Content on this website is not medical advice. For medical advice speak to your physician.

Two Dried Leaves





Dr. Kostenuik's work with individual physicians, hospitals, organizations and medical schools includes teaching, speaking, coaching, and promoting physician health and wellness, burnout prevention, stress reduction, mindfulness and meditation, mindful parenting, and interpersonal skills. 

In response to requests by physicians and patients for tools to address acute stress reactions during the COVID-19 pandemic, Dr. Kostenuik has developed Psychological First Aid Tools for COVID-19 based on evidence-informed principles. The tools are available here

During the COVID-19 pandemic, Dr. Kostenuik has been invited to speak to organizations including Health Canada, Canadian Medical Association (CMA), Medical Psychotherapy Association of Canada, Joule, Ontario College of Family Physicians, YMCA, University of Toronto, McMaster University, North York General Hospital, Toronto East Health Network, and McKenzie Health.

Read below for links to upcoming live interactive online sessions, series, and courses. Dr. Kostenuik provides group peer support through the Canadian Medical Association and individual peer guidance through the Ontario College of Family Physicians. 

If you are interested in personal coaching email directly to schedule a free call.

Click the More or Menu tab to find many free resources and helpful links (mindfulness, meditation, parenting, breathing practices, yoga, and more).

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Learn How to Get Off the Path to Burnout

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"RECHARGE to Prevent or Overcome Burnout"

8-Week Online Interactive Series

Oct 20 - Dec 8, 2021

Wednesdays 1-2:30pmET +Q&A

Includes 16 hours live interactive session time, plus recordings & handouts

Fee: $800 (early bird $650 until Sep 6, 2021)

This 8-week online interactive series includes a practical action plan to help get you off the path to burnout and into healthy sustainable habits for a more enjoyable and fulfilling life. Interact with peers, get support and build a healthier future.

Dr. Marcia Kostenuik is a physician, medical psychotherapist, teacher, speaker, and coach who treats physicians suffering from burnout and stress. Individual coaching is also available, email for details.

Space is limited. Register now. 

Early bird pricing until Sep 6.

Click here for more info or to register or email

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Conversation About Physician Families, LGBTQ2S+ Topics, & The Pandemic

(with expert panel, Q&A)

Pre-register here:

Tues Nov 23, 12-1pmEasternTime

The pandemic has affected those from the LGBTQ2S+ community in distinct and challenging ways. Join the conversation Nov 23rd to hear stories about how physicians and their family members from the LGBTQ2S+ community have been coping as they face challenges such as parenting as a same-sex couple or solo, accessing transgender health care, and dealing with discrimination, while also juggling the demands of working during Covid. An expert panel will answer questions, present trends, clarify terminology, and provide resources to help families access supports. Be prepared for an engaging and helpful conversation!

No fee. Space is limited.
Project has received no funding

Hosted by Dr. Marcia Kostenuik MD FCFP BSc. Marcia is a physician, medical psychotherapist, teacher, speaker, educator, & physician coach who teaches online interactive courses on parenting, mindfulness, & overcoming or preventing burnout. More info at

Expert panelists include members of the LGBTQ2S+ community who work with the Family Health Team Trans Health Program & Family and Youth Programs assisting individuals & families with a variety of community, mental health, and medical supports for LGBTQ2S+ individuals & their loved ones.

Meet the panel:

Jon Novick (he/him) MDCM, FRCPC, Psychiatrist, Associate Medical Director with the OMA Physician Health Program

Sarah Crawford (she/her) is an Ontario Certified Teacher & Peer Advisor for North Simcoe Muskoka Trans Health Services

Ali Tuckey (they/them) has a post-graduate degree in social service work & is the Youth Programs Manager at the Gilbert Centre

Jaime Campbell (he/him) RSW works as Trans Health Therapist & Navigator with North Simcoe Muskoka Trans Health Services

Marcia Kostenuik (she/her) MD, FCFP provides peer support for the Canadian Medical Association & Ontario College of Family Physicians, is on the board of directors Medical Psychotherapy Association of Canada, & teaches University of Toronto medical residents

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Setting Limits: Learn How to Say 'No" Kindly

(Session date has passed. Email to request a copy of the recording)

Learn how to recognize & understand the cost of not setting healthy limits & boundaries. Dr. Kostenuik shares ethical principles & effective communication skills that can help you say "No"- without the guilt!

This session is back by popular demand.

NEW: Registrants will receive access to a content video after the session.

Dr. Marcia Kostenuik MD FCFP BSc RYT is a physician, medical psychotherapist, speaker, teacher, personal coach and registered yoga instructor. In her private psychotherapy practice she helps physicians suffering from burnout, stress, and interpersonal challenges. She facilitates peer support through the Canadian Medical Assocation, is a peer guide for the Ontario College of Family Physicians, teaches medical residents at the University of Toronto, and is on the board of directors of the Medical Psychotherapy Association of Canada.




Mindfulness, Meditation, and Yoga Nidra

10 Month Series - Live Online

Monthly Interactive Sessions

Sep 13 2021 -Jun 13 2022

Includes over 10 hours live interactive session time, plus videos/recordings

Fee: $250 (early bird $225 until Sep 1, 2021)

Enjoy monthly experiential guided awareness practices that allow the body and mind to relax, renew and recharge. Whether you are suffering from burnout, stress, or other challenges you will find relief from tension and be guided to potentially resolve longstanding patterns of stress. Dr. Kostenuik is a physician, medical psychotherapist, teacher, coach, and registered yoga teacher with training in yoga Nidra and experience teaching and leading mindfulness and meditation.

Space is limited. Register now. 

Early bird pricing until Sep 1.

Click here for more info or to register



If you are a Canadian physician, medical student or resident - get support at a live interactive peer support session.

Mindful Parenting

Overcoming Burnout

Stress Reduction Practices

(click below for calendar)

Free Peer Support Sessions For
Canadian Physicians & Medical Learners. Sponsored by Canadian Medical Association. Faciitated by Dr. Kostenuik.
(Pre-registration required.)

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Peer Support


(CMA sponsored)

Mindfulness can help bring a moment of pause, insight, and wisdom before reacting and responding to children of all ages from newborn to adult. The group sessions include new themes each week, experiential mindfulness practices and practical skills that apply to parenting, relationships, and work-life balance.

New themes each session.

You must register in advance.

Click calendar below to pre-register:

See Calendar & Pre-Register

Sessions sponsored by CMA Wellness Connection. Registration open to Canadian physicians, medical residents and medical students.




For Candian Physicians

(CMA sponsored)

Learn the ABCs of Psychological First Aid for COVID-19

& valuable information about vicarious trauma

You will learn how to:

-immediately reduce anxiety, panic and dissociation

-provide psychosocial support to individuals in distress

-identify those needing specialized care


Next session: May 13 , 2021, 12-1pmET/9amPT

You must register in advance.


See Calendar 2020/2021

Registration open to Canadian physicians, medical residents and medical students.

Sessions sponsored by CMA Wellness Connection.

Calm Sea

Psychological First Aid Tools for Research and Training

If you are a researcher, clinician or other professional or organization interested in using the tools for research purposes, or if you would like to book an online group session, contact Dr. Marcia Kostenuik at



To read about how to use the Psychological First Aid Tools for COVID-19 or to download/print the tools for personal use click here.



Learn how and why the tools were developed

What is psychological first aid?

PSYCHOLOGICAL FIRST AID is a humane and practical approach to addressing acute psychological reactions after a mass emergency. This approach is commonly used in humanitarian and foreign aid contexts. Psychological first aid can be adapted for clinical use to help physicians during the COVID-19 pandemic.

Dr. Kostenuik has created clinical tools using elements of

  • psychological first aid

  • psychotherapy and emergency medicine

  • trauma-informed therapy

According to a systematic review of psychological first aid, interventions after a mass emergency should be practical, easy to learn and promote a sense of:

  • safety

  • self-efficacy

  • empowerment

  • connectedness

  • calm

  • hope​

Why new tools?

Physicians and patients are asking for practical tools to address acute psychological distress in themselves and others during the COVID-19 pandemic. Existing psychological and mental health first aid resources may be inappropriate or impractical for health care workers and for COVID-19 as they are designed for foreign aid workers in poor countries, are intended for specific mental illnesses, or require significant training.

Physicians need tools that are easy to learn, use and remember, and that are immediately effective for the types of acute reactions that they and their patients are experiencing. 

Most acute psychological reactions to the pandemic are normal responses to an abnormal situation. The majority of these acute reactions can and should be addressed with supportive measures and do not require psychiatric or specialized care.

During a pandemic physicians are faced with an increased demand from patients for emotional and psychological support. Physicians on the frontlines and those responding in other care settings need tools to respond to anxiety, panic, and severe acute stress and grief reactions in patients, family members and peers. New skills and approaches are needed to help address both the VOLUME and TYPES of acute psychological reactions that occur in response to a global pandemic.

Why trauma informed tools?

After an extreme stressor, a significant minority of individuals are at risk of developing serious disorders including post-traumatic stress disorder (PTSD) and depressive, anxiety and substance use disorders.

The ABC123 and L.A.R.G.E. Psychological First Aid Tools address two key risk factors for the development of post-traumatic stress disorder:

  • peri-traumatic dissociation

  • lack of social support

The ABC123 tool provides physicians with immediate skills to respond effectively to acute anxiety, panic and peri-traumatic or post-traumatic dissociation. The L.A.R.G.E. tool promotes social support and connection.

Why mnemonic memory aids?

Semi-structured approaches and the use of mnemonic memory aids are common in emergency and acute care medicine and help ensure safer and more consistent delivery of care and skills. 

The ABC123 and L.A.R.G.E. mnemonics help physicians remember the skills even when they may be under extreme stress themselves. The tools help frame an effective clinical encounter making it easier to respond to patients in an organized and safe way. Having an effective easily remembered approach can increase physician confidence in handling acute psychological distress and may reduce the risk of errors, adverse events, difficult patient encounters and complaints. 

How can these tools help during COVID-19?

During a pandemic the increased volume of individuals needing psychosocial support risks overwhelming physicians and the health care system. The ABC123 and L.A.R.G.E. Psychological First Aid Tools can be used by physicians without specialized mental health training, as well as nurses, first responders, support staff, and non-specialized personnel. 

It is recommended by WHO and the Inter-Agency Standing Committee that all responders, community leaders, teachers, and the entire population affected by the COVID-19 pandemic be trained in basic psychological first aid. The ABC123 and L.A.R.G.E. psychological first aid tools are easy to learn, use and remember and can be rapidly disseminated for immediate use. These tools were designed specifically for the COVID-19 pandemic but may be useful in other contexts.

What if individuals need more than first aid?

After a mass emergency, a significant minority of individuals, especially those from vulnerable populations, may experience emerging, regressing or worsening mental illness and will require specialized mental health support. The tools include a triaging element to help recognize red flags indicating the need for referral to crisis services or other specialized care.

Go To ABC123 and LARGE Tools (PDFs)

(These tools are intended for a Canadian audience.)


In case of crisis contact your local crisis services:

Crisis Services Canada: 1-833-456-4566 (24hrs), Text 45645 (4pm-midnight)

Mental Health Crisis Line: Barrie ON 705-728-5044, 1888-893-8333

Canadian Mental Health Association:


WHO/PAHO Mental Health Protection and Psychosocial Support in Epidemic Settings 2016

Bisson 2020 Systematic review of Psychological First Aid

IASC Addressing Mental Health and Psychosocial Aspects of COVID-19 Outbreak

WHO Mental health and psychosocial considerations during the COVID-19 outbreak

Image by Deniz Altindas


To know thyself is the beginning of wisdom.