Division Co-Chairs: Dr. Simon O'Brien, MD, LMCC, CCFP, FRCP (PCH) and Dr. Naz Alavi, MD, FRCPC and Dr. Taras Reshetukha, MD, FRCPC (Co-Chairs KHSC)
Administrative Support: Claire Chow (KHSC)
The Division of Adult Psychiatry is comprised of an energetic multidisciplinary group of psychiatrists, psychologists, social workers, nurses, occupational therapists and pastoral care workers. Faculty members are engaged in a wide range of activities including providing clinical services, teaching, research and administrative duties.
The Division of Adult Psychiatry out of Hotel Dieu Hospital offers acute psychiatric assessment and treatment to adults over the age of 18 through the following services: Inpatient Services, Outpatient Services and Emergency Psychiatry and Community Liaison. We have also two specialised regional programs: Heads Up! - Early Psychosis Intervention Program and Eating Disorders Program.
The Division of Adult Psychiatry at Providence Care provides a wide array of specialized services through three program areas - Adult Treatment and Rehabilitation, Geriatric Psychiatry and Forensic Services. Each of the three services offers a continuum of care - inpatient, outpatient and community - with an emphasis on reintegrating clients into the community at the earliest possible opportunity. As we move forward with restructuring, Providence Care will take on a clearly defined role as a regional provider of specialized services to people with serious mental illness and a regional resource to community agencies. In its role as a teaching facility, Providence Care participates in the training of students and a number of clinical staff conduct clinical research to contribute to the understanding of mental illness and treatment.
The Community Mental Health Services at Providence Care are described here.
The Adult Division also has comprehensive Psychotherapy Services and more information can be found on the Academic page under the Postgraduate tab.
Personality Disorders Service provides care for non-psychotic adults who have been diagnosed with a personality disorder. These individuals tend to experience intense and distorted thoughts, and engage in self-destructive and socially inappropriate behaviours that are hard to change and impacts aspects of daily life.
Consultation and Education
The program psychiatrist, Dr. Jamey Adirim, provides consultation to family physicians, community psychiatrists, agencies, and other caregivers. Consultations are typically in the area of medication management, treatment, strategies, diagnosis, and issues that arise in psychotherapy. Other members of the Personality Disorders Service team offer assessments and consultations to professionals and community agencies in their area of specialty, as well as education in the understanding and treatment of personality disorders. We assist agencies in starting psycho-educational groups and provide placements for students in psychiatry, nursing, medicine, psychology, social work and nutrition.
Teaching and Reseach
Psychiatrists and psychologists with the Personality Disorders Service hold joint appointments at Queen's University and Providence Care and are active in teaching and research. Research interests include: The Treatment of Personality Disorders, The Biology of Stress, Learning Disabilities, Childhood Trauma, Sexual Orientation, Minfulness, Eating Disorders, Program Effect on Hospitalization, Common Factors in Psychotherapy, Gender Identity, Posttraumatic Dissociation, Attachment, and the Changing Role of Psychiatry at a Student Health Service.
The principal researchers are: Dr. Margo Rivera, Clinical Leader of the Personality Disorders Service and Director of Psychotherapy, Department of Psychiatry, Queen's University, and Dr. Juliet Darke, Psychologist, Personality Disorders Service.
The Emergency Psychiatry at Queen’s University is a team of clinicians and psychiatrist who assess and treat individuals with acute mental health problems who have presented to the Emergency Department at Kingston Health Sciences Centre (Kingston General Hospital site).
We work closely with the Emergency Medicine team at KHSC. After our team gets consulted to see an individual, we will meet with them as a team or individually. As part of the assessment, we will ask questions to understand the problems and concerns of the patient. Once all the information has been gathered, the team will meet to make a decision about the best care we can provide. We work with our patients to develop the best plan for them.
We also work closely with inpatient, outpatient and community mental health services to assist individuals in finding the right level of care. People experiencing a psychiatric crisis arrive in the Emergency Department in many different ways. Our goal is to provide the best support to individuals in crisis in our community.
The Emergency Psychiatry attendings each have varied interest expertise.
· Clinical Lead: Dr. Nazanin Alavi has interest in improving suicide risk assessment in the emergency settings.
· Dr. Eric Prost has expertise in women’s reproductive psychiatry.
· Dr. Taras Reshetukha has extensive clinical practice in addiction and concurrent disorders.
· Dr. Dijana Oliver has interest in psychopharmacology.
· Dr. Megan Yang has expertise in transitional age youth.
Teamwork and collaboration are our main goals. We work as part of a multidisciplinary team including mental health social workers, nurse coordinators, psychiatry nursing staff, psychiatry residents, students and psychiatrist.
During the Emergency Psychiatry rotation residents do not cover other services. Usually, the team consists of a senior psychiatry resident, 1-2 junior psychiatry residents, and 1-2 off-service residents from family medicine or emergency medicine services.
Residents work as a team. Junior residents are involved in assessment of the patients under supervision of the senior psychiatry resident and the staff psychiatrist. This encourages all junior residents to get involved in the care of the patients and also helps the senior residents with leadership role.
ER psychiatry rotation lets the students and residents learn a different set of skills with a different patient population and supervisor, providing unique perspectives daily. It also allows for the knowledge acquisition and practice of acute care psychotherapy interventions that can be done in the ER setting.
Residents will get the opportunity for doing ER psychiatry at different stages of their training. They will usually do 2-3 blocks as a junior resident, and 1-2 blocks as a senior resident.
Online Psychotherapy Lab aims to improve the lives of all those affected by mental health disorders through the advancement in mental health research. Primarily located at Queen's University, Kingston Health Sciences Centre, Hotel Dieu Hospital site, Kingston, ON.
In our online Psychotherapy Lab, we design, different online psychotherapy modules and courses for various mental illnesses including Major Depressive Disorder (MDD), Generalized Anxiety Disorder (GAD), Social Anxiety Disorder (SAD), Obsessive Compulsive Disorder (OCD), Post-Traumatic Stress Disorder (PTSD), Borderline Personality Disorder and substance use disorder.
Through online psychotherapy more service at lower cost could be delivered which could potentially double the performance of the healthcare system. This change in wait time and increased coverage could lead to significant financial and societal cost savings, given the debilitating impact of mental health disorders on individuals’ functioning while waiting for proper care. Diagnosis based care delivery through an online clinic provides a new approach to address the barriers of receiving therapy in the multi-cultural and geographically dispersed society.
Check out the QUOPL website for more information here.
The QUOPL is led by Dr. Nazanin Alavi, Psychiatrist and Assistant Professor.
Chrysalis Day Program is for people with severe, persistent symptoms that have not been resolved in other settings. Participants must be highly motivated to struggle toward responsible, independent functioning in the community. All Chrysalis participants live in the community and participate as outpatients.
Chrysalis is a highly structured and intensive treatment program that integrates Dialectical Behaviour Therapy with a psychodynamic approach in group therapy. All participants develop short and long-term goals for personal change, and progress in meeting these goals is monitored in a weekly Goals group.
The Chrysalis Group Treatment Program offers a variety of groups. To access most of these groups, you a physician or therapist referral is required. To participate in the additional programs, successful completion of the Managing Powerful Emotions group is required.
Managing Powerful Emotions (DBT Group)
The Managing Powerful Emotions group runs 90 minutes once a week, for twelve weeks. The group consists of the following two sections: distress tolerance and emotion regulation. Weeks 1 to 6 cover the ‘distress tolerance’ material and include concepts such as accepting reality, willfulness versus willingness, and crisis survival skills. Participants will be asked to put together a distress tolerance box based on these lessons and present it at Week 6. Some participants may decide that this first section, particularly the crisis survival strategies, is what you really needed and may opt to finish up at that point. Weeks 7 to 12 consist of the ‘emotion regulation’ portion of the group, where you will learn to identify your emotions, understand the purpose of your emotions, recognize what activates them, and use skills to help you gain control over emotional outbursts that create significant and ongoing difficulties.
In order to have successfully completed this group, you must attend at least 9/12 sessions, actively participate in the group, complete worksheets on a weekly basis, and use the skills and tools in your day-to-day life. If you have met all these requirements, you will then be considered for the more advanced DBT skill-building groups (Mindfulness and People Skills).
In addition to Managing Powerful Emotions (MPE), the Chrysalis Group Treatment Program offers a variety of groups. To access most of these groups, you will need to have your physician or therapist send a referral form with collateral information to our office; and you will need to have successfully completed the MPE group.
Mindfulness (DBT Group)
The Mindfulness group meets once a week, for one hour, for 12 weeks. Successful completion of the MPE group is needed to be considered for the Mindfulness group. This group is about learning a set of skills to intentionally observe, describe, and participate in the reality of life in a non-judgemental way. Dialectical Behaviour Therapy mindfulness skills are really mindfulness skills for the beginner, that is, for people who cannot yet regulate themselves well enough to have a formal meditation practice.
People Skills (DBT Group: Interpersonal Effectiveness)
People Skills meets once a week, for 75 minutes, for 12 weeks. Successful completion of the MPE group is needed to be considered for the People Skills group. The group teaches participants effective ways to communicate when dealing with interpersonal challenges. It focuses on skills to be effective in getting what you want with other people while being respectful to both yourself and others.
Seeking Safety (Substance Abuse and Emotion Regulation)
Seeking Safety is a skills-building group that attends to individuals struggling with both substance abuse and emotional and/or Seeking Safety is a skills-building group that runs 90 minute-sessions, once a week for six months. Individuals must be referred and interviewed before being accepted into this group. The group attends to individuals struggling with both substance abuse and emotional and/or behavioural dysregulation. The group teaches members specific skills to deal more effectively with their emotional suffering through understanding their emotional and behavioural dysregulation and how to make more productive choices for themselves. Lesson topics range from self-soothing and harm reduction to symptom management and relapse prevention. Weekly goals are made each session, and members are responsible for meeting their goals.
Kaleidoscope Day Program
The Kaleidoscope Day Treatment Program is group treatment that runs three mornings a week, Tuesday to Thursday. It is designed for people with severe, persistent symptoms that have not been resolved in other settings. Participants must be highly motivated to work towards responsible, independent functioning in the community. The Day Program is highly structured and integrates Dialectical Behaviour Therapy with a psychodynamic approach. Potential day program participants must have successfully completed the following three DBT-informed groups: Managing Powerful Emotions, Mindfulness, and People Skills.
The groups in the Day Program are safe communities where people can experience and reflect on the dynamics of interpersonal relationships. How participants respond within the groups can be both a source of insight into destructive personal patterns and a powerful catalyst for change. All Day Program participants develop short- and long-term goals for personal change, and progress in meeting these goals is monitored in a weekly Goals group.
At the end of each 15-week semester, participants review their progress with staff. If they have demonstrated excellent attendance, active participation, and significant improvement in symptoms, and they show evidence of continuing need and motivation, some may re-register for a second semester. Participants' community health-care providers are expected to continue to manage the participants’ ongoing care, and the Kaleidoscope Day Program is considered an addition to their efforts.