Combatting Clinician Burnout Through Wellness Practices

At the 2020 virtual Psych Congress Elevate conference, Psych Congress Steering Committee member Saundra Jain, MA, PsyD, LPC, discussed clinician burnout and using wellness practices as a possible antidote. In this podcast, she explores the topic. 

Dr. Jain is a psychotherapist in private practice and an Adjunct Clinical Affiliate for the School of Nursing at the University of Texas at Austin.

Read the transcript:

Thank you for joining me for this podcast on wellness. My name is Dr. Saundra Jain and I'm a member of the Psych Congress Steering Committee. It is so nice to be spending some time with you today.

When discussing wellness, let me start with a common question that we're often asked. What role does wellness play in mental health treatment? We all know that our patients make the best teachers. So let me do this—let me share our story, how our patients taught us the importance of wellness.

When our patients started feeling better, we saw symptomatic improvement. We began checking their levels of wellness. We used a common scale. This is what we found. We were shocked how often their levels of wellness were actually quite low. Sadly, these patients were improving, but their overall wellness was not anywhere near optimum levels.

We captured the striking difference by using the WHO-5 Well-Being Index to measure their levels of well-being. We began paying attention to this difference, and systematically started using the WHO-5 as our tracking tool.

The scale was new to our patients. Once they became used to filling it out, we found something interesting. They became much more active in their treatment. In fact, they even started asking us what they could do to improve their levels of wellness.

As you'll begin to see, this is where the idea of the wellness program began to develop. Very quickly, our research moved into wellness.

I'm happy to tell you that the data so far showed that by implementing wellness-enhancing practices, like exercise, mindfulness, sleep, nutrition, social connectedness, and positive psychology practices, we really can improve not only depression, anxiety, sleep, but we can also improve levels of wellness like happiness, enthusiasm, resilience, and optimism.

We recently validated a new wellness scale called the HERO Wellness Scale, which is yours to use. It's our gift to you and to your patients. I believe wellness definitely has a major role to play when it comes to our treatment planning efforts.

As clinicians, we certainly want to see a decrease in psychiatric symptoms, we want improvement in functionality, but let's not stop there. We also want to include wellness in our treatment planning efforts. We really believe this is the best path to achieving a well-rounded approach to treatment.

Let's do this, let's take a moment. Let's consider wellness' effect on our brains. Patients and clinicians alike often ask if these wellness strategies actually change the brain. What's the neurobiological impact of these practices?

I have to tell you without a doubt, the data is convincingly positive. As an example, mindfulness meditation illustrates how this practice actually changes the brain. Study after study shows that with only an 8-week intervention of mindfulness, brain structures like the amygdala and the hippocampus change in positive ways.

Repeat studies show an increase in gray matter volume in the hippocampus, so we know there are definite brain changes. Let's do this. Let's put this information in context. In mental health, we know that chronic depression and anxiety damage the hippocampus. It actually atrophies.

Having an intervention—here a nonpharmacological intervention—one that actually improves the health of the hippocampus by increasing gray matter volume, using this as an intervention with patients, come on. This just absolutely makes sense.

These positive brain changes are supported by the data for other wellness-enhancing practices in addition to mindfulness meditation. Things like optimized sleep and nutrition, exercise, and social connectedness. If we want to work toward a healthier brain, these practices are effective strategies.

Here's a really tough question. How do we, as clinicians, take this information and put it into practice in order to help our patients? Many of you know about our WILD 5 Wellness research efforts.

Before we go any further, we want to thank you for all the help and support that you've shared with us over these many years. Without you and your patients' willingness to participate in all of these studies, honestly, this project would still be just an idea. So thank you very much.

If you're new to Wild 5 Wellness and the KickStart30 program, it's a 30-day evidence-based wellness program. It's simple and has an element of trackability that's super important. It's something you can suggest to your patients as a way to augment their current treatment.

The workbook contains everything patients will need. The program was designed in a way to promote self-management. It empowers patients to take an active role in their treatment.

Some clinicians that are using the program in their practices will direct their patients to Amazon, where the workbook is available, and others will keep the workbooks in their offices, and simply give them to their patients that are interested in this type of program.

As a side note, all proceeds from the sale of the workbook are donated to mental health charities at the end of each year. This really is a labor of love.

One other thing to mention. There's a tracking form in the workbook, which we'd encourage you, as practitioners, to review with your patients when you are meeting with them. There's something very powerful about the tracking element of this program.

What we learned is that when patients know someone's going to look at the tracking form, or ask them about it, it really seems to increase their motivation to stick with these practices. Please remember, the goal of this program is not perfection.

It's very important to regularly remind our patients of this. We don't want them to get discouraged when they miss a few days and then they simply want to quit the program.

Over the years, we've had really positive feedback from you, our colleagues, and from the many patients that have participated in our study. If I may, again, thank you very much, as well as your patients for your support and encouragement in this work.

Wellness is certainly important to our patients, granted, but what about wellness for all of us? The ones that are actually taking care of patients. We all know that clinician burnout definitely seems to be of great interest in the last few years and for obvious reasons.

Based on our research, we found that wellness-enhancing practices improve not only disease markers, like depression and anxiety, but also wellness markers. So by improving wellness, we may actually be able to tackle some element of clinical burnout.

However, there's another issue that must be mentioned in terms of clinician burnout. That is working in a toxic system. To me, toxic system means one where wellness is not a priority for all of us. But the system actually harms a person's wellness.

Here are a couple examples of that. In some studies, we see that healthcare providers report excessive work hours, excessive administrative tasks. How about this one, an enormous amount of time spent using electronic medical records. These are all mentioned as contributing to individual levels of burnout.

Honestly, we all know that wellness is not a cure-all when we try to understand clinician burnout. But it might make sense to implement a wellness intervention at the administrative or corporate level in hopes that positive changes systemwide or top down would result.

We've covered a lot in our time together today. I hope you'll continue to investigate the many benefits of wellness. We will continue to do our research and we promise to share our findings with all of you. Thanks again for taking time to join me in this conversation today about wellness. See you soon.