BC Psychologist summer 2 011 The economic sensibility of full public mental health coverage p.19 Do you really need an ad agency? p.29 How to tell your patients that you have cancer p.14 bcpsychologists 204–1909 W Broadway Vancouver BC V6J 1Z3 T: 604-730-0501 F: 604-730-0502 social media gone wild? let us show you the ropes. Connected: Effective and Ethical Marketing Strategies for Psychologists A workshop hosted by the BC Psychological Association and presented by Dr. David Ballard September 23rd, 9am to 4pm stop mooing. register now. www.psychologists.bc.ca Robson Oliveira/sxc.hu letter from the president letter from the executive director member survey of bcpa’s public outreach activities cpa practice directorate update comings & goings: staff changes 05 06 08 10 13 14 16 how to tell your patients that you have cancer kwantlen’ students psychology public outreach efforts 19 the economic sensibility of full public mental health coverage 25 crowd pysch & the stanley cup riot 29 do you really need an ad agency? 33 nominations open for the psychologically healthy workplace awards BC Psychologist Want to inform your colleagues of initiatives benefiting both your profession and the public? Send us 50 words, and we will include them in the News section of the BC Psychologist ~~~ EDITOR IN CHIEF Joti Samra, Ph.D., R.Psych. EXECUTIVE EDITOR Joanne Tessier, Ph.D., R.Psych. PUBLISHER Rebecca Smith ART DIRECTOR | ASSISTANT EDITOR Giovanna Di Sauro EXECUTIVE ASSISTANT Jeni Campbell BOARD OF DIRECTORS Sign up now for our marketing & social media workshop for psychologists. Go to our website > News & Events > BCPA Workshops and Events. PRESIDENT Joti Samra, Ph.D., R. Psych. VICE-PRESIDENT Derek Swain, Ed.D., R.Psych. SECRETARY Anne Dietrich, Ph.D., R.Psych. TREASURER Robert Colby, M.S., R.Psych. DIRECTORS Ted Altar, Ph.D., R.Psych. Jordan Hanley, Ph.D., R.Psych. Atholl Malcolm, Ph.D., R.Psych. ADVERTISING RATES Members and affiliates enjoy discounted rates. For more information about print and web advertising options, please contact us at [email protected] Presents Hypnosis and Trauma: Integrating Hypnosis into the Treatment of Traumatized Children and Adolescents DATE: Saturday & Sunday October 29th & 30th, 2011 TIME: Registration- 8:30 am: Workshop 9 am –4:30 LOCATION: Vancouver General Hospital Paetzold Health Ed. Centre, 899 West 12th Ave. Vancouver, B.C. This workshop will provide a conceptual framework for understanding why hypnosis is particularly suited to the prevention, assessment and treatment of trauma. A review of the current understanding of neuroplasticity, attachment, hypnotic rapport and dissociation will provide a foundation for hypnotic work. There will be attention to how hypnotic language can be modified for prevention and treatment of trauma. There will also be video examples of cases and experiential exercises to facilitate learning. Participants will be able to conceptualize a new framework for their hypnotic work with children & adolescents perform at least 3 hypnotic techniques for treating traumatic symptoms explain the relationship between therapeutic play & hypnosis integrate these new techniques into their practices for the benefit of their clients’ patients. Outline of topics: 1. What is trauma- definitions and a conceptual framework 2. From assessment to building resiliency for the future 3. Why think hypnotically? How to use hypnosis. 4. Neurobiology and neuropsychology- attachment and rapport 5. Play, dissociation and hypnosis 6. Developmental considerations 7. The child’s response to trauma 8. Systems and families 9. Hypnotic techniques with case examples for each 10. Changing perceptions, shifting senses- integrating mind and body With: Dr. Julie Linden Julie H. Linden is a licensed psychologist with over 30 years of psychotherapy experience treating people of all ages. Young children, adolescents, adults, couples and families consult her for a wide range of reasons. Julie’s specialties include the treatment of anxiety, depression, and somatic symptoms; medical and psychological trauma, pain management techniques, and hypnotherapy; gender sensitive therapy; play therapy, ADHD and learning differences and Dissociative Disorders. She is the current President-elect of the International Society of Hypnosis, Past President of the American Society of Clinical Hypnosis, and Past President of the Greater Philadelphia Society of Clinical Hypnosis. To register and for more information visit our website: www.hypnosis.bc.ca Email: [email protected] Phone: (604) 688-1714 SUBMISSION DEADLINES November 15 | March 1 | June 1 | September 1 PUBLICATION DATES January 15 | April 15 | July 15 | October 15 CONTACT US 204 - 1909 West Broadway, Vancouver BC V6J 1Z3 604-730-0501 | www.psychologists.bc.ca MISSION STATEMENT BCPA provides leadership for the advancement and promotion of the profession and science of psychology in the service of our membership and the people of British Columbia. ADVERTISING POLICY The publication of any notice of events, or advertisement, is neither an endorsement of the advertiser, nor of the products or services advertised. The BCPA is not responsible for any claim(s) made in an advertisement or advertisements mailed with this issue. Advertisers may not, without prior consent, incorporate in a subsequent advertisement, the fact that a product or service had been advertised in the BCPA publication. The acceptability of an advertisement for publication is based upon legal, social, professional, and ethical consideration. BCPA reserves the right to unilaterally reject, omit, or cancel advertising. DISCLAIMER The opinions expressed in this publication are those of the authors, and they do not necessarily reflect the views of the BC Psychologist or its editors, nor of the BC Psychological Association, its Board, or its employees. Canada Post Publications Mail #40882588 COPYRIGHT 2011 © BC PSYCHOLOGICAL ASSOCIATION All images are property of their respective authors. Cover image: Tomasz Kobosz/sxc.hu Inside back cover: Melodi T./sxc.hu 4 bc psychologist www.psychologists.bc.ca LETTERS Letter from the President Dear Colleagues, joti samra, Ph.D., R.Psych. I hope that everyone is having a happy start to our (semi) summer! This letter follows on the heels of a protracted, emotionally intense, rollercoaster playoff season. The ultimate end to the season was one that was tremendously disappointing to most British Columbians at a number of levels. Despite the dismay at how inappropriately a small group of individuals reacted to our loss, throughout the process I was struck by the opportunities that were available to educate others about our profession. The public was hungry for information on the psychology of group behaviour, the causes of intense emotional reactions, factors that lead to emotional escalation and behavioural disinhibition, and contributors that lead individuals to engage in behaviours they otherwise would not (e.g., rioting, violence). I found there were myriad opportunities that arose to speak about psychology and human behaviour in the media, with non-psychologist colleagues, and with friends and families. This highlighted for me the importance of all of us being mindful of day-to-day opportunities we have to continue to educate others about how psychology is such an integral part of all of our lives. Joti is the President of BCPA. You can reach her and the rest of the Board of Directors at [email protected] In terms of association activities, moving into the fall the Board will be working on developing and articulating a strategic plan and identifying actionable priorities, in consultation and collaboration with the College of Psychologists of BC (CPBC). Strengthening relationships with the CPBC is in my opinion essential for us to collectively move forward as a profession in this province, and to this end I and other Board members have had a number of meetings with Dr. Andrea Kowaz, Dr. Michael Elterman, and Dr. Amy Janeck over recent months. We recognize that having a stronger voice with our provincial and regional governments is a key component of us seeing tangible changes in the delivery of psychological services to the public. To this end, I will be arranging meetings along with Dr. Kowaz to meet with key government representatives in the fall. Additionally, Dr. Derek Swain has dedicated a number of days of time over the past months working to compile written and presentation materials that can facilitate our discussions with government. This information, along with the activities and documents put together by other board members and Association volunteers is helping to build a strong base of information that makes a strong “business case” for improved access to psychological services in our province. We are working on strengthening relationships with colleges and universities, and would like to highlight the range of opportunities that exist for undergraduate and graduate students to be involved. I would very much encourage those of you who work in educational institutions to inform students of volunteer opportunities that exist. As always, I look forward to any feedback and suggestions for the Board moving forward over the coming months. I hope everyone has a great summer! Respectfully submitted, Dr. Joti Samra, R.Psych. f www.psychologists.bc.ca bc psychologist 5 LETTERS Letter from the Executive Director The time is right to make your voice heard Rebecca Smith Rebecca is the Executive Director of BCPA. She can be reached at 604-730-0501 or at [email protected] Hey! What happened to spring? Here I am writing for the summer edition of the BC Psychologist and I don’t remember having a spring. There was a long wet winter, and then more winter, then more winter, and now — here it is, July! It is funny how things happen so quickly and, seemingly without our input or even noticing at all, they change: sometimes for the better, sometimes not. This is true of the weather and so too, of our professional and political landscape. While it is true that we have no control of the weather, it is not true that we haven’t any control over our professional and political landscape. We hold the power to change these things in our hands. Whether it is simply by exercising our right to vote, or expending an all-out lobbying effort, the power is ours. Margaret Mead once said, Never doubt that a small group of thoughtful, committed people can change the world. Indeed, it is the only thing that ever has. Let’s pull together and prove her right once again. Though there are not great numbers of Registered Psychologists in British Columbia and not all of you are members of the BCPA, we can make a difference if we work together thoughtfully and with commitment. Indeed, there are already steps being made by BCPA Committees like the Community Engagement Committee and the Psychologically Healthy Workplace Awards Committee. With every public event we engage in, every press release, and every tradeshow we participate in, we are reaching our hands out to others to join us, to learn more about the value and import of psychology and of the role of mental health in our lives, our economy, and the very fabric of society. Every time we talk to someone about stress, anxiety, healthy workplace policies, and lifestyle choices, we are gaining more support to our efforts — we are growing in number. There is no denying that the time is right. Our audiences’ ears are ready for the message that mental health is as important as physical health, and that Registered Psychologists are leaders in this field. Registered Psychologists have a part to play in building and maintaining the overall health of British Columbia, from the classroom to the workplace, in families, factories and fairs. From sporting arenas to the freeways, we are always affected by our mental health and that of those around us. Our audiences — the people and the politicians of British Columbia — are aware that something must be done. They are aware that the current way of doing things is not working, and not sustainable. Together, we are committed to building a better future: a sustainable and psychologically healthy future for all British Columbians. I trust you will want to join us, work with us, have your voice heard, have an impact on the change that is already underway. I am looking forward to hearing from you soon. At your service, Rebecca Smith Executive Director f 6 bc psychologist www.psychologists.bc.ca NEWS milestones membership renewals We would like to share with you the unfortunate news of one of our members’ passing. Dr. Robert Shepherd passed away on June 3, 2011. You can read the full obituary and sign the guest book online at http://www.legacy.com/Link. asp?I=LS000151768430X The membership renewal period for 2011-12 has started. The renewal deadline is August 31, 2011. You can renew your membership by cheque, or by credit card. To renew by credit card, log in to our website first, then fill in our online renewal form. If you have forgotten your username, please call us. You can reset your password online. Please be aware that, if you renew after August 31st, you will be charged a late fee. board nominations & elections This year, five positions will be up for election on the Board of Directors of the BC Psychological Association (BCPA). As specified by a 2010 Special Resolution, three of the newly elected directors will begin service of one-year terms, and two will begin service of three-year terms, in order to achieve the staggering of Board elections required by our Constitution. All the directors of BCPA are volunteers. Their role is one of governance; to steer the Association and work towards the achievement of our goals and purposes, as stated in the Constitution. They are responsible for attending monthly meetings, as well as for serving as Board liaisons by sitting on one or more committees. Our online nomination & motion/special resolution form can be accessed from this page: http://www.psychologists.bc.ca/ nomination-form-2011. Please log in before attempting to complete the form. opportunities to partner with vancouver agencies BCPA is currently exploring opportunities to partner with Vancouver agencies to provide services to the disadvantaged. In order to find potential psychologist participants, we need to hear from you. Are you interested in: Expanding or diversifying your Vancouver practice? Providing services to underserved populations? Willing to work with community agencies? Willing to help develop service and funding proposals? Please contact Rebecca Smith at [email protected] to let us know your interest and availability. Please be advised that only current BCPA members in good standing can submit motions/special resolutions, as well as nominations to the BCPA Board of Directors. You are encouraged to review our Constitution, our most recent Annual Report, and our Strategic Plan, all of which are available to members through our website under “About Us” after logging in. Workshops & other events salary survey We are looking for members interested in writing short articles for our blog. No experience with blogging is required. If you already have a blog, we might be able to repost your articles on the Association’s blog. Please check your email during the summer as we will be sending out an invitation to participate in a salary survey. The results of this survey will contribute to our advocacy efforts. Call us if you need to change your email address. There will not be any Ethics Salons this summer. Registrations are open for our September social media & marketing workshop — check our website for more details and to register. Our Annual General Meeting is scheduled to take place on November 25, 2011. bloggers wanted www.psychologists.bc.ca bc psychologist 7 news Member Survey of BCPA’s Public Outreach Activities An overview of our May 2011 feedback & opinion survey results In May 2011, the Board of Directors of BCPA decided to look at what our members think of the past year’s public outreach initiatives. All these initiatives were funded and run under the auspices of two committees, the Community Engagement Committee (CEC), and the BCPA Awards Committee, with the support of the BCPA staff. Outreach activities’ return on investment cannot be readily quantified as we are not selling a product, nor have we run a campaign; however, a member survey can give us a good indication of whether our members at least support our efforts in this direction. This was the most popular BCPA member survey yet, with more than 300 people (about 42% of the entire membership) answering at least some questions, and leaving a large number of comments and suggestions. It can be easily seen that, generally speaking, BCPA members are very supportive of the current activities of the CEC, although a majority of comments asked BCPA to put a stronger focus on government outreach as well (which would fall under the purview of the Advocacy Committee & budget). The survey also provided very useful information in 8 bc psychologist www.psychologists.bc.ca terms of internal (member) communication. A majority of members heavily rely on printed sources and e-mails to receive association and event updates, while only a minority is relying on the website, inspite of the fact that the website is frequently updated and hosts a much larger amount of information. Many members are also still confusing the E-mail Forum (an advertising-free, member-only discussion list) with the e-mail announcements. Another interesting fact is that “word of mouth” is a powerful force among psychologists: 26.2% of respondents mentioned that this was a source of Association-related information. We would therefore like to encourage you to share news about upcoming events and volunteer opportunities with as many colleagues as possible. You can easily do this by using the “Tell a Friend” function available through our website when you register for a workshop, as well as the “Forward” function available for our weekly e-mail announcements. In conclusion, BCPA members are keenly paying attention to the work and efforts of their Association, and they generally support our current outreach activities, which should aim to include a government outreach program. www.psychologists.bc.ca bc psychologist 9 news Practice Directorate Update Read the June 2011 progress report CPAP & the practice directorate The Practice Directorate’s primary mandate will be to support and facilitate advocacy across provinces and territories. The Directorate operates under the oversight of a Council (known as CPAP) made up of representatives from the provincial and territorial associations of psychology across Canada. CPAP operates as a functionally autonomous body that is accountable to the CPA Board for matters relating to policy and finance. CPAP is led by a Chair appointed from among provincial and territorial representatives. (from www.cpa.ca) national survey: the practice directorate has been working with delta media, an ottawa-based communications firm, to develop a national survey of canadians’ knowledge of, and attitudes towards, professional psychology in Canada. The survey will augment data from key informants from provincial, territorial and federal governments (politicians and officials), the media and professional associations. The survey will inform a national campaign to improve access to psychological services, being developed at this time. Ekos Research Associates, a well respected national polling company, has been contracted by the Directorate. The survey is currently ‘in the field’ and results will be available in July, 2011. A total of 2800 people will be surveyed and this is considered to be a very strong sample size for a national survey. The confidence limits will be +/- 2%, 19 times out of 20. The British Columbia Psychological Association is participating in the survey as a member of the Practice Directorate Council and has contributed $3,000.00 to increase the number of respondents in British Columbia. Delta Media will analyze the data, prepare a report of findings, and provide a presentation deck that the British Columbia Psychological Association can use to present the data. The survey data will support a national advocacy campaign (see below). It is suggested that each association use the survey report as a basis for discussion of the issues with our “allies” (e.g. patient/consumer groups, other professional associations) in order to determine what they can support. The consultation information will inform the national campaign and we hope our allies will carry some of our messages forward as well. The British Columbia Psychological Association may wish to use the data as part of the association’s advocacy efforts during upcoming provincial elections. National Advocacy Campaign: two of the Directorate’s strategic directions are to increase the use of a common brand, lexicon and set of recommendations to governments across Canada and to increase access to psychological services. The National Advocacy Campaign has as its tag line ‘Solutions’ ‘Improving Access to Psychological Services for Canadians’. It will be rolled out by all provincial and territorial associations and CPA so governments receive a common message and common solutions. There will be a dedicated web page on the CPA web site. Psychology’s relationship to primary care will be one focus. The Campaign is being developed as we speak and will be rolled out in the fall of 2011. Provincial Elections: several provinces will be having provincial elections in the fall of 2011. There is a desire to collaborate on a web based advocacy strategy similar to the one used by CPA for the General Election. This is being explored. Communications: increasing communications to boards of directors and memberships regarding the activities of the Directorate is a priority. This will enhance the currency of each association as part of the collective activity. More specific information will be forthcoming. Marketing: CPA has hired Mr. Tyler Stacey-Holmes as the Director of Association Development, Membership and Public Relations. He is a marketing professional with 10 bc psychologist www.psychologists.bc.ca many connections in the marketing community. Mr. Stacey-Holmes is working on Psychology Month, specifically to rebrand the event in terms of developing a new logo, creating messaging that resonates with Canadians and developing marketing packages that each province can use. He has purchased the domain PsychologyMonth.ca and expects to develop a “one stop shop” for Psychology Month information. He is currently working with three marketing firms to help develop the psychology “brand” and is developing motion stating that the PD supports the adoption of the doctoral standard as the required educational level for the licensing of psychologists across Canada. The motion was tabled to be discussed at the next Council meeting in January, 2012. This is intended to be an aspirational motion since the entry to practice standard is a matter for governments and colleges. However, the associations taking a united position will have significant political resonance. In addition, it will demonstrate a national unanimity regarding the future development more on the web CPA Practice Directorate: www.cpa.ca/practitioners/ practicedirectorate/ BCPA Advocacy Committee (log in for full access): www.psychologists. bc.ca/content/advocacycommittee Policies endorsed by the Council Support for the Doctor of Psychology (PsyD) education and training model Canadians, regardless of income, have a right to access psychological services Support the development of internship and practicum placements for psychology students, interns, and residents in Canada Source: cpa.ca several potential sponsors in looking at a “cause marketing” campaign in the future. Mr Stacey-Holmes will also be available on a limited basis to assist the Practice Directorate in its advocacy activities. Government Relations: CPA is examining the feasibility of hiring a government relations specialist as a staff member. The Practice Directorate has agreed to consider contributing some money on an annual basis to be able to access the person’s service on an as needed basis. This will allow individual provincial/territorial associations to have access to these services on a limited basis. Doctoral Standard: the associations discussed the possibility of passing a of the profession. It is not clear at this time if the associations can all agree. Individual Manitoba Psychologists Contribute to the Directorate’s Advocacy: the Manitoba Psychological Society provided members with the opportunity to support advocacy by making a contribution to the Practice Directorate. A number took advantage of the opportunity. The Directorate would like to thank the Manitoba psychologists and the Society for their foresight and generosity. CPA/APA Dues Changes: Dr. Karen Cohen (CEO of CPA) provided an update of CPA’s efforts to maintain the status quo in terms of the current dues arrangement www.psychologists.bc.ca bc psychologist 11 The Directorate has contracted with a communications firm to develop to assist in the development of a common advocacy language and strategy platform. This will enable the associations to be “talking the same talk” when working with governments. The result will be a common message regarding psychological services across Canada giving the governments the knowledge that psychology is “on the same page”. Source: cpa.ca between the two organizations. Currently, a member of one can have membership in the other associations for half price. More information will be distributed as it becomes available. This issue primarily affects CPA and the Canadian jurisdictions that have affiliate status with APA and the APA return to CPAP and the Practice Directorate of part of the advocacy levy paid by Canadians to APA. These funds help support the work of the Practice Directorate. Practice Directorate Council Changes: the term of Dr. Jennifer Frain, Chair of the Practice Directorate’s Council has expired and she is now President Elect of CPA. Dr. Andrea Piotrowski of the Manitoba Psychological Society is the new Chair. Dr Dorothy Cotton (Ontario) replaces Dr Lorne Sexton (Manitoba) as the CPA representative to Council. The BC Psychological Association would like to thank the outgoing Council members and particularly Dr Frain who was CPAP and Practice Directorate Chair for a number of years. 12 bc psychologist www.psychologists.bc.ca Insurance Dr. Rodney Handcock of McFarland Rowlands Insurance Brokers provided an update on insurance claims by psychologists across the country. The insurance company is considering offering more features as part of the professional liability package and he indicated that he will provide a summary of the considerations which will then be made available to the associations. Rodney has a doctoral degree in Social Psychology from the University of Western Ontario. Motions: motions regarding concussions and neck injuries in sports, mental health parity, recovery in mental health and patient centered care were adopted in principle pending rewording by the Practice Directorate’s Management Committee. Two of the motions were carried forward from the Board of the Ontario Psychological Association. f NEWS Comings and Goings Please welcome our new staff members as i noted in my letter on page six, time passes and things change — sometimes far too quickly. this too is the case with the administration of the bc psychological association. So, it is with sadness that I bid farewell to my office staff: Jeni Campbell and Giovanna Di Sauro. After two years service in our office, Jeni Campbell, our Executive Assistant, has decided that the time is right to go back to school and to work towards the realization of her dreams of becoming a psychologist herself. During her tenure here, she has made a definite impact on the efficiency and accuracy of our office systems, accounting and member services. Rebecca Smith Rebecca is the Executive Director of BCPA. She can be reached at 604-730-0501 or at [email protected] Giovanna Di Sauro leaves us after about two years of service in order to move to Kingston, Ontario, to attend law school at Queen’s University. As our Communications Officer and Advertising Liaison, Giovanna made visible and effective changes in the way we communicate with our members and with the public. She was instrumental in developing our social media presence, and a driving force in the development of our new website. Both Jeni and Giovanna have left an indelible impression with their dedication and incredible work ethic. Their personalities and good humour have been integral to creating the psychologically healthy team that I have been proud to lead. Although I will miss them very much I am sure you will join with me in wishing them nothing but success and happiness in the future. We will miss them both! As with every departure there is an arrival, thus I will ask that you join with me in welcoming our incoming staff members: Alex Yip, our new Executive Assistant, and Eric Chu, our new Marketing and Advertising Coordinator. I look forward to working with them, to creating a new and effective team, and to continuing to offer our members and the public the efficient and friendly service that they have come to expect from BCPA. f Please join us in welcoming our new staff members & send farewell messages to our outgoing staff members by writing an email to [email protected] www.psychologists.bc.ca bc psychologist 13 ethics How to Tell Your Patients That You Have Cancer A psychologist’s journey robin mcgee, ph.d. (University of Western Ontario) is a recipient of the IWK Award for Outstanding Practice in Clinical Psychology. She is also Past President of the Association of Psychologists of Nova Scotia. She can be reached at [email protected] this is not the article i had hoped to be writing. i would much rather have written about provincial advocacy, fee schedules, or adhd. Instead, I must write about what I learned when I had to close my public and private practices, due to a diagnosis of advanced cancer. I am writing to share my journey, in the hopes that others may benefit from my experiences. Cancer will strike 40% of us by the end of our lives. Of those, half are within their working careers at the time of diagnosis. This means that many working psychologists could experience this illness, and have to cope with its professional as well as its physical impact. No one wants to need this article, but some of you unfortunately will. What are the ethical and practical considerations a psychologist must make when terminating a practice due to this illness, or any other incapacitating illness? The professional literature has surprisingly little guidance on this matter: most published work on forced termination is about managed care or therapists moving to other jobs. These situations do not yield the same powerful emotions as cancer, either for the patient or the therapist. When I was diagnosed with Stage III colorectal cancer in May of 2010, I went from someone who had taken only two sick days in the past five years to someone who would need to take the entire year off for extensive treatments. I had no experience with being incapacitated. I did not know how to proceed to turn myself from a fit highly active professional to an invalid, or how to navigate this disjuncture in the best interests of patients. CPA ethical standards have relatively little to say about therapist illness. The clearest reference is Standard 1.42, which addresses incapacitation of a therapist only in terms of security plans for records: a psychologist must “collect, store, handle, and transfer all private information, whether written or unwritten…in a way that attends to the needs for privacy and security… This would include having adequate plans for records in circumstances of one’s own serious illness, termination of employment, or death”. In contrast, the APA standard 3.12 regarding Interruption of Psychological Services is more explicit: “Unless otherwise covered by contract, psychologists make reasonable efforts to plan for facilitating services in the event that psychological services are interrupted by factors such as the psychologist’s illness, death, unavailability, relocation, or retirement”. APA standard 10.09 regarding termination of therapy adds: “When entering into employment or contractual relationships, psychologists make reasonable efforts to provide for orderly and appropriate resolution of responsibility for client/patient care in the event that the employment or contractual relationship ends, with paramount consideration given to the welfare of the client/patient”. This article was previously published by the Association of Psychologists of Nova Scotia, and included in the Nova Scotia Psychologist (2011) Volume 23, n.1. Republished with permission. 14 bc psychologist Another ethical consideration for the ill psychologist is the APA standard 2.06 regarding Personal Problems and Conflicts. It states: “(a) Psychologists refrain from initiating an activity when they know or should know that there is a substantial likelihood that their personal problems will prevent them from performing their work-related activities in a competent manner. (b) When psychologists become aware of personal problems that may interfere with their performing work-related duties adequately, they take appropriate measures, such as obtaining professional consultation or assistance, and determine whether www.psychologists.bc.ca they should limit, suspend, or terminate their work-related duties”. Psychologists must not practice when impaired by serious disease. However, most cancers are insidious, and do not result in functional impairment until well into the illness or treatment. How can a psychologist balance his or her need to guard against impaired practice versus the need to terminate services judiciously? The thrust of all these standards is that it behooves all psychologists to have a “back up” plan in case of incapacitation or death. Many provincial regulatory bodies now require psychologists to identify alternative psychologists those who will assume practice responsibilities in such an eventuality. And yet, the CPA and APA standards give scant guidance on how to manage the communication aspects of one’s personal tragedy in the context of delivery of psychological services, particularly psychotherapy. The core ethos of the CPA ethical principles is communication. Careful communication is the mainstay of most competent practice. Ethical principles governing communication, and of careful planning of service delivery and treatments, are the basis for ethical practice when confronted by the threat of incapacitating illness. Application of the spirit of CPA ethical principles and standards helps to shed light on how to negotiate one’s exit from psychology work under such dreadful circumstances. I was of course staggered by my diagnosis. How could this be true? I was a fit, highly active professional in my 40s. I worked over 40 hours each week, happily and industriously. I loved my work, my family, my friends, and my community. I had just finished a term as the President of my professional association. And yet, I had to absorb the realization that I was in the grip of a lethal disease, and that my life as I knew it was about to take a radical and sudden departure. My first obligation was communication with those to whom I provide service. I made my first calls within hours of the fateful appointment that gave me my news. In retrospect, I was so aswim with shock that I ought to have waited. My first call was to my supervisor at my public job, the Coordinator of Student Services at the regional school board. Fortunately (or perhaps unfortunately) she was well experienced with cancer and its debilitating impact on staff. I was naively trying to reassure her that I would be able to meet some of my upcoming work commitments – my mind had not fully grasped the truth of my situation. But she knew. She was supportive but firm – she would put me off work as of that moment. She would make all the necessary arrangements with Human Resources. I would need to cease my direct service work in schools effective immediately. Disclaimer If you are facing an ethical dilemma, you are encouraged to refer to the College of Psychologists of BC’s Practice Support service for more information on ethical guidelines. This article is not meant to provide, and should not be considered as, legal advice. If you need legal advice, please consult a lawyer. We kindly ask that you do not contact the author of this article for the purposes of receiving legal advice. A public service job has the benefit of infrastructure. My work with the school board primarily entailed consultation to schools regarding students with behavioral or mental health issues. Now, my responsibilities would have to be transferred to other school board staff. I attended several meetings with my school board colleagues to determine how my services would be delivered by others. I had some unique aspects to my practice that could not be assumed by other staff, given the rare nature of the skills involved. For example, I was the only staff person trained in the diagnosis of Autistic Spectrum Disorder. As a result of my illness, and a concurrent maternity leave of one other specialist from public mental health, screening and diagnosis of school-aged children suspected of Autistic Spectrum Disorder had to be suspended. We worked with our mental health partners to craft a memorandum to the doctors and other agencies, informing them of the new limitations to public psychology services. My next concern, and my biggest challenge, was how to inform my private patients. Over and above my public sector job, I maintained a small but thriving private practice. The practice was limited to — continued on page 22 www.psychologists.bc.ca bc psychologist 15 features Kwantlen’ Students Psychology Public Outreach Efforts jocelyn lymburner, ph.d., r.psych. Dr. Jocelyn Lymburner has taught psychology at the undergraduate and graduate level for over a decade, joining the faculty of Kwantlen Polytechnic University in 2004. She is a strong advocate of service learning, working to increase relevancy in education and to build strong ties between academia and the community. In addition to her role as an educator, Jocelyn is a Registered Psychologist, working with adults and couples on the North Shore (www.drlymburner.com). kwantlen polytechnic university offers three unique psychology degrees — a bachelor of applied arts in psychology, a bachelor of arts in psychology, and a bachelor of science in applied psychology. As a polytechnic university, Kwantlen focuses heavily on applied learning and the psychology department has been at the forefront in terms of innovative course offerings and assignments. One such example is a third year Advanced Topics in Psychopathology course. Students in this course are tasked with working in conjunction with a community organization to produce a resource on the topic of mental disorders for a population outside their class. Over the past few years, students have created a wide variety of useful tools for their communities, including informational YouTube videos on various forms of psychopathology, board games designed to increase awareness about mental health, pamphlets and posters on the coping with anxiety, depression, and substance abuse, and educational presentations for highschool students designed to reduce the stigma associated with mental illness. For the past two years, the BCPA Public Education Committee has generously agreed to offer awards to the top projects emerging from the class. In the following article, the talented 2011 student recipients of this award, Rahul Abedin and Robin Elson, present their projects. Website on Depression & AIDS (by Rahul Abedin) According to the 2009 United Nations AIDS report there are over 33 million people in the world living with HIV/AIDS. In Canada there are 21,000 individuals diagnosed with AIDS and in BC alone over 4000 individuals have tested positive. Within these statistics it is imperative that we remember the human perspective. Each diagnosed individual, depending on which part of the world they come from and a multitude of other factors, has her or his own unique circumstances and challenges. Depression is the most common comorbid mental disorder diagnosed with HIV/AIDS and the combination of the two can create fatal circumstances for many individuals. My goal in creating the website DepressionAIDS.net is to provide a resource centre focusing on HIV/AIDS related depression that can be accessed by anyone with an internet connection, free of charge and available 24/7. As a university student I am always trying to stay up to date with academic research. I wanted to present this same empirical information, in an easy to understand format, to those who may not have access to academic journals. Therefore, the backbone of DepressionAIDS.net is the article analysis section, consisting of academic research on depression and HIV/AIDS. Each posted article is broken down into a simple and non-intimidating format: who the researchers and participants are, the length of the study, the methodology of the study, and its findings. In addition to the 24 article analyses, visitors to the website have access to general resources on depression and HIV/AIDS, BC crisis line information, a calendar of relevant community events, and can exhange ideas on an anonymous forum. Future plans include the addition of a section dedicated to statistics and videos of clinicians talking about different facets of treatment. To date, DepressionAIDS.net has had over 500 visitors, with most visits targetted toward the article analyses. My hope is to continue promoting the website as a free resource containing essential information that can be 16 bc psychologist www.psychologists.bc.ca BRITIsh COLumBIa sChOOL OF PROFessIOnaL PsyChOLOgy 406-1168 Hamilton Street, Vancouver, BC V6B 2S2 | Ph: (604)682-1909 | Fx: (604) 682-8262 | E-mail: [email protected] The BC School of Professional Psychology is presenting a Basic Training in Eye Movement Desensitization and Reprocessing (EMDR). This course is approved by the Eye Movement Desensitization and Reprocessing International Association (EMDRIA) and will cover the material of Part One/Level I and Part Two/Level II training. Objectives of Course Participants will learn to use EMDR appropriately and effectively in a variety of applications. Such use is based on understanding the theoretical basis of EMDR, safety issues, integration with a treatment plan, and supervised practice. Part One/Level I EMDR training is usually sufficient for work with uncomplicated PTSD in most clients. Part Two/Level II is necessary for working effectively with more complex cases, special populations and more severe, long-standing, or complicated psychopathology. The course will be in two parts. Qualified applicants will have a minimum of Master’s level training in a mental health discipline and must belong to a professional organization with a code of ethics, or be a graduate student with appropriate supervision. Approved for Continuing Education Units by the Canadian Counselling Association. Register online at www.emdrtraining.com (see Vancouver page) For more information, please contact Alivia Maric, Ph.D., R.Psych. at 604 251-7275 or at [email protected] Instructor Marshall Wilensky, Ph.D., R.Psych. EMDRIA Approved Instructor Format Lecture, discussion, demonstration, video: 20 hours. Supervised practice (during the training weekends): 20 hours. Consultation: 10 hours (live, online) Dates Session One: October 21 – 23, 2011 SessionTwo: January 27 –29, 2012 Times Friday 9:00 am - 5:00 pm Saturday and Sunday 9:00 am - 4:30 pm Consultations Wednesdays, November 16, December 14, 2011, February 15, 2012, 6:30 pm - 9:30 pm Location Vancouver School of Theology (UBC Campus) Tuition Full course: $1,850 before September 10, 2011; $1,950 after September 10, 2011. Previously trained EMDR clinicians can get updated for half price. accessed by anyone. Please feel free to pass this website link along to any one whom you feel may benefit. of these presentations is on the decrease of prejudice and myths associated with mental health matters. About the author: Rahul Abedin is currently completing his Bachelor of Arts Degree in Psychology at Kwantlen Polytechnic University. He has experience working with HIV/AIDS patients at the rural St. Francis Xavier Hospital in Assin Foso, Ghana. His goal is to complete a Clinical Psychology degree and work with war effected individuals around the world. These presentations are effective, but I began to wonder how much of this important information the youth could retain two or three days afterwards. I also realized that only a small percentage of the pertinent information could be given to the youth before either the presentation ran out of time or became so full of facts and figures that it became overwhelming to the average high school student. I wanted to create a simple, effective, and relatively cheap way of reaching youth and giving them a resource that they were likely to look at and use. Posters and pamphlets have limited use as they tend to be ignored in the media saturated world of youth today, and websites can be a daunting and confusing medium that may not be accessible to every youth. Mental Health Education for Youth: Playing Cards (by Robin Elson) Recently I began volunteering with an organization known as Bluewave, which is aimed specifically at educating youth (12-20yrs) on mental health matters. The organisation primarily conducts presentations in high-schools. During presentations, young volunteers speak about mental health issues they personally suffer from or are familiar with through family and friends. The volunteers share their own experiences and answer questions. The focus To this end I decided to create educational playing cards, with each suit representing the four most common mental health issues concerning youth in Canada (Depression, www.psychologists.bc.ca bc psychologist 17 Addictions, Eating Disorders, and Suicide). The cards are completely functional and can be used as a normal set of playing cards, however each card contains information relating to mental health issues. For example, in the suit of hearts (i.e., Depression) some cards contain information debunking commonly held myths about depression, others outline steps on how to talk to friends or family members who might be suffering from depression, while still others detail common signs and symptoms of the disorder. The other suits also follow this pattern with some cards presenting a simple statistic on prevalence, and others detailing how to communicate effectively with a loved one suffering with a mental health issue. The idea is that as the youths repeatedly use the cards the information will begin to sink in. The language is purposely assessable to the age group and avoids the use of technical terms. There are also two joker cards that contain more websites that people can access if they wish to find further information on a specific issue, as well as information on issues not presented in the cards (e.g., Schizophrenia or stress from bullying or school work). The central idea is the reduction of stigma through the education of youth and the elevation of mental health issues to the level that they deserve in the education system of Canada. About the author: Robin Elson is currently completing a Bachelor of Arts in Psychology at Kwantlen Polytechnic University. He also works part time for a private organisation Bluewave that is aimed at promoting youth education of mental health issues. He spends most of his free time travelling and, as a result, is most interested in cross-cultural implications and applications of psychological research. f 18 bc psychologist www.psychologists.bc.ca features The Economic Sensibility of Full Public Mental Health Coverage UBC Okanagan student offers argument for public health coverage of psychological interventions the impact of mental illness on society is often overlooked due to the seemingly individualistic nature of mental illness; it is hard to associate the sufferings of an individual with the suffering of society as a whole. It is estimated that, in Canada, the yearly economic losses stemming from mental illness exceed $14 billion (Hunsley & Lee, 2010). To put these losses into perspective, $14 billion accounts for 6% of the national budget, and 2.6% of the national debt (Department of Finance Canada, 2010). Of the $14 billion in mental health related losses, much can be attributed to workplace difficulties. For instance, Gewurtz, Kirch, Jaconbson, and Rappolt (2006) found that individuals who suffered from mental illness felt as though they had no future in terms of their work. This lack of career aspiration, combined with difficulties concentrating and, for individuals with a previously diagnosed mental disorder, a fear of relapse, led to a reduction in productivity. This study also found that the stigma surrounding mental illness affected not only people’s ability to work, but also limited their perceptions regarding options in obtaining work. In a similar vein, it has been demonstrated that, for individuals with certain mental illnesses, 80% of employment terminations are attributable to social and character related issues (Hanley-Maxwell, Rusch, Chadsley, & Renzaglia, 1986). However, despite substantial economic losses at the hands of mental illness, and despite the release of Toward Recovery and Well-Being: A Framework for a Mental Health Strategy for Canada (2009) by the Mental Health Commission of Canada, this country does not have a national mental health strategy yet (Hunsely & Lee, 2010), unlike twothirds of the world’s countries. Any strategy aimed at reducing the economic losses attributed to mental illness must actively involve psychologists, as their skill set is essential in treating mental disorders. The main reason why psychologists are essential in treating mental disorders – as opposed to psychiatrists or general practitioners – is due to their therapeutic approach. Whereas psychiatrists and general practitioners primarily rely on drug-based interventions (pharmacotherapy) when treating mental disorders, psychologists primarily rely on psychotherapy. Although pharmacological therapy is the best choice for certain mental disorders (e.g. schizophrenia), a combination of psychotherapy and pharmacotherapy is preferable for most mental disorder as it is the most cost-effective (e.g. Domino et al., 2009; Mitte, 2005; Sava et al., 2009). Further, meta-analyses have revealed that, relative to specific mental disorders, combined psycho-pharmacological therapies are highly effective in treating mental disorders (e.g. Eddy, Dutra, Bradely, & Westen, 2004), and that, in combined psycho-pharmacotherapies, pharmacotherapy makes a small, but yet still significant, contribution to the overall www.psychologists.bc.ca sean n. riley Sean Riley is currently an undergraduate student at the University of British, Okanagan. When not in class, Sean spends his time conducting research with various faculty members in both forensic psychology and cognitive psychology. This paper was written as part of a class project. Course instructor: Dr. Mike Woodworth, R.Psych. Mike Woodworth is an Associate Professor at UBC Okanagan. He received his Doctor of Philosophy in 2004 from Dalhousie University. His primary areas of research include psychopathy, criminal behaviour, and deception detection. bc psychologist 19 effectiveness of treatment (Cuijpers, van Straten, Hollon, & Anderson, 2010). Additionally, psychotherapeutic interventions have significantly smaller relapse rates than pharmacological interventions (e.g. De Maat, Dekker, Schoevers, & De Jonghe, 2006). In essence, these studies indicate that combined psycho-pharmacotherapies are highly effective and cost-efficient when it comes to treating mental disorders. However, due to the small effect size of pharmacotherapy in combined psycho-pharmacological therapies, and the superiority of psychotherapy over pharmacotherapy in reducing relapse rates, mono-psychotherapies are a highly suitable alternative when combined therapies are not available. In relation to a mental health strategy, these findings highlight the importance (and effectiveness) of psychologists when it comes to treating mental disorders. Any attempt to sway policy makers in the direction of full mental health coverage for those suffering from mental illness must outline the economic sensibility of such a 20 bc psychologist losses per person, and was calculated by dividing the $14 billion in economic losses by the number of people who suffer from mental illness. Further, ∆P, ∆X, and ∆T respectively represent the predicted changes in the total population, percentage of people suffering from mental illness, and the percentage of mentally ill persons who seek treatment. The first equation (A) models the increase/ decrease in revenue for any given year by calculating the cost of providing therapy, and then subtracting the reduction in economic losses attributable to mental illness. A positive solution indicates that the reduction in economic losses is less than the cost of covering mental health services – and thus is not economical – while a negative solution indicates that the reduction in economic losses is greater than the cost of covering mental health services – and thus economically sensible. The second equation (B) models how revenue gains compound over time. This equation also factors in how variables change over time. Using the most recent statistics available to us, our first equation was used to calculate program. To do this, we have created two simple equations that estimate the increase in revenue resulting from the coverage of mental health services (see box below). how much revenue would have been created this year had mental health services been covered under provincial health care. We used 5 as the average number of hours in Here, Y is the increase/decrease in revenue, N is the average number of hours patients will spend in therapy, C is the cost per hour for therapy, P is the total population, X is the percentage of the total population that suffers from mental illness, T is the percentage of mentally ill persons who will seek treatment, R is the percentage of mentally ill persons whose symptoms undergo remission, F is the percentage of mentally ill persons who experience symptom relapse within 12 months, and 4375 is the dollar amount of economic therapy (Huygen & Smits, 1983; Kenardy, et al., 2003), a $175/hour therapy rate (as suggested by the BCPA), a population total of 34, 278,400 (Statistics Canada, 2011), a mental illness prevalence rate of 10% (StatsCan, 2003), a 9.5% (1) treatment seeking rate (StatsCan, 2003), and remission-relapse rates of 52% and 24% respectively (2) (de Bruijin, van der Brink, de Graff, & Vollebergh, 2006; De Maat, Dekker, Schoevers, & De Jonghe, 2006; Keller, et al., 1994). www.psychologists.bc.ca Our calculations revealed that it would have cost $284,938,500 to cover mental health services, and that the reduction in total economic losses stemming from mental illness would have been $562,839,375, which ultimately translates into a $277,900,875 increase in revenue. We hope that this information could help shed light onto an issue that is of the utmost importance not only to individuals suffering from mental illness, but also to society and our economy as a whole. Notes (1) The 9.5% treatment seeking rate is derived from Statistics Canada’s data regarding the number of people from the total population who have had contact with mental health services in the past 12-months. Although Statistics Canada’s numbers (9.5%) reflect the percentage of the total population, we applied this percentage to the mentally ill subset as data for treatment seeking rates of mentally ill persons was non-existent. The 9.5% treatment seeking rate is, most likely, a conservative number; however, because the ratio of cost to revenue gained per person is 875:4375, ((PX)T) is only important in determining the magnitude of revenue gained (the larger the T value, the greater the increase in revenue), not whether mental health coverage is economically sensible. As such, it is not overly detrimental to use the 9.5% treatment seeking rate in our equations. Craving Withdrawal Model. Addiction, 101, 385-392. doi: 10.1111/j.1360-0443.2006.01327.x De Maat, S., Deeker, J., Schoevers, R., & De Jonghe, F. (2006). Relative efficacy of psychotherapy and pharmacotherapy in the treatment of depression: A meta-analysis. Psychotherapy Research, 16, 562-572. doi: 10.1080/10503300600756402 Department of Finance Canada. (2010). Annual Financial Report of the Government of Canada Fiscal Year 2009-2010. Retrieved from http://www.fin.gc.ca/afr-rfa/2010/index-eng.asp Domino, M. E., Foster, M. E., Vitiello, B., Kratochvil, C. J., Burns, B. J., Silva, S. G., March, J.S. (2009). Relative cost-effectivenes of treatments for adolescent depression: 36week results from the TADS randomized trial. Journal of the American Academy of Child & Adolescent Psychiatry, 48, 711720. doi: 10.1097/CHI.0b013e3181a2b319 Eddy, K.T., Dutra, L., Bradley, R., & Westen, D. (2004). A multidimensional meta-analysis of psychotherapy and pharmacotherapy for obsessive-compulsive disorder. Clinical Psychology Review, 24, 1011-1030. doi: 10.1010/j. cpr.2004.08.004 Gewurtz, R., Kirsh, B., Jacobson, N. & Rappolt, S. (2006). The influence of mental illnesses on work potential and career development. Canadian Journal of Community Mental Health, 25, 207-220. Hunsley, J. & Lee, C. M. (2010). Introduction to clinical psychology. Missassaga Ontario: John Wiley & Sons Canada Ltd. Huygen, F.G. & Snits, A.J. (1983). Family therapy, family somatics, and family medicine. Family Systems Medicine, 1, 23-32. doi: 10.1037/h0089632 Keller, M., Yokers, K.A., Warshaw, M.A., Pratt, L.A., Gollan, J.K., … , Lavori, P.W. (1994). Remission and relapse in subjects with panic disorder and panic with agoraphobia: A prospective short interval naturalistic follow-up. Journal of Nervous and Mental Disease, 182, 290-296. doi: 10.1097/00005053199405000-00007 Kenardy, J.A., Dow, M.G.T., Johnston, D.W., Newman, M.G., Thomson, A., & Taylor, C.B. (2003). A comparison of delivery methods of Cognitive-Behavioral Therapy for panic disorder: An international multicenter trial. Journal of Consulting and Clinical Psychology, 71, 1068-1075. doi: 10.1037/0022006X.71.6.1068 Mitte, K. (2005). A meta-analysis of the efficacy of psychoand pharmacotherapy in panic disorder with and without agoraphobia. Journal of Affective Disorders, 88, 27-45. doi: 10.1016/j.jad.2005.05.003 (2) Remission and relapse rates for mental illness as a whole were unattainable. As such, rates were estimated by taking the remission and relapse rates of the three most prevalent mental disorders (depression, panic disorder, and substance use disorders) (StatsCan, 2003) and averaging them. f Sava F. A., Yates, B. T., Lupu, V., Szentagotai, A., & David, D. (2009). Cost-effectiveness and cost-utility of cognitive therapy, rational emotive behaviour therapy, and fluoxetine (Prozac) in treating clinical depression: A randomized clinical trial. Journal of Clinical Psychology, 65, 36-52. doi: 10.1002/jclp.20550 References Statistics Canada (2011, March 24). The Daily. Retrieved from http://www.statcan.gc.ca/daily-quotidien/110324/dq110324beng.htm Cuijpers, P., van Straten, A., Hollon, S. D., & Andersson, G. (2010). The contribution of active medication to combined treatments of psychotherapy and pharmacotherapy for adult depression: A meta-analysis. Acta Psychiatrica Scandinavica, 121, 415-423. doi: 10.1111/j1600-0447.2009.01513.x Statistics Canada. (2003). Canadian Health Survey: Mental Health and Well-being (StatsCan publication No. 82-617XIE). Retrieved from http://www.statcan.gc.ca/pub/82-617x/4067678-eng.htm #1 De Bruijin, C., van der brink, W., de Graaf, R., & Vollebergh, W. M. A. (2006). Three year course of alcohol use disorders in the general population: DSM-IV, ICD-10, and the www.psychologists.bc.ca bc psychologist 21 Cancer — continued from page 11 psychotherapy, mostly with adults. Although I only saw three patients a week, I had been practicing this way for nearly 15 years. Consequently, I had many longer term patients, and some with very significant diagnoses (Bipolar midtreatment. Sadly and ironically, I was seeing several patients for cancer-related bereavement. I was deeply concerned with the impact of my departure on my private patients, particularly the very vulnerable. During my graduate years, I had been schooled in a psychodynamic approach to therapy dynamics. The approach I had been trained in clearly emphasized very firm boundaries with clients. Self-disclosure was something I had almost never done. How could I share my news sensitively? How would I handle their understandable reactions? How would I manage the transference (and countertransference) issues? How would I manage the issues involved in transfers to other therapists? As another consideration in my case, I practice in a semi-rural area. In small town Nova Scotia, word gets around. I was concerned that my private patients would learn the truth before I could tell them myself. If I worked in a major city, I could perhaps simply announce I was closing my practice for health reasons and share no further. But where I live and work, that approach might not be sufficiently sensitive or even feasible. Moreover, my cancer treatment would oblige me to continuously wear a slow infusion bottle clearly labeled “chemotherapy”. My patients who required a few more sessions to terminate therapy would clearly see it. Should I, or could I, keep the reason for my departure from practice away from patients? Tomasz Kobosz/sxc.hu Disorder, Complex PTSD, OCD). At the time, I had several patients in the middle of protocols for EMDR (Eye Movement Desensitization Reprocessing) therapy for trauma. For those of you who do not know EMDR, the protocol does not lend itself to transfer to another therapist 22 bc psychologist www.psychologists.bc.ca One of my first steps was to call my professional psychology association. Not only did I need to inform them as part of my obligation as Past President on the Executive, I needed guidance. I asked the executive director: did she know of any other psychologist in Nova Scotia who had undergone cancer and possibly faced these same dilemmas? She was indeed able to connect me with a senior psychologist who had experienced cancer in the past – same cancer, same stage. This mentor shared with me that she had been forthright with all her patients, and gave them three options: to wait for her to recover, to transfer to another therapist, or to stop therapy. She wisely counseled me to anticipate that my patients were human, and that I could anticipate all the range of human reaction. They will surprise you, she said. She was right. I made a list of all my cases. With each case, I weighed the best approach to the forced termination. There were many to consider: how fragile were they? How strong was the therapeutic alliance? How long had I seen them for? Were they in active treatment, or was their next appointment far off? How close was the client to a natural termination: could I reasonably finish with them in the few weeks I had before my daily radiation therapy began? Were their issues and presenting problems such that they would need extra support? For those needing transfers, who would be a good match for them? APA standard 10.10 states that “prior to termination psychologists provide pretermination counseling and suggest alternative service providers as appropriate”. I only had a few weeks before my daily radiation treatments would start – I did not have the time to see each client personally. I resolved to place patients in three categories: those who could be redirected by phone, those who needed a personal session to prepare them for transfer, and those I could reasonably finish with within a few weeks. I was able to reach many by telephone. These patients were those on my waiting list, those I who had only one session, or those whose return appointments were far into the future. I was able to tell them that I need to close my practice for “health reasons”. It was difficult to hear the note of curiosity and bewilderment in their voices; however, most were satisfied with the list of alternative therapists I provided. For those I needed to redirect with a new referral, I arranged consent to forward my records to the relevant service provider. The second group were those with whom I had a longstanding treatment relationship for serious diagnoses. With each patient I arranged a session in which I told them I had to close my practice, and I told them why. Although this degree of self-disclosure went against my grain, it seemed to me to be the only genuine thing to do. I reasoned that these individuals needed to know that I was not leaving them for any lesser reason than cancer. Also, I did not want them to hear my news from elsewhere. One patient had that misfortune, and was badly shaken by it before I could reassure them in person. Out of respect for the work we had done together, I felt it best to be straightforward with these individuals. Prior to these sessions, I was in touch with other therapists who I considered good matches, and thus was able to offer an alternative therapist. I was able to reassure them that I had taken every possible step to ensure continuity to their care, and I offered a joint session between us and the new therapist to facilitate handover. They had the option of finding their own therapist or terminating; however, each one of these patients accepted the transfer I had arranged. I was indeed surprised by many of my patients’ reactions. Instead of crumbling, or crying, or becoming angry, most were wonderful. Some reacted with genuine shows of affection (“But I love you!” one said, as she jumped from the chair to hug me). Some were stunned, and needed several repetitions of my news to absorb it. Some responded with a kind of sober awe. Some patients announced with confidence that they were well enough to wait for me to recover to resume treatment. My mentor was right: many of those I thought would fall apart were strong and brave. Only one patient betrayed impatience and fear, but was reassured by an alternative referral. And my own reactions? I was genuinely touched and impressed with the degree of compassion and maturity my patients demonstrated, even though it felt so odd to be on the receiving end of their concern. The next step involved transferring patients to other therapists. I was blessed with caring colleagues who came, pro bono, to joint sessions that I arranged to facilitate transfer. Because the patients had been www.psychologists.bc.ca bc psychologist 23 prepared by my individual session with them, the focus of the transfer sessions was to meet and share with the new therapist. Their relief and mine was palpable, and our partings were dignified by the warmth and support of the incoming therapist. The third final category was those patients who were very close to a natural termination, but had a few important aspects of their protocols to complete. Most of these were EMDR patients. I had several concerns with my remaining patients. Would they feel they needed to take care of me, and hence not be forthcoming with their issues? Would they “fly into health” prematurely? Would they deem their own issues to be insignificant against what they knew of mine? Was I truly able to focus on them, given the distress and preoccupation that I was experiencing? With each case, the best solution to these concerns was the negotiation of a very clear treatment plan and goals. Fortunately, EMDR has a very structured protocol. But with all patients, the clearer the plan from the onset of therapy, the clearer the path towards mature conclusion. The specificity of the plan allowed both me and the patient to hone in on the work that had to be done. I was pleased and relieved to see that each of my remaining patients was able to adopt a focused approach to their remaining therapy. I may have been aided in this by the fact that I continued to feel well, and that I had no side effects from my chemotherapy, so that they were reassured by my apparent health. Each one of the remaining patients completed therapy with flying colours. When the time came, I was able to embark on my daily radiation treatments with a clear conscience and a clear schedule. The final challenge arose with regard to former patients who wanted to do things for me. Once the word of my illness spread throughout my semi-rural community, several patients contacted me to offer me concrete help: lawn-mowing, food, drives to medical appointments. How to handle their kind, well-meaning offers of tangible help? Would such help cross 24 bc psychologist www.psychologists.bc.ca important boundaries better left in place? Would they be injured or hurt if I refused their assistance? Would I deprive them of a meaningful act of closure or respect? Once I came home from a medical appointment to find that my lawn had been mowed by a former patient, who had left a note explaining her good deed. For most of these situations, I was able to suggest alternative arms-length gestures that seemed appropriate. If I could match these gestures to a meaningful aspect of the patient’s therapy with me, this seemed to satisfy all requirements. For example, one of my PTSD patients, who I had transferred to another therapist, had identified “70s music” as a resource and a “safe place” for himself during his work with me. When he offered to drive me to appointments, I asked him instead if he would make me a CD of his favourite 70s music. “That way,” I told him, “when we each listen to it, you can think of me getting better, and I can think of you getting better”. I accepted with grace all the gifts I was given, especially the homemade “get well” cards made by my child patients, and thanked the donors with genuine gratitude. How to summarize what I learned? Although it is difficult to keep one’s composure when surprised by cancer, there are others out there who can assist you to do so. Your professional association can help. I learned again the importance of service delivery and therapy planning, both before and after a diagnosis of cancer threatens that plan. I learned about the generosity of colleagues. I learned about the importance of frank and genuine interaction with patients when both of us are humbled by fate and the human condition. All of my experiences underscored for me the beauty and value of what we do as psychologists, and confirmed for me that our work has been one of the most proud purposes of my life. God willing, I will return to that work someday. f opinions Crowd Psychology & the Stanley Cup Riot as i sit to write this article many opinions abound as to what occurred on the night of june 15, 2011. chief among them seems to be the idea that the mayhem was caused by “criminals”, “thugs”, and “anarchists”. this opinion was publicly stated by the premier of the province, the Mayor of Vancouver, and the Chief of Police. Three days later by June 18, 2011, several people had turned themselves in to the police, some had gone “on line” and offered an apology for their behaviour; and most noteworthy was the identification of Nathan Kotylak, an up and coming elite water polo player. Criminals? Thugs? Anarchists? I would venture to say that most of these people were unknown to the police and couldn’t even define the term ‘anarchism’. This seems to run counter to the prevailing opinion of who was responsible for all the violence and destruction. What is going on here? The events of June 15, 2011, constitute a serious conflict that very quickly degenerated into a violent tragedy. I will attempt to explain several social psychological principles that are critical in the understanding of crowd behaviour. Group Behaviours We often use the behaviour of others to guide our own. This is the Principle of Social Proof (Cialdini, 1993), or imitative effects. If a particular style of clothing is in vogue, without fail a significant portion of the public will adopt the style. The fashion industry, for example, relies heavily upon this principle of human behaviour. It knows that we often use the preferences of others as (social) proof that we should be doing the same thing. This tendency to use other’s behaviour as a standard for our own can have tragic consequences, as it did on the night of June 15, 2011. The pressure we experience to conform, or fit in with the crowd, is present during demonstrations of public disorder. Ordinary, well socialized individuals can become violent, and/or law breaking, in response to their perceptions of group norms that run contrary to their own private preferences. This seems incredulous, doesn’t it? Why would a responsible, law-abiding person act in such an irresponsible and illegal manner? As presidential counsel John Dean III testified during the Watergate trial, “To get along, you go along”. mike webster, ed.d., r.psych. Dr. Webster is a consulting police psychologist in private practice. He specializes in crisis management and has worked with the RCMP for over thirty years. You may remember Philip Zimbardo’s famous prison role-play study (1982) that took place in the basement of Stanford University’s psychology department. A group of normal young male psychology students were randomly assigned roles as either prisoners or guards. Both the prisoners and the guards were provided with impersonal uniforms. They were able to hide behind their uniforms (including mirrored sunglasses for the guards) and lose their individuality, thus reducing their awareness of both their public and private identities. Six days into the experiment it had to be terminated due to the excessive brutality of the guards and the emotional effect their behaviour was having on the prisoners. The most interesting aspect of this aborted study was that the effects were obtained in a group of normal, well socialized individuals participating in a simulated situation. Their loss of personal identity and reduced self awareness had dramatic effects on their behaviour. In effect, the role the guards had been assigned overrode their www.psychologists.bc.ca Disclaimer The views expressed in the “Opinions” section of this publication are those of the authors alone, and they do not reflect the views of the BC Psychologist, nor of the BC Psychological Association and its Board. bc psychologist 25 personal characteristics. Moreover, in tests of related dynamics it seems that social conditions conducive to punitiveness have more influence over aggressive behaviour than individual characteristics (Larsen et al., 1971). Passive participants at large events like the Stanley Cup gatherings, in downtown Vancouver, can succumb to conformity pressure and behave in ways that they would normally not choose to. In addition, there is a related consequence of lowered self awareness on individual behaviour in group situations. Behavioural contagion (Wheeler, 1966) is a common disinhibiting effect that can influence individuals into engaging in behaviours that they previously may have fantasized but never acted upon. Some of those looting stores during the Stanley Cup riot may have been motivated by this effect. Individuals who have only wished they had a new BlackBerry see others looting an electronics store and walking away, so they do the same. The combination of the highly arousing nature of the riot and their identification with the group lead to deindividuation; where individuals lose the sense of, or pay less attention to, their own moral standards. The chaos of the riot and the anonymity of the crowd reduce individual self awareness and minimizes fears of being caught. The effects of deindividuation within a group can specifically influence individual aggressive behaviour. A complete understanding of the previously noted dynamic necessitates a review of excitation transfer theory (Zillman, 1983). The gist of this theory states that, however produced physiological arousal dissipates slowly over time. Consequently, as individuals move from situation to situation a residue of that arousal may persist. So during the Stanley Cup riot, some of the arousal generated in individuals early in the evening could still have been present in them later in the evening. If they now encounter even a minor annoyance, or frustration, this could produce an intensified emotional reaction; rage may result rather than mild irritation. These transfer effects are most likely to Jason Antony/sxc.hu 26 bc psychologist www.psychologists.bc.ca occur under a couple of conditions. First, they are more likely when people are unaware of the residual arousal. This is not uncommon as small elevations in arousal are difficult to detect (Zillman, 1988). Second, these transfer effects are more likely to occur when we are aware of our arousal and we attribute it to events occurring in the immediate situation (Taylor et al., 1991). So during the evening of June 15, 2011, some of those present could have been carrying residual arousal, generated earlier in the evening, but attributed it to the events they were witnessing and responded by joining in. Deindividuation re-enters the equation at this point. Excitation transfer effects are most likely to occur when we deindividuate, that is when we experience reduced self awareness and reduced awareness of our moral standards. And of course, individuals are more likely to deindividuate when they are an anonymous part of a large crowd. At these times, participants may be less aware of residual arousal and more likely to attribute it to the external cues of their present situation. The potential result being an instance of excitation transfer and increased aggression. Finally, some ask if passive participants outnumber active participants why don’t they interfere when they see someone, for example, damaging property. The answer lies in the concept of diffusion of responsibility. Observation and research suggest that as the number of by-standers increases, the diffused responsibility results in a decrease in pro-social behaviour. This bystander effect finds individuals in a crowd waiting for someone else to make a move. What is overlooked is that everyone else is doing the same thing, creating an example of pluralistic ignorance. inherent in being a part of a large crowd. In other words, those responsible for the Stanley Cup riot of 2011 could include some well socialized and responsible individuals. As the public is not likely to accept the banning of large gatherings (e.g. Celebration of Light, Olympics, Stanley Cup), or the substitution of bears for police dogs, what are the police to do? The answer to this question is really a topic for another article; I will provide a brief opinion here. The Vancouver Police Department did a very good job with what they had. The management of well over 100,000 people in the downtown core requires an overwhelming police presence. (You need “meet and greet” on the street and “hats and bats” waiting nearby). The numbers necessary to manage such a large crowd will only come from a Regionalized Police Service. It is much easier to stage and deploy your own personnel than beg and borrow from other police services. The Stanley Cup riot of 2011 was yet another cry for regionalized policing in the Lower Mainland of British Columbia. f References Larsen, K.S., Coleman, D., Forges, J. & Johnson R. (1971). Is the subject’s personality or the experimental situation a better predictor of a subject’s willingness to administer shock to a victim? Journal of Personality and Social Psychology, Vol. 22, pp. 287-295. Taylor, S.L., O’Neal, E.C., Langley, T. & Butcher, A.H. (1991). Anger arousal, deindividuation, and aggression. Aggressive Behaviour, 17, 193-206. Wheeler, L. (1966). Toward a theory of behavioural contagion. Psychological Review, 73, 179-192. Zillman, D. (1988). Cognition-excitation interdependencies in aggressive behaviour. Aggressive Behaviour, 14, 51-64. Zimbardo, P.G., Haney., Banko, W.C. & Jaffe, D. (1982). The Psychology of Imprisonment. In J.D. Brigham & L. Wrightsman (Eds.), Contemporary Issues in Social Psychology (4th ed., pp. 230-245) Monterey Ca: Brooks Cole. Conclusion It seems after a brief perusal of the pertinent psychology that the threats to public order and security, during large scale public gatherings, come not only from a few “criminals, thugs, and anarchists” but also from the psychological vulnerabilities www.psychologists.bc.ca bc psychologist 27 BCPA Disaster Response Network Disaster Psychosocial Services in British Columbia BCPA is a member of APA’s Disaster Response Network. One key difference is that while most DRN members in the states participate through affiliations with their local Red Cross, BCPA’s DRN volunteers primarily serve through Disaster Psychosocial Services (DSTRS) under the Ministry of Health. The DSTRS Network is comprised of professional therapists/clinicians who are willing to volunteer their time in the event of a disaster. The Network presently consists of approximately 600 volunteers from the B.C. Association of Clinical Counsellors, the B.C. Psychological Association and the B.C. Association of Social Workers. As these three professional associations are provincially based it is possible to provide local, community-based psychosocial support when the need arises. The psychosocial services that DSTRS and BCPA DRN members may provide include: • • • • • • • • • • • • Coordination of Disaster Behavioural Health Volunteers Collaborative Assessment of Community Needs Psychological First Aid Brief Assessment One-to-One Support Brief Crisis Counselling Crisis Line Response Psycho-educational Interventions Development/ Distribution of Materials Worker Care Consultation Group Presentations Psychosocial response involves a range of supportive services with those who are affected by an emergency or disaster, including the promotion of individual, family and community resiliency. These various services are used to help diminish long term psycho-social effects, to clarify the current situation, and to improve adaptive coping strategies. If you are interested in participating or finding out more about BCPA’s Disaster Response Network, please contact us at [email protected] or 604-730-0501. HELP US HELP THOSE IN NEED opinions Do You Really Need an Ad Agency? Get what you want without paying for their fancy lattes Arjun Kartha/sxc.hu even print is not “the man” anymore when it comes to ad dollars and marketing outcomes after having spent two years as communications officer for the bc psychological association, i would like to give you my two cents regarding the perennial search of the silver bullet, that is the advertising agency that will miraculously solve all of our outreach headaches, and that will have the stroke of genius of instilling the subliminal desire of seeing a psychologist in the public’s subconscious. Just kidding… the message I would really like to send is a simple one: no advertising guru can cause a sudden change in public awareness, nor can a super-expensive flash campaign achieve this. Causing a change in public awareness takes time and constant effort more than it takes money and, because of this, it requires two things: qualified staff and, maybe most importantly, fully-formed, simple, clearly enunciated, and measureable objectives. GIOVANNA DI SAURO Giovanna is the Communications Officer & Advertising Liaison for the BC Psychological Association. You can find out more about her at www.gdisauro.com. Additionally, something needs to be made exceptionally clear: the future of ad campaigns does not lie in traditional media, but in the non-traditional sphere of social media. Let’s crunch some numbers. While this is not the case for psychologists (who are mostly boomers), the median age of the Canadian population is 39.5; simply put, this means that millions of Canadians are not buying newspapers anymore, but logging into Facebook multiple times a day. You might not be doing this, but many of members of our audience are. Surely enough, www.psychologists.bc.ca bc psychologist 29 outsmart them, don’t outspend them — Terry O’Reilly The Age of Persuasion about 83% of Canadians watch TV, but you need to consider both the costs of advertsing on TV and their engagement level. A well-run Facebook campaign that reaches an engaged audience costs about zero dollars, while advertising in the Shaw TV listings channel (the one nobody watches) for three weeks costs about $50,000. Keep in mind that a successful campaign may run in excess of $100,000. Research shows that four out of five online Canadians use social media. And given that two thirds of Canadians in 2005 were already surfing the web, we can deduce that social media safely reach about 60% of the population. Unlike TV viewers, social media consumers are highly engaged and can be targeted more effectively. Members of our audience could skip TV advertising using PVRs, but they will visit and interact with a Facebook page “liked” by their friends; additionally, they may actively promote it to other networks. Now ask yourself this question: would you pay $50,000 for insufficient TV advertising, or about $0 to reach millions of Canadians who willingly log into their social media accounts every day? Keeping in mind that BCPA is a very small non-profit organization with a tiny budget, the second option is quite obviously best suited to our means. If that is the case, BCPA should plan a full-blown, long-term social media campaign to promote public awareness , and the benefits of increased access to psychologists. To do that, we can either pay dedicated staff (which we already have), or hire an agency. Before making a decision, let’s ask ourselves these questions: hat do we think hiring an agency will achieve? W W hat skills are we looking for? Do we already have them in-house? Here is some useful information to consider while formulating the answers to those questions: An advertising agency cannot tell us what we want. Only we can determine that. Advertising will increase awareness of psychology/psychologists, but it will not increase our returns if there are major barriers to access (e.g. if people cannot afford these services). BCPA staff is highly trained and qualified for their positions, and all BCPA hires have university degrees; incoming staff is also trained by their predecessors. Additionally, unlike an ad agency, staff members have a vested interest in seeing your campaign succeed, and they do not have multiple clients competing for their time and attention. We need to review the current strategic plan of the Association, take another look at our finances by re-reading last year’s annual report, and come up with some measureable objectives: what exactly do we want people to know about and think of us? If we cannot formulate some good answers to these questions, but still decide to venture into advertising without any measurable action items, we will risk wasting a lot of money without achieving much — money which could eventually be used on a well thought-out campaign. Disclaimer The views expressed in the “Opinions” section of this publication are those of the authors alone, and they do not reflect the views of the BC Psychologist, nor of the BC Psychological Association and its Board. 30 bc psychologist It is time for all psychologists in this beautiful province to join BCPA, become active members of our committees, and seriously get involved. Paying membership fees can fund the BCPA office, but this is just the beginning. f For some marketing wisdom & more information Terry O’Reilly & Mark Tennant (2009) The Age of Persuasion: How Marketing Ate Our Culture. Knopf Canada. BCPA’s current strategic plan: http://is.gd/BkQqPE Last year’s annual report: http://is.gd/mkOL9O www.psychologists.bc.ca 2011/12 New Members Application Form CONTACT INFORMATION First Name: Last Name: Middle Name: Degree: Employer: Would you like to participate in the BCPA E-mail Forum? Yes No Mailing Address & Main Phone (not available to the public) Company: Street Address: City: Province: Phone: Postal Code: Fax: Main E-mail Address (required): Referral Service Address & Phone (available to the public) Street Address: City: Bus. Phone: Province: Postal Code: Fax: Website: Complete (front and back) and mail this form to: BC Psychological Association, 204 - 1909 West Broadway, Vancouver, BC V6J 1Z3 MEMBERSHIP CATEGORIES MEMBERSHIP FEES (INCLUDING TAXES) q Membership Open to R. Psychs. & R. Psych. Assocs. $356.90 q Membership with Referral Service Open to R. Psychs. & R. Psych. Assocs. Includes a free web profile. If you already have a website, you may list your website in your referral settings. $538.37 q Retired Membership $63.52 q Out-of-province Membership $63.52 PLEASE INCLUDE A CHEQUE, NOT POST-DATED, AND MADE OUT TO “BCPA” Processing may be delayed if you include the wrong amount, incomplete, or post-dated cheques. It usually takes two-three business days for your application to be processed; however, it might take longer if we are receiving large numbers of applications. You must fill in this form to join BCPA; we cannot accept applications over the phone. If you prefer paying by credit card, please join online at www.psychologists.bc.ca By signing below, I ____________________ hereby understand and agree to the following terms: a I am a registrant of the College of Psychologists of BC (CPBC), or I am a retired registrant of the College of a a a a Psychologists of BC. CPBC registration #: ___________ If limitations are put on my practice, or my registration is suspended or cancelled by the College of Psychologists of BC, I agree to notify BCPA within five working days. Referral Members: if there are any limitations, terms or conditions to my registration to practice psychology, I agree to modify my practice accordingly, and apply these limitations to all referrals received through BCPA. Referral Members: I agree to review my referral settings online quarterly for accuracy of contact information, geographical areas of service, and areas of practice. I agree to review and adhere to the Forum guidelines and understand that they can be found at www.psychologists.bc.ca/content/e-mail-forum I have read, understood, and agreed to the applicable declarations above. Signature: Date: Mail this form with your cheque to: BC Psychological Association, 204 - 1909 West Broadway, Vancouver, BC V6J 1Z3 community & psychology PHWA Committee Accepting Nominations for 2012 PHW Awards psychologically healthy organizations demonstrate greater resiliency and benefit from reduced operating costs, less lost time, improved productivity and stronger customer/client relations. The British Columbia Psychologically Healthy Workplace Awards Committee, a standing committee of the British Columbia Psychological Association, is acknowledging and awarding organizations that recognize and excel in ensuring a healthy workplace for their employees with the 2012 Psychologically Healthy Workplace Awards. The award is open to all BC companies that demonstrate excellence in the following five criteria for a psychologically healthy workplace: Employee Involvement; Work- Life Balance; Employee Recognition; Employee Growth and Development; and Health and Safety. The deadline for nominations is October 14th, 2011. Winners will be recognized at an awards event on February 16th, 2012. more on the web This is a press release recently ditrsibuted to the media through the CNW Group newswire. All of our press releases are available through the CNW website, as well as through our website under News & Events > Press Releases. The impact of the downturn in the economy has affected all sectors in British Columbia. However, research shows that engaged, satisfied and involved employees help companies improve their bottom line and thrive, even in difficult times. As Barry Forbes, President and CEO of Westminster Savings Credit Union noted: “We recognize the vital link between the well-being of our employees and the success of our credit union. Westminster Savings’ track record of low turnover and strong organizational performance demonstrates the positive benefits of investing in programs that promote a psychologically healthy workplace.” Westminster Savings Credit Union was a 2007 and 2009 winner of the BC Psychologically Healthy Workplace Awards and went on to be recognized at the international awards event in Washington, DC. The Psychologically Healthy Workplace Award was founded by the American Psychological Association in 1999, brought to Canada in 2004, and last awarded in 2009. British Columbia was the first province to offer this award in Canada. Today, 52 states, provinces and territories across Canada and the United States participate in the award. For an application or more information on the awards, interested organizations can go to www.phwa.ca. Additional information is available by contacting the Committee Chair, Dr Joti Samra, by emailing [email protected] f Complement HealtHCare, a multidisciplinary clinic located within the West Vancouver Community Centre, is seeking a psychologist to join our team of practitioners that includes Chiropractors, Naturopaths, Massage Therapists, a Dietitian, Psychologists and a Counsellor. We currently have availability for Thursdays or Fridays in a full-service office in a great location. For more information, please email [email protected] www.complementhealthcare.com www.psychologists.bc.ca bc psychologist 33 About the Presenter q I will attend Dr. Ballard’s workshop David W. Ballard, PsyD, MBA, currently serves as Assistant Executive Director for q I agree to the Cancellation Policy (required) Connected: Effective and Ethical Marketing Strategies for Psychologists Marketing and Business Development at the American Psychological Association and the APA Practice Organization. In this capacity, he designs and directs Name: efforts related to health and well-being in the workplace, works to enhance psychology’s position in the marketplace, provides research and development Address: and strategic consultation to further the Practice Directorate’s marketplace agenda, and oversees the development of resources to help psychologists build, manage, market, and diversify their practices. Dr. Ballard also spearheads the City: Psychologically Healthy Workplace Program. Postal Code: Learning Objectives Phone: • Identify emerging needs and challenges by conducting internal and external environmental analyses • Apply marketing and communication strategies that are effective, yet ethically Email: and professionally appropriate • Explain how the appropriate use of web-based communication technologies can benefit psychologists, the profession and the general public • Explore the clinical, legal and ethical issues that may arise when psychologists use social media technologies and describe risk management strategies • Identify communication channels and techniques to fit their client population and professional activities • Create an action plan for starting to apply new marketing and communication strategies to their professional activities About the Workshop This session will focus on current market trends and the practical, concrete Early bird registration (June 14 - July 31, 2011) q q Regular price $263.20 (incl. HST) BCPA Members and Affiliates $184.80 (incl. HST) Regular registration (August 1 - September 16, 2011) q q Regular price $288.96 (incl. HST) BCPA Members and Affiliates $210.56 (incl. HST) Meal requirements q q q Regular meal Vegetarian meal Special needs or allergies (please include details below) skills psychologists need to reach potential clients and connect with referral sources who could benefit from psychological services. Participants will learn how to use basic marketing principles and techniques to build relationships, communicate relevant information that can facilitate effective healthcare decision-making, develop new services to meet emerging community GST/HST # 899967350. All prices in CDN funds. needs, and make the best use of resources to remain viable in the evolving Mail this form to 204-1909 West Broadway, Vancouver BC marketplace. Special attention will be given to multi-channel communication V6J 1Z3; include a cheque for the right amont, not post- and how practicing psychologists can use websites, social media, and other dated, and made out to BCPA. Please register online at www. electronic tools to create a win-win-win scenario, benefiting psychologists, the psychologists.bc.ca if you prefer using a credit card. profession, and the general public. Dr. Ballard will provide specific examples of The workshop fees listed above includes printed handouts, how practitioners can use social media platforms such as LinkedIn, Facebook, morning & afternoon coffee, and lunch. All participant and Twitter, the opportunities and challenges these technologies present, and information is protected under the Personal Information Act. that may arise. Friday September 23, 2011 in Vancouver, BC. Six CE credits. Cancellation policy: cancellations must be received in writing by September 12, 2011. A 20% administration fee will be deducted from all refunds. No refunds will be given after September 12, 2011. risk management strategies for addressing clinical, legal, and ethical issues in this world there’s two kinds of people, my friend: Those with blogs, and those who dig. You dig. stop diggin’. fill in that form. PROFESSIONAL LIABILITY INSURANCE EXCLUSIVE B.C.P.A. MEMBERSHIP PROGRAM This Professional Liability Program is exclusive to B.C.P.A. Members covering the investigation and defense against any civil action brought against you arising out of rendering or failure to render professional services Includes $50,000 for Legal Expenses incurred in respect to disciplinary hearings. Penal Defense Coverage is now automatically included at no additional charge Johnston Meier Insurance Agencies Group ALSO AVAILABLE…. 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