Health Issues Within Canadian Psychology

Belinda Liu, Helen Chin, Henry Look,
Kate McCausland, Marie Cera, Randy Fraser,
Sundeep Toor, Van Le, Danielle Jackle,
Claire Vanston, & Rose Pelleirn



1.0 Zeitgeist

Marie Cera, Randy Fraser, & Kate McCausland

During the early 1970s, there was a slight interest in health issues, especially in the workplace. People were cynical about the coming fitness trend, calling it the "Great Recreation Rip-off".

During the early 1980s, there was an increasing interest in general health. Funding for health research was directed predominantly towards trying to find a cure for cancer. Also, much research in the U.S. reflected issues pertaining to the military. This was also a time when psychiatric institutions were in the process of down-sizing, and trying to establish community care facilities for the mentally ill. At this time, herpes was the STD that people worried about catching, the disorder of anorexia was gaining recognition as a problem, fertility research made possible "test tube babies", and the issue of depression was a subject of interest. It was becoming more acceptable for women to be interested in fitness and exercise, and enrollment in aerobics classes began. The "war on drugs" waged by governments in the U.S. and Canada at this time was focused on that "evil weed", marijuana. It seemed that the public viewed psychotherapy as "trendy".

During this period, two monthly columns appeared in popular Canadian magazines. This reflected the public's need to ask professional health care providers various questions regarding health issues. There was a strong view that Canadians, as a group, were unhealthy in addition to a desire to make Canadians aware of this problem (using surveys)

In 1982, there were 10 articles published in Canadian magazines regarding health testing, compared to an average of 1 article per year in previous years.

The year 1983 saw the beginning of recognition of AIDS. Also in this year, medical advances made possible successful human heart transplants, and interest in the transplant of other organs flourished. The public began viewing plastic surgery as a lifestyle choice. Much health research focused on nutrition and on neurology.

The computer revolution really kicked in during 1984, thus computers became an increasingly important resource for health care providers. Interest in the psychology of health care itself also began to develop. The issue of child abuse was one that came to the forefront. During this year, drought and famine devastated many African countries, and this was covered extensively by the media.

In general, during the mid-80's there was an increasing focus on getting Canadians psychologically and physically fit. There was an increasing emphasis within the popular media on holistic health, and in trying to "keep the doctor away". There was also a growing interest in preventative medicine in all areas of health care.

The year 1985 saw recognition of AIDS as a major growing epidemic, and research funds began being diverted towards this area. This was also a time of a burgeoning "self-help" movement in terms of both physical and psychological health.

During the late '80's, there was a big explosion in the number and length of health articles carried in Canadian magazines. Beginning in 1986, Canadian popular magazines reflected the public's interest in the health care system and the increasing cost of health care. There was growing concern over reforming the health care system, and public comparison over Canadian versus American systems of health care delivery. In North America, addiction (especially drug addiction) was identified as both a health concern and a social problem. As well, Alzheimer's disease was a focus of much health research.

In 1987, there was over 180 articles concerning health issues published in popular Canadian magazines. This is the year that the "fitness boom" came into full swing. AIDS was a concern on people's minds, and sex therapists tried to give people advice on health care and contraception, and AIDS prevention - the "safe sex" revolution began.

This trend of interest in health issues by the public has gathered momentum since 1987, continuing to the present. Areas that were subject to the largest number of magazine articles include: Health promotion, health education, health facilities (hospital, work, home), health clubs and resorts, surveys on health and health planning.

1988 was a year in which "crack" cocaine was identified as the cause of America's problems. The effects of poverty on children's health and well-being was beginning to be recognized, in addition to the extent to which children were affected by this problem. Non-smokers began to assert their rights to clean air, and used the media to help get their message out. The so-called "New Age" movement, in health and cultural interests, emerged.

At the end of the decade (late '80's), several issues were given much media coverage to meet public interest. "Teen sex" was identified as a social concern, although the American government was unwilling to effectively promote contraception as a means of helping to deal with this. New technologies, such as the development of RU-486 (abortion pill) were ignored by North American governments. Computers became integral to the efficient delivery of health care on this continent. The "war on drugs", the '80's parallel to the Vietnam War, was in full effect and popularized through government propaganda.

In 1991, it appeared that there was a backlash growing against the big fast-food chains and the unhealthy foods they usually provide. As spas and health & fitness clubs grew in popularity, people (especially teens) turned to steroids to help them attain the perfect physique - this reflected an "obsession with the body". This may have reflected a concern with death, anxieties evoked in the public in response to the "Gulf War".

Abortion issues became the cause of much debate in the early '90's, as governments imposed increasing restrictions on women's' access to safe health care. Concerns over infertility and aging by the "Baby Boomers" sparked increased research interest in this area.

In 1994, there was an ongoing recognition that psychological symptoms can be linked to physical problems. Researchers also found that contrary to what was previously believed, that alcohol could be healthful! Interest continued in health education, resorts, and surveys. Breast cancer became a focus of interest during this time, and women lobbied for governments to devote more research money to this health issue. Cognitive research was a hot topic as well among both researchers and the public.

In 1995, research showed that women suffer coronary problems as frequently as do men; thus, preventative programs should also be targeting women more so than before. There was a large amount of media interest in the causes and possible remedies of obesity, a major North American health problem. The public's interest in leisure and lifestyle issues as they relate to health also predominated.

2.0 Health Issues in Canadian Psychology from 1976 to 1979

Helen Chin & Van Le

Benjamin (1976) has suggested from his literature review that people are highly influenced by lay other persons in their natural environments. The literature reviewed included two domains: the first was the "lay referral network" which refereed to a collection of associates in the community that give advise or referrals to individuals seeking help. The other was the "lay treatment network" which is a review of the various forms of informal helping structures in the natural environment.

Empirical evidence reveals that the person seeking help in our culture is highly subject to the influence of non- professionals in the community. Benjamin pointed out that the two most influential groups are friends and kin. Furthermore, he recommended that future professional practice should be to utilize the human resources and social supports available in the natural environment.

The treatment network mainly included self-help groups which became popular as society approached the post world war years. These people engaged in personal problem-solving for members who share common concerns (e.g.., social actions for low-status people). These self-help groups were especially attractive to a lot of soldiers who were quite vulnerable both economically as well as psychologically. For the most part, these veterans did not want to engage in traditional psychotherapy where an authoritative psychologist would direct the way the session should progress. Instead, people chose to engage in a non- conformity environment where they could talk about their problems as they wished. Afterall, society has learned that conformity (e.g.., during the war) only brings further frustrations and problems. Therefore, Benjamin suggested that, with the recognition that people in the community are important and influential on each other, psychologists should learn to close the gap between the authoritative professional image and the humanistically oriented person.

Connectively with the previous idea, an article on the Canadian health survey (1979) proposed that health survey in the community is "an unusually valuable resource" for a psychologist. Furthermore, it would be a useful resource for psychologists interested in health and health-related behaviours. The CHS (Canada Health Survey) attempted to quantify psychosocial health rather than just focusing on physical health as the absence from disease. The survey topics included risk factors that were involved in one's lifestyle (e.g.., alcohol and tobacco use, and preventives) and emotional health (e.g.., psychological well- being, alcohol -related problems) and other physical problems. The survey's purpose was to aide, plan, and evaluate social programs and policies.

Thus, throughout the late 70s, we see issues such as community understanding and health (physical and especially mental) awareness in the general public becoming more critical a goal for psychologists to achieve. The aftermath of the world wars was the baby boom. By the 70s, Canadian society had been drastically changed by these matured baby boomers. This new generation, who had never experienced war, had values such as non- conformity and individualism imposed on them by the previous generations. Thus issues such as understanding human conditions were encouraged in order to prevent future disasters.

2.1 References

Gottlieb, B. H. (1976). Lay Influences on the Utilization and Provision of Health Services: A Review. CANADIAN PSYCHOLOGICAL REVIEW, 18, 126-135.

Stephens, T. (1979). The Canada Health Survey: A Source on the Well-being of Canadians. CANADIAN PSYCHOLOGICAL REVIEW, 20, 88-91.

3.0 Health Issues in Canadian Psychology from 1980 to 1983

Belinda Liu & Henry Look

According to Muldoon, a review of the work of a number of major health commissions and task forces across Canada since 1984 revealed common themes such as increasing health care costs, dissatisfaction with the existing organizational structure in the delivery of health care, issues of the quality of accessibility of care, cholesterol screening, community care programs, etc. (Muldoon, 1994).

Six articles in Canadian Psychology, between 1980 and 1983, reflect some of the common themes in health care that Muldoon mentioned. There are 3 articles in each of the periods from 1980 to 1981, and from 1982 to 1983.

3.1 1980 to 1981

There are three health or health related articles being found in 1980 and 1981 period. The first article is about creating a culture of mental illness culture. These authors observed differences in admission rates of residents into mental hospitals among the 46 counties of the Province of Ontario. The one major factor underlying these differences was the proximity of psychiatric facilities to residents. The two other factors which related directly were the number of general practitioners per capita and the general lack of economic growth. Longitudinal studies revealed that increases in psychiatric facilities regularly preceded increases of admission rates of county residents; it was observed that counties without facilities also had low admission rates. They concluded that the presence of a mental institution in or near by a community creates a mental illness culture, defined by altered precepts and practices of members toward the proper mode of resolution of ordinary and extraordinary problems of living. Another article talked about community psychology in Canada. The author pointed out that the differences of community psychology in the United States and in Canada are in the socio-political development and the effects these differences have had on the training and practice of community psychology. The other article is about the Guidelines for therapy and counselling with women, approved by the Canadian Psychological Association. They provide such guidelines because of the unequal power differential between therapists and clients, especially female clients. The Guidelines are hoped to be employed in the training & practice of psychologists, and also by non-psychologists as well.

3.2 1982 to 1983

Morgan (1982) presented a new form of therapy that could relieve depression, anxiety neuroses, sexual dysfunction, reducing social isolation and withdrawal, and so on. It employed an unusual method (i.e. fastening two large helium-filled balloons to the ears of a client). The client must wear these balloons 24 hours per day for an entire week. At the end of the week, the client returns to the therapist and the balloons are removed. This technique is, however, not recommended when the client: 1) has a poor sense of humor, combat experience, or an attorney, 2) has not had EST training, 3) is financially insolvent 4) can spell Iatrogenic.

In a second article, Wersh, Tritt, Stambrook and Dushenko (1982) described the development of a model for psychological service delivery in a community based health care facility. Demographic characteristics, presenting problems, modes of intervention, and number of contact hours were analyzed for 75 children referred for psychological assistance in a one-year period. The findings of the study have clear implications for the contributions that psychologists can make towards an interdisciplinary approach to comprehensive health care for children in a primary health care setting. Based on the findings, a flexible model providing both consultation and primary therapy was proposed.

In the last article, according to Dunn (1983), recent advances in the area of health care psychology are noted, especially those involving the conceptualization and treatment of lifestyle and chronic health problems. The central task incumbent upon both organized psychology and individual psychologists is that of creating an underlying structure of clear boundaries and standards for clinical practice and training in health care psychology.

This study highlights the need for the profession of psychology to examine and create guidelines in psychological service delivery, professional role models, training, and scientific methods pertaining to general health care. This need arises because of a sizable increase in the number of psychologists working within health care systems.

3.3 References

"Guidelines for Therapy and Counselling with Women ", CANADIAN PSYCHOLOGY, 21, 185-186.

Davidson, P.O.,(1983). Some Cultural, Political and Professional Antecedents of Community Psychology in Canada, CANADIAN PSYCHOLOGY, 22 ,315-320.

Dunn, R.J.(1983) Psychology and Health Care, CANADIAN PSYCHOLOGY. 24 (2), 89-94.

Morgan, R.F.(1982) Balloon therapy, CANADIAN PSYCHOLOGY 23(1), 45-46.

Muldoon, J. (1994) Health and Health Policy, JOURNAL OF CANADIAN STUDIES, 29.3 , 169-76.

Silverman, I. & Saunders, D. (1982). Creating the Mental Illness Culture: Demographic Studies of Mental Institutionalization in Ontario", CANADIAN PSYCHOLOGY, 21,121-128.

Wersh, Joanne, et al., (1982). Providing Psychological Services in a Private Pediatric Setting, CANADIAN PSYCHOLOGY, 23, 221- 227.

4.0 Health Issues in Canadian Psychology from 1986 to 1988

Sundeep Toor

The psychological theme of the eighties was prevention and intervention of mental illnesses. Canadian psychologists had come to recognize that certain health issues were actually mental problems that individuals could not solve themselves. Psychologists began placing emphasis on treatment of degrees of obesity (White, 1986).

Obesity was considered a serious problem that frustrated its victims and it needed to be solved not only medically but also psychologically. In cases of obesity certain medical treatments, like surgery were combined with psychological intervention such as behaviour modification (White, 1986).

Chronic pain was also another re-occurring topic which incorporated psycho-somatic tendencies. Psychologists were beginning to understand that pain was not only a physical problem but that it could be influenced by cognitive and socio- cultural factors (Alcock,1986). They were able to treat chronic pain and to rehabilitate the injured worker. Various processes were suggested by psychologists as potential targets for prevention and intervention in the lives of people who were suffering from chronic pain.

Craig (1987) discusses the consequences of caring and examines many cognitive, affective, behavioural and social processes as targets for preventing and intervening in the lives of chronic sufferers. This is another example of how psychology was orienting towards prevention and intervention. However, in 1987 health psychology ran into some stumbling blocks. In spite of the success of health psychology, legislation had prohibited health psychologists from practicing their skills (Lacroix, 1987). Therefore during this time period Canadian psychologists were still struggling to gain credibility.

4.1 References

Alcock, J. E. (1986). Chronic pain and the injured worker. CANADIAN PSYCHOLOGY, 27(2), 196-199.

Craig, K. D. (1987). Consequences of caring: Pain in the human context. CANADIAN PSYCHOLOGY, 28(4), 311-316.

Lacroix, R. (1987). Stumbling blocks to the practice of health psychology: A Canadian perspective. CANADIAN PSYCHOLOGY, 28(3). 280-284.

White, D.R. (1986). Treatment of mild, moderate, and severe obesity in children. CANADIAN PSYCHOLOGY, 27(3). 262-268.

5.0 Health Issues in Canadian Psychology from 1984 to 1989

Danielle Jackle & Sundeep Toor

Between the years 1984 and 1989 the articles examining health psychology have demonstrated a strong emphasis towards physiological conditions while concentrating on psychosomatic issues related to prevention and intervention. Further, Canadian psychologists have come to recognize that certain health issues were actually mental problems in which individuals could not solve themselves. During this time period, psychologists began to place emphasis on treatment of degrees of obesity (White, 1986). Obesity was considered a serious problem that frustrated its victims, and psychologists noted that this condition not only needed to be solved medically, but also psychologically. In cases of obesity, certain medical treatments, such as surgery or medication, were combined with psychological interventions, specifically, behaviour modification (White, 1986).

Chronic pain constituted another re-occurring topic which incorporated psychosomatic tendencies with intervention. Psychologists were beginning to understand that not only was pain a physical problem, psychologists also demonstrated that it could be influenced by cognitive and socio-cultural factors (Alcock, 1986). Medical Health specialists found that they were able to treat chronic pain, and rehabilitate the injured worker both medically and psychologically (Alcock, 1986).

After examining intervention in further detail, researchers have noted several behavioural and cognitive training techniques when dealing with health psychology and the disorders associated with it. For example, Janel Gauthier (1985), discusses two biofeedback approaches to treat migraine headaches. Both of these biofeedback approaches concentrate on natural approaches to migraine headaches, as opposed to a biochemical approach.

Other research related to intervention promotes different behavioural cognitive techniques in dealing with type A behaviour, along with its leading cause to coronary heart disease (Seraganian, 1985). Even though this particular behavioural cognitive technique is a type of intervention by trying to deal with already existing type A behaviour, there is also some indication of prevention in other areas as a result. For instance, by reducing type A behaviour, an individual also reduces the chances of coronary heart disease, as well as less major conditions. These conditions would include: ulcers, migraine headaches, asthma, as well as high blood pressure.

In exploring prevention in greater detail, researchers stress that aerobic exercise, a nutritious diet, as well as cognitive and behavioural changes are strong contributor to a sense of "well being". For example, Steve Killip(1984), reports that an individual who maintains a well balanced diet and aerobic exercises reports having a greater sense of well being as compared to an individual who does not maintain such a schedule. By enforcing this schedule as described by Killip(1984), individuals further reported less life stressors and improved coping skills when dealing with stress related matters

5.1 References

Alcock, J.E. (1986). Chronic Pain and the Injured Worker. CANADIAN PSYCHOLOGY, 27 (2), 196.

Gauthier, J. (1985). Biofeedback Training and Migraine Headaches: Review of Therapeutic Mechanisms. CANADIAN PSYCHOLOGY, 26 (2a),

Killip, S.M. (1984). Aerobic Exercise and Psychological Well Being. CANADIAN PSYCHOLOGY, 25 (2a),

Seraganian, P. (1985). Behavioural Aspects of Coronary Heart Disease. CANADIAN PSYCHOLOGY, 26 (2), 113.

White, D.R. (1986). Treatment of Mild and Sever Obesity in children. CANADIAN PSYCHOLOGY, 27 (3), 196.

6.0 Health Issues in Canadian Psychology 1989-1995.

Claire Vanston & Rose Pelleirn

Four studies relating to health and psychology were found in the Canadian Psychology Journal for studies published between 1989 to the present. Of these four, three related to aging and gerontology. The fourth article reviewed the results of studies of factors that affect the mental and physical health of women who combine occupations with their existing roles as wives and mothers.

The emphasis on aging and the elderly seems to reflect a growing trend in research. Those over the age of 65 have been noted as the fastest growing population group, with the baby boomers finally approaching and subsequently reaching retirement age. Psychologists seemed to not only be concerned with the mental health of those over 65, but they also paid a great deal of attention to the families of the elderly; those who may have to care for their aging family members (Gottlieb, 1989).

Successful aging is also a focus. Strategies are outlined in one research article to enhance the aging process (Wong, 1989). Another article's emphasis is focused on motivation and the senior citizen (Vallerand & O'Conner, 1989). Four types of motivation have been outlined as a framework in which to study the elderly in this area of research.

This entire area of study calls necessary attention to the process of aging. In the past the caring professions have been criticized for their lack of attention in the gerontological field. It is evident from the focus of these studies that psychology is now giving the elderly much needed, and long overdue research. These writers hope to see this trend continue.

The final study relates to women who combine the multiple roles of wife, mother, and employee. This article reviews the results of studies of factors that affect the mental and physical health of these women (Carrier & Roskies, 1993). This direction in psychological study may reflect the continuing trend in the health industry which is to pay attention to the mental and physical health of women. The scientific community seems to have realized that women's issues are another field that has been under studied in past decades. This trend seems to reflect "catch up" research for women.

Health issues as they relate to Canadian psychology do not seem to have been an area of strong research in this seven year time span, that is being addressed. Only four articles on health could be found. The research that does exist in psychology seems to relate to groups of the population that have previously not been in research, such as women and the elderly. Perhaps this trend towards studying ALL groups of the population will continue well into the 21st century and beyond. Then hopefully much will be learned about the under studied groups, as we now know about the white Canadian male, the first year university student, and the laboratory rat.

6.1 References

Carrier,S., & Roskies,E. (1993). What are the conditions that affect the health of women with multiple roles? CANADIAN PSYCHOLOGY, 34, 26-44.

Gottlieb,B.H. (1989). A contextual perspective on stress in family care of the elderly. Special Issue: Psychology of aging and gerontology. CANADIAN PSYCHOLOGY, 30, 596-607.

Vallerand,R.J., & O'Conner,B.P. (1989). Motivation in the elderly: A theoretical framework and some promising findings. Special Issue: Psychology of aging and gerontology. CANADIAN PSYCHOLOGY, 30, 538-550.

Wong,P.T. (1989). Personal meaning and successful aging. Special Issue: Psychology of aging and gerontology. CANADIAN PSYCHOLOGY, 30, 516-525.