Resilience Among Health Care Workers during the COVID-19 Pandemic

Brandi Person, Clinical Psychology Intern, Horizon Health Network

February 23, 2021

As a clinical psychologist in training, I am eager to share how we can borrow various psychotherapeutic principles to help build resilience in you — our health care workers (HCWs).

The impact of COVID-19

Stress associated with multiple recommendations from authorities, fear of illness for oneself and loved ones, social discrimination or stigma, financial instability, extended periods of isolation, and ongoing loss and grief is jeopardizing the mental health and resilience in the general population, but HCWs are arguably the most affected group of people in the fight against the virus.

Unfortunately, you as HCWs face additional challenges that increase your vulnerability to distress and burnout. You must cope with rapidly changing policies, adapt to work outside your usual scope, manage fear and uncertainty about personal protective equipment (PPE), navigate moral distress and witness trauma.

As a result, you are at risk for diminished mental health amidst the pandemic. In a recent study, just over half of HCWs surveyed reported depression symptoms (50.7%), while 44.7% experienced anxiety and 36.1% reported a sleep disorder.

Promoting Resilience in Health Care Workers

Resilience can be defined as adapting to changes caused by stressful events in a flexible way and recovering from negative emotional experiences. It’s about our ability to withstand adversity.

In health care, resilience encompasses being able to care for patients and oneself while enduring uncertainty and unpredictability. Now, there is the added stress of a global pandemic that has infiltrated our work life (and personal life).

COVID-19 is a major threat to our resilience, and research shows we need to protect the mental health of HCWs during the pandemic. After all, maintaining the success of the health care system and provision of health care services depends on the well-being of you, our HCWs.

According to the American Psychological Association, it is crucial to promote psychological resilience of during the pandemic so you may continue to work with the intensity and focus your jobs require. Because of your training in understanding wellness, distress, and psychotherapeutic treatment, psychologists are well positioned to respond to this need.

Applying Psychotherapeutic Principles to Bolster Resilience

Here are a few examples of psychotherapeutic techniques that can offer you the opportunity for reflection and validation, and for learning about the nature of stress, coping, and resilience:

Group Therapy

A group setting offers an opportunity to amplify existing connections within the health care team. Group learning and discussion of shared experiences can promote collegiality, understanding, connection and belonging. Sharing success stories can help you find joy amidst chaos and can reinforce a sense of purpose. Challenges brought on by the pandemic can be openly discussed and problem-solving can become a team effort that offers valuable support. 

Cognitive Behavioural Therapy (CBT)

CBT can illustrate the relationship between thoughts, feelings, and behaviors. It emphasizes that even when so much is uncertain and out of our control, we can remain in charge of our own thoughts. Identifying cognitive distortions can be a place to start. An example of such a distortion is “catastrophizing.” HCWs are trained to anticipate worst-case scenarios in the clinical setting, but this pattern of thought can lead to anxiety and fear when applied to other contexts. In terms of behavioural activation strategies, recommendations for behaviours that may have a positive impact on emotion (e.g., exercise, socializing virtually) can provide you with practical guidance.

Mindfulness-Based Stress Reduction

Mindfulness-Based Stress Reduction can be used to facilitate stress management. Breathing exercises, body scans, and short, guided meditations are grounding. These techniques can be empowering when practiced individually or with patients. This practice may simply entail taking two minutes during each shift to focus on your breathing and give your body a break. An alarm can be set to remind you to take a moment to relax and refocus.

Interpersonal Therapy

Speaking openly about the process of grief and life transitions can be normalizing and validating as we relate to others, especially when colleagues are grieving (e.g., working with dying patients and their families, losing loved ones to COVID-19, and experiencing the loss of typical social connection). A common role transition that has emerged during the pandemic is from clinician to “hero.” As society applauds the heroes working on the front lines, you may struggle with this new identity and how to navigate it, managing feelings of being an impostor, not doing enough, and not receiving adequate compensation to take on the new title.

Dialectical Behaviour Therapy (DBT)

DBT can identify gray areas where opposing ideas co-exist. Sentiments such as, “I am tired and scared and I do not want to go to work” and “This is my calling and I love my job” are common themes. DBT encourages us to hold these thoughts in mind and allow them to both be true, reducing the tension of having to choose. DBT can also focus on the ways you regulate your emotions (e.g. identifying how emotions escalate into distress and how you might de-escalate yourself).

Motivational Interviewing

Motivational Interviewing focuses on rolling with resistance and prompting change. It can be helpful in supporting HCWs who are struggling with maladaptive habits and behaviors imposed by the pandemic.

To all HCWs: thank you for being resilient during these difficult times! I encourage you to seek support if you are feeling overwhelmed by the impacts of COVID-19.

Brandi Person is a Clinical Psychology Intern with Horizon who splits her time between Clinical Neuropsychology at Horizon’s Stan Cassidy Centre for Rehabilitation (SCCR) and Integrated Service Delivery (ISD) for Children and Youth Mental Health at Horizon’s Victoria Health Centre.