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

 
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DR. MARCIA KOSTENUIK MD

PHYSICIAN   TEACHER   SPEAKER   COACH

MD STRESS REDUCTION

PHYSICIAN HEALTH & WELLNESS

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, courses, and peer support.

If you are interested in individual coaching email marcia@drtkostenuik.com.


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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FREE SESSIONS

Hosted &  Facilitated by Dr. K.

Space is limited. Pre-registration required.

RECHARGE From Burnout

Info Session

June 23, 12-1pmET 2021

Yoga Nidra ("yogic sleep")

Mindfulness & Meditation for Deep Relaxation

June 30, 12-1pmET 2021

Click session date for details.

All are welcome: physicians, partners, and non-physicians

 

BURNED OUT?

Learn How to Get Off the Path to Burnout

 
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REGISTRATION OPEN

"RECHARGE To Prevent or Overcome Burnout"


8-Week Online Interactive Series

Oct 20 - Dec 8, 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 marcia@drkostenuik.com for details.


Space is limited. Register now. 

Click here for more info or to register

Free info session: June 23, 12-1pmET 2021 

 
Meditation

REGISTRATION OPEN

"FINDING STILLNESS:

Mindfulness, Meditation, Deep Relaxation"

10 Month Series - Live Online

Monthly Interactive Sessions

Sep 13 -Jun 13 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. 

Click here for more info or to register

Try a free session: June 30th, 12-1pmET

 
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YOGA NIDRA

Mindfulness & Meditation for Deep Relaxation


Open to all. Space is limited.

Pre-registration required:

June 30th, 12-1pmET

Be prepared for deep relaxation with this guided practice based on Yoga Nidra ("yogic sleep"). 

Group Mindfulness & Meditation Session for Stress Reduction

  • No experience required

  • If possible find a quiet comfortable space and be prepared to relax and unwind

  • All practices can be done at your desk chair if necessary

  • Optional: folded blankets, yoga mat


Session hosted by Dr. Marcia Kostenuik MD. Marcia is a Canadian physician, medical psychotherapist, teacher, speaker, coach, and certified yoga instructor.

Read brief bio here.

 

GET SUPPORT

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

Free Peer Support Sessions For

Canadian Physicians & Medical Learners:

Overcoming Burnout - May 27 & June 24, 12pmET

Mindful Parenting - May 13 & June 15, 7pmET

Stress Reduction - June 10th, 12pmET

Psychological First Aid - May 13th, 12pmET

(Pre-registration required. Hosted by CMA. Facilitated by Dr. K)

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STRESS REDUCTION PRACTICES

FOR PHYSICIANS

- LIVE ONLINE INTERACTIVE -

NEW PRACTICES EACH SESSION

(CMA sponsored)

Experience and learn stress reducing practices, including mind-body techniques, that can be easily done at work or at home.

No experience required. You must register in advance.

UPCOMING DATES:

June 10, 2021, 12pmET/9amPT

-See Full Calendar & Pre-Register

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

Facilitated by Marcia Kostenuik, MD
During these sessions, you will experience and learn a variety of stress reducing techniques designed to restore balance, regulate the nervous system and improve well-being. New strategies and mind-body practices will be introduced at each session. You will have the opportunity to return to learned practices and experience new ones week by week. The sessions are guided by Dr. Marcia Kostenuik who practices medical psychotherapy, is a certified yoga instructor, and who works with physicians suffering from burnout and stress. Practices can be done at home or at work and can be modified to suit your needs. No experience required.

 
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MINDFUL PARENTING

Peer Support

FOR CANADIAN PHYSICIANS

(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 date to pre-register:

May 18th 7-8pmET/4-5pmPT

June 15th 7-8pmET/4-5pmPT

See Calendar & Pre-Register

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


 

PSYCHOLOGICAL FIRST AID TOOLS

-LIVE ONLINE SESSION-

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.


REGISTER HERE:

See Calendar 2020/2021

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

Sessions sponsored by CMA Wellness Connection.

 
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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 marcia@drkostenuik.com

 

GET THE TOOLS

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.

 

PSYCHOLOGICAL FIRST AID TOOLS FOR COVID-19

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.)

Resources:

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: cmha.ca


References:

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

Socrates

To know thyself is the beginning of wisdom.