COVID-19 The Impact of - The CAP Monitor - College of Alberta Psychologists
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The Impact of
COVID-19
The CAP Monitor
THE COLLEGE OF ALBERTA PSYCHOLOGISTS // SUMMER 2021 // ISSUE 66
CAP Monitor 66 www.cap.ab.ca Summer 2021 | 2
Who’s Who Council
President Reagan Gale
President-Elect Greg Schoepp
Past-President Kerry Mothersill
Treasurer Kathleen Kelava
Public Members Elaine Andrews
Michèle Stanners
Garrett Tomlinson
Members-at-Large Michael King
Ex officio Richard Spelliscy
Recording Secretary Wendy El-Issa
Committee Chairs
Credentials Evaluation Sub-Committee Ali AL-Asadi
Practice Advisory Committee Kevin Wallace
Registration Advisory Committee Christina Rinaldi
Registration Approvals Sub-Committee Jill Turner
Jacquie Pei
Substantial Equivalency Sub-Committee Ali AL-Asadi
College Staff
Registrar and Chief Executive Officer Richard Spelliscy
Deputy Registrar and Complaints Director Troy Janzen
Assistant Deputy Registrar and Assistant Complaints Director Monty Nelson
Assistant Deputy Registrar and Director of Professional Guidance Deena Martin
Finance Director Wendy El-Issa
Director of Privacy and Information Management Lindsey Bowers
Executive Coordinator Kathy Semchuk
Complaints Coordinator and Hearings Director Aimee Brooks
Academic Credentials and Program Evaluation Coordinator Erica Pang
Academic Credentials and Program Evaluation Coordinator Kymberly Wahoff
Registration Coordinator Ingrid Thompson
Registration Assistant and Examinations Coordinator Sheri Price
Administrative Generalist Kris Trojan
Administrative Generalist Charmaine Thomsen
Receptionist/Administrative Assistant Crystal Willms
Supervision Consultants
Jon Amundson - aapsych@telus.net - 403-289-2511
Walter Goos - waltergoos@shaw.ca - 780-986-7592
Supervision consultants are available to advise provisional psychologists and supervisors. They also
assist in the resolution of conflicts between provisional psychologists and supervisors.
Contents
04 28
Registrar’s Letter What is the Gold Program?
08 32
President's Letter COVID-19 Effects on the Mental Health
of Vulnerable Populations
10
Council News
38
COVID-19 Fatigue: Why Albertans Are
Exhausted and How Psychologists Can Help
11
Bill 46: Health Statutes Amendment Act,
2020: Frequently Asked Questions (FAQ)
42
Ethical Challenges for Psychologists
16 During a Pandemic
Check In
50
17 Register Updates
Pandemic: Psychological Impacts for
Members and Those We Serve
51
Professional Guidance Department
20
The COVID Pandemic and the Yin and
Yang of Psychoactive Drug Use 57
Stats Page
25
A Rise in Eating Disorders During the 58
COVID-19 Pandemic? References
CAP Monitor 66 www.cap.ab.ca Summer 2021 | 4
Registrar’s Letter
described the second wave
of COVID-19 as a triple
threat to the mental health
of Canadians. The identified
threats include the social,
emotional and economic
consequences of COVID-19,
increased substance use and a
reduction in treatment options
as displaced employees no
longer have access to mental
health benefits and some
publicly funded resources
The Psychological have reduced or suspended
Effects of COVID-19: programming because of the
Will Alberta be Ready pandemic (https://rsc-src.ca/
for the Mental Health en/news/easing-disruption-
Pandemic? covid-19-supporting-mental-
health-people-canada). A
Approximately one year ago
second Nanos poll conducted
(May 2020) a Nanos poll
by the Canadian Psychological
conducted on behalf of the
Association (CPA) and the
Mental health Commission of
Council of Professional
Canada, revealed that more
Associations of Psychologists
than four in 10 Canadians
(CPAP) supported the RSC
reported feeling stress regularly
findings highlighting that
(33%) or all the time (13%) in
three in 10 Albertans believed
the preceding month because
that COVID-19 has negatively
of the COVID-19 pandemic.
impacted their ability to
The same proportion believed
access mental health care.
that their mental health is
While a clear preference was
somewhat worse (28%) or
reported for in-person sessions
worse (10%) since the beginning
(73%), the same percentage
of the pandemic. Significantly,
of respondents said they were
and despite the pandemic, a
willing or somewhat willing to
strong majority (83%) indicated
receive digital health care from
that mental health care was
a psychologist (https://cpa.
equally important as physical
ca/docs/File/Media/Alta%20
health care (https://www.
COVID-19%20CPA%20CPAP%20
mentalhealthcommission.ca/
Nanos%20Survey.pdf).
sites/default/files/2020-05/
nanos_covid_may_2020.pdf). Canada is not alone. Each year
the American Psychological
The Royal Society of Canada
Association (APA) conducts
(RSC) in October 2020
a survey on how stress is
CAP Monitor 66 www.cap.ab.ca Summer 2021 | 5
impacting the United States of our community is often
population. Approximately linked to the economy. Wang
eight in 10 (78%) reported et al. (2020) has reported that
that COVID-19 has been a every 1% increase in long term
significant source of stress. unemployment has resulted
Relative to Canada, a higher in an increase of 0.83% in
proportion (67%) of those suicide rates (https://www.
surveyed reported increased frontiersin.org/articles/10.3389/
stress because of the pandemic fpubh.2020.00060/full). It is
(https://www.apa.org/news/ possible that the relationship
press/releases/stress). between COVID-19 related
unemployment may be more
A more recent poll conducted
latent, potentially buffered
by Ipsos (2021) on behalf
by the rapid deployment of
of Sun Life reported that
financial relief programs.
60% of Canadians reported
experiencing mental difficulties Alberta’s government has made
but more than half (54%) have some much-needed initial
not sought out treatment. This commitments to shore up crisis
is an increase in the amount intervention services. Such
of stress reported in earlier services are highly valuable;
Nanos research and more however, they do not fully
closely aligns with that of address the needs of Albertans
our American counterparts. with complex psychological
Ipsos (2021) noted that a and diagnosable difficulties.
significant proportion (44%) Individuals with these needs
of respondents believed that often require much more
the second wave of lockdowns planned, comprehensive, team/
had a greater impact than the evidence-based and sustained
first on their mental health treatment approaches to be
(https://www.ipsos.com/en-ca/ truly effective. Prior to the
covid-continues-take-heavy- pandemic, access was cited
toll-canadians-mental-health). as one of the most significant
Affordability and stigma were barriers to receiving such mental
identified in the Ipsos (2021) heath services. The more recent
survey as the primary reasons Nanos (2021) survey found that
for not seeking professional one third of the respondents
help. Of those surveyed, 12% believed that COVID-19 had a
had lost group benefit coverage negative (33%) or somewhat
because of being laid off. This negative (23%) impact on their
latter finding is consistent with ability to access mental health
the concerns voiced by the RSC. care by a psychologist. Research
is just beginning to look at the
Research to date has not
possible long-term physical,
established a direct link
neurocognitive and mental
between COVID-19 and a rise in
health effects of the current
suicide rates. This is significant,
pandemic.
as the emotional well-being
CAP Monitor 66 www.cap.ab.ca Summer 2021 | 6
The primary mandate of the and underfunded public
College of Alberta Psychologists mental health system. Until
(CAP) is public protection mental health is funded in an
through the promotion of equivalent manner to physical
ethical and professional health, systemic and societal
practice standards. The primary discrimination will likely prevail.
mandate of the Psychologists’
What can Albertans do in the
Association of Alberta (PAA)
interim? First and foremost,
is advocacy for the profession
Albertans can look to their
of psychology. Our shared
past resiliency in overcoming
objective is the public interest.
economic downturns and
It is our unified belief that
significant public emergencies
there has never been a more
such as the recent wildfires
critical need for increased
and floods. Countless acts of
funding for psychological
goodwill, from simple kindness
services including, but not
to true heroics, promoted the
limited to, crisis intervention.
wellness of both those who
Despite being deemed essential
received and those who gave.
service providers, allowing
These acts bestowed a sense of
the continued provision
well-being in all Albertans who
of face-to-face services,
were privileged to witness such
most psychologists working
strength and human goodness.
across Alberta successfully
transitioned partially or fully What can psychologists do
to virtual platforms to do their for Albertans? They can help
part in reducing the spread of Albertans familiarize themselves
COVID-19. with common signs of anxiety,
depression and stress.
Most Alberta psychologists are
Encouraging others to take their
private practitioners who do not
own emotional temperature as
receive public funds for their
well as that of family, friends and
professional services. As noted
co-workers is an important next
above, a significant proportion
step. This is exemplified by New
of individuals no longer have
York’s recent initiative, “How are
access to employee assistance
you doing, really?” Never has
programs that have traditionally
there been a more important
paid for some mental health
time to reach out to others when
services, nor do many have
feeling alone or overwhelmed, or
the discretionary resources
when we see others experiencing
to purchase private mental
the same. The benefits are
health services, especially
mutual. Intentionally promoting
when encountering economic
self-care is also important, as
hardship. These Albertans
known benefits exist.
must rely on an overburdened
CAP Monitor 66 www.cap.ab.ca Summer 2021 | 7
Albertans can also turn to health outcomes related to
psychologists for evidence- COVID-19 and the increased
based help. We are ready. work demands it imposes
The Nanos (2020) survey (see https://link.springer.com/
revealed that Canadians have article/10.1186/s12889-020-
the greatest confidence in 09322-z; also see https://www.
psychologists when seeking to cmaj.ca/content/192/17/e459).
address mental health issues. Self-care is also increasingly
Albertans can also access both recognized as an ethical
crisis and support services by obligation for psychologists
telephone and/or online. An (see https://doi.apa.org/
increasing number of mental doiLanding?doi=10.1037%2Fcap
health apps are available to 0000153). This is echoed
support clients. Online referral by Abramson (2021) in her
services (811) in addition to that recent APA article, The Ethical
offered by the PAA are available Imperative of Self-Care.
in most areas of the province. Importantly, what works for the
Many urban centres now have public also works for us!
24-7 mental health clinics and
crisis intervention teams.
Psychologists, like other
healthcare workers, are also Richard J. Spelliscy, Ph.D.,
not immune to poor mental R. Psych. Registrar & CEO
CAP Monitor
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CAP Monitor 66 www.cap.ab.ca Summer 2021 | 8
President’s Letter
stimuli through small plexiglass
cut-outs (be warned: sometimes
things can get stuck!), sanitize
Wechsler blocks and headphones
(note: always let the earphones
dry before putting them on!)
and remind clients to keep their
mask secured above their nose. I
have wondered about the validity
of using the patterns on fabric
masks as a sort of projective
test. My dogs have barked during
assessments when my mic was
Welcome from CAP Council to unmuted, my children’s Lego has
this Issue of The CAP Monitor, been visible in my “office space”
with a focus on COVID-19 and I’ve been taught to use
fingernail cleanliness (easier to
I write this message during a
note over a videocam) as a proxy
somber time, with COVID-19
for overall hygiene. Like many of
incidence rising across the
us, I’ve become more familiar with
province and indeed across
telebehavioural health standards
the country. Psychologists are
of practice and the benefits and
not immune to the stress and
drawbacks of different telehealth
uncertainty that the pandemic has
platform and data solutions. It’s
caused for us and our colleagues,
been overwhelming, exciting,
clients and loved ones. In this
ridiculous and challenging all at
issue you will read articles about
the same time. Perhaps you can
COVID-19 and rising mental health
relate.
needs. We hope the information is
as helpful as it is timely. In addition to impacting the
way we practice, it’s clear that
Like most of CAP’s regulated
COVID-19 impacts mental health.
members, my professional life has
A recent study in The Lancet
been significantly impacted by
Psychiatry showed that up to a
COVID-19 over the last 13 months.
third of individuals diagnosed
I moved from my business office
with COVID-19 are subsequently
to a built-in desk under my six-
diagnosed with a neurological
year-old’s bunk bed. Upon return
or psychiatric disorder (Taquet,
to the office, I adopted the use
Geddes, Husain, Luciano, &
of a large Plexiglas divider and
Harrison, 2021). For many of
temperature screening, and
these individuals, this is their first
remained masked throughout
mental health diagnosis. Risk
protracted neuropsychological
of psychiatric and neurological
assessment batteries. I’ve learned
morbidity appears to be highest
how difficult it can be to pass test
CAP Monitor 66 www.cap.ab.ca Summer 2021 | 9
in individuals who become sickest others. Albertans face a tough
with COVID-19, including those are road ahead; I am hopeful that
admitted to intensive care. Beyond psychologists in Alberta will
the better known comorbidities support and strengthen Alberta
of stroke, Parkinsonism and and Albertans’ recovery.
major neurocognitive disorder,
Psychology offers unique value
individuals who have experienced
in responding to COVID-19. Our
COVID-19 are at increased risk for
insights on human behaviour
conditions such as mood disorder,
are crucial in multiple aspects of
anxiety disorder, psychotic
pandemic response, including
disorder, insomnia and substance
public health, workplace safety and
use disorder. Emerging research
engagement and education, and in
about “long COVID” also suggests
the acute, primary and long-term
prominent mental health sequelae,
care sectors. Indeed there is no
including low mood and anxiety
branch of psychology that does
(Taquet, Luciano, Geddes, &
not have something to offer in
Harrison, 2021). Psychologists are
response to COVID-19. We can also
leaders in how people make sense
use our knowledge and skills to
of and understand their world,
support each other and ourselves.
and should not be surprised by
this data. COVID-19 has turned But, just as we are not immune
lives “upside down,” including to stress, psychologists are not
our own. Some have observed immune to COVID-19 or its impact
that COVID-19 has created a on our mental health and well-
“cultural trauma” (Demertzis & being. I urge all psychologists to
Eyerman, 2020), one we have all be especially diligent about doing
experienced and which we must what is needed to take care of
all address. ourselves, so we can effectively
and appropriately care for others.
Despite, and perhaps because of,
Onward, my friends. Do not lose
these challenges, I remain hopeful.
hope.
I am hopeful for CAP’s regulated
members and the people they
support. Psychologists are
equipped with a mighty toolbox,
including empathy, self-awareness,
Reagan Gale, Ph.D., R. Psych.,
commitment and service to
President, CAP Council
CAP Monitor 66 www.cap.ab.ca Summer 2021 | 10
Council News
CAP Council bridges of understanding At their April 2021 meeting,
Welcomes our New towards reconciliation. She is a CAP Council increased the
Public Member, founding member of Futura20, minimum professional liability
Michèle Stanners! a new collaboration between insurance requirement
female leaders and influencers from $1,000,000.00 to
from Alberta and Quebec to $5,000,000.00. The minimum
identify the next “big ideas” to amount of $5,000,000.00 is
advance women’s issues. She consistent with other regulated
has sat on numerous boards, health professions under the
is a long standing and active Health Professions Act.
member of the International
This increase will be
Women’s Forum, and has
implemented in the 2022-2023
recently joined the ViTreo Group
fiscal year. This means that
as Senior Counsel. She is a
next year at practice permit
graduate of Harvard University,
Michèle is a nationally renewal time, all CAP regulated
an accomplished pianist and
recognized culture leader and members will need to declare
provides strategic advice to
nation builder with over 30 that they (or their employer)
leaders throughout Canada.
years’ experience developing have, and will maintain, current
https://www.michelestanners.
the arts and cultural landscape and active professional liability
com/
in Canada. She is a pioneer in insurance in the minimum
indigenous relations, launching Increase in amount of $5,000,000.00. All
in 2000 the Crossroads program Professional Liability regulated members are also
for the Canadian Unity Council Insurance encouraged to obtain additional
and advising and leading the insurance for professional
Making Treaty 7 Cultural Society One of the main functions of conduct inquiries. Those
following the tragic passing public protection is ensuring regulated members who are
of its founder. As a result of that regulated members have retiring or taking extended leave
this work, she has developed adequate professional liability are also encouraged to seek
a unique arts and experience insurance if a claim is made additional insurance that cover
based methodology to build against them. claims in perpetuity.CAP Monitor 66 www.cap.ab.ca Summer 2021 | 11
CAP Monitor 66 www.cap.ab.ca Summer 2021 | 12
include: establishing entry to practice Allowing for the amalgamation of
requirements; adopting a code of ethics; Colleges
developing practice standards;
implementing a continuing competence Bill 46 allows for two or more Colleges to
program and ensuring compliance. make an application to the Minister of
Health to amalgamate. Section 78(2)
Important to note, the amended legislation outlines the steps required to make an
does not allow "any individual who is an application for amalgamation. Importantly,
officer or senior employee of a professional Bill 46 does not mandate amalgamation,
association or labour union that represents however, this is occurring in some Canadian
members of a regulated health profession" jurisdictions. The complexities of
to be appointed or elected to any of the amalgamation are only recently being
following positions: identified. The rationale for amalgamation
primarily relates to economies of scale.
(a) member of a council; Currently, the Government will onlyentertain
(b) member of a registration committee, voluntary amalgamation proposals.
competence committee or hearing
tribunal; Creating a centralized, public facing
(c ) complaints director or the complaints online registry of regulated health
director's delegate; professions
(d) hearings director or the hearings
All regulated health professions are
director's delegate;
currently required to have online public
(e) registrar or the registrar's delegate;
facing member registries in addition to
(f) president of a council or the regularly updating the Provincial Provider
president's delegate. Registry. Difficulties arise with the former
when the public wishes to raise a concern
Further, if an individual is already in one or make a complaint and is unaware of
of the positions listed above and the health provider's specific contact
subsequently because an officer or information/profession. A centralized
senior employee as described, the registry of regulated health professions
individual is not eligible to continue to allows the public to more easily identify
serve and their appointment or elected whether a healthcare professional is a
term will be terminated. regulated member and to determine which
College should receive their complaint.CAP Monitor 66 www.cap.ab.ca Summer 2021 | 13
:CAP Monitor 66 www.cap.ab.ca Summer 2021 | 14
psychotherapy and counselling services. Psychologists help people to overcome or
Some, however, do not have psychology manage their problems/symptoms using a
as their primary focus of study, training,or variety of evidence based treatments or
supervision, but rather as an optional, interventions.
limited or secondary area. Typically,
psychotherapists and counsellors do not What specifically is a registered
have formal assessment training or psychologist?
experience in the areas of educational,
cognitive, personality or A psychologist studies how we think, feel
neuropsychological functioning. Many do and behave from a scientific viewpoint and
not have training in mental health applies this knowledge to help people
diagnosis. In contrast, psychologists are understand, explain, and change their
required to have in-depth education, behaviour. In Alberta, psychologists are
training, and supervision in cognitive, required to have as a minimum a graduate
affective, social, and biological bases of degree in psychology from a recognized
behaviour. educational program that includes core
content areas, 1600 hours of post degree
Psychologists have a long-standing supervised practice, successful completion
tradition of being scientist-practitioners. of the Examination for Professional Practice
That is, they rely on evidence-based in Psychology and the Ethics and
practices. In addition to offering Jurisprudence Examination. Many
supportive counselling,they offer in-depth psychologists have also completed degrees
treatment and assessment of complex, at the doctoral level.
often concurrent, serious mental health
conditions. As notedabove, these include
What do Psychologists do?
suicide/criminal risk, child access/custody,
learning, developmental, and Psychologists engage in research, practice
neuropsychological evaluations (i.e., (assessment and intervention), and
dementia/brain trauma). teaching across a wide range of topics
having to do with how people think, feel,
Most practicing psychologists are trained and behave. Their work can involve
to assess and diagnose problems in individuals, groups, families, as well as,
thinking, feeling, and behaviour, as well to larger organizations in government and
help people overcome or manage these industry. They work with clients of all ages
problems. Psychologists are uniquely with many specializing in one area (i.e.
trained to use psychological tests to help pediatrics, adult, geriatrics). Here are
with assessment and diagnosis. some of the kinds of topics towards whichCAP Monitor 66 www.cap.ab.ca Summer 2021 | 15 • • • • • • • • • • •
CAP Monitor 66 www.cap.ab.ca Summer 2021 | 16
Check In
Check In
CAP Meetings and Deadline Dates Feedback Update Information
Feedback Should you have any questions, or require further
information, please contact CAP by email (psych@
We want to hear from you! Let us know what you
cap.ab.ca) or by phone at 780.424.5070. Email
thought of this issue in this short feedback survey:
addresses are mandatory for all members of CAP. It
https://www.surveymonkey.com/r/CAPMonitor66.
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College 0f Alberta Psychologists Emails
Do we have your current information?
The Psychologists Profession Regulation (2005)
Please notify CAP of any changes to your postal
Section 25(1) requires all applicants/regulated
address, phone and fax numbers or email address.
members to provide, among other information,
To update your contact information:
current home and business email addresses along
with telephone numbers. By unsubscribing to CAP • Log in to the Member Portal
emails, you will be required to generate a new
• Go to the “I Want To” box on the left of the
email address and provide it forthwith to CAP. It is screen
imperative that CAP has timely and effective means
• Click “Update my Contact Information”
to communicate with all applicants and regulated
members. If you need any assistance please contact CAP at
psych@cap.ab.ca.CAP Monitor 66 www.cap.ab.ca Summer 2021 | 17
Pandemic:
Psychological
Impacts for
Members and
Those We Serve
Judi Malone, Ph.D., R. Psych.
T
he COVID-19 pandemic is of pocket and most were willing Alberta (PAA) has used these
shaping history, impacting (but did not prefer) to access findings to advocate for health
the story of our profession services via telepsychology. Given equity for Albertans, who have
in Alberta. Like pieces of a jigsaw Canada’s longstanding crisis of already been reeling from our
puzzle, the impact on community access to mental health services, economic downturn.
members and psychologists— compounded by the pandemic’s
and our collective professional toll, these findings underscored Over half of Canadians
response—will all become part of the need for innovative and reported a negative impact
that narrative. sustainable solutions that will on their ability to access
allow increased access to care by services by a psychologist
Community impacts psychologists.
The Council of Professional
Associations of Psychology Results for Albertans were
in Canada, together with similar. COVID-19 is impacting
the Canadian Psychological the psychological health of
Association, commissioned Albertans and worsening access
Nanos Research to conduct a to psychologists. Even though
series of representative polls in psychologists, highly trained in
Fall 2020 seeking community evidence-based practices, play a
input on psychological vital role in assessing and treating
pandemic impacts. National data health, 57 percent of respondents
indicated that COVID-19 was indicated they had less access due
worsening Canadians’ access to the pandemic and 76 percent
to psychologists. Over half of had access only via private
Canadians reported a negative insurance or by paying out of
impact on their ability to access pocket. Again, most were willing
services by a psychologist, 73 (but did not prefer) to access
percent had access only via services via telepsychology. The
private insurance or by paying out Psychologists’ Association ofCAP Monitor 66 www.cap.ab.ca Summer 2021 | 18
Impacts on psychologists
Community Impacts (cont.)
Although resilient, psychologists are not immune from these
impacts. No known models exist regarding how to operate
The Canadian
as a psychologist or as a professional association during a
Mental Health
pandemic. From April to October 2020, PAA members were
Association,
surveyed six times about the impacts of the COVID-19 pandemic
Alberta
on psychological practice in Alberta. Each survey asked about
Division,
the impact of the pandemic on members, professionally and
administered a
personally, and about their perception of these impacts on those
similar survey
to whom they provide psychological services. It also asked about
between April and May 2020 to
members’ use of telepsychology, their practice clarity and the
understand the pandemic’s mental
effectiveness of PAA’s communication with and professional
health impact on Albertans across
support for them.
rural and urban areas. The nearly
2,000 respondents highlighted a The results of these repeated member surveys indicated that
wide variety of pandemic-specific most members transitioned to telepsychology with increasing
concerns. These encompassed confidence in their working conditions and employment stability.
eight general themes: Progressive increases were seen in workloads and social
commitments. Respondents reported being negatively impacted
• isolation
personally by the pandemic, but they perceived such negative
• limited access to mental health impacts to be even greater for those they served. Similarly,
support respondents reported that their self-care, psychological health
• mental health challenges and overall functioning were all deficient in comparison to pre-
pandemic levels, but they perceived these deficiencies to be
• anxiety
even greater for their students, patients and clients. Results also
• economic concerns
indicated that telepsychology did not appear to improve efficacy
• uncertainty about the future or connectedness of services, but most respondents considered
• family and relationship concerns it a sufficient alternative under the circumstances. Also notable
was an increase in the intention to continue using telepsychology
• education worries
(79%) post-pandemic. Respondents felt they had good access to
Also noted were popular coping needed pandemic-specific resources and support from the PAA,
mechanisms and supports which but some continued to report that the influx of information was
included staying connected, overwhelming.
physical activity and health,
Professional response
self-care, outdoor/different
environments, maintaining a An impressive professional response has taken place in addressing
routine, increasing support and this collective challenge. We have witnessed psychologists
learning, information intake and collaborating with and supporting one another in communities of
acceptance of the situation. practice. The College of Alberta Psychologists (CAP) and the PAA
moved swiftly to develop key resources and communications and
These results underscore the to coordinate this response, to the benefit of all Albertans but also
significant concerns the pandemic with regard to member-specific supports and advocacy.
has raised for individuals and
families in Alberta. However, they PAA’s professional response has targeted both Albertans and
also point to our population's PAA members. Public support included the launch of the PAA
strength and resilience. Disaster Response Network (DRN), media engagement for public
awareness, advocacy for access and needs and several public
education resources for psychological coping during pandemics,CAP Monitor 66 www.cap.ab.ca Summer 2021 | 19
including infographics and press PAA
Author releases shared online, in social
Psychology in Alberta moved
media and on YouTube. We even
to separate regulatory college
had a specialized version where
and professional association
Kristi-Anna Steiestol, R. Psych
functions in 1996, well before
and RN, tailored a psychological
the requirement to do so was
coping resource for nurses in
in place. Together with CAP,
Alberta.
we have developed a strong,
Launched in March 2020, PAA’s beneficial working relationship
DRN continues to operate, based on our mutual goals for the
with volunteer psychologists psychological health and wellness
providing up to three pro bono of all Albertans.
sessions with Albertans who
In 2021, PAA marks its 25th
may have been traumatized by
anniversary as a professional
the pandemic. In this launch,
association, acting as the voice
we have prioritized healthcare
of, and for, psychology in Alberta.
providers and first responders
Your professional association is
for this recovery stage (versus
the voluntary body that advocates
crisis intervention) program.
for psychology in Alberta, informs
Hundreds of PAA members
JUDI MALONE the public and the media and
have volunteered to provide
advocates for consumers of
Judi L Malone, Ph.D., R. Psych. these services through either
psychotherapy and psychological
(AB/AUS) is the CEO of the direct psychological services
and mental health services. Our
Psychologists’ Association or one of two presentations on
mission is to advance the science-
of Alberta with extensive Psychological Coping During
based profession of psychology
experience collaborating to Pandemics.
and to promote the well-being
strengthen the role and profile and potential of all Albertans.
Resources and supports for
of psychology and access
psychologists across the career
for Albertans. Dr. Malone Alberta psychologists have
lifespan continue to be a priority.
has a wealth of scientist- demonstrated their resilience
PAA hosts monthly informal online
practitioner experience from and leadership during this
pandemic-specific gatherings
clinical practice, academic pandemic beyond the professional
of members. Public education
roles, and in research. She has supports provided. This directly
resources have been tailored
expertise in working in health aligns with PAA’s vision that the
for use with patients, clients,
disparity and both national and association and our members are
students and others served by
international perspectives from recognized leaders in enhancing
psychology in Alberta. PAA hosts
dual registration in Alberta and the psychological health of all
a series of free pandemic practice
Australia. Her clinical expertise Albertans.
adaptation webinars on trauma,
is in trauma, the neurobiology
school psychology, counselling In closing
of addictions, and professional
psychology and supervision. This narrative is incomplete, with
ethics in rural and small
Both PAA and CAP continue to many more pieces to explore in
communities. She is an adjunct
update extensive online COVID-19 the puzzle of pandemic impacts
with Educational Psychology at
resource libraries and, together, in Alberta. We look forward to
the University of Alberta and
are pivoting to online delivery learning together on this journey,
Charles Sturt University.
of our joint PAA–CAP townhall as we really are writing this story
sessions. together.CAP Monitor 66 www.cap.ab.ca Summer 2021 | 20
The COVID Pandemic and the Yin
and Yang of Psychoactive Drug Use
Kevin G. Alderson, Ph.D., R. Psych.
“It was the best of times, it was the worst of times, it was the age of
wisdom, it was the age of foolishness, it was the epoch of belief, it
was the epoch of incredulity, it was the season of Light, it was the
season of Darkness,…”
(para. 1, A Tale of Two Cities, Charles Dickens).
A
s COVID-19 hurricaned that the pandemic has, indeed, et al., 2017). Opioid overdoses are
into our lives, it was “worsened the ongoing health now the leading cause of death in
easy to forget that crisis of opioid-related harms Canada for individuals between
another pandemic had been and deaths” (para. 1). Data from 18 and 35 years of age (Eibl et
deepening into a catastrophe for Ontario indicated that between al., 2017). The Government of
decades. Health Canada (2021) 1991 and 2010, opioid-related Canada (2021b) reported that
reported on March 29, 2021, deaths increased by 242% (Eibl Canada lost 19,355 individuals toCAP Monitor 66 www.cap.ab.ca Summer 2021 | 21
opioid-related deaths between
January 2016 and September
2020.
The Government of Canada
Today’s opioid crisis did not, reported that Canada lost
however, spring out of a mist. The
groundwork for it had been laid 19,355 individuals to opioid-
30 years ago. The first wave of the
opioid crisis began in 1990 or 1991 related deaths between January
due to the increased prescription
practices by physicians who were 2016 and September 2020.
led to believe by pharmaceutical
companies that opioids were
“safe” (Dayer et al., 2019). The of overdoses and deaths. About estimated that Americans spent
second wave began in 2010 as 71% of stimulant deaths between about $1 trillion buying illegal
increased overdoses and deaths January and September 2020 drugs between 2000 and 2010, or
occurred from heroin, followed involved cocaine, while 46% about $100 billion annually.
by the third wave in 2013 due involved methamphetamines
Periodically throughout COVID-19,
to deaths caused by synthetic (Government of Canada, 2021b).
provincial governments closed
opioids (typically fentanyl). The number of hospitalizations
many services that were unrelated
McCann, Pineo and Schwartz in Canada due to stimulant
to basic needs, with two notable
(2020) predicted a fourth wave, overdoses between January 2016
exceptions: liquor stores and
triggered by COVID-19, which and September 2020 was 10,518
cannabis outlets. These were
has demonstrated a profoundly (Government of Canada, 2021b).
deemed as “essential services”
negative effect on the mental
Perhaps we should ramp up the (Mosleh, 2020). Timothy Leary’s
health of particularly vulnerable
war on drugs that Nixon began words echo as Canadians
populations.
in 1971. Unfortunately, America’s continued to “turn on, tune in,
Opioids are not the only drug war on drugs has proven a drop out” (Ott & Joseph, 2017)
class fueling substantial numbers dismal failure. Kilmer et al. (2014) during the pandemic.
While the impact of cannabis
legalization on youth remains
uncertain, what we know (based
on a study of 6,709 Canadian
grade 9 to 12 students who use,
or have used, marijuana) is that
the younger a person is when
they begin using it, the likelier
it is that they will (a) continue
using, (b) increase frequency of
use, and (c) drive a vehicle after
getting high (Azagba & Asbridge,
2019). With legalization,
Canadians have now become the
guinea pigs of an international
“weed” experiment (Wadsworth
et al., 2020).CAP Monitor 66 www.cap.ab.ca Summer 2021 | 22
Miller and Oberbarnschiedt Unsurprisingly, drugs must decision, an election promise
(2017) released a report in the also go through a review that the Right Honourable
United States regarding medical process before becoming Justin Trudeau committed to
marijuana (MM). They wrote that it legally available in Canada implement if the Liberal party
“does not meet the legal definition (Government of Canada, 2015). took power in 2015 (Tucker,
of drug as defined by the Food The five primary stages (each 2013).
and Drug Administration (FDA) in of which contains several
Statistics Canada conducts
the US” (Miller & Oberbarnschiedt, substages) include initial drug
the Canadian Tobacco, Alcohol
2017, p. 335). For a drug to be research, pre-clinical trials,
and Drugs Survey (CTADS)
considered safe by the FDA, clinical trials, drug approval
every two years. The 2019
it must undergo 12 stages of process, and after approval
results are expected sometime
drug testing: MM has not been (SPharm, 2021). Identical to the
in either March or April 2021
subject to any of these stages. situation in the United States,
(see https://www23.statcan.
Furthermore, MM is not available MM never went through any of
gc.ca/imdb/p2SV.pl?Function
in pharmacies, does not proceed the stages of the drug review
=getSurvey&SDDS=5289). The
through the typical prescribing process. Although MM has been
2017 results were based on
route and may be grown by available in Canada for 20 years,
16,349 respondents in Canada,
care providers who receive no even the Government of Canada
interviewed by telephone
supervision or regulation (Miller & (2016) wrote that “Cannabis
between February and
Oberbarnschiedt, 2017). Studies (marijuana, marihuana) is not
December 2017. The study’s
that have claimed medicinal an approved therapeutic drug
results represent a weighted
properties were performed on in Canada” (para. 1). Moreover,
total statistically of 30.3 million
cannabinoids, not on smoked the Government of Canada
Canadian residents aged 15
marijuana and THC. Marijuana (2021a) described several of
years and older (note that
is also associated with the the long-term risks of cannabis
residents of the territories are
use of other drugs (Miller & use. The legalization of cannabis
not included in the CTADS).
Oberbarnschiedt, 2017). in Canada was a political
I compared the 2015 and 2017 CTADS surveys (Government of Canada, 2017, 2019, respectively). The
percentages provided refer to past-year use only. See Table 1 for a summary of these results.
Table 1. 2015-2017 Past-Year Substance Use in Canada in Percentages (Ages 15+)
# Substance 2015 2017 % Change
1 Cigarette smokers 13% 15% +2%
2 E-cigarettes 13% 15% +2%
3 At least one of six illegal drugs (includes cannabis) 13% 15% +2%
3 Cannabis alone 12% 15% +3%
4 At least one of five illegal drugs (excludes cannabis) 2% 3% +1%
5 Alcoholic beverages 78% 78% 0
6 Stimulants obtainable from a physician 1% 2% +1%
7 Sedatives/tranquillizers 11% 12% 0*
8 Opioid pain relievers 13% 12% 0*
9 Psychoactive pharmaceuticals (above three, combined) 22% 22% 0
10 Reported at least one harmful effect from illegal drugs 1% 2% +1%
* Not a statistically significant difference in the study.CAP Monitor 66 www.cap.ab.ca Summer 2021 | 23
The comparison reveals that opioids produce the greatest psychiatry. Most of the work
past-year drug use increased in degree of pain relief compared in this area is with psilocybin,
Canada between 2015 and 2017. to other pain medications the active ingredient in those
Increased drug use increases (Alderson & Gladding, 2021), mushrooms best left where
the number of individuals who and this is critical for people they grow by passersby. Some
will become addicted. Cannabis suffering from terminal research is being done using
use continues to increase in the illnesses. There are two caveats, LSD. Psilocybin is being used
general population (Canadian however: (a) the Centers for with people who experience
Centre on Substance Use Disease Control and Prevention depression, anorexia, obsessive-
and Addiction, 2020). Many (Dowell et al., 2016) surmised compulsive disorder and
evidence-based protective that limited evidence exists addictions. Individuals with
factors can help buffer regarding the long-term benefits histories of psychosis and
individuals from developing of prescribing opioids for the bipolar disorder are excluded.
substance use disorders, but long-term management of pain; Nutt and Carhart-Harris opined
the legalization of psychoactive and (b) chronic opioid use that psychedelics might work
drugs is not one of them dysregulates reward functioning, because these conditions are
(Alderson, 2020). which leads to increased pain internalizing disorders. “The
sensitivity (Finan et al., 2018). psychedelic experience opens
The dark side of psychoactive
a therapeutic window that
use, however, paints only one Nutt and Carhart-Harris (2021)
disrupts entrenched thinking
side of the developing drug provided an update regarding
and allows insight, which with
saga. It is undeniable that the use of psychedelics in
psychotherapeutic supportCAP Monitor 66 www.cap.ab.ca Summer 2021 | 24
can lead to a recalibration of resistant depression (Kokane et consciousness, it is critical to
one’s spectrum of associations” al., 2020). Kokane et al. (2020) remember that what goes up
(Nutt & Carhart-Harris, 2021, reported that “ketamine’s must also come down. The
p. 122). Although effect sizes efficacy, however, is transient, brain will need to readjust after
have been higher than current and patients must return to the a drug high, and this occurs
treatments, the authors noted clinic for repeated treatment as as allostasis and homeostasis
that confirmation bias might be they experience relapse” (p. 1). mechanisms work to bring the
inflating the results. organism back to stability. Our
The above are a few examples
work as addiction psychologists
Ketamine, which is technically a of the yin and yang of
will continue to be with
dissociative anesthetic, has been psychoactive drug use. As
those who increasingly find
used on the street by some as a humans continue searching for
themselves on a perilous path
date-rape drug. Recently, it has ways to catapult themselves
with their drug use. This work
also been given to individuals quickly into better moods
will not end anytime soon, and,
with chronic and treatment- and explorative states of
more likely, never will.
Kevin Alderson, Ph.D., R. Psych., is a professor emeritus of counselling
Author psychology from the University of Calgary. He has been a registered
counseling psychologist since 1986 and served as president of the
College of Alberta Psychologists in 2018-2019.
Dr. Alderson holds the highest level of membership within the
International Society of Substance Use Professionals, and he is also a
professional member of the Association for Addiction Professionals
(NAADAC). Dr. Alderson sits on the editorial board of both the
Journal of Alcoholism, Drug Abuse & Substance Dependence and the
Austin Journal of Drug Abuse and Addiction. He holds membership
in the American Counseling Association, the American Psychological
Association, and the Canadian Counselling and Psychotherapy
Association. Between 2008 and 2020, Dr. Alderson was the editor-in-
chief of the Canadian Journal of Counselling and Psychotherapy. He is
KEVIN ALDERSON the founder of both the first doctoral credential in the counseling and
psychotherapy field in Canada and of its first doctoral program.
Dr. Alderson has authored 11 books and several scholarly articles and
book chapters. His most recent books include Choosing the Right
Counselor for You (2020) and The Concise Guide to Opioid Addiction
for Counselors (2021), both co-authored with Samuel T. Gladding and
published by the American Counseling Association. He is also the solo
author of the 720-page textbook called Addictions Counseling Today:
Substances and Addictive Behaviors (2019, Sage Publications).
He completed an MSc in clinical, school, and community psychology
from the University of Calgary and a Ph.D. in counseling psychology
at the University of Alberta. Dr. Alderson is married and is the father
of two adult children. Outside of counseling, he enjoys racket sports,
dancing, hiking, camping, and weight training.CAP Monitor 66 www.cap.ab.ca Summer 2021 | 25 A Rise in Eating Disorders during the COVID-19 Pandemic Kristin M. von Ranson, Ph.D., R. Psych. Department of Psychology, University of Calgary Eating disorders are serious (Galmiche, Déchelotte, Lambert, The advent of the COVID-19 conditions (Klump et al., 2009) & Tavolacci, 2019). Furthermore, pandemic has affected the lives of with mortality rates five times eating disorders tend to be people across the globe, including higher than expected (Iwajomo under-diagnosed (Silén et al., those with eating disorders. In et al., 2020); as currently defined, 2021). Public perception has addition to COVID-19’s direct they are also more prevalent than yet to catch up to these facts impact on physical health, public previously understood. According (Mond & Arrighi, 2011), and the health restrictions that have to a recent review, eating seriousness of eating disorders is accompanied it have profoundly disorders affect approximately often underestimated. However, disrupted the social, educational 8.4% (range: 3.3% to 18.6%) of awareness is growing of the and work lives of people across women and 2.2% (range: 0.8% gravity and pervasiveness of the globe since a pandemic was to 6.5%) of men in their lifetimes eating disorders. declared in March 2020. Perhaps
CAP Monitor 66 www.cap.ab.ca Summer 2021 | 26
the most pervasive stressor has the small average effects they disorder symptoms and related
been the curtailment of social described may disguise the psychopathology, such as food
interaction via physical distancing deleterious impacts of COVID-19 restriction, overexercising,
public health orders, to limit virus pandemic lockdowns on a subset purging, anxiety and depression
spread. Social isolation has been of individuals. (Richardson et al., 2020). Those
linked to several indices of poor seeking help from NEDIC via
So, what impact have the
health, such as depression, anxiety chat often indicated a worsening
COVID-19 pandemic and
and psychosis (Morina et al., 2021). of eating disorder symptoms.
accompanying lockdowns had on
Numerous cross-sectional studies Since the pandemic began, a
eating disorder psychopathology?
have pointed to negative effects Calgary eating disorder support
News reports in Alberta and
of pandemic public health orders group involved five times more
elsewhere have documented
on mental health, focusing on participants than usual and noted
large jumps in numbers of eating
depression and anxiety symptoms that wait times for publicly funded
disorder cases over the past
(Bueno-Notival et al., 2021; Racine eating disorder treatment had
15 months (Cademartori, 2021;
et al., 2021; Ravens-Sieberer et jumped (Underwood, 2021).
Hounsell, 2021; Marsh, 2021;
al., 2021; Vindegaard & Benros,
McMillan, 2021). Additionally, signs In a study conducted in the first
2020; Xiong et al., 2020; Wang
of increased demand for eating weeks of the pandemic lockdown,
et al., 2021). Moreover, evidence
disorder treatment services have more than 1,000 individuals with
indicates that those with pre-
emerged since the pandemic self-reported eating disorders
existing psychopathology are more
began. Treatment providers from the United States and
vulnerable during this pandemic
and treatment programs have the Netherlands described
both to COVID-19 infection
expressed concerns over surging heightened anxiety and worsened
(Wang, Xu, & Volkow, 2021) and
eating disorder rates (Vescera, eating disorder behaviours
to deteriorating mental health
2021; Weikle, 2021) and described (Termorshuizen et al., 2020). Those
(Castellini et al., 2021).
rises ranging from 28% to 63% with previous eating disorders
However, some studies have in demand for assessment and reported heightened vulnerability
suggested more limited impacts treatment for eating disorders in to relapse. Ample results from
on mental health. For example, 2020 over pre-pandemic 2019 other studies have corroborated
a review and meta-analysis of (Spettigue, 2021; Weikle, 2021), the exacerbation or reappearance
longitudinal studies and natural suggesting heightened incidence of eating disorder symptoms (Giel
experiments of associations of eating disorders. et al., 2021; McCombie et al., 2020;
between COVID-19 lockdowns and Phillipou et al., 2020; Schlegl et al.,
Research evidence tends to
mental health identified only small 2020; Schlegl et al., 2021), as well
support these news reports
increases, on average, in anxiety as increased food restriction and
of upticks in eating disorder
and depression, and no significant binge eating behaviours among
prevalence and treatment-seeking
decline in reported well-being or members of the general public
during the pandemic, although
life satisfaction (Prati & Mancini, (Phillipou et al., 2020). However,
most studies have been cross-
2021). These authors concluded some participants also noted
sectional. Early in the pandemic,
most people have shown positive effects of the pandemic,
the National Eating Disorder
psychological resilience in the face such as feeling connected with
Information Centre (NEDIC)
of COVID-19 pandemic restrictions. friends and family and the use of
reported a significant increase
Despite the methodological adaptive coping skills (McCombie
in help-seeking, relative to
strengths of this review, which et al., 2020).
comparable periods in previous
identified well-controlled studies
years by people with eating The weight of the available
and used meta-analysis to
disorder symptoms, as well longitudinal evidence reinforces
combine the results of 25 studies,
as increases in specific eating the cross-sectional findingsCAP Monitor 66 www.cap.ab.ca Summer 2021 | 27
of worsening eating disorder COVID-19 pandemic (Simone et al.,
Author symptoms during the pandemic, 2021).
particularly among those with
In summary, eating disorder
pre-existing psychopathology,
prevalence has increased and
including eating disorders
severity has worsened overall
(Castellini et al., 2021; Flaudias et
during the COVID-19 pandemic.
al., 2020; Nisticò et al., 2021; Trott
Eating disorders carry a substantial
et al., 2021; Zhou & Wade, 2021;
burden (Santomauro et al., 2021)
but see Martínez-de-Quel et al.,
and warrant clinical attention. How
2021). Multiple reasons have been
should a psychologist proceed?
proposed for the disproportionate
First, be aware of the range of
impact of COVID-19 lockdowns
eating disorder symptoms and
on eating disorder symptoms and
screen patients for them, as eating
prevalence. Increases in behaviours
disorders can occur in people of
such as binge eating may stem
all ages, genders, shapes, sizes
from dysfunctional strategies
KRISTIN M. VON RANSON and ethnicities. Eating disorders
to manage aversive emotions
commonly co-occur with other
Kristin von Ranson, Ph.D., (Castellini et al., 2021). Cooper
psychopathology and are often
R. Psych., is Professor of and colleagues (2020) theorized
hidden. Second, familiarize
Clinical Psychology at the that pandemic-related disruptions
University of Calgary and an yourself with the eating disorders
may have unique impacts on those
award-winning mentor. Her treatment literature. A team
with eating disorders, for example,
program of research aims to of Canadian eating disorder
reduce the burden of eating due to food insecurity and limited
treatment experts has published
disorders and related problems food access, media consumption
evidence-based, consensus-driven
across the lifespan. One of and fatphobic messages (e.g.,
her major research interests treatment recommendations for in-
regarding the “Quarantine 15”
is the research-practice gap person and virtual care of children,
pounds), exercise constraints, and
in psychotherapy provision. adolescents and emerging adults
She has published more than limited health care access. Others
aged 25 and younger (Couturier
75 scientific publications, have suggested the disruption of
et al., 2020, 2021). Another useful
and her research has been routines and lack of structure may
funded by the Canadian source of clinical information and
contribute to worsened eating
Institutes for Health Research, guidance is the UK’s National
disorder symptoms (Clark Bryan
PolicyWise for Children & Institute for Health and Care
Families, the National Eating et al., 2020; Rodgers et al., 2020;
Excellence, https://www.nice.org.
Disorders Association, and Termorshuizen et al., 2020), as
uk/search?q=Eating%20disorders.
the University of Calgary. Her well as increased media exposure
current affiliations and service and the removal of protective
roles include: elected Fellow
factors such as adaptive coping About the Author
and Director for Research-
Practice Integration for the strategies and social support Contact information:
Academy for Eating Disorders, (Rodgers et al., 2020). Studies
Kristin M. von Ranson
elected member of the Eating have supported some of these
Disorders Research Society, Department of Psychology,
hypothesized mediators. For
Associate Editor of Frontiers in University of Calgary
instance, research indicates that
Psychology’s section on Eating 2500 University Dr. NW,
Behavior, and editorial board psychological distress, stress
Calgary, AB T2N 1N4
member of the International management, financial problems,
kvonrans@ucalgary.ca
Journal on Eating Disorders and and sudden schedule changes may
Behavior Therapy. have promoted eating disorder 403-220-7085
psychopathology during theCAP Monitor 66 www.cap.ab.ca Summer 2021 | 28
What is the Gold Program
Yvonne Legris, Ph.D., R. Psych.
Millard Health
I
n Alberta, from January
to March 2021, over 8,000
WCB claims have been
accepted due to COVID-19 illness
arising during the course of
employment, with an average
two-week period away from
work. As is common with tracking
during the pandemic, information
changes rapidly, and current time
away from work has extended,
particularly for people suffering
from long haul COVID-19
symptoms. Long haul COVID-19
symptoms include brain fog In Alberta, from January to March 2021, over 8,000 WCB claims have
(i.e., concentration and focus been accepted due to COVID-19 illness arising during the course of
concerns, word-finding difficulty employment
and executive functioning deficits
such as poor planning and The term “Gold Program” is of gathering initial information
impulse control, task inhibition, used in preference to the term occurs to further delineate
etc.), physical and mental “COVID Program” as a purposeful their state of readiness for the
fatigue, breathing concerns distinction to avoid possible program, followed by a joint
such as shortness of breath and client stigmatization in being intake with the rehabilitation
coughing, pain such as joint and known as a “COVID client” taking team (OT, ET and PT), which
chest pain, sleep disruptions, part in a COVID program. develops a treatment plan. The
anxiety, depression, and PTSD psychology intake follows to
The program operates from
symptoms and possible Post- assess psychological functioning,
a biopsychosocial model that
ICU PTSD (Murray, 2020). These current needs, protective factors,
“takes into account the physical,
high numbers reflect the impact available supports and existing
psychological, and social
of the pandemic and underscore coping ability and psychological
factors of the disease or injury
the need for treatment designed mindedness. The process is
and promotes an integrated
to address and treat these thorough and has changed and
approach to treatment” (Borrell-
needs. As a leading provider of been modified in a variety of
Carrio, 2004). The treatment
occupational rehabilitation and ways to accommodate fatigue
team is multidisciplinary in
disability management services in levels for workers and to ensure
focus including psychologists,
Alberta, Millard Health Treatment maximum gain for their efforts.
physicians and occupational,
Centre developed the Gold For example, intake times are
physical, exercise and
Program. This is a specialized reduced from one and a half hours
rehabilitation therapists. Once
rehabilitation program to assist to one hour and are spaced out
a client is referred to the Gold
workers presenting with the array throughout the week rather than
Program, a triage assessment
of long haul COVID symptoms. occurring all on one day.You can also read
