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A novel program that coaches healthcare workers effectively bolsters wellness and resilience in the face of the ongoing COVID-19 pandemic.

Investigators found the program they developed successfully reduced the severity of mental health threats in healthcare workers.

The pandemic has been "an enormous threat to the resilience of healthcare workers," said program leader Benjamin Rosen, MD, assistant professor, Department of Psychiatry, University of Toronto, and staff psychiatrist at Sinai Health in Toronto, Ontario, Canada.

"Working at a hospital this year, you're not only worried about battling COVID, but you're also enduring uncertainty and fear and moral distress, which has contributed to unprecedented levels of burnout," Rosen added

The findings were presented at the virtual American Psychiatric Association (APA) 2021 Annual Meeting.

"Psychological PPE"

Building on previous experience supporting colleagues through the 2003 severe acute respiratory syndrome (SARS) outbreak in Toronto, Rosen's team designed and implemented an initiative to support colleagues' wellness and resilience early in the COVID-19 pandemic.

The Resilience Coaching for Healthcare Workers program is designed to support psychological well-being during times of chronic stress and help healthcare workers "keep their heads in the game so that they can sustain the focus and the rigor that they need to do their work," Rosen said during a press briefing.

Participating coaches are mental health clinicians with training in psychological first aid, resilience, and psychotherapy to provide peer support to units and teams working on the frontline. The program provides a kind of "psychological PPE" to complement other protective measures, Rosen explained.

There are currently 15 coaches working with 17 units and clinical teams at Sinai Health, which encompasses Mount Sinai Hospital and Bridgepoint Active Health, both in Toronto. Most coaches provide support to groups of up to 15 people either virtually or in person. More than 5300 staff have received coaching support since the program's launch in April 2020.  

Mary Preisman, MD, consultation liaison psychiatrist at Mount Sinai Hospital, who is involved with the program, said it's important to note that coaches are not in clinical relationships with healthcare providers, but rather are applying diverse psychotherapeutic tools to deliver collegial support. When clinical support is requested, coaches facilitate connection with other psychiatrists.

"An Excellent Model"

Preliminary analysis of qualitative data, which includes interviews with coaches and providers, suggests that coaching is successful in mitigating the severity of mental health threats that healthcare workers face.

"The feedback so far is that coaching has really helped to strengthen team cohesiveness and resilience, which has been really encouraging for us," Rosen said.

For example, some participants said the coaching improved relationships with their colleagues, decreased loneliness, and increased the sense of support from their employer.

Others commented on the value of regularly scheduled coaching "huddles" that are embedded within the work environment.

Rosen said the program is funded by academic grants through the end of next year, which is key given that Toronto is currently in the middle of a third wave of the pandemic.

"One of the things that we learned from previous pandemics is that the psychological impact on healthcare workers usually exceeds the infectious outbreak. There been studies that show, even years after a pandemic or an epidemic has ended, the psychological consequences anxiety and distress persist," Rosen said.

Briefing moderator Jeffrey Borenstein, MD, president & CEO, Brain & Behavior Research Foundation and editor-in-chief, Psychiatric News, said the Toronto team has developed "an excellent model that could be used around the world to support the well-being of healthcare workers who are on the frontlines of a pandemic."

This research had no commercial funding. Rosen, Preisman, and Borenstein have reported no relevant financial relationships.

American Psychiatric Association (APA) 2021 Annual Meeting. Presented May 1, 2021.

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