“Psychology Works” Fact Sheet: Chronic Pain Among Seniors

What is chronic pain?

Pain that does not go away and lasts for a few months or more is called chronic pain. Often chronic pain is the result of a known disease or injury and may last longer than the usual healing time associated with the disease or injury.

Sometimes medical tests cannot determine the cause of chronic pain. In most cases, the best way to assist a person with chronic pain is to help him or her learn how to manage it.

Pain can have different characteristics (e.g., burning, stabbing, and throbbing), tends to be accompanied by negative emotions (e.g., anger, fear) and can affect a person’s physical, mental, and emotional well-being. It can also affect a person’s physical functions making it harder for him or her to walk, bend, lift or sit. It can interfere with daily activities such as bathing, cooking, cleaning and working.

Pain can disturb sleep or appetite and decrease energy levels. It can interfere with roles and relationships with friends and family. Mentally, chronic pain can make it harder to concentrate or remember things. Emotionally, people with chronic pain can feel irritable, anxious and depressed. Psychologists play a central role in helping people manage chronic pain and the many consequences it has upon their well-being.

How common is pain among seniors?

Pain becomes more common as people get older. Research has shown that, during any one year, most seniors experience at least one significant pain problem, many of which are chronic. Common pain problems among seniors are:

  • pain from arthritis;
  • back pain;
  • leg pain;
  • pain following shingles;
  • pain following a stroke;
  • cancer pain;
  • post-polio syndrome; and
  • pain associated with other conditions such as chronic bronchitis, emphysema, stomach ulcers, fibromyalgia, and osteoporosis.

What are some common myths about pain and aging?

There are a number of myths about aging and pain. For example, many people (including some health professionals) sometimes say that “pain is a natural part of growing old”. This is not true. Pain is not caused by age. Pain is more common in older adults because the diseases or injuries that most often cause pain are more common in older adults.

It is important that the disease/injury and the pain be treated – no matter the person’s age. If we think of pain as a “natural part of growing old”, we may not treat a senior’s pain as seriously as we treat a younger adult’s pain.

Other common myths are that:

  • “older adults suffer less from pain than younger adults”;
  • “older adults can’t handle stronger painkillers or can easily become addicted to painkillers”; and
  • “pain medications always interfere with physical and mental functioning”.

Further, some older adults might feel less entitled than younger adults to ask questions of their health care providers and some health care providers might provide less information to them.

None of these myths and views about pain and aging are true or helpful and could prevent a senior from seeking and receiving the full range of pain treatment options available.

Is pain among seniors under-treated?

Perhaps because of some of the myths just described, pain among seniors is under-assessed and under-treated. Seniors are under-represented in clinics specializing in the treatment of pain. When a senior has another condition which affects his or her ability to communicate (e.g., Alzheimer disease), health professionals may not identify a pain problem.

Educating health professionals about how to evaluate pain in older adults is important and methods designed to identify and assess pain in people with severe dementia have been developed and are being evaluated in Canada and elsewhere. Older adults should seek treatment for their pain and ask questions about the range of medical and psychological treatments available.

Treating chronic pain among seniors

Similar to younger adults, seniors can benefit from treatments such as physiotherapy, occupational therapy, massage therapy, psychological therapy, and medications to manage their pain. However, research has shown that coordinated combinations of treatments for pain (e.g., psychological therapies combined with physiotherapy and medical management) show the best results.

The combination of different types of treatment is sometimes referred to as inter or multi-disciplinary treatment because it is delivered by a team of different health professionals such as physicians, psychologists, physiotherapists and occupational therapists.

Working with professionals who have special expertise in the treatment of pain among seniors is important. For example, because seniors’ bodies tend to process medication more slowly than those of younger adults, medications might have to be administered differently. Similarly, a pain management psychologist working with seniors must understand the problems unique to older age groups.

There are many benefits to treating chronic pain. These may include:

  • increased energy level;
  • improved physical functioning (e.g., sitting, walking, standing);
  • better sleep and appetite;
  • greater activity and independence;
  • more social involvement and better relationships with others;
  • better concentration; and
  • improved mood, self-esteem and sense of well-being.

What can psychologists do to help people with chronic pain? Is treatment effective?

Psychologists treating older adults for chronic pain often work within inter-disciplinary health care teams or coordinate treatment with the other health care services that the older adult might receive.

Because pain can be made better or worse by many factors, it is very important that the treating psychologist, or other pain specialist, communicate with the other health care professionals involved in the older adult’s care. Communication can only take place with the patient’s agreement (or in the case of persons with severe cognitive impairments, with the agreement of a close relative or legal guardian).

Psychological interventions focus on helping the older adult improve quality of life in spite of pain which, in turn, can decrease the burden of the pain experience. These interventions typically include cognitive-behavioural techniques which look at how physical sensations, feelings, thoughts and behaviours affect each other and our day-to-day functioning.

For example, a person with chronic pain may stop taking his or her regular walk to the community centre. Without the walks to the community centre, the person may become even less fit, may have a lower mood, and have fewer social contacts – all of which can worsen quality of life and the experience of pain. Psychological interventions can improve quality of life, and sometimes decrease pain, by helping the person with pain:

  • cope with depressed, anxious or irritable mood;
  • improve communication with others;
  • improve his or her social supports;
  • learn techniques and strategies to improve sleep and achieve relaxation; and
  • learn how to pace and organize activity.

Where do I go for more information?

The Canadian Psychological Association has a number of fact sheets that describe treatments for a number of conditions including chronic pain, depressioninsomnia, and generalized anxiety disorder. These treatments can be used and adapted to address some of the problems often seen in older adults with chronic pain.

For information about chronic pain, contact the Canadian Pain Coalition (http://www.canadianpaincoalition.ca/ ; 905-404-9545). The primary Canadian organisation dedicated to the study of pain is the Canadian Pain Society http://www.canadianpainsociety.ca.

For information on pain from arthritis, contact the Arthritis Society at http://www.arthritis.ca.

For information on pain from osteoporosis, contact the Osteoporosis Society of Canada at http://www.osteoporosis.ca.

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, in cooperation with the Canadian Coalition for Seniors Mental Health, by Drs. Thomas Hadjistavropoulos and Sheryl Green, Department of Psychology, University of Regina.

Revised: February 2017

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

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“Psychology Works” Fact Sheet: Depression

What is depression?

Almost everyone feels sad or “depressed” at certain times. Clinical depression (also called Major Depressive Disorder or MDD) is confirmed by the presence of at least five symptoms for at least a two week period.

The possible symptoms of Clinical depression include sadness, loss of interest in usual activities, changes in appetite, changes in sleep, changes in sexual desire, difficulties in concentration, a decrease in activities or social withdrawal, increased self-criticism or reproach, and thoughts of, or actual plans related to suicide.

Clinical depression may vary in its severity and in its extreme forms can be life threatening and may require hospitalization.

Whereas Clinical depression is a more severe form of depression which can be fairly time-limited, Dysthymic Disorder (also called Dysthymia) is a less-severe, but more chronic type of depression.

Dysthymia is recognized when three of the symptoms listed above are present for at least two years. Some individuals also experience what is called “double depression”; this situation occurs when a person has ongoing Dysthymia, but from time to time also meets the criteria for Clinical depression.

Major Depressive Disorder is distinguished from Manic Depression or Bipolar Disorder in that in MDD the individual only experiences periods of depression, and potentially returns to normal functioning in between times. In Bipolar Disorder, however, the individual will cycle between depression and periods of hypomania or full manic problems (euphoria, high energy, lots of activity).

Approximately 1% of Canadian men and 2% of Canadian women are clinically depressed at any point in time and about 5% of men and 10% of women will experience clinical depression at some point in their life. Women are at about twice the risk of men to experience clinical depression. These rates of depression are fairly consistent in various countries around the world.

Depression is often a recurring condition, as a person who has had one episode of clinical depression is at high risk for repeated experiences, and this risk of recurrence increases with each subsequent episode. Prevention, early assessment and intervention are thus recognized as critical aspects of health care.

Although the causes of clinical depression are complex and vary from individual to individual, it is now clear that a variety of factors increase the risk of a person experiencing clinical depression.  Women may face an increased time of risk after childbirth.  Other risk factors include having a parent who has been clinically depressed, physical illness or ongoing disability, the death or separation of parents, major negative life events (in particular, events related to interpersonal loss or failure), pervasive negative thinking, physical or emotional deprivation, and previous episodes of depression.

Some individuals experience depression in a regular seasonal pattern. Finally, some medical conditions and the effects of some medications can either look like, or induce, a depressive episode.

What psychological approaches are used to treat depression?

Given the large number of people who experience depression and its profound negative effects, psychologists have devoted considerable effort to study depression and develop effective treatments. These efforts have resulted in a number of treatments with evidence to support them.

Cognitive therapy is the most well-studied psychological treatment for depression and has the most consistent evidence to support its use.

Cognitive therapy involves the recognition of negative thinking patterns in depression and correcting these patterns though various “cognitive restructuring” exercises. Cognitive therapy also uses behaviour change strategies.

Cognitive therapy has been shown to successfully treat approximately 67% of individuals with clinical depression. Alone among all the treatments for depression, accumulating evidence suggests that cognitive therapy reduces the risk of having a subsequent episode of depression.

Behaviour therapy helps patients increase pleasant activities and overcome avoidance and withdrawal through efforts to become more engaged in the world.

Behaviour therapy also teaches strategies to cope with personal problems and new behaviour patterns and activities. Behaviour therapy is offered in individual or group therapy and works about 65% of the time.

Interpersonal therapy is another treatment for depression, based on the idea that interpersonal stresses and dysfunctional patterns are the major problems experienced in depression.

Interpersonal therapy teaches the individual to become aware of interpersonal patterns and to improve these through a series of interventions. Interpersonal therapy has a success rate that is comparable to behaviour therapy and cognitive therapy.

Short-term psychodynamic therapy is a treatment which focuses on the identification of core conflictual themes in the way a person thinks about themselves or their interpersonal relations, some of which may be unconscious.

This treatment approach uses the therapeutic relationship as a model for other relationships and uses corrective experiences in therapy to lead to other changes in the depressed person’s life. Evidence suggests that the efficacy of Short-term psychodynamic therapy is comparable to other treatments for depression.

In addition to the above treatments, several other psychological treatments have promise in treating depression. These treatments have some evidence to support their use although they are not as well-established as the first three treatments.

Reminiscence therapy is a treatment that has been developed for older adults. It involves teaching people to remember times when the individual was younger and functioned at a higher level than as a depressed older adult.

Self-control therapy and Problem-solving therapy are treatments which combine some elements of cognitive and behaviour therapy for depression and teach better self-control and problem-solving behaviours in problem situations. A regular routine of moderate aerobic exercise has also demonstrated reductions in depression.

An important note about psychological treatments for depression is that they are roughly as successful as pharmacotherapy for depression.  In fact, psychological treatments often have significantly lower drop-out rates than pharmacotherapy (approximately 10% in psychological therapies versus 25-30% in drug therapy) which may be related to the fact that drug therapies for depression often have unpleasant side-effects.

There is some evidence that cognitive therapy in particular reduces the risk of relapse relative to those individuals who are treated with drug therapy. Other treatments for depression include electroconvulsive therapy and light therapy (the latter for people who suffer Winter-time Seasonal Depression, also called Seasonal Affective Disorder; SAD).

Psychological treatments are effective and safe alternatives to drug therapy for depression when provided by a qualified professional psychologist.

Although the evidence is somewhat inconsistent at present, it does not appear that combining drug and psychological treatments significantly enhances the success of either of these treatments alone.

However, because some of the drug therapies may lead to a quick response they may be effectively combined with psychological treatments which provide for longer term change. Further research on the costs and benefits of combined treatments is clearly warranted.

It is also worth noting that psychological treatments that focus on relapse prevention have been developed and tested. One model in particular, called Mindfulness Based Cognitive Therapy, has demonstrated the ability to reduce the risk of relapse, relative to treatment as usual and medications, especially for individuals who experience recurrent depression.

In summary, depression is a disabling and potentially chronic disorder. There are a number of successful treatments, which include psychosocial and biological treatments. Unfortunately, there is no clear way to know in advance to which treatment any one person with depression will respond.

Research does suggest, however, that it is important to identify and treat depression as soon as possible, to prevent its development into a chronic problem. Further, long-term and more severe depression is associated with increased risk of suicide, so timely and effective intervention from a qualified and professional health care provider is recommended.

Where do I go for more information?

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

This fact sheet was prepared for the Canadian Psychological Association by Dr. Keith Dobson, Department of Psychology, University of Calgary.

Revised: January 2017

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

Canadian Psychological Association
141 Laurier Avenue West, Suite 702
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Tel:  613-237-2144
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“Psychology Works” Fact Sheet: Perinatal Anxiety

(Anxiety during pregnancy and baby’s first year)

What is perinatal anxiety?

Having a baby is typically a wonderful time in our lives. It is also a time of great change and uncertainty.  No wonder nearly all of us have an increase in worry and anxiety. Anxiety is a natural response we experience when we feel unsafe or threatened. We do not have to be in danger to experience anxiety. Even the idea of harm coming to ourselves or our loved ones —especially our baby— can make us feel anxious. During pregnancy, we may worry about the baby’s health and childbirth.  After birth, we may worry about the baby’s eating, sleeping, and safety.  Sometimes we don’t have specific worries.  Instead, we have a vague feeling of dread that something bad will happen. We may start avoiding situations, tasks, or even our own baby. We can also become extra careful and do more than is necessary (e.g., spend lots of time searching for information related to our worries). Although everyone experiences anxiety differently, changes in how we think, feel, and act are common.

Anxiety can affect our:

  • thoughts(e.g., worrying too much, imagining the worst, trouble concentrating and focusing)
  • actions or behaviours(e.g., avoiding, excessive planning, checking over and over again)
  • feelings (e.g., scared, on edge, irritable, numb, frozen)
  • bodies(e.g., upset stomach, racing heart, tense muscles, jumpy, not hungry, sleep trouble)

When is anxiety a problem?

Although anxiety can seem very scary, it is normal. It can even be helpful. Anxiety can help our body become stronger to deal with danger.  However, sometimes we have a lot of false alarms (we react as if there is danger when there is no real danger). When anxiety becomes upsetting and affects how we live our lives, it can become a problem or disorder. Approximately 20 percent of pregnant and new moms experience anxiety and related disorders. But perinatal anxiety does not only affect moms. Expecting and new parents of all genders, ages, and backgrounds can experience perinatal anxiety.

It is time to seek help when we…

  • feel anxious, on edge, or worried a lot, most days
  • notice anxiety is really upsetting us or getting in the way of daily life such as
    •  avoiding places, activities, people or situations that may bring anxiety
    •  doing too much of certain things (e.g., asking for a lot of reassurance)
    •  trouble carrying out routine activities
    •  difficulty enjoying the pregnancy or new baby
    •  more tension in close relationships

What helps people with perinatal anxiety get better?

People with perinatal anxiety may benefit from the following options (alone or in combination):

  • psychological therapy
  • pharmacological treatment
  • psychosocial support

The best ways to get better will depend on the severity of the symptoms of perinatal anxiety and personal preference. Decisions are best made with the support of a trained health professional.

What psychological approaches are proven to treat perinatal anxiety?

The primary psychological treatment that helps people with perinatal anxiety is Cognitive Behaviour Therapy (CBT). CBT involves learning new ways of thinking and behaving that can help reduce anxiety.

Scientific research shows that many people who receive CBT will experience improvements in anxiety.  CBT works for many anxiety problems including excessive worry, obsessions, panic, and post-traumatic stress. CBT can also help us feel more confident about our ability to cope with anxiety related to becoming a parent and caring for our baby.

What can psychologists do to help people with perinatal anxiety?

Psychologists help people take an active role in positive change. They can help us feel better and reduce how much anxiety is getting in the way of living our lives to the fullest.

A psychologist can help us to learn and practice skills to manage anxiety. Some examples are:

  • PSYCHOEDUCATION: Learning about anxiety is an important first step. It is often very comforting to know that we are not alone and it is not our fault.
  • SELF-CARE: If we are going to have the energy to take care of a new life, we need to take care of ourselves. This includes eating well, exercising, getting as much rest as we can, and taking time for ourselves (even if it is only a few minutes).
  • FLEXIBLE THINKING: When we are anxious, our thinking is sometimes unhelpful. The first step is to learn to recognize these unhelpful thoughts.  Next, we develop more helpful ways of looking at our situation and ourselves. This will often include learning to be kinder to ourselves.
  • FACING FEARS: Anxiety tends to change our behaviour in unhelpful ways (e.g., avoiding situations that trigger our anxiety). This makes us feel better in the short term but increases anxiety over time. Facing fears helps us learn that the things we fear are not as dangerous as we think.
  • RELAXATION & MINDFULNESS:. Learning skills such as calm breathing, muscle relaxation or mindfulness can help us reduce or better manage the bodily symptoms that are part of anxiety. Mindfulness techniques can also help us look at our thoughts differently. Mindfulness can help us notice and get untangled from our anxious thoughts so our thoughts have less power over us.

What is postpartum OCD?

Obsessive Compulsive Disorder (OCD) is an anxiety-related mental health problem. People with OCD experience thoughts that they don’t want to have and engage in behaviours they feel compelled to do.

The unwanted thoughts in postpartum OCD are often about harm to one’s baby. These thoughts can be frightening to ourselves and others. However, OCD thoughts are not associated with an increased risk of violence or harm to the baby. CBT can help improve the lives of mothers experiencing postpartum OCD.

Becoming a parent is a big change in our lives. Experiencing anxiety is often part of it. Fortunately, we can learn psychological strategies to help us manage our anxiety.

Psychology Works for Perinatal Anxiety!

Where can I go for more information?

You can consult with a registered psychologist to find out if psychological interventions may be helpful 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/.

A CBT expert can help us learn new skills to use in our daily life leading up to the birth and after the baby arrives. For the names of certified CBT Therapists in Canada, go to: https://cacbt.ca.

If you can’t find a trained CBT therapist in your community, you can use CBT self-management guides to help you learn these skills.  You can find free resources on anxiety for expecting and new parents at:

This fact sheet has been prepared for the Canadian Psychological Association, in cooperation with AnxietyBC, by Registered Psychologists Drs. Melanie Badali12, Martha Capreol3, Nichole Fairbrother4, Michelle Haring2, Sarah Newth2, and Adrienne Wang3.
1AnxietyBC, 2North Shore Stress and Anxiety Clinic. 3Changeways Clinic, 4University of British Columbia.

Date: March 23, 2018

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

Canadian Psychological Association
141 Laurier Avenue West, Suite 702
Ottawa, Ontario    K1P 5J3
Tel:  613-237-2144
Toll free (in Canada):  1-888-472-0657

“Psychology Works” Fact Sheet: Cannabis Use

Cannabis is the most commonly used illegal drug in Canada (Canadian Centre of Substance Use and Addiction). In April 2017, the Government of Canada took steps to legalize cannabis for recreational purposes. It is currently legally available for medical purposes.

How does Cannabis affect young people?

Research suggests that regular or heavy use of cannabis in adolescence (ages 10-20 according to the World Health Organization) is related to difficulty in school, lower income, suicidality, greater welfare dependence and unemployment, as well as lower life satisfaction.

Our brains continue to develop up to the age of 24 years. Cannabis can change the way the brain develops, and medical imaging tests have shown differences between brains of cannabis users and non-cannabis users. Specifically, verbal learning, memory, and attention are negatively affected by acute and chronic use of cannabis. This effect can last even after someone stops using cannabis.

How does Cannabis affect mental health?

Cannabis use is related to mental health and mental illness. For example, research suggests that cannabis use is associated with psychosis, especially for those who use at an earlier age, who frequently use high potency cannabis, and who have a genetic predisposition for psychosis. There is also some research suggesting that cannabis use is associated with depression, bipolar disorder, and anxiety, though causality has not yet been clearly established for all such outcomes.

How does Cannabis affect judgement and decision making?

Executive functioning, which is our ability to plan, prioritize, and problem solve, is negatively affected by heavy or chronic cannabis use. This can lead to poor decision-making, planning, and organizing. Acute cannabis use is associated with an increased risk of motor vehicle collisions, especially fatal collisions.

What are the prevention and treatment options for dependence and abuse of Cannabis?

Research suggests that structured, school-based programs focused on making wise decisions about cannabis use, healthy coping, and substance use resistance skills offered in early adolescence can have strong effects on reducing cannabis use. Motivational Enhancement Therapy (MET) helps individuals resolve their ambivalence to get treatment and stop their drug use, and it has shown positive effects on reducing cannabis use in youth. Cognitive-behavioural therapy, motivational interviewing, and multi-dimensional family therapy are also shown to be helpful.

Where can I get more information?

Recommendations for the Legalization of Cannabis in Canada – provides further information regarding the research and recommendations for the legalization of cannabis in Canada: http://cpa.ca/docs/File/Position/Position_Paper_Recommendations_for_the_Legalization_of_Cannabis_in_Canada-September_2017.pdf

The Centre for Addiction and Mental Health – provides information about use and abuse of cannabis: http://www.camh.ca/en/hospital/health_information/a_z_mental_health_and_addiction_information/marijuana/Pages/about_marijuana.aspx

Government of Canada – general information about cannabis: https://www.canada.ca/en/health-canada/services/substance-abuse/controlled-illegal-drugs/about-marijuana.html

Here to Help – Cannabis Use and Youth: A parents’ guide: http://www.heretohelp.bc.ca/workbook/cannabis-use-and-youth-a-parents-guide

This fact sheet has been prepared for the Canadian Psychological Association (CPA) with information from the Recommendations for the Legalization Cannabis in Canada, a position paper prepared for the CPA by its Task Force on the Legalization of Cannabis.

Date: January 9, 2018

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

Canadian Psychological Association
141 Laurier Avenue West, Suite 702
Ottawa, Ontario    K1P 5J3
Tel:  613-237-2144
Toll free (in Canada):  1-888-472-0657

Welcome Ada L. Sinacore, PhD, CPA President-Elect

Welcome Ada L. Sinacore, PhD, CPA President-Elect

Ada L. Sinacore
The CPA is happy to announce that Professor Ada L. Sinacore has been elected by the CPA board as President for 2021-2022. Professor Sinacore will serve as President-Elect between now and the Annual General Meeting, at which point she will replace current president Dr. Kim Corace. While all members of the Board are elected by the membership, the President is elected by the Board.  Professor Sinacore’s appointment followed from a process inviting all members of the Board to submit a candidacy statement to the Board for consideration. After a review, the Board voted to elect Professor Sinacore from among the candidates.

Ada L. Sinacore, Ph.D. is a professor in, and the Graduate Program Director for, the Counselling Psychology Program at McGill UniversityAs well, she is an associate member of the Institute for Gender, Sexuality, and Feminist Studies, and the Director of the Social Justice and Diversity Research Lab.  Professor Sinacore has over 25 years of experience working in the U.S., Canada, and abroad, and is internationally recognized for her expertise and extensive presentations, publications and activism addressing social justice and human rights concerns at the individual, institutional, societal and policy levels.

She is actively involved in research that addresses topics related to societal inequities and disparities in education and mental health such as workplace harassment, bullying, gender based violence and sexual violence. Additionally, Professor Sinacore has chaired the accreditation panel and has been active in a range of activities with CPA.  As well, she is a member of the advisory council of the Global Network of Psychologists for Human Rights. Professor Sinacore has received numerous honors and awards and is actively sought out for her expertise in consultation and program evaluation.

Professor Sinacore says,

“It is imperative during these uncertain times that we have leadership that is informed by Human Rights and Social Justice. Goal five of CPA’s Strategic Plan explicitly states: “To be an association that promotes and models equity, diversity and inclusion (EDI) in all we do.” As we have seen in this past year the organization has a great deal of work to do with regard to EDI. As an academic who has devoted her career to producing scholarship and informing teaching using the lens of social justice and diversity, I believe any initiatives related to EDI need to be informed by the principles of human rights and social justice.”

Congratulations Professor Sinacore, we look forward to your leadership and collaboration in the coming year.


“Psychology Works” Fact Sheet: Pain in Children with Intellectual Disabilities who are Nonverbal

What is an intellectual disability?

According to the American Association on Intellectual and Developmental Disabilities, an intellectual disability:

  1. begins before age 18
  2. presents itself within different settings (e.g., at school, at home) through observable limitations in both
    • adaptive behaviour (e.g., personal hygiene, social skills), and
    • level of intellectual functioning (i.e., a child’s thinking ability).

These limitations cannot be explained by differences in one’s culture. Children may have these limitations but also have strengths in other areas. Children with intellectual disabilities are usually able to learn and improve in specific areas of functioning when their challenges are well-identified, and personalized supports are put into place.

There are a number of conditions and developmental periods in which a child is at risk for developing intellectual disabilities. First, chromosomal and genetic errors can lead to a number of syndromes associated with intellectual disabilities (e.g., Down Syndrome). Intellectual disabilities can also be caused by other factors during the pre, peri, and postnatal period (e.g., extremely low birth weight, infection, physical trauma). The degree of impairment can be determined, and classified into different categories:

  • Mild Intellectual Disability:
    • these children may experience difficulties in school, and can generally live independently
  • Moderate Intellectual Disability:
    • these children often remain at or below the level of a grade three student, and may be consistently dependent on others in some areas
  • Severe/Profound Intellectual Disability:
    • these children usually require support for the majority of daily activities, and many of these children do not have fully developed language skills.

What does it mean to be nonverbal?

In relation to this information sheet, nonverbal refers to children who have been diagnosed with an intellectual disability and do not communicate using spoken language. In other words, these children do not communicate with others using words or with a universally recognized form of sign language (e.g., American Sign Language). Children may occasionally be considered as nonverbal if they have a few words, but do not use them consistently or meaningfully.

What is pain?

The International Association for the Study of Pain defines pain as “an unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage”. Pain experience (how a person perceives what they are feeling) is different from pain expression (how a person shows that they are in pain). Pain is subjective: both pain experience and pain expression vary from person to person.

As individuals may experience pain differently, self-report is a very common method of pain measurement. However, many children who have intellectual disabilities and are nonverbal may not be capable of providing accurate self-reports about their pain. For this reason, caregivers are often asked to estimate the severity of pain a child is experiencing through observing their behaviour/pain expression. In this way, social factors may also come into play and be particularly important in a context where caregivers are relied on more heavily.

How does having an intellectual disability and being nonverbal impact pain experience and expression?

In the past, it was thought that children with intellectual disabilities did not experience pain in the same way that those without intellectual disabilities do. The belief that children with intellectual disabilities do not feel pain, are less sensitive to pain or are indifferent to pain still exists among some individuals. These beliefs are contrary to the findings of more recent research studies. The reason some individuals with intellectual disabilities, particularly those who are nonverbal, may appear to be insensitive to pain could be because they may express pain differently than other children. There are many potential explanations for this difference in expression, one being due to difficulty communicating effectively.

In what ways do children with intellectual disabilities communicate their pain to others?

As noted above, caregivers are often asked to report on these children’s pain. In some instances, caregivers may be able to see the source of pain (e.g., an open wound), however, in other cases, this may not be possible. Lack of a visible source of pain should not be interpreted as an absence of pain. Despite this, assessing the presence and severity of pain may be difficult for caregivers because children who have intellectual disabilities and are nonverbal do not always express pain very clearly. In some cases, even those caregivers who know the children very well still have difficulty assessing pain severity and location. Research suggests that parents are capable of identifying common behaviours expressed by their children who have intellectual disabilities and are nonverbal when they are in pain (see section below).

Studies seeking to create a list of common ways to express pain in this population have identified some general behaviours that may indicate a child is in pain. For example, the Non-Communicating Children’s Pain Checklist[1] [2] is a scale that has been used successfully by a variety of caregivers (e.g., health care providers, teachers, parents). A list of the behaviours on the NCCPC appears below. It is important to note that each individual may express pain differently and their baseline behaviour should be taken into consideration. Likewise, some of these behaviours may not always communicate pain; they may also express distress or frustration. Further, a child will not necessarily express all of these signals at once while in pain.

  • Vocal Behaviour: moaning/whining/whimpering (fairly soft), screaming (very loud), crying (moderately loud)
  • Social Behaviour: not cooperative/cranky/irritable/unhappy; less interaction with others/withdrawn, seeks comfort or physical closeness; difficult to distract/unable to satisfy
  • Facial Expression: furrowed brow; changes in eyes; not smiling; lips pucker up/tighten/pout/quiver; clenches or grinds teeth/thrusts tongue out
  • Activity: not moving/less active/quiet; jumping around/agitated/fidgety
  • Body and Limbs: stiff/spastic/tense/rigid; gesturing or touching part of body that hurts; protects/favours/guards what is hurting; sensitive to touch
  • Physical Signs: sweating; change in colour; tears; gasping

How can we ensure accurate pain assessment and management for children with intellectual disabilities who are nonverbal?

Effective pain assessment is critical for effective pain management.  These processes are challenging, due to many factors including differences in pain expression and cognitive limitations. Research has demonstrated that primary and secondary caregivers have varying pain-related beliefs, some of which may not be accurate. These beliefs may also influence care decisions. First, training programs may be an effective way to improve pain-related knowledge of those who care for children with intellectual disabilities. Second, further development and implementation of effective pain assessment tools for these caregivers could help to improve pain management in this population. Some medical settings have adopted the use of ‘tool kits’ for managing pain in children with disabilities, such as Holland Bloorview’s Chronic Pain Assessment Toolbox[3] for children with disabilities. Finally, ensuring that child-specific pain information is shared between a child’s various caregivers across settings is likely important. The Caregiver Pain Information Guide[4] is one example of a resource under development which aims to serve this purpose.

Where can I get more information?

To Access the Non-Communicating Children’s Pain Checklist[1],[2]:

To Access the Chronic Pain Toolbox[3]:

To Access the Caregiver Pain Information Guide[4] to be available at:

Additional Online Resources:

OUCH! How Understanding Pain can Lead to Gain when it Comes to Supporting Those with Developmental Disabilities *Not solely directed to children*:  https://www.porticonetwork.ca/documents/38160/99698/sss%2520vol%25206%2520issue%25205%2520-%2520ENGLISH.pdf/bf828358-15c9-48f6-a7d7-70812c0df146

Pain Assessment in the Nonverbal Patient: Position Statement with Clinical Practice Recommendations (MedScape) *Not solely directed to children with intellectual disabilities*: http://www.medscape.com/viewarticle/533939

Understanding Pain in Patients with Intellectual Disabilities (MedScape)*Not solely directed to children*:  http://www.medscape.com/viewarticle/752725

Cited References:

Breau, L.M., Camfield, C.S., McGrath, P.J., & Finley, G.A. (2003). The incidence of pain in children with severe cognitive impairments. Archives of Pediatric and Adolescent Medicine, 157, 1219-1226.Breau, L.M., Camfield, C., McGrath, P.J., Rosmus, C., & Finley, G.A. (2001). Measuring pain accurately in children with cognitive impairments: Refinement of a caregiver scale. Journal of Pediatrics, 138(5), 721-727.

Breau, L. M., Finley, G. A., McGrath, P. J., & Camfield, C. S. (2002). Validation of the non-communicating children’s pain checklist–postoperative version. Anesthesiology, 96(3), 528-535.

Breau, L.M., Lotan, M., & Koh, J.L. (2011). Pain in individuals with intellectual and developmental disabilities. In: Patel, D.R., Greydanus, D.E., Omar, H.A., & Merrick, J. (Eds.), Neurodevelopmental Disabilities: Clinical Care for Children and Young Adults (255 – 276). New York: Springer.

Drew, C.J. & Hardman, M.L. (2007). Intellectual disabilities across the lifespan. USA: Pearson Education Inc.

Genik, L. M., McMurtry, C. M., & Breau, L. M. (2017). Caring for children with intellectual disabilities part 1: Experience with the population, pain-related beliefs, and care decisions. Research in Developmental Disabilities, 62, 197-208.

Genik, L. M., McMurtry, M., Breau, L., & Lewis, S. P. (2018). Improving pain assessment and management knowledge of children’s respite workers: Development and preliminary effectiveness of the “Let’s Talk About Pain” training program. Journal on Developmental Disabilities, 23(2), 115-115.

Genik, L.M., Millett, G.E., & McMurtry, C.M. (under review). Facilitating respite: Preliminary evaluation of the Caregiver Pain Information Guide for children with disabilities.

Herr, K., Coyne, P.J., McCaffery, M., Manworren, R., & Merkel, S. (2011). Pain assessment in the patient unable to self-report: Position statement with clinical practice recommendations. Pain Management Nursing, 12(4), 230-250.

Hunt, K. A., & Franck, L. S. (2011). Special needs require special attention: A pilot project implementing the paediatric pain profile for children with profound neurological impairment in an in-patient setting following surgery. Journal of Child Health Care, 15(3), 210-220.

McGrath, P.J., Rosmus, C., Camfield, C., Campbell, M.A., & Hennigar, A. (1998). Behaviours caregivers use to determine pain in non-verbal, cognitively impaired individuals. Developmental Medicine & Child Neurology, 40(5), 340-343.

Oberlander, T.F. & Symons, F.J. (Eds.). (2006). Pain in children and adults with developmental disabilities. United States of America: Paul H. Brookes Publishing.

Orava, T., Provvidenza, C., Townley, A., & Kingsnorth, S. (2018). Screening and assessment of chronic pain among children with cerebral palsy: a process evaluation of a pain toolbox. Disability and rehabilitation, 1-9.

Symons, F.J., Shinde, S.K., & Gilles, E. (2008). Perspectives on pain and intellectual disability. Journal of Intellectual Disability Research, 52(4), 275 – 286.

Zabalia, M., Breau, L. M., Wood, C., Lévêque, C., Hennequin, M., Villeneuve, E., … & Breau, G. (2011). Validation of the French version of the non-communicating children’s pain checklist-postoperative version. Canadian Journal of Anaesthesia, 58(11), 1016-1023.

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 was originally prepared for the Canadian Psychological Association by Lara M. Genik (University of Guelph), Dr. C. Meghan McMurtry (University of Guelph) and Dr. Lynn Breau (Glenrose Rehabilitation Hospital). The current version was updated by Lara M. Genik (University of Guelph and Dr. C. Meghan McMurtry (University of Guelph).

May 2020

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

Canadian Psychological Association
141 Laurier Avenue West, Suite 702
Ottawa, Ontario    K1P 5J3
Tel:  613-237-2144
Toll free (in Canada):  1-888-472-0657


[1] Breau, L. M., Finley, G. A., McGrath, P. J., & Camfield, C. S. (2002). Validation of the non-communicating children’s pain checklist–postoperative version. Anesthesiology, 96(3), 528-535.[2] Zabalia, M., Breau, L. M., Wood, C., Lévêque, C., Hennequin, M., Villeneuve, E., … & Breau, G. (2011). Validation of the French version of the non-communicating children’s pain checklist-postoperative version. Canadian Journal of Anaesthesia, 58(11), 1016-1023.

[3] Orava, T., Provvidenza, C., Townley, A., & Kingsnorth, S. (2018). Screening and assessment of chronic pain among children with cerebral palsy: a process evaluation of a pain toolbox. Disability and rehabilitation, 1-9.

[4] Genik, L.M., Millett, G.E., & McMurtry, C.M. (under review). Facilitating respite: Preliminary evaluation of the Caregiver Pain Information Guide for children with disabilities.

“Psychology Works” Fact Sheet: Behavioral and Psychological Symptoms of Neurocognitive Disorders in Seniors

What are Neurocognitive Disorders (NCD)?

Neurocognitive Disorders are characterised by a cognitive decline which affect one or more cognitive domains such as memory and learning, executive functions, perceptivomotor activities, attention, language and social cognition. The decline must be significant in comparison with the person’s prior functioning, can be reported by the person or a family member, and objectified by a clinical assessment (e.g. neuropsychological evaluation). When cognitive decline does not affect the functional autonomy, about it is considered as a mild cognitive disorder. However, when deficits have more impact on functional autonomy, a diagnosis of major cognitive disorder can be made Neurocognitive disorders have many etiologies such as Alzheimer disease, Vascular disease, Lewy Body disease, Frontotemporal Disorders, etc.

What are the behavioural and psychological symptoms of dementia (BPSD)?

People who suffer from a neurocognitive disorder, such as Alzheimer’s disease, can have a number of difficulties related to:

  • thinking (e.g., paranoid beliefs, delusions, , hallucinations);
  • mood (e.g., anxiety, depression, apathy); and
  • behaviour (e.g., aggressiveness, yelling, wandering, manipulating objects and inappropriate sexual conduct).

80 to 97% of older people with Alzheimer disorders may present BPSD during their disease (Gauthier S, Cummings J, Ballard C, Brodaty H, Grossberg G, Robert P, et al. Management of behavioral problems in Alzheimer’s disease. Int Psychogeriatr. 2010;22(3):346-72.)

What causes BPSD?

BPSD can be caused by a number of factors. These include:

  • brain changes associated with the neurocognitive disorder;
  • environmental factors such as , excessive demands, sensory overstimulation (e.g. too much noise or agitation in the environment), the absence of visual cues to help the person remain oriented (e.g., the green tagged door is the kitchen, the door with the picture of trees is the person’s bedroom), too few activities or pastimes;
  • social factors such as challenging interpersonal or social relationships or situations (e.g., non adaptative communication);
  • individual factors related to the person’s physical or emotional state such as pain, fatigue, stress, fear, boredom, or other unmet basic needs.

What are the effects of BPSD?

The distressing nature of BPSD can affect the quality of life of the person. He/she can feel left aside, can be frustrated or angry, feel lonely or hurt. The presence of BPSD also increases the risk of physical and chemical contention. But BPSD also affect relationships with family and caregivers, as well as treatment. Family caregivers may see a decrease of their quality of life and feel more psychological distress as anxiety and depression symptoms, culpability, hopelessness as well as difficulties to cope with BPSD. This context may precipitate the decision by the family to place the patient in residential care. The staff of residential care center can also find it difficult to care for a person with BPSD (e.g. resistance and physical agitation can make hygiene care more challenging).  They may report stress, anxiety, fear, helplessness, distress, burnout and they are more at risk of work-related accident.

What can psychologists do to help people with BPSD?

Studies have shown that psychological approaches are effective for reducing disruptive BPSD in individuals with neurocognitive disorder.

It is generally recommended that BPSD be treated first with nonpharmacological approaches, which are effective for many psychological and behavioral symptoms in individuals with neurocognitive disorders. However, when the situation is urgent or severe (i.e., there is a risk for the safety of the person or to others), pharmacological intervention might be added to non pharmacological approaches. Although some medications may help in treating BPSD, the risks and side-effects of the medication need to be carefully considered against their usefulness.

The implication of the psychologist in BPSD management is important. The psychologist’s mandate is quite diverse, and he/she can play an important part both with the person with BPSD and with the caregivers (family and staff members).

ASSESSMENT

The psychologist does a thorough assessment of symptoms – what they are and what makes them better or worse. Some psychosocial models have been developed for BPSD. One of the most popular is the Cohen Mansfield unmeet needs models (Cohen-Mansfield, 2000) who address BPSD as the result of unmeet needs. Another interesting model is the Newcastle Model developed by James (2011).  This model integrated elements of the experience of the person with neurocognitive disorder, the Cohen-Mansfield need model and cognitive behavioural model. With this model, clinicians work with caregivers to develop a hypothesis about the BPSD and take into account many contextual factors as personality traits, mental health, life story, social environment, etc. Second, the psychologist uses the findings from the assessment to develop a plan for intervention in collaboration with the caregiver and, in specific case, with the nursing team.

PSYCHOLOGICAL INTERVENTION

Psychological intervention as psychotherapy with patient with mild cognitive disorder may help decrease anxiety and depression symptoms (e.g. adaptation of CBT). The psychologist can also be involved to provide psychological support to the person and/or the family after a diagnosis of major neurocognitive disorder (e.g. understanding the illness, acceptance), or during life transitions associated with the illness (e.g. placement in a long-term care facility). Throughout the illness, psychological interventions can help reduce the person’s distress (e.g. reminiscence therapy, validation techniques).

BEHAVIOURAL INTERVENTION

Behavioural interventions can help by structuring routines and the environment in order to eliminate the factors that trigger or maintain symptoms.

For example, some patients manifest aggressive behaviour during personal hygiene activities, such as bathing. In this situation, the discomfort associated with bathing may be the trigger and avoiding the activity is the reinforcer. Rather than reducing the time devoted to bathing, it may be more useful to divert the patient’s attention away from the activity using conversation, music, etc. At the same time, it is necessary to reinforce appropriate behaviour that occurs during bathing. Similarly, lack of activity during the day may contribute to apathy and depressive symptoms. Scheduling pleasant activities may be a useful approach in this case.

Structuring activities in such a way to reduce stress is another approach. For example, a patient may present symptoms that are worse at a period of the day when he is very much involved in an activity. For this individual, it may be useful to provide rest and relaxation rather than activation during this specific time of day.

For another patient, symptoms may be worse during a period of the day when he is by himself and not doing anything. If the assessment reveals that symptoms are not usually present when the patient is engaged in activity, this might be the time to schedule visitors or arts and crafts.

Interventions such as sensory stimulation can also be of help. These include giving the patient fabric or a foam ball to handle, pictures in a book or magazine to look at, music to listen to, scents to smell, etc. Sometimes, if a particular person cannot be present to provide social interaction, listening to him or her on tape or watching him or her on video can be a good alternative.

It is not always necessary to stop patients from wandering. Organizing the environment to allow the patient to be physically active can be very helpful. For example, create specific areas in the residence where the patient can move about safely. Concealing outside doors and emergency exits can deter patients from exiting unsafely.

CAREGIVERS and NURSING TEAMS

Psychologists can have an important role to address distress and resistance of caregivers and nursing teams who work with people with BPSD. As a member (or partner) of the treating team, they can help identify the team’s difficulties, provide a space to vent their frustrations or express their concerns (debriefing), and help maintain motivation and bell-being within the team. They can also help the team in reaching a better understanding of the illness and the BPSD and help implement nonpharmacological interventions through formal teaching or coaching, in order to increase the team’s ability to manage BPSD.

At last, the psychologist can work with the family members in individual or group setting. The intervention could focus on increasing the caregiver’s knowledge of neurocognitive disorders and BPSD or coaching the caregiver on BPSD management techniques. The psychologist also plays a key role in assessing and addressing caregivers’ burnout and psychological distress. Psychotherapy can be necessary to address issues such as guilt and acceptance.

Where do I go for more information?

For more information visit the Alzheimer Society of Canada at http://www.alzheimer.ca.

http://capsulesscpd.ca/ (in French)

https://www.baycrest.org/Baycrest/Education-Training/Educational-Resources/Responsive-Behaviours

https://www.msss.gouv.qc.ca/professionnels/maladies-chroniques/alzheimer-et-autres-troubles-neurocognitifs-majeurs/processus-cliniques-et-outils/ (in French)

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 Dr. Philippe Landreville, Université Laval.

Revised: September 2020 by Caroline Ménard and Laurence Villeneuve, psychologists at the Institut Universitaire de Gériatrie de Montréal (IUGM)

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

Canadian Psychological Association
141 Laurier Avenue West, Suite 702
Ottawa, Ontario    K1P 5J3
Tel:  613-237-2144
Toll free (in Canada):  1-888-472-0657

“Psychology Works” Fact Sheet: Sexual Health After a Heart Attack

Sexual activity is an important part of quality of life and is often a great concern for both patients and their partners after a cardiac event. Fears and concerns may temporarily interfere with sexual spontaneity and response.

A few factors may interfere with your sexual health after your discharge from the hospital. You might temporarily suffer from mild depression, which will affect your sexual desire. Some medications may also impact sexual function. You might fear that sexual activity will cause another heart attack or your spouse might silently think the same. For the majority of patients, this will last a short period of time and life will pick up where it left off before you had a cardiac event.

There are also some unique difficulties that men and women may face. For example, erectile dysfunction (ED) is often associated with heart disease in men. The same factors that contributed to blocking the arteries of your heart can block arteries elsewhere in your body. Some medications may also contribute to ED. A healthy lifestyle that incorporates a heart healthy diet, exercise and reaching a healthy weight has been shown to correct ED in 30% of obese patients.

Women may face difficulties with several aspects of the sexual response cycle, including desire, arousal, and orgasm. Women may avoid intercourse due to pain caused by decreased blood flow or friction resulting from not enough lubrication. Over-the-counter lubricants can often address this concern and prevent further problems in the sexual and interpersonal relationship from developing.

Many of the sexual difficulties that people face after a heart attack, however, stem from just not knowing enough about whether they can safely have sex again.

When is it safe to engage in sexual activity after a heart attack?

If you have recently had a heart attack, your doctor will likely recommend that you wait one week or more (several months if you experienced complications) before resuming sexual activity. After this healing period, the risk of having a heart attack during sex is actually quite low. The risk is comparable to that of getting angry and is reduced if you exercise regularly and take your medication.

From a cardiac standpoint, sexual intercourse is like any other physical activity; your heart rate and your blood pressure increase. The effort on your heart is about the same regardless of your position. The activity is often compared to walking at three to six kilometers per hour on a level surface, or climbing 20 stairs in 10 seconds. However, each individual may have different physical factors to consider. It is important to always talk to your cardiologist/family physician before resuming sexual activity.

How can psychological strategies help to maintain my sex life after a heart attack?

  • Start slowly and have realistic expectations. The first few weeks after a heart attack can be very stressful on your partner and yourself. Both of you might still be tired. Plan sexual activity for the time of day when you have the most energy and are least bothered by other health issues. You might also want to avoid having sex after a large meal. Give yourself a few hours to digest. Similarly, limit the amount of alcohol you drink and avoid using tobacco as both of these may affect sexual function. If you have chest pain or shortness of breath, speak to your doctor.
  • Physical affection without sex is just as important. Explore your senses: hold hands, hug, and touch your partner. Create a bit of romance with music, candles, and special scents. You can also maintain emotional closeness by doing things like having regular date nights.
  • For anyone,communication is key to an enjoyable sex life, and this is especially true after a heart attack. Agree to have honest discussions. Tell each other what you like and don’t like. If you are experiencing some communication difficulties in your relationship, meeting with a psychologist can help to improve communication skills.
  • There aremany factors that can affect desire, including fatigue, fear/anxiety, depression, pain/physical discomfort, and drug-related sexual side effects. If you are experiencing any of these additional issues, it can be helpful to meet with a psychologist to specifically address these difficulties.

Where can I get more information?

Thriving with Heart Disease: A Unique Program for You and Your Family. Live Happier, Healthier, Longer – by Sotile & Cantor-Cooke (includes a chapter specifically on sexual functioning)

Heart and Stroke Foundation of Canada:  www.heartandstroke.com

Canadian Association of Cardiovascular Prevention and Rehabilitation:  www.cacpr.ca

Sex Information and Education Council of Canada (SIECCAN):  www.sieccan.org

The Society of Obstetricians & Gynaecologists of Canada:  www.sexualityandu.ca

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. Heather Tulloch, University of Ottawa Heart Institute, Dr. Hannah Marchand, Kingston Orthopaedic and Pain Institute, and Dr. Michele de Margerie (physician), University of Ottawa Heart Institute.

Revised: September 2020

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

Canadian Psychological Association
141 Laurier Avenue West, Suite 702
Ottawa, Ontario    K1P 5J3
Tel:  613-237-2144
Toll free (in Canada):  1-888-472-0657

 

CPA’s “Psychology Works” Fact Sheets responding to COVID-19

The CPA has produced a series of Fact Sheets in response to the coronavirus pandemic:

  • Why Does Culture Matter to COVID-19? – PDF | HTML 06/04/2020
  • Grief, Bereavement and COVID-19 – PDF | HTML 05/12/2020
  • Research Funding Information as relates to COVID-19 – PDF | HTML 05/08/2020
  • Guidance for Psychology Students as Relates to COVID-19 – PDF | HTML 05/08/2020
  • Guidance for Psychology Faculty and Researchers as Relates to COVID-19 – PDF | HTML 05/08/2020
  • Emotional and Psychological Challenges Faced by Frontline Health Care Providers During the COVID-19 Pandemic – PDF | HTML 04/07/2020
  • Psychological Practice and the Coronavirus (COVID-19) – PDF | HTML 03/18/2020
  • Student Wellness and COVID-19 – PDF | HTML 04/02/2020
  • Helping Teens Cope with the Impacts of and Restrictions Related to COVID-19 – PDF | HTML 03/31/2020
  • Psychological Impacts of the Coronavirus (COVID-19) – PDF | HTML 03/20/2020
  • Working from Home During COVID-19, With and Without Children – PDF | HTML 03/17/2020
  • Coping With and Preventing COVID-19 – PDF | HTML 04/04/2020

You can find all of our “Psychology Works” Fact Sheets here


“Psychology Works” Fact Sheet: Psychological Risk Factors and Heart Disease

What is heart disease?

Heart disease, also known as cardiovascular disease, is a general term for a variety of conditions that affect the heart and blood vessels. It is a chronic disease that can lead to serious events including heart attack and death. Heart disease is one of the leading causes of death in Canada and worldwide.

What are the risk factors for heart disease?

There are many risk factors for heart disease. There are “uncontrollable risk factors” including age, sex, heredity, and ethnicity. There are also “modifiable risk factors” that can be controlled or impacted by changes that you make in your lifestyle. These risk factors include smoking, excessive alcohol intake, excess body weight, high blood pressure, abnormal blood cholesterol levels, sedentary behaviour or limited exercise, diabetes, and excessive stress, anxiety, and depression.

Stress and anxiety and heart disease

Everyone experiences stress at some point in life. In these situations, your body reacts by releasing stress hormones, which in turn increases sweating, breathing, heart rate and blood pressure, as your body revs up into high gear to deal with the perceived stress. In the short term, these reactions may be helpful. However, in the long-term stress can be damaging. When individuals experience constant stress over a long period of time, fat cells may be converted into cholesterol, platelets can become more “sticky,” and patterns of daily life may change (decreased amount of healthy eating, regular exercise, and rest).

It is common for cardiac patients to experience varying degrees of fear or nervousness related to their health condition. About one in five (20%) cardiac patients experience significant anxiety symptoms that interfere with daily functioning including: uncontrollable worry, restlessness, irritability, muscle tension, headaches, sleep disturbances, increased fatigue, sweating, and/or gastrointestinal/stomach problems.

Depression and heart disease

Depression is also common in people with heart problems. Similar to anxiety, about one in five patients experience clinical (or major) depression that significantly interferes with daily functioning. Symptoms include feelings of sadness, loss of interest in pleasurable activities, changes in weight and/or appetite, sleep disturbances, decreased energy, difficulties with concentration/memory, feelings of worthlessness, helplessness, or hopelessness, and/or thoughts about suicide/death. Depression can contribute to both the onset of heart disease, and to poorer outcomes following a diagnosis of heart disease.

How can psychological treatments help to manage heart disease?

Psychologists play an important role in helping people to prevent and manage chronic diseases like heart disease. In addition to general training in the treatment of depression and anxiety, many psychologists are also specifically trained to help people cope with chronic diseases. In fact, some cardiac rehabilitation programs have a psychologist on their team.

Here are some ways that psychological approaches can help to prevent and manage heart disease:

  • Stress and anxiety management – How you perceive stress in your life affects the level of stress or anxiety that you experience. It is important to learn how to recognize and identify your own “stress triggers” and how stress impacts you on a daily basis. To begin managing anxiety, it is important to develop healthy coping strategies including becoming aware of emotions which can trigger anxiety, learning relaxation and deep breathing techniques, distracting yourself from thoughts or physical symptoms, doing something pleasurable, sharing fears and worries with someone you trust, and focusing on what you can control rather than on the things you cannot. Additionally, positive social support networks (e.g., friends and family) and daily physical activity help reduce the effects of stress and anxiety.
  • Depression management – Negative thinking, low activity levels, and difficulty handling strong emotions are often involved in depression. Many people with heart disease may also have unresolved issues of loss, grief, and anger, which may be weighing them down and draining their energy. Getting help to learn new ways of thinking and learning to better manage negative thoughts and strong emotions can be beneficial. Additionally, it is important to set realistic goals and engage in self-care activities such as regular exercise and doing pleasurable activities, even if you do not feel like doing so.
  • Making and maintaining lifestyle changes – Psychologists and psychological strategies can also help people to make and maintain changes in their diet and exercise routines, which are important parts of managing heart disease. Psychologists can assist with issues such as identifying and enhancing your motivation for change, setting realistic and achievable goals, and building on success in making lifestyle changes.

Where can I get more information?

Thriving with Heart Disease: A Unique Program for You and Your Family. Live Happier, Healthier, Longer – by Sotile & Cantor-Cooke

Mind Over Mood: Change How You Feel by Changing the Way You Think – by Greenberger & Padesky

It’s Not All in Your Head: How Worrying about Your Health Could Be Making You Sick – and What You Can Do About It – by Asmundson & Taylor

Full Catastrophe Living: Using the Wisdom of Your Body and Mind to Face Stress, Pain and Illness – by J. Kabat-Zinn

Heart and Stroke Foundation of Canada: http://www.heartandstroke.com

Canadian Association of Cardiovascular Prevention and Rehabilitation: http://www.cacpr.ca

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. Hannah Marchand, Kingston Orthopaedic and Pain Institute, and Dr. Heather Tulloch, University of Ottawa Heart Institute.

Revised: September 2020

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

Canadian Psychological Association
141 Laurier Avenue West, Suite 702
Ottawa, Ontario    K1P 5J3
Tel:  613-237-2144
Toll free (in Canada):  1-888-472-0657

“Psychology Works” Fact Sheet: Panic Disorder

Imagine yourself relaxing by the pool. Suddenly, for no apparent reason, you feel faint, your chest hurts, you can’t breathe, your legs tremble, you think you’re having a heart attack and you’re dying. You may be having a heart attack or you could be one of several thousand Canadians suffering from panic disorder.

What is panic disorder?

Panic Disorder (PD) is marked by repeated attacks of panic that occur unexpectedly in the absence of any situational threat (i.e., they occur “out of the blue” and without any warning). These attacks begin quickly and build to a peak rapidly (usually in 10 minutes or less). They are often accompanied by a sense of imminent danger or impending death and an urge to escape. Panic attacks are often described as “the most terrifying experience I’ve ever had”. They leave the individual emotionally drained, frightened, feeling vulnerable and anxious about their health.

PD sufferers often live in fear of having another panic attack. Some fear that the attacks indicate the presence of an undiagnosed, life-threatening illness (e.g., cardiac disease). Others fear that the attacks are an indication that they are “going crazy” or losing control. Some individuals significantly change their behaviour (e.g., quit a job) in response to the attacks.

Individuals with PD often develop agoraphobia. The essential feature of PD with agoraphobia is anxiety about being in places or situations from which escape might be difficult (or embarrassing) or in which help may not be available in the event of having a panic attack. Agoraphobic fears typically involve situations such as being alone outside the home or being home alone; being in a crowd or standing in line; being on a bridge or in an elevator; and travelling in a bus, train or car. The situations are avoided or endured with considerable dread, or confronted only when accompanied by a trusted companion.

Untreated, PD may lead to both chronic debilitating anxiety and excessive visits to health care facilities. PD often is compounded by other problems. Depression occurs in 50%-65% of individuals with PD. It is also common for them to develop other anxiety disorders. It is estimated that 36% of people with PD have substance abuse problems (drugs and/or alcohol).

Who gets panic disorder?

PD is found more often in women than men. PD can appear at any age but it begins most often in young adults. The onset of PD is often preceded by a period of considerable stress (e.g., from an overload of work, the loss of a loved one, a move to a new city, a serious accident, a surgery, a divorce) or the anticipation of a stressful life event. It can also start right out of the blue. Studies throughout the world indicate that three out of every 100 individuals will suffer from PD at some point in their lives. It rarely goes away by itself.

What causes panic disorder?

Many individuals attribute PD to a lack of “strength” or “character”. Nothing could be further from the truth. Although no one knows the exact causes of PD, most experts believe that PD is caused by a combination of biological and psychological factors. For example, PD appears to run in families. This suggests that a genetic predisposition toward PD may exist. Another line of research shows that people with PD may have abnormalities in brain activity and biochemistry. Still another line of evidence suggests that there is a strong psychological component to PD. For example, scientists have found that people prone to panic attacks are much less likely to panic when they are told in advance about the sensations that some situations (e.g., hyperventilation) or substances (e.g., caffeine) will cause.

Can panic disorder be treated?

The vast majority of people with PD can be helped with the right professional care. Furthermore, they can almost always be treated without being admitted to a hospital. Recovery may occur in a matter of months but can take longer depending on individual circumstances. People with PD often have more than one disorder, which can complicate treatment. A successful treatment program must address all of an individual’s related problems including any depression or substance abuse that might accompany the underlying PD.

Can psychology help?

The most successful treatment approaches to PD include behavioural and cognitive therapies as well as medication. Results from numerous studies suggest that the best psychological approaches are as effective as the best pharmacological approaches in the short term and more durable over the long term.

However, there is no single correct approach: there are individuals who do not respond to cognitive-behavioural treatments and who may respond positively to medication; conversely, there are individuals who are resistant to pharmacotherapy and who may benefit from cognitive-behavioural therapy; finally, there are patients who may benefit more from a combination of both treatment approaches.

Behaviour therapy helps individuals reduce their fears and gain more control over difficult situations. It focuses on exposure to the actual physical sensations that someone experiences during a panic attack, as well as the situations that the individual fears and avoids.

Cognitive therapy attempts to change people’s thought patterns by helping them identify and criticize their unrealistic thoughts and helping them replace those thoughts with more realistic, positive ways of viewing the attacks. Psychologists developed behavioural and cognitive therapies and most often use a combination of both to treat PD. Patients have fewer and less severe panic attacks, actively participate in their own recovery and learn skills they will continue to use in many situations after the therapy ends.

Antidepressant and anti-anxiety medications can ease symptoms. Anti-anxiety medications (e.g., benzodiazepines) are fast-acting and may be used as a short-term solution to decrease acute anxiety. Antidepressants may be used in the longer term treatment of PD, but can take weeks to produce noticeable therapeutic benefits.

Both online and in-person support groups may be useful. Many people learn from others, use the support offered by group members and need the reassurance that they are not the only ones with PD.

Well-conceived smartphone applications (apps) using behavioural and cognitive strategies for the management of anxiety and panic attacks may be helpful. They can provide valuable support in daily life.

Effective treatment can bring significant relief to 70 to 90 percent of people with PD.

Where do I go for more information?

More information can be found on the following websites:

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

This fact sheet has been prepared for the Canadian Psychological Association by Dr. Janel Gauthier, Université Laval, Québec.

Revised: May 2020

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

Canadian Psychological Association
141 Laurier Avenue West, Suite 702
Ottawa, Ontario    K1P 5J3
Tel:  613-237-2144
Toll free (in Canada):  1-888-472-0657

 

Strong Majority of Canadians Want Improved Access to Psychologists

CPA LogoCPAP logo

Strong Majority of Canadians Want Improved Access to Psychologists

January 5, 2021 (Ottawa) – Canada and countries throughout the world increasingly recognize the importance of mental health to the success of their citizens, economies and societies.  The COVID-19 pandemic has placed a significant burden on our mental health and wellbeing, making the need for timely access to mental health care even more urgent.

The Canadian Psychological Association (CPA) and the Council of Professional Associations of Psychologists (CPAP) asked Nanos Research to survey over 3,000 Canadians to better understand how they perceive the role of psychologists, the barriers and solutions to accessing care, and the quality of care they receive.

“This survey shines a light on the importance Canadians place on their mental health and the value they place on psychologists in helping people address their mental health problems”, said Dr. Karen Cohen, CEO, CPA.  “Canadians are clear that Canada needs innovative and sustainable solutions across the public and private sectors that will improve timely access to evidence-based mental health care for people who need it”.

“The need for additional investments to care for those with mental health and substance use problems has never been more acute”, said Mr. Christopher Cameron, CPAP Executive Director.  “More specialized and individual care will be needed by those Canadians with pre-existing mental health conditions and by those who develop them as a result of COVID-19”.

The survey found:

Barriers to Access Care

  • 78% of Canadians report that psychological services costing too much for them to pay for themselves is a very significant (52%) or somewhat significant (26%) barrier.
  • 73% of Canadians say that the services of psychologists are not being covered by provincial/territorial health plans is a very significant (47%) or significant (26%) barrier.
  • 68% of Canadians say wait times to see a psychologist being too long is a very significant (35%) or somewhat significant (33%) barrier.
  • 66% of Canadians say that psychological services not being covered by their employer’s health benefit plan is a very significant (40%) or somewhat significant (26%) barrier.
  • 46% of Canadians say that preferring to deal with these problems/disorders on their own is a very significant (16%) or somewhat significant (30%) barrier.
  • 39% of Canadians say not wanting others to know they are seeing a psychologist is a very significant (14%) or somewhat significant (25%) barrier.

Solutions to Improve Access to Care

  • Almost 9 out of 10 Canadians (57%) support or somewhat support (31%) improving access to psychologists through the publicly-funded health care system.
  • 83% of Canadians say psychologists working collaboratively with other health professionals, such as a family physician in primary care teams, is a very good idea (50%) or good idea (33%).
  • 76% of Canadians think that better access (more funded mental health care services and higher financial caps) to psychologists through their employer health benefit plan is a very good idea (42%) or good idea (34%).

A majority of Canadians perceive psychologists as being effective in helping people with specific mental health problems like depression, anxiety, learning disabilities, dementia, addiction, and the stress of being diagnosed with a disease.  Canadians also perceive psychologists as being effective in diagnosing people with mental health problems like depression, anxiety, learning disabilities, dementia and addiction.

The COVID-19 pandemic has reached beyond our physical health and we are likely to feel its psychological and social impacts for some time to come.  We must invest and protect our most valuable assets…people.  There is no health without mental health.  The CPA is committed to working collaboratively with all levels of government, employers and insurers to ensure that Canadians receive evidence-based care where, and when, they need it.  The time to act is now.

To review the results in detail – which includes a breakdown by provinces and territories, gender and age, please to the CPA’s website:  cpa.ca.

– 30 –

About the CPA

The Canadian Psychological Association is the national voice for the science, practice and education of psychology in the service of the health and welfare of Canadians.  The CPA is Canada’s largest association for psychology and represents psychologists in public and private practice, university educators and researchers, as well as students.  Psychologists are the country’s largest group of regulated and specialized mental health providers, making our profession a key resource for the mental health treatment Canadians need.

About CPAP

The Council of Professional Associations of Psychologists is comprised of 13 national, provincial and territorial psychology associations, and has four objectives: facilitating knowledge exchange amongst member associations; identify and share best practices amongst member associations; advocating for the needs of Canadian psychologists and the people that they support; and develop leadership potential and capacity in Canadian psychologists.

About the Survey

Nanos Research conducted a representative online survey of 3,070 Canadians, drawn from a non-probability panel between September 25th and October 2nd, 2020.  The results were statistically checked and weighted by age and gender using the latest Census information and the sample is geographically stratified to be representative of Canada.  The research was commissioned by the Canadian Psychological Association and was conducted by Nanos Research.

Contact: Mr. Eric Bollman
Communications Specialist
Canadian Psychological Association
(613) 853-1061
ebollman@cpa.ca(613) 853-1061


To view the national survey results, click HERE.

Provincial/Territorial Survey Results:


“Psychology Works” Fact Sheet: Obsessive Compulsive Disorder

What is obsessive-compulsive disorder?

Have you ever had a strange or unusual thought just pop into your mind that is entirely out of character for you? Maybe you’ve had the thought of suddenly blurting out an embarrassing or rude comment, or of causing harm or injury to another person, or of doubting whether you acted correctly in a particular situation.

Have you had an irresistible urge to do something that you know is entirely senseless, like checking the door even though you know it is locked, or washing your hands even though they are clean?

Most people experience unwanted, even somewhat bizarre or disgusting thoughts, images and impulses from time to time. We don’t feel upset by these thoughts and urges, even though they seem pretty unusual for our personality and our experience.

Some individuals, however, suffer with a special type of unwanted thought intrusion called obsessions. Obsessions are recurrent and persistent intrusive thoughts, images or impulses that are unwanted, personally unacceptable and cause significant distress.

Even though a person tries very hard to suppress the obsession or cancel out its negative effects, it continues to reoccur in an uncontrollable fashion.

Obsessions usually involve upsetting themes that are not simply excessive worries about real-life problems but instead are irrational concerns that the person often recognizes as highly unlikely, even nonsensical.

The most common obsessive content involve (a) contamination by dirt or germs, (b) losing control and harming oneself or other people, (c) doubts about one’s verbal or behavioural responses, (d) repugnant thoughts of sex or blasphemy, (e) or deviations from orderliness or symmetry.

Compulsions are repetitive, somewhat stereotypic behaviours or mental acts that the person performs in order to prevent or reduce the distress or negative consequences represented by the obsession. Individuals may feel driven to perform the compulsive ritual even though they try to resist it.

Typical compulsions include repetitive and prolonged washing in response to fears of contamination, repeated checking to ensure a correct response, counting to a certain number or repeating a certain phrase in order to cancel out the disturbing effects of the obsession.

People with clinical OCD typically have both obsessions and compulsions (although some may be more aware of struggling mainly with either obsessions or compulsions), with the majority (81%) experiencing more than just one kind of obsession or compulsion.

Approximately 1% of the Canadian population will have an episode of OCD, with the possibility that slightly more women experience the disorder than men. The majority of individuals report onset in late adolescence or early adulthood, with very few individuals experiencing a first onset after 40 years of age.

OCD is also seen in childhood and adolescence where it is a similar symptom pattern to that seen in adults. OCD tends to be a chronic condition with symptoms waxing and waning in response to life stresses and other critical experiences. It is uncommon for individuals to spontaneously recover from OCD without some form of treatment.

Depending on the severity of the symptoms, OCD can have a profound negative impact on functioning. In severe cases, obsessive thoughts and repetitive, compulsive rituals can consume one’s entire day. Like other chronic anxiety disorders, OCD often interferes with jobs and schooling. Social functioning may be impaired and relationships can be strained as family and close friends get drawn into the individual’s OCD concerns.

The actual cause of this disorder is not well known. Genetic factors may play a role but to date there is little evidence of a specific inheritance of OCD.

Studies have suggested there may be some abnormalities in specific regions or pathways of the brain. Other research indicates that critical experiences or personality predispositions might be related to increased susceptibility for OCD.

However, there is no known single cause to OCD. Instead, most of the genetic, biological and psychological causes probably increase susceptibility to anxiety in general rather than to OCD in particular.

What psychological approaches are used to treat OCD?

Since the early 1970s research has shown that behaviour therapy is the most effective treatment for most types of OCD. It involves experiencing the fearful situations that trigger the obsession (exposure) and taking steps to prevent the compulsive behaviours or rituals (response prevention).

These studies have shown that 76% of individuals who complete treatment (13-20 sessions) will show significant and lasting reductions in their obsessive and compulsive symptoms.

When measured against other treatment approaches such as medication, behaviour therapy most often produces stronger and more lasting improvement. In fact, there may be little advantage to combining behaviour therapy and medication given the strong effects of the psychological treatment.

However, up to 20% of people with OCD will refuse behaviour therapy or drop out of treatment prematurely. One of the main reasons for this is a reluctance to endure some discomfort that is involved in exposure to fearful situations.

More recently, psychologists have been adding cognitive interventions to the behaviour therapy treatments involving exposure and response prevention. Referred to as cognitive behaviour therapy (CBT), this approach helps people change their thoughts and beliefs that may be reinforcing obsessive and compulsive symptoms and can help individuals feel less fearful of exposure and response prevention exercises. Also, the cognitive interventions can be particularly helpful if you are mainly struggling with obsessions, rather than compulsions.

Together with exposure and response prevention, the CBT approach has been shown to be effective in offering hope to individuals suffering from OCD.

What are the symptoms of OCD1?

  • presence of obsessions and/or compulsions;
  • obsessions and compulsions cause marked distress, are time consuming, or significantly interfere in daily activities;
  • the content of the obsessions and compulsions is not restricted to concerns associated with another psychological disturbance such as the preoccupation with food in an eating disorder or guilty ruminations in major depression, nor are the symptoms directly caused by the effects of a substance or general medical conditions.

1 Based on the diagnostic criteria of OCD as found in the Diagnostic and Statistical Manual of Mental Disorders (5th ed.) of the American Psychiatric Association (2013).

Where do I go for more information?

The following websites provide useful information on OCD:

Other helpful resources include:

  • Purdon, C., & Clark, D.A. (2005). Overcoming Obsessive Thoughts: How to Gain Control of your OCD. New Harbinger Publications.
  • Baer, L. (2012). Getting control: Overcoming your obsessions and compulsions (3rd ed.). Plume.De Silva, P. & Rachman, S. (1992). Obsessive-Compulsive Disorder: The Facts. Oxford University Press.
  • Foa, E. B., Yadin, E., & Lichner, T. K. (2012). Exposure and Response (Ritual) Prevention for Obsessive-Compulsive Disorder: Therapist Guide (2nd).Oxford University Press
  • Steketee, G., & White, K. (1990). When Once is not Enough: Help for Obsessive Compulsives. New Harbinger Publications.
  • Munford, P.R. (2004). Overcoming compulsive checking: Free your mind from OCD. New Harbinger Publications.
  • Munford, P.R. (2005). Overcoming compulsive washing: Free your mind from OCD. New Harbinger Publications.
  • Abramowitz, J.S. (2009). Getting over OCD: A 10-step workbook for taking back your life. Guilford Press.
  • Challacombe, F., Oldfield, V.B., & Salkovskis, P. (2011). Break free from OCD: Overcoming obsessive compulsive disorder with CBT.
  • Grayson, J. (2014). Freedom from obsessive-compulsive disorder:  A personalized recovery program for living with uncertainty (updated edition).  Berkley Publishing Group.
  • Winston, S. M., & Seif, M. N. (2017). Overcoming Unwanted Intrusive Thoughts: A CBT-Based Guide to Getting Over Frightening, Obsessive, or Disturbing Thoughts. New Harbinger Publications.

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

 This fact sheet has been prepared for the Canadian Psychological Association by Dr. David A. Clark, University of New Brunswick. It was revised most recently in 2020 by Dr. Gillian Alcolado, University of Manitoba.

Revised: July 2020

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

Canadian Psychological Association
141 Laurier Avenue West, Suite 702
Ottawa, Ontario    K1P 5J3
Tel:  613-237-2144
Toll free (in Canada):  1-888-472-0657

“Psychology Works” Fact Sheet: Generalized Anxiety Disorder

What is generalized anxiety disorder (GAD)?

If you have Generalized Anxiety Disorder you will experience chronic, excessive, and uncontrollable worry. You may also be on edge, be easily fatigued, have difficulty concentrating, feel irritable, experience muscle tension, and have problems sleeping.

GAD is one of the most common anxiety disorders. Canadian data suggest that one out of every 12 individuals will suffer from GAD at some time in their life. It can be mild or it can contribute to unemployment and serious family and social problems.

GAD can lead to other problems such as fear of meeting people (social anxiety disorder), severe panic attacks (panic disorder), and depression. If left untreated, those with GAD are at greater risk of developing medical problems such as heart disease, diabetes, and cancer.

Proven psychological approaches to treat GAD

There are a number of proven psychological therapies for GAD. They will help you gain control over your worries, decrease your anxiety, and improve your quality of life. The therapies that have been shown to be most helpful are:

  • cognitive re-evaluation to help you correct thinking patterns that increase worry;
  • behavioural experiments to help you cope with uncertainty;
  • imaginal exposure to help you confront rather than avoid your fears;
  • problem-solving training to help you learn better ways to solve everyday problems; and
  • progressive relaxation to decrease your physical symptoms of anxiety such as rapid breathing and sore muscles.

Research shows that psychological treatments are effective in treating GAD

Psychological therapy is very effective in the treatment of GAD. In a Canadian study, 77% of those receiving short-term psychotherapy (16 sessions of cognitive re-evaluation, problem-solving training, and exposure) remained GAD-free one year after treatment.

The fact that you get better and stay better after psychological therapy is certainly an important consideration for those seeking help for anxiety-related problems.

Where do I go for more information?

For more information visit the following website:

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 Dr. Michel J. Dugas, Université du Québec en Outaouais.

Revised: October 2020

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

Canadian Psychological Association
141 Laurier Avenue West, Suite 702
Ottawa, Ontario    K1P 5J3
Tel:  613-237-2144
Toll free (in Canada):  1-888-472-0657

“Psychology Works” Fact Sheet: Gambling

What are gambling and gambling problems?

Most Canadians play games of chance for money or other prizes. Popular gambling activities include lottery and raffle tickets, scratch tickets, casino games, slot machines, video lottery terminals (VLTs), bingo, sports betting and informal card games. In Canada and around the world, people have had more and more opportunities to gamble over the past 30 years.

Although most Canadians are recreational gamblers, about 5% of the adult population develops gambling-related problems. These problems can range from the person who over spends on one occasion to the person who has a longer-term problem controlling his or her gambling activity.

At the extreme end of the scale is Gambling Disorder which is continued and extreme gambling that is maladaptive because of its negative effects on family, personal and work life (APA, 2013). About 1% of adults experience this severe form of the disorder.

Indicators1 may include: repeated unsuccessful attempts to control, cutback or stop gambling, restlessness or irritability when making these attempts, needing to gamble with increasing amounts of money to achieve the desired excitement, preoccupation with gambling, gambling to escape from problems or emotions such as depression or anxiety, lying to family members or others about the extent of gambling,  jeopardizing relationships, jobs or career opportunities because of gambling, and relying on others to provide money to relieve the financial consequences of gambling. Chasing losses (returning to gamble on another day to win back lost money) is considered a key feature.

There is no one cause of gambling problems and it is clear that biological, psychological and social factors all play a role. Gambling problems tend to run in families and people who have or have had problems with other addictions such as alcohol are at an increased risk of developing a gambling problem.

Gambling problems can also be related to clinical depression but we do not yet fully understand whether gambling problems lead to depression, whether depression contributes to gambling problems, or both. People who are impulsive (for example, people who make decisions without thinking about consequences) are also more likely to have gambling problems. Most gambling also occurs in a social context. People gamble because their friends and family are gambling.

What can psychologists do to help people who have gambling problems?

Researchers have been active in examining k how successful we are at treating people with gambling problems. In most areas of the country, programs and counsellors use treatment approaches that are similar to those used for drug and alcohol problems. These approaches can be provided individually or in groups and for inpatients and outpatients. Most cities have chapters of Gamblers Anonymous which offer mutual support groups that operate on a twelve-step, spiritual model.

Research supports psychologists’ use of cognitive and behavioural treatments with problems gamblers. Cognitive treatments help people understand and change thinking that maintains maladaptive gambling.

For example, problem gamblers try to predict the outcome of their next bet by considering the outcomes of earlier bets.

This kind of thinking is false and risky. A certain outcome is not more likely because it has or has not occurred on earlier bets – the chance of a certain outcome remains the same for each bet. With behavioural treatments, people change their behaviours and environment in order to make it harder for them to gamble. For example, people will often limit their access to cash.

Research also highlights the importance of motivation in overcoming gambling problems. Motivational enhancement techniques help people to understand how gambling effects their lives and the mixed feelings they might have about stopping gambling.

To date, there are no medications which have been proven to be effective in treating problem gambling.

Where do I go for more information?

The website for the Responsible Gambling Council, http://www.responsiblegambling.org has a comprehensive list of links to Canadian treatment programs, Gamblers Anonymous and provincial help lines.

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

1 Based on the diagnostic criteria of gambling disorder as found in the Diagnostic and Statistical Manual of Mental Disorders (5th Ed.) of the American Psychiatric Association (2013).

This fact sheet has been prepared for the Canadian Psychological Association by Dr. David Hodgins, a faculty member in the Clinical Psychology Program at the University of Calgary, Calgary, Alberta. He is affiliated with the Alberta Gaming Research Institute http://www.addiction.ucalgary.ca.

Revised: October 2020

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

Canadian Psychological Association
141 Laurier Avenue West, Suite 702
Ottawa, Ontario    K1P 5J3
Tel:  613-237-2144
Toll free (in Canada):  1-888-472-0657

 

“Psychology Works” Fact Sheet: Needle Pain

Why does pain from needle procedures matter?

Needle procedures are used to prevent, diagnose, monitor, and treat various health conditions. For example, insulin injections and finger pokes are a common experience for people with diabetes while bone marrow aspirations and lumbar punctures are experienced by people with cancer. Immunizations/vaccinations are the most common source of needle pain in childhood. For example, the Canadian Immunization Schedule recommends over 20 needles, not including yearly flu vaccinations, before a child reaches the age of 18. While vaccinations are a critical part of health care that have made a major difference in the prevention of infectious diseases, pain can be a consequence of these procedures. If the pain from needle procedures is not properly managed, there are short and long term consequences including longer procedure times, increased risk of fainting and injuries, negative memories, fear and avoidance of future procedures.

Why does pain from needle procedures matter?

The good news is that there are many ways that pain and distress during needle procedures can be managed. Types of strategies include:

  • procedural – how the clinician performs the procedure (e.g., no aspiration for immunizations)
  • physical – across ages, sitting upright is usually helpful unless the person has a history of fainting. If there is a history of fainting, a technique called muscle tension can be helpful.
  • pharmacological – topical anesthetics or other medications for more invasive procedures.
  • psychological strategies. More on these below for preschoolers and older.

The recommended strategies can change depending on the age of the person getting the needle. For example, infants benefit from kangaroo care (<1 month) or being closely held by the caregiver, breastfeeding, and/or sugar water for more minor procedures such as immunizations or venipunctures.

Research shows that the psychological techniques listed below help to reduce immunization pain, and can help for other needle pain in children as well as adults. They are all relatively easy to use and low in cost, if not free. Each technique can be adjusted as needed, depending on a person’s age and the specific procedure they are having.

  • Education and Preparation – everyone deserves to know what procedure they are getting, why, and what will be done to make it comfortable (what they can do and what others will do). Provide choice when possible: for example, do they want to look at or away from the needle? What coping strategies will they use? Do they want a caregiver or other trusted individual to be present?

    Before a needle procedure:

    • Answer any questions people have in a way that is honest but appropriate for their age
    • Tell very young children about the needle only a little while before the procedure
    • Tell older children, adolescents, and adults about their procedure before the day in question so they can prepare coping strategies
  • Communication to the individual immediately before and during the procedure. For all ages:
    • Speak calmly, clearly, with simple wording.
    • Signal the start of the procedure in a neutral way (e.g., “1, 2, 3, here we go”).
    • Do not say “it won’t hurt”. That does not help and it is not necessarily true so could led to mistrust.
    • Do not reassure (e.g., say “it’s okay” or “almost done”) over and over again. It does not help.
  • Distraction – these are strategies that involve taking a person’s attention away from the procedure. Use age-appropriate distraction techniques such as:
    • Talking about things other than the procedure (e.g., holidays, favourite movie)
    • Toys
    • Videos (with adult coaching to engage for younger children)
    • Singing
    • Video games
    • Books
  • Deep breathing or blowing – this strategy involves the person taking slow, deep, regular breaths, which can help with feeling relaxed. Using a toy is recommended for school-aged children and adolescents (e.g., pinwheel or bubble wand) which then also includes distraction. Children (and adults) can be instructed to take a calm and slow breath from their diaphragm (e.g., “take a deep breath in from your tummy. When you breathe in, your tummy should fill up like a balloon. Then breathe out pushing out all the air.”). Adults may also find coughing or taking a deep breath in and holding it (for brief injections such as immunizations) helpful.

What if a high level of needle fear is present?

Needle fear is present in about 2/3 of children and 1/4 of adults and can range from mild to severe levels. The strategies listed above are helpful for people with low to moderate needle fear. Across the lifespan, about 10% of individuals have high levels of needle fear that can interfere with their willingness to undergo needed medical procedures. At the most severe end of the spectrum, ~4-5% of individuals have a phobia related to needles which is characterized by extreme fear and anxiety and called blood injection injury phobia. People who have high levels of needle fear require different strategies than are listed above – they need to undergo exposure-based therapy in which they face their fear in a controlled, hierarchical manner. After their fear reduces, they can then benefit from the traditional pain and distress management strategies.

Where do I go for more information?

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

This fact sheet has been prepared for the Canadian Psychological Association by Dr. C. Meghan McMurtry, University of Guelph. The current version is based on the 2011 version written by Dr. C. Meghan McMurtry, Dr. Christine T. Chambers, Dalhousie University, and Dr. Anna Taddio, University of Toronto.  

Updated: May 2020

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

Canadian Psychological Association
141 Laurier Avenue West, Suite 702
Ottawa, Ontario    K1P 5J3
Tel:  613-237-2144
Toll free (in Canada):  1-888-472-0657

Pandemic December: How to stay connected and resilient in a COVID-19 holiday season

This year’s holiday season will no doubt be different. The holidays are already a time of increased mental health risks because of anxiety, depression, seasonal affective disorder, alcohol/substance use and other factors. Now, the COVID-19 pandemic will add a major pressure to the festive season.

Whether you mark holidays in December or not, typical winter customs are being disrupted. The pandemic has had a significant impact on society’s ability to connect and has also reduced individuals’ access to wellness-maintaining strategies and activities. …

Read the full article by Kerri Ritchie and Caroline Gerin-Lajoie here: (https://theconversation.com/pandemic-december-how-to-stay-connected-and-resilient-in-a-covid-19-holiday-season-150678


“Psychology Works” Fact Sheet: Seasonal Affective Disorder (Depression with Seasonal Pattern)

Do you, or someone you know, ever start to feel dips in your energy, become irritable, and feel down every fall?  Keep reading to see if you may need to talk to someone about how you feel.

What is Seasonal Affective Disorder?

Seasonal Affective Disorder (SAD), or Depression with Seasonal Pattern, is a condition that comes and goes based on seasonal changes, appearing in the fall and going away in the spring/summer. This diagnosis should only be considered when the feeling is beyond the “winter blues” due to the lack of engagement in typical hobbies and/or outdoor activities due to weather.  Seasonal Affective Disorder can also occur during spring and summer although it is not as common to experience SAD during the warmer seasons.

There is debate regarding the cause of SAD. There is some that believe SAD is influenced by exposure to sunlight. Our bodies react to how much sun we are exposed to through our circadian rhythm. Our circadian rhythm is our natural clock that regulates many things, including mood and sleep.   Exposure to sunlight may also affect chemicals in our brain (serotonin) and our body (melatonin), which also influences how we feel.  Other experts do not believe there is enough evidence to support this theory, and connect mood changes to being inside more and being unable to engage in the same outdoor activities/hobbies that you enjoy.  This influence to mood can still benefit from treatment with a psychologist.

Who is at risk of developing SAD?

It is estimated that SAD makes up 10% of all reported cases of depression. Approximately 15% of Canadians will report at least a mild case of SAD in their lifetime, while 2-3% will report serious cases. People with a family history of any form of depression may also be at risk of developing SAD.  Canadians are particularly at risk, as we have decreased sunlight during the winter months.

If you have a history of depression or bipolar disorder, your symptoms may become worse seasonally.

What are the symptoms of Seasonal Affective Disorder?

If you have SAD, you may find yourself feeling many symptoms of depression, especially irritability, and you may be more sensitive in interpersonal relationships. People often report that their energy levels are unusually low, causing them to feel tired, heavy, or lethargic. As a result, you may feel that your regular sleep schedule doesn’t provide adequate rest. Oversleeping is commonly reported in SAD.

You may find that your appetite has changed, and you may crave foods that are higher in carbohydrates, starch, and fat. Some people report weight gain, especially when you are frequently eating “comfort foods” (e.g., high calorie and fast foods). You may lose interest in activities that you once enjoyed, which may cause you to develop a more avoidant or sedentary lifestyle. Physical intimacy may appear uninteresting or too demanding. You are also likely to feel stressed, distracted, sad, guilty, or hopeless.

Can Psychology Help Seasonal Affective Disorder?

There are many ways to reduce symptoms of SAD or the winter blues. The most widely recommended psychotherapy for SAD is cognitive behavioural therapy (CBT).  CBT helps individuals focus on immediate thoughts, moods, and feelings, which allows problems to be broken down and made more manageable. Your psychologist may also recommend lifestyle changes in the winter, such as opening blinds, going outside, and exercising. You can undergo CBT either alone or in a group setting. Research suggests that CBT can help improve present symptoms while providing you with a healthy defense for future episodes.

Other forms of psychotherapy commonly used for the treatment of SAD are counselling and psychodynamic therapies. These therapies allow you to discuss concerns and worries with a therapist in an open and confident environment. You may discuss feelings about yourself and others, or past experiences that could be influencing your symptoms. One goal is to identify any memories or feelings that could be influencing your current state of mind. Once possible causes have been identified, you will work through them to resolve any negative influences presently affecting you.

Are there other treatments for Seasonal Affective Disorder?

Some studies have identified light therapy as an effective method for improving symptoms. In this therapy, the user sits in front of a special light box or lamp for approximately 30 minutes a day. Light therapy can be administered in a doctor’s office, or at home with your own equipment on a schedule recommended by a clinician. You should consult with your doctor before beginning light therapy. Light therapy is not suitable for everyone as there can be negative side-effects associated with this treatment including eye strain, agitation, headaches, and nausea. Light boxes should only be purchased after a discussion with your treating professional, as not all light boxes are effective, and you may want to review with your treating professional the research regarding the use of light boxes.

Exposure to natural light can be helpful. Research has found benefits from exposure to sunlight within one hour from waking up in the morning, particularly for people with SAD. You can sit beside a window, keep your blinds open when you are home, trim branches that block light on your property, or take frequent walks outside with proper UV protection.

Most importantly, it is also encouraged that you live a healthy and balanced lifestyle to improve symptoms and reduce the severity of future episodes. Try incorporating exercise into your daily routine. Exercise will help increase your physical and mental well-being, ease your stress, and reduce feelings of lethargy. Eat a healthy diet and be mindful not to overindulge cravings for high sugar/starch/fatty foods. Make sure to stick to regular sleeping habits to combat fatigue and avoid oversleeping.  Additionally, make sure that you have a healthy level of vitamin D in your diet with your physician and/or pharmacist.

Although your symptoms may initially make this difficult, keep in regular contact with family and friends, both in person and via electronic means. These networks can provide opportunities to socialize and refresh your mood. Reach out to people in your support network for comfort and understanding. This can help ease feelings of guilt, isolation or hopelessness. Make sure to spend some leisure time doing activities that you find rewarding and gratifying. Practice mindfulness and pacing inside the home if you cannot make it outside (in front of windows if possible). Finally, exercise stress management techniques such as meditation and mindful breathing.

Alternatively, your physician may decide that medication, such as an antidepressant, is an effective treatment for you. Pharmacotherapy likely will be recommended for symptoms that are severe and have a significant impact on daily functioning. There are side effects with medications, which should be discussed with your prescribing professional.

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/

This fact sheet has been prepared for the Canadian Psychological Association by Sarah Amirault, Carleton University.

Date: July 2018

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

Canadian Psychological Association
141 Laurier Avenue West, Suite 702
Ottawa, Ontario    K1P 5J3
Tel:  613-237-2144
Toll free (in Canada):  1-888-472-0657

“Psychology Works” Fact Sheet: Social Anxiety  

What is Social Anxiety?

It is common to feel some anxiety in social situations from time to time.  Many of us feel anxious when we’re at a job interview, on a first date, or giving a speech.  We all want to make a good impression and be liked.  However, some people feel very nervous and uncomfortable in social situations.  Individuals with social anxiety worry a great deal about doing something embarrassing and others thinking badly of them.  They tend to be very self-conscious and constantly feel “on stage.”  While some people with social anxiety fear lots of different social situations (e.g., meeting new people, going to parties, starting conversations, being the centre of attention, ordering food in a restaurant, etc.), some people only get anxious in very specific situations (e.g., public speaking).  When faced with feared social situations, individuals with social anxiety tend to experience the following:

  • Thoughts: negative thoughts about themselves (e.g. “I’ll say something stupid,” “I’ll look anxious,” “I’ll have nothing interesting to say”) and how other people will react to them (e.g. “People won’t like me,” “Classmates will think I’m boring,” “Colleagues will think I’m weird”)
  • Feelings: anxiety, fear, nervousness, embarrassment, shame
  • Body reactions: sweating, blushing, trembling, shaking, racing heart, upset stomach, nausea, dizziness, lightheadedness, choking sensations, dry mouth
  • Behaviours: avoidance of social situations (e.g., skipping the party, not going to a meeting or class, saying “no” to social plans with friends) and the use of safety behaviours, which include any actions used to try and feel safer and less anxious in a social situation (e.g., saying very little, avoiding eye contact, rehearsing what you say before you say it, not expressing your opinion, using alcohol or drugs).

When does social anxiety become a problem?

Social anxiety becomes a problem or is considered a disorder when it feels intense, happens a lot, causes us distress, and affects different parts of our lives including:

  • Work and school (e.g., missing work or school, trouble participating in meetings or classes, poor performance at work or school, not pursing certain school programs or jobs/careers, and difficulty talking to bosses and co-workers or teachers and other students)
  • Relationships and friendships (e.g., difficulty making and keeping friends, trouble dating, and difficulties being assertive and opening up to people)
  • Recreational activities and hobbies (e.g., avoiding trying new activities or joining things such as going to the gym, joining a running club, or taking an art class)
  • Day-to-day activities (e.g., difficulty completing daily activities such as grocery shopping, ordering food at a restaurant, making phone calls, asking for help, and using public transit)
If social anxiety is a problem for you, seek help.  There are treatments that work!

Who has problems with social anxiety?

Anyone can have problems with social anxiety. You might not know from the outside that someone is suffering on the inside. When social anxiety causes distress and gets in the way of functioning in life, we call it Social Anxiety Disorder. It is one of the most common anxiety disorders, 8-12% of people being diagnosed at some point in their lives.

Research suggests that both genetics and environment can play a role in the development of social anxiety problems.  Social anxiety tends to run in families, which means if someone in your family has an anxiety problem you may be more likely to develop one.  Various life events or experiences, such as being teased or bullied, can play a role.  Social anxiety problems can develop slowly over time, often starting in elementary school or early adolescence, or after a particularly embarrassing or stressful event.

What treatments help people with social anxiety?

Pharmacological interventions (medications) can help people with Social Anxiety Disorder. Ask your family doctor (General Practitioner) or Psychiatrist about options.

Cognitive Behaviour Therapy (CBT) is the gold standard nonpharmacological treatment for social anxiety disorder. Scientific research shows that CBT helps people with social anxiety. CBT involves learning new ways of thinking (cognition) and acting (behaviour), which can lead to reducuctions in anxiety.  A typical course of CBT is 12 to 20 one-hour sessions.

People with social anxiety tend to overestimate the threat of social situations and underestimate their ability to cope with them. CBT teaches cognitive techniques (e.g., identifying and challenging unhelpful thoughts or beliefs) to help people feel less anxious and engage in social situations more.

People with social anxiety also tend to avoid feared social situations or people. Avoidance works well in the short term (e.g., anxiety temporarily goes down by skipping the party) but causes more problems in the long run (e.g., missing out on meeting new friends, sending yourself the message that that situation is dangerous and you can’t cope). A CBT therapist will help you gradually face your excessive fears. The process of “exposure” helps reduce anxiety by teaching people (through experience) that situations are safer than they think and they can manage them.

Mindfulness-based therapy and Interpersonal therapy can also help people with social anxiety; however, they appear to be less effective than traditional CBT. Mindfulness-based therapy (MBT) involves learning to pay attention to your thoughts, feelings, sensations, and surroundings in the present moment, without judging. Interpersonal therapy (IPT) involves exploring issues in relationships with other people to help you understand and improve interpersonal situations.

The good news is that psychotherapy has been shown to be effective for most people with social anxiety disorder, which means most people get better with treatment. However, it can take several weeks to months, or even longer to notice changes.  In terms of medication, it can take some trial and error to find the right medication.  So stick with it, change takes time.

How can psychologists help people with social anxiety?

  • Psychologists educate people about social anxiety so they understand what it is and how to handle it.
  • Psychologists conduct assessments that help clarify diagnosis and develop a plan for tackling social anxiety.
  • Psychologists provide effective treatments, such as Cognitive Behavioural therapy (CBT).
  • Psychologists engage in research to help us better understanding social anxiety and improve treatments.
  • Psychologists can advocate for people with social anxiety. Currently, not every Canadian can freely and easily access evidence based psychological treatments for social anxiety disorder.
Psychology Works for Social Anxiety!

For more information:

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

You can find additional information and free self-help resources on social anxiety at:

This fact sheet has been prepared for the Canadian Psychological Association, in cooperation with AnxietyBC, by Dr. Melanie Badali and Dr. Kristin Buhr, Registered Psychologists at the North Shore Stress and Anxiety Clinic.

Date: June 29, 2018

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

Canadian Psychological Association
141 Laurier Avenue West, Suite 702
Ottawa, Ontario    K1P 5J3
Tel:  613-237-2144
Toll free (in Canada):  1-888-472-0657

“Psychology Works” Fact Sheet: Caregiver Stress

Caregiving can be a positive experience, but without proper support the stress associated with caregiving responsibilities can compromise the well-being of both the caregiver and the care recipient.

What does it mean to be a caregiver?

Carers (also called family caregivers or natural support) are those in the circle of care, including family members and other significant people who provide unpaid support to a person in need. It is estimated that 8.1 million Canadians (1 in 4) provide some level of care to a family member or friend with a chronic mental or physical illness or disability (Statistic Canada, 2013). Carers contribute $25 billion in unpaid labour to our health system (Hollander et al, 2009).

The degree of the unpaid carer’s involvement can vary over time and is dependent on the availability of external resources, on the needs of the care recipient, and on the caregiver him/herself (their needs and own capacity to help). Some care recipients may require assistance with only a few tasks, while others with more pronounced impairments may require continuous care and supervision for most or all activities of daily living. For example, the intensity of caring for elderly parents is often lower than caring for an ill child or spouse (Statistics Canada, 2012). Care needs can also fluctuate over time. Some conditions are time-limited and happen later in life (e.g., Alzheimer’s) while others can be life-long (e.g., mental illness, children with developmental challenges).

You may be caring for a loved one who has reduced physical, mental, emotional, social and/or cognitive ability due to age, accident, physical and/or serious mental illness.  Although most caregivers report providing care for one individual at a time, it is not uncommon to care for multiple friends or family members.  More than 1 in 5 (22%) Canadians reported more than one family member with a mental health problem in 2012 (Pearson, 2015).

As a carer, you may be expected to execute a variety of tasks such as:

  • Transportation and/or running errands
  • Feeding and/or preparing meals
  • Clothing, bathing/grooming
  • Managing toileting/Incontinence
  • Transferring/lifting
  • Managing difficult behaviours
  • Administering medication, assisting with medical treatments/therapies
  • Liaising with health providers
  • Assisting with indoor/outdoor property maintenance and household chores
  • Providing emotional support and coping strategies
  • Socialization
  • Monitoring safety of loved one
  • Monitoring comfort of others

These tasks may present themselves uniquely or jointly, and each has unique impact on your stress.

What are the causes and symptoms of caregiver stress?

As you provide care, you may experience symptoms of stress. If not properly addressed, stress may become chronic. This is especially true for long-term caregiving, such as for children with developmental disabilities or chronic illness, or for loved ones of any age with serious mental or chronic physical illness. The unpredictability of certain conditions can have a strong impact on the experience of stress; caregivers are not always able to control or predict the challenges associated with their caregiving responsibilities. This can be especially difficult for carers who do not adapt easily to unexpected situations.

Stress related to caregiving can be direct or indirect. It can result from the number, duration and intensity of the tasks associated with caregiving, as well as the loss or grief that are often associated with having a family member or friend with a chronic mental or physical illness or disability. Stress can also be associated with financial strain due to work disruption or costly treatment, conflicts in interpersonal relationships, poor health, and compromised social relationships. Indirect stress is not less important but may not be easily recognized at the outset of a caregiving cycle.

It is estimated that 6.1 million carers are juggling work and caregiving responsibilities. Fifty-percent of carers are between the ages of 45-65, their peak earning years (Statistics Canada, 2013). You may experience disruptions in work, such as unpaid time away or temporary absence from your career.

In certain caregiving situations, the illness or disability may impact the carer’s own physical or mental health as well as their emotional stability. Many caregivers report they neglect their own health needs, such as booking personal health appointments, skipping meals or eating a poor diet, not getting enough sleep, smoking, abusing substances, and not tending to psychological or emotional distress. Further, caregivers who are older, are of lower socioeconomic status, or have limited support networks appear to be at higher risk.

Other symptoms of caregiver stress may include:

  • Depression, anxiety, and/or irritability
  • Trouble concentrating
  • Disturbed sleep
  • Feeling exhausted despite adequate rest
  • A weakened immune system
  • Loss of interest in personal needs, desires, and pastimes
  • Increased feeling of resentment towards the care recipient and/or family/friends
  • Loss in satisfaction of being a caregiver
  • Feeling helpless, hopeless and isolated

Each of these factors, individually and collectively, can have a significant impact on the stress experienced by the caregiver.

However, caregiving can be a satisfying experience and most caregivers report some positive consequences for both the family and themselves (National Opinion Research Center, 2014). This includes stronger bonds and commitments, resourcefulness, pride and satisfaction, as well as growth and adaptation. Additionally, caregivers report a stronger sense of purpose in life, increased tolerance, empathy and compassion. Providing caregivers with information and support can help to enhance the positive aspects of caregiving experience and to reduce the stress associated with it

How can I reduce my caregiving stress?

Counselling, therapy, Mindful meditation, yoga, journaling, and/or having a pet, are some ways that can reduce caregiver stress.

Communicate your concerns and needs with others. Consider seeking out local organizations, support groups, and associations that assist with caregiving. They may be able to connect you with resources, allowing you to share responsibilities.  Meeting with other caregivers with similar situations may help to break isolation and share difficult experiences. Social media platforms can be an important way to connect with others, especially when the caregiver cannot get out of the house or is isolated.

By sharing your concerns and needs you are less likely to feel that you are isolated in providing care. This will give you an opportunity to assess your emotional wellness. It will also give you an opportunity to assess how you feel concerning your caregiving responsibilities. While under certain circumstances you have no choice but to fulfil your caregiving responsibilities, you may like to learn that it is okay to say “no” when you are feeling overwhelmed. Accept that your feelings and needs are legitimate; they affect your health and your ability to provide needed care.

Ask for and accept help from family or friends. If help is not actively offered, talk with family or friends who would be able to help. You may find it less stressful if a few people participate in dedicated responsibilities. It is important to share responsibilities when other people are involved in caregiving. This ensures that everyone involved feels comfortable and competent to carry their responsibilities.

Be mindful of your physical and mental health. Keep up with personal health appointments, eat a balanced diet, and ensure that you are getting enough sleep. It is recommended to set aside at least 30 minutes four times a week for exercise. It is important to take a break from your responsibilities to reduce physical and mental exhaustion. Arrange some time each week to socialise or engage in hobbies/leisure activities. Focus on the things that are within your control and approach your responsibilities with a positive and self-compassionate attitude. Self-compassion and positive thinking have been found to be effective defenses against chronic stress and burnout.

How can psychologists help with caregiver stress?

Caregivers are often engaged with many healthcare providers, including physicians, psychologists, nurses, physiotherapists, social workers and home support workers, among others. They can also help with stress reduction strategies.

A psychologist can assist you in the process of recognizing the loss and grief that are often associated with caregiving. Proactive stress reduction is important so that you can sustain your own well-being and better fulfill your caregiving duties.  This, along with support and education about your loved one’s illness and its course can ease some of the negative consequences of caregiving.

Therapy can also help you find positive aspects of caregiving, both for the family and for yourself. At times in caregiving, some difficult relationship dynamics can develop.  A psychologist can assist carers and the person needing care to have conversations that lead to greater understanding and awareness of both people’s needs, thus reducing stress.

You may benefit from psychotherapy such as cognitive behavioural therapy (CBT), interpersonal therapy, or psychodynamic therapy. All forms of psychotherapy allow you to deal with your stress, concerns, worries and other symptoms with a therapist, in a secure environment.

  • In CBT, your therapist will guide you through thoughts and behaviours that are self-defeating and pose a negative influence on your life. The goal of CBT is to provide you with the skills to challenge these negative thoughts and maladaptive behaviours. By minimizing the influence of negative thoughts and behaviours, you will be able to develop a balanced perspective on the events that occur every day in your life and surrounding environment.
  • Through interpersonal therapy, you will learn to self-evaluate any challenges that you may have in communicating your needs with others. The goal is to improve communication skills so that your intentions are understood, and your needs are met. This can help reduce certain burdening feelings associated with caregiving. It will also help to strengthen your relationships with family, friends, the care recipient and any supporting resources that can assist you with caregiving.
  • Through psychodynamic therapy, you can uncover unconscious feelings that are negatively influencing your mood and attitude. The goal of this therapy is to allow you to recognize, understand, and manage these unconscious feelings. This therapy has been found to be less effective than CBT and Interpersonal therapy in treating caregiver stress and depression.

Some carers experience symptoms severe enough to consider medication. Selective serotonin reuptake inhibitors (SSRIs) are the preferred antidepressant for treating depression resulting from caregiver stress. SSRIs influence the balance of serotonin in the brain, which helps with mood regulation; common side effects of SSRIs include agitation, dry mouth, drowsiness, nausea, and dizziness to name a few. Medication prescribed by a physician may be combined with any of the psychotherapies mentioned.

Where can I get more information?

The Canadian Mental Health Association – provides helpful information and resources to people caring for a loved one with a mental illness:
http://www.cmha.ca/mental-health/find-help/family-and-caregiver-support/

The Canadian Home Care Association – provides helpful information and resources for caregivers:
http://www.cdnhomecare.ca/content.php?doc=223

American Psychological Association (APA) – provides helpful information and resources for caregivers:
http://www.apa.org/search.aspx?query=caregiver
http://www.apa.org/search.aspx?query=caregiving

Provincial associations of psychology – provides access to information from psychological associations for each province or territory:
https://cpa.ca/public/whatisapsychologist/ptassociations/

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/

References

Pearson, C. (October, 2015). “The Impact of Mental Health Problems on Family Members,” Health at a Glance, Statistics Canada catalogue no. 82-624-x, http://bit.iy/1Lio1HL.

Hollander, M. J., Lui, G., Chapell, N. L. (2009). Who Cares and How Much? The Imputed Economic Contribution to the Canadian Healthcare System of Middle-Aged and Older Unpaid Caregivers Providing Care to The Elderly, Law & Governance, 12(2): 42-49 /a

National Opinion Research Center. (May, 2014). Long term care in America: Expectations and realities. Retrieved from http://www.longtermcarepoll.org/PDFs/LTC%202014/AP-NORC-Long-Term%20Care%20in%20America_FINAL%20WEB.pdf

Portrait of caregivers, 2012 – Statistics Canada. https://www150.statcan.gc.ca/n1/pub/89-652-x/89-652-x2013001-eng.htm

Turcotte, M. (2013). Family caregiving: What are the consequences? Ottawa: Statistics Canada. Retrieved from: http://www.statcan.gc.ca/pub/75-006-x/2013001/article/11858-eng.pdf

This fact sheet has been prepared for the Canadian Psychological Association by Anna Beth Doyle, Concordia University and Ella Amir, AMI-Quebec.

Date: July 2018

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

Canadian Psychological Association
141 Laurier Avenue West, Suite 702
Ottawa, Ontario    K1P 5J3
Tel:  613-237-2144
Toll free (in Canada):  1-888-472-0657

“Psychology Works” Fact Sheet: Enuresis and Encopresis in Children

“Psychology Works” Fact Sheet: Enuresis and Encopresis in Children

What are enuresis and encopresis?

Enuresis means urinating (peeing) where you shouldn’t (e.g., in bed or in clothing). Encopresis means defecating (pooping) where you shouldn’t (e.g., in clothes or on the floor). To have enuresis or encopresis:

  • A child must be old enough to be toilet trained, meaning 5 years old or older for enuresis and 4 years old or older for encopresis. Children younger than this probably just need more time to learn. You can look at our resources below on toilet training for more ideas on helping these children.
  • The wetting or soiling (pooping) must also happen regularly. That means at least twice a week for enuresis and once a month for encopresis.
  • The wetting or soiling must also happen That means this problem must happen for at least 3 months.

Some  children with enuresis only have problems at night (bedwetting), referred to as nocturnal enuresis. Enuresis and encopresis are separate problems, but they can sometimes occur together.

Enuresis is fairly common in young children, affecting about 5-10% of 5-year-olds. Enuresis becomes less common as children get older, but about 1% of those over 15 years old have it. Encopresis is less common, with about 1% of 5-year-olds having it.

It is important to know that children almost never wet or soil their clothes  to upset you! Most children would rather be able to use the toilet properly.

Why does my child have enuresis or encopresis? What are the risk factors?

There are many reasons children may develop enuresis or encopresis. Some common risk factors are:

  • Lack of toilet training. Although some children seem to learn without being taught, many need someone to clearly teach them to use the toilet.
  • Toilet training before the child was ready.
  • Stress (e.g., birth of a younger sister or brother, moving, new daycare, etc.).
  • Constipation (difficulty pooping) or pain when pooping.
  • Eating too much “junk food” and not enough fibre (e.g., fruit, whole grains).
  • Not drinking enough.
  • Family history of enuresis (especially for bedwetting).
  • Bladder infections.
  • Distractibility (a distractible child may not listen to their body telling them they need to pee or poop).
  • Anxiety about toilets, germs, bathrooms, or separation from mom or dad.

Sometimes the cause of a child’s enuresis or encopresis is unknown.  All we can do is try to help them cope with it and treat it as best we can.

Why are enuresis and encopresis a problem?

Children with encopresis or enuresis may develop low self-esteem, feel anxious or sad, and struggle with behavioural problems. Some children with encopresis or enuresis may feel alone and embarrassed, and may be teased by other children. Children with encopresis or enuresis may also struggle with learning and school, and tend to miss more school than their peers.

Encopresis and enuresis can also have a negative impact on the family. Having a child with encopresis or enuresis can be stressful for parents. They often worry about their child being teased at school and about what other families may think. Parents of children with encopresis or enuresis may feel judged, alone, anxious, and helpless. Parents may also become frustrated with their child and the other parent, which can be hard on their relationships.

How can psychologists help children with enuresis and encopresis?

Children with enuresis and encopresis often benefit from seeing a psychologist. Many children with enuresis and encopresis get better with time even without treatment. For these children, treatment simply helps it happen faster.

Psychologists can:

  • Help children become aware of the signs their body uses to tell them they need to go to the bathroom.
  • Explain enuresis and encopresis to families in a way that helps them see the accidents as the problem instead of placing the blame on the child.
  • Provide behavioural treatment to encourage the child to use the toilet.
  • Help parents guide their children in healthy eating and drinking habits that are important for bowel and bladder control.

There are many treatment options available for enuresis and encopresis.  Medical treatments can help and are sometimes necessary (e.g., the use of laxatives or enemas). Behavioural treatments have longer lasting results in treating enuresis and encopresis. Examples of common treatment approaches include:

  • Dry bed training with a urine alarm for treating bedwetting. This approach involves having the child wake up in the night on a bathroom schedule and using an alarm to wake the child up if an accident happens. It is also important to praise the child when they stay dry!
  • Enhanced Toilet Training for encopresis. This approach combines the use of a toileting schedule, modeling how to properly poop to the child, rewards, education on which body parts are involved with pooping, and medication.

Listed below are some ways parents and caregivers can help. See a psychologist for more support in using these:

  • Reduce shame: When children poop and pee in inappropriate places such as their pants, they frequently feel shame and embarrassment. Parents may accidentally add to these feelings by showing their frustration, anger, or disappointment towards the child when accidents occur. This shame and embarrassment can lead to children having more difficulty with using the toilet. Talking about the issue in a way that externalizes the toileting difficulties (e.g., “That tricky poop is causing us some problems, isn’t it?”) helps to take the blame off of the child.
  • Encourage and model healthy habits: Healthy, fibre-filled foods and fluid intake play a key role in helping children struggling with enuresis and/or encopresis. It is important to explain to children how what we eat and drink is related to our bowel and bladder control. Knowing that children are constantly learning from watching others, we can be helpful with healthy eating examples.
  • Help your child identify their need to go: We know that our bodies give us clues when we need to pee or poop. Children with enuresis or encopresis may not notice these. We can help by pointing out these signs to children in a clear, non-judgmental way. For example, saying, “Your legs are crossed. That might mean you need to pee. Let’s go!”

Are there other professionals we should see?

Medical doctors and nurse practitioners can help rule out other causes of your child’s wetting or soiling. They can also help your child with constipation and pain when pooping.

Dieticians can help with ideas for a healthy, fibre-filled diet to help maintain your child’s ability to poop regularly.

Physiotherapists can help your child strengthen the muscles needed to hold pee and poop in. They can also help children learn to pee and poop on command (learn to open and close their sphincters voluntarily) and can help your child figure out when they need to go.

Where do I go for more information?

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

 

This fact sheet has been prepared for the Canadian Psychological Association by Dr. Jennifer Theule, Brenna Henrikson, and Kristene Cheung, University of Manitoba

Date: February 7, 2019

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

Canadian Psychological Association
141 Laurier Avenue West, Suite 702
Ottawa, Ontario    K1P 5J3
Tel:  613-237-2144
Toll free (in Canada):  1-888-472-0657

“Psychology Works” Fact Sheet: Health Anxiety

What is health anxiety?

Most people have felt anxious about their health or the health of loved ones at some point in their lives. In fact, we are often faced with health situations in which it is entirely appropriate to feel some anxiety. For example, you may be waiting for the results of a biopsy or your friend may have just been diagnosed with a serious illness. It is natural to feel anxious and upset in these situations. Similarly, most of us worry about death and dying from time to time. Experiencing anxiety about illness and death is normal.

Worries about health and dying can become a problem if they get in the way of living and enjoying life. Health anxiety involves fears of having or developing a serious disease such as cancer, heart disease, or multiple sclerosis. Health anxiety is often associated with high levels of worry, substantial focus on bodily symptoms, repeated checking for signs and symptoms related to health concerns, focus on death and dying, and frequent efforts to obtain reassurance from family members, friends, or health care professionals. Some people with health anxiety avoid going to doctors because of fears of being diagnosed with a serious disease or because of dissatisfaction with previous health care experiences. Individuals with health anxiety may also avoid other situations related to illness and death, including activities such as spending time with loved ones who are ill, attending funerals, and writing a will.

Worries about health may be triggered by experiences such as everyday symptoms (a skipped heartbeat, a headache), a frightening experience such as finding a breast lump, or coping with illness or death of a loved one. Anxiety may also be triggered by stories about health issues in the community or media. Worries may be mild and transient or they may have a more severe and chronic course, waxing and waning over time. Some individuals may worry about one specific illness or body symptom, while others worry about many. Health anxiety can occur on its own and may then be termed illness anxiety disorder.  It may also be part of other problems such as panic disorder, generalized anxiety disorder, obsessive-compulsive disorder and depression. People who have diagnosed medical conditions may also experience high levels of anxiety as a reaction to their health problems. In some circumstances, the level of health anxiety may be excessive and may interfere with normal functioning and enjoyment of life.

How prevalent is health anxiety?

Estimates suggest that 3-10% of the general population suffer from significant health anxiety. Up to 30% of the population experience intermittent or milder fears about their health. This is a relatively common problem and one that can cause significant interference. It can also be costly to the health care system when it results in high levels of health service utilization.

What are the main causes of health anxiety?

There are a variety of factors that may contribute to the development and onset of problems with health anxiety. These include:

Genetics: Some people are born with a temperament that leads them to be more prone to experiencing anxiety than most people. In addition, most forms of anxiety run in families to some degree.

Family background and childhood experiences: Individuals who experience a stressful family life during their childhood (such as family conflict, high family stress, or abuse) are more likely to develop problems with anxiety and depression. People who have problems with anxiety in general may be more likely to also have worries and fears about health and illness.

Social Learning: We can learn many things from our parents, siblings, or other significant people in our lives. Sometimes these lessons can be positive but at times we can pick up negative things from those around us. Children often model what their parents or siblings do. For example, if an anxious parent avoids a range of situations, children watching this are likely to behave in similar ways (i.e., engaging in avoidance).

Parents or other important people can also pass on fears through verbal communication. For instance, fearful or anxious people may be overly concerned about potential dangers and often communicate these fears to their children by saying certain things, such as: “If you have a stomach ache you had better stay home and be in bed until you feel better” or “Did you hear about Sally – she was fine one day then she was diagnosed with brain cancer, and now she’s dead”.  In this case, viewing health as fragile and illness as painful and deadly may lead a child to become focused on health concerns, avoid certain situations, or worry excessively about illness and death.

Illness and death experience: Health anxiety may also be related to stressful experiences with illness and death in childhood or during the adult years.

What psychological treatments are used to treat health anxiety?

The primary psychological treatment that has been shown to be effective with this problem is cognitive-behavioural therapy (CBT). This treatment involves:

  • understanding anxiety and how problems with anxiety can develop;
  • decreasing specific behaviours such as checking one’s body for symptoms and asking for reassurance about one’s health;
  • learning how to counter the excessive worries about health and illness;
  • overcoming avoidance of situations related to illness and death using exposure strategies;
  • learning to face worries about illness realistically and directly which can reduce the fear associated with these thoughts;
  • coping with fear of death by emphasizing the importance of accepting the reality of death and enjoying life to the fullest; and
  • general anxiety management strategies such as relaxation techniques and increasing exercise.

How effective are psychological methods of treating health anxiety?

Research demonstrates that cognitive-behavioural treatment is helpful in reducing fears about having and/or getting a serious illness. Studies show that individuals receiving from 6 to 20 treatment sessions generally report decreased illness fear and a reduction in accompanying depression. Both individual and group treatments are effective.

Where do I go for more information?

For the public:

For the professional:

  • Treating Health Anxiety and Fear of Death: A Practitioner’s Guide. By P. Furer, J.R. Walker, & M.B. Stein (2007). New York: Springer.
  • Treatment of Health Anxiety and Hypochondriasis: A Biopsychosocial Approach. By J. Abramowitz & A. Braddock (2008). Ashland, OH: Hogrefe & Huber.
  • Treating Health Anxiety: A Cognitive-Behavioral Approach. By S. Taylor & G.J.G. Asmundson (2004). New York: Guilford Press.
  • Tackling Health Anxiety: A CBT Handbook. By H. Tyrer (2013). London: RCPsych Publications.

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

 

This fact sheet has been prepared for the Canadian Psychological Association by Patricia Furer, Ph.D., C.Psych., Dept. of Clinical Health Psychology, University of Manitoba.

Revised: June 2020

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

Canadian Psychological Association
141 Laurier Avenue West, Suite 702
Ottawa, Ontario    K1P 5J3
Tel:  613-237-2144
Toll free (in Canada):  1-888-472-0657

Articles & Resources from BMS

BMS logoBMS is producing an ongoing series relating to COVID-19.


Canadian Journal of Behavioural Science Call for Nominations – Editor: 2021 – 2025

The Board of Directors of the Canadian Psychological Association (CPA) has opened nominations for the Editorship of Canadian Journal of Behavioural Science for the years 2021-2025. Candidates must be members of the CPA and should be available to start receiving manuscripts July 1, 2021 to prepare for issues to be published in 2022.

To self-nominate or nominate candidates, prepare a brief statement of approximately one page in support of the nomination. Nominations, accompanied by the nominee’s vitae, should be submitted before January 22, 2021 to:

Dr. Lisa Votta-Bleeker
ATTENTION: Chair, CPA Publications Committee
Canadian Psychological Association
Email: executiveoffice@cpa.ca

Interested individuals may obtain more information directly from the Editor, Allison J. Ouimet via email at Allison.Ouimet@uottawa.ca.

Click here to download the announcement (PDF)


CPA webinar ‘COVID and the Canadian Winter’ now available on YouTube

The CPA webinar ‘COVID and the Canadian Winter‘ recorded on Thursday is now up on our YouTube channel. Featuring presenters Dr. Ben C.H. Kuo, Dr. Heather Hadjistavropoulos, Dr. Janine Hubbard, and Dr. Yael Goldberg speaking on racism, teletherapy, children, isolation & anxiety.


https://www.youtube.com/watch?v=wYYB8zkt39k&feature=youtu.be


The CPA is now receiving abstracts for its 2021 convention.


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.

Click here to submit an abstract.

  1. Deadline for submissions for 3- and 6-hour workshops extended to January 22nd, 2021.
  2. Deadline for submissions for all other presentation types is January 22nd, 2021.

CPA members, affiliates and non-members and non-affiliates are encouraged to submit!

If you have any questions, please consult the FAQ page.


“Psychology Works” Fact Sheet: Post-Traumatic Stress Disorder

Most of us have experienced at least one traumatic event in our life. The events can have long lasting impact on our life, on our sense of self and identity, our belief system and on our overall functioning, whether personal, social, or occupational. We might have constant distressing memories of the upsetting or traumatic event, have bad dreams, feel that we are constantly on guard for any signs of threat or danger, fear of an impending doom or something bad happening, feel emotionally numb, feeling withdrawn, not having much tolerance for stress or public, feel angry, irritable, anxious, ashamed or guilty, or feel excessively jumpy.

Trauma has an individual impact. Each person might experience and feel the symptoms of trauma differently. For some PTSD is associated with emotional dysregulation such as flashbacks, distressing memories of the trauma, feeling excessively jumpy and being constantly on guard whereas for others, it is related to emotional numbness and self-isolation.

The majority of individuals exposed to potentially traumatic events experience posttraumatic symptoms, shortly after the traumatic event. Over time, in particular within the first month or so, the symptoms tend to gradually improve. In some cases, however, the symptoms can increase over time, create more emotional and psychological distress and interfere with overall functioning. In the latter case, the symptoms might be reflective of diagnosis of posttraumatic stress disorder.

There are as well risk factors that can increase vulnerability to PTSD (e.g., childhood adversity and abuse; high stress), risk factors during PTSD (e.g., accumulations of traumatic incidents; lack of social support), and risk factors following PTSD (e.g., financial or relationships strains; physical injuries); and the risk factors can contribute to severity and duration of posttraumatic stress reactions and impact functioning and recovery. Furthermore, the risk factors that contribute to the development of PTSD are not the same risk factors maintaining PTSD.

If the symptoms do not improve over time, and exacerbate over time, in particular over a month, cause more distress or you feel that you have more and more difficulty engaging in your daily activities or responsibilities and/or the symptoms are impacting your overall functioning then you might be suffering from PTSD. In such case, seeking professional from a mental health professional such as a qualified clinical psychologist can be helpful.

What are the symptoms of PTSD?

The Diagnostic and Statistical Manual of Mental Disorders, 5th edition, DSM-5, (American Psychiatric Association, 2013)[1], defines PTSD and its four clusters of symptoms, including intrusive memories of the trauma, avoidance of trauma related stimuli, negative changes in mood or cognitions, and arousal symptoms.

PTSD symptoms[2] for adults, adolescents, and children older than six; symptoms must persist for more than one month:

  1. Exposure to actual or threatened death, serious injury, or sexual violence in one (or more) of the followings:
    1. Directly experiencing the traumatic event(s).
    2. Witnessing the event occurring to others
    3. Learning that the traumatic event(s) occurred to a loved one such as family member or a close friend; and in such case, the event(s) must have been violent or accidental.
    4. Experiencing repeated or extreme exposure to aversive details of the traumatic event(s). For instance, police officers conducting child abuse investigations. The exposure in this category is work related.
  2. Intrusion symptoms:
    1. Recurrent, distressing and intrusive memories or images of the traumatic event(s).
    2. Distressing dreams or nightmares related to the traumatic event.
    3. Flashbacks, a sense of reliving the event or acting or feeling as if the event were recurring. Note: children may re-enact the event in their play.
    4. Experiencing psychological distress following any triggers related to the traumatic event or any cues that might resemble the event.
    5. Experiencing physiological reactions following triggers. For instance, heart pounding, sweating, and/or chest pain.
  3. Persistent avoidance:
    1. Avoidance of distressing memories, thoughts, or feelings about the trauma.
    2. Avoidance of reminders of the trauma. For instance, location, going out alone, conversations, some people or objects, some materials on TV, and/or activities related to the event. It also not uncommon to engage in safety behaviours such as leaving the house always accompanied; when sitting in public, ensuring the back is against the wall.
  4. Negative alterations in cognitions and mood:
    1. Inability to remember certain important aspect of the traumatic event(s).
    2. Exaggerated negative beliefs about self, others or the world. For instance, “I am a failure”, “I am weak”, “I cannot trust anyone”, “the world is completely dangerous no matter where you go or what you do”.
    3. Distorted cognitions about the cause or consequences of the traumatic event. In such case, it leads to either blaming self and/or blaming others. For instance, “it is my fault it happened”, “I should have done this, done that”.
    4. Persistent negative emotions such as feeling constant anxiety, guilt or shame.
    5. Diminished interest in activities or hobbies previously enjoyed
    6. Feeling emotionally numb or emotionally distant or cut off from others. For instance, you know you love your family but feel emotionally distant or numb and have difficulty feeling the love.
    7. Inability to experience positive emotions such as feeling happy or love.
  5. Marked alterations in arousal:
    1. Irritable behavior and angry outbursts. It could be either verbal or physical
    2. Reckless or self-destructive behavior. For instance, if alcohol is consumed excessively to reduce distress then that can also be a type of self-destructive behaviour.
    3. For instance, feeling constantly on guard for signs of threat or danger.
    4. Exaggerated startle response. For instance, feeling excessively jumpy at any sound or noise.
    5. Difficulties with concentration, focusing or attention or memory.
    6. Sleep disturbance. For instance, difficulty falling or staying asleep; early morning awakening.

The American Psychological Association (APA)[2] developed a guideline that provides recommendations on psychological and pharmacological treatments for posttraumatic stress disorder (PTSD) in adults. The guideline is based on recommendations of the Institute of Medicine report, Clinical Practice Guidelines We Can Trust (IOM, 2011).

Among many recommendations, strong recommendations are provided for the following interventions:  cognitive behavioral therapy (CBT), cognitive processing therapy (CPT), cognitive therapy (CT), and prolonged exposure therapy (PE). For pharmacological treatment, there are recommendations for fluoxetine, paroxetine, sertraline, and venlafaxine. There are significant individual differences as well as comorbidities among mental health conditions and comorbidities between mental and physical health conditions. Co-morbidities such as depression, anxiety disorders, substance use disorders, personality disorders, or and/psychosis are common. Thus, a comprehensive assessment to help with a comprehensive case conceptualization and whole person management approach can subsequently help towards optimizing treatment options for each person. It is recommended to always consult with your mental health professional and prescribing physician for any pharmacological treatment that might help concurrent with evidence-based psychological treatment.

Self-care, including for instance, balanced healthy diet, proper sleep hygiene, exercise, seeking quality support, managing thoughts and emotions, setting meaningful and realistic graduated goals, active problem solving, and remaining hopeful are among the many proactive strategies that help towards health, quality of life and well-being.

Where do I go for more information?

You can consult with a registered psychologist to find out if psychological interventions might be of help to you. Provincial, territorial, and some municipal associations of psychology often maintain referral services. For the names and coordinates of provincial and territorial associations of psychology,

More information about PTSD/treatment of PTSD can be found at:

Where can I get more information about psychology/psychologists?

Provincial associations of psychology:  https://cpa.ca/public/whatisapsychologist/PTassociations/

Psychology Foundation of Canada: http://www.psychologyfoundation.org

American Psychological Association (APA): http://www.apa.org/helpcenter

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. Katy Kamkar, Ph.D., C. Psych, Clinical Psychologist & Chair, Canadian Psychological Association, Traumatic Stress Section.

Date: August 2020

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

Canadian Psychological Association
141 Laurier Avenue West, Suite 702
Ottawa, Ontario    K1P 5J3
Tel:  613-237-2144
Toll free (in Canada):  1-888-472-0657


[1] American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders. (5th ed.). Author: Washington, DC.

[2]Clinical Practice Guideline for the Treatment of Posttraumatic Stress Disorder (PTSD) in Adults American Psychological Association. Guideline Development Panel for the Treatment of PTSD in Adults. Adopted as APA Policy February 24, 2017 https://www.apa.org/ptsd-guideline


“Psychology Works” Fact Sheet: Climate Change and Anxiety

Experiencing Anxiety Related to Climate Change

Climate change is a “long-term change in the average weather patterns that have come to define Earth’s local, regional, and global climates.”[1] Because of the uncertainty and severity of climate change, people are seeking treatment for negative feelings related to climate-related events and the future of our planet.  These negative feelings may include a sense of powerlessness and hopelessness about the current and future state of the natural environment, one’s own quality of life in relation to climate-related events, and about general human health and wellbeing.

What Contributes to Anxiety Related to Climate Change?

Feelings of anxiety about the state of the Earth’s climate can be experienced before, during, and after a climate-related event[2]:

Before a Climate-related Event

Warnings of climate-related events, such as hurricanes, storms, and wildfires, can cause acute worry about personal safety, the safety of loved ones, and/or the safety of homes and other property. Worry may also be experienced when people consider the possibility of impending and serious environmental problems—in the body of environmental psychology literature, this is known as habitual ecological worrying[3]. Individuals experiencing this type of worry may cope better by adopting pro-environmental attitudes and actions. Sometimes this form of worry can become less constructive if it is associated with feelings of loss, helplessness, frustration, and an inability to improve the situation. In the environmental psychology literature, this is known as eco-anxiety.[4]

During a Climate-related Event

Human mental health can be significantly affected during a rapid climate-related event. Victims of these events may quickly and unexpectedly lose property and belongings. Some may also lose family members and friends to disasters caused by climate change. Human mental health can also be impacted by climate-related events that occur gradually over time. For example, those who live in areas of the world where climate change has significantly affected landscapes and livelihoods tend to report a deep sadness, or solastalgia, about environmental change.

After a Climate-related Event

When a loss of friends and family, community, homes and belongings, employment, and economic certainty occurs because of a climate-related event, the results can be far-reaching and long-lasting. Outcomes may include depression, post-traumatic stress disorder (PTSD), grief, despair, aggression, interpersonal difficulties, substance abuse, and even suicide. In some cases, individuals may develop a condition called the climate change delusion,[5] characterized by a belief that one’s actions, no matter how insignificant, will have a serious negative effect on those suffering through climate-related events.

Who is Most Vulnerable?

Gifford and Gifford (2016) reference studies indicating that anxiety related to climate change tends to strongly affect children, older adults, individuals with pre-existing mental health conditions, and people with fewer economic resources. For example:

  • Children with anxiety about climate change may experience symptoms such as low mood, anxiety, nightmares, flashbacks, social withdrawal, and difficulty being separated from caregivers. These symptoms have been shown to be more severe in children than adults and may persist later in life.
  • Older adults can be more physically vulnerable to changes in the climate around them, and are sometimes less able to employ effective coping mechanisms, such as pro-environmental behaviours, during times of distress.
  • People with fewer economic resources may also be more vulnerable to climate-related events as a result of their living conditions, employment conditions or status, a lack of access to resources, goods and services, and inability to engage in pro-active eco-conscious behaviours.
  • Individuals living in countries with fewer resources available to protect people against the ramifications of climate-related events may become more severely affected by climate change.

How can Psychologists Help People who are Experiencing Anxiety about Climate Change?

Psychologists have the knowledge and expertise to help people process the negative effects of climate change on mental health, as well as to encourage effective and positive behavior.[6]

Psychological Practice and Services

Although some people may cope with their concerns about climate change by engaging in some form of climate-related activism (e.g., avoiding the use of single-use plastics, recycling, using less water, and so on), others may cope by disengaging or worrying excessively. Psychological therapies can help individuals experiencing anxiety about the climate to gain control over their worries, decrease their anxiety, and improve their overall quality of life. Therapies that can be effective are:

  • Cognitive re-evaluation therapy to help correct thinking patterns that cause and increase worry
  • Problem-solving training to learn better ways to solve everyday problems
  • Exposure therapy to help confront and control, rather than avoid and be controlled by, fear
  • Progressive relaxation to help decrease some of the physical symptoms of anxiety.[7]

For children, youth and young adults who have experienced a climate-related event or are experiencing anxiety about the climate, psychologists working in schools, colleges, and universities are available for support in school and academic settings.

Psychological Science

Psychological research can provide answers to existing and emerging climate-related questions. Whether the focus is to change destructive behaviors, like minimizing the use of motor vehicles, or to embrace beneficial actions, like using public transit, psychological research is key to understanding how people think about the environment and economic issues.[8]

Advocacy

Individuals, organizations, and all levels of government have a critical role to play in both understanding and addressing the relationship between climate change, health, the economy, and the behaviour of individuals. Effective responses to climate change will require promoting behavioural change at the individual and collective levels. Environmental psychologists can assist organizations and government in the development of education programs and public policies that overcome the discrepancies between what people understand about climate change and their everyday behaviours related to the environment.[9] For those experiencing anxiety and other mental health issues, appropriate funding for mental health services at all levels of society is important.

Knowledge Mobilization

To increase awareness of climate change as well as promote more responsibility and behaviour change on the part of Canadians, understanding how people process information and make decisions is important. Accurate and consistent information about climate change should be provided to individuals by trusted and knowledgeable organizations in an encouraging manner. Messages should be motivating and focus on the positive outcomes of prevention strategies, rather than be discouraging or frightening.

For More Information:

More information on the intersections between psychology and climate change can be found in these references:

  • Gifford, R. (2011). The dragons of inaction: Psychological barriers that limit climate change mitigation and adaptation. American Psychologist 66, 290–302.
  • Steg, L., & Vlek, C. (2008). Encouraging pro-environmental behaviour: An integrative review and research agenda. Journal of Environmental Psychology, 29, 309-317.

You can consult a registered psychologist to find out whether psychological interventions might be helpful for you. For the names and locations of provincial and territorial psychological associations, please visit https://cpa.ca/public/whatisapsychologist/PTassociations/

This fact sheet has been prepared for the Canadian Psychological Association by Dr. Lindsay J. McCunn, Vancouver Island University, Mr. Alexander Bjornson, Vancouver Island University, and Dr. Robert Gifford, University of Victoria.

Date: December 1st, 2020

Please contact us with questions or comments about any of the Psychology Works Fact Sheets at factsheets@cpa.ca

Canadian Psychological Association
141 Laurier Avenue West, Suite 702
Ottawa ON K1P 5J3
Tel: 613-237-2144 or toll free (in Canada): 1-888-472-0657


[1] https://climate.nasa.gov/resources/global-warming-vs-climate-change/

[2] Gifford, E., & Gifford, R. (2016). The largely unacknowledged impact of climate change on mental health. Bulletin of the Atomic Scientists, 72, 292-297.

[3] Verplanken, B., & D. Roy. (2013). ““My worries are rational, climate change is not”: Habitual ecological worrying is an adaptive response.” PLoS ONE, 8 (9), e74708.

[4] Rabinowitz, P. M., & A. Poljak. (2003). “Host-environment medicine: A primary care model for the age of genomics.” Journal of General Internal Medicine, 18 (3), 222–227.

[5] National Wildlife Federation. (2011). The psychological effects of global warming on the United States and why the U.S. mental health care system is not adequately prepared. National Forum and Research Report, February 2012. https://www.nwf.org/pdf/Reports/ Psych_Effects_Climate_Change_Full_3_23.pdf.

[6] https://www.theguardian.com/environment/2020/oct/08/anxiety-climate-crisis-trauma-paralysing-effect-psychologists

[7] https://cpa.ca/docs/File/Publications/FactSheets/PsychologyWorksFactSheet_GeneralizedAnxietyDisorder.pdf

[8] https://cpa.ca/docs/File/Government%20Relations/Canadian%20Psychological%20Association’s%202020%20Pre-Budget%20Submission.pdf

[9] https://cpa.ca/docs/File/Government%20Relations/Canadian%20Psychological%20Association’s%202020%20Pre-Budget%20Submission.pdf

“Psychology Works” Fact Sheet: Depression Among Seniors

What are the symptoms of depression in older adulthood?

The Canadian Psychological Association’s fact sheet on Depression lists the symptoms of depression. These symptoms also identify depression in older adults. Symptoms typically manifested by older adults suffering from depression include loss of energy, decreased interest and pleasure in usual activities, pain and somatic complaints, and complaints of memory problems.

Who is affected?

Depression should not be seen as the unavoidable fate of older age. Still a number of seniors experience depression. On the one hand, the rate of major depression in older adults is relatively low, touching 3-5% of older adults aged 65 and over living in the community. On the other hand, the prevalence of symptoms of depression in this population is significantly higher, with about 15% of older persons in the community reporting significant levels of depressive symptoms

Some subgroups of older adults present a higher risk for depression, in particular individuals afflicted by chronic disease, older adults living in long-term care and nursing homes, and those providing care for a family member (e.g., to a partner suffering from dementia).

What are the other problems associated with depression?

Depression increases the risk of death in older adults by 2 to 3 times. Depression constitutes the most important factor associated with risk of suicide in old age.

Depression amplifies the functional disabilities produced by physical illness, interferes with treatment and rehabilitation, and further contributes to decline in physical and cognitive functioning.

Why is depression often missed and/or under-treated among seniors?

Depression can be hard to detect in older adults for several reasons. Older adults are often reluctant to admit to psychological symptoms or difficulties and are more likely to communicate their psychological distress by complaining of physical symptoms. Several symptoms of depression (e.g. sleep problems, feeling fatigued, and lack of energy) also naturally occur in older adulthood; as such, in some cases these symptoms may be mis-attributed to normal aging rather than depression. Also, the myth that it is normal for older adults to feel some amount of depression may result in true cases of clinical depression being overlooked.

What are the causes of depression in later life?

A history of depression in earlier adult life is a risk factor for depression in later adulthood. Chronic health problems and the loss of spouse, especially for men, can be associated with depression. Major depression may also occur after experiencing a cerebrovascular accident (stroke).

Factors such as loss of control and independence as the result of illness and/or disability, loneliness, and lack of social support can also lead to depression in older age.

What psychological approaches are useful to treat depression among seniors?

Several psychological treatments for depression used with young and middle-aged adults are also effective with older adults. In particular, cognitive behaviour therapy, interpersonal therapy, problem- solving therapy and reminiscence therapy are treatments whose efficacy is supported by empirical research.

Cognitive-behaviour therapy helps individuals with depression become aware of how thoughts influence mood and behaviour and learn to correct negative ways of thinking in order to alleviate depression.

Interpersonal therapy helps the depressed person cope with current stresses and challenges in interpersonal relationships – in particular in the context of conflicts, grief and bereavement, changes in roles, and social support.

Problem-solving therapy helps individuals with depression develop effective problem-solving skills to cope with current difficulties, such as managing a health condition or adjusting to living in a nursing home.

Reminiscence therapy helps individuals with depression re-evaluate personal memories in order to rediscover a sense of worth and life coherence and meaning.

These psychological treatments are safe and effective alternatives to medications, with combined drug and psychological treatment often used for complex cases.

Psychological treatments can be particular useful for people who are unable to, or unwilling, to take antidepressant medications.

Where do I go for more information?

More information on depression in older adults, including more detailed descriptions of psychological treatments and other supports, can be found in the National Guidelines for Seniors’ Mental Health: The Assessment and Treatment of Depression, Canadian Coalition for Seniors’ Mental Health (2006).

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 Dr. Philippe Cappeliez, Emeritus Professor, School of Psychology, University of Ottawa.

Revised: March 2020

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

Canadian Psychological Association
141 Laurier Avenue West, Suite 702
Ottawa, Ontario    K1P 5J3
Tel:  613-237-2144
Toll free (in Canada):  1-888-472-0657

COVID-19 Worsening Canadians’ Access to Psychologists

CPA LogoCPAP logo

COVID-19 Worsening Canadians’ Access to Psychologists

December 2, 2020 (Ottawa) – With the significant impact COVID-19 is having on the mental health of Canadians, the Canadian Psychological Association (CPA) and the Council of Professional Associations of Psychologists (CPAP) asked Nanos Research to survey over 3,000 Canadians to better understand how they are managing their mental health and accessing care provided by psychologists.

“We are very concerned about the global pandemic’s impact on the mental health of Canadians, now and into the foreseeable future.  Canada had a crisis of access to mental health care before the pandemic.  Now, more than ever, we need to implement innovative and sustainable solutions – in the public and private sectors – to improve timely access to mental health care provided by psychologists when the people of Canada need it”, said Dr. Karen Cohen CEO of the CPA.

“While other public surveys tell us that Canadians’ mental health is in decline, we need to ensure that the public and private sectors have the policies, programs and services to meet this impending demand for mental health care”, said Mr. Christopher Cameron, CPAP Executive Director.  “Psychologists are highly trained professionals who can play a vital role in assessing, treating and managing one’s mental health.”

In a pandemic environment where face to face human contact is not an option, Canadians have a strong preference to be treated face-to-face by a psychologist.  The CPA, however, is encouraged that there is an openness to using technology.

The survey found:

Access to Care

  • 56% of Canadians report that COVID-19 has had a negative (33%) or somewhat negative (23%) impact on the ability of Canadians to access mental health care provided by psychologists.
  • At 73%, the majority of Canadians prefer to receive psychological services face-to-face. Although older Canadians (55+) are more likely to say they would prefer to receive services face-to-face (80%) than those 35 to 54 (70%), and 18 to 34 (65%).
  • 92% of Canadians report that they have not accessed services from a psychologist since the COVID-19 pandemic. Of note, older Canadians (55+) are less likely to report having accessed services (3%) than those 35 to 54, or 18 to 34 (11% each).
  • For those who accessed psychological care during COVID-19, 47% of Canadians report it was provided through private insurance, 26% from the public health system, or 26% from out-of-pocket expenses. The highest group paying out-of-pocket 55+ years (39%) is likely because in retirement fewer have employer-provided, private health insurance.
  • For those who accessed psychological care during COVID-19 (8%), 84% of Canadians report it was provided within a reasonable (50%) or somewhat reasonable (34%) period of time.
  • 85% of Canadians would be willing (58%) or somewhat willing (27%) to attend if an in-person assessment by a psychologist was needed for memory loss, stroke, brain injury, ADHD, or a learning disorder.

Virtual Care

  • With physical/social distancing rules in place, 71% of Canadians say they are willing (36%) or somewhat willing (35%) to use technology – like telemedicine – to receive mental health care provided by psychologists.
  • Of the 29% of Canadians who had concerns using technology to receive care provided by psychologists, they identified the following issues: (1) privacy/ confidentiality (8%); (2) barriers to establishing good communication (5%); (3) security/ hackers (4%); (4) prefer face-to-face (3%); (5) impersonal (2%); and (6) challenges using technology (2%).

Given the unprecedented times in which we live, we must invest and protect our most valuable assets…people.  Our first wealth must always be our mental health.  The CPA is committed to working collaboratively with all levels of government, employers and insurers so that Canadians receive evidence-based care where, and when, they need it.

To review the results in detail – which includes a breakdown by province and territory, gender and age, please visit our website:  cpa.ca.

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About the CPA

The Canadian Psychological Association is the national voice for the science, practice and education of psychology in the service of the health and welfare of Canadians.  The CPA is Canada’s largest association for psychology and represents psychologists in public and private practice, university educators and researchers, as well as students.  Psychologists are the country’s largest group of regulated and specialized mental health providers, making our profession a key resource for the mental health treatment Canadians need.

About CPAP

The Council of Professional Associations of Psychologists is comprised of 13 national, provincial and territorial psychology associations, and has four objectives: facilitating knowledge exchange amongst member associations; identify and share best practices amongst member associations; advocating for the needs of Canadian psychologists and the people that they support; and develop leadership potential and capacity in Canadian psychologists.

About the Survey

Nanos Research conducted a representative online survey of 3,070 Canadians, drawn from a non-probability panel between September 25th and October 2nd, 2020.  The results were statistically checked and weighted by age and gender using the latest Census information and the sample is geographically stratified to be representative of Canada.  The research was commissioned by the Canadian Psychological Association and was conducted by Nanos Research.

Contact: Mr. Eric Bollman
Communications Specialist
Canadian Psychological Association
(613) 853-1061
ebollman@cpa.ca(613) 853-1061


To view the national survey results, click HERE.

Provincial/Territorial Survey Results:


“Psychology Works” Fact Sheet: Psychological Interventions for Acute Pain Management in Children

What is acute pain?

Acute pain is typically described as a mild to intense sharp pain. It comes on quickly and lasts for a short period of time, usually providing a signal to the body that something is wrong. Experiencing acute pain is important because it is a part of our body’s built-in warning system. The experience of pain varies across individuals, which means that the same painful event can be felt very differently among children.

Pain is like a puzzle that is made up of different pieces. There is a biological piece (e.g., previous injuries can make a person more sensitive to pain), a psychological piece (e.g., memories of past pain experiences can impact future pain experiences) and a social experience piece (e.g., the people who are in the room with you can impact how much pain you feel and how much pain you actually express). Even within the same person, the impact each piece has can change from situation to situation or as someone matures over their life. So even the same painful event can be experienced by the same person differently at different points in time!

Common causes of acute pain in children include everyday bumps and bruises (e.g., when a child falls off a bike), routine medical procedures (e.g., getting a needle at the doctor’s office), and post-surgical pain (e.g., the pain following tonsil removal that often lasts days). A person’s report of pain must be respected and paid attention to, no matter how old the person is. Sometimes a child cannot tell us they are in pain because they are too young or have intellectual or developmental disabilities. However, a good rule of thumb is that anything that causes pain in adults will also cause pain in children. There are well-validated ways to help assess and understand the pain of infants, children, and teens.  

Assessment of acute pain in children

Scientists and clinicians know that pain is tricky to assess even in adults, so a lot of work has gone into trying to understand the best ways to measure pain in children. With infants, toddlers, and preschoolers, watching body language is often the best way. For example, the FLACC (Face, Legs, Activity, Cry, Consolability) scale instructs caregivers to focus on the infant/child’s grimacing face, flailing legs, arched body or squirming, if they are crying, and how easily they are consoled. If children are hospitalized, it’s possible to use physiological measures like heart rate or how much oxygen is circulating in the blood. The higher the heart rate or the lower the oxygen saturation in the blood, the more stress the child is in and the more pain we assume the child is experiencing. Some pain assessment tools used in the hospital, such as the PIPP-R (Premature Infant Pain Profile-Revised), incorporate both behaviours and physiology measures. Sometime around the age of 6 or 7 years, children are able to self-report their pain more reliably, so parents and health professionals should try to ask them about their pain. For example, the Faces Pain Scale – Revised[1] (see below) is a great way to ask early school-aged children about how much something hurts. For older children and teens, who may have a good understanding of how rating scales work, you can just use a numeric rating scale without any aids. For example, you could ask an older child or teen, “On a scale of 0 to 10, where 0 is no pain and 10 is the worst pain you can imagine, how much pain are you experiencing right now?”.

Why is acute pain a priority in children?

Acute pain occurs frequently in both healthy children and those with chronic illnesses. Although pain serves an adaptive role, it may have adverse effects on the body, mind and social wellbeing of children if left unmanaged. Through experience, children learn the concept of pain, and previous experiences of pain influence how they experience pain in the future. Without appropriate assessment and treatment, acute pain can change how a child processes pain. A fear of needle-related procedures and avoidance of medical appointments may also develop if pain is not properly managed. Sometimes, acute pain can even lead to longer-term pain (i.e., pain that lasts more than 3 months). For example, research has suggested that anaesthesia and analgesia during surgery is important as it may protect a child from longer term pain.

Psychological strategies for managing acute pain in infants, children, and teens

Whether you are the parent (or caregiver) of an infant, child, or teenager, research shows that you play a major role in helping your child prepare for and cope with acute pain experiences. The way your child depends on you for support might look different depending on how old your child is.

Managing pain in infants and toddlers

Since infants (< 2 years old) haven’t yet developed the abilities needed to understand why they are in pain or what they can do to feel better, they rely on their caregivers more than ever to help them make sense of and cope with the experience. Parents can help reduce acute pain in infants and toddlers. One strategy parents can use with their infants that does not require any preparation is as easy as ABCD! The ABCD approach requires parents to calm themselves to help them calm their child. The ABCD’s are:

  1. Assess your own anxiety. Your infant looks for hints from you to help them make sense of what’s happening. When you are calm, your infant is more likely to feel calm, too. If you have your child in your arms, your slow heartbeat will help you keep your child calm.
  2. Belly breathe if you are stressed. Take some slow deep breaths in through your nose and into your belly. Slowing your breathing will slow your heart rate which can help slow your infant’s breathing and heart rate.
  3. Use a calm, close cuddle with your infant. Your cuddle is extremely comforting to your infant, especially when used before, during, and after painful experiences. Depending on how old and active your infant is, this might involve skin-to-skin contact (holding your infant, dressed only in a diaper, against your bare chest, breastfeeding your child) or hugging your child while they sit in your lap or stand between your legs or while in your arms.
  4. Distract your infant at the right moment. Distracting your infant using a toy, book, bubbles, or song, or by talking to them about something unrelated to the pain can help him or her calm down, but you should wait 30-45 seconds for their crying to slow down and their eyes to open before you start the distraction. Infants might show you that they are not ready for distraction yet (by becoming more upset, pushing the toy away, or looking away in response to the distraction). If this happens, go back to cuddling.

Managing pain in younger children (3-10 years)

Between the ages of about 3 and 10, children are gradually learning what they can do to get themselves through painful experiences, but still rely heavily on their parent or caregiver taking charge of the situation. During this broad age stage, successful coping with pain will usually involves a combination of child-led and parent-led strategies, with a greater emphasis on the parent the younger the child is.

While there are strategies that will work at any age from about 3 to adolescence (described later on), children in this stage have some unique psychological considerations. Children in this stage might experience some anticipatory worries when they know a painful procedure is coming. To help prepare their child for a painful experience, parents can take some extra steps in advance of a planned painful procedure:

  • Decide when and how to share information with your child about an upcoming painful procedure. Younger children can be told the day of the procedure. Older children and teens should be told at least the day before, so that they can prepare coping strategies ahead of time and might benefit from learning about and practicing the steps involved in the procedure.
  • Answer your child’s questions honestly. For example, if your child asks if a needle will hurt, you might say “It might hurt a small or medium amount, but it will be over soon”.
  • Consider offering your child some choice in how their pain is managed, such as how they want to be distracted during the procedure, whether they want to hold your hand, and what they would like to do after the procedure. Offering choices to a young child is usually not helpful and might overwhelm the child. For older children, offering choices in advance (such as before you leave the house) helps them know what to expect and can help them feel more in control of the situation. They can also be motivated to get through the unpleasantness for a reward immediately after the painful procedure (e.g., lollipop) or in the near future (e.g., ice cream stop on the way home). In the below section are strategies that will work with children across childhood.

Managing pain in older children and teens (10+ years)

As children progress through the tween and teen years, they often take on an increasingly independent role in managing their pain. Although the preparatory strategies described above can help reduce the stress your child experiences before a procedure, they should always be used in combination with strategies for managing the pain while and/or after it occurs.

The following strategies can help reduce pain in children and teens during and after a painful experience:

  • Effective strategies for distracting your child will vary depending on their age, abilities, and interests, and might include blowing bubbles or pinwheels, playing with a toy or video game, watching a movie, listening to music, or using virtual reality technology. Generally speaking, the more actively the child is involved in the distraction activity, the more powerful the distraction will be.
  • Guided imagery. Through guided imagery, you can help your child use their imagination and senses to picture themselves in a different, more calming place. Guided imagery scripts for children of all ages are available online.
  • Belly breathing. Breathing exercises that involve diaphragmatic (or “belly”) breathing can be used with children to help them feel calmer during and after painful experiences. Children can be instructed to breathe in through their nose and into their belly (keeping a hand on their belly to check that it rises with each breath) and breathe out through their mouth.
  • Coping statements. Teaching children to use coping statements can help them think more positively and feel less negatively about the painful event. Having children repeat statements such as “I can get through this” or “I know the pain will go away”, aloud or in their head, can help them feel better. Reminding them after the painful experience about how well they did, how short the pain was, or how “worth it” the reward was will also help them build better pain memories for the future.

Parent behaviours to avoid

Sometimes despite the best intentions, parents overuse behaviours that have been linked to higher pain-related distress. Parents and caregivers should try to notice and limit their use of these behaviours:

  • Reassuring your child by saying things like “it’s ok” or “you’re fine” when your child is visibly distressed or before they are distressed. It can cause them to feel confused, increasing their distress, or it can signal to them that something scary is coming, because parents don’t usually reassure their child when things are fine.
  • Criticizing your child’s response to pain. Saying things like “your brother didn’t cry after his needle” or “big girls don’t cry” may teach a child that it is not okay to express pain when they are feeling it, increasing future distress and pain.
  • Apologizing for your child’s pain. Apologizing for your child’s pain when you are not the one who caused it can confuse your child. It can also suggest to him or her that their pain has caused distress for you, which can further increase their distress.

Where can I get more information?

Learn more about assessing and treating acute pain at the AboutKidsHealth Pain Hub, a health education resource for children, youth, and caregivers approved by The Hospital for Sick Children (https://www.aboutkidshealth.ca/pain). In addition to describing psychological strategies we mention in this sheet, this resource provides parent- and patient-friendly information sheets that describe important physical (such as using smells and sounds or massage) and pharmacological strategies (such as acetaminophen, sugar water, or numbing cream) that often add to the success of psychological strategies.

You can also 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 websites 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 Miranda Di Lorenzo, Shaylea Badovinac, and Dr. Rebecca Pillai Riddell, York University.

Date: November 24, 2020

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

Canadian Psychological Association
141 Laurier Avenue West, Suite 702
Ottawa, Ontario    K1P 5J3

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

[1] Faces Pain Scale – Revised. Copyright ©2001, International Association for the Study of Pain.

CPA’s 2020 Student Research Grants: Rules and Eligibility Criteria – DEADLINE NOV. 27th, 4pm!

CANADIAN PSYCHOLOGICAL ASSOCIATION STUDENT RESEARCH GRANTS : RULES AND ELIGIBILITY CRITERIA

APPLICANT ELIGIBILITY CRITERIA

The Canadian Psychological Association (CPA) wishes to support student research in all areas of psychology.

Funding up to $1,500.00 is available per project.  For 2020, a maximum of 10 awards will be dispersed.  Deadline for applications is Friday November 27, 2020 at 4pm EST.

At the time of application and if successful, over the term of the grant, the applicant/grantee must be a graduate student affiliate in good standing of the CPA; enrolled full-time in a psychology graduate program at a provincially or territorially chartered Canadian University. The applicant’s/grantee’s direct supervisor must also be a member in good standing of the CPA.

Students can only be funded once from this funding opportunity.

The adjudication committee will consider the following in evaluating proposals:

  1. Applicant’s Qualifications
    • Scholarships & Awards
    • Publications
    • Conference Presentations & Other Relevant Experience
  2. Merits of Proposal
    • Rationale & Background
    • Feasibility, Design & Methods
    • Potential Impact & Originality

NEW THIS YEAR!

CPA logoCSBBCS logo

One additional award valued at $1,500.00 will be given out to a proposal specific to the Brain and Cognitive Sciences; this award is financially co-sponsored by Canadian Society for Brain, Behaviour and Cognitive Science (CSBBCS).  To apply for this award, a student applicant/grantee and their supervisor must be an affiliate/member in good standing, at the time of application and over the term of the grant (if successful), of either the CPA or the CSBBCS.

APPLICATION REQUIREMENTS

Applications must be submitted electronically via this link: https://cpa.ca/machform/view.php?id=15577

Applications can be submitted in English or in French.

Application requirements include:

  1. An abstract of 250 words or less summarizing the research.
  2. A description (maximum 5 double-spaced pages including references, figures) outlining:
    1. the rationale and background, feasibility, design and methods, potential impact, and originality
  3. Status/proof of REB review process (i.e. acknowledgement/confirmation from REB that application has been received, process is underway, or approval has been granted)
  4. Specific amount requested, including an itemized budget.
  5. CV of applying student.
  6. A statement from the student’s department chair that the department supports the student’s application and will comply with the CPA’s rules for funds administration if the student’s application is successful. The letter must note that expenditures will only be authorized once REB approval or registration is obtained.  The appropriate University administrator’s name, email address, postal address, title and business phone number should be indicated.

Applications not meeting all of the proposal requirements will not be considered for funding.

RELEASE OF FUNDS

For funded projects, the CPA will release funds upon receiving a valid certificate of compliance from the Research Ethics Board (REB) of the applicant’s institution along with confirmation of affiliate status from the CPA’s Membership Department (or the CSBBCS’s Membership Department in the case of the CPA-CSBBCS Joint Award).

RESPONSIBILITIES OF GRANT RECIPIENTS

Successful applicants will be expected to provide a final (or progress) report to the CPA’s Scientific Affairs Committee (science@cpa.ca) of the outcome of their research (approximately 500 words) within 18-months of receiving funding. Successful applicants will also be expected to submit a 150-word write up of their research for Psynopsis, the CPA’s quarterly magazine. The CPA should be acknowledged in any publications or presentations resulting from the research.  Unused funds after the defense of the thesis must be returned to the CPA.

GENERAL RULES

  • Note that only one of the following grants can be held at any given time: CPA Student Research Grant, CPA Student Section Research Grant, BMS-sponsored Research or Leadership Grant. Eligible students can apply for one or more of these grants but can only hold one grant.
  • At the time of application and if successful, over the term of the grant, the applicant/grantee must be a graduate student affiliate in good standing of the CPA (or the CSBBCS in the case of the CPA-CSBBCS Joint Award); enrolled full time in a psychology graduate program at provincially or territorially chartered Canadian University.
  • At the time of application and over the term of the grant (if successful), the applicant’s/grantee’s direct supervisor must also be a member in good standing of the CPA (or the CSBBCS in the case of the CPA-CSBBCS Joint Award)
  • Proposals with co-applicants will not be accepted/considered.
  • Grants are awarded to eligible student researchers and are administered through the institution’s administration systems. The student grantee authorizes expenditures in accordance with the CPA’s policies and requirements, as outlined here, and with institution policies. No one may initiate or authorize expenditures from the CPA grant account without the student grantee’s delegated authority.
  • Grant funds must contribute towards the direct costs of the research for which the funds were awarded, and the benefits should be directly attributable to the grant. The institution pays for the indirect or overhead costs associated with managing the research funded by CPA.
  • Expenditures will only be authorized once Research Ethics Board (REB) approval is obtained.
  • Each institution establishes appropriate procedures, systems and controls to ensure that the CPA’s requirements are followed. The institution has the right and responsibility to withhold and withdraw approval of expenditures proposed by a student grantee that contravene the CPA’s requirements or the institution’s policies and, when appropriate, to seek advice or ruling from the CPA as to eligibility of expenses.
  • The CPA follows the Canadian tax regulation for reporting and as such, will be required to issue a T4A. Please contact the CPA’s Executive Assistant, Kimberley Black via telephone: Local: 613-237-2144, ext. 323; Toll-free : 1-888-472-0657 ext. 323, to provide your Social Insurance Number.

ELIGIBLE EXPENSES

  • Research personnel (e.g., research assistant)
  • Consulting fees (e.g., programmer, statistician)
  • Fees paid for the purpose of participant recruitment, such as modest incentives to consider participation (i.e., to establish a potential participant pool), where approved by a Research Ethics Board
  • Fees paid to research participants, such as modest incentives for participation, where approved by a Research Ethics Board
  • Materials

NON-ELIGIBLE EXPENSES

  • Costs of alcohol
  • Costs of entertainment, hospitality and gifts
  • Travel/registration/accommodation costs related to attending a conference
  • Costs related to staff awards and recognition
  • Education-related costs such as thesis preparation, tuition and course fees, leading up to a degree
  • Costs involved in the preparation of teaching materials
  • Costs of basic services such as heat, light, water, compressed air, distilled water, vacuums and janitorial services supplied to all laboratories in a research facility
  • Insurance costs for buildings or equipment
  • Costs associated with regulatory compliance, including ethical review, biohazard, or provincial or municipal regulations and by-laws
  • Monthly parking fees for vehicles, unless specifically required for field work
  • Sales taxes to which an exemption or rebate applies
  • Costs of regular clothing
  • Patenting expenses
  • Costs of moving a lab

APPLICATION FORM

You cans submit your application here: https://cpa.ca/machform/view.php?id=15577

BMS Scholarship: Student Research and Leadership Development – DEADLINE NOV. 27th, 4pm!

BMS SCHOLARSHIP:

STUDENT RESEARCH AND LEADERSHIP DEVELOPMENT

Sponsored by BMS, the Canadian Psychological Association (CPA) and the Council of Professional Associations of Psychology (CPAP) wish to support student research and leadership development in all areas of psychology.

For 2020:

  • Up to two (2) awards will be dispersed per project for research-based submissions, at amounts up to $2,500.00 per application.
  • Up to five (5) awards will be dispersed to individuals wishing to pursue training, either practice or leadership focused, at amounts up to $500.00 per application.

ELIGIBILITY CRITERIA

At the time of application and if successful, over the term of the grant,

  • the applicant must be a current graduate student affiliate of the CPA and/or a current graduate student member of a provincial psychological association; enrolled full time in a psychology graduate program at a provincially or territorially chartered Canadian University; and
  • the applicant’s direct supervisor must also be a current member of the CPA and/or a provincial psychological association.

Of note, students can only be funded once during the lifetime of this funding program.

Applications by co-applicants will not be accepted/considered.

USE OF FUNDS

Awarded funds can be used to cover expenses as follows:

Research-Based Submissions Leadership and Practice-Focused Submissions
Direct research costs such as participant honorarium equipment, research assistant (see Eligible and Not Eligible Expenses for full list) but cannot be used to fund travel to attend conferences. Enrollment in a course/workshop, registration for a leadership or practice event, or other activity with appropriate justification.

ADJUDICATION OF APPLICATIONS

In evaluating applications, the adjudication committee will consider the following:

Research-Based Submissions Leadership and Practice-Focused Submissions
Applicant’s Qualifications (scholarships & awards, publications, conference presentations & other relevant experience)

Merits of Proposal (rationale & background; feasibility, design & methods; potential impact & originality)

Relevance to career development

Area of psychological study and practice

APPLICATION REQUIREMENTS

Applications can be submitted in English or in French. Applications not meeting all proposal requirements will not be considered for funding.

Research-based Submissions Leadership and Practice-Focused Submissions
·         An abstract of 250 words or less summarizing the research project.

·         A description (maximum 5 double-spaced pages including references, figures) outlining the rationale and background, feasibility, design and methods, potential impacts, and originality.

·         Status/proof of REB review process. (i.e. acknowledgement/confirmation from REB that application has been received, process is underway, or approval has been granted)

·         Specific amount requested, including an itemized budget.  If the BMS funding will only cover part of the costs, indicate institutional, personal, or other sources of support sought or obtained.

·         CV of applying student.

·         A statement from the student’s department chair that the department supports the student’s application and will comply with the CPA’s rules for funds administration if the student’s application is successful.  The appropriate University administrator’s name, email address, postal address, title, and business phone number should be indicated. For research applications, the letter must note that expenditures will only be authorized once REB approval is obtained.

·         A description (maximum 5 double-spaced pages) outlining the focus of the practice or leadership activity, an overview of when/were the activity will take place, duration of the activity, intended objectives of the activity, and relevance to the applicant’s career development.

·         Status/proof of event/activity registration.

·         Specific amount requested.  If the BMS funding will only cover part of the costs, indicate institutional, personal, or other sources of support sought or obtained.

·         CV of applying student.

·         A statement from the student’s department chair that the department supports the student’s application.

APPLICATION DEADLINE AND SUBMISSION PROCESS

Applications for the 2020 awards must be received by 4pm EST on November 27, 2020.  The winners will be announced by late December.

Applications must be submitted electronically via the appropriate link

Research-Based Submissions Leadership and Practice-Focused Submissions
https://cpa.ca/machform/view.php?id=30292 https://cpa.ca/machform/view.php?id=30405

RELEASE OF FUNDS

For funded research projects, the CPA will release funds to the student’s university upon receiving a valid certificate of compliance from the Research Ethics Board (REB) of the applicant’s institution.

For funded practice and leadership-focused activities, the CPA will release funds directly to the funded applicant upon receiving confirmation of registration in the specified activity.

GENERAL RULES AND RESPONSIBILITIES OF GRANT RECIPIENTS
Note that only one of the following grants can be held at any given time: CPA Student Research Grant, CPA Student Section Research Grant, BMS-sponsored Research or Leadership Grant. Eligible students can apply for one or more of these grants but can only hold one grant.

Successful applicants will be expected to provide a final (or progress) report to the CPA (approximately 500 words) within 18 months of receiving funding; successful applicants will also be expected to submit a 150-word write up for Psynopsis and their provincial association’s newsletter or website.

BMS should be acknowledged in any publications or presentations resulting from the research or presenting on the leadership or practice activity.

Research funds are awarded to eligible students and are administered through the institution’s administration systems. The student grantee authorizes expenditures in accordance with the CPA’s policies and requirements, as outlined here, and with institution policies. No one may initiate or authorize expenditures from the CPA grant account without the student grantee’s delegated authority. Each institution establishes appropriate procedures, systems and controls to ensure that the CPA’s requirements are followed. The institution has the right and responsibility to withhold and withdraw approval of expenditures proposed by a student grantee that contravene the CPA’s requirements or the institution’s policies and, when appropriate, to seek advice or ruling from the CPA as to eligibility of expenses.

Funds must contribute towards the direct costs of the research or practice/leadership training for which the funds were awarded, and the benefits should be directly attributable to the grant. For research awards, the institution pays for the indirect or overhead costs associated with managing the research funded by the CPA.

The CPA follows the Canadian tax regulation for reporting and as such, will be required to issue a T4A.  The CPA will provide funded applicants with a secure link by which to obtain their social insurance number.

ELIGIBLE RESEARCH GRANT EXPENSES

  • Research personnel (e.g., research assistant)
  • Consulting fees (e.g., programmer, statistician)
  • Fees paid for the purpose of participant recruitment, such as modest incentives to consider participation (i.e., to establish a potential participant pool), where approved by a Research Ethics Board
  • Fees paid to research participants, such as modest incentives for participation, where approved by a Research Ethics Board
  • Materials

ELIGIBLE PRACTICE/LEADERSHIP EXPENSES

  • Registration fees to participate in practice or leadership event
  • Fees for print or digital materials to support learning objectives of event
  • Travel and hotel costs to attend in-person even
  • Meal costs (based on CPA schedule) not otherwise provided by in-person event

NON-ELIGIBLE EXPENSES

  • Costs of alcohol
  • Costs of entertainment, hospitality and gifts
  • Travel/registration/accommodation costs related to attending a conference
  • Costs related to staff awards and recognition
  • Education-related costs such as thesis preparation, tuition and course fees, leading up to a degree
  • Costs involved in the preparation of teaching materials
  • Costs of basic services such as heat, light, water, compressed air, distilled water, vacuums and janitorial services supplied to all laboratories in a research facility
  • Insurance costs for buildings or equipment
  • Costs associated with regulatory compliance, including ethical review, biohazard, or provincial or municipal regulations and by-laws
  • Monthly parking fees for vehicles, unless specifically required for field work
  • Sales taxes to which an exemption or rebate applies
  • Costs of regular clothing
  • Patenting expenses
  • Costs of moving a lab

Spotlight: CPA Campus Representative Kaytlin Constantin

Kaytlin Constantin photo
photo credit Bianca Sabatini Photography

Emily and Lucy

One of these days, and hopefully sooner rather than later, Kaytlin Constantin is going to kick someone in the ribs. She was scheduled to compete at a kickboxing tournament in May, but it got postponed. And postponed again. And postponed once more. She’s looking forward to the day it actually takes place, but is hoping she will not be competing in the 55-and-older division by the time it does. Rib-kicking is much worse for you when you are 55 and older. In the meantime, kickboxing helps with confidence, and with determination. Kaytlin says,

“A trainer I once had told me ‘What doesn’t challenge you doesn’t change you.’ So when I’m going through a tough time I tell myself this, that maybe it’s an opportunity for growth. To me it means, some goals can be hard, but that it also means you’re growing toward something or achieving something.”

Despite the ups and downs of 2020, Kaytlin is still growing toward something. She is, like the rest of us, kicking it at home. She is a CPA Campus Rep at the University of Guelph, which means she’s involved in all aspects of the campus rep program. She describes it as being the middle person for all the other reps. That means organizing and helping the other student reps to fulfil their duties, being a liaison between students and the university, and also between students and the CPA.

The Campus Rep job is primarily about making connections and helping navigate processes. Students who want to become CPA Student Reps, who want to present at the CPA Convention, or who are looking to submit articles to Mindpad, the newsletter publication written, edited, and published by the CPA Section for students.

Kaytlin did her undergrad degree at Lakehead, where she was a CPA Undergrad Rep. That means she’s been repping the CPA for about five years now, and seems to have no intention of stopping here.

“When I was an undergrad rep, I led a workshop for other students to help them create posters for the CPA convention. It was the first experience I had in more of a leadership role. Learning what the CPA convention is all about, and becoming familiar with the guidelines and expectations, was a big step in my journey to take on more leadership roles and duties.”

Perhaps Kaytlin’s lengthy involvement with CPA helped paved the way for her success. As a fourth year PhD Candidate in clinical child psychology, Kaytlin holds a Vanier Canada Graduate Scholarship, one of the most prestigious awards available for Canadian graduate students. With this funding, she has been working on her dissertation, supervised by Dr. Meghan McMurtry in the Pediatric Pain, Health and Communication (PPHC) lab, which focuses on better understanding the way parents respond when their child is in acute pain, like during a needle procedure. Related to this, she and a team of clinicians and researchers have been working on a virtual intervention for parents and children, to help kids manage their fear of needles. Which, it turns out, is an even more timely research project than anyone could have imagined nine months ago.

TAKE FIVE WITH KAYTLIN CONSTANTIN

What is the psychological concept that blew you away when you first heard it?
The idea of self-compassion, recently, has been huge for me. The notion of responding to your own pain and suffering with the same warmth and kindness that you would to a friend. What’s amazing is how strong an effect that can have on someone’s overall well-being. I used to think being critical of myself made me a better student, researcher, clinician. But I’ve come to realize through my work in this program, and through my research, that self-compassion is an empowering and beneficial psychological skill to practice.

Favourite book
I have a favourite type of book. I like memoirs and autobiographies. I like learning about peoples’ life experiences, and I think that when someone has had a very different life experience from your own, to learn about that person’s life and to develop more perspective. Recently I’ve read Educated by Tara Westover, and Born A Crime by Trevor Noah.

Favourite word
Right now, I think I’d have to say ‘certainly’. I’ve always struggled with my confidence, and appearing confident in my work. And I feel like sometimes adding the word ‘certainly’ can help me feel more confident.

If you could spend a day in someone else’s shoes who would it be and why?
I’m going to say AOC (Alexandria Ocasio-Cortez). I think she’s just phenomenal, and her advocacy around racial, economic, social justice, environmental issues is so inspiring. I would love to be able to pick her brain one day, or just shadow her for a day to see what her days are like and what her strategies and approaches are for the work she does.

If you could become an expert at something outside psychology, what would it be?
Probably something related to politics or policy works. I feel really passionate about making psychological services more accessible. Often in my day-to-day work, I feel that a systems-level change is needed, and we can’t separate health, including mental health, from socio-economic and demographic factors. And so, I think that it’s important for those of us in a position where we have a voice to be able to advocate and work toward making services more accessible and inclusive.

Kaytlin always knew she wanted to work with children, and is well on her way to doing so. Growing up in the small Northern Ontario mining town of Marathon, she never thought the path to working with children would have been psychology – her only exposure and knowledge of the discipline was through movies and television. Like the therapist who shows up in some episodes of Law & Order: SVU. But a particularly inspirational high school English teacher began to speak about the human condition, and the human mind, in the context of Shakespeare and other classic works. That teacher told Kaytlin about all the various paths psychology could provide, and she determined she was going to learn about the mind, and why people do what they do. Now here she is, just a few years later, preparing a five-week therapeutic intervention to help kids manage their fears.

Growing up in such a remote community, Kaytlin has been keenly aware of some of the impediments to receiving psychological services. She knows first-hand how geographic location can be one of the biggest barriers to receiving needed care and attention. With the intervention she’s planning, she sees the benefit of tele-psychology, especially for people in more remote locations. She also sees the more rapid embrace of technology, accelerated by the pandemic, that has allowed some of those barriers to be lessened.

Ah yes, the pandemic. It’s sort of impossible to talk to anyone now without discussing it in some way. It’s keeping us cooped up inside, preventing us from meeting at large conventions, and canceling kickboxing tournaments indefinitely. Kaytlin is taking it all in stride, and says she has been lucky enough to be able to work from home, continue with her dissertation and clinical activities, and carry on with her duties as a CPA Campus Rep, like organizing workshops – it’s just that now, they’re over Zoom. She’s especially interested in getting other students involved, whether they be collaborating with another psychology student association or signing up to be a CPA Undergrad Rep.

“It’s a great opportunity for networking, as well as a chance to develop some more leadership skills. Getting connected with other psychology student associations, becoming informed about what kind of psychology initiatives they’re involved in, and helping support and promote a community in psychology has been a wonderful experience.”

And the kickboxing? It seems like one of those sports that would be difficult to do while maintaining physical distancing. To keep up with training, does Kaytlin have anyone in her bubble who could be a willing (or unwilling) sparring partner?

“I have had to get creative…I think maybe some friends from my gym would be willing to mask up and hold pads to train, we’ll have to see! Life does go on!”

Life does, indeed, go on. Kaytlin will get her PhD. More people will connect to psychologists through remote internet platforms. Children will overcome their fear of needles. And some day, hopefully sooner rather than later, Kaytlin will earn points in competition for kicking someone right in the ribs.

CPA’s 82nd Annual Convention & Tradeshow – Virtual Event

June 7 – 25, 2021

CPA 2021 Virtual Conference Logo

Location: Virtual
Email: convention@cpa.ca
Website: https://convention.cpa.ca/

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.


The CPA has created an electronic submission system for Providers and Sponsors submitting applications to grant CPA-approved Continuing Education credit through CPA’s Continuing Education (CE) Approval Programme.

The CPA has created an electronic submission system for Providers and Sponsors submitting applications to grant CPA-approved Continuing Education credit through CPA’s Continuing Education (CE) Approval Programme.

This change also applies to existing Sponsors submitting Annual Reports for 2020-2021. This change in submission procedures includes the development of an online system for processing credit card payments. Details are available at https://cpa.ca/professionaldevelopment/applicationforms/ (English) or https://cpa.ca/fr/professionaldevelopment/applicationforms/ (French).

Spotlight: CPA Student Mentor Emily Cruikshank and Mentee Lucy Muir

Emily Cruikshank photo

Emily and Lucy

In 1958 a woman named Sue immigrated to Canada from Hong Kong. She faced a language barrier, culture shock, and a brand-new community into which she was entering. It must have been quite difficult, but also quite fascinating, to experience everything that was new and different about our country. Emily Cruikshank thinks about Sue, her grandmother, a lot. What frightened her? What amused her? What did she find overwhelming, and what did she take to right away? And how did she manage to make connections with other people despite all the obstacles?

Emily thinks about Sue because her experience has been very different. Emily makes connections quite easily, sometimes in ways that come as a surprise.
Lucy Muir photo
When students sign up for the CPA’s Student Mentorship program, they fill out a questionnaire that, much like a dating site, pairs them with a mentor or mentee that shares common traits. Are they looking to follow a similar career path? Is their reason for choosing psychology aligned with that of the other person? What are they looking to get out of their school, their courses, and their affiliation with the CPA?

Every now and then, the partnership that is formed goes well beyond the commonalities identified by that questionnaire. Such is the case with Lucy Muir, an undergrad psychology student at Ryerson, and her mentor Emily Cruikshank, a PhD student at the University of Alberta.

Emily is really into popular music – the way pop songs affect people, the way they influence culture, and the music of history that shapes the music of today. Before going to Ryerson for psychology, Lucy spent six years working across Canada in the radio industry.

TAKE FIVE WITH EMILY CRUIKSHANK AND LUCY MUIR

What is the psychological concept (bystander apathy, confirmation bias, that sort of thing) that blew you away when you first heard it?
Emily: So many! Psychology is such a rich and interesting field. But one that really shook me has to do with situational attribution or the idea that the role you are given can impact your behaviour so much. When I first learned about the Stanford Prison Experiment and the Milgram Shock Experiment I could not believe that people could do such awful things based on suggestions. But once I understood the motivation behind these actions I realized that none of us are that far off from “shocking” an innocent person!
Lucy: The rubber hand illusion! That’s and experiment where the participant has one hand out on the table, and their other hand is hidden behind an object. Then the researcher puts a rubber hand where that hidden hand would ordinarily be, beside the real hand. Then the researcher strokes your hidden hand and the rubber hand at the same time. Eventually, the participant feels the sensation IN the rubber hand. They feel as if that rubber hand is part of their body!

Do you have a sport? What is it and do you watch, play, follow it?
Emily: I am slowly getting better at long-distance running, and I love following some of the big long-distance runners in Canada and all over the world. But my all-time favourite sport is Rhythmic Gymnastics. I was on a provincial-level team when I was a young girl and I fell in love with the strength and beauty of the sport. I think it is such an amazing combination of athleticism, dance and art. My mom and I always watch the world championships and the Olympics together.
Lucy: Both of us are long distance runners. When I’d go for a long run, weird stuff was happening in my brain, and that’s one of the things that got me into psychology – I thought, ‘I want to know more about what is going on!’

If you could spend a day in someone else’s shoes who would it be and why
Lucy: As I’m answering all these questions, I’m thinking maybe I want to be a Broadway star! I’m always thinking about Broadway. So I’d love to spend a day in the mind and shoes of any of the cast members of Hamilton!
Emily: Oh my gosh, right!? I totally agree. Anyone from Hamilton. But I still think I would choose my grandma when she first came to Canada. I have always been so amazed at her strength in coming to Canada from Hong Kong and wondered what it must have been like for her.

If you could become an expert at something outside psychology, what would it be?
Emily: I would love to be an expert in popular music. It’s an area I love, I took one class in my undergraduate degree on the topic, and I think it is so cool that you could become an academic on something that impacts and changes our culture so heavily and at such a quick pace!
Lucy: There’s so much! But I would probably say physics, like quantum physics or something. I was really into math in high school and I didn’t go anywhere with it, but I’ve always found it fascinating.

Favourite word
Emily: Empower
Lucy: Burrito

Lucy is a passionate long-distance runner, and gets out to run every day as she finds it helps her mental health, especially during this pandemic where she is stuck inside so much of the time. Emily is also a distance runner, and has done 10k races and half marathons.

And, of course, they share a passion for psychology. When Lucy describes being blown away by the rubber hand illusion, Emily chimes in right away – that WAS amazing, wasn’t it? She expands on the concept, describing how that particular phenomenon has led to some interesting therapies for people with amputated limbs.

Theirs is a symbiotic mentor-mentee relationship. They meet about once a month, and Lucy tells Emily all about what she’s doing, and where she might need help. Recently, she needed some clarification on the very broad concept of ‘consciousness’.

“I just talked to Emily about it. I wasn’t quite getting what consciousness actually was, and we basically talked it out. Emily wasn’t giving me a quick nice definition for what it is – because that might not even exist – but we just talked it out. And now I get it a lot better. We also talk about just general school things, like doing classes over Zoom, and that’s pretty great.”

It’s pretty great for Emily as well. When the opportunity came up to become a mentor, she realized she wished she had had one herself as a young undergrad. So she signed up, was paired with Lucy, and they entered the program together. But that was only the beginning for Emily, who became quite inspired with the process – enough to extend her mentorship far beyond just the CPA program.

“I got really excited about [being a mentor] because I’m a big advocate of mentoring, especially for people who are looking to move forward in their studies in psychology. When I got into grad school, I wanted to participate in bridging the gap between people in undergraduate work who were interested but maybe didn’t know what options were out there. I’m really happy that the CPA is doing this kind of program because I think it’s so helpful. My program at the University of Alberta has their own internal mentoring program, so I’m also mentoring a student in the first year of their Masters program. I even do some work at my undergrad alma mater [MacEwan University] where I go into one of the 400-level classes each semester and do a Q&A about graduate school with them.”

Imagine how Sue’s life would have been different had she had a mentor when she arrived in Canada. Someone to show her who the Chinese-speaking community was, where to find the groceries she wanted, how to navigate finding employment, housing, and education for her family. Even without a mentor Sue managed to overcome all the hurdles she faced, with a strength that impresses Emily to this day.

Sue passed down some of that strength to Emily, who now shares some of it with Lucy. Lucy brings a strength of her own to Ryerson, to her studies, and to this partnership with Emily. Together, they are better off than they would be alone – and the fact that they enjoy speaking with one another is a nice bonus.

Perhaps one day they can meet in person, maybe at a race weekend half-marathon event somewhere in Canada. In the meantime, Emily will complete her PhD and go into the clinical work toward which she’s been working. Lucy will make her way through psychology studies, her future and a variety of career paths wide open to her. She says her initial attraction to the discipline came from sport psychology. Emily jumps in.

“My husband was telling me how these e-sport teams even have their own sport psychologists now, who work with them on their training for video game competitions. They do it in Korea and China, and I just thought wow – that’s a whole other level of sports psychology!”

So how about that for a career path, Lucy? Sports psychologist for a Korean team of Super Smash Brothers experts?

“Yep, done. Decision made. This is now what I’m working toward, officially.”

Call for applications for TUTOR-PHC

This call for applications for TUTOR-PHC is open to graduate students, post-doctoral fellows, mid-career clinicians, and decision makers from across primary health care. Please find more information below or distribute to people in your organization or department that may be interested in this opportunity. Thank you.

What is the TUTOR-PHC program?

Transdisciplinary Understanding and Training on Research – Primary Health Care (TUTOR-PHC), is a one-year, pan-Canadian interdisciplinary research capacity building program that has been training primary and integrated health care researchers, clinicians and decision-makers from family medicine, nursing, psychology, epidemiology, social work, occupational therapy, education, policy and many other disciplines since 2003.

CLick her for the Flyer PDF (version français ici)
Why apply?

  • Primary health care interdisciplinary research training
  • Earn University Credit & MAINPRO+ credits
  • Valuable feedback on your own primary health care research
  • Gain increased knowledge and skills in Patient-Oriented Research
  • Mentorship from experienced interdisciplinary primary health care researchers and decision-makers
  • NETWORKING experiences with research mentors & 200+ pan-Canadian / international alumni
  • Interdisciplinary team experience

TUTOR-PHC trainees gain enhanced evidence-informed decision making & leadership skills to help them become the primary health care leaders of tomorrow.

  • Each trainee will be responsible for a $3000 CND program fee

The deadline to apply is   November 30, 2020

For more information, please go to the website at: www.uwo.ca/fammed/csfm/tutor-phc

 Please contact Project Coordinator, Rob Van Hoorn (tutor@uwo.ca) if you are interested in applying.

Spotlight: Alejandra Botia, Chair-Elect of the Student Section of the CPA, and the Student Representative on the CPA Board of Directors

Alejandra Botia

“To know how to persevere
when the way grows long
and does not end
To find in the roots the answer to
this undeciphered story”

– Fonseca, ‘Vida sagrada’

Alright, these are not the actual lyrics to the Fonseca song ‘Vida sagrada’, they’re a weak English translation to the Spanish lyrics. Fonseca is a Colombian singer, and ‘Vida sagrada’ is a song about war, conflict, income inequality, and environmentalism. And, despite such heavy subject matter, it will make you want to get up and dance, just as Alejandra Botia said it would. If there’s one thing Alejandra knows (besides psychology) it’s salsa dancing.

Alejandra has only recently begun to reconnect with her Colombian roots (like salsa dancing, and Fonseca). She and her family moved to Canada when she was 12 years old, and she began quickly to detach from her country’s culture. She stopped listening to Spanish music, she started focusing entirely on the English language, and becoming integrated into Canadian culture. She became a competitive swimmer, and started the journey of lifelong learning that led her to psychology.

Alejandra is currently pursuing her PhD in Counselling Psychology at UBC. She is the Chair-Elect of the Student Section of the CPA, and she is the Student Representative on the CPA Board of Directors and will be for the duration of her term as Chair-Elect, Chair, and then Past Chair of the section. As is the custom. The way of a student in psychology is long, and does not necessarily have an end to it – but Alejandra says the experiences along the way are invaluable.

“The main reason that I wanted to become chair-elect, and be on the board, is that throughout my experiences as a student I’ve become really passionate about student engagement and professional development. It’s all about the opportunities that come up along the way that make our educational experience that much more rewarding than if you’re just going through courses and doing what you have to do.”

TAKE FIVE WITH ALEJANDRA BOTIA

What is the psychological concept that blew you away when you first heard it?
The concept of bystander apathy blew my mind in a way. It was a simple way to understand something that always seemed complex in my mind. It always seemed odd that people could see others in need of help, and yet their actions were not helpful. I was trying to understand what happened in those situations, where people just kind of froze. A better understanding of this allows me to act differently in a situation where someone needs help.
I was at a restaurant at my sister’s birthday dinner, and there was a car that crashed straight into the store across the street. Thankfully it was late at night and it was closed, so no one was inside. I remember the sound was so loud, everybody came out of the restaurant and they were standing, assessing what had happened and I think assessing whether someone needed help. But I noticed that it wasn’t everyone who got closer to see if that person needed help, and not everybody was picking up their phones to call 911. It was only a few people who were doing that, while everyone else was kind of standing still. That was a situation where I thought about bystander apathy, and how it affects our ability to help someone who might be in need.

Favourite book?
One of my favourites I’ve read recently is Untamed, by Glennon Doyle. It just speaks to so many issues that I feel passionate about. It touches on body image and eating disorders, and also on the idea of gender – becoming a woman. How much of that process in the world we think is natural, but really a lot of it is learned.

Favourite quote?
“Breathe, let go, and remind yourself that this very moment is the only one you know you have for sure” – Oprah Winfrey
I think COVID has some influence over why that’s my favourite quote right now, and also going through this PhD process where there are so many moving parts that demand my attention. I need to remember that if I don’t find ways to stay present and mindful, that time just goes by. And it goes by quite quickly.

If you could spend a day in someone else’s shoes who would it be and why?
I’ve been following Alexandria Ocasio Cortez for a while now. I would love to be in her brain for a day. I find her so confident, and eloquent, and strong. I think what I admire the most about her is how she doesn’t allow what others think of her to stop her from taking a stand on what she believes.

If you could become an expert at something outside psychology, what would it be?
I’d have to say the ocean. When I was little I wanted to be a marine biologist. I think that’s because when I was five, I thought that meant you would just get to play with dolphins all the time. But I’m still fascinated by it now, and I think if I could be an expert in ocean matters, that would be amazing.

Alejandra chose psychology because she wanted to learn how to help people by facilitating their work toward accomplishing their goals and experience higher levels of wellbeing. Over many years of study, she has become passionate about the intersection of psychology and areas of social justice. She’s extremely interested in how psychology can influence change at the societal level. Being a CPA board member has helped in this pursuit, not only as an inspiration but as an affirmation of those passions.

“One of the ways being part of these initiatives, and being on the board, has really helped me is that I can take that passion and learn how to transform it in a practical way. I’m learning how to take action, how to communicate with the rest of my team, brainstorming ideas so we can best benefit the Student Section. But also it’s teaching me to speak up, and learning that it’s okay to speak up. Bringing forward new initiatives and new ideas where there are people who will hear you, and who will support you. That’s what has made this a really wonderful experience already.”

Alejandra is not simply content with making the most of the opportunities afforded her as the Chair-Elect of the Student Section or the Student Representative on the CPA Board. She is also keenly invested in breaking new ground. For example, she and her cohort recently created the Counseling Psychology Student Association. She is proud of what her team, including Katie McCloskey , Syler Hayes, Sarah Woolgar, and Christopher Cook has accomplished in a short time. As Chair-Elect, she coordinates the mentorship program and contributes to newsletters, the adjudication of student grants, and to the annual conference by helping with the organization of the student section events.

Along with some teammates, she will soon be leading a workshop on equity, diversity, and inclusion. Alejandra’s main job, of course, is to work in collaboration with the Executive Team, continuously reflecting on how they can better serve our student community. All this while pursuing her other passions in the field of psychology – women’s leadership, vocational growth, and factors related to resilience in eating disorders. So what inspired her to take on even more on top of all this, to become as involved as she has in the future of Canadian psychology?

“I think one thing that drew me to it is that I’m becoming more and more involved in understanding matters relating to the intersection of psychology and social justice. So learning how to come prepared, how to be ready to speak about it, and stand by it without fear of what might happen, was a major part of what I hoped to gain by getting involved. And I have!”

Some time ago, Alejandra gave up competitive swimming and started to focus on salsa dancing. Despite the pandemic, she’s able to keep up with her lessons – she met her partner salsa dancing, and so the two of them can get some dancing in at home, in those fleeting downtimes where there is no school, and there are no executive duties, to which she must attend.

Re-connecting with her Colombian roots has been transformational for Alejandra. As Fonseca sings, she is finding in her roots the answer to an undeciphered story. It’s a story she’s currently writing, in a project she has tentatively called ‘Letters to Stella’. Stella was Alejandra’s grandmother, with whom she was very close. Stella would sometimes visit from Colombia, and Alejandra would sometimes go there to visit Stella. Sometimes, when she’s feeling down or overwhelmed, she thinks about Stella and what she would say to her in those moments. So she had this book idea where she’d be writing letters to Stella.

“She was always cheering me on and just so curious about my life.”

Were Stella alive today, there is no doubt she would be fascinated, and proud, of Alejandra’s life. She is pursuing her dream, she is re-connecting with Colombia, she’s dancing away in her apartment, confined by COVID with her partner. But of course, this is just the beginning of Alejandra’s life, and her journey. As Fonseca says;

“The way grows long, and does not end.”

Except that Fonseca, like Alejandra, says it in Spanish.

Alejandra Botia salsa dance team.

Spotlight: Ece Aydin, CPA Undergrad Representative for the UBC-Okanagan campus

Ece Aydin.
Ece Aydin has lived in the same place now for three whole years. This is unusual for her, as she has previously moved around all over the world for her entire life. Ece came straight out of high school into psychology at UBC Okanagan – but high school was in Dubai. Born in Turkey, Ece moved to Europe when she was five. There was a time where her family moved back to Turkey, and since then she has gone to an international high school in countries all over the world. Her three years at UBCO are maybe the first time in a long time she has spent three years in just once place.

Ece decided she wanted to study psychology when she was fifteen. She was fascinated by human behaviour – how our thoughts influence our behaviour, and vice versa. She was comfortable with hearing problems and anxieties from her friends, and she was good at helping them out. Now, a few years later, Ece is a third-year psychology student at UBC Okanagan, and this year became an Undergrad Representative for the CPA. A straight line academically, if not geographically.

“The things I’m learning blow my mind every single day.”

After Ece finishes her undergrad, she hopes to go to grad school – and stay in the same area. She hopes to be able to do her grad school in Vancouver, and after that a PhD in counselling psychology. Her passion is child and developmental psychology, with an eye toward adolescent psychology and addiction one day.

“I really believe in early interventions. As a child we can be molded into any type of person. Especially with disorders as children, like ADHD or autism, I feel like diagnosis in early years is really important for children to be able to navigate their lives in the future.”

When it comes to addiction, Ece really feels that early intervention is key, but also that the stigma society places on those who suffer can be overcome. That people who have substance use difficulties can be accepted, and integrated into society, in a more accepting way than they currently are. The destigmatization of addiction is something that comes up often in our conversation.

TAKE FIVE WITH ECE AYDIN

What is the psychological concept that blew you away when you first heard it?
I think it was something I learned in one of my psych classes in grade 11. It was the first time I heard about the fundamental attribution error. Which basically means that when we make a mistake, we tend to blame external factors, like our environment. But when someone else makes the same mistake as we did, we tend to blame it on their personal flaws. I never knew that I was actually doing this, until it was defined and had a name associated with it.

You can listen to only one musical artist/group for the rest of your life. Who is it?
It’s probably Amy Winehouse, as depressing as that may sound. But it’s very peaceful for me, and it has a lot of sentimental meaning for me as her album was one of the first birthday presents I remember receiving.

Top three websites or apps you could not live without and why
My messaging app, because I have to keep in contact with people, especially right now. There are people I haven’t seen in many months with whom I like to be in constant contact. Also the CNN international news, because I kind of get anxious when I don’t know what’s going on around the world. And for the third one…I guess Pinterest. I like the whole ‘organizing’ aspect of it.

If you could spend a day in someone else’s shoes who would it be and why?
That’s a very hard question. I remember when I was a kid seeing Doctors Without Borders on TV, and I think I would really like to see what that’s like. To see how it is that they’re so selfless that they go into situations that we couldn’t even imagine.

If you could become an expert at something outside psychology, what would it be?
Definitely art. It’s something I do in my personal time, and I would want to be an amazing artist, or an art critic. I want to be able to see a piece of art and define right away what it is, what the story behind it is, and what emotion they’re trying to convey.

“Whoever you are, and whatever addiction you might be going through, that doesn’t define you as a person. That’s just something you went through. And I hope to get out there and help others understand exactly what addiction is.”

As she began her second year at UBCO, Ece was looking for ways to become more involved. Student life had to be more than just attending and passing classes, right? She found the CPA website, and saw that they had Student Members and Student Affiliates. She found the Student Representative on the campus, and discovered that they were looking for an Undergraduate Rep. It was, as Ece describes, the lucky break she had not even been aware she was seeking.

“It’s really nice to be part of a psychology network where there are so many researchers and students like me. I find that I learn so many interesting things all at once when I get newsletters from the CPA.”

Of course, with COVID, the life of a CPA Undergrad Rep is not exactly like it has been for previous students in the same position.

“I haven’t been able to do anything yet this semester…I wanted to host workshops, and events, and things like that to introduce myself to other psych students – explain to them what the CPA is and the benefits of membership. But as you know, the pandemic has changed a lot of plans. We’re going to send out social media posts so anyone who is on our campus can join, and get to know us. But of course everything is going to be virtual.”

This also means that not only has Ece been living in the same place for three years, she has now been confined to the same place for eight months. Maybe this is a welcome rest, although being an undergrad psychology student, coupled with being a CPA Student Rep, does not make for the most restful of lives. What it does mean, however, is that Ece has been able to focus on her environment, and her studies, for as much time as it takes to know what she wants, and where she wants to go.

“I am going to help people in my life. This is what it’s all for, in the end.”

BMS SCHOLARSHIP: STUDENT RESEARCH AND LEADERSHIP DEVELOPMENT

BMS, the company that brokers the professional liability insurance program for members of the CPA and members of provincial/territorial associations of psychology, has launched a grant program to support student research and leadership development in all areas of psychology.  For 2020, up to two (2) awards will be dispersed per project for research-based submissions, at amounts up to $2,500.00 per application and up to five (5) awards will be dispersed to individuals wishing to pursue training, either practice or leadership focused, at amounts up to $500.00 per application.  Eligibility criteria and application details will be announced shortly and posted here. Please direct any questions about this competition to science@cpa.ca.