The NZCCP wishes you and your loved ones all the best for the challenges of the COVID-19 virus pandemic, the periods of self-isolation, and the disruption to “psychological business as usual.” We are receptive to doing what we can to support members through this difficult time, so please be in touch.
UPDATE TO MANDATORY VACCINATION ORDERS
Changes to the Mandatory Vaccination Order came into force at 11.59pm Sunday 23 January 2022.
These changes require health practitioners to be:
Fully vaccinated AND have received the booster OR
Have a valid exemption
Practitioners must have had their booster by 15 February 2022 or by six months from the end of their primary vaccination course. If the mandated date of your booster dose falls before the date your booster shot is due, you are not required to get your booster until you reach the six-month threshold, however you are eligible
from three months after the completion of your primary vaccine course.
Information about these changes is available on the Ministry website.
All responsible authorities are required to refer information it receives about any individual practitioners who do not comply with the mandatory vaccination orders directly to the Ministry.
All people covered by the vaccination order also need to wear a medical grade mask. What is meant by a medical grade mask? – MoH have advised that you need a Type IIR/level 2 or above surgical mask to meet this requirement. What if a client refuses to wear a mask? – You will need to conduct your own personal health and safety risk assessment. You may offer the person telehealth or advise that they can be referred to another provider. You must however not discriminate based on their vaccination status. It is your right to ask a client to wear a mask. If a client advises they have a mask exemption apply the personal risk assessment as above.
Practitioners in private practice are responsible for sourcing suitable PPE themselves.
We are still seeking clarification from the Ministry as to whether there are any exceptions to the wearing of masks by practitioners and will update on the website when we have this.
Further resources
Guidance for healthcare workers who are COVID-19 cases or contacts during an Omicron outbreak
Guidance for critical health services during an Omicron outbreak
Please, if you have any questions about the application of the order or any other matter regarding the COVID-19 vaccine mandate contact the Ministry directly at: healthorders@health.govt.nz
Guidance for the COVID Protection Framework (CPF)
Additional guidance for allied health services COVID19 Protection Framework FINAL.pdf detailing the impact of the COVID protection framework on Allied Health services.
Allied Health CPF Flow Chart FINAL.pdf to help ascertain if your health service can lawfully require vaccination certificates as an entry requirement to your premises
NZPB/NZCCP/NZPsS Joint Statement: Ethical Concerns regarding the Vaccine Mandates
MPS Guidance: COVID-19 & Managing unvaccinated patients
COVID Vaccinations:
Countering Vaccine Misinformation: A Practical Guide for Healthcare Providers
Here are some resources for supporting people to overcome barriers to vaccination, and to help with needle phobia or anxiety about having a vaccination.
Suggestions for adults and older adolescents
With severe needle phobia the aim is to get the person through the two COVID vaccinations, not to totally overcome the needle phobia as that will take more work and more time. Those with severe needle phobias should still be referred as long-term psychological therapy will be helpful beyond COVID vaccinations. Exposure therapy and CBT for needle phobia takes time – often months, so the one-off benzodiazepine option gives people an immediate path.
Discuss and make a plan with GP, PRN benzodiazepine such as Lorazepam is an option to discuss on a case-by-case basis. The GP and nurse should know in advance and have a plan in place:
- Identify a support person, essential if benzodiazepines are to be used as the client will not be able to drive)
- Brief their support person on comfort/reassurance strategies – hold hand, coach breathing etc
- Minimise waiting time - have all preparatory work (screening questions, checking personal details) done by phone before arriving at the clinic; no waiting in the waiting room – phone into reception and then go straight through to procedure room
For those only moderately anxious then addressing the fear of pain is relevant. It is still good to book a special vaccination time with GP practice nurse who knows ahead of time the client is anxious. Once again, less time in waiting room. All prep before the person is in the room so that they can be ‘in and out” as quickly as possible.
Think 5 Ps.
- Preparation (see above)
- Procedural – a quick vaccination is best – not a slow administration.
- Physical - Sitting upright is helpful unless a person is concerned about fainting, then lying down is better and reassurance that fainting can be managed and not to be embarrassed about it. Tensing leg muscles and lying down can help reduce fainting. If someone is a known fainter (has a vasovagal reaction) then relaxation is unhelpful and will make them worse. Instead use applied muscle tension (https://www.anxietycanada.com/sites/default/files/AppliedTension.pdf & NHS guidelines for fainting treatment using applied tension)
- or children we talk about comfort positions, sitting on a caregiver’s lap. Face away from the needle preparation and vaccine drawing process so that it happens behind the person. Look away across other shoulder and use cognitive and visual distraction before and during injection.
- Pharmacological – numbing cream (buy at pharmacy but about $17) or Buzzy (can be ordered online for about $50, some clinics have them, you can ask – they are not just for children), cold spray not better than placebo but some people find it reassuring.
- Psychological - primarily distraction, active is best. Easiest is watching a video on their phone, or talking to the nurse or support person about things that aren’t about the procedure (see Supporting someone who is anxious)
Suggestions for children
The following is based on the Minnesota children’s hospital comfort promise, and the video features advice from a very young ‘psychologist in the making’.
Resources for disabled and autistic people
- How to prepare for the COVID-19 Vaccination - HealthCare NZ
- Excellent range of resources including e-learning and written guidance for whanau and caregivers
- https://www.healthcarenz.co.nz/service/explore-specialist-advice/preparing-for-the-covid-19-vaccination/
Other resources
- Self-Treatment of Needle Phobia
- NHS relaxation for fear of needles
- oVRcome - a self-help VR app specifically for needle phobias (and other phobias too)
- A list of clinical psychologists who are available to help with needle phobia
The NZ Psychologists Board has developed an information sheet regarding requests for vaccination exemptions.
Ministry of Health position statement on the management of unvaccinated individuals in healthcare settings.
Practising during the pandemic
Here are some links and resources that may be helpful:
- The Government has set up a COVID-19 portal for businesses. It includes links to materials from government agencies on a wide range of topics including Health, Travel, Worksafe, Employment, IRD, etc.
- The Ministry of Health’s website has a dedicated COVID-19 coronavirus page, which is frequently updated with the latest reliable information and advice on preparedness and response.
- Wellbeing Support for Frontline Health Workers: As part of the Ministry of Health’s COVID-19 National Psychosocial Campaign, HealthcareNZ is now providing free psychological support to frontline healthcare and support workers with to 5 free sessions via telehealth platforms. How are you feeling today? To book an appointment call 0800 820 080 or emailhcnz.wellbeing@healthcarenz.co.nz.
- BPS Guidance for Psychological Professionals during Covid-19
- BPS Psychological needs of healthcare staff
The Board's document Best Practice Guideline – The Practice of Telepsychology is very useful for assisting us to practise online safely and effectively
More information can be found at the NZ Psychologists Board’s COVID 19 webpage (https://psychologistsboard.org.nz/for-practitioners/covid-19/)
Questions about Practising Under COVID-19 Conditions? The NZCCP, the Psychologists Board, and the NZ Psychological Society have worked together to give consistent responses to any questions psychologists have about providing psychology and neuropsychology services during the COVID-19 pandemic. The answers to these questions can be viewed at NZPB/NZCCP/NZPsS: COVID19 FAQ with RESPONSES
If you have questions about practising psychology during the COVID-19 Lockdown and subsequent levels, please send them to covid19@nzpb.org.nz and a group from the Board, the College, and the Society will attempt to answer them.
MPS has made allowances for the situation and “reassure that should you need to do a remote consultation with a patient whom you would ordinarily see face-to-face, your membership with Medical Protection will enable you to request assistance for matters that could arise from such consultations during this time.”
ACC has also approved Telehealth for additional service types for the duration of the COVID-19 response in the treatment of ACC’s clients accessing Integrated Services for Sensitive Claims, Psychological Services, and Clinical Psychiatric Services. Individual waivers to use Telehealth for these services will not be required for the duration of the COVID-19 response. For further information regarding ACC requirements please refer to the website.
Telepsychology "Pearls of Wisdom": For many of us, assessment and therapy by telepsychology is a new skill to learn. This document contains tips that have been gleaned from personal experience, relevant literature, and discussion with practitioners about how to make telepsychology as safe, effective, and sustainable as possible.
Several other NZ based resources are available that may assist people to learn more about online therapy and other aspects of practising during the pandemic:
- COVID-19 and Telehealth Provision for Health Providers
- Best practice guide for telehealth
- Sample Informed Consent for Telepsychology
- TOAH-NNEST has been working on developing guidelines for Telehealth. Click here to download the document
- Safe Network has shared their Teletherapy Policy as a great example of what organisations might need to have in place to support their clinical work with clients.
- Resource for checking draft reports during COVID-19 lockdown
- Christchurch Psychology: COVID-19 – Alert Level 2 – Health and Safety Guidelines
There is also a lot of discussion and suggestions on the NZCCP Private Practitioners Facebook group site and at TeletherapyNZ
- Mental Health Foundation:Top tips for looking after mental health and wellbeing during COVID-19 and beyond.
- ALL RIGHT? Getting through this together
- Explaining Covid 19 to Kids
- Managing Stress & Anxiety in Times of Crisis
- Ministry of Health: 'Self-care and Support for NZers during Covid-19'
- Some tips for handling self-isolation during COVID-19
- Help us to fight COVID-19 in the Auckland Region. For opportunities to help Community – Health Professionals register here:
https://www.cognitoforms.com/NorthernRegionalAlliance/RegisterForCOVID19StaffingSupport - Guidelines on the Psychological and Emotional Aspects of Covid 19 (EMDREurope)
- Guidelines EMDR Therapy online
Increase in scamming activity: Right now there is significant scamming activity going on and we urge people to be extra vigilant as fraudsters seek to exploit the coronavirus (COVID-19) crisis. Click here for some information and advice about how to deal with these.