Psychology Month has focused on dozens of aspects of the pandemic, a global catastrophe that is deeply tragic. To close out Psychology Month, we focus on a few positives that have come about as a result of COVID-19.
The CPA has been adjusting, like everyone else, to working from home and embracing the new normal. Our work has been guided by our CEO, Dr. Karen Cohen.
CPA’s Communications Specialist, Eric Bollman talks to CPA’s CEO, Karen Cohen
“The tail of COVID is going to be a long one. It’s going to be psychosocial, and financial. Long after we get vaccines, long after we achieve population immunity, we’re still going to be addressing the psychosocial and financial impacts of living through a pandemic this long.”
Shortly after the NBA announced the suspension of their season on March 11, 2020, there was an all-staff meeting at the CPA head office in downtown Ottawa. The realization was dawning on everyone, and fast, that we were about to enter a different world – both in terms of our own work lives, and in terms of the role of psychology in the world at large.
We knew things were changing – if the NBA could shut down, the rest of the world was not far behind. We knew we’d all be sent home, and we spent that meeting discussing how that would work. Who needed a laptop? Who needed a refresher on Microsoft Teams, having slept through the training session less than a week before? What we did not know was that this would be the last time we saw each other in person for more than a year.
Our CEO, Dr. Karen Cohen, does not follow basketball. For her, the realization was more incremental. But she reached it at the same time, if not a little before, the rest of us. She made the decision to shut down the office and send everybody home.
“We were trying to make the decision that not only would best take care of our workplace, but that would make us a good corporate citizen. It was clear that if the world was going to be successful in managing the pandemic, we had to put in a community effort. “
As the world changed, and the CPA started working from our homes across Ottawa and connecting with people across the country, we realized that psychology was going to have an outsized role to play in helping people and communities manage the pandemic. CPA wanted to help in that effort. Dr. Cohen credits the staff at the CPA for making this transition work, almost seamlessly.
“Everything CPA has been able to contribute to managing the pandemic is to the credit of the association’s leadership, its membership and its staff. From the outset, our goal was to listen and respond to what people needed; what staff needed to work efficiently from home, what individuals and families needed to support each other, what members needed to face disruptions in their work, and what decision-makers needed to develop policies to help communities.
At first though, those lockdowns were not extended – we truly thought we’d be back at work in a few weeks, maybe a couple of months. Karen and the rest of the management team made sure to check in, and to cover their bases early on.
“One of the things we did at the outset was to survey staff – asking what’s keeping you up at night? How can we make things better? What are you most concerned about? And not just to ask the questions but to try to do something about them. We developed policies and made decisions that considered the things staff were worried about and responded to what they needed. We realized that psychology had some tools and suggestions to help them cope so we developed a webinar for staff on coping and resilience. We also reached out to staff one on one and really tried to hear them so we could help make things easier for them.”
We then thought that the survey and webinar might be helpful to the staff of other of CPA’s not for profit association partners and we delivered them to about a dozen of them. The survey enabled leaders to better understand the needs of their workplaces and psychology had some tools and suggestions to help workers cope. Something that was created internally, for the use of our own staff, ended up being of value to other organizations and an unforeseen contribution our team has been able to make.
While we didn’t know how long the pandemic would last, or what the long-term effects would be, the one group we knew for sure would be affected long-term were frontline health care workers. We were already seeing reports from Italy and Spain of overflowing hospitals, a health care system in crisis, and doctors and nurses overcome with exhaustion and despair. So what could we do?
The first major effort of the CPA during the pandemic was to ask our practitioner members if they would be willing to offer their services to frontline healthcare workers, on an urgent basis, as they faced the stressors of delivering health care services during a pandemic. It seemed essential that the people who were out there fighting against this scourge of a virus had every support possible as they took care of everyone else and, because of their work, faced heightened risk of contracting the virus and bringing it home to their families.
“Hundreds of psychologists came together to do that. It was good for CPA, it was good for psychology, and most importantly, it has been good for the health providers psychologists helped.
From there, it was a question of developing and delivering information, and getting as much of it out to members, decision-makers and Canadians as possible. Psychologists across Canada answered the call to help create more than a dozen COVID-specific fact sheets for students, psychologists, faculty, people working from home and more. Our team developed webinars, started a podcast, and undertook the herculean effort of moving the CPA annual convention online with just a few months notice.
The CPA team has been collaborating with innumerable other organizations and agencies, commissioning surveys and public opinion polls, and advocating for mental health to be front and centre in every governmental pandemic-related decision and policy across Canada. The work is ongoing, and it is not likely to stop any time soon.
“We know that rates of anxiety, depression and substance use have gone up as people cope with this prolonged chronic stressor. We can see the impact managing the pandemic has had on our work, relationships, and wellbeing. Maybe the pandemic has shown us that a pandemic takes as much of a psychological toll on our lives as a biological one. Maybe the pandemic has shown us that managing a critical health event successfully is as much about psychological and social factors as it is about the biological ones. Maybe, governments, workplaces, and insurers will fully realize that mental health matters and that it is time that making investments in mental health care matters too.”
Friends since they did an internship together at the Children’s Hospital of Eastern Ontario, child psychologists Dr. Laila Din Osmun, Dr. Mary Simmering McDonald, and Dr. Jenn Vriend are trying to reach as many kids and parents as they can during the pandemic with the Coping Toolbox podcast.
Laila Din Osmun, Jenn Vriend, and Mary Simmering McDonald
Everyone is swamped. Kids, learning virtually for the past year and dealing with constant uncertainty. Parents, looking after those kids and trying to work remotely or cope with being out of work. Psychologists, whose services are more in demand than ever but who don’t have any spots available for new clients.
Dr. Laila Din Osmun is a parent and a psychologist, dealing with two young children learning from home and an increasing demand for her professional services. She started spending time with her two children, aged five and seven, throughout the week and moved her practice to the weekends. She found she was turning people away because she just didn’t have the availability to see the number of people seeking services. And so she did something that may seem illogical – she added a whole other project to her workload.
In conversation with her friends Dr. Jenn Vriend and Dr. Mary Simmering McDonald, Dr. Din Osmun found that they were experiencing the same thing. The three had become friends during an internship at the Children’s Hospital of Eastern Ontario (CHEO), and now all three were child psychologists in private practice in Ottawa. None of them could keep up with the demand.
How do you get essential information to as many people as possible as quickly as possible? Nothing can replace one-on-one therapy, but there was clearly a void as the supply was not coming close to matching the demand. Dr. Din Osmun proposed a podcast. Coping techniques for kids, delivered one episode at a time, coupled with discussions of the issues facing families during the pandemic and some personal stories about spending time at home with their own children.
The CopingToolbox: A Child Psych Podcast was born. The first episode was published February 17th, discussing specific coping strategies (setting boundaries, practicing gratitude) for children and parents during COVID.
“Everybody’s feeling overwhelmed right now, myself included. My friends, my clients – it’s a really difficult time. One of the things I’ve been practicing is just allowing myself to feel some of those feelings. Sometimes we feel sad and we don’t want to, or we feel anxiety and we don’t want to. But it’s a really difficult time and we’re going through a lot, and I think it’s really important that we allow ourselves to feel that feeling for a little while.”
Jenn Vriend, The Coping Toolbox Episode One
Future episodes will deal with subjects like depression, as the three friends try to bring more services to more people through a new and interesting platform. On the podcast, they refer to themselves as ‘Dr. Laila’, and ‘Dr. Jenn’, and ‘Dr. Mary’. To an outsider, this might remind people of the ‘Dr. Bobby’ episode of Friends (okay it’s me – I’m the outsider who was reminded of that episode) but it also creates a friendly and welcoming atmosphere should kids be listening with their parents. This was clearly an intentional choice, as was the use of the word ‘toolbox’. Says Dr. Laila,
“We called it The Coping Toolbox because we wanted to provide tools for coping. Not getting into too much detail, and we wanted it to be useful. At the end of every podcast we give three coping skills that we review for the people listening.”
In episode one, those skills are; take a few minutes and breathe, modeling positive behaviours for your kids, and being kind to ourselves. On the podcast, Dr. Jenn says;
“We’re modeling positive behaviours, but we’re not doing it perfectly. So we can take a deep breath, do our best to model those positive behaviours, for ourselves as well as our kids, and then just be gentle and kind to ourselves knowing that we’re doing the best we can given the situation.”
All three Coping Toolbox podcast co-hosts know about doing their best given the situation. They all have young children at home, and each of them brings a different perspective. While Dr. Din Osmun has set aside a large portion of her work to take care of the kids while her husband works a demanding job, Dr. Simmering McDonald, a mom of 3- and 5-year-old boys, is balancing her clinical practice with her husband’s long work days, limited childcare, and weekly appointments regarding the health needs of family members.
In The Coping Toolbox Episode One, Dr. Simmering McDonald notes, “it’s important to consider our own well-being and our own mental health. This is necessary for our own functioning but also for the functioning of our kids and our families.” Dr. Vriend speaks about grief, something many people are experiencing with COVID-19. She separated from her son’s father a few years ago, then sadly he passed away in the summer of 2020. “I’ve had to learn not just single parenting but lone parenting, where you’re it – you’re kind of the everything. I think that perspective, during the pandemic, is going to be interesting to discuss. I remember at one point feeling like ‘I’m my son’s entire world’. I’m his teacher, and I’m his coach, and I’m his mom, and I’m his dad, and it felt very overwhelming. It can add a different perspective because there are a lot of people who discuss both parents, and when you’re a single parent it can hurt a little bit and I think the pandemic has created a whole other layer for single parents and for lone parents.”
In professional practice, divulging personal details is not something psychologists do. But in the context of a podcast, doing so can help the narrative hit home – a narrative that, in the case of The Coping Toolbox, is warm, friendly, expert-driven and truly helpful for many who can’t access that help in other ways at the moment. Dr. Din Osmun says,
“It’s been a crazy time, and we just can’t meet the demands right now. It was getting really frustrating, and the three of us kept talking in group conversations – how can we help? We’re so limited in what we can do. We had the idea of creating a podcast, but we knew nothing about podcasting. The three of us are clinicians in private practice, we have no expertise in podcasting whatsoever. It was a huge learning curve, but we figured this IS something we can do to help people because it’s something the three of us can do from home. We felt like this was a way to help more people in a shorter period of time.”
Laila has taken the lead on the podcast, including taking on hosting duties and – the most painstaking and time-consuming job of all – the editing after the fact. It will all be worthwhile if enough people listen and take away something helpful they did not already know.
You can find The Coping Toolbox: A Child Psych Podcast on Apple Podcasts. https://podcasts.apple.com/ca/podcast/the-coping-toolbox-a-child-psych-podcast/id1553993639
Introducing The Coping Toolbox: A Child Psych Podcast. Dr. Jenn Vriend, Dr. Laila Din Osmun, and Dr. Mary Simmering McDonald are three child psychologists from Ottawa.
Charles Henry Turner was a zoologist, one of the first 3 Black men to earn a PhD from Chicago University. Despite being denied access to laboratories, research libraries, and more, his extensive research was part of a movement that became the field of comparative psychology.
Dr. Turner was a civil rights advocate in St. Louis, publishing papers on the subject beginning in 1897. He suggested education as the best means of combatting racism, and believed in what would now be called a ‘comparative psychology’ approach.
Charles Henry Turner was a zoologist, one of the first 3 Black men to earn a PhD from Chicago University. He became the first person to determine insects can distinguish pitch. He also determined that social insects, like cockroaches, can learn by trial and error.
Despite an impressive academic record, Dr. Turner was unable to find work at major American universities. He published dozens of papers, including three in the journal 'Science', while working as a high school science teacher in St. Louis.
Despite being denied access to laboratories, research libraries, and more, his extensive research was part of a movement that became the field of comparative psychology.
Dr. Turner was a civil rights advocate in St. Louis, publishing papers on the subject beginning in 1897. He suggested education as the best means of combatting racism, and believed in what would now be called a 'comparative psychology' approach. He retired from teaching in 1922, and died at the age of 56 on Valentine's Day in 1923.
Dr. Penny Corkum studies sleep and children, and created Better Nights Better Days, a cross-Canada trial that improved sleep for both kids and parents before the pandemic. In the last year, Dr. Corkum and her team went back to those families to see how they were doing during COVID. Their launch of a revamped Better Nights Better Days for the pandemic era is imminent.
“When we launched our survey study asking parents during the pandemic how their child’s sleep was impacting them, what really came up was that it’s the whole family and not just the child. So we not only had to help the child sleep better but also give strategies for the parent to sleep better. So we added that into the intervention as well.”
It probably goes without saying that sleep is incredibly important for children. Difficulty falling asleep and staying asleep can have a big impact on a child, in terms of daytime functioning. They’re not able to focus or learn as well, and it might result in behavioural problems. Dr. Penny Corkum has been studying sleep in children for a long time. In the last decade, her sleep studies have taken the form of connecting parents and families with the interventions they now know work for children and sleep. Part of this is an e-health program, online tools that parents can access when they need them.
Between 2016 and 2018 Dr. Corkum and her team ran a cross-Canada trial called Better Nights, Better Days, to see if this program was effective. It was, and the program resulted in improved sleep, improved daytime functioning, and even parents were less tired during the day as a result. Then the pandemic hit, and it became a constantly evolving crisis – lockdown for a while, then lockdown lifted. School online from home then back to in-person classroom learning. Right away, sleep patterns were disrupted for both children and adults around the world.
The team went back to the families who had participated in the original Better Nights, Better Days trial, to see how they were doing during the pandemic.
“It seemed like a good place to start because we already knew about their sleep, and we knew that they had learned a lot of strategies to help their child sleep. We were curious – were they still using these strategies? There was some research coming out at the time that suggested families were actually having better sleep, since they didn’t have to get up at a certain time. But that’s not what we found. A small portion of our families were doing better, but about 40% of the children and 60% of the parents were sleeping worse than they were before the pandemic.”
A lot of this was happening because of disruptions in routine and structure. We sleep best when we have consistency in our days – a regular bedtime, a regular time to wake up, a standard time for supper. All of this was being upended by a constantly evolving pandemic and the restrictions that went along with it. Two of the biggest factors were anxiety as a result of worry about the pandemic, and screen time. Kids were using screens a lot more while locked down at home which was disrupting their sleep in a big way.
With new data collected from the Better Nights, Better Days cohort, Dr. Corkum and her team could move forward. Almost all the parents said they were still using the interventions they had used for sleep pre-pandemic. 95% of them said that they thought other families should have access to these strategies during the pandemic. Based on this, the Better Nights, Better Days team was able to get some funding to launch an intervention for all families during the pandemic.
That new program launches Very soon – hopefully very early in March. It is free for families to use, intended for parents of children ages 1-10 who are struggling with falling asleep and staying asleep. There have been slight modifications, now that Dr. Corkum and her team have information about the pandemic and how it impacts sleep. They’ve also added to the intervention some information about parents’ sleep, and how to help parents sleep better. Sleep is essential for the whole family!
Dr. Corkum also runs a diagnostic clinic in Truro, Nova Scotia that brings together pediatricians, school psychologists, health psychologists and others to do differential diagnostics for kids who have fairly complex presentations and need a comprehensive assessment. Well, she normally does. But in the past year the doors have remained closed because they just can’t have all those people together in one room. It’s disappointing for Dr. Corkum and her team, who likely won’t be able to re-open until next year. Therapy can be done virtually, diagnostic assessments not so much.
Dr. Corkum says she misses working at Dalhousie and seeing her students, staff and colleagues but doesn’t miss the walk! Her parking spot is far from the office that carrying a bag, and papers, and a laptop through deep snow or a blizzard makes the walk to work something of a nightmare and a serious workout, every winter. She’s still getting the walk and the workout in – but walking a big dog three times a day is a much more pleasant experience.
Fresh air, exercise, and sleep are three of the things that can make life during the pandemic a more pleasant experience. And with the launch of Better Nights, Better Days which has been modified for the COVID-19 context, Dr. Corkum is making at least one of those things easier and more accessible as of today. You can sign up for the Better Nights, Better Days during COVID-19 study here:
As part of the federal government’s pre-budget consultation process of which CPA contributed to, the House of Commons Standing Committee on Finance released its report. Importantly, two of its top five recommendations focused on investing in a long-term mental health COVID-19 recovery plan for all Canadians, and targeted investments that will improve access to primary care, mental health supports and virtual care. It also included a recommendation to provide a one-time 25% increase in funding to the Tri-Councils for research restart and recovery. Hopefully all three will be reflected in the 2021 federal budget.
Given that Prime Minister Trudeau recently signaled the federal government’s willingness to discuss increasing its share of health funding to the provinces and territories, the CPA and the Canadian Alliance on Mental Illness and Mental health (CAMIMH) wrote to the Prime Minister and Premier urging them to increase their investments in mental health services and treatments.
CPA Letter to Prime Minister and Premiers
CAMIMIH Letter to Prime Minister and Premiers
At Dalhousie University, Dr. Natalie Rosen studies sexual health in the context of couples. Many people thought there would be a baby boom during the pandemic – Dr. Rosen explains why this hasn’t happened.
Where are all the babies? When the COVID-19 pandemic started creating lockdowns in March of 2020, the memes were everywhere. The generation that was sure to come from the pandemic baby boom was being given all kinds of names – Coronials! Baby Zoomers! We were all looking forward to making lame jokes in 2033 about these children entering their Quaranteens.
It made some sense that we would think that way – hey, we’re stuck at home with nothing else to do, we’ll probably all bake more cheesecake, learn a new instrument, and make a bunch of babies. But the boom never came. In fact, Canada’s birth rate in 2020 declined by 0.73% from 2019 – continuing a steady trend downward that continues into 2021 (we are projected to decline by 0.74% this year). So what gives?
Dr. Natalie Rosen specializes in couples and sex. Dr. Rosen is a clinical psychologist and an associate professor in the departments of Psychology and Neuroscience, and Obstetrics and Gynecology at Dalhousie University. She and her team are currently in the middle of several longitudinal studies with couples, some of which began before the pandemic. They’re hoping that they get some good data at the end of the studies that can shed light on the impacts of pandemic-related stress on sexual health, particularly for vulnerable groups like new parents. In the meantime, she’s looking at other studies that are just now starting to release data.
“A study published last Spring in the States looked at the impact of COVID on people’s sex lives. What they found was that just over 40% of people said their sex lives had taken a hit and were declining. Just over 40% said it was about the same, and then there was a minority of about 13% who reported that their sex lives had actually improved during the pandemic. I think it’s fair to extrapolate to some extent to Canadians, which means a big chunk of us are experiencing a declines in their sex lives.”
So what happened? Why aren’t people having sex more than ever? Where are all the babies we were promised in the memes? Dr. Rosen says we probably should have known this would be the case.
“I think that was wishful thinking. We actually know that for many people, stress and uncertainty puts quite a damper on mood and desire for sex. Of course, there are lots of individual differences, so not everyone is the same, but for many people stress and uncertainty negatively impact sexuality. Also, when you think about all the young families who have had these extended periods of time with their kids at home – not only is that a stressor, but it’s also interfering with opportunities for sex.”
Dr. Rosen’s research focuses on sexual dysfunction from a couples’ perspective. In the past, much of the research has focused on the person with the problem – but of course many sexual problems exist within the context of the couple, and she says that very often the other person in the relationship really wants to be involved and to do something differently in order to help their partner and improve their sex lives. Dr. Rosen’s team is hoping to expand the availability of couple-based, empirically supported, treatments available for sexual dysfunction. They have an upcoming publication reporting on a randomized clinical trial for the results of a novel couple therapy vs. a medical intervention for pain experienced during sex, and they are hoping to do the same with low desire. They’ve just launched a CIHR-funded study into couple therapy when women have low sexual desire.
Dr. Rosen’s clinical work is small. She works with a few couples each week who have sexual problems, such as pain during sex and low desire, and with couples who are going through major life transitions, like becoming new parents. In the beginning of the pandemic she paused her practice because it was impossible to meet in-person, but Halifax is doing well enough that she was able to start seeing couples in person again last Fall. She says that some of the couples she sees have adapted to virtual sessions and now prefer that, so going forward it looks like her clinical practice will be the kind of hybrid model we might expect to see in most clinical settings post-pandemic.
The biggest disruption for Dr. Rosen is likely the lack of travel – in a typical year she’s on a plane every six weeks or so, going to an academic conference, or visiting her family in Ottawa or Toronto. She says that now, she hasn’t seen most of her family in over year outside her husband and two children – but that this slowing down of the pace of life has had its benefits.
“For us it’s been a kind of investment in the nuclear family, spending lots of time just the four of us. And we’ve also had the chance to really explore a lot of the nooks and crannies of Nova Scotia! I also find that it’s forced me to take a step back and evaluate what’s important to me. I can get caught up in the minutia of my work, and particularly early in the pandemic I felt the frustration of trying to find work-life balance with two young kids at home. But you take a deep breath, and you figure out your values - health, family, happiness. I care about my work a lot, but there’s a pandemic, and there are many times when it just can’t be the number one priority!”
People across Canada are re-evaluating their priorities and have been for almost a year now. Like Dr. Rosen and her family, they are finding ways to support one another, to balance work and home life, and to stay as healthy and happy as they can throughout. Dr. Rosen emphasizes that finding ways to prioritize and connect sexually with your partner has many benefits for health and well- being. And that’s a valuable thing to do – just don’t feel like you have to live up to the memes of March!
The CPA is honoured to have been recognized by the Scotiabank Transfer Some Good campaign. They have made a donation to Strong Minds Strong Kids, Psychology Canada in our name. The CPA’s offering of pro-bono services by psychologists across Canada for frontline healthcare workers is ongoing.
A mentor to countless black psychologists, Keturah Whitehurst’s contributions to psychology extend beyond her own work to the work of her protégés that continues today.
Keturah Whitehurst was the first African-American woman to intern at the Harvard Psychological Clinic, and the first Black psychologist to be licensed in Virginia. She created the first counseling service at Virginia State College.
She received her Master's from the historically Black research university Howard in the 40s, and a PhD from Radcliffe in the 50s. She was a mentor to many future leaders in Black psychology - notably Aubrey Perry, who was the first Black person to graduate with a PhD in psychology from Florida State.
Dr. Whitehurst died in 2000, at the age of 88.
Photo from Kirsten's Psychology Blog
Dr. Joanna Pozzulo and the Carleton University Psychology Department launched a virtual space for researchers, students, and other stakeholders called MeWeRTH (The Mental Health and Well-being Research and Training Hub). It’s a means of connecting the university with community organizations and anyone else who might be a consumer of mental health and well-being research.
“You’re going to come out of this pandemic either a contestant on the Great Canadian Baking Show, or a really good murderer.”
“Hmmm. Yes, I hope it leans more toward the baking…but you never know?”
Dr. Joanna Pozzulo spends a lot of her spare time during the pandemic learning new recipes, and reading murder mysteries. Dr. Pozzulo is the world’s foremost expert in the psychology behind children’s eyewitness identification. She has spent more than two decades working in Criminal Justice psychology, and so she doesn’t read a murder mystery the way the rest of us do. She notices what is plausible, and what is implausible, and the many mistakes the killer inevitably makes. “I wouldn’t do it that way”, she thinks…getting one step closer to becoming really good at murder.
As the Chair of the Department of Psychology at Carleton University, Dr. Pozzulo has been doing a lot more during the pandemic than baking stacks of cookies and devouring stacks of mystery novels. She and her department have launched a virtual space for researchers, students, and other stakeholders called MeWerth (The Mental Health and Well-being Research and Training Hub). It’s a means of connecting the university with community organizations and anyone else who might be a consumer of mental health and well-being research.
“It’s a varied group, all focused on conducting research that is of high quality around topics of mental health and well-being. Ultimately, being able to disseminate evidence-based research to the public to improve daily lives.”
MeWerth was planned before the pandemic began, which meant that the virtual platform was a little bit ahead of the curve. Dr. Pozzulo says that COVID had little impact on the creation of MeWerth, but it did make the team rethink how they were going to bring people together.
“Even though it is a virtual space, the traditional idea is that you have a launch, and you invite people to a place and you have, almost a party. We were initially going to launch it in September, but we were in the middle of COVID, so we moved the launch to December and made it virtual. It worked out really well, because we were able to reach a far larger audience without concern for borders or public health risks. We had people attend from all over the world. It was great to get so many people involved when traditionally that would not have been possible. We had one person tune in from Turkey – you can imagine the travel from Turkey to Ottawa, I’m thinking it probably wouldn’t have happened otherwise.”
MeWerth is a multi-disciplinary space with a broad range of topics. Some are COVID-related, most are not. Dr. Rachel Burns is a member working on studies related to diabetes (how and when do spouses influence the health and wellbeing of people with diabetes?). Dr. Johanna Peetz is researching financial factors in well-being. Dr. Michael Wohl is looking at several facets of addiction, notably gambling addiction, including a study on casino loyalty programs.
Every Wednesday is #WellnessWednesday at MeWerth. On the website there is a ‘Wellness Corner’ where this week Dr. Robert Coplan’s research explores the novel concept of “aloneliness”, conceptualized as the negative feelings that arise from the perception that one is not spending enough time alone. A concept that very much applies during the current pandemic. This is just one of many facets of MeWerth, a platform Dr. Pozzulo already considers to be a success.
“We had 800 people register to attend the launch, a number that’s unheard of in an academic environment - to have so many people from so many different backgrounds be interested in something. I was really pleased, and it signalled to me that we were filling a need, and maybe we had underestimated how much that need was there. I’m seeing lots of interest in MeWeRTH – and its continued interest. I’m thrilled about that and I hope we can continue to grow MeWeRTH both locally and globally.”
For Dr. Pozzulo and her team to grow MeWerth, more researchers, students, community groups, organizations and other stakeholders will need to discover the web platform and sign up (https://carleton.ca/mental-health/). So, if you are one of those individuals interested in mental health and well-being, you probably should sign up. Or else…
Or else Dr. Pozzulo might not share any of her fresh-baked chocolate and candied-pecan éclairs with you.
June 7 – 25, 2021
Spanning three weeks from June 7th – 25th, the CPA’s 2021 Virtual Event will provide many opportunities for personal and professional growth, and highlight the many ways in which the science, practice, and education of psychology can benefit society, improve lives, and advance the discipline.
Please continue to monitor CPA’s Convention website for information about a Virtual Conference this June.
Meet some of the psychologists who have been profiled in this Psychology Month. We speak with Dr. Adrienne Leslie-Toogood, Dr. Christine Chambers, Courtney Gosselin and Dr. Mélanie Joanisse about their work during the pandemic.
Dr. Vina Goghari is the Editor of the Canadian Psychology journal. The amount of pandemic-related research and article submissions has been overwhelming in the past few months. The upcoming COVID special edition of the journal will present papers that cover a very broad range of topics related to the pandemic.
Dr. Vina Goghari had big plans for 2020. There were going to be conferences that would synergize with her vacations – including one in Banff where she was planning to rent a cottage and hang out with some of her friends. A couple of talks in Vienna were going to allow her to explore the nearby areas and experience Austria for the first time. Instead her breaks disappeared, her workload increased threefold, and she ended up stuck at home with a kidney stone for five months. 2020, right?
Dr. Goghari is a professor at the University of Toronto where she is the Graduate Chair of the Clinical Psychology program. What interests us here at the moment is Dr. Goghari’s position as the editor of Canadian Psychology/Psychologie canadienne, the flagship journal of the Canadian Psychological Association. The bulk of a journal editor’s work is remote already, so very little has changed in that respect, but the pandemic has created a bit of a slowdown in the review process.
“The ability of academics to spend their time on peer review has been impacted. I find they’ve still been gracious, and people are still volunteering to review these papers, but sometimes we find that people need more leeway in terms of time to actually get us the review back. We’ve been lucky that both the authors and the reviewers are having a little bit more patience with each other, and the editor, and the associate editors. It allows us to make sure this process is still equitable and fair and we still get enough reviews.”
Another thing that has, predictably, changed is the number of submissions Canadian Psychology is receiving concerning COVID itself. So many, that they have prepared a special issue just for the pandemic. Dr. Goghari says the volume of articles has been overwhelming.
“We did a call for COVID papers in May dealing with psychological perspectives on the pandemic – we feel a psychological, as well as a Canadian/International, lens is very important to helping people deal with the pandemic in terms of work and life balance and mental health. The Special Issue will be coming out in the next few weeks. We saw a record number of papers for that call. This was especially so (true) for the two of us who are the English-speaking editors ̶ we were fielding a tremendous number of papers! It was positive in the sense that the psychological perspective on the pandemic is resonating with people, but also really increased our workload, as we always want to ensure we do a professional job with all submissions. Luckily we were able to get through all of them, and I really think we have a fantastic special issue
Canadian Psychology is a generalist journal, which allowed Dr. Goghari and her team to design the COVID special issue with intention. They wanted the articles to cover a wide range of topics related to Canadians, and to reflect different parts of our society and our population. There are articles about work, sleep, mental health, adults, children, training, and much more. There are also two articles in French, and Dr. Goghari hopes that there is something for everybody in this journal issue.
Not only have they seen an increase in COVID papers, but papers regarding race-related issues that have become increasingly front and centre over the past year. More papers addressing topics such as mental health and racial disparities have been submitted. Dr. Goghari says she wishes this has also been the case for journal in the past given the importance of these societal issues, but is heartened to see that this is more of a focus now.
“One of the things COVID highlighted was that the pandemic doesn’t affect everyone equally. There are certain groups that are more affected by the pandemic like the elderly, we know that there were racial disparities in both outcome and incidence of the virus. And so the two things came together – the societal tensions on race, but also highlighted and made worse by the COVID pandemic interacting with these factors.”
Dr. Goghari says that she is encouraged by the rise in awareness created by the new focus on inequities and dismantling the systemic causes of racism. She is also encouraged by the number of papers she and her team are receiving surrounding COVID and expects that the studies launched later in the pandemic that focus on longer term impact, challenges, opportunities, and resilience, will produce some new, useful, and fascinating results. Dr. Goghari is above all an optimist. Even when it comes to missing out on some great trips, and a kidney stone!
“I find I don’t really miss the things like travel – they were just perks. I miss seeing my friends and my family. I also had some interaction with the health care system because I had a kidney stone for five months. I was very grateful for all the people who are still doing ultrasounds and CT scans and keeping the hospitals clean for us. They were just so kind! Even though they themselves were dealing with all these things, I was touched by their professionalism and their help even while I could see the burden on the health care system. When the kidney stone clinic had to close, there was an onslaught of people and we all have to get in…it was a very eye opening experience. Given what the health care workers go through, they were tremendous even though they must be in a difficult situation. I think COVID plus a kidney stone made me grateful for all the smaller things!”
Dr. Judy Moench has helped create protocols to help her Alberta community and others during the pandemic. Prepped 4 Learning helps teachers, parents, and kids cope with disruption. The Self-care Traumatic Episode Protocol (STEP) is helping mental health clinicians, hospital staff, and others decrease stress and increase coping.
“I feel like a budding musician who started out in the basement! During COVID we weren’t able to get into a studio or anything like that so I literally developed these videos in my basement using audio on my phone.”
The Self-care Traumatic Episode Protocol fits into a neat little acronym – STEP! Was this one of those programs that worked backward, to shoehorn its description into an easily-remembered four-letter word? Dr. Judy Moench says no.
“It was named that on purpose because it’s a modified version of a protocol that was developed called EMDRGTEP – which is the Eye Movement Desensitization and Reprocessing Group Traumatic Episode Protocol.”
Nobody worked backward, I think we can assume, to make EMDRGTEP a neat little acronym!
Dr. Moench is a registered psychologist in Alberta with a private practice, and also an adjunct professor at the University of Alberta. During COVID, she’s been working on a number of protocols that might be helpful in the community. One is a school-based program, focused on the universal promotion of emotional health with an emphasis on the well-being of students. Prepped 4 Learning is a self-regulation program that starts with teachers and parents helping kids regulate to learn, all the way up to what to do if there is a crisis in school. Dr. Moench thinks STEP might be helpful in this setting as well, for teachers in particular, and they are beginning research with school staff soon.
STEP was launched during the pandemic to assist mental health clinicians, medical staff, and other front line workers to decrease stress and increase coping. The idea was that because people were unable to meet in person a computer-delivered protocol was necessary. This was not intended to be a substitute for psychological treatment or medical diagnoses, but that a 90-minute session with STEP videos could develop containment strategies that would allow them to continue working on the front lines through this time of overwhelming stress. Eye movement is part of the process.
“Eye movement is part of EMDR Therapy, an approach that has an eight-phase model, and you go through all the phases with a client to help them resolve unprocessed material and recover from distressing life experiences. STEP is an adapted protocol but it still uses eye movements and goes through modified phases of treatment – you print out a worksheet, and the person taps from one side of the protocol sheet to the other side and follows with their eyes as they’re doing that. The eye movements help to add distance and give calmness around the event that is being processed. It helps to consolidate the memory in a more cohesive way.”
Normally Dr. Moench and her team would do this kind of activity in groups in the office. You know, in the before-times. Now, this program has to be modified for online delivery, which means a few steps have been adapted. Typically, EMDR treatment would involve an extensive history with the client – with STEP, this has been modified to a few specific questions up front that ensure the person is ready and eligible to use the protocol. For example, someone who was thinking about suicide, or had a complex trauma history, may be better served with one-to-one EMDR Therapy.
Another thing that sets STEP apart is that it is designed to deal with only one very specific trauma episode at a time – right now, the trauma brought on most recently by the COVID-19 pandemic. Dr. Moench calls this ‘titration’, and it narrows the focus to that one episode and excludes the larger history that might otherwise be part of treatment.
“With STEP, the research study we did focused exclusively on COVID. Since then, I’ve used it with other things that aren’t specifically COVID-related…even though right now everything is kinda COVID-related! But there are other events that are happening along with the pandemic.”
The STEP protocol has been used in Alberta with mental health clinicians, with a small group of staff from the United Nations, and with other national and international groups in which Dr. Moench is a member. Right now, she and her team are making a more professional version of the current STEP videos – after all, the originals were shot in her basement with audio from her phone! Only time will tell if this psychology-as-garage-rock-band will be a pandemic-specific flash in the pan (like the Strokes) or a longer lasting international sensation (like U2).
Hey…that’s got us thinking now. How come there hasn’t been a Live Aid / Live 8 pandemic relief show yet? Those were always super-distanced!
Dr. Chloe Hamza has an article in the upcoming Canadian Psychology journal COVID-19 special edition entitled ‘When Social Isolation Is Nothing New’. It’s part of an ongoing study of post-secondary students, some of whom had pre-existing mental health concerns before the pandemic, and some of whom didn’t.
Dr Chloe Hamza
Dr. Chloe Hamza is an assistant professor in the department of Applied Psychology and Human Development at the Ontario Institute for Studies in Education at the University of Toronto. She’s the lab director of the CARE lab (Coping, Affect, and Resilience in Education), and her research has been broadly about stress and coping among postsecondary students. It was with this focus that she and her team ran a study looking at the psychological impacts of COVID-19 among postsecondary students.
Like so many other studies at this time, Dr. Hamza and her team were lucky to have already done a similar survey, that one in May of 2019. This meant that repeating many of the same questions with many of the same participants could give a good indication of where they were now, with the pandemic, compared to where they were before.
“We had some pre-COVID assessment data, and then we went back in May 2020 and surveyed students again. We were looking at stress, coping, and mental health before and during the pandemic. What we had originally hypothesized was that students with pre-existing mental health concerns would be those who would be most adversely impacted by the pandemic. But what we found was that students who had pre-existing mental health concerns fared similarly or were actually improving during the pandemic. Whereas students without pre-existing mental health concerns showed the greatest decline in mental health.”
This study, and these results, have resulted in an article that will be published in this month’s COVID-19 special issue of the journal Canadian Psychology. (See our upcoming profile of Dr. Vina Goghari for more on the journal the day the special edition comes out.) The article is called ‘When Social Isolation is Nothing New’, and it details these findings from Dr. Hamza and her team.
“When we looked at why those students without pre-existing concerns were declining, we found that increasing social isolation seemed to be associated with deteriorating mental health. What that seems to suggest is that if you were feeling socially disconnected before the pandemic, which in our case was among students with pre-existing mental health concerns, the start of the pandemic and distancing guidelines may have been less impactful. In contrast, if you weren’t used to experiencing social isolation, and this was a real change for you, your mental health was more likely to decline.”
It looks, for now, as though students with pre-existing concerns were already experiencing some kind of isolation socially pre-pandemic, and that has made the adjustment easier and less impactful for them than it has for others. There are of course other possibilities that might account for the findings of Dr. Hamza and her team, and they plan to explore those in a follow-up study that is beginning right now.
“For many students some stressors actually decreased. For example, having multiple competing demands, or academic pressures, lessened. Which sort of makes sense if you think about how universities initially responded to the pandemic. Students weren’t going to class any more, they may not be going to work, and so the demands on their time – both academic and vocational – may have decreased.”
The follow-up study is currently under way, where Dr. Hamza and her team are asking those same students how they’re coping now during the pandemic. Some of it will involve the results of the previous study, where they will ask the participants about the results. “Here are some of our findings – how does this resonate with you? Do you think it’s accurate? What are some of the reasons you think we might have seen this result back in May?”
While that study is ongoing, Dr. Hamza is also focused on her own students – trying her best to ensure that they remain engaged, well, and healthy through what has been a very difficult school year. Her department does a ‘wellness challenge’ which challenges people to get outside and walk, or pick up and learn a new instrument, or try a new recipe. All things we can do to maintain better mental health during this time of isolation. Things that are good both for those of us who are still new to distancing and socializing remotely, and for those of us for whom social isolation is nothing new.
The Canadian Society for Exercise Physiology (CSEP) recommends that adults aged 18 or older do at least 150 minutes/week of moderate-to-vigorous intensity exercise, with each session lasting at least 10 minutes. All adults should also do muscle and bone-strengthening exercises at least twice/week. Older adults (65+) with poor mobility should regularly do activities that help to improve balance and prevent falls (e.g., yoga).
Canadian statistics show that most adults don’t meet these requirements, with levels of physical activity decreasing as people age. This is a particular problem for people with kids, as children and youth look to adults to model good behaviours; statistics show that only 15% of children (5-11 years) and 5% of youth (12-17 years) meet their recommended level of physical activity (60 minutes/day).
What Do “Moderate” and “Vigorous” Mean?
The definitions of “moderate” and “vigorous” physical activity depend on your age, health status, current level of activity, and relative level of (dis)ability. For example, a young, able-bodied athlete might not be affected by a brief walk, while an older, generally inactive person with poor mobility might experience this as “vigorously intense.” The following guidelines can help:
- Moderately intense physical activities should noticeably raise your heart rate. While you’re doing moderately intense physical activity, you should be able to have a conversation, but not be able to sing your favourite song.
- Your resting heart rate increases a lot while doing vigorously intense physical activity, although you shouldn’t feel uncomfortable as a result. While doing a vigorously intense activity, you shouldn’t be able to say more than a few words without having to take a breath.
What Are the Mental Health Benefits of Physical Activity?
Regular physical activity comprised of both cardiovascular and resistance exercise, has many mental health benefits. The longer you stick with your exercise schedule and the more often you exercise, the more benefits you’ll see. For example, research shows that regular physical activity can help:
- Prevent depression and anxiety disorders and may be as effective as psychological and pharmaceutical treatments for depression and anxiety;
- Reduce day-to-day stress;
- Particularly among middle-aged individuals, reduce the risk of cognitive decline, measured as a slowing in attention, memory, and concentration, later in life;
- Individuals perform better than others their age on tests of cognitive ability (e.g., memory, attention, processing speed);
- Boost academic performance (e.g., grades) in children, youth and young adults;
- Lower the risk of developing neurodegenerative diseases (e.g., Alzheimer’s Disease) and can make the symptoms of these diseases less severe (e.g., issues with memory, concentration, attention);
- Increase self-reported happiness and lower levels of sadness and loneliness, both in the short-term and later in life;
- Reduce feelings of fatigue, improve sleep quality, and lower your risk of insomnia (provided vigorous exercise is not done too soon before bed);
- Enhance the impact of the treatment of addictions, particularly in the reduction of cravings;
- Boost self-esteem, itself a key sign of good mental health and overall well-being, from early childhood straight through older adulthood; and
- Aid in the treatment of eating disorders, chronic pain (tailored to your physical abilities), post-traumatic stress disorder, schizophrenia, and body dysmorphic disorders (i.e., being obsessed with a real or imagined physical “flaw”).
Why Does Physical Activity Have These Benefits?
There is no single reason why physical activity has mental health benefits. Instead, research suggests that benefits come from the combined physiological, psychological, social, and neurological effects of exercise.
- Physiological: Physical activity both boosts your body’s production of endorphins and endocannabinoids, which are chemicals that help you to relax, feel more pleasure, and feel less pain, and reduces the amount of cortisol (i.e., “stress hormone”) that your body produces.
- Psychological: Regular physical activity helps to increase feelings of self-esteem and self-efficacy, or how much you believe in yourself to accomplish important goals. Short bursts of exercise can also make you happier in the moment by interrupting negative trains of thought.
- Social: People who exercise regularly tend to have bigger social networks and stronger relationships with friends and family. The regular face-to-face interaction that comes from group exercise (e.g., fitness classes, team sports) boosts your mood and can help to prevent depression.
- Neurological: Physical activity helps your brain to use and produce more dopamine and serotonin – chemicals produced in your brain that make you feel happy. People who exercise regularly also have more blood flow to the brain, better brain functioning, and even have more brain matter in certain areas (e.g., hippocampus, which is associated with memory).
How Do I Get Started and Stay Motivated?
Before you get started, you should ask yourself why you want to exercise, and what types of exercise might be best for you based on your physical (dis)abilities, personality, and goals. Consult your family physician for help in developing a healthy and realistic exercise plan.
Some of the most common reasons for not exercising include: not having enough time; not having enough money; not having enough energy; and feeling uncomfortable (physically or socially). Solutions for these can include:
- Planning to exercise frequently, but in short bursts (i.e., 10 minutes or more).
- Scheduling your day so you exercise when you tend to have more energy, and always try to do what you can.
- Finding free or low-cost activities that you enjoy (e.g., walking, cycling, or pick-up sports).
- Not pushing yourself too hard and trying to find an environment where you feel comfortable and motivated (e.g., home, outdoors, with a buddy).
Once you’ve started your exercise program, there are many ways to help you stick with it. Researchers from numerous areas of psychological research (e.g., clinical, sport, and social psychology) suggest that you:
- Make a plan and set regular, concrete goals.
- Don’t delay.
- Be realistic in choosing and committing to an exercise regimen.
- Remind yourself why exercise is important to you every day and whenever you’re facing difficulties.
- Ensure you eat regular, well-balanced meals and sleep regularly.
- Focus on you and your accomplishments, not what other people are doing.
- Track your progress and celebrate small gains.
- Make physical activity part of your daily routine.
- Don’t do the same thing every time and try to do activities you enjoy.
- Plan for how you’ll deal with potential obstacles or distractions.
- Practice self-compassion, especially when you haven’t met your daily or weekly goals.
- Find an exercise buddy who’s similar to you (e.g., age, fitness level, ability level).
Where Can I Go for Help or to Learn More?
Visit the CSEP website for physical activity guidelines: http://www.csep.ca/en/guidelines/get-the-guidelines.
Community and recreation centres offer a variety of programs that can help you add physical activity to your daily routine.
Drop-in sports and fitness classes are a great way to sample what’s available before committing to anything.
See a psychologist to discuss motivational tips, concerns you may have related to self-image and exercising, and strategies specific to your needs.
Where Can I Get 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, please visit: https://cpa.ca/public/whatisapsychologist/ptassociations/
CPA Sport and Exercise Psychology Section: https://cpa.ca/aboutcpa/cpasections/sportandexercise/v
American Psychological Association (APA) Division 47: http://www.apadivisions.org/division-47/
This fact sheet has been prepared for the Canadian Psychological Association by Matthew Murdoch, Canadian Psychological Association.
Date: November 2016
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Dr. Laurie Ford at UBC has school psychologists to train, students adjusting to online learning, and innovations to replace hands-on experiences. She also has a community garden and two great dogs!
“Every night we talk on FaceMail”.
Two things are getting Dr. Laurie Ford through this pandemic in a positive way. One is her nightly ‘FaceMail’ chats with her dad in Oklahoma. Not sure if this means FaceTime, or FaceBook, or Zoom or some other video chat platform, but dad calls it FaceMail and so FaceMail it is. The other is a community garden where Dr. Ford is the President. The garden has become a meeting-place and something of a pandemic oasis throughout the past year. Sometimes up to six or seven people, Laurie and her friends, will head to the garden after work, sit well-distanced on the various plots, and share a laugh and a glass of wine. Maybe pull some weeds. It’s a nice break from long days at work.
“I’m getting a lot of work done – when all I have to do is go to the front of my house and come back. The bad thing is I think many of us are working too much, as the lines between work and home are blurring.”
Even Dr. Ford’s beloved community garden has become part of that blurring of work-home-life, her meetings with friends inspired her to do the same with her grad students. A few months into the pandemic, she suddenly realized that most of her students lived in Vancouver but had never actually met one another in person! With the exception of one student stuck in Australia and one stuck in Alaska, she invited them all to meet, in person, at the garden. (The two stranded students were able to join virtually, by Zoom.)
Dr. Ford is at UBC. She is the Director of Training for the School and Applied Child Psychology program and has been involved in training school psychologists for a long time. She is also a board member at the CPA. As the pandemic has gone on, she has become more and more accustomed to Zoom calls, as has her dogs Gracie Belle and Cooper come to say hi and investigate the goings-on before wandering off to find more interesting ‘dog stuff’ as Dr. Ford goes back to teaching her now presumably more interested class.
“One of the big things, from a training perspective, is to figure out ways that students can get some of that hands-on training, in schools and in clinical settings, when everything’s restricted. The other part that’s related to training is – how do you move to train people to do service delivery in less traditional ways?”
Right now, Dr. Ford’s training is primarily preparing Masters and Doctoral-level school psychologists. Training that would ordinarily involve a lot of hands-on experience. Before 2020, Dr. Ford would take her students to a local homeless shelter for some classes. Others would take place in a rehab clinic, or a xʷməθkʷəy̓əm (People of the River Grass) longhouse located within walking distance of the UBC campus. Dr. Ford says, just being in these physical locations was a huge part of the experience. That, of course, has not been possible in the past year. So they are finding some workarounds.
Members of community join Dr. Ford’s Communities Systems class some weeks as they try alternate ways to immerse students in a variety of settings. In this class and others, she’s also experimenting with videos, podcasts, and other methods of delivering information that are different that simple Zoom lectures. She says she has been surprisingly impressed by how many of her students are doing the extra work and taking advantage of the extra content she makes available to them.
“I think I was just so determined to make this be awesome, even though it sucked being on line, that it’s made me become more familiar with the technology of teaching online, but it has also in some ways made me work harder to find diverse sources of information. I actually think I’m better teaching this course than I have been in the past. I’ve had to work harder to be more creative to find new and better ways to engage my students. It’s made me think like the kids a little bit – I’m doing less lecturing and I’m using podcasts and videos. They’re good teaching pedagogies that we talk about but then we kind of get lazy, you know? So I really think I’m doing a little bit of a better job this year!”
Dr. Ford has a big personality, the kind that can fill a lecture hall in person better than a Zoom screen. She says she misses that part of teaching, addressing a large room full of people, and it’s clear that will be the first thing on the docket, whenever this pandemic ends and she can get back to the front of a class. But while it goes on, she hopes that the innovations she and her students have come up with have made her a better teacher, and they have certainly made her more tech-savvy. When the spring arrives, her students will be able to meet one another again, in a safely distanced fashion. They still have the community garden.
And Laurie’s dad will still have his FaceMail.
What is attachment?
Attachment is a special emotional relationship between two people, with an expectation of protection. Usually when we talk about attachment, we’re talking about the relationship between a child and his or her parents or caregivers. Sometimes we talk about attachment in romantic relationships as well. The attachment between parents and children is our focus here.
Almost every child attaches to someone. When they don’t, it is usually because of unfortunate circumstances, such as being raised in an orphanage or experiencing severe abuse or neglect. Children with no attachments are very rare and may have an attachment disorder. They, along with and their caregivers, usually need professional help. Attachment disorders are not our focus here. Information on attachment disorders can be found at: http://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/FFF-Guide/Attachment-Disorders-085.aspx
Children can attach to a small number of adults, usually those who take care of them. They don’t usually attach to other children. Although children can have great relationships with lots of adults (teachers, babysitters, family friends), they don’t really attach to those people. They like them and trust them because their experience in their attachment relationships tells them that it is safe to do so.
Although almost all children do develop attachments, attachments can vary in their level of “security.” Psychologists, researchers, and therapists often categorize attachment relationships. The main categories are secure, insecure, and disorganized. Most children (about 60%) are securely attached. Secure attachments are the best for children’s development. Disorganized attachments lead to the most difficulties in mental health and behaviour. Children can have different styles of attachments with different caregivers.
What are the different styles of attachment?
Securely attached children explore what is around them when their caregiver is nearby. They also check in by looking at their caregiver regularly. If their caregiver leaves they usually stop exploring. When their caregiver returns they are happy to see them and calm down quickly if they are upset. Secure attachments have been shown to help children learn, empathize, develop relationships, cope with stress, handle fear, and be independent.
There are two types of insecure attachment. In insecure avoidant attachment, children don’t appear to care whether their caregiver is there or not, but they actually care a lot. These children usually explore a lot. When their caregiver returns after leaving them these children often ignore them, but if we measure their stress response using physiological measures like heart rate, we find that they’re actually quite upset.
Children with resistant insecure attachment often appear clingy. They usually stick close to their caregiver and don’t explore much. They get very upset when their caregiver leaves them. They are not easily calmed when their caregiver returns.
Children with disorganized attachments are more unpredictable. As babies, they might do unusual things like freezing or coming to their caregiver with their head turned away. As preschoolers they tend to be bossy and controlling.
How do attachments develop?
Attachments develop over time as a child and caregiver interact. It is innate or “hard-wired.” When a child has a need, their caregiver responds. For example, if a child falls off her bike and her caregiver comes over and comforts her, the child learns to expect that. On the other hand, if the caregiver yells at her she learns to expect that. It isn’t so much what happens in any one situation, so much as the pattern of reactions that matter. Over time, the child learns what will happen when they have a need. Will their caregiver respond kindly and fulfill their need? Ignore them? Yell? This pattern determines the attachment style between a child and a specific caregiver. You can’t always see someone’s attachment style. It is only activated (turned-on) when they’re in need (e.g., stressed, sick, scared, or hurting).
Children also learn what they need to do to get their needs met. Do they need to ask, yell, or cry? Eventually, kids start to expect all relationships to be like their attachment relationships. So they start to trust people, be unsure of people, hide their feelings, or not know what to expect. They also learn how they should behave in relationships.
When does attachment develop?
The building blocks of attachment start soon after birth. Attachment becomes clearer around 6 to 9 months of age, Each of us develops an attachment style that characterizes our approach to relationships over the course of our lifetime, but attachment styles can change based on experiences or in response to treatment.
How do I help my child securely attach?
There are lots of things you can do to help your child securely attach. First, try to be there for them when they need you. Second, let them explore or interact with what is around them when they’re ready. Here are some other things you can do:
- Be sensitive to your child’s needs and emotions and try to respond in a way that is in tune with them.
- Talk about feelings: your feelings and their feelings. Label everyone’s feelings and indicate that it’s okay to feel whatever you feel. You can do this even when they’re babies.
- Stay with your child when they’re upset. Even when your child is misbehaving, you need to show them you love them. Don’t send them away or threaten to leave.
- Enjoy your child: play with them, laugh with them, read with them, watch their television shows.
- Follow your child’s lead. This shows them you value their ideas and thoughts.
- Take charge when needed. This helps your child feel safe.
- Be consistent, predictable, and stable. This helps kids feel safe.
- Set limits. Too much freedom makes kids feel anxious, even if they think they want it. You need to be the strong one who lets them know what are safe limits.
- Accept them for who they are. You don’t need to approve of their behaviour, but you need to love them whatever they do.
What if I make a mistake?
It’s okay! Attachments are built on thousands of experiences and are always able to change. Research shows that kids need “good enough” parents not perfect parents. In fact, there’s something to be said for a child facing some adversity (not too much, but a little). This teaches children that they can manage these situations and helps build resilience.
What if my child isn’t securely attached?
There are a variety of different attachment-based therapies available that are supported by research. These include Parent-Child Interaction Therapy; Circle of Security; Watch, Wait, and Wonder; Interaction Guidance, Reflective Family Play, and others. See a psychologist or talk to your child’s paediatrician for appropriate evidence-based local referrals. The above-mentioned therapies and others supported by research should be favoured. There are some other therapies that indicate they are for attachment, but that are not evidence-based.
Where can I get more information?
- The Best Start Resource Centre: http://healthybabyhealthybrain.ca
- The Hospital for Sick Children: http://aboutkidshealth.ca
- Attachment Network of Manitoba: http://attachmentnetwork.ca/
You can consult with a registered psychologist to find out if psychological interventions might be of help to you and your child. 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: http://www.cpa.ca/public/whatisapsychologist/PTassociations
This fact sheet has been prepared for the Canadian Psychological Association by Jen Theule, Ph.D., C.Psych., University of Manitoba.
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What is gender dysphoria?
Gender dysphoria refers to the distress that some people feel with their physical sex and/or gender role.
Some theorists propose that gender exists on a spectrum rather than being fixed opposites. Most people experience the sense that their physical bodies (i.e., female/male) are a good reflection of their gender identities (i.e., their internal sense of gender, or core gender) as women and men – they are cissexual/cisgender (the Latin prefix “cis” meaning “the same”). The term transgender (or increasingly, trans) refers to the many different ways that a person may experience their gender identity as different than the one assigned to them at birth. Some people experience a more marked inconsistency between the physical bodies they were born into and their gender identities. For example, they may have male genitalia and have been raised as male, yet identify as a woman. Still others identify more androgynously or feel they occupy a more middle space on the gender spectrum (e.g., genderqueer), and yet others might have a more fluid sense of gender (e.g., non-binary, gender-fluid). Those who feel less categorical may indicate a preference on a gender spectrum, such as being transfeminine or transmasculine.
How common is gender dysphoria?
It is a complex task to establish solid prevalence rates among hidden, and stigmatized, populations and there are no large-scale population studies of gender identity of which we are aware. Recent community-based research efforts such as Ontario’s Trans Pulse Project have proposed innovative methods to best approximate prevalence, such as respondent-driven sampling. Public health and epidemiology principles suggest that the prevalence rates of health issues capture only those who present for treatment and that these numbers represent the metaphorical “tip of the iceberg”. Of note, anecdotally, gender identity clinics across Canada have seen a significant surge in number of referrals over the past few years. Another clear referral trend is trans women and men presenting in fairly equal numbers, where it was previously thought that there were many more trans women than trans men. A recent demographic study conducted by the Trans Pulse Project shows that trans communities are diverse in age, sexual orientation, ethno-racial and educational backgrounds, and relationship and parental status.
Gender dysphoria in adolescents
Gender dysphoria in adolescence may be accompanied by depressed mood, anxiety, and behavioural problems, all of which can considerably heighten the adolescent’s distress. The Standards of Care outlined by the World Professional Association for Transgender Health (WPATH, 2012) recommend a careful assessment involving the family, and ample opportunities for an adolescent’s gender exploration. If indicated, staged medical interventions are advised, often beginning with fully reversible ones such as puberty-delaying or –blocking hormones, to integrate and evaluate their effects before moving on to a next stage. Additional clinical competencies are required for working with adolescents.
Gender dysphoria in adults and transitioning
How people manage their gender dysphoria is a highly individual process that can depend on factors such as degree of dysphoria, financial resources, health status, and social support including relationship status and human rights protections. People may choose to live in accordance with their assigned/physical sex and not undergo any physical changes. Some might present themselves in a manner consistent with their core gender only in certain situations, such as at home or with specific groups of friends. Others may choose to live socially in accordance with their core gender through changes to their name and/or appearance, without undergoing any medical changes. Many adults with gender dysphoria do seek to change their body, however, to bring it more in line with their gender identity, a process called “medical transition”. They may do this by means of hormonal treatment, electrolysis, chest/breast surgery, cosmetic surgeries, gonadal and/or genital surgery. For those who feel it right for themselves, transition generally has a relatively high degree of satisfaction. Moreover, emerging research shows that there is a significant reduction in symptoms of distress and/or psychopathology during the process of medical transition, particularly after the initiation of hormone therapy (Heylens et al., 2014; Keo-Meier et al., 2015). Similarly, timely access to care and medical transition was among the factors associated with a strong reduction in suicide risk among a large Canadian community sample (Bauer et al., 2015).
How people access care for medical transition depends on the kind of intervention they desire and where they live in Canada. Hormone therapy can masculinize a body (with testosterone) or feminize a body (with an anti-androgen and estrogen source). Results can vary significantly depending on such factors as age and genetics. Hormones have some reversible and some irreversible effects, and can take approximately two years to determine their full effect. Increasingly, family doctors with training are prescribing hormone therapy, some on an informed consent model and some with assistance from a mental health professional with special competence in this area, or endocrinology, where indicated (LGBT Health Program, 2015).
Gender affirming surgeries are covered by many (but not all) of the provincial and territorial Ministries as insured services under the public health care plan. Among those where coverage is available, not all available surgeries are considered insured services. Even in cases of provinces with good coverage, there may be financial costs, such as travel, and the emotional toll of long wait lists for surgical assessments and/or surgery. In order to access these surgeries, clients must meet criteria for Gender Dysphoria (GD), along with what are considered eligibility and readiness criteria. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5; American Psychiatric Association, 2013) outlines the criteria for GD as a “marked incongruence between one’ s experienced/expressed gender and assigned gender” for a minimum of six continuous months, defined by at least 2 of the following: (1) marked incongruence between experienced gender and primary and/or secondary sex characteristics, (2) a strong desire to be rid of one’s primary and/or secondary sex characteristics on account of a marked incongruence with experienced gender, (3) a strong desire for the primary and/or secondary sex characteristics of the other gender, (4) a strong desire to be the other gender, (5) to be treated as the other gender, or (6) a strong conviction that one has the typical feelings of the other gender (there is language to also acknowledge an alternative gender). To meet criteria, there must be evidence of distress about the incongruence. GD subtyping is with, or without, a disorder of sexual development. There is now a post-transition specifier for those living full-time as themselves with the help of one transition-related medical intervention.
The World Professional Association for Transgender Health (WPATH) Standards of Care (SOC) (Coleman et al., 2012) are a set of international guidelines for the care in working with trans clients, whose interpretations may differ based on national and regional context and health policies. The SOC have different eligibility and readiness criteria for different surgeries; the more significant the surgery, the higher the bar. Candidate recommendations for surgery are provided by a mental health professional with diagnostic powers (including psychologists and psychological associates) and special competency in Gender Dysphoria. Recommendations for gonadal and genital surgeries require two mental health recommendations and that clients be of legal age (18). Eligibility criteria for gonadal and genital surgeries is one year of continuous hormone therapy. A further eligibility criterion for genital surgeries is one continuous year of Gender Role Experience, where the person presents in their core gender in everyday public life, as part of a lived informed consent. There is also a set of readiness criteria for every surgery, which includes aspects such as having good mental health stability, social support, and knowledge of the intervention, its risks and a thoughtful aftercare plan. Requirements vary across provinces and territories, however, and individuals who are considering physical interventions are advised to consult with a local or regional mental health professional with competence in this area. Some provinces have identified providers or organizations empowered to carry out assessments for publically-funded surgeries. The Canadian Professional Association for Transgender Health (CPATH; contact information below) may be a useful resource.
There have been more recent provincial and federal policy changes to reflect the reality that some trans people, for a variety of reasons, do not have transition-related surgeries (TRS- also known by some as sex reassignment surgeries). For example, the Ontario Human Rights Commission’s case of XY (2013) found that the bar of needing TRS to change one’s sex designation on provincial identity documents was discriminatory and now a letter from a medical doctor or psychologist suffices. Federally, a changed birth certificate can now be the basis for a changed sex designation on one’s Canadian passport (2015). Some community members are calling for the option of a gender neutral identity marker.
What causes gender dysphoria?
The exact cause of gender dysphoria remains unknown. Researchers have been trying to understand how much of gender identity is the result of nature (biological influences) or nurture (social or environmental influences). There is evidence to suggest that both have a role. There are debates about at what age gender identity is considered fixed, however, many would generally agree this is around the time of puberty. This means for those who clearly meet criteria for GD, therapy will not change their identity, nor would it be considered ethical do try to do so. If indicated, a social and/or medical transition is considered the treatment of choice.
Although gender dysphoria has been viewed as a mental health issue in recent history, it was not always this way. Recorded history includes many descriptions of people, from a range of cultures, who did not fit into the simple categories of male or female. In some cases, these people were highly regarded by virtue of their insight into both female and male worlds (e.g., 2-Spirited People of the 1st Nations, 2008). It is important to remember that the idea of two opposite sexes may be a recent, Western idea.
What is the Role of Psychologists?
The psychologist’s role in working with adults with gender dysphoria is varied and generally includes the following:
- Assessing and identifying a client’s gender dysphoria;
- diagnosing and providing treatment for any co-occurring mental health conditions (such as anxiety or mood-related problems) or substance use;
- exploring with the client the range of treatment options and their implications;
- determining readiness for hormonal or surgical treatments;
- helping clients adjust to their changing life circumstances as they transition;
- educating family members, employers, and institutions about gender dysphoria; and
- advocating on behalf of individuals to ensure that school and work environments are accepting and accommodating of gender diverse adolescents and adults, and their gender expression.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
Bauer, G.R., Scheim, A.I., Pyne, J., Travers, R., & Hammond, R. (2015). Intervenable factors associated with suicide risk in transgender persons: a respondent driven sampling study in Ontario, Canada. BMC Public Health, 15: 525
Coleman, E., Bockting, W. O., Botzer, M., Cohen-Kettenis, P., DeCuypere, G., Feldman, J, et al. (2012). Standards of Care for the health of transsexuals, transgender and gender-nonconforming people, 7th version. World Professional Association of Transgender Health.
Heylens, G., Verroken, C., De Cock, S., T’Sjoen, G., and DeCuypere, G. (2014). Reassignment therapy on psychopathology: A prospective study of persons with a gender identity disorder. Journal of Sexual Medicine, 11, 119-126.
Keo-Meier, C.L., Herman, L.I., Reiser, S.L., Pardo, S.T., Sharp, C. & Babcock, J.C. (2015). Testosterone treatment and MMPI-2 improvement in transgender men: A prospective controlled study. Journal of Consulting & Clinical Psychology, 83, 143-56.
LGBT Health Program (2015). Guidelines and protocols for hormone therapy and primary health care for trans clients. Toronto: Sherbourne Health Centre. http://sherbourne.on.ca/lgbt-health/guidelines-protocols-for-trans-care/
2-Spirited People of the 1st Nations (2008). Our relatives said: A wise practices guide – voices of Aboriginal trans people. Toronto: http://www.2spirits.com/
- Canadian Professional Association for Transgender Health (CPATH). CPATH is an interdisciplinary professional organization devoted to the health care of individuals with gender variant identities.cpath.ca
- Rainbow Health Ontario. This provincial program offers educational trainings, public policy advocacy and an online resource database to improve the health of LGBT people and access to competent care. http://www.rainbowhealthontario.ca/
- Vancouver Coastal Health Transgender Health Information Program. This BC-wide information hub providing access to information about gender affirming care and supports.http://transhealth.vch.ca
- World Professional Association for Transgender Health (WPATH; formerly known as the Harry Benjamin International Gender Dysphoria Association). WPATH is an international multidisciplinary professional association devoted to promoting evidence-based care for transgender health. WPATH provides ethical guidelines concerning the care of individuals with gender dysphoria, as well as a membership directory and resource lists.wpath.org
Where can I get 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, go to https://cpa.ca/public/whatisapsychologist/ptassociations/.
This fact sheet has been prepared for the Canadian Psychological Association by Nicola Brown, Ph.D., C.Psych., Centre for Addiction and Mental Health, ON.
Your opinion matters! Please contact us with any questions or comments about any of the Psychology Works Fact Sheets: firstname.lastname@example.org
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What is chronic pain?
Chronic Pain is pain that does not go away. When pain lasts longer than 3 or 6 months, or beyond the usual time of recovery, it is said to be chronic. Different types of chronic pain exist, many of which are not clearly understood. Chronic pain may be associated with an illness or disability, such as cancer, arthritis, or a phantom limb. Some types of pain start after an injury or accident and become chronic over time. Others may begin gradually, as is sometimes the case with low back pain. In some types of chronic pain, like migraine headaches, the pain is recurrent, rather than constant. There are many other kinds of chronic pain, such as postsurgical pain, fibromyalgia, and neuropathic pain. In some cases, the cause of the pain remains unknown.
Research indicates that between 10% and 30% of Canadians experience chronic pain. The direct and indirect costs associated with this are staggering, with estimates in the billions of dollars annually. Women tend to have slightly higher rates of chronic pain than men. People of all ages can experience chronic pain, but it is most common in middle age (for additional information about pain in the elderly, please see the CPA “Chronic Pain Among Seniors” Fact Sheet). Chronic pain can make simple movements hurt, disrupt sleep, and reduce energy. It can impair work, social, recreational, and household activities. People who have been injured in accidents may develop other symptoms, such as anxiety and depression. Chronic pain can have a negative impact on financial security and, in some cases, it can contribute to alcohol or drug abuse. It can also disrupt marital and family relationships.
Pain is invisible. As a result, many people who experience chronic pain feel misunderstood and/or alone in their suffering. Some people feel judged or stigmatized, whereas others believe pain is “all in their head.” Pain is, indeed, “all in the head” because the brain is located in the head, and the origin of pain resides in the brain. Because chronic pain can negatively impact quality of life and functional abilities, it is not surprising that more than a quarter of people who experience chronic pain also experience significant depression or anxiety.
Medications are often used to treat chronic pain. Indeed, medications can help, however, the suitability of long-term use needs to be carefully considered and monitored.
How can a psychologist help a person with chronic pain?
Psychologists focus on many aspects of chronic pain, including assessment, treatment, research, teaching, and advocacy. In terms of treatment, psychologists use several different approaches and techniques to help people with chronic pain improve their quality of life, regain their sense of purpose, and improve their functional abilities. Psychologists address important themes, such as acceptance and loss, and they help people with chronic pain through support, education, and skill building in areas such as relaxation, mindfulness, problem solving, goal setting, sleep, assertiveness, and adaptive thinking.
Cognitive behavioural therapy (CBT) is a form of psychological treatment that focuses on thoughts, feelings, and actions. It aims to help people think and behave in more adaptive ways. Acceptance and commitment therapy (ACT), another psychological approach, focuses on acceptance, choice, and committed action. It aims to help people live in ways that are consistent with their core values. Mindfulness meditation is yet another approach that can help individuals with persistent pain. In all cases, a basic treatment goal is to improve functioning and quality of life, as opposed to eliminating pain symptoms. A vocational assessment examines a person’s interests, aptitudes, and abilities. It can be useful for individuals who may need to change the way they work or the type of work they do. Psychotherapy for anxiety and/or depression can be helpful for individuals experiencing chronic pain, as can treatment for drug or alcohol abuse, when required. Couple, marital, or family therapy can also be beneficial for addressing pain-related interpersonal difficulties.
Are psychological approaches effective?
Numerous scientific studies have demonstrated the effectiveness of psychological approaches in helping people with chronic pain. Psychological treatments have been shown to improve quality of life and functioning in many life domains, such as activities of daily living, emotional health, and interpersonal relationships. Following psychological treatment, people report they are more active, more confident, and more in control of their lives, as well as less depressed and less anxious. In many cases, they endorse reductions in pain and physical symptoms. Even though people may continue to experience pain, it is often more manageable.
Although individual therapy may be offered, people experiencing chronic pain are often treated in groups where they are able to share their experiences with others. Because chronic pain is complex, psychologists frequently work in interdisciplinary or multidisciplinary teams comprised of other health care professionals, such as physiotherapists, occupational therapists, physicians, nurses, and social workers. Again, the primary treatment goal is to help people with chronic pain develop satisfying and healthy lifestyles. Interdisciplinary chronic pain rehabilitation programs are as effective in reducing pain intensity as medications and medical interventions; however, they are more effective in decreasing medication use, reducing health care utilization, improving functional activities, improving mood, and promoting return to work.
How can research help?
In addition to working directly with people who experience chronic pain, psychologists have contributed significantly to our understanding of chronic pain through many types of research. For example, some studies focus on reducing the incidence of chronic pain through injury prevention or early intervention programs. Other studies examine the effectiveness of chronic pain treatments. Some researchers examine how psychological variables influence pain and suffering, whereas others study the role of the central nervous system in a variety of chronic pain conditions.
Where can I get more information?
For information about chronic pain, you could contact the Chronic Pain Association of Canada (www.chronicpaincanada.com) or the Canadian Pain Society (www.canadianpainsociety.ca).
Information about pain in children is available at the web site entitled “Pediatric Pain – Science Helping Children” at Dalhousie University, http://pediatric-pain.ca/ .
Consultation with or referral to a registered psychologist can help guide you as to the use of the therapies mentioned in this Fact Sheet.
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, please visit: https://cpa.ca/public/whatisapsychologist/ptassociations/
This fact sheet has been prepared for the Canadian Psychological Association by Dr. John Kowal, a private practice psychologist.
Revised: January 2021
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What is bullying?
Bullying among children and youth is defined as repeated, unwanted aggressive behaviour(s) by a youth or group of youths. It involves an observed or perceived power imbalance. It can result in physical, social, or educational harm or distress for the targeted youth.
- The power imbalance may be based on differences in size, strength, ability, popularity, appearance/body size, race/ethnicity, culture, religion, financial resources, sexual orientation, gender identity/expression, or any other difference.
- Bullying is a relationship problem. Over time, the person who is bullying feels more and more powerful and the person who is being bullied feels more and more helpless, shamed, and trapped.
- Bullying requires relationship solutions. That is, solutions that create safety and social-emotional growth for those who bully, those who are bullied, and those who witness it.
- Bullying happens most often when few adults are around (e.g., school playgrounds, hallways, cyberspace).
- At least 1/3 of bullying is experienced beyond school boundaries (e.g., recreation settings, online).
Forms of bullying
- Physical bullying: physical aggression such as hitting, kicking, shoving, stealing or harming property.
- Verbal bullying: teasing, name calling, put-downs, shaming, threatening or humiliating others.
- Social bullying: excluding others, damaging friendships, negative gossiping, spreading rumours etc. This is also known as indirect or relational bullying.
- Cyber bullying: is the use of electronic communication technology to bully others. The technology itself creates a power imbalance. It reaches youth anywhere and at any time, messaging is instantaneous, the audience can be huge, and the messages can be permanent.
In 2018, a large and representative sample of Canadian youth in grades 6 through 10 were asked whether they have been involved in bullying over the last two months.
- 36% of the sample reported they had been involved in bullying at least once over this time period.
- 6% bullied others
- 20% were bullied
- 9% reported they both bullied others and were bullied
- Being bullied is more common among girls than boys – approximately 1 in 3 Canadian girls are bullied.
- Bullying others is more common among boys than girls.
- Teasing or name calling is the most common form of bullying for both boys and girls.
- Bullying rates in Canada have remained relatively stable over the last 12 years. Relative to other wealthy nations, Canada ranks in the middle in terms of bullying rates (23rd out of 35 nations).
Bullying – The role of peers
Observational research of elementary school children showed that bullying incidents occurred every 7 minutes on the playground and bystanders were present for 85% of these incidents. Bystanders influence bullying dynamics in both ways:
- When bystanders remain passive observers, this sends the message that bullying is acceptable. The bigger the audience, the longer the bullying incident lasts.
- When bystanders intervene, the bullying stopped within 10 seconds in 57% of observed incidents.
Defending against bullying is a complex, social-emotional task for bystanders. They must recognize the event as bullying, take responsibility for helping, and have the skills necessary to intervene successfully. Research suggests that defending can take multiple forms:
- Comforting: Offering emotional support to the person being bullied.
- Reporting: Telling a teacher or another adult about the bullying.
- Solution-focused: Using assertiveness or problem solving to stop the bullying.
- Aggressive: Using retaliation against the aggressor.
Youth should be encouraged to defend using the behavior that is safest and most effective for them in the moment. Boys tend to defend aggressively and may need help to develop more prosocial intervention strategies6.
Who is at risk?
of being bullied?
- Those with few friends who are seen as unable to defend themselves
- Those with a disability, neurodevelopmental difference, special healthcare need, intellectual exceptionality (both gifted and learning disability)
- Overweight children and youth
- LGBTQ children and youth report being bullied significantly more and more severely than other students
of bullying others?
- Children and youth who believe that bullying is normal
- Those who have friends who bully
- Not all children and youth who bully are alike. Some are popular and socially skilled, while others have behaviour problems and few friends.
Dangers and psychological impacts
Bullying is a health issue. It is linked to both short and long-term mental and physical health problems and academic under-achievement. Strong and supportive relationships with parents, a caring and responsive school environment, and positive relationships with family and friends can all help protect against long-term harm. The harm related to bullying is related to:
- Severity and frequency of the bullying behaviour
- Pervasiveness of involvement in bullying (e.g., is bullying happening in just one relationship or place, or in many relationships and places?)
- Chronicity of involvement in bullying (how long has the bullying gone on? Have there been other bullying problems in the past?)
Children and youth whose bullying involvement has been severe/frequent and/or pervasive, and/or chronic require the most intensive and focused support.
Research has documented many immediate and long-term negative impacts of bullying involvement:
- Negative impacts of bullying are significant and have been found across all cultures.
- For some individuals, the impacts can last throughout life.
- Lessons learned about the abuse of power in relationships from bullying may carry over to: sexual harassment, dating aggression, intimate partner violence, workplace harassment, child and elder abuse.
- Children and youth who both bully others and are bullied tend to have the most severe and enduring problems, including the negative impacts in both lists below.
Negative impacts linked to bullying others
- Substance abuse
- Aggression and anti-social behaviour
- Sexual harassment and dating aggression
- Academic problems and increased school dropout rate
- Delinquency and criminal behaviour
Negative impacts linked to being bullied
- Depression, anxiety, mood disorders
- Substance abuse
- Low self-esteem and social confidence
- Isolation and loneliness
- Poor peer relationships
- Stomach aches, headaches
- “Toxic stress” or enduring low grade systemic inflammation which is linked to disease
- School absenteeism and learning problems
- Contemplating, attempting, or committing suicide
How can psychologists help?
- Provide training for staff members on how to promote healthy relationships and social climates, and to identify and address bullying issues.
- After training, teachers report feeling more supportive toward children who are bullied and more confident handling bullying issues.
- Recommend school policies that address prevention, intervention and evaluation.
- Develop intervention strategies for children who are involved in bullying problems that develop social-emotional capacity and skills. Counsel students and families dealing with impacts of bullying and victimization.
Those who bully others?
- Help them recognize and understand the negative impacts of their bullying on others and on themselves.
- Support understanding of human rights to safety, respect, and dignity.
- Help develop the ability to control behaviour, resist peer pressure, and use problem solving strategies.
- Help find ways to use their power in a positive way (e.g., identify leadership roles).
- Find opportunities to engage in positive social experiences with a diverse mix of peers where the focus is on making a contribution to the greater good (e.g., peer mentoring, or peer mediation)
Those who are bullied?
- Help develop an immediate plan of safety so they can feel comfortable attending school and participating in community activities.
- Listen, empathize, and reduce shame and self-blame.
- Help them understand and assert their human rights to safety, respect, and dignity.
- Help find ways to build self-esteem, confidence and healthy interests.
- Find opportunities to form positive friendships with peers.
- Support understanding of human rights and healthy relationships.
- Educate about bullying and its impacts on health and well-being.
- Use role-play and scripts to teach bystanders specific skills for standing up to various bullying situations, instead of being passive or joining in.
- Run workshops to build assertive communication skills and problem solving skills, and peer pressure resistance.
Where can I get more information?
Additional information about bullying can be found at www.prevnet.ca. For downloadable resources, see Factsheets and Tools for Schools at http://www.prevnet.ca/resources/bullying-prevention-facts-and-tools-for-schools
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, please visit: https://cpa.ca/public/whatisapsychologist/ptassociations/
This fact sheet has been prepared for the Canadian Psychological Association by Annie Tang, Dr. Joanne Cummings, Dr. Debra Pepler, and Kelly Petrunka, PREVNet. This fact sheet was updated by Dr. Wendy Craig and Laura Lambe.
141 Laurier Avenue West, Suite 702
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 Centers for Disease Control and Prevention (2014). Retrieved from http://www.cdc.gov/violenceprevention/pdf/bullying_factsheet.pdf.
 Craig, W., Pickett, W, King, M. (2020) The health of Canadian youth: Findings from the health behavior in school-aged children study. Public Health Agency of Canada, retrieved from https://www.canada.ca/en/public-health/services/publications/science-research-data/youth-findings-health-behaviour-school-aged-children-study.html#ch10
 UNICEF (2020). Canadian companion to the UNICEF report card 16. Retrieved from: https://www.unicef.ca/en/unicef-report-card-16
 Craig, W. & Pepler, D. (1997). Observations of bullying and victimization in the schoolyard. Canadian Journal of School Psychology, 2, 41-60. See: http://www.prevnet.ca/sites/prevnet.ca/files/research/PREV-Craig-Pepler-1997-Communique-peers.pdf for a downloadable research summary of this article.
 O’Connell, P., Pepler, D., & Craig, W. (1999) Peer involvement in bullying: Issues and challenges for intervention. Journal of Adolescence, 22, 437-452.
 Hawkins, D.L., Pepler, D., & Craig, W. (2001). Peer interventions in playground bullying. Social Development, 10, 512-527. See http://www.prevnet.ca/sites/prevnet.ca/files/research/PREV-Hawkins-etal-2001-Communique-peer-intervention.pdf for a downloadable research summary of this article.
 Lambe, L. J., & Craig, W. M. (2020). Peer defending as a multidimensional behavior: Development and validation of the defending behaviors scale. Journal of School Psychology, 78, 38-53.
 Taylor, C. & Peter, T., with McMinn, T.L., Schachter, K., Beldom, S., Ferry, A., Gross, Z., & Paquin, S. (2011). Every class in every school: The first national climate survey on homophobia, biphobia, and transphobia in Canadian schools. Final report. Toronto, ON: Egale Canada Human Rights Trust. Retrieved from:
 Hymel, S. & Swearer, S. (2015). Four decades of research on school bullying. American Psychologist, 70, 293-299.
 Hymel, S. & Swearer, S. (2015). Four decades of research on school bullying. American Psychologist, 70, 293-299.
See also: Ozdemir, M., & Stafttin, H. (2011). Bullies, victims, and bully-victims: A longitudinal examination of the effects of bullying victimization experiences on youth well-being. Journal of Aggression, Conflict and Peace Research, 3, 97-102.
 Farrington, D.P. & Toffi, M. M. (2011). Bullying as a predictor of offending, violence, and later life outcomes. Criminal Behaviour and Mental Health (21)2, 90-98. See also: Fergusson, D. M., Boden, J. M., & Horwood, L. J. (2014). Bullying in childhood, externalizing behaviors, and adult offending: Evidence from a 30-year study. Journal of school violence, 13(1), 146-164.
 Bowes, L., Maughan, B., Ball, H., Shakoor, S., Ouellet-Morin, I., Caspi, A., Moffitt, T.E., and Arseneault, L. (2013). Chronic bullying victimization across school transitions: The role of genetic and environmental influences. Development and Psychopathology, 25, pp 333-346.
 Copeland, W. E., Wolke, D., Lereya, S. T., Shanahan, L., Worthman, C., & Costello, E. J. (2014). Childhood bullying involvement predicts low-grade systemic inflammation into adulthood. Proceedings of the National Academy of Sciences, 111(21), 7570-7575.
See also: Rueger, S. Y. & Jenkins, L. N. (2014). Effects of peer victimization on psychological and academic adjustment in early adolescence. School Psychology Quarterly, 29, 77-88.
See also: Vaillancourt, T., Hymel, S., & McDougall, P. (2013). The biological underpinnings of peer victimization: Understanding why and how the effects of bullying can last a lifetime. Theory into Practice, 52(4), 241-248.
According to the most recent Canadian Tobacco, Alcohol and Drugs Survey, about 4.2 million people in Canada over the age of 15 smoke tobacco. This is the lowest national smoking rate ever recorded, but is still about 15% of the adult population, with provincial rates ranging from 11% in B.C. to 20% in New Brunswick. Smoking is a leading cause of illness and early death in Canada, reinforcing the need to bring this national smoking rate down even further to allow all Canadians to live longer, healthier lives.
Quitting smoking reduces your chances of developing many physical conditions (e.g., cancers, heart disease, respiratory diseases). Quitting smoking also has a lot of mental health benefits. Compared with those who continue to smoke, people who quit smoking experience the following benefits for many years after quitting: less stress and anxiety; fewer symptoms of depression; more frequent positive emotions; higher overall quality of life; and feeling healthier in general.
Why is Smoking So Addictive?
Nicotine is the major addictive chemical in cigarette smoke and acts very quickly in your body, reaching your brain in about 10-20 seconds. Within about 2 hours of finishing your cigarette, nicotine levels in your body drop by 50%. This leads to cravings, feeling anxious or irritable, and generally feeling ‘down.’
Nicotine affects a number of important chemicals in your brain and body, which can boost your mood, reduce stress, make you feel energized, and even reduce pain. However, these effects are short-lived and most common in new or occasional smokers. This is because your body adapts to these changes over time, resulting in a need to smoke more over time in order to feel any of these effects – or just feel ‘normal.’
Although nicotine is very addictive, it’s not the only reason why people have trouble quitting. For regular smokers, lighting up a cigarette is often part of a routine. Whether you smoke after dinner, on work breaks, or when socializing, smoking in response to daily triggers can make it more difficult to quit.
What Treatments Are Available?
Quitting smoking involves managing the physical symptoms and breaking the links between smoking and how you feel, what you do, with whom who you spend time, and how you see yourself. As a result, it often takes many attempts, and many treatment types, before you’re able to quit successfully.
Quitting “cold turkey” is one of the most common approaches, but it’s also one of the least effective. A number of treatments are proven to help make your quit attempt a success:
- Behavioural Therapy: These treatments target the beliefs, attitudes, and behaviours that support an addiction. Common therapies include cognitive behavioural therapy, acceptance and commitment therapy, and functional analytic therapy.
- Nicotine Replacement Therapy (NRT): NRT comes in two forms: slow release (e.g., nicotine patch) and rapid-delivery (e.g., nicotine gum, inhalers). NRTs help to reduce cravings and withdrawal symptoms by releasing small amounts of nicotine into your body, but are not addictive.
- Prescription Medication: In Canada, two major prescription drugs are used to help people quit smoking: varenicline and bupropion. These drugs affect nicotine receptors in your brain and help to reduce cravings and withdrawal symptoms. Varenicline also helps to make smoking less pleasurable.
Note: You should always consult a doctor for information on the risk of side-effects or interactions before using NRTs or prescription medications.
Varenicline is the most effective on its own, but all three types of treatment work. While using at least one of these treatments can boost your odds of successfully quitting by as much as 80%, research shows that the best way to quit is by combining treatments. The two most successful combinations are:
- Combined NRTs, which involve using a combination of a slow-release NRT (e.g., nicotine patch) and a rapid-delivery form (e.g., nicotine inhaler).
- Combined Pharmacotherapy and Behavioural Therapy. You can boost your chances of quitting by using pharmacotherapy (i.e., NRT or prescription drugs) while getting help to quit from a licensed mental health professional (e.g., registered psychologist).
Quit-lines and online help, whether on their own or combined with other treatments, can also increase your likelihood of staying smoke-free.
What Doesn’t Work?
Aversion therapies (e.g., smoking until you feel sick), alternative tobacco products (e.g., chewing tobacco, snuff, e-cigarettes, and alternative therapies (e.g., hypnotherapy, acupuncture, and natural herbs and remedies) don’t improve your odds of quitting.
How Can I Help Myself Quit?
Whatever route you choose, keep in mind that it can be incredibly difficult to quit smoking. Even if it takes you many tries, you can eventually succeed.
Whether it’s your first attempt or your fifth, psychological research shows that there is much you can do to make your quit attempt a success:
- Set concrete and realistic goals (e.g., set a specific ‘quit date’).
- Start using treatments before you quit.
- Tell your friends and family that you’re quitting and let them know how they can help.
- Embrace change in your daily routine, social circle, and motivations.
- Find a buddy who is also trying to quit.
- Gradually reduce your smoking before you quit.
- Start by reducing the amount you smoke.
- Reward yourself, even for small gains.
- Make a plan to deal with withdrawal symptoms (e.g., headaches, sadness, irritability, anxiety) in the first 1-4 weeks after quitting. These are signs that your body is recovering.
- Follow the 4 Ds to help deal with cravings: Distract yourself, Drink water, take Deep breaths, and Delay smoking for as long as possible.
- Get active.
- Keep your focus on what you don’t enjoy about smoking rather than what you enjoy.
- Forgive yourself if you have the occasional cigarette.
- Keep yourself busy.
- Understand your triggers and learn how to manage them.
- Replace cigarettes with other things, activities, and people that you enjoy.
- Re-identify yourself as a “non-smoker” or “former smoker” to your friends, family, co-workers, and yourself.
- Accept that this will be difficult for a while, but the rewards will last a lifetime.
Where Can I Go For Help?
Your family doctor can help you to develop a plan for quitting, figure out which treatments might be most effective, and refer you to other health care professionals who can also help you quit smoking. Doctors can also advise you on the safety of NRTs and medications (e.g., side-effects, interactions).
Registered psychologists can help you develop a plan for quitting and provide therapy that will help you quit. Psychologists can offer a variety of effective therapies and will work with you to figure out which one is likely to work best for you. Check with your provincial or territorial psychological association at https://cpa.ca/public/whatisapsychologist/ptassociations/ to find a psychologist in your area who can help you quit smoking.
Health Canada and the Canadian Cancer Society offer a free, confidential ‘quitline’ at 1-866-366-3667. Their telephone counsellors are trained to provide support and help you create a plan for quitting.
You can also seek online help at http://breakitoff.ca/, which includes support forums, information on treatments, self-help resources, and a mobile app.
This fact sheet has been prepared for the Canadian Psychological Association by Matthew Murdoch, Canadian Psychological Association.
Date: August 2016
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Ottawa, Ontario K1P 5J3
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Dr. Christine Chambers is part of the #ScienceUpFirst initiative, the Scientific Director at the CIHR Institute of Human Development, Child and Youth Health, and many other things. The biggest change for her during the pandemic might be as the Scientific Director of SKIP (Solutions for Kids in Pain).
Dr Christine Chambers
Busy mom of 4, PhD Psychologist, Scientific Director @CIHR_IHDCYH , Scientific Director @KidsInPain , Professor & Tier 1 @CRC_CRC in Children's Pain @DalhousieU
- Christine Chambers’ Twitter bio
You’ll note that the first word in Dr. Christine Chambers’ Twitter bio is ‘busy’. It’s a shame that Twitter bios allow a maximum of 160 characters only…or maybe it’s a blessing? By the time people finished reading hers, they might have no time left for doomscrolling! That’s also why we have profiles such as this one, which, as you will note, has no character limit whatsoever.
I feel lucky to have been able to spend half an hour speaking with Dr. Chambers. When I first started at the Canadian Psychological Association, I had made plans to meet with Dr. Chambers in the spring of 2020, when she would be in Ottawa for a conference. Back then, that was how meetings worked – you would wait until you were in the same city, then you would squeeze in some time. Things operate a little differently now but with Dr. Chambers, even on Zoom it’s still about squeezing in time.
Dr. Chambers is speaking with me just after one Zoom meeting and just before another, each one involving a different hat she wears. One of those hats is as the scientific director of Solutions for Kids in Pain (SKIP).
“SKIP is a federally funded national mobilization network, focused on moving research into practice. We received funding for four years, so our first year of operation was in the ‘before-times’. - In that first year we laid groundwork, developed relationships, built momentum. The pandemic hit just as we were entering into our second year of operation. It’s fascinating, both in terms of the areas of focus that we’re engaging in right now, but also just the process of knowledge mobilization.
How research gets moved into practice is based a lot on relationshipsand bringing people together. In our first year we had so many workshops, and we played a key convening and catalyzing role in bringing people together on a number of issues in physical spaces. All of a sudden you lose your ability to do that. Thankfully we had a lot of partners in SKIP who were already in the digital space either with health providers or with parents, so we had the right tools and the ability to leverage those.
From a content perspective, obviously vaccinations are a huge topic right now. In the area of children’s pain, vaccination pain evidence is very robust. Anna Taddio and others like Meghan McMurtry (also a psychologist) have pulled together this evidence and there’s a clinical practice guideline. So we’ve been doing a lot of public engagement around needles, and how to prepare for needles.
Virtual care has obviously also been something people in the healthcare space have been engaging in in new and different ways, and Katie Birnie – also a psychologist in SKIP – has been leading some really interesting work in this space.
Another thing though, and every health person is struggling with this right now, is how do you keep your issue (in my case pain) a priority in the middle of the pandemic? We were working to improve pain management in Canadian health institutions, now we have to figure out how to keep that issue a priority while competing against all this very important focus on the pandemic. So it’s been a hell of a year!”
Dr. Chambers says she’s been pleased and surprised at how well the team at SKIP has been able to keep pain front and centre, and how well institutions are responding. There have been many champions for this cause working for many years, and the disruption of COVID may actually have made things a little easier. One, because a lot of people in the healthcare space are re-constructing their practices in a different way, and two, because talking about pain and pain management gives those health institutions a bit of a break from talking about the pandemic.
Another hat Dr. Chambers wears as an expert with the #ScienceUpFirst initiative, combatting online disinformation around the pandemic, the vaccine, and more. (See our profile of Dr. Jonathan Stea for more details on #ScienceUpFirst.)
“This is a fantastic collaboration led by Tim Caulfield and Senator Stan Kutcher, and I was thrilled to be one of the psychologists that was an early joiner. I’ve been using social media for a number of years to help promote the work we’re doing and to raise awareness with a particular focus on parents. So it’s been really nice to be a part of this group addressing misinformation head-on. I have my eye on the types of misinformation that gets shared around children and families. It’s a wonderful group of people trying to make sure that evidence (in my case psychological evidence) is embraced and accepted.”
Some more hats. Dr. Chambers is a professor at Dalhousie University. She runs a research lab where they generate new knowledge about children’s pain. And she is also the Scientific Director of the Canadian Institutes of Health Research Institute of Human Development, Child and Youth Health.
“It has been a busy year! It was going to be a busy year before the pandemic, but the pandemic really took it up a notch. It’s a privilege to have the opportunity engage in so many different roles, and I tell people I’m definitely not bored during the pandemic! And also I think that never before has Canadian science and global science been on such a stage. Never before have we needed science more, or have needed to communicate the role of science. So it’s important that psychologists have visibility, and that the psychological evidence be generated and shared. I’m always trying to put up my psychology flag at every table I sit at, and reminding people of the value of psychology.”
Dr. Chambers has four kids between the ages of 9 and 14. Several years ago, she realized that all this research – research she had been instrumental in creating – was not being used to the benefit of her own children. It was then that she started getting into the mobilization side of things, the advocacy and media and policy veins. This involved creating videos, becoming active on social media, and ensuring that knowledge moves to where it needs to go and it led to a career of many hats.
“All this great psychological research is wonderful, but if it sits in journals, or in conferences, and doesn’t actually get out into the hands of people who need it, then what was the point?”
The CPA Board and staff are saddened to announce the passing of Dr. David Evans, a past-President of the CPA (1996) and an Honorary Life Fellow. Dr. Evans was a professor emeritus at Western University, having been a professor in the clinical psychology program at Western for 30 years. Dr. Evans consulted to many health and police agencies over the course of his career and served on the leadership of several organizations of psychology provincially, nationally and internationally. Among his many publications, he is well known for his most recent books The Law, Standards, and Ethics in the Practice of Psychology (3rd ed., Carswell); Essential Interviewing (8th ed., Brooks/Cole); Cultural Clinical Psychology (Oxford University Press) and the Handbook of Clinical Health Psychology (Academic Press). The CPA extends its condolences to his family, friends and colleagues. The discipline and profession is built on the contributions of its leaders.
As a psychologist, Dr. Olivia Hooker worked to change the unfair treatment inflicted upon inmates at a New York State women’s correctional facility. In 1963 she went to work at Fordham University as an APA Honours Psychology professor, and was an early director at the Kennedy Child Study Center in New York City.
Olivia Hooker was six years old when she lived through the 1921 Tulsa race massacre in the Greenwood District of Tulsa, Oklahoma. She went on to become the first Black woman in the US Coast Guard, joining during World War II in February of 1945. She later went back to the Coast Guard, joining the Auxiliary in Yonkers, NY at the age of 95 in 2010.
Her GI benefits allowed her to get a Masters from Columbia University, followed by a PhD in psychology at the University of Rochester.
As a psychologist, Hooker worked to change the unfair treatment inflicted upon inmates at a New York State women's correctional facility. In 1963 she went to work at Fordham University as an APA Honours Psychology professor, and was an early director at the Kennedy Child Study Center in New York City.
Honoured by the American Psychological Association, the Coast Guard, President Obama, and a Google Doodle, Olivia Hooker died in 2018 at the age of 103.
When the pandemic began, Dr. Mélanie Joanisse created a simple, easy, and funny Guide to Wellness for her frontline co-workers at the Montfort hospital. It immediately took off and has been shared and translated around the world to help healthcare workers everywhere.
“I wrote this in what I would call a hypomanic phase…as psychologists, we always have to pathologize any kind of creativity.”
Dr. Mélanie Joanisse was still processing the fact that she was not going to be able to attend a Pearl Jam concert when she had something of a viral moment in the early days of the pandemic. Can we still say ‘going viral’? Or has that phrase now passed out of the lexicon like so many others before it that conjure unwelcome memories? Anyway, a lot of people suddenly found Dr. Joanisse’s work. Like, a LOT of people. Her ‘Guide To Wellness’ was being discovered.
“I got a call from the communications director at the Montfort hospital, who said ‘what was your marketing and communication strategy for this? [Mélanie laughs heartily] I was like…none? She said we were being bombarded with messages from people who said they like it, and I was starting to receive a lot of emails – even from people in Europe – saying ‘we like this, can we translate it?’ And so I said sure, go for it! So the communications team at the Montfort helped me to create a creative commune so people would understand that they could just take it.”
Dr. Joanisse’s has a private practice in Ottawa, but does a lot of work at the Montfort Hospital, Ontario’s only francophone hospital. When the pandemic first hit, she saw at the Montfort the stress that the staff was experiencing. The sudden worry among doctors and nurses. The occupational therapists and social workers who were wearing masks and gowns, something they would never have done before. It was all hands on deckand changed how everyone was working. She wanted to do whatever she could in her capacity as a psychologist to help.
“As a psychologist I’m not trained in acute care – no one would want me in the ER! So I figured maybe doing a guide would be helpful. I was reading a lot online, and there are a lot of good resources, but I was just picturing a physician or a nurse or an RT sitting down with a list of 25 papers that they could read on wellness. I just pictured them shutting down their computers and saying ‘I don’t have time or the capacity for this’.”
So Dr. Joanisse set about writing something that encompassed as much as possible about the evidence-based ways to wellness, but to package it in a more engaging way. Visually attractive, a little bit funny, and representative of what frontline healthcare workers were experiencing. An easily-digestible light read, rather than another arduous undertaking.
“The only mask you should be wearing is a medical mask; please discard the infallible mask, as research has shown it suffocates its users.”
- From the Guide To Wellness
The humour in the guide comes from Dr. Joanisse herself. She’s extremely funny, in a very natural way, and that good humour has helped her get through this pandemic and all the setbacks. Like the Pearl Jam concert she missed – her first realization of how big COVID-19 was going to be was that cancelation. Or, more recently, the Chiefs loss in the Super Bowl – her husband is a huge Chiefs fan and just after they were married they flew to Kansas City to take in a game at Arrowhead. In 2019, moments before the pandemic really took hold, the Chiefs finally overcame decades of ineptitude to deliver a Super Bowl victory to fans like Mélanie’s husband.
“Last year when they won, it was pre-pandemic so we were at a friend’s house for the Super Bowl. He got up and spontaneously screamed ‘this is the best day of my life!’ There was a silence, and everyone looked at me. I was like, sorry daughter…birth…wedding…I’m just putting that in my pocket. The next time I spend I don’t know what on what, I’m bringing that card out!”
Now, after watching her husband celebrate the greatest day of his life, Dr. Joanisse is something of a Chiefs fan too. This is perhaps more because of Laurent Duvernay-Tardif, the French-Canadian starting right guard with a doctorate in medicine who left the Chiefs in the offseason to join the front lines of the pandemic back in Montreal. Just the kind of person who might benefit from the Guide to Wellness.
Dr. Joanisse still sees stress in her co-workers at the Montfort. Now, it’s not the stress of uncertainty that existed at the beginning of the pandemic, but rather a stress borne of long hours, fluctuating numbers, a desire for the pandemic to be over, and sheer exhaustion. She’s heartened, however, that many have taken her Guide To Wellness to heart – not only at her own hospital, but at institutions around the world.
“Now I know people in Hawaii, BC, all over the world. All types of different healthcare workers have reached out to me. It has been quite the experience, I have to say. And very moving, to know that this has touched people in that way.”
Congratulations to this year’s student research grant recipients! Grants were provided by the CPA, jointly by the CPA and CSBBCS, and by BMS.
MindBeacon had a bit of a head start on other similar groups when the pandemic began, as they had already been providing online services for some time. Dr. Khush Amaria is the Senior Clinical Director at MindBeacon, and the last year for her has been packed with speaking engagements.
“My Zoom background used to have my Parent Report Card up there but I took it down because I wasn’t doing very well – my cooking skills were poor, there were many problems.”
Dr. Khush Amaria’s Zoom background now has a bar graph made by one of her children, which really is ideal – it’s homey, warm, colourful and comforting – but also scientific! Just the atmosphere she probably wants to evoke for CBT Associates and MindBeacon.
If you are a resident of Ontario, a pop-up window appears when you go to the MindBeacon website. ‘Free therapy for Ontario residents! MindBeacon’s Therapist Guided Program is now free thanks to funding by the Government of Ontario.’ They were always providing live therapy through a digital stream with the CBT Associates division of the company, but it was restricted to Ontario only. During the COVID-19 pandemic, they have expanded their Live Therapy program (now capitalized and official) across Canada, and the Ontario portion is now free thanks to government assistance.
“The one thing that is so clear to me is the demand. In the summer we may have seen about 800 new accounts created each week. In the fall that number was reached close to 2,000 new accounts some weeks. It’s indicating that Canadians are struggling, but that they’re not waiting – they’re reaching out for help right now.”
Dr. Amaria is the Senior Clinical Director at MindBeacon and manages the CBT Associates side of the business. During the pandemic, that has meant she does a huge amount of speaking engagements. Companies who reach out looking for an expert in stress, or anxiety, or depression, get Dr. Amaria’s full attention, as she walks them through some of the steps they can take to alleviate the difficulties of their employees. She gets them to understand what level of help they might need, and what supports are available.
“Sometimes it’s a company that will come to me and say, ‘we’re all feeling a little concerned about each other, and we don’t know how to know if our colleagues are doing well’. So what I often do is talk about how we identify stress in ourselves. A common topic might be ‘what is burnout vs. just feeling burnt out?’ How can you be there for others? For me that’s a really nice way to make psychology and the science of psychology understandable to the day-to-day person. My intention with almost every single event I’m part of is to have people feel like they can walk away with a plan.”
That plan may be that they research the thing Dr. Amaria was talking about. Or they’re going to reach out to a friend that they think might not be doing so well. Or that they themselves will reach out because they’re not doing well. It’s always about reminding people of the supports that are available, and destigmatizing mental health – recognizing that mental health is an integral part of everyday health.
In March of 2020, MindBeacon was one of the companies chosen by the Ontario government to provide services quickly and on-demand to Ontarians, which meant that Dr. Amaria and her colleagues expanded their roster of psychologists, and other mental health professionals, very quickly.
“We had to figure out really quickly how we could build our roster, and we brought on psychologists but we also brought on registered social workers. We needed to be able to deliver services, and our psychologists could then be involved in places where diagnosis was required, or helping with triaging, or oversight. Our psychologists are involved in developing protocols. We recognized that some people don’t fit the criteria of having a depressive disorder or being anxious – but they have stress! So we launched this amazing managing stress protocol in the fall because many people just needed to ‘tweak’ their stress management skills. That was a psychologist who wrote that out and put that material in there. That’s the nature of what we do.”
Another major thing that happened during the pandemic was that MindBeacon went public. Dr. Amaria is a psychologist, still does clinical work, oversees the residency program at CBT Associates, speaks to large groups and does a lot of work as a spokesperson for the company. What she does not do is IPOs and the stock market.
“I’m not sure I really understand most of it – but the most amazing thing about it was the attention that this garnered, and the investment coming back into us as a company to continue to support Canadians. So that’s been really neat.”
When GameStop stock took off, and Wall Street was all in an uproar, Dr. Amaria says she got the Coles’ Notes version of it from her husband, presumably during one of those moments when she was not doing one of the many jobs she has at the moment. Maybe during one of the forced getting-outdoors breaks they take with their school-age children. Taking care of stress levels and mental health is something clinicians have to remember as well.
“I remind myself I need to take a dose of my own medicine in a way. In a week I might talk to 1,000 people about stress management, and share examples from my own life. It’s about recognizing that we’re all in it together, and we do really have to work on mental health. Nobody is immune – it doesn’t matter if you’re a psychologist or a therapist, taking care of your mental health is effortful, and we all have to do something.”
For some of us, doing something means reaching out to a friend, or taking a walk outside. For others, it might mean reaching out to Live Therapy from MindBeacon. Maybe doing something is as simple as learning something new. Like improving one’s ‘cooking skills’.
Inez Beverly Prosser was a Texas native who taught in segregated schools in the early 1900s. She travelled to the University of Cincinnati to obtain her doctorate in 1933, making her the first Black woman with a PhD in psychology.
Very little is known about Inez Beverly Prosser, a Texas native who taught in segregated schools in the early 1900s. Her state's universities were segregated, so she travelled to the University of Cincinnati to obtain her doctorate in 1933, making her the first Black woman with a PhD in psychology.
Sadly, Dr. Prosser was killed in a car accident a year after earning her PhD, but her dissertation was widely discussed for years afterward. She found that Black students in segregated schools had better mental health and social skills than those in integrated schools - in large part because of the prejudicial attitudes of the white teachers in those integrated schools. https://feministvoices.com/profiles/inez-beverly-prosser
Dr. Helen Ofosu runs IO Advisory in Ottawa where she helps organizations and businesses tackle structural racism and promote equity, diversity, and inclusion. During the pandemic, more and more groups are looking for this kind of assistance and her business is growing.
Dr. Helen Ofosu
“There are certain people who, pre-pandemic, were super-productive and making amazing contributions at work. But because they weren’t bragging, buttering up the boss, or charismatic, they were overlooked. But now, when everyone’s at home, it’s easier to track who is contributing – who is sending in work product. So, all the “doers” are kind of getting their chance to shine.”
Dr. Helen Ofosu is writing a book. The working title is The Resilient Career, and will impart lessons she has learned over a 20 year career in Work and Business (Industrial/Organizational) Psychology. It will be a resource for people dealing with underemployment, harassment, workplace scapegoating, or being a newcomer to Canada trying to adapt to a new culture in the workplace. A lot of the book will be about employees’ identities, and how those tie into career progression, as well as some insights around the “glass cliff” phenomenon (i.e., women and racialized people being more likely than men to achieve leadership roles in an organization in times of crisis, when the chance of failure is much greater).
It may seem like writing a book during the COVID-19 lockdown is something a person with a lot of time on their hands would decide to do. That does not seem to be the case for Dr. Ofosu, who is an HR Consultant, Executive Coach, and Career Coach who runs I/O Advisory Services in Ottawa. Much like the employees she sees getting more recognition for the work they do during the pandemic, Dr. Ofosu is getting more recognition as well. The bulk of her clients were once in Ottawa, but now that Zoom is the de facto way to connect she is working with companies all over Canada, and sometimes the US and Saudi Arabia.
An additional reason for that branching out is the newfound focus companies are placing on systemic discrimination, anti-racist workplaces and restructuring their policies around equity, diversity, and inclusion. That happens to be Dr. Ofosu’s specialty – what she refers to as a ‘passion project’ turned full-fledged business line. This process is taking something of a different turn now as well, with the pandemic forcing this kind of coaching to be done at a distance. At the moment, this is mainly taking the form of mentorship and sponsorship programs for employees.
“My favourite model is one that I’ve been experimenting with and tweaking – it’s blending mentorship with allyship. At the same time that we train mentors to be more effective working with racialized people with whom they may not have a lot of experience, we’re also going to train a second group of people called ‘allies.’ These are people who may be senior and well-intentioned in the organization, but who don’t have the time to dedicate to either a one-on-one protégé or a small group of protégés. But they can still benefit from some training around systemic discrimination and what it means to be a good ally and mentor. They can then be out there in their organization as resources and influencers on more of an ad hoc basis.”
The mentors and the allies both receive the same kind of training – but while the allies tend to have giant workloads and full calendars and therefore less time to dedicate to this sort of thing, the mentors commit to six month or year-long programs where they check in with Dr. Ofosu regularly.
Mentors are ideally people in leadership positions in the organization. They are people with good ‘soft skills’ (e.g., communication, empathy, judgement, strategic thinking, etc.) and a genuine interest in supporting the career development of more junior employees. This way they will be more effective at imparting the lessons learned to the rest of their teams.
It was shortly after the death of George Floyd that a group in Toronto reached out to Dr. Ofosu, and it’s with this group that she has been developing the mentorship program as it stands today to support communication, marketing, and PR professionals in Canada. Now the federal government has caught wind, and she’s working with them to get this program launched there as well.
That likely means more work, which might also mean less time working on her book. But Dr. Ofosu will find the time, while still taking the occasional break. One of the perks of living in Ottawa is all that free time outdoors taking long walks and shoveling snow, where she puts on her headphones and listens to R&B, gospel, and hiphop music. Then she’ll come back in refreshed, ready to work on that book (with support from her American editor) and to get busy supporting leaders and dismantling structural racism at organizations across Canada.
Kenneth & Mamie Phipps Clark were psychologists famous for their ‘doll experiment’. Their findings, that even black children showed preference for white dolls from as early as three years old, played a role in outlawing segregation.
The COVID-19 pandemic has made racism worse around the world for marginalized communities. Racism has made the pandemic worse for those communities as well. Dr. Maya Yampolsky specializes in social and cultural psychology, with a particular focus in her research on systemic racism and how racism enters into our personal lives.
In the spring of 2020, there was a COVID outbreak at a homeless shelter in Ottawa. The outbreak was traced back to two immigrant women who were both working at multiple long-term care homes in the city, and who lived at the homeless shelter. As new Canadians with few job prospects, personal support worker positions were some of the only jobs the two women could get. Those jobs paid so little that they were forced to work in more than one location in order to make enough money to live. Even then, they did not make enough to afford rent and so they had to live at the homeless shelter. It was a perfect storm of transmission as vulnerable people in one population brought the virus to vulnerable people in another. As many pointed out at the time, this was eminently predictable.
COVID-19 has had a disproportionately devastating effect on Black people, Indigenous people, immigrants and refugees. Pretty much anyone that has been disadvantaged by institutions and societies over generations are now even more vulnerable because of health inequities. Dr. Maya Yampolsky is an Assistant Professor in Psychology at Université Laval. She specializes in social and cultural psychology, with a particular focus in her research on the experience of managing multicultural and intersectional identities, and how those identities are related to our broader social relationships and broader social issues – especially systemic racism and how racism enters into our personal lives.
We’re speaking on Zoom, Dr. Yampolsky in her apartment in Quebec City, in front of a blank wall that I notice looks a lot like the hallway outside my high school gym. It turns out this is by design – an avid yoga practitioner, Dr. Yampolsky has been with a group call the Art of Living Foundation for about 20 years. They are an organization that promotes individual and community development through yoga and yogic philosophy. When teaching a course, Dr. Yampolsky prefers a neutral, blank background. That said, I get the sense that a yoga class with Maya would be an awful lot of fun. She is exuberant, cheerful, friendly and animated in a way that comes through even a Zoom screen. Even when the subjects we’re discussing are rather sombre and depressing compared to yoga. Subjects like COVID, and racism.
“A lot of research showed that Black Canadians of Caribbean origin or African origin, populations that are descendants of enslaved peoples from previous centuries, these groups have continuously been targeted. As a result there’s stress, and there’s illness that builds up in the body. So a lot more of these members of our population have chronic illness, which makes them more vulnerable to COVID, and to having a more intense experience with it. This means they have worse cases and a higher mortality.”
Around the world, Black, Indigenous, Hispanic and Southeast Asian people have felt the greatest impact from the pandemic. This is in part because of the stress that comes along with the continuous targeting Dr. Yampolsky speaks about, but also because those groups are the most likely to be essential workers. Frontline healthcare employees, people who work in long-term care facilities, areas that are more susceptible to exposure. Worse health outcomes, increased exposure, and more long-term neglect of marginalized communities have combined to create a storm during the pandemic.
“This isn’t overt racism, like hatred. But it is something that manifests from the existence of structural racism that creates inequalities that then come to the surface when a pandemic hits.”
Dr. Yampolsky, along with her colleagues Andrew Ryder, John Berry, and Saba Safdar, created the fact sheet ‘Why Does Culture Matter to COVID-19’ for the CPA. That fact sheet inspired a review article she is currently working on with Rebecca Bayeh (1st author) and Andrew Ryder (last and corresponding author). Every time culture and COVID is discussed, it takes Dr. Yampolsky and her colleagues in new directions. Racism is a big part of that. With the pandemic, one thing leapt out very early.
“The World Health Organization has said that we don’t name diseases after places. And yet, people kept insisting on calling this the China Virus or worse. From there we saw a lot of hate speech emerging, and there’s been a lot of hate crime. Here in cities like Toronto and Montreal, there were a lot of defacements of businesses and sacred spaces like Buddhist temples. Asian-Canadians and Asian people abroad, in the global diaspora, and people who looked phenotypically Asian (like Northeastern states in India) were being targeted as the source of the virus and being associated with disease.”
This is sadly not a new thing. We’ve seen this before many times, with virtually every epidemic and pandemic in human history (the 1918 influenza pandemic is still called the ‘Spanish flu’ today, even though the first reports of the outbreak were in Kansas, and no evidence suggests that Spain was particularly hard-hit or that outbreaks occurred there earlier than anywhere else).
Dr. Yampolsky explains that part of the reason for this is that the human brain has shortcuts wired into it to be able to avoid danger – we see disease and immediately try to determine the source of the danger, leading us to associate a virus with a whole group. But of course, it’s more complicated than just this. It wasn’t as though everything was great, and then suddenly the pandemic created more racism – there had been a steady rise in overt racism and hate groups leading up to the onset of COVID-19, a trend that was merely accelerated by the pandemic.
Racism has always existed, and it is always there among the public – the rise has been in overt, or as Dr. Yampolsky put it, “audacious” racism. Hate groups and far-right terror groups in North America and Europe have been more bold in sharing their vitriol publicly. Even some political actions have acted to exacerbate racial tensions. Dr. Yampolsky points to Bill-21 in Quebec, the law that bans people working in public services from wearing ‘religious symbols’ of any kind.
“Anything that essentially targets a minority group will also condone hate toward that group. By its very nature, it singles them out for discrimination. And we were seeing a lot of that already.”
Discrimination against virtually all minority groups has been amped up as a result of COVID-19, in large part because that discrimination was on the rise already. The advent of the pandemic became an excuse to further scapegoat those marginalized groups among those who were already trafficking in hate. These populations already tended to be more vulnerable than others because a history of systemic racism has set them up that way.
In the middle of this perfect storm, Dr. Yampolsky sees a silver lining, maybe a light at the end of the tunnel.
“Hopefully the fact that COVID happened, and then this latest big anti-racism movement – as far as I can tell, the biggest since the civil rights movement – in a way COVID facilitated drawing our attention to what was an existing situation. We weren’t going out, we weren’t being distracted, and so our attention was drawn towards anti-racism. This, positively, has yielded a lot more awareness about racism, and institutional valuing and awareness about racism as well. So that also gives me hope – in the sense that COVID showed us that we’re all connected, it also drew our attention to these things that needed repair, and needed work. I hope that it does end up building more responsible, more healthy, and happier connections with one another.”
There’s still a huge amount of work to do building those connections. To avoid another scenario like the one that happened in Ottawa in the spring, immigrants and refugees require greater supports. Personal support workers, and others we consider essential, require higher salaries. We also need to build ethical and cooperative interactions with Black and Indigenous peoples. There must be equitable and affordable housing for all. And the structural systems that create these conditions must be dismantled.
Dr. Maya Yampolsky is one of the people that will move us closer, as a society, to creating those connections. After an hour with her on Zoom, it’s almost impossible not to be inspired to get out there and start working on dismantling racist structures and historic disenfranchisement. And also, maybe even to sign up for her yoga class.
May 13-14, 2021
- Location: University of Ottawa
The Interdisciplinary Conference in Psychology (ICP) is an international peer-reviewed academic conference organized each year by graduate and undergraduate students from the School of Psychology at the University of Ottawa. ICP will be celebrating its tenth anniversary on May 13th and 14th, 2021, online.
ICP aims to foster reflections and discussions on the different innovative approaches towards interdisciplinary research. The conference is an event for all students, professors, and researchers. It offers a unique opportunity to showcase and discuss innovative research on all topics related to psychology. It provides a forum for interdisciplinary learning and collaboration between students and experts.
For more information about ICP, please visit our website: www.icp-cip.com.
La Conférence interdisciplinaire en psychologie (CIP) est une conférence nationale revue par les pairs. Elle est organisée chaque année par les étudiants des cycles supérieurs et du premier cycle de l’École de psychologie à l’Université d’Ottawa. La CIP célébrera son dixième anniversaire le 13-14 mai, 2021, en ligne.
La CIP cherche à promouvoir les réflexions et les discussions sur les différentes approches novatrices de la recherche interdisciplinaire. La conférence est un événement unique pour les étudiants, professeurs et chercheurs. Elle offre l’opportunité de présenter et de discuter de recherches innovatrices par rapport à tous les sujets liés à la psychologie. La CIP fournit un forum pour l’apprentissage interdisciplinaire et la collaboration entre étudiants et experts.
Pour plus d’informations à propos de la CIP, veuillez visiter notre site Web : www.icp-cip.com.
Dr. Maya Yampolsky spoke to us about the intersection of the pandemic and both structural and overt racism. It was too much to put into just one profile, so we are sharing the whole conversation on Mind Full.
Dr. Karen Blair and her colleagues created the ‘COVID-19 Interpersonal & Social Coping Study’ which surveyed hundreds of Canadians over several months. One of the most striking results they found was the impact of the pandemic on LGBTQ+ university students.
“One student broke up with her girlfriend just as the pandemic began. She was sent home but wasn’t out to her family. So she was heartbroken, that young love heartbreak that totally guts you, but her family didn’t even know she was gay. And so she couldn’t be heartbroken in front of them. At the same time her brother was home, with his girlfriend stuck in another city. And so their parents were doting on him – empathetic and supportive of the poor moping brother, sad at being separated from his girlfriend. And she’s watching this knowing she can’t even tell them that she’s heartbroken, that she got dumped because of the pandemic.”
Dr. Karen Blair is an assistant professor of psychology at Trent University. She is also the Chair of the Sexual Orientation and Gender Identity Section of the CPA, and has been since 2014, a fairly long time to be the chair of a section. She says she’s likely to remain the Chair until at least 2022, as it would be a pretty big ask to get someone to take over virtually, in the middle of our current pandemic.
One of the things Dr. Blair has done during the pandemic is the ‘COVID-19 Interpersonal & Social Coping Study’. It was a large, ongoing survey of hundreds of Canadians on a variety of topics. It found as the pandemic progressed between May and July, Canadians wore masks more often and supported mandatory mask mandates more strongly.
Dr. Blair and her team also looked at Intimate Partner Violence (IPV), and found that the sample couples who had negative reactions to COVID-19 were at greater risk of perpetrating and being the victim of IPV. Their results found that married or common law couples are at greater risk for psychological IPV victimization; women and married or common law couples are at greater risk for psychological IPV perpetration; and younger individuals, parents, mixed-sex couples, and individuals in newer relationships are at greater risk for sexual IPV victimization.
They also looked specifically at Nova Scotians and how they were coping with the pandemic relative to other Canadians. Nova Scotians reported higher levels of social support, mental wellbeing, and medical help seeking behaviours. Nova Scotians also reported more engagement in WHO recommendations, feelings of competency to engage in social distancing and more positive attitudes toward mandatory mask regulations.
Part of the survey had participants writing notes to their past and future selves - one was a message to a past self, before the pandemic began. The other, a message to a future self several weeks later (see Courtney Gosselin profile).
Perhaps the biggest thing Dr. Blair and her team keyed on in the survey was LGBTQ+ university students who were dealing with the pandemic, home life, and distance learning.
When the first lockdown and stay-at-home orders came down way back in March of 2020, students from all over Canada were sent home from school. Accommodations were made for those who could not return home – those whose home was in a hot spot, like Italy. Or those who may not have been able to get back to Canada once they left for their home countries. But students whose needs could be met only on campus, like the LGBTQ+ population, were not considered.
Universities across Canada closed on March 13th. Students were, for the most part, given 24 hours notice that they would be moving back home. For LGBTQ+ students, that meant giving up the support systems they had cultivated at school – social groups, roommates, dorm communities and so on. It also meant that for many of them, they were going home to a place where there was simply no support at all. Everything else in the family might be fine, but for these kids there is a huge part of themselves that is having to hide.
“Parents were scrambling to get their kids home, kids were scrambling to move out. In all that chaos we never stopped to ask if we were sending closeted kids home to unaccepting families.”
In addition to the students who remain closeted at home, there are some who may have it even worse – their family knows, but is hostile about their orientation or identity. Which means they are being berated for it every day, stuck in a place they can’t escape, where the support system they’ve built outside the home is inaccessible.
Even virtual support becomes difficult for these students. Now stuck at home with a family that doesn’t accept their sexual orientation, or their gender identity, there is often not a place private enough to have that conversation over Zoom or Skype without the danger of a parent or sibling overhearing the discussion.
These youth, while experiencing all the same upheaval the rest of us went through with the pandemic, had this added layer of a difficult home life. Dr. Blair says this difficulty doesn’t tend to extend to adult LGBTQ+ people – the 30- or 40-year-olds who are settled and married.
“Someone asked me the other day how it has affected me, and I thought not really – I might actually be doing really well. I’m stuck at home with my wife… we’re both academics and often collaborate with each other so we’ve been able to be great supports to each other throughout the various lockdowns.”
Dr. Blair herself relocated during the pandemic to be closer to family. While her wife’s family is now within driving distance and they are only one flight (instead of two) from her own family, the pandemic has meant they haven’t been able to realize the benefits of seeing their families more despite living closer. But the fact that they both have families that want them to visit, and that are happy to be cooped up with one another, puts them in a place many of the university youth Dr. Blair speaks about can only dream of being.
One day, hopefully, those LGBTQ+ youth will get to that place. For now, they must navigate their way through a difficult school year, the same global pandemic with which we’re all dealing, and a certain kind of isolation and difficult home situation most of us won’t experience. What they are missing is a community, a peer group, and a support system. And someone with whom they can share their heartbreak.
The CPA is pleased to announce that registration is now open for its 82nd Annual National Convention. Taking place, virtually, from June 7th – 25th with Pre-Convention Workshops, taking place from May 31st – June 5th, this is an event not to be missed!
Courtney Gosselin was one of 25 students from Canada and the UK who worked on the COVID-19 Coping Study between March and August. Part of the study was letters people wrote to their past selves (pre-pandemic) and future selves (what they thought at the time would be post-pandemic).
“Find time for yourself, life will slow down, and that’s okay. Take time to learn lessons, take time to really appreciate everything. You are strong, creative and independent, which will all come in handy.”
- Anonymous, writing a note to their past self during the pandemic
Courtney Gosselin is a graduate student in clinical psychology at Acadia University. She’s doing her Masters-level research with Dr. Karen Blair and Dr. Diane Holmberg, and as COVID-19 has overwhelmed most of our lives, their research has moved in that direction as well. Dr. Blair and her colleagues embarked on a large-scale COVID-19 coping study. At the end of the survey, there were two questions – one was a message to a past self, before the pandemic began. The other, a message to a future self several weeks later.
The questions were inspired by a video made by Italian filmmaker Olmo Parenti called 10 Days Later. In the earliest part of the pandemic, when Italy was being hit harder than nearly any country in the world, Parenti asked Italians to record messages to themselves just ten days earlier – what did they wish they had known just ten days ago?
“What you might think is coming is not nearly what is coming. What is happening is much, much worse than what you thought it could be.”
- Anonymous Italian citizen, 10 Days Later video
The Italian 10 Days Later video was filmed in early March. At the time, it was intended to be a warning to the rest of the world. It was estimated that at the time, France and the United States were about 10 days behind where Italy was in the progression of COVID-19, and the hope was that people in those, and other countries, would see this and take the virus seriously.
When Courtney and her group began asking the two questions developed by Dr. Blair, it was much further into the pandemic. Like, a few weeks further into it, which in March and April was a fairly large passage of time in which an awful lot happened here in Canada. She and fellow Acadia student Abbey Miller developed a coding scheme to look at the more than 500 responses.
There was at least one person who advised their earlier self to “Buy Zoom shares, sell Air Canada, don't worry about toilet paper.”, but very few were so self-serving. What Courtney and her team were struck by was the overall tone of hope, the positivity, and the more optimistic and encouraging series of messages. Advice to take time for self-care, to slow down and enjoy the little things in life. The encouraging messages were ten times more common than the discouraging ones.
“This is a chance for you to connect with the part of yourself that thrives on solitude, thinking, listening to nature, watching the sun rise and set.”
While the messages to past selves were largely optimistic, the messages to future selves were a little different. A lot of them would fall into the category of “hey, self – is it over yet?” Says Dr. Blair, “none of us thought it would go on this long either. Now that we think about it, instead of asking them to write to themselves six weeks from now, we should also have asked them to write for six months, or a year, from now.” Some participants stayed in the study for four weeks, and often their future messages would be the same week in and week out – how are things NOW?
“As the world opens up, how do we cope with physical distance, the funerals that have been postponed and loss in general (not due to COVID sickness but impacted by its limitations)?”
Courtney and Dr. Blair say they would like to do another survey of this kind with a different set of questions to see if the optimism and hope that they saw back in March and April has remained. They would do it a little bit differently though, as logistically this one was a bit of a nightmare for their lab. Software, time zones, and other factors came into play and resulted in a group of students going into the lab almost every night to send out the surveys manually, from 6 pm in Newfoundland to 6 pm in BC.
It was, as a result, a very labour-intensive study to run. Especially for the students, like Courtney and the 24 others from Canada and the UK who worked on it between late March and early August. At the beginning, as the pandemic was just hitting Canada and the study was just beginning, they were running on adrenaline. The need to get something done, the need to find a way to help during the COVID-19 crisis, drove them to work longer hours and search for answers.
If they were to do it again now, would they have the same motivation? Would they feel the same urgency, almost a year into the pandemic? It’s tough to say – just as it’s tough to say whether the responses would have a similar tone today as they did back in April. As one participant said,
“Am I still being a positive person?”
French version follows / La version française suit.
Dear Fellow Students,
I hope you are all having a wonderful start of the Winter semester.
Although our academic year is only halfway over, we are already looking towards next year. The Student Section Executive is now accepting applications for our 2021-2022 Executive positions. A number of positions have become available for the 2021-2022 academic year:
(b) Graduate Student Affairs Executive
(c) Justice, Equity, Diversity and Inclusion Executive (new position!)
(d) Francophone Affairs Executive
To apply for one of these five positions, please send the following to Alanna Chu, our Communications Executive at: email@example.com
- A statement of intent that indicates the position for which you are applying, why you would like to hold the position, and what qualities you would bring to the position (250-300 words)
- A short biography that includes information on academic activities, academic goals, and personal interests (250-300 words)
- Your curriculum vitae
You may submit application materials in either English or French. Statements of intent and biographies will be translated and posted on the CPA website for the election phase (30 days).
DEADLINE: February 28th, 2021 at 11:59 PM
If you have any questions, please do not hesitate to contact me at: firstname.lastname@example.org
Looking forward to your applications!
Chair, Section for Students in Psychology
Canadian Psychological Association
J’espère que le début de votre session d’hiver se déroule à merveille.
Malgré le fait que l’année académique n’est encore qu’à mi-chemin, nous sommes déjà en train de penser à l’année prochaine. Le conseil exécutif pour la Section des étudiants de la SCP accepte maintenant des candidatures pour l’année 2021-2022. Un nombre positions sont devenues disponibles pour l’année académique 2021-2022 incluant:
(b) Directeur/Directrice des affaires de troisième cycle
(c) Directeur/Directrice de la justice, l’équité, la diversité et l’inclusion (nouvelle position !)
(d) Directeur/Directrice des affaires francophones
Des descriptions détaillées des positions et du processus d’élection peuvent être retrouvées ici ou sur notre site web : https://cpa.ca/fr/etudiants/etudiantsenpsychologie/sommaire-des-taches-executives/
Pour appliquer pour ces positions, s’il vous plait envoyez les documents suivants à Alanna Chu Palermo, notre directrice des communications, à l’adresse suivante: email@example.com
- Une déclaration d’intérêt qui indique la position pour laquelle vous désirez appliquer pour, pourquoi vous aimeriez occuper cette position et quelles qualités vous amèneriez à la position (250-300 mots maximum);
- Une courte biographie qui inclut de l’information sur vos activités académiques, vos objectifs académiques et vos intérêts personnels (250-300 mots maximum)
- Votre curriculum vitae
DATE LIMITE: 28 Février 2021 à 23h59
S’il vous plait soumettez vos documents d’application en anglais ou en français. Les déclarations d’intérêt et les biographies seront affichées sur le site web de la SCP pour l’élection après que tous les documents des postulants soient reçus le 28 Février 2021. Une période de vote de 30 jours suivra. Davantage d’information à propos des procédures de vote sera fournie à une date ultérieure.
Si vous avez des questions, n’hésitez pas à me contacter à l’adresse suivante : firstname.lastname@example.org
Au plaisir de lire vos candidatures!
Présidente, Section des étudiants en psychologie
Société canadienne de psychologie
The proliferation of disinformation and misinformation online over the past few years has become more dangerous with the advent of the COVID-19 pandemic. Dr. Jonathan Stea, a clinical psychologist and an adjunct assistant professor at the University of Calgary, is one of two psychologists invited to join Science Up First, an initiative bringing together experts from every field to combat disinformation online.
Jonathan N. Stea
“That the outbreaks of Spanish influenza, which have given army officials some concern, may have been started by German agents who were put ashore from a submarine, was the belief expressed today by Lieut. Col. Phillip S. Doane, head of the Health and Sanitation Section of the Emergency Fleet Corporation. … 'It is quite possible that the epidemic was started by Huns sent ashore by Boche submarine commanders,’ he said. ‘We know that men have been ashore from German submarine boats, for they have been in New York and other places. It would be quite easy for one of these German agents to turn loose Spanish influenza germs in a theatre or some other place where large numbers of persons are assembled.’” (New York Times, ‘Think influenza came in U-boat’, September 19, 1918).
You can find that story on Page 11 of Dr. Steven Taylor’s book The Psychology of Pandemics: Preparing for the Next Global Outbreak of Infectious Disease. Conspiracy theories are nothing new. Conspiracies surrounding pandemics are nothing new. What has changed is the speed at which they are spread, and the maliciousness with which they are created.
Lieut. Col. Doane may have thought German U-Boat submariners were coming ashore to spread the flu in movie theatres, and his story was told to the New York Times. It was read by New Yorkers who may, or may not, have believed him. The fact that this opinion exists only in archival material and does not persist to this day, is indicative that either few people read it, few of them believed it, or both.
Lieut. Col. Doane’s theory was not posted to an 8-Chan thread, picked up by a Russian bot farm, posted to Facebook by sixty accounts, disseminated by dozens of questionable ‘news’ platforms, discovered by the President of the United States and tweeted to 90 million people, many of whom were eager to believe and spread the rumour.
This is where we live now, where disinformation and falsehoods can spread from one person to millions across the world in the blink of an eye. And in the time of a pandemic, this can be dangerous, destructive, and harmful in more ways than just fighting between friends and family members. It can put whole populations in greater danger than they need to be.
It is for this reason that scientists across Canada have come together to create the #ScienceUpFirst initiative. Dr. Jonathan N. Stea, a clinical psychologist and an adjunct assistant professor at the University of Calgary, is one of two psychologists who were asked to join the team. Along with Dr. Christine Chambers, Dr. Stea is providing his psychological expertise to combatting disinformation online – specifically, for , disinformation about COVID-19 and COVID-19 vaccines.
“It’s an ethical imperative for psychologists to promote evidence-based patient care and public health– so I’ve always been interested in things like pseudoscience and health-related misinformation. Calling that stuff out is one of our ethical imperatives.”
#ScienceUpFirst emerged from conversations between Timothy Caulfield, a professor of health, law, and policy at the University of Alberta, and Senator Stan Kutcher of Nova Scotia. Professor Caulfield has been researching online disinformation and how to debunk it for decades. Senator Kutcher, before becoming a senator, was the Department Head of Psychiatry at Dalhousie University. They got together to assemble a team of science communicators, epidemiologists, chemists, biologists, geneticists, bioethicists, infectious disease experts, and of course psychologists. Dr. Stea says,
“There is a lot that psychology can bring to the table. We’re trained extensively in science, we’re trained in critical thinking, and we’re trained to understand the ways in which we interpret information and the world more generally. I’ve personally applied these skills to communicate to the public through mainstream media channels, such as articles about tackling health-related misinformation, like how to address vaccine hesitancy and how to identify fake science news.”
This coalition of scientists is dedicated to debunking the misinformation that is out there now. They also want to do the same, as quickly as possible, after a new false narrative emerges online. And there are a lot of them – Bill Gates is microchipping you through vaccines, the numbers are being inflated to control people somehow, alternative medicine cures the virus, the list goes on. And on, and on, and on. Add to that the already loud and vocal anti-vaccination movement that predated the pandemic, and it looks like an uphill battle. But it’s one Dr. Stea is ready to wage.
“Science is an ever-evolving process, and sometimes there are disagreements between scientists. I think for the first time, science is being exposed to the public the way it has always been – as an iterative, evolving process. But for people who are unaware of that, sometimes it can be kind of jarring and it can leave people vulnerable to traps of misinformation. You’ll hear anecdotes, or testimonials on Facebook about how vaccines are extremely dangerous or how Bill Gates caused all this or something. And we want to take accurate, science-informed information and amplify that.”
The initiative is not just scientists railing against misinformation, it is designed for regular Canadians, and regular people around the world, to help amplify the message in the name of public health and protecting their communities.
Your brother-in-law posted online that the COVID-19 was engineered in a lab in China. Your former boss is constantly posting memes about the vaccine being unsafe and untested. Hank from high school is pretty convinced the virus itself is a hoax, meant to distract us all from Pizzagate. Go to #ScienceUpFirstFirst.com, the site that’s designed to help you in combatting these conspiracy theories and false information. They’re fully committed to this fight and want to provide you with the tools to join in as well so that you are not railing against misinformation alone.
Dr. Stea’s day job involves providing psychological treatment in a specialized interdisciplinary outpatient clinic for people who present with both substance use and psychiatric disorders. With the pandemic, he and his colleagues have helped people with these conditions adapt and cope with the additional stressful layer of COVID-related anxiety and uncertainty.. Social media, and the conspiracy theories it perpetuates, does not help. And the volume of these things is only increasing. And of course, that’s where Dr. Stea is spending a fair amount of his spare time.
In 1963, Republican Presidential candidate Barry Goldwater refused to distance himself from the John Birch Society, a powerful conservative group claiming that the bulk of the American congress, including President Eisenhower, were communist conspirators. Later the JBS would push the bogus claim that laetrile, a chemical compound found mostly in the seeds of apricots, was a cure for cancer. In 1964, Goldwater was defeated in one of the biggest landslides in American history, and the John Birch Society was forced out of respectable Republican circles
In 2019, Marjorie Taylor Greene voiced support for the theory that the school shooting at Marjorie Stoneman Douglas High School was a “false flag” attack. She also advanced the conspiracy theory that there was a video – though she hadn’t seen it herself because it does not exist – circulating on the “dark web” of Hillary Clinton cutting off a young girl’s face and wearing it herself as a mask while drinking that young girl’s blood. In November of 2020, Marjorie Taylor Greene was elected to Congress as a Republican Representative from Georgia.
Much of this, of course, stems from Donald Trump who was the biggest source of disinformation and conspiracy theories in the world. Disinformation about COVID-19 is estimated to have declined by 73% on Twitter since Trump had his account disconnected by the platform. And so now may be the perfect time to strike. If genuine science and fact can flood the internet at the same pace as false stories can be spread by trolls, then perhaps we have a chance to stem what the WHO calls a “global infodemic”.
It’s an uphill battle, but it is one that must be waged. Dr. Stea and his colleagues are ready to take it on – and they’re in it for the long haul.
Dr. Adrienne Leslie-Toogood works with elite athletes in Manitoba. When the pandemic hit, those athletes were spread out across the world, some unable to return home. In response, Dr. Leslie-Toogood launched the #TerrificTuesdays Zoom therapy sessions, a podcast, a book club, and much more to connect athletes across levels, disciplines, and the world.
“I learned what it’s like to do something for the last time and now know that it’s not about doing it perfectly but about the privilege of getting to do it and staying connected to my why.”
- Leanne Taylor, Canadian paratriathlete, #TerrificTuesdays
Dr. Adrienne Leslie-Toogood is sitting on a Bosu ball during our Zoom chat. This suddenly seems like a pretty great idea – a way to maintain a little bit of physical fitness during that portion of our days when we are most sedentary in front of our computer cameras. This may not have been Dr. Leslie-Toogood’s motivation for choosing the Bosu ball – there is a perfectly serviceable office chair right next to her – but that chair has been commandeered by a rather presumptuous dog. The presence of a dog enhances any Zoom call, and so this is a perfectly acceptable arrangement.
The pandemic has forced us all to figure out acceptable arrangements, the kind we might not have imagined a year ago. Very often those new arrangements turn out to be positive, and sometimes they break new ground. Such is the case with Dr. Leslie-Toogood’s work, and with her clients, many of whom are elite athletes across Canada and, currently, around the world.
Usually, those athletes are in their own little bubbles (not the COVID kind of bubble, but rather a “hardcore athletes striving for the same goal” bubble). Olympic athletes rarely interact with NCAA divers. Top-level gymnasts don’t tend to run in the same circles as paratriathletes. Even within the Olympic community there’s little crossover between say, cyclists and water polo players. That is, until now – when Dr. Leslie-Toogood and her team initiated #TerrificTuesdays, to connect elite athletes from all different sports, and all different levels, to support one another during the pandemic.
This involves weekly Zoom calls with NCAA players whose seasons have been canceled, Olympic hopefuls who missed out on a chance of competing at Tokyo in 2020, internationally ranked table tennis players whose tournaments have been delayed time and again, and basketball players in a tight bubble in Europe where their teams are located.
Those calls have been extraordinarily productive, as elite athletes from all walks of life connect virtually over great distances and share their experiences and their wisdom with one another. Dr. Leslie-Toogood and her team collate some of that wisdom and share it on the Canadian Sport Centre Manitoba Twitter account, @cscmanitoba, under the hashtag #TerrificTuesdays.
“We are all trying to be excellent people, but the path to that excellence is unique.”
- Michelle Sawatzky-Koop, Canadian volleyball player, #TerrificTuesdays
The #TerrificTuesdays program started to invite in outside guests, like dieticians to provide cooking lessons. Before long, it was being replicated in other programs across Canada as the athletes involved found it so helpful and productive. Now an expert on Zoom technology, Dr. Leslie-Toogood decided to expand her technological prowess even further.
She started a podcast.
Heroes In Our Midst is available - on her website www.drtoogood.com and features interviews with dozens of incredible Olympic and Paralympic athletes, coaches, referees, athletic therapists and more. What Dr. Leslie-Toogood wanted to do was to tell the story about the human being behind the performance. She says, “sport is not about how fast you run but about who you become in the process of trying to run fast.” The podcast series is really about who these athletes have become, as much as it is about their sport and their process.
“I love the freedom you get from riding a bicycle. I’m free to go explore anywhere in the world, anywhere there’s a road. I can go to the mountains. I can go find beautiful places. I can go fast and push myself. I really just love cycling for that.”
- Leah Kirchmann, Olympic cyclist, Heroes in Our Midst
Then there’s a book club for athletes – one of the books they read was Win In The Dark by Joshua Medcalf. Dr. Leslie-Toogood says “for me it was a metaphor for the time. So many athletes are training without anyone watching, doing a lot of work in the dark”. Like everything else, a book club is a tool for conversation. There’s more, but at this point it would be easier to list everything she is not doing than everything she is doing!
It’s all about creating community and connection. Dr. Leslie-Toogood has connections with athletes all over Manitoba and the world, but until now those athletes had little connection with one another. Now they’re dealing with a devastating global pandemic, the postponement or loss of some of their dreams, and the struggle to stay motivated while isolated or in quarantine. But they’re not dealing with those things alone. They are connecting with others going through similar experiences and sharing their stories in an effort to help as many people as they can.
One hopes that when life returns to a semblance of normality, some of these things will remain. It would be great if #TerrificTuesdays stuck around, and if the podcast series continued (there is a second season planned for April, featuring people in other disciplines with whom Dr. Leslie-Toogood works as well. Firefighters, teachers, RCMP, and more). And who can’t get behind a good book club?
One thing that will almost certainly evolve before the pandemic ends, however, is the relationship between Dr. Leslie-Toogood, her assertive dog, her comfortable office chair and her less-comfortable Bosu ball.
https://cscm.ca/ - Canadian Sport Centre Manitoba
Dr. Andrew Ryder helped prepare the Fact Sheet ‘Why Does Culture Matter to COVID-19’ for the CPA. An Associate Professor in the Psychology department at Concordia University, Dr. Ryder self-identifies as a ‘cultural-clinical’ psychologist, and the intersection of culture and the pandemic is in his wheelhouse.
Why have some countries dealt with the COVID-19 so much better than others? How is it that others have fared so very, very badly? It’s not always as simple as good government vs. bad, or effective messaging vs. chaotic messaging. More often, it comes down to the people themselves. Do they tend to be rule-followers? Is there societal pressure to take public health seriously, and how do citizens of those countries respond to that pressure?
These are the type of questions that are of particular interest to Dr. Andrew Ryder. An Associate Professor and, currently, Associate Chair in the psychology department at Concordia University, Dr. Ryder self-identifies as a ‘cultural-clinical’ psychologist. His research is largely about how cultural context shapes mental illness like depression and anxiety. With COVID now, there are some new avenues to explore.
“I’ve turned my attention to whether culture may be involved in shaping physical illnesses, which we’re accustomed to seeing as strictly biological. Rather than retooling myself as a COVID-19 researcher, what I’ve been doing is applying the cultural-clinical framework to research that is being done by many of my colleagues.”
Of course, no country is a cultural monolith. Within every larger society are smaller cultural groups, each with their own ethno-cultural backgrounds, residing in different parts of the country and having different socio-economic statuses. And the difference between those groups in terms of combatting the pandemic can be stark, even within the borders of the same country. And on an even smaller scale, each individual within each community differs on their belief, approach, and conformity to the larger group ethos.
But let’s begin on the “macro” level – how might culture be involved in shaping physical illness?
“It’s an infectious disease, and an infectious disease that is socially transmitted. You have to get it from someone. Many of the things we are being told to stop the spread are behavioural. For example, wearing a mask. You might say ‘well that’s the same behaviour everywhere’, but it isn’t really. In Japan, Korea, Taiwan, it’s doing that thing you always do even when you just have the sniffles. For another cultural group it might be doing something absolutely novel.”
Then on the “meso” level – how might smaller cultural groups within those larger societies approach this?
“We know of some cultural groups where [mask-wearing] immediately seems like an imposition on liberty. Like there’s some kind of core cultural value that is violated by the government telling you to do something unusual. Your psychological state is different when you’re doing something that feels normal versus abnormal under the circumstances.”
What ends up happening, says Dr. Ryder, is that while we all feel like we’re doing the same things – mask wearing, social distancing – those things actually play out very differently for different people. He has spoken to some clients who were into the second week of lockdown before they even knew there was a lockdown. Computer programmers who lived in their basement and had their lives changed very little. Then there are others whose entire way of life was upended overnight.
So what, given the significant differences across cultures on a large scale and a small scale, should be done? Dr. Ryder co-authored a fact sheet for the CPA on Culture and COVID-19 with his colleagues Dr. Maya Yampolsky, Dr. John Berry, and Dr. Saba Safdar, that sought to answer that question. (‘Why Does Culture Matter to COVID-19’)
“An unprecedented number of people worldwide are concerned about the same disease and are experiencing broadly the same distancing measures. As such, there may be a temptation to focus on the similarities. At a minimum, policymakers, healthcare workers, and the public at large should keep in mind that the pandemic experience may be very different for different people. These differences are shaped by the society in which one lives, the communities of which one is a part, and culturally-shaped individual variations. Complicating matters, appreciation for difference does not mean treating all responses equally when it comes to effectively mitigating a pandemic. Clearly, some cultural patterns are more effective than others.”
Cultural differences seem to be enormous factors both in containing the spread of COVID-19 and in accelerating it. Some countries are doing exceptionally well, others not so much. And no one factor can determine why but Dr. Ryder points to a few factors. One is the “tightness” of a society, meaning the level of uniformity and narrowness in that society’s understanding and expectation is when it comes to rules, norms and customs. This seems to correlate directly with the degree to which that society accepts and implements public health guidelines. Another is “relational mobility”, which is a measure of how much people move around, and especially how much they move around between various social groups. This tends to correlate with the speed of the spread in those societies.
Never before has there been an event like the COVID-19 pandemic that can highlight the cultural differences in communities, cities, regions, and countries around the world, in terms of how they respond. For self-identified cultural-clinical psychologists like Dr. Ryder, that presents a whole new fascinating series of studies upon which to build his understanding and his work.
His attention is now turning toward cultural variations in how we will recover. Who will bounce back first, and who will bounce back better? How will the logistics of vaccines be handled, and how will those logistics intersect with public concerns about those vaccines? More than anything else, Dr. Ryder’s interest is in the long term. How effectively will different people in different societies respond to the crisis, learn from it, and be better prepared down the line for any future similar outbreaks?
Some of those questions are being answered right now, others will take some time before a larger picture emerges. In the meantime, each of us is fighting a devastating global disaster in our own way. It’s the difference in the ways each of us fight it that could be most illustrative in mitigating potential future damage the next time something like COVID-19 occurs.
March 29, 2021
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Dr. Ian Nicholson is the Manager for Psychology and Audiology at the London Health Sciences Centre (LHSC), and a former President of the CPA. As with most hospitals, the LHSC has had to change many of their practices since early 2020, including the way they deliver instruction as a teaching hospital.
It is a tough time to work in a hospital. Hospitals are, of course, one of the first places to have felt the effects of the COVID-19 pandemic. Even those that are not currently nearing capacity are well aware that an increase in COVID-19 cases in their community could suddenly make beds scarce. Across Ontario, they are planning ahead for this by ensuring there are beds available, all the while dealing with patients in as safe a manner as possible and supporting vaccination clinics for the rest of the community.
London Health Sciences Centre (LHSC) is one of those hospitals. In addition to juggling advance planning, vaccination, and the safety of staff and patients, it has a few other balls in the air as well. An acute care teaching hospital, they have changed the way instruction is delivered across the board. They are also a children’s hospital, and provide a broad range of other physical and mental health acute care services, all of which have had to make major alterations as a result of COVID-19.
Much of this comes under the purview of Dr. Ian Nicholson, the Manager for Psychology and Audiology at LHSC. While COVID-19 in London was not, at the time we spoke, overwhelming the hospital and pushing it to capacity, LHSC was accepting patients from elsewhere in the province where the strain was more severe, and the possibility that such a thing could happen in London was always in the back of everyone’s mind. This means that Dr. Nicholson has to perform a delicate balancing act between keeping his staff safe, both physically and mentally, and providing psychological services to the patients that come through his hospital. Said Dr. Nicholson,
“The primary difficulty from a management standpoint is the balancing of the need to provide psychological services to patients in a way that is both safe to the patients as well as safe to staff. Given the broad ways in which psychologists work with patients in acute care hospitals, that means a broad range of strategies that have to be used to keep everybody safe during this pandemic.”
Those strategies are myriad, and most involve virtual technologies. Students who do not require work hours in a hospital to graduate are not going in. Psychology Residents are being trained to provide care virtually, often by teachers who are themselves just learning how to deliver virtual care. The supervision of residents and their educational activities are also being done virtually. The team of psychologists is still going into the hospital itself for work, but providing much of their expertise virtually, from offices elsewhere in the building.
Dr. Nicholson still goes in to the hospital every day. He gets screened at the front doors, just like the rest of the staff and the patients who enter the building. He spends the bulk of the day in his office, as he did before. The biggest change he sees in his own job is that he misses the casual discussions that would occur thanks to a chance meeting somewhere in the hospital – walking down the hallway, standing in the cafeteria line, those quick chats about a new idea or a new approach.
“In management, very often you have the meeting, but then you also have the chat before the meeting, or the meeting after the meeting to follow up on one of the items. Those things aren’t happening as much now. When you have these virtual meetings (we use WebEx at my hospital) there’s very little opportunity for schmoozing or chit-chat. This makes it more difficult to have the conversations you normally would around other things.”
Much like psychologists in other hospitals, one of the things Dr. Nicholson is seeing in staff is the impact this pandemic is having. Not that they are putting in longer hours than they normally do, but the added layers of protection mean that every procedure, every intake, is a little more difficult now. Constantly thinking about the pandemic takes its toll, as does being prepared for a wave that could come at any time. And, like elsewhere in the province, the pandemic is affecting both the home and work lives of all staff. Thankfully, he believes we are rounding this corner with something of a light at the end of the tunnel – a light that starts at the London Health Sciences Centre.
At the direction of the Government of Ontario, the hospital has set up a vaccination clinic, and they are vaccinating people as quickly as they can, as much as their supply allows. Based on direction from the Ministry of Health, the health units are prioritzing staff and residents of long-term care facilities, but are hoping that with more vaccine supply they can move on to the hospital staff and physicians shortly.
When the end of the pandemic does come, it will be thanks to the efforts of hospitals like London Health Sciences Centre. On that day, it will still be tough to work in a hospital. But rather than being the place where they watched the pandemic begin, they will be able to look at their workplace as the place where it began to end.
Chelsea Moran is a PhD student in Clinical Psychology at the University of Calgary. Along with her supervisor Dr. Tavis Campbell, the bulk of her research has been about behavioural medicine – adherence to health behaviours. That research took a fortuitous turn when the pandemic began in early 2020.
“People are more likely to adhere to physical distancing behaviours when their motivations were that they wanted to protect other people, and they wanted to protect themselves. That they want to contribute to the overall well-being of their community. Given that information, although we can’t say for sure, theoretically public health messaging that incorporates those pieces can increase adherence.”
Okay…neat. So public health messaging should focus on keeping the individual safe and keeping their community and everyone around them safe. Seems reasonable. But what is the alternative? What other messaging could there possibly be during a global pandemic if it isn’t to keep your friends and neighbours and yourself safe from the virus? It turns out there is a lot more nuance that that!
Chelsea Moran is a PhD student in Clinical Psychology at the University of Calgary. Along with her supervisor Dr. Tavis Campbell, the bulk of her research has been about behavioural medicine – adherence to health behaviours. Before March of 2020, that meant things like finding ways to promote physical activity and encourage sticking to medication regimens among people with chronic illnesses, like heart disease.
When the pandemic hit, Chelsea and Dr. Campbell thought that the work they had been doing on adherence to personal health behaviours could be applied to adherence to public health behaviours. What makes a person stick to a plan? What motivates them to continue doing the thing that will keep them alive? And how does that translate from the individual level to a community, public space?
Chelsea’s focus is now on the factors that promote adherence to COVID-19 public health guidelines, like physical distancing, mask wearing, and the like.
“We’re looking at individuals, and their day-to-day decision-making processes surrounding these things, and then using that to inform some of the wider public health campaigns that everyone is being exposed to.”
In their research, Chelsea, Dr. Campbell and collaborators Dr. Adina Coroiu and Professor Alan Geller discovered that adherence to physical distancing guidelines was motivated by two main factors. In a survey of more than 2,000 people globally, they found that the desire to protect oneself and the desire to protect other people were (surprisingly to the researchers) almost equally motivating factors.
So back to the messaging. Showing people that wearing a mask and sticking to a tight bubble keeps them, and other people, safer seems to be the way to go. This messaging can work. But what are the alternative messages? What might the media, public health officials, and politicians be saying that doesn’t work? What other message IS there?
What Chelsea has been seeing, and what Dr. Campbell has been showing in some of his own work, is that much of the public messaging can sometimes have a fear-based component. There’s a big difference, as Chelsea points out, between a message that says, “wearing a mask makes you less likely to infect your neighbour”, and “not wearing a mask could kill your neighbour”. The message often is that if the guidelines are not followed, the cases will go up and there will be more death as a result.
While fear can be a motivating factor in the short term, in the long term it doesn’t help. This is true of individual health behaviours as well. It’s much easier to get someone to be healthier by emphasizing the positive benefits to their well-being that come from exercise, rather than telling them “if you don’t exercise you will have a heart attack”.
Another thing Chelsea, Dr. Campbell and their team discovered in their survey was one of the sources of motivation to break the rules – to go against public health guidelines. It wasn’t surprising, but it was good to have it quantified in data, that loneliness was a significant factor in people eschewing physical distancing rules. Chelsea lives alone, and she has been feeling that loneliness as well. Her family is in Ottawa, her partner is in Toronto, and while they connect on Zoom and Skype and FaceTime and all that, it’s tough not to feel a little disconnected.
Chelsea’s practicum placement is at a hospital – one in which she has never set foot since she provides clinical services virtually or over the phone. She has met her clinical supervisor in person once, in September. Chelsea has to stay in Alberta, because that’s one of the provincial rules – even virtually, you must physically BE in Alberta to see clients in Alberta. And so she does. She says she’s grateful for the way the University of Calgary has made online learning accessible so quickly, and once she’s done,she may move to Toronto to be with her partner. For now, they make do.
“We have a standing phone date. He has about an hour commute on the way home from work, so we connect over the phone, catch up, and debrief on how our days went. And then FaceTime and Zoom are good because they provide that visual feedback, the non-verbal support from people.”
Chelsea is staying put. As a trainee, she’s seeing people via virtual platforms, doing school online, and generally coping with a solitary existence for the time being. She wants to keep herself safe, and wants those around her to stay safe as well. That motivation thing is really working!
Dr. Gabrielle Pagé works with people experiencing chronic pain. During the COVID-19 pandemic, she and her team have had to pivot to a number of different forms of care. They have discovered some expected results among those suffering from chronic pain, but also some real surprises.
“Chronic pain has always been one of the more neglected areas within the health care system. Within the context of the pandemic, we didn’t expect that to improve – rather, the opposite.”
Dr. Gabrielle Pagé is an assistant professor in the Department of Anesthesiology and Pain Medicine at the Université de Montréal. She is also a clinical psychologist working out of the Montreal General Hospital specializing in chronic pain conditions. When COVID-19 struck, Dr. Pagé and her team decided now was the time to move more toward an advocacy role, to inform the public about chronic pain, and to make this a larger part of the overall health care discussion.
They began by launching a Canada-wide survey of people experiencing chronic pain, and found out that over the first few weeks of the pandemic and the lockdown, 2/3 of them reported that their pain was getting worse. This was in April-May, right as the first wave was rising across all provinces. The idea that most people’s chronic pain would get worse at this time was an expected result given the magnified difficulties to access pain treatment, increased stress and social isolation.
What was less expected – and almost shocking for Dr. Pagé and her team – was that a small group, 5-10% of respondents, actually reported that their pain had been lessened during this time.
Stress is a big predictor of the severity of chronic pain. When patients are stressed out, they experience more pain – more pain leads to more stress, which leads to…well, you get the idea. So it was very surprising that such a large number of people reported an improvement. Maybe they were going for walks, taking the time to connect with family members, or were laid off from a job that had been causing the bulk of their stress. Dr. Pagé can’t say what the cause is, or was, but she is determined to find out.
As I’m speaking with Dr. Pagé, her team is wrapping up a follow-up study to the one they conducted in May. Will the outcomes be similar, or will something new present itself? They should know soon enough. Also, as we’re speaking, Montreal is entering Day One of the big winter lockdown. Curfews in place, all non-essential businesses closed, and the multidisciplinary pain clinic in the Montreal General Hospital is deciding how to move forward.
Dr. Pagé’s clients, for the most part, have been receptive to virtual therapy. Even the group therapy programs which were a concern seem to have adapted well.
“The social bond, the connection that they make and just being around other people who get what it’s like to have pain every day, is one of the central elements of group psychotherapy in chronic pain. So we were wondering how that would translate into a virtual format, being able to see people only through a screen. We’re doing a qualitative research study around this. And while it’s very preliminary, so far it appears that the screen is not a barrier for them to create bonds between one another.”
Because of the nature of the work, however, many of Dr. Pagé’s clients either don’t have access to computers, phones, or tablets – or are unable to use them. For this reason, the clinic has moved to a more hybrid form of care. Group sessions and many individual meetings are still conducted online, but for those who are unable, or uncomfortable doing so, the clinic remains open for in-person masked and distanced visits. While it`s great to be able to offer this service, it`s quite a challenge to demonstrate presence and empathy during therapy through a mask and face shield!
This means Dr. Pagé still goes into the hospital, in one of Canada’s COVID hotspots. She gets screened for symptoms at the door goes through the protocols every time and then she goes home to an 8-year-old who is, at the time of this writing, doing virtual schooling, and a 4-year-old boy going to daycare.
It can be a demanding situation. Thankfully, Dr. Pagé does not experience chronic pain herself. But she is doing everything she can to collect data and get the message out. It’s stressful to have pain. And it`s painful to be stressed. There is a vicious cycle there, and one that is under-recognized in the overall health care system. A system that is starting to realize, more than ever before, where all those gaps lie.
Dr. Jenn Gordon is an associate professor at the University of Regina, and a Canada Research Chair in the bio-psychosocial determinants of women’s mental health. A study she conducted at the beginning of the pandemic identified a major gap in how women in academia were faring during the pandemic compared to their male counterparts, especially among those with young children.
The pandemic, and the resulting lockdown, has not affected everyone equally. This is true across nearly every demographic, including the most highly educated among us. In a survey of almost 1,000 academic faculty members, it was found that parents of young children were less productive and worse off all around – especially, and most significantly, women who were parents of those young children. Women like Dr. Jenn Gordon.
Dr. Gordon is an associate professor at the University of Regina, and a Canada Research Chair in the bio-psychosocial determinants of women’s mental health. She is also the mom of three very young children. Her husband is an accountant. That meant that when the pandemic first started, causing lockdowns back in March of 2020, Dr. Gordon’s husband was in the thick of a suddenly more complicated tax season.
With her husband working long hours preparing taxes, their children gravitated toward Mom – even though Mom had a huge amount of work to do herself. In addition to her work with the University of Regina, the research she does on the effects of estrogen on the mood of menopausal women, and her work with the Women’s Mental Health Research Unit, Dr. Gordon is also the editor for the Health Psychology and Behavioural Medicine newsletter at the CPA. It was the section newsletter that sparked the idea for this study.
Dr. Gordon and Dr. Justin Presseau, the Chair of the Health Psychology and Behavioural Medicine Section, were discussing article ideas for the newsletter. Dr. Gordon says,
“I suggested a piece that talked about academics, and the tough time that faculty are having. Particularly around parenthood, and juggling having kids at home while working and that sort of thing. [Dr. Presseau] suggested that instead of just a piece, why don’t we survey profs across Canada and ask how they’re doing. So we did.”
Almost 1,000 professors responded to the survey, and many of the results were as expected. Most experienced a decrease in work satisfaction, in productivity and publications and grant submissions – with data collection being totally on hold at that time. What was more surprising however, was the size of the gap in those areas between academic faculty who had kids under the age of 13, and everybody else. And then the even bigger gap between men and women who were parents to those young children.
Women were worse off compared to men. Fewer grant submissions, fewer first-author publications, and an ever-widening gap in work satisfaction. Dr. Gordon acknowledges that this survey represents only a slice in time, a snapshot of where we were when the pandemic and the lockdowns began. A follow-up study is in the works, to see whether these effects diminished over time or increased. Her situation today hearkens back to concerns Dr. Gordon had when she first decided to become a researcher several years ago – the idea of work-life balance.
“Could I have a family if I was a researcher, would I have to give up my life? I was always flip-flopping, but over time I decided that I really love research, and the choice became clear.”
While she found that work-life balance soon after embarking on a career in research, specifically research into hormone levels and estrogen levels and how they affect the mood of menopausal women, the pandemic has altered that balance significantly – both for the participants in her survey, and for Dr. Gordon herself. But it has also provided her with an interesting, and timely, research study that, depending on how long the pandemic lasts, might produce more studies down the road on academic faculty, gender disparities, and work-life balance for parents of young kids. Parents like Jenn herself.
Dr. Steven Taylor of UBC was the first person to identify a need for a comprehensive look at the psychology surrounding pandemics. His book, “The Psychology of Pandemics: Preparing for the next Global Outbreak of Infectious Disease” was published presciently in October of 2019, a month before the first COVID-19 case appeared in Wuhan.