Hospital psychology in Canada.

Examined Canadian hospital psychology in terms of the existing organizational models, professional practices, academic activities, and professional orientations of hospital psychologists in a survey of 340 hospitals. Results reveal that psychologists were active clinically and academically in Canadian hospitals in a wide variety of health care areas in addition to traditional mental health areas. In the majority of hospitals, psychologists were organized in independent departments of psychology or behavioral science, although physician influence appeared to be a strong factor in practice. Medical staff membership and academic appointments for hospital psychologists were relatively low. Recommendations for the future development of hospital psychology in Canada are outlined. (French abstract) (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

L'accessibilité à des traitements pour les troubles anxieux au Canada: Un commentaire.

Responds to Gauthier (see record 2004-17185-003) who commented on the two articles by Koerner et al (see record 2004-17185-001) and by Roberge et al (see record 2004-17185-002. The purpose of this response is to discuss the issue of limited availability of mental health services for anxiety disorders in Canada. From a public health perspective, the authors emphasize the importance of gathering Canadian empirical data on the organization of mental health services for anxiety disorders. Specifically more research is needed on care requirements, and the financial and structural barriers that restrict access to mental health services at the regional, provincial and national levels. The authors also discuss the role of psychologists in improving mental health care in Canada. Cost-effectiveness studies conducted in interdisciplinary practice environments could demonstrate the value added by psychology in the organization of mental health care for anxiety disorders. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The Role of Canadian Psychologists in Conducting Fitness and Criminal Responsibility Evaluations.

Historically, only physicians, typically psychiatrists, were permitted to conduct forensic mental health evaluations for the courts. In the United States, the courts have affirmed increasing acceptance of involvement of psychologists since the 1940s. In Canada, the legal system continues to adhere to the assumption of medical dominance to a large extent. For instance, Canadian legislation requires that a physician conduct court-ordered assessments of fitness to stand trial and criminal responsibility. In this article, relevant Canadian law is compared to American law, and empirical research on the ability of psychologists to assess fitness and criminal responsibility is discussed. These legal and empirical reviews are used to generate policy recommendations regarding the qualifications of forensic examiners. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The Costs of Anxiety Disorders and their Treatment: A Commentary.

Comments on two review papers by Koerner et al (see record 2004-17185-001) and by Roberge et al (see record 2004-17185-002): one examining the economic burden of anxiety disorders, and the other the economic benefit of cognitive behaviour therapy for anxiety disorders. It is evident from both these papers that Canadian data on the direct and indirect costs of treating and not treating anxiety disorders are lacking and sorely needed. In addition to demonstrating the importance of addressing cost-related issues in Canadian mental health research, the authors of these papers present basic concepts of economic evaluation. They also identify the areas more in need of cost analysis and discuss the implications of the Canadian findings for health-care policy and research in Canada. Overall, the two articles have the potential of convincing Canadian psychologists to become more active in cost research and, thus, to contribute to advocacy efforts for better mental health services in Canada. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Empirically supported treatments: Too little, too late: A commentary.

The impact on Canadian professional psychological treatment practices of the American Psychological Association's Division 12 (Clinical Psychology) Task Force's development of criteria and listings for empirically supported psychological treatments, along with other industrial efforts to standardize the identification of treatments with established efficacy is described in the article by J. Hunsley et al (see record 1999-01869-001). D. R. Evans proposes that the evidence-based movement is too little, in that considerably more, and much more complex evidence for what professional psychologists do is required. It is too late, in that both in Canada and the US professional psychologists have suffered considerable setbacks in both the economic and popularity domains. There is a broad range of treatment proposals professional psychologists make to their clients daily, which are fraught with a lack of research backing. There is a vicious circle in that unless evidence-based practices become the norm, and, hence, the stuff of media, it is difficult to convince new and even some old practitioners to adopt them. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Professional associations' strategies for revitalizing professional psychology.

The professional associations of psychologists are working to revitalize professional psychology. In response to recent challenges, these associations have attempted to (a) remove barriers to quality services within the mental care health delivery system; (b) help psychologists become better integrated within the overall health care system, as opposed to being narrowly defined as mental health professionals; and (c) help more psychologists move into services outside of the health care delivery system. These 3 strategies are motivated by a vision of psychology as a broad problem-solving discipline that can contribute to human welfare in a varied range of domains. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A Survey of Hospital Psychology in Canada.

Despite the major advances in health psychology over the past decade and the changes that have taken place in the Canadian health sector, there remains a paucity of information available about the structure of psychological services in Canadian health-care settings. The most current information about psychology in Canada's hospitals was gathered in 1982 - almost 20 years ago (Arnett, Martin, Steiner, & Goodman, 1987). This article updates the previous information, as it presents the results of a survey that was sent to 975 acute, psychiatric and continuing care health facilities with a minimum patient bed count of 100. Detailed information about the number of psychologists and administrative organizations of psychological services in Canada are reported. The range of services provided by psychologists in health-care settings has expanded, and professional autonomy, as shown by the existence of independent departments of psychology, has changed. The implications of these results for the organization and delivery of psychological services in Canadian healthcare, and for advocacy on the part of psychology, are provided. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

La psychologie et la santé.

This article traces the historical development of Canadian medicare and its significant influence on shaping not only the clinical services provided within Canada's public health care system but also its major impact on the nation's overall health research agenda. Particular emphasis is placed on how this has influenced the development and role of psychology in the public health care system. It is argued that all psychologists, whether their work is focused on the applied or experimental areas of the discipline, have much to offer Canadians across the entire health care spectrum. Nevertheless, psychological services in the public health care system, and particularly in hospitals, have mainly developed within and continue to be primarily focused around mental health. Services in nonmental health areas of health have been more limited, although their importance is well recognized. The current situation partly reflects the limited training in general health issues that clinical psychologists-in-training generally receive in many graduate school programs in Canada. However, it also reflects the overall influence of medicare on the development of Canada's health care system. Medicare has tended to focus the activities of Canada's health care system primarily on treating illness rather than on preventing it and/or maintaining health. Also, medicare has oriented Canada's health care system mainly toward delivering medical services rather than providing more comprehensive health services (e.g., the "medically necessary" criterion for funding). However, times are changing. The growing emphasis among health policymakers in Canada on illness prevention and health promotion (e.g., the creation of the federal government Public Health Agency of Canada in 2004) will significantly expand psychology's role across all areas of health. Psychology education and training programs are urged to seriously examine whether psychology practitioners and researchers are being adequately prepared at present for the much broader array of future interdisciplinary professional, research, and educational activities and responsibilities that will emerge. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychology and health.

This article traces the historical development of Canadian medicare and its significant influence on shaping not only the clinical services provided within Canada's public health care system but also its major impact on the nation's overall health research agenda. Particular emphasis is placed on how this has influenced the development and role of psychology in the public health care system. It is argued that all psychologists, whether their work is focused on the applied or experimental areas of the discipline, have much to offer Canadians across the entire health care spectrum. Nevertheless, psychological services in the public health care system, and particularly in hospitals, have mainly developed within and continue to be primarily focused around mental health. Services in nonmental health areas of health have been more limited, although their importance is well recognized. The current situation partly reflects the limited training in general health issues that clinical psychologists-in-training generally receive in many graduate school programs in Canada. However, it also reflects the overall influence of medicare on the development of Canada's health care system. Medicare has tended to focus the activities of Canada's health care system primarily on treating illness rather than on preventing it and/or maintaining health. Also, medicare has oriented Canada's health care system mainly toward delivering medical services rather than providing more comprehensive health services (e.g., the "medically necessary" criterion for funding). However, times are changing. The growing emphasis among health policymakers in Canada on illness prevention and health promotion (e.g., the creation of the federal government Public Health Agency of Canada in 2004) will significantly expand psychology's role across all areas of health. Psychology education and training programs are urged to seriously examine whether psychology practitioners and researchers are being adequately prepared at present for the much broader array of future interdisciplinary professional, research, and educational activities and responsibilities that will emerge. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Professional practice out of the urban context: Defining Canadian rural psychology.

There is an often unacknowledged difference between urban and rural practice in psychology which lacks clarity, in part, because of the lack of a common definition of rurality. Rural psychology in Canada presents complex and nuanced aspects of professional practice. The professional and social milieus of rural communities position the practising psychologist within a context that may differ vastly from urban settings. The rural context highlights the need to define this specific practice setting. This paper proposes a tentative definition of rural Canadian professional practice in psychology. This is meant to elucidate the distinct practice, training, and ethical considerations that may be the realities of the psychologists who are in professional practice in rural Canada. Rural professional practice is unique and Canadian training programs are urban-based. Training of future psychologists needs to acknowledge the unique features of rural practice to meet our obligations to students specifically and to rural Canadians generally. This is enhanced with a shared definition of rural professional practice in psychology. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Shaping the Future of Psychological Services in the Canadian Health-Care System: A Response to Romanow and Marchildon (2003).

Our response to Romanow and Marchildon's article (see record 2003-09748-001) on the role of psychology in the Canadian health-care system focuses on two challenges that emerge from the article, namely the continuing marginalization of mental health services and the dominance of political considerations over compelling scientific evidence for the impact of psychological services on health and recovery from illness. We conclude our comment with calls for (a) continuing efforts to educate policymakers, the media, and Canadians about the value of psychological services and (b) active involvement from psychologists in efforts to develop new models of primary health care in Canada. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Clinical and health psychology: Future directions.

Whether clinical psychology continues to comprehensively serve the public and to benefit from enhanced future professional opportunities depends significantly on its ability to extend the professional identity and mainstream activities of clinical psychologists beyond the current nearly exclusive focus on mental health. Clinical psychology needs to embrace all areas of health with the same vigor and skill that has been applied to mental health. This enhancement in professional role requires significant change in the educational approach of many Canadian clinical psychology doctoral training programs. Such suggested change will undoubtedly provoke much resistance. Considerable leadership will be required of our professional associations and accreditation bodies to encourage and guide the broadening of clinical psychology educational and training programs. Suggestions for educational reform are presented here to stimulate discussion rather than to provide a blueprint for the re-conceptualization of clinical training. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Specialty designation in psychology: Developing a Canadian model.

The Canadian Psychological Association (CPA) and the Council of Provincial Associations of Psychologists created a task force in 1986 to study the issue of specialty designation in Canada. As part of fulfilling its mandate, the task force surveyed 41 CPA sections and 237 Canadian psychologists and reviewed the status and history of specialty designation in the US, UK, and Australia. Based on that data, the task force concluded that it was timely for Canadian psychology to implement a specialty designation system that would be voluntary and certify minimal competence. The rationale for the development of a Canadian specialty designation system is presented. (French abstract) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Principles of surgical management of ovarian carcinomas

Most comparisons of the relative effectiveness of cost containment in the Canadian and U.S. health systems trace Canada's greater success to its single-payer approach. However, these studies ignore the substantial variation that exists in hospital and personal health care spending among both the American states and the provinces and territories of Canada. Four American states have adopted all-payer hospital rate setting; one other uses competitive bidding. All five show rates of growth in per capita hospital spending comparable to (and in some cases, lower than) the Canadian jurisdictions. Hospital spending, as a percentage of state gross domestic product (GDP), declined or remained constant in four of the five states. In four out of the five, growth in per capita spending on personal care, as a percentage of GDP, remained or fell below the national average. By contrast, in Canada, per capita spending on both hospitals and personal health care increased as a percentage of GDP in ten out of eleven jurisdictions. In each of the U.S. states, government played a central role in structuring the terms of payment and thus strengthened the hand of purchasers over providers. This strategy, rather than specifically a single-payer or universal health insurance approach, seems to be the key to limiting the growth in health costs to the growth in state or national income.     

Review of Mental health law in Canada.

Reviews the book, Mental health law in Canada by Harvey Savage and Carla McKague (1987). Mental health professionals who come into contact with the law in the course of their work generally have an interest in the well-being of the client. However, they often feel dismayed and confused because of their lack of understanding of mental law and the legal system in general. Until recently, mental health professionals in Canada could not turn to a single volume which would help explain mental health law, including their clients' rights. However, Harvey Savage and Carla McKague's book, Mental health law in Canada, will help alleviate some of the concern and confusion Canadian mental health professionals have come to know. Although some authors have written about Canadian mental health law in specific contexts (e.g., criminal responsibility or fitness to stand trial), Savage and McKague's contribution is the only available comprehensive source directed to the law affecting psychiatric patients. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Credentialing in Canada: The Zimet Conference.

The Zimet Conference was held in August 1981 in Winnipeg, Canada to discuss the credentialing of psychologists in Canada. The conference reviewed past Canadian efforts and obtained the view of Carl Zimet on US experiences with developing a registry. Following the conference, the Canadian Psychological Association (CPA) asked the coalition of provincial psychological associations for a proposal on a national registry to be presented to CPA at the 1982 annual CPA convention. (French abstract) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychologists in Canadian medical schools.

Conducted a national survey of 67 psychologists holding academic appointments in 16 Canadian medical schools. The number of psychologists, their professional activities and work attitudes, and the organizational models of psychology at the medical schools were examined. Results indicate major differences in the average number of psychologists at Canadian and US medical schools. However, among the 2 groups of psychologists, a number of strong similarities in work activities and attitudes were found. (10 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Professional psychology in transition.

Reviews the book, Professional psychology in transition by Herbert D?rkin and Associates (see record 1986-97926-000). This edited volume is a must for at least two groups of psychologists in Canada: (1) those interested in expanding and strengthening their share of the psychological services market; and (2) those interested in the development of psychology as a profession. The book contains three sections. The first, entitled "Trends in the Profession," documents the nature, scope, and influence of psychology's 45,000 licensed psychologists in the US. Sections 2 and 3 move us closer to the Canadian experience. Section 2 focuses on training and practice issues, and should be read by all those who train professional psychologists. Section 3 deals with economics and competition and presents us with some intriguing glimpses of our future. The book is highly recommended. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The science and practice of empirically supported treatments.

The impact on Canadian professional psychological treatment practices of the American Psychological Association""s Division 12 (Clinical Psychology) Task Force""s development of criteria and listings for empirically supported psychological treatments, along with other industrial efforts to standardize the identification of treatments with established efficacy is described in the article by J. Hunsley et al (see record 1999-01869-001). Here Hunsley et al extend their previous discussion and reply to other commentaries (see records 1999-01869-002, 1999-01869-003, 1999-01869-004, 1999-01869-005, 1999-01869-006) by viewing the current emphases in the Canadian health care system on accountability and empirically supported treatment (ESTs) as an unparalleled opportunity for professional psychology to deliver on its birthright. The generalizability of US experiences to Canadian contexts is discussed. Clinical practice guidelines should and will become the norm for providing evidence-based services in psychology, yet it would be impossible to develop such a guideline without empirical evidence proving that there are "best" interventions for a given problem. Canadian research issues in this light are discussed along with future challenges to professional psychology in Canada. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mental health: A shared concern of the international community.

Describes socioeconomic aspects affecting mental health in the world, such as the massive growth of cities, migrations of people, and the shrinking of the family unit in developed countries. International comparisons that examine differences and similarities between developing and industrialized countries are discussed. The needs of children and the elderly are discussed, and some examples of service delivery to these groups include improving daycare facilities, ensuring that schools foster psychosocial development, finding new roles for the elderly, and preventive and curative health services. Mental health services in Canada are highlighted, and some suggestions are proposed regarding areas of contribution of Canadian psychologists. (French abstract) (8 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)