Cheryl Regehr | University of Toronto (original) (raw)

Papers by Cheryl Regehr

Archival Science

Building on previous work investigating the impact of exposure to (a) records with traumatic pote... more Building on previous work investigating the impact of exposure to (a) records with traumatic potentialities and (b) interactions with donors and community researchers whose suffering is documented in the archives, this study sought to better understand emotional aspects of archival work. Using a diary research methodology, 15 archivists engaged in diary keeping for approximately four months. What emerged was a broad set of events and experiences that triggered a wide range of emotional responses arising from archival work. This included: pre-existing emotional states and characterological traits; emotional exchanges in the workplace with colleagues and others; emotional demands of the work (including emotion work and emotional labour); team and leader interactions arising from group tasks and leader behaviour; and organizational policies, climate, resources and demands. This broader set of interactional factors forms the foundation on which traumatic and other troubling events are e...

International Journal of Environmental Research and Public Health

Autism spectrum disorder (ASD) is a complex neurological and developmental disorder that has seen... more Autism spectrum disorder (ASD) is a complex neurological and developmental disorder that has seen an increase in prevalence over the past two decades, particularly in low and middle-income countries. The purpose of the current paper is to examine the experiences of mothers in Ethiopia raising a child with ASD through employing a qualitative research design involving semi-structured interviews with twenty mothers. The experiences of mothers in this study fell into three thematic areas: (1) grieving and experiencing other emotions arising from the diagnosis of their child; (2) developing, understanding and defining autism; and (3) accepting the diagnosis and developing coping strategies for raising their child. The findings revealed that raising a child with autism introduced a new lifelong experience to mothers’ everyday lives, profoundly changing their parenting role and transforming their view of mothering. Recognition of the experience of “new mothering” and mothers’ meaning-makin...

Archival Science

There is growing awareness in archival communities that working with records that contain evidenc... more There is growing awareness in archival communities that working with records that contain evidence of human pain and suffering can result in unsettling emotions for archivists. One important finding of this work, however, is the considerable variability in not only the nature of responses, but also the nature of records that provoke emotional responses. Using in-depth qualitative interviews with 20 archivists from across Canada and one from the United States, and employing grounded theory methodology, this study sought to better understand the nature of emotional responses and factors associated with distress. Archivists described a wide range of reactions including shock, intrusive thoughts, profound senses of anger, sadness and despair, and ultimately at times disrupted functioning in personal and occupational spheres. One factor that has been associated with increasing vulnerability to distress in other occupational groups is empathic engagement, which is understood to have two e...

The British Journal of Social Work, 2021

Social workers and other professionals providing mental health services are regularly required to... more Social workers and other professionals providing mental health services are regularly required to make high-stakes decisions in situations characterised by conflicting demands. To better understand the factors that drive clinical decision making in situations of risk and uncertainty, we used a design-based research framework to pilot a new approach for improving professional decision making. The programme, which combined simulated interviews, a master class series and personal monitoring of real-time decisions, was designed to focus explicit attention on biological, emotional, cognitive and contextual influences on decision making. Preliminary results from a pilot study suggest that during and immediately following the intervention, clinicians demonstrated new insights into their decision making processes. In addition, they reported benefitting both from the opportunity to reflect individually and share reflections with others. Physiological data demonstrated an association between ...

International Journal of Law and Psychiatry, 2022

This qualitative case study examines the impact of video evidence of violent crime in the tragic ... more This qualitative case study examines the impact of video evidence of violent crime in the tragic Canadian case of serial killers Paul Bernardo and Karla Homolka. Through in-depth interviews with those centrally involved in the case, interviews with criminal justice professionals currently working with video evidence of violent crime, and review of official documents and media reports, we explore the complex role video evidence played in this case and the legacy it continues to have in society, the justice system, and in the individual lives of those involved twenty-five years later. Two primary sources of harm arose in our analysis: critogenic harm related to the use of video evidence in the justice process; and harm arising from the media publicity surrounding the video evidence. Both of these sources of harm intensified the trauma for victims and their families, and contributed to distress and trauma reactions of criminal justice professionals and members of the jury. Given the global increase in the use of video-evidence in criminal justice processes, it is imperative that continuing harms to those involved in the process are considered and mitigated.

ObjectivesThe primary objective was to estimate the positivity rate of air travelers coming to To... more ObjectivesThe primary objective was to estimate the positivity rate of air travelers coming to Toronto, Canada in September and October, 2020, at arrival, day 7 and day 14. Secondary objectives were to estimate degree of risk based on country of origin; to assess knowledge and attitudes towards COVID-19 control measures; and subjective well-being during the quarantine period.DesignProspective cohort of arriving international travelers.SettingToronto Pearson Airport Terminal 1, Toronto, Canada.ParticipantsPassengers arriving on international flights. Inclusion criteria were those aged 18 or older who had a final destination within 100 km of the airport; spoke English or French; and provided consent. Excluded were those taking a connecting flight; who had no internet access; who exhibited symptoms of COVID-19 on arrival; or who were exempted from quarantine.Main outcome measuresPositive for SARS-CoV-2 virus on RT-PCR with self-administered nasal-oral swab, and general well-being using...

BJPsych Open, 2021

Background Nations throughout the world are imposing mandatory quarantine on those entering the c... more Background Nations throughout the world are imposing mandatory quarantine on those entering the country. Although such measures may be effective in reducing the importation of COVID-19, the mental health implications remain unclear. Aims This study sought to assess mental well-being and factors associated with changes in mental health in individuals subject to mandatory quarantine following travel. Method Travellers arriving at a large, urban international airport completed online questionnaires on arrival and days 7 and 14 of mandated quarantine. Questionnaire items, such as travel history, mental health, attitudes toward COVID-19, and protection behaviours, were drawn from the World Health Organization Survey Tool for COVID-19. Results There was a clinically significant decline in mental health over the course of quarantine among the 10 965 eligible participants. Poor mental health was reported by 5.1% of participants on arrival and 26% on day 7 of quarantine. Factors associated w...

International Archives of Occupational and Environmental Health, 2021

Public transportation workers are exposed to higher levels of stress related to accidents, injuri... more Public transportation workers are exposed to higher levels of stress related to accidents, injuries, and person-under-train events when compared to other workers. This systematic review integrates the existing literature on mental health among high-risk public transportation workers to estimate the prevalence of post-traumatic stress disorder (PTSD), major depressive and anxiety symptoms following critical incidents while on duty. This systematic review is part of a larger systematic review which examines mental health and work outcomes of individuals working in professions at high risk of critical incident exposure, i.e., high-risk professions. Articles were included if they measured the prevalence of PTSD, Major Depressive Disorder (MDD) and Anxiety Disorder (AD) in a transportation population following exposure to a major incident, for example, a person-under-a-train. Among the ten articles, all reported prevalence of PTSD which ranged from 0.73 to 29.9%. Four articles reported prevalence of depression among transportation workers exposed to a critical incident and prevalence outcomes ranged from 0.05 to 16.3%. Only two reported prevalence of anxiety from 1.3 to 13.9%. This literature reports that transportation workers are prone to involvement in traumatic accidents leading to higher rates of PTSD compared to the general population. Strategies to reduce transportation accidents and to provide transportation workers follow-up mental health support is needed for this vulnerable population.

Clinical Social Work Journal, 2020

While simulation has become an increasingly sophisticated and standardized method of clinical tea... more While simulation has become an increasingly sophisticated and standardized method of clinical teaching and performance assessment in social work, unlike other clinical and health care fields, it is not generally used in other areas of social work research. Yet, it has the potential to address challenges and limitations in several areas of social work research. For instance, in the area of professional decision-making, research has demonstrated high variability in the conclusions of not only different professionals encountering the same case, but also in a single professional encountering a case at different times. However, research that would elucidate differences in professional decision-making is complicated by logistical and ethical constraints of real-life practice, and the fact that professional decision-making occurs outside the realm of conscious deliberation rendering the individual unable to fully articulate the process by which they arrived at their final conclusion. Simulation research methods can address some of these challenges through providing the opportunity to: observe professional decision-making in real time; reflect on the decisional process while reviewing recordings; and compare the approaches of professionals to standardized cases. This paper reviews the use of simulation research methods in clinical and health science fields and the types of simulation research. It then describes the manner in which simulation methods have been applied to a specific program of social work research that examines professional decision-making in high stakes situations, contributing to clinical practice. Keywords Simulation • Standardized patients • Clinical decision-making • High-fidelity Simulation in the form of role play has a long tradition in social work education (Hargreaves and Hadlow 1997), but has recently become an increasingly sophisticated and standardized method of clinical teaching and performance assessment (Bogo 2010; Kourgiantakis et al. 2019a, b, c; Mooradian 2008). It is used to teach procedural competencies such as knowledge and skill acquisition (Sacco et al. 2017), brief intervention skills (Putney et al. 2019), online clinical skills (Washburn and Zhou 2018), supervision skills (Maynard 2019), interprofessional collaboration (Neander et al. 2018; Nimmagadda and Murphy 2014); and to conduct readiness for practice assessments (Havig et al. 2020).

Journal of Loss and Trauma, 2020

While universities regularly face emergency situations that affect their operations, the global d... more While universities regularly face emergency situations that affect their operations, the global disruption caused by COVID-19 is unprecedented, presenting unique challenges to universities. This article describes the initial stages of crisis response at a large research-intensive university in the center of a diverse international city. Structural, operational, social/ psychological, and communication challenges have shifted during five phases we experienced in COVID-19: preplanning, approaching crisis, immediate crisis, prolonged uncertainty, and planning for restart and recovery. Key to managing challenges is clear but flexible incident management structures, and constant interaction and collaboration among groups addressing varying aspects of the operation.

Police Practice and Research, 2019

In addition to high-risk and high-stress events that police officers routinely encounter, many ar... more In addition to high-risk and high-stress events that police officers routinely encounter, many are also exposed to extreme traumatic exposures or disasters caused by nature (eg. Hurricanes) and human action (e.g., terrorist attacks or plane crashes). These exposures can result in a variety of adverse reactions including post-traumatic stress disorder (PTSD), acute stress disorder, major depressive disorder and anxiety disorders. Understanding and accurately measuring the burden of disease arising from involvement in extreme events, on policing organizations and individual police officers is critical for policy makers and those who plan and deliver services. This systematic review synthesizes existing research on large-scale disasters, in order to further our understanding of how extreme events impact the mental health of police officers. The results found variability in the reported rates of mental disorder; however, there are some clear trends. Overall, the rates of PTSD among police officers that are consistently lower than those of civilians affected by the same disaster, and are lower than other occupations. This undoubtedly speaks to the resilience and training of members of policing organizations that prepare them for this work. Studies also demonstrate that reported distress in terms of acute stress disorder, anxiety and depression, continues to rise in some groups as time-elapsed from the event lengthens; suggesting a need to ensure that mental health supports are provided at later stages after the event.

Corrections, 2019

In addition to the daily stressors of the job, correctional officers are exposed to violence, dir... more In addition to the daily stressors of the job, correctional officers are exposed to violence, direct threat to themselves, and ultimately workplace injury at rates considerably higher than that of other workers. Yet, while the mental health aftermath of such exposures have been frequently studied in other public safety professions, the consequences for correctional officers are relatively unknown. The current systematic review examines the existing literature on correctional officers to provide prevalence estimates of PTSD, acute stress disorder, major depression and anxiety disorder. The literature on this topic is very limited, but nevertheless provides evidence of high prevalence of PTSD, depression and anxiety when compared to other occupational groups and the general population. PTSD is most strongly associated with physical violence and injury encountered on the job. Depression and anxiety are most strongly associated with low levels of perceived support from the organization, low job satisfaction, and low-perceived social valuing of the roles these officers perform. These findings have implications for future research and for occupational health and safety interventions in support of these key members of the public safety workforce.

Journal of business continuity & emergency planning, 2017

Crisis planning in institutions of higher learning has focused largely on emergency management, p... more Crisis planning in institutions of higher learning has focused largely on emergency management, physical safety and technology recovery. While these are clearly important, many aspects of planning for continuity have largely been ignored, including planning for the post-secondary education sector's core business, that is, the delivery of graduate and undergraduate academic programmes. Use of the term 'academic continuity' as a component of institutional planning is relatively new in higher education. Discussions on academic continuity have often centred on the use of technology-enhanced education and online teaching in the event of crisis or disaster affecting campuses. However, online approaches are only one aspect of academic continuity planning. Using examples of two different crisis situations encountered at a large urban university spanning three campuses, this paper presents an approach to academic continuity planning that can potentially serve as a model for other...

Journal of mental health (Abingdon, England), Jan 15, 2018

Information and communication technologies (ICTs) offer immense benefits for university students ... more Information and communication technologies (ICTs) offer immense benefits for university students including enhancing engagement and connections with others and promoting self-directed and interactive learning. Perceived anonymity and the absence of social cues, however, may contribute to risk of interpersonal aggression. While extensive research examines bullying in child and adolescent educational settings, this study addresses a gap regarding post-secondary environments. An internet-based survey was provided to 5004 university students to examine the nature, extent and consequences of cyber-aggression. The survey received a response from 1350 students, a response rate of 28.5%. To enable further exploration, nine focus groups and eight individual interviews were conducted. This exploratory study found one quarter of respondents had a private video or photo shared without their permission and 28% were sent angry, vulgar, threatening or intimating messages. Perpetrators were most li...

The journal of the American Academy of Psychiatry and the Law, 2017

Despite research identifying high levels of stress and traumatic stress symptoms among those in t... more Despite research identifying high levels of stress and traumatic stress symptoms among those in the emergency services, the impact of these symptoms on performance and hence public safety remains uncertain. This review paper discusses a program of research that has examined the effects of prior critical incident exposure, acute stress, and current post-traumatic symptoms on the performance and decision-making during an acutely stressful event among police officers, police communicators, paramedics and child protection workers. Four studies, using simulation methods involving video simulators, human-patient simulators, and/or standardized patients, examined the performance of emergency workers in typical workplace situations related to their individual profession. Results varied according to level of acuity of stress and the nature of performance and decision-making. There was no evidence that PTSD had a direct impact on global performance on tasks for which emergency responders are ...

The Canadian Journal of Psychiatry, 1998

Objective: To discuss the implications ofrecent legislative changes andcourt decisions in Canada ... more Objective: To discuss the implications ofrecent legislative changes andcourt decisions in Canada that have placed the privacy ofpsychiatric records information at risk. New areas of exposure include client access to clinical informationprovidedbyfamily members, parental access to children's records, andcourt access to clinical records in civil, criminal, andfamily law matters. Method: A review ofrecent legislative changes and court decisions pertaining to access to psychiatric records. Conclusion: At present, psychiatric records can no longer be regarded as confidential. Recent changes in the concept ofprivilege oftreatment records necessitates several changes in psychiatric practice regarding informed consent to treatment, content ofclinical records, and responses to demands for information.

The Canadian Journal of Psychiatry, 2001

Objective: Recent research has called into question the “dose-effect” model of understanding resp... more Objective: Recent research has called into question the “dose-effect” model of understanding response to trauma and has turned attention to the contribution of personality and environmental factors. This research seeks to model the interrelation of relational capacity (a component of personality), perceptions of social support, and posttraumatic distress. Method: A group of firefighters (n = 164) completed questionnaires that addressed exposure to traumatic events, social support, current level of distress, and relational capacity. Structural equation modelling was used to develop a framework for understanding traumatic reactions. Results: The overall fit of the hypothesized model was excellent. Relational capacity had a significant negative effect on support, indicating that perceived social support decreased as disturbances in relational capacity increased. Perceived social support had a significant negative effect on level of distress. Conclusion: While some emotional response to...

Journal of Loss and Trauma, 2015

ABSTRACT Suicide risk assessment is a critical component of mental health practice for which the ... more ABSTRACT Suicide risk assessment is a critical component of mental health practice for which the stakes are high and the outcomes uncertain. This research examines the consistency with which clinicians make determinations of suicide risk and factors influencing clinical confidence. Seventy-one social workers interviewed two standardized patients performing in scenarios depicting suicidal ideation, judged whether the patient required hospitalization, and completed standardized suicide risk assessment measures. Self-ratings and qualitative interviews explored participants’ confidence in their judgment of risk. Participants had highly divergent views regarding whether or not the risk of suicide was sufficiently high to require hospitalization. However, regardless of the ultimate decision reached, participants were equally confident when recommending either clinical course of action. The variation in risk assessment appraisals in this study, despite at times high rates of confidence in risk appraisals, speaks to the need for ongoing training, consultation, and increased decision support strategies.

Handbook of Stress in the Occupations

The Journal of Nervous and Mental Disease, 2000

Archival Science

Building on previous work investigating the impact of exposure to (a) records with traumatic pote... more Building on previous work investigating the impact of exposure to (a) records with traumatic potentialities and (b) interactions with donors and community researchers whose suffering is documented in the archives, this study sought to better understand emotional aspects of archival work. Using a diary research methodology, 15 archivists engaged in diary keeping for approximately four months. What emerged was a broad set of events and experiences that triggered a wide range of emotional responses arising from archival work. This included: pre-existing emotional states and characterological traits; emotional exchanges in the workplace with colleagues and others; emotional demands of the work (including emotion work and emotional labour); team and leader interactions arising from group tasks and leader behaviour; and organizational policies, climate, resources and demands. This broader set of interactional factors forms the foundation on which traumatic and other troubling events are e...

International Journal of Environmental Research and Public Health

Autism spectrum disorder (ASD) is a complex neurological and developmental disorder that has seen... more Autism spectrum disorder (ASD) is a complex neurological and developmental disorder that has seen an increase in prevalence over the past two decades, particularly in low and middle-income countries. The purpose of the current paper is to examine the experiences of mothers in Ethiopia raising a child with ASD through employing a qualitative research design involving semi-structured interviews with twenty mothers. The experiences of mothers in this study fell into three thematic areas: (1) grieving and experiencing other emotions arising from the diagnosis of their child; (2) developing, understanding and defining autism; and (3) accepting the diagnosis and developing coping strategies for raising their child. The findings revealed that raising a child with autism introduced a new lifelong experience to mothers’ everyday lives, profoundly changing their parenting role and transforming their view of mothering. Recognition of the experience of “new mothering” and mothers’ meaning-makin...

Archival Science

There is growing awareness in archival communities that working with records that contain evidenc... more There is growing awareness in archival communities that working with records that contain evidence of human pain and suffering can result in unsettling emotions for archivists. One important finding of this work, however, is the considerable variability in not only the nature of responses, but also the nature of records that provoke emotional responses. Using in-depth qualitative interviews with 20 archivists from across Canada and one from the United States, and employing grounded theory methodology, this study sought to better understand the nature of emotional responses and factors associated with distress. Archivists described a wide range of reactions including shock, intrusive thoughts, profound senses of anger, sadness and despair, and ultimately at times disrupted functioning in personal and occupational spheres. One factor that has been associated with increasing vulnerability to distress in other occupational groups is empathic engagement, which is understood to have two e...

The British Journal of Social Work, 2021

Social workers and other professionals providing mental health services are regularly required to... more Social workers and other professionals providing mental health services are regularly required to make high-stakes decisions in situations characterised by conflicting demands. To better understand the factors that drive clinical decision making in situations of risk and uncertainty, we used a design-based research framework to pilot a new approach for improving professional decision making. The programme, which combined simulated interviews, a master class series and personal monitoring of real-time decisions, was designed to focus explicit attention on biological, emotional, cognitive and contextual influences on decision making. Preliminary results from a pilot study suggest that during and immediately following the intervention, clinicians demonstrated new insights into their decision making processes. In addition, they reported benefitting both from the opportunity to reflect individually and share reflections with others. Physiological data demonstrated an association between ...

International Journal of Law and Psychiatry, 2022

This qualitative case study examines the impact of video evidence of violent crime in the tragic ... more This qualitative case study examines the impact of video evidence of violent crime in the tragic Canadian case of serial killers Paul Bernardo and Karla Homolka. Through in-depth interviews with those centrally involved in the case, interviews with criminal justice professionals currently working with video evidence of violent crime, and review of official documents and media reports, we explore the complex role video evidence played in this case and the legacy it continues to have in society, the justice system, and in the individual lives of those involved twenty-five years later. Two primary sources of harm arose in our analysis: critogenic harm related to the use of video evidence in the justice process; and harm arising from the media publicity surrounding the video evidence. Both of these sources of harm intensified the trauma for victims and their families, and contributed to distress and trauma reactions of criminal justice professionals and members of the jury. Given the global increase in the use of video-evidence in criminal justice processes, it is imperative that continuing harms to those involved in the process are considered and mitigated.

ObjectivesThe primary objective was to estimate the positivity rate of air travelers coming to To... more ObjectivesThe primary objective was to estimate the positivity rate of air travelers coming to Toronto, Canada in September and October, 2020, at arrival, day 7 and day 14. Secondary objectives were to estimate degree of risk based on country of origin; to assess knowledge and attitudes towards COVID-19 control measures; and subjective well-being during the quarantine period.DesignProspective cohort of arriving international travelers.SettingToronto Pearson Airport Terminal 1, Toronto, Canada.ParticipantsPassengers arriving on international flights. Inclusion criteria were those aged 18 or older who had a final destination within 100 km of the airport; spoke English or French; and provided consent. Excluded were those taking a connecting flight; who had no internet access; who exhibited symptoms of COVID-19 on arrival; or who were exempted from quarantine.Main outcome measuresPositive for SARS-CoV-2 virus on RT-PCR with self-administered nasal-oral swab, and general well-being using...

BJPsych Open, 2021

Background Nations throughout the world are imposing mandatory quarantine on those entering the c... more Background Nations throughout the world are imposing mandatory quarantine on those entering the country. Although such measures may be effective in reducing the importation of COVID-19, the mental health implications remain unclear. Aims This study sought to assess mental well-being and factors associated with changes in mental health in individuals subject to mandatory quarantine following travel. Method Travellers arriving at a large, urban international airport completed online questionnaires on arrival and days 7 and 14 of mandated quarantine. Questionnaire items, such as travel history, mental health, attitudes toward COVID-19, and protection behaviours, were drawn from the World Health Organization Survey Tool for COVID-19. Results There was a clinically significant decline in mental health over the course of quarantine among the 10 965 eligible participants. Poor mental health was reported by 5.1% of participants on arrival and 26% on day 7 of quarantine. Factors associated w...

International Archives of Occupational and Environmental Health, 2021

Public transportation workers are exposed to higher levels of stress related to accidents, injuri... more Public transportation workers are exposed to higher levels of stress related to accidents, injuries, and person-under-train events when compared to other workers. This systematic review integrates the existing literature on mental health among high-risk public transportation workers to estimate the prevalence of post-traumatic stress disorder (PTSD), major depressive and anxiety symptoms following critical incidents while on duty. This systematic review is part of a larger systematic review which examines mental health and work outcomes of individuals working in professions at high risk of critical incident exposure, i.e., high-risk professions. Articles were included if they measured the prevalence of PTSD, Major Depressive Disorder (MDD) and Anxiety Disorder (AD) in a transportation population following exposure to a major incident, for example, a person-under-a-train. Among the ten articles, all reported prevalence of PTSD which ranged from 0.73 to 29.9%. Four articles reported prevalence of depression among transportation workers exposed to a critical incident and prevalence outcomes ranged from 0.05 to 16.3%. Only two reported prevalence of anxiety from 1.3 to 13.9%. This literature reports that transportation workers are prone to involvement in traumatic accidents leading to higher rates of PTSD compared to the general population. Strategies to reduce transportation accidents and to provide transportation workers follow-up mental health support is needed for this vulnerable population.

Clinical Social Work Journal, 2020

While simulation has become an increasingly sophisticated and standardized method of clinical tea... more While simulation has become an increasingly sophisticated and standardized method of clinical teaching and performance assessment in social work, unlike other clinical and health care fields, it is not generally used in other areas of social work research. Yet, it has the potential to address challenges and limitations in several areas of social work research. For instance, in the area of professional decision-making, research has demonstrated high variability in the conclusions of not only different professionals encountering the same case, but also in a single professional encountering a case at different times. However, research that would elucidate differences in professional decision-making is complicated by logistical and ethical constraints of real-life practice, and the fact that professional decision-making occurs outside the realm of conscious deliberation rendering the individual unable to fully articulate the process by which they arrived at their final conclusion. Simulation research methods can address some of these challenges through providing the opportunity to: observe professional decision-making in real time; reflect on the decisional process while reviewing recordings; and compare the approaches of professionals to standardized cases. This paper reviews the use of simulation research methods in clinical and health science fields and the types of simulation research. It then describes the manner in which simulation methods have been applied to a specific program of social work research that examines professional decision-making in high stakes situations, contributing to clinical practice. Keywords Simulation • Standardized patients • Clinical decision-making • High-fidelity Simulation in the form of role play has a long tradition in social work education (Hargreaves and Hadlow 1997), but has recently become an increasingly sophisticated and standardized method of clinical teaching and performance assessment (Bogo 2010; Kourgiantakis et al. 2019a, b, c; Mooradian 2008). It is used to teach procedural competencies such as knowledge and skill acquisition (Sacco et al. 2017), brief intervention skills (Putney et al. 2019), online clinical skills (Washburn and Zhou 2018), supervision skills (Maynard 2019), interprofessional collaboration (Neander et al. 2018; Nimmagadda and Murphy 2014); and to conduct readiness for practice assessments (Havig et al. 2020).

Journal of Loss and Trauma, 2020

While universities regularly face emergency situations that affect their operations, the global d... more While universities regularly face emergency situations that affect their operations, the global disruption caused by COVID-19 is unprecedented, presenting unique challenges to universities. This article describes the initial stages of crisis response at a large research-intensive university in the center of a diverse international city. Structural, operational, social/ psychological, and communication challenges have shifted during five phases we experienced in COVID-19: preplanning, approaching crisis, immediate crisis, prolonged uncertainty, and planning for restart and recovery. Key to managing challenges is clear but flexible incident management structures, and constant interaction and collaboration among groups addressing varying aspects of the operation.

Police Practice and Research, 2019

In addition to high-risk and high-stress events that police officers routinely encounter, many ar... more In addition to high-risk and high-stress events that police officers routinely encounter, many are also exposed to extreme traumatic exposures or disasters caused by nature (eg. Hurricanes) and human action (e.g., terrorist attacks or plane crashes). These exposures can result in a variety of adverse reactions including post-traumatic stress disorder (PTSD), acute stress disorder, major depressive disorder and anxiety disorders. Understanding and accurately measuring the burden of disease arising from involvement in extreme events, on policing organizations and individual police officers is critical for policy makers and those who plan and deliver services. This systematic review synthesizes existing research on large-scale disasters, in order to further our understanding of how extreme events impact the mental health of police officers. The results found variability in the reported rates of mental disorder; however, there are some clear trends. Overall, the rates of PTSD among police officers that are consistently lower than those of civilians affected by the same disaster, and are lower than other occupations. This undoubtedly speaks to the resilience and training of members of policing organizations that prepare them for this work. Studies also demonstrate that reported distress in terms of acute stress disorder, anxiety and depression, continues to rise in some groups as time-elapsed from the event lengthens; suggesting a need to ensure that mental health supports are provided at later stages after the event.

Corrections, 2019

In addition to the daily stressors of the job, correctional officers are exposed to violence, dir... more In addition to the daily stressors of the job, correctional officers are exposed to violence, direct threat to themselves, and ultimately workplace injury at rates considerably higher than that of other workers. Yet, while the mental health aftermath of such exposures have been frequently studied in other public safety professions, the consequences for correctional officers are relatively unknown. The current systematic review examines the existing literature on correctional officers to provide prevalence estimates of PTSD, acute stress disorder, major depression and anxiety disorder. The literature on this topic is very limited, but nevertheless provides evidence of high prevalence of PTSD, depression and anxiety when compared to other occupational groups and the general population. PTSD is most strongly associated with physical violence and injury encountered on the job. Depression and anxiety are most strongly associated with low levels of perceived support from the organization, low job satisfaction, and low-perceived social valuing of the roles these officers perform. These findings have implications for future research and for occupational health and safety interventions in support of these key members of the public safety workforce.

Journal of business continuity & emergency planning, 2017

Crisis planning in institutions of higher learning has focused largely on emergency management, p... more Crisis planning in institutions of higher learning has focused largely on emergency management, physical safety and technology recovery. While these are clearly important, many aspects of planning for continuity have largely been ignored, including planning for the post-secondary education sector's core business, that is, the delivery of graduate and undergraduate academic programmes. Use of the term 'academic continuity' as a component of institutional planning is relatively new in higher education. Discussions on academic continuity have often centred on the use of technology-enhanced education and online teaching in the event of crisis or disaster affecting campuses. However, online approaches are only one aspect of academic continuity planning. Using examples of two different crisis situations encountered at a large urban university spanning three campuses, this paper presents an approach to academic continuity planning that can potentially serve as a model for other...

Journal of mental health (Abingdon, England), Jan 15, 2018

Information and communication technologies (ICTs) offer immense benefits for university students ... more Information and communication technologies (ICTs) offer immense benefits for university students including enhancing engagement and connections with others and promoting self-directed and interactive learning. Perceived anonymity and the absence of social cues, however, may contribute to risk of interpersonal aggression. While extensive research examines bullying in child and adolescent educational settings, this study addresses a gap regarding post-secondary environments. An internet-based survey was provided to 5004 university students to examine the nature, extent and consequences of cyber-aggression. The survey received a response from 1350 students, a response rate of 28.5%. To enable further exploration, nine focus groups and eight individual interviews were conducted. This exploratory study found one quarter of respondents had a private video or photo shared without their permission and 28% were sent angry, vulgar, threatening or intimating messages. Perpetrators were most li...

The journal of the American Academy of Psychiatry and the Law, 2017

Despite research identifying high levels of stress and traumatic stress symptoms among those in t... more Despite research identifying high levels of stress and traumatic stress symptoms among those in the emergency services, the impact of these symptoms on performance and hence public safety remains uncertain. This review paper discusses a program of research that has examined the effects of prior critical incident exposure, acute stress, and current post-traumatic symptoms on the performance and decision-making during an acutely stressful event among police officers, police communicators, paramedics and child protection workers. Four studies, using simulation methods involving video simulators, human-patient simulators, and/or standardized patients, examined the performance of emergency workers in typical workplace situations related to their individual profession. Results varied according to level of acuity of stress and the nature of performance and decision-making. There was no evidence that PTSD had a direct impact on global performance on tasks for which emergency responders are ...

The Canadian Journal of Psychiatry, 1998

Objective: To discuss the implications ofrecent legislative changes andcourt decisions in Canada ... more Objective: To discuss the implications ofrecent legislative changes andcourt decisions in Canada that have placed the privacy ofpsychiatric records information at risk. New areas of exposure include client access to clinical informationprovidedbyfamily members, parental access to children's records, andcourt access to clinical records in civil, criminal, andfamily law matters. Method: A review ofrecent legislative changes and court decisions pertaining to access to psychiatric records. Conclusion: At present, psychiatric records can no longer be regarded as confidential. Recent changes in the concept ofprivilege oftreatment records necessitates several changes in psychiatric practice regarding informed consent to treatment, content ofclinical records, and responses to demands for information.

The Canadian Journal of Psychiatry, 2001

Objective: Recent research has called into question the “dose-effect” model of understanding resp... more Objective: Recent research has called into question the “dose-effect” model of understanding response to trauma and has turned attention to the contribution of personality and environmental factors. This research seeks to model the interrelation of relational capacity (a component of personality), perceptions of social support, and posttraumatic distress. Method: A group of firefighters (n = 164) completed questionnaires that addressed exposure to traumatic events, social support, current level of distress, and relational capacity. Structural equation modelling was used to develop a framework for understanding traumatic reactions. Results: The overall fit of the hypothesized model was excellent. Relational capacity had a significant negative effect on support, indicating that perceived social support decreased as disturbances in relational capacity increased. Perceived social support had a significant negative effect on level of distress. Conclusion: While some emotional response to...

Journal of Loss and Trauma, 2015

ABSTRACT Suicide risk assessment is a critical component of mental health practice for which the ... more ABSTRACT Suicide risk assessment is a critical component of mental health practice for which the stakes are high and the outcomes uncertain. This research examines the consistency with which clinicians make determinations of suicide risk and factors influencing clinical confidence. Seventy-one social workers interviewed two standardized patients performing in scenarios depicting suicidal ideation, judged whether the patient required hospitalization, and completed standardized suicide risk assessment measures. Self-ratings and qualitative interviews explored participants’ confidence in their judgment of risk. Participants had highly divergent views regarding whether or not the risk of suicide was sufficiently high to require hospitalization. However, regardless of the ultimate decision reached, participants were equally confident when recommending either clinical course of action. The variation in risk assessment appraisals in this study, despite at times high rates of confidence in risk appraisals, speaks to the need for ongoing training, consultation, and increased decision support strategies.

Handbook of Stress in the Occupations

The Journal of Nervous and Mental Disease, 2000