Symposia
Disaster Mental Health
Louisa G. Sylvia, Ph.D.
Psychologist
Massachusetts General Hospital
Boston, Massachusetts
Dustin J. Rabideau, Ph.D.
Instructor in Investigation
Biostatistics, Massachusetts General Hospital
Boston, Massachusetts
Joanna Streck, PhD
Clinical Fellow
Harvard Medical School/Massachusetts General Hospital
Boston, Massachusetts
Gregory Fricchione, MD
Associate Chief of psychiatry
Massachusetts General Hospital
Boston, MA
Elyse Park, PhD, MPH
Professor
Harvard Medical School/Massachusetts General Hospital
Boston, Massachusetts
Background
The impact of COVID-19 has caused frontline clinicians (FCs) to experience high levels of stress. To mitigate the negative impact of COVID-19, we adapted an existing evidence-based resiliency program, Stress Management and Resiliency Training Program (SMART-3RP), for FCs and explored moderators of stress coping to determine who might benefit most from the group program.
Methods
English-speaking FCs (N=102) from hospitals within a large medical system enrolled in the SMART-3RP program (i.e., 1 hour virtual groups via Zoom, 8 times, twice weekly). Assessments were completed pre/post treatment; the primary treatment outcome was stress coping (0-10 scale). We explored moderators of stress coping, including sociodemographic, work, and clinical (i.e., mindfulness, anxiety, depression, self-compassion, loneliness, health uncertainty, coping and emotionally balanced thoughts) variables. We calculated pairwise mean differences in stress coping and then fit linear mixed effects regression models with random individual intercepts to incorporate all available data into our analysis. Models were fit with and without interaction terms between the potential moderator and a pre/post indicator. Each potential moderator was assessed using a likelihood ratio test (LRT).
Results
Stress coping improved pre to post-group. Sociodemographic and work characteristics did not significantly moderate stress coping. Clinical variables (increased anxiety, depression, and loneliness; reduced mindfulness, self-compassion, coping and emotionally balanced thoughts) did significantly moderate stress coping.
Conclusion
These data suggest that certain FCs, or individuals with more stress and fewer coping skills, may benefit from a stress management and resiliency group, but that sociodemographic and work characteristics may not have an impact on treatment outcomes.