes expectations around assignments, exams, and other academic requirements. For example, you could ask for flexibility on timelines given your current time zone.

Impacts on Graduate Students and Student Research

For some students, COVID-19 has had significant impacts on your research. Graduate students have been particularly impacted during this crisis. The combination of financial uncertainty, pressure to graduate within a given time frame and before funding runs out, managing your research and teaching responsibilities, disruption in their academic work, and lost conference presentation opportunities underscores the importance of prioritizing your mental health and well-being. Remember to have realistic expectations for your work and progress during a global pandemic. It is okay if you feel that you do not have the mental or emotional capacity to produce knowledge or undertake research during a global crisis. Here are other tips for coping as a student researcher:

  • Create a daily routine and set realistic goals for yourself.
  • Reach out to your department for support and stay in touch with your supervisors and have conversations about how you plan on carrying on with your work during this new reality.
  • If you had been accepted to submit at a conference and the conference was cancelled, contact the conference organizers regarding their policy about noting the conference acceptance on your CV, and obtaining the word on how to do so.
  • Talk to your university’s research officer to understand what, if any, impacts COVID-19 will have on any student funding you may have (e.g., scholarships, bursaries, fellowships).
  • See if your research can be conducted through online surveys or if your research protocol can be moved to an online experiment.
  • If possible, use this time to talk to your professors about working on publications, while not losing sight of the mental resources required to cope with COVID-19.

Keep Busy and Beat Boredom

Self-isolation and physical distancing have drastically changed the way we conduct our daily lives. Boredom is a common response as we adjust to staying home to help flatten the curve. Keep busy in order to stave off boredom and potential impacts on your psychological response to COVID-19. Here are some ideas:

  • Stay connected: There are different online platforms for games/entertainment to help you stay connected with your loved ones. Some popular applications are SnapChat, TikTok, Houseparty, Zoom, and Jackbox.
  • Jump on a viral challenge: There are countless challenges on social media that encourage people to try something different and share it with the online community. Try “draw something”, “until tomorrow” or “see a dog, send a dog”. For more ideas, check out this news article.
  • Discover a new hobby: You could use the extra spare time to try new activities such as zines, journaling, visiting museums virtually, karaoke, virtual escape rooms, and more! Additionally, consider checking out popular online courses as many websites are currently offering free lessons for the foreseeable future. If you have been interested in trying your hand at a new creative pastime, online courses can give structure and provide advice to help with that learning curve. Try engaging creatively in projects such as drawing, sewing or playing a new instrument.
  • Organize!: COVID-19 has shown the scale in which we need governments to fund public services such as healthcare and education. This pandemic can also be a window of opportunity to re-envision a just society. Liaise with activist organizations such as the Canadian Federation of Students, Fight for 15 & Fairness, Migrant Workers Alliance for Change, Climate Strike Canada, Our Time and other groups to get involved.

When Psychological Distress Becomes Too Much

It is normal to be emotionally affected by events like wide-spread illnesses and that everyone will react differently to current world events.  However, if any of the following signs and symptoms persist beyond a couple of weeks, persist to the point where you are not able to carry out the home or work-related activities permitted by physical distancing advisories, and are accompanied by intense feelings of despair or helplessness or suicidal thoughts you are well advised to consult a regulated health care professional such as a psychologist, your family physician, a nurse practitioner, psychiatrist, or other mental health provider.

  • Sleeping poorly, too much or too little
  • Avoiding others, even within the confines of social distancing
  • Experiencing headaches and stomach problems
  • Crying
  • Talking less
  • Feeling anxious, depressed or having panic attacks
  • Feeling angry, guilty, helpless, numb, or confused
  • Thinking about or watching too much television on COVID-19 or pandemics
  • Not wanting to get out of bed
  • Having difficulties concentrating
  • Excessive eating
  • Drinking more alcohol or taking more prescription drugs
  • Having little patience
  • Feeling overprotective of loved ones

Where do I go for more information?

To obtain  important and up to date information about COVID-19, visit the Public Health Agency of Canada (PHAC) website at https://www.canada.ca/en/public-health/services/diseases/2019-novel-coronavirus-infection.html

Provincial, territorial, and some municipal associations of psychology often maintain referral services. For the names and coordinates of provincial and territorial associations of psychology, please visit:  https://cpa.ca/public/whatisapsychologist/PTassociations

This fact sheet has been prepared Genevieve Charest and Sofia Descalzi (Canadian Federation of Students) and Dr. Lisa Votta-Bleeker and Samantha Stranc (Canadian Psychological Association).

Date: April 2, 2020

Your opinion matters! Please contact us with any questions or comments about any of the Psychology Works Fact Sheets:  factsheets@cpa.ca

Canadian Psychological Association

Tel: 613-237-2144
Toll free (in Canada): 1-888-472-0657

Audio Update: Christine Korol telehealth and online therapy

Posted on by CPA Webmaster


The CPA daily COVID-19 quick chat starts today with Dr. Christine Korol, who talks to us about taking your psychological practice online.

Access to Title in Psychology (March 2020)

Posted on by CPA Webmaster

The CPA convened a Task Force to review the use of title (i.e. psychologist) within the profession of psychology.  In March 2020, the CPA released the report CPA Task Force on Title: Model Language Suggestions which includes recommendations for: consistency in the legislated exemptions across the provinces and territories; and collaboration with its provincial and territorial psychology association partners to advocate for the adoption of this exemption model across the country.

“Psychology Works” Fact Sheet: Helping Teens Cope with the Impacts of and Restrictions Related to COVID-19

Posted on by CPA Webmaster

Adolescents are likely to be strongly affected by public health emergencies such as the novel coronavirus (COVID-19). Public health directives to reduce transmission have likely meant cancellations of organized sport teams and recreational activities, missed celebrations, cancelled school trips, reduced or lost employment, loss of opportunities to socially engage with peers, and loss of in-class academic learning – proms, graduations and exams may soon follow. These impacts, combined with indirect exposure to the virus through social and TV media coverage, may challenge their coping skills in very significant ways.

The stressors of COVID-19 come during a period of great physical, social and emotional change for adolescents.  At a time when they are forming identities, beliefs and values, they may be more likely than adults to act impulsively, push boundaries and assert their invincibility.  These latter behaviours may make them particularly vulnerable to contracting an infectious disease like COVID-19. 

Some Reactions to Expect

In general, most teens are strong, sensible and have good social support systems that will help them cope and respond well to distressing events. Nevertheless, a major stressful event or public health emergency can have many effects on teens. Some common reactions include:

  • Worries, fears, and anxiety about their safety and the safety of family and friends
  • Fear of other major emergencies
  • Negative ideas about and mistrust of others, particularly those of different backgrounds
  • Increase in disruptive behaviours, for example arguing, defiance, angry outbursts
  • Increased crying, sadness or depressed feelings
  • More difficulty concentrating or paying attention
  • Variations in energy levels – either less active and tired, or more active, impatient and agitated
  • Problems sleeping – either sleeping too much or not enough
  • Problems eating – either eating too much or not enough

How to Help

Teens need the adults in their lives to pay attention to their feelings and reactions. Remember that:

  • teens can cope with stressful situations, and you can help them.
  • they will express their feelings in different ways, both directly and indirectly.
  • teens need your assurances that they are safe and that you will be there for them if they feel upset.
  • teens will be impacted by the ways in which they see parents and other adults handle the situation, so it is important to be mindful of your own reactions and engage in good self-care.

This experience of lockdowns, forced closures, and physical distancing is new for most people in today’s world.  Your teens are likely in the house more during this pandemic than they have been for a long time and will be again after the pandemic has settled; cherish this time with each other.

Don’t over-react. Many of the reactions that teens may show at this time, including a certain amount of moodiness and arguing, can be normal features of adolescence. You should, however, pay attention to behaviours that are new and to any that are really disturbing to you and show understanding and support. If the behaviours are dangerous or seriously disruptive, or if they don’t improve after a few weeks, parents, family members or teachers should help the teen to get help.

On the other hand, teenagers may pretend not to be affected or concerned in an effort to convince themselves they are invincible or to appear “above it all” and “cool.” In reality, they may be scared, confused, worried and in need of your help.

Here are some suggestions on how to help your teenagers cope:

Grief and Loss. Grief includes shock, denial, anger, numbness, sadness, and confusion; it is a normal response to loss of all kinds, including those associated with the real or feared losses during public health emergencies. Nothing like COVID-19 has ever happened before in most of our lifetimes. Because of the changes to our daily lives as a result of COVID-19, teens are missing once-in-a-lifetime events, such as school trips to Europe, graduations, proms, and there is no way to stop or rewind the clock so that they can have these moments back. While loss of life may trump the loss of a prom, losing out on milestone events is significant and painful for everyone.  Let them talk to you about what they are missing; don’t dismiss their concerns and distress. Hear them and understand that these are big moments in their lives and let them grieve the loss of these experiences. Explain that it can take time to get over a loss and encourage them to be patient with themselves and with others.

Honest Reassurance. Offer reassurance based on the real steps that are being taken to address the situation and explain the importance of following public health directives such as physical distancing.  Admit that there are things you just don’t know, including how long the current situation will last. However, don’t hesitate to tell them that many people are working to ensure everyone’s safety, and that by following public health directives we decrease the chance that anything will happen to them or you.

Listen to what they have to say about the events and how they perceive them. Provide them, as best you can, with factual information and help them distinguish opinion from fact. Try not to lecture or interrupt.

Humour. When dealing with difficult circumstances, watching or listening to something humorous can be helpful. However, some teens may crack jokes about tragedies in “an unconscious effort to distance themselves from their fears”.  Discourage disrespectful jokes while not cutting off lines of communication.

Anger. Teens, and people in general, may feel angry about what they have lost. Anger is often based on feelings of threat, fear, helplessness and vulnerability. Turn the conversation to the underlying feelings; tell them how you feel and options to best deal with these feelings.

Affection. Be patient with teens and with yourself. Find simple, daily ways to show teens that you love them — hugs, words of praise, fun time together.

Comforting Friends. If teens have friends who have been directly affected by COVID-19, help them find ways of comforting them; they may avoid talking to them out of fear of causing more pain. They may need help to know how to offer comfort and support, especially in these times of physical distancing.

Social Media and TV Coverage. Both you and your teenager may want to limit exposure to news coverage of the virus.  Teens should not be shielded from the facts about the virus but watching too much new coverage can put them, and anyone for that matter, in an emotionally overloaded, anxious state. Watch TV news coverage together and talk about what you are seeing, hearing, and feeling.

Maintain Family Routines. Maintain family routines, particularly around sleeping and eating. Schedules help: waking up at a set time, schoolwork, leisure time, outside time when possible.

For most of us, times of stress may not be good times to make important decisions.  If teens are quite upset by COVID-19 events, encourage them to take the time they need to think through any big decisions.

Appropriate Adult Behaviour and Responses. Talk to teens about what you think and feel about the circumstances related to the virus so they can understand them better. They will gain confidence to deal with their own feelings if you show them that you have strong feelings and that you can cope with them in healthy ways.

Vulnerable Teens. Stressful events and an ongoing climate of uncertainty and worry can have a greater impact on teens who are vulnerable. This may include teens who have experienced serious bullying, difficult family separations, deaths in the family, family violence, sexual assault, a traumatic refugee experience, clinical depression, an anxiety disorder or other mental illness, a history of drug/alcohol abuse, self-injury or suicide attempts. Some vulnerable teens may experience a return or worsening of mental health problems or unhealthy behaviours, up to and including suicide attempts.

Teens, Technology and Physical Distancing

Disasters and emergencies are often times when people and communities would normally come together in friendship and social support.  COVID-19 however is different because we cannot physically come together.  While we must keep physically distant from each other to reduce spread of the virus, we don’t have to keep our social distance.  We just have to engage with others in a different manner; one with which teens are usually more familiar than their parents!  

One of the ways to stay connected socially while physically distancing is by staying connected online. In fact, physical distancing requirements may have little impact on the current generation of teens who are used to socializing through their cell phones, tablets and apps like Houseparty and Snapchat.  Online contact can help teens stay connected to their peers, especially if teens can videochat with their friends or co-play mobile games with their friends.

Online contact can also allow teens to stay connected with family members and loved ones who are far away and/or may be challenged by the physical distancing requirements. In this case, teens can be a helpful source of connectedness and support for loved ones, particularly those who may be elderly or vulnerable.

During physical distancing, school websites and libraries can make use of technology to help students complete online-based schoolwork; online resources may also be used for virtual extracurricular classes, science projects, and Lego challenges.

Helpful Activities for Teens

Teens can benefit from participating in activities that can help them feel better while still maintaining physical distancing, such as:

  • Relaxing Activities. Encourage activities like reading, listening to music, taking a walk, riding bikes, etc.
  • Diaries and Drawing. Some teens benefit from writing their thoughts and feelings in a diary, or drawing/painting about their feelings.
  • Recreational Activities. Vigorous physical activities and sports help reduce stress, and make people feel more alert, happy and energetic. While many teens have lost participation in organized sports, they may still be able to practice or play their favourite sport at home, or take up a new physical activity, such as biking or running.

Families can also embrace this time by engaging in activities together such as: tackling household projects previously put on hold, doing chores, painting or re-decorating a teen’s room, trying out new recipes, exercising together, playing board games and doing puzzles, watching movies, and going for family walks.

When to Seek Help

Some teens may be more at risk for a persistent or strongly negative response, or even for suicidal behaviours. Be watchful and prepared to seek professional help if your teen shows some of the responses listed below and keep communication open by checking in to see how they are doing. They may benefit from talking with a health professional such as a psychologist, social worker, physician, nurse or psychiatrist who can help them understand and deal with how they are feeling.

  • Behaviour problems
  • Learning problems
  • Angry outbursts
  • Withdrawal from family and technology-based connectedness to their friends
  • Frequent nightmares or other sleep disturbances
  • Physical problems such as nausea, headaches, weight gain or loss
  • Feeling very anxious or afraid
  • Ongoing sadness or depression
  • Hopelessness about life or the future
  • Increased risk-taking or problems with the law
  • Abuse of alcohol, street drugs, medicines or solvents
  • Suicidal thinking or behaviour

Where do I go for more information?

To obtain important and up to date information about COVID-19, visit the Public Health Agency of Canada (PHAC) website at https://www.canada.ca/en/public-health/services/diseases/2019-novel-coronavirus-infection.html or your local health authority.

Provincial, territorial, and some municipal associations of psychology often maintain referral services. For the names and coordinates of provincial and territorial associations of psychology, please visit:  https://cpa.ca/public/whatisapsychologist/PTassociations 

Kids Help Phone:  https://kidshelpphone.ca/

 

This fact sheet has been prepared for the Canadian Psychological Association by Dr. Lisa Votta-Bleeker, Deputy Chief Executive Officer, Canadian Psychological Association.

Date: March 31, 2020

Your opinion matters! Please contact us with any questions or comments about any of the Psychology Works Fact Sheets:  factsheets@cpa.ca

Canadian Psychological Association

Tel: 613-237-2144
Toll free (in Canada): 1-888-472-0657

 

Mental Health Commission of Canada (MHCC)

Posted on by CPA Webmaster

The MHCC is here for you

Resource hub dedicated to mental health and wellness during the COVID-19 pandemic

Dear friends:

Given the ever-changing events around the COVID-19 pandemic, we are all experiencing varying degrees of a normal reaction to an abnormal event. 
 

ACCESS OUR NEW RESOURCE HUB HERE

As you know, the Mental Health Commission of Canada (MHCC) isn’t a mental health services provider. Regrettably, we cannot respond to requests from individuals or clinicians. But during this time, what we can offer you is curated, evidence-based information you can trust.

In times of high anxiety and stress, it’s more important than ever to safeguard your mental wellness. That includes stemming the tide of non-essential information and paring down your news consumption. It also includes accessing reliable sources of information.

Our commitment is to share credible information and resources related to mental wellness during the COVID-19 pandemic on a dedicated resource hub. It will provide you with tools we have created, links to credible national and international resources and share the proactive measures we are taking to promote mental health as we work together to plank the curve.

While our country has collectively mobilized to practice physical distancing, the strength of our social connections is more important than ever.

We’ll get through this by supporting each other in the spirit of solidary that you’ve always found on our social media channels, and which now extends to this new resource hub. 

Keep safe and let’s stay connected.

Sincerely, 

Louise Bradley, C.M.
President and CEO

Joint statement from APA, CPA, APPIC, and ASPPB regarding the impact of COVID-19 on psychology training in North America.

Posted on by CPA Webmaster

Education & Training in Health Service Psychology – COVID-19 – Joint Statement Updated 3-19-2020

The Association of Psychology Postdoctoral and Internship Centers (APPIC), the American Psychological Association (APA), the Canadian Psychological Association (CPA) and the Association of State and Provincial Psychology Boards (ASPPB) have received questions and concerns from programs and students concerned about how COVID-19 will impact their training experiences and if it will impact their completion of degree requirements. The range of ever-changing information, sometimes conflicting, from different organizations in which psychology graduate students train throughout the U.S. and Canada has contributed to increasing anxiety.

The purpose of this communication is to provide information coordinated by APPIC, APA, CPA, and ASPPB about how information will be shared as it becomes available. The community should expect further updates as this situation continues to develop, and public health guidelines are clarified by various agencies. We will continue to review updates from the Centers for Disease Control (CDC) and the Public Health Agency of Canada (PHAC). We anticipate that COVID-19 will impact the ability of some students to complete their internship/residency requirements, as psychological services will be disrupted, and further travel regulations will result in postponed training and education in psychology as well as other health professions. This impact will affect internships and postdoctoral fellowships, as well as information about accreditation and licensure. We intend to continue to update programs as this situation evolves, prioritizing student, faculty, and patient safety.

We recognize that programs may need to employ varying approaches and strategies that are influenced by individual institutional policies and procedures; local, state or provincial/territorial, and federal regulations; and possible variations in the spread of COVID-19. Licensing boards and colleges have to respond to jurisdictional requirements; as an accrediting agency recognized by the USDE (US Department of Education) and CHEA (Council of Higher Education Accreditation), the APA’s Commission on Accreditation (CoA) is charged with upholding minimum standards such that the public is assured that accredited psychology education and training programs conform to that which is delineated in the APA Standards of Accreditation; CPA’s Standards and Procedures need to enable accredited institutions to meet the provisions of their provincial/territorial degree granting authority and membership in Universities Canada. APPIC relies on its programs to ensure that ALL graduates meet the requirements, but also encourages programs to be flexible when possible and to follow institutional guidelines and employment rules typically controlled by individual sites regarding leave time.

APPIC, the APA’s Commission on Accreditation and CPA’s Accreditation Panel believe that program faculty and supervisors are in the best position to make decisions during training about trainee competence, including psychological intervention and assessment. and we trust that performance requirements set by programs will be effective in assessing trainee competence and safety.

Next Steps:

For everyone, although we cannot issue a blank statement that will cover all training sites and all regulatory boards, rest assured that we – APA, CPA, APPIC, APA CoA (Commission on Accreditation), and CPA Commission on Accreditation Panel– are working with our programs to be flexible, and we are

working with ASPPB and psychology regulatory boards to stay in communication and updated through this time. For up-to-date information about licensure jurisdiction-by-jurisdiction, visit the ASPPB website (www.asppb.net) that is updated daily as new information is available.

We recognize that this is a stressful time for all stakeholders involved in education and training. Our organizations have staff who are available to assist you as situations arise. Please contact the appropriate agency with your questions, and please understand that there might not be immediate answers to some questions. We will do our best to give you updates as we learn more facts that impact training and licensure.