In March 2020, as the COVID-19 pandemic hit the East Coast, Nicole DeTore, PhD and colleagues in the Resilience and Prevention Program at Mass General developed a brief online course with the goal of introducing healthcare workers to psychological techniques used to manage stress and enhance resilence. The online course, called Resilience Training (RT) for Healthcare Workers, consists of three 12–19 minute videos including didactic information, experiential exercises, and testimonials from healthcare workers. Viewers learn about techniques shown to maintain or enhance aspects of emotional resilience, including mindfulness, mentalization, and self-compassion. The course materials were adapted from a related, existing program developed for young adults (Burke et al, 2020).
The RT course was made available on an online platform and was advertised in system-wide emails listing wellness resources for all employees in the Mass General Brigham (MGB) hospital system. A total of 554 participants completed the baseline mental health survey, endorsing moderate to high levels of emotional distress. This group included nurses (26.9%), physicians (13.9%), and health care workers in other hospital roles (59.2%).
Participants completed mental health surveys at entry into the study and again at one and two months. A total of 231 participants out of 554 (41.7%) viewed at least a portion of the RT course. The researchers analyzed data for the participants who completed two or all three or the follow-up assessments.
Of those who completed all three assessments and participated in the course (n = 38), significant improvements in resilience and reductions in emotional distress were observed one and two months later, in comparison to those who did not participate in the course (n = 110). The researchers observed that greater levels of resilience at baseline were associated with lower levels of emotional distress at both the second and third assessments. Interestingly, greater exposure to COVID-19 patients at baseline was not related to levels of emotional distress at subsequent timepoints.
Although beneficial, the number of participants who completed the course was low. The authors note that “information overload” and the heavy reliance on computer technology during the pandemic, may have interfered with the capacity of participants to view the videos and complete all three assessments. They also point out that the follow-up period of this study was only two months, and further studies are needed to determine how long the observed effects are maintained.
These initial findings, while they must be interpreted with caution given the small size of the sample and the non-randomized design, suggest that a brief, online intervention may be beneficial to healthcare workers, even in the midst of a crisis. In addition, the findings of this study are consistent with prior evidence indicating that healthcare workers are willing to engage in online, wellness-focused courses. However, physicians were less likely to participate in this intervention than other healthcare workers. Given the high rates of depression, stress, and burnout in this population, it is crucial to determine if this type of intervention is acceptable to and effective in reducing stress and enhancing resilience in this population.
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Burke AS, Shapero BG, Pelletier-Baldelli A, Deng WY, Nyer MB, Leathem L, Namey L, Landa C, Cather C, Holt DJ. Rationale, Methods, Feasibility, and Preliminary Outcomes of a Transdiagnostic Prevention Program for At-Risk College Students. Front Psychiatry. 2020 Feb 25;10:1030.
DeTore NR, Sylvia L, Park ER, Burke A, Levison JH, Shannon A, Choi KW, Jain FA, Coman DC, Herman J, Perlis R, Fava M, Holt DJ. Promoting resilience in healthcare workers during the COVID-19 pandemic with a brief online intervention. J Psychiatr Res. 2022 Feb;146:228-233. doi: 10.1016/j.jpsychires.2021.11.011. Epub 2021 Nov 7. PMID: 34857369; PMCID: PMC8572311.
Nicole DeTore, PhD is a clinical and research psychologist, Director of Research for the Resilience and Prevention Program (RAPP), and an Assistant Professor of Psychology at Harvard Medical School. Her research focuses on developing and studying interventions that can prevent the onset or reduce the severity of serious mental illnesses.
