Dr. Christine Wekerle is an associate professor in pediatrics at McMaster University specializing in the field of clinical psychology. Much of Dr. Wekerle’s work is focused on youth mental health, child maltreatment, and harm reduction. She is also the Editor-in-Chief of the Child Abuse and Neglect Journal and the founder of the mental health app, JoyPop. Below we highlight a glimpse of our interview with Dr. Wekerle.
Q: Tell us about yourself and what inspired you to enter the field today?
A: I went to graduate school in clinical psychology wanting to help people and was able to work in very broad areas of close relationships, violence, and trauma. I was able to work in the area of child sexual abuse, as well as child maltreatment more generally, largely focusing on prevention. In other words, rather than trying to understand the impact of child maltreatment, adversity, and trauma, we were focused on prevention, what works, and where we should explore next.
The first prevention intervention that I helped to develop was the Youth Relations Project, which is a dating violence prevention program. Adolescent dating violence was a fairly unknown area—we struggled to find pre-existing interventions that worked—but the data in our randomized controlled trial (RCT) not only showed a drop in dating violence experienced, but also a drop in trauma symptoms! We hadn’t specifically targeted trauma symptoms per se, but our research hinted that trauma symptoms were something that needed to be looked at further. My first publication was in 1998, and I have been conducting research in this area ever since.
Q: What makes studying mental health in adolescents so unique?
A: Adolescence is such an important area in learning lessons and is also an important developmental area in terms of brain development. They are going to develop more in terms of abstract thinking, conceptualization, and strategic thinking. Therefore, this is a point where you can have a lot of positive change. During this stage, adolescents are also supposed to take risks, which are a part of figuring out their own identities. Given this, it is a really great period to provide interventions, as youth are really energized to go with that extra help.
Q: How has your research changed since the onset of the pandemic?
A: We planned to do an in-person JoyPop study with Six Nations and now we’ve had to switch that all online. We are also in the middle of finishing up a research study with Youth in Child-Welfare. Relationships are so important in resilience. Building these relationships involve skills that we develop and it also requires practice. Therefore, by not seeing people in person, you are left to practice over Zoom—some individuals are not comfortable with having their camera on all the time. Similarly, young kids like to bump into each other, hug, and high-five and this stuff just isn't there in the virtual world.
Q: What are the biggest causes of poor mental health in university students? Have these changed since the pandemic?
A: Yes, I do think they have changed. Previously, I think the major causes for poor mental health were stress and maladaptive coping. For example, drinking to cope, using substances to cope, or sex. This is the quick thing that individuals often do to cope to make themselves feel better. I would also say connectedness is another factor and I think that has really come in with the pandemic. These feelings of being disconnected often amplify the stress impact greatly.
Q: Are there any treatment or lifestyle changes that you would recommend to anyone suffering from poor mental health?
A: We do know from research that exercise effectively addresses mild to moderate depression. I think incorporating deep breathing is another broad benefit. When we think of things like yoga, a big piece of that is deep breathing. When you think of mindfulness, a big piece of that is calm breathing.
Q: Tell us about JoyPop?
A: The app came about through understanding that technology has a strong role in the lives of youth today and understanding that we have a lot of evidence on what to do. Other apps haven’t explored all those aspects of mental health, with some focused on meditation, and others on exercise or nutrition, but trying to pool them all together through the psychological sciences is what is important.
When we talk to youth in our consultations, they are always dealing with mental health under stressful circumstances, such as university, perceived pressures on physical appearances, performance anxiety, etc. We also focused on boys who were victims—observing how they pursue their resilience—we knew we required gaming to capture their diverse interests and adversity in JoyPop.
Previous research on Tetris was significant, it indicated that playing it showed a reduction in trauma symptoms and it can serve as a distraction task because you’re focusing on manipulating blocks. It is hard to be focused and nervous at the same time when your focus is really high—if you provide the distraction of Tetris, it can help alleviate something else.
We also know that some people are visual learners and research has shown that art features have benefits in mental health apps. Sleeping is also a big issue for all of us whether we are mentally healthy or not. Therefore, we also incorporated ease of sleeping features with water sounds, based on our work on water quality with the Six Nations.
Our research also points to self-compassion as an important construct, so being able to self-love, self-care, and being gentle with yourself is critical when you make mistakes. Therefore, we created journaling prompts for defining self-compassion and gave individuals opportunities to write about their own self-compassion. We also saw that social connectedness in research is the top resilience factor and we strived to incorporate this in two ways. Firstly, we have a drop-down menu of 24/7 hotlines, as we really want users to be able to talk to someone rather than text. Secondly, we have a “circle of trust,” which includes up to six people who you know will pick up the phone when you call; it could be a caseworker, an elder, a mentor, or whomever.
Q: What are the biggest barriers to accessing mental health resources and how do we remove these barriers?
A: I think the biggest barrier to accessing mental health is the wait-lists that exist and that’s where I think JoyPop would be really useful: when you have to wait for therapy or counseling. During this wait, you could offer something like this app.
I think the other thing is the idea of focusing on positive mental health, not only things such as disorders or stuff impairing your functionality, but also investing in actions that can improve your positive mental health. This comes back to the prevention mindset rather than waiting until issues get very serious: where you’re not eating, you’re not sleeping, and you’re overusing substances. Therefore, with positive mental health, you will be able to weather these issues or potentially recover quicker.
Q: How can we help each other out as students?
A: I think students need to connect with each other and promote positive mental health. You can also think about how you might be able to get together physically but in a safe manner, such as through virtual or online gaming. My son actually celebrated his birthday with an online escape room, which was a really unique way of bringing everyone together.
In medical school, I facilitate some of the medical foundations classes and the students have a Jamboard (virtual whiteboard), and as a group, they can put pictures and write messages on there. So there are definitely ways to get more interactive in this online world.
Q: What was one of your most memorable experiences throughout your education or research?
A: One of the most impactful experiences of my undergrad was that I could just go down the hallway and chat with my psychology professors and I think that’s so important because there is no doubt that you will need referee letters and I think young people have challenges with that.
Whenever I bring youth into something, it is also memorable. There have been television shows, interviews, and radio interviews where I bring youth to discuss adolescent violence and they always light up and shine as they have so much wisdom to share!
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