Óscar Sánchez-Hernández
Merav Barkavi-Shani2- 1Department of Evolutionary and Educational Psychology, University of Murcia, Murcia, Spain
- 2Department of Personality, Evaluation and Psychological Treatment, University of Murcia, Murcia, Spain
Introduction
Populations affected by the COVID-19 pandemic have a significantly higher prevalence of depression, anxiety, insomnia, post-traumatic stress disorder, and psychological stress compared to the general population under normal circumstances, as indicated by the meta-analysis by Cénat et al. (2021). Other studies with large samples carried out in different countries indicate that throughout the confinement, there is a progressive worsening of mental health (Ammar et al., 2020). On the other hand, we know that the application and increase in the levels of social distancing have been necessary, since the results of the studies find that they have conduced to a significant reduction in the spread of infection and the number of deaths (Daghriri and Ozmen, 2021). Some studies indicate that the population may be hard to adhere to these restrictions and the population may have fatigue in performing social distancing rules (Harvey, 2020; Shirali et al., 2021).
Gilbody et al. (2021) note that the mental health research community has been successful in describing the nature of the impact of COVID-19, but less so in generating solutions and providing clinical trial data to establish what works to mitigate the impacts. We suggest employing interventions to promote resilience in families. We also reflect on the need for the emotional self-care of mental health professionals in this context of a pandemic.
Promotion of Resilience in Families in the Face of Confinement in the Covid-19 Pandemic
A study by Zayas et al. (2021) points to the need for interventions to promote resilience for the general population in times of pandemic, alluding to the study on the preliminary analyzes of the “Resilience and Well-being Programme: Stay at Home” (Sánchez-Hernández and Canales, 2020a,b), which is a psycho-educational intervention applied in confinement and de-escalation of the first wave of the pandemic in Spain, to promote well-being and prevent emotional problems (see Table 1). The sample consisted of 259 participants, 68.3% women and 31.7% men, with a mean age of 39.33 years (SD = 14.3). The group that received the Resilience and Well-being Programme was made up of 80 participants and the control group by 179 (Sánchez-Hernández and Canales, 2021). Participants reported high satisfaction with the programme and improvement, from pretest to post-test, in resilience, psychological well-being, post-traumatic stress symptoms, ease of handling the pandemic, and mood. The analyzes of differences between the groups indicate, in a statistically significant way, that the group to which the programme was applied has fewer symptoms of post-traumatic stress, greater ease of dealin g with the pandemic, and better mood, compared to the control group in the post-test (Sánchez-Hernández, 2020b; Sánchez-Hernández and Canales, 2021). The analyzes (Sánchez-Hernández, 2020a; Sánchez-Hernández and Canales, 2021) indicate that satisfaction with the programme, following th e programme's guidelines, and the development of certain programme skills, predict following prudent and healthy behaviors during confinement (e.g., staying home, wearing masks, social distancing, hand washing, and follow sanitary recommendations in general). These results are encouraging and have yet to be confirmed with experimental design studies.
Table 1. Well-being Pills from the resilience and wellness program: “stay at home” (Sánchez-Hernández and Canales, 2020b).
Emotional Self-Care of Mental Health Professionals
Mental Health professionals are at increased risk of burnout, due to the emotional demands of their work. Studies found that the prevalence of burnout among them can range from 20 to 40 percent (O'Connor et al., 2018; Laverdière et al., 2019; Yang and Hayes, 2020). In particular, during the COVID-19 pandemic, health professionals have been at heightened risk of depression, anxiety, burnout, insomnia and other disorders (Morin and Carrier, 2020; Al-Humadi et al., 2021; Olashore et al., 2021; Rajabimajd et al., 2021). The COVID-19 pandemic has caused heavy psychological impact among healthcare professionals especially women and frontline workers (Sun et al., 2021). In addition to this, healthcare providers may receive public stigma (Patel et al., 2021).
Positive psychology interventions (PPI) are intentional activities that aim to cultivate positive feelings, behaviors, or cognitions (Seligman et al., 2004). In a review of published papers on 15 PPIs conducted at places of work, in the period 2000–2011, improvements had been found, after interventions, in happiness, positive mood, positive emotions, vigor, positive self-perception, psychological capital (PsyCap-hope, optimism, and self-efficacy) and resilience, and reductions in stress, depression, and anxiety (Meyers et al., 2013).
Previous interventions have focused mostly on strengthening self-compassion, as a way helping professionals to cope with stress and prevent burnout, through mindfulness training or loving kindness meditation (i.e., Boellinghaus et al., 2014). A type of intervention found to be beneficial in work settings has been positive psychology. One of the basic models of such interventions is the PERMA model for well-being, designed by Peterson et al. (2005) and Seligman (2002, 2011). A fundamental exercise in positive psychology would be the counting of daily blessings (gratitude). In a gratitude intervention, participants are encouraged to reflect on, and acknowledge, things they are grateful for.
Mead et al. (2021) examined protective factors during the first wave of lockdown on the well-being in of 138 participants from the United Kingdom and found that “gratitude” and “tragic optimism” were identified as key positive psychological attributes contributing to well-being.
Lakioti et al. (2020) presented a study to investigate the factors that help therapists maintain their resilience to work stressors. Participants were Greek mental health practitioners (N = 163). The study suggests that positive psychology concepts are useful variables in the mental health professionals' resilience field. Particularly meaning, positive emotions, and satisfaction with relationships might play an important role in the development of strategies for improving therapists' mental health and functioning. Litam (2021) conducted a study used a national sample of professional counselors (N = 161) providing services during the COVID-19 pandemic to examine the extent to which perceived stress, coping response, resilience, and posttraumatic stress predict burnout, secondary traumatic stress, and compassion satisfaction. The results indicated that resilience had a strong positive relationship with compassion satisfaction and a strong negative relationship with burnout. Perceived stress was also strongly positively related to burnout. This study's findings emphasize the importance for professional counselors to cultivate resilience and self-care practices during the pandemic, and perhaps during crisis and disaster mental health counseling more generally. This finding has led to daily gratitude exercises being recommended for everyone, and but specifically for mental health professionals; it would be beneficial for them to write three good things that happened to them each day. It was found in meta- analyzes that the most effective interventions at work were: gratitude and strengths (Donaldson et al., 2019). Moreover, the positive impact of gratitude has been found to contribute to longevity, well-being, and a reduction in psychopathology (Jans-Beken et al., 2020).
Discussion
The meta-analysis by Cénat et al. (2021) indicates that since the COVID-19 pandemic has broken out, the population-wide prevalence of depression, anxiety, insomnia, post-traumatic stress disorder, and psychological stress has risen markedly. In Greece (Lakioti et al., 2020) found that positive psychology concepts are useful variables in the mental health professionals' resilience to work stressors.
As the article by Gilbody et al. (2021) points out, the mental health research community has been successful in describing the nature of the impact of COVID-19, but less so in generating solutions and providing clinical trial data to establish what works to mitigate the effects of COVID-19 impacts. It is necessary to analyze this imbalance and promote clinical trial studies to promote well-being, prevent emotional problems, and carry out early detection and intervention of emotional disorders. We suggest employing interventions to promote resilience in families (Sánchez-Hernández et al., 2022). We also reflect on the need for the emotional self-care of mental health professionals in the context of a pandemic through the daily practice of gratitude exercises involving “three good things that happened to me.”
Author Contributions
ÓS-H carried out mainly the section Promotion of Resilience in Families in the Face of Confinement in the COVID-19 pandemic. MB-S and RB mainly carried out the section Emotional Self-Care Of Mental Health Professionals. The rest of the sections have been carried out by the three authors. All authors contributed to the article and approved the submitted version.
Conflict of Interest
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
Publisher's Note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.
References
Al-Humadi, S., Bronson, B., Muhlrad, S., Paulus, M., Hong, H., and Cáceda, R. (2021). Depression, suicidal thoughts, and burnout among physicians during the COVID-19 pandemic: a survey-based cross-sectional study. Acad. Psychiatry 14, 1–9. doi: 10.1007/s40596-021-01490-3
Ammar, A., Chtourou, H., Boukhris, O., Trabelsi, K., Masmoudi, L., Brach, M., et al. (2020). COVID-19 home confinement negatively impacts social participation and life satisfaction: a worldwide multicenter study. Int. J. Environ. Res. Public Health 17, 6237. doi: 10.3390/ijerph17176237
Boellinghaus, I., Jones, F. W., and Hutton, J. (2014). The role of mindfulness and loving kindness meditation in cultivating self-compassion and other-focused concern in health care professionals. Mindfulness 5, 129–138. doi: 10.1007/s12671-012-0158-6
Cénat, J. M., Blais-Rochette, C., Kokou-Kpolou, C. K., Noorishad, P. G., Mukunzi, J. N., McIntee, S. E., et al. (2021). Prevalence of symptoms of depression, anxiety, insomnia, posttraumatic stress disorder, and psychological distress among populations affected by the COVID-19 pandemic: a systematic review and meta-analysis. Psychiatry Res. 295, 113599. doi: 10.1016/j.psychres.2020.113599
Ciarrochi, J., Hayes, L., and Bailey, A. (2016). Sal de tu Mente y entra en tu vida Para Adolescentes. Bilbao: Desclée De Brouwer.
Daghriri, T., and Ozmen, O. (2021). Quantifying the effects of social distancing on the spread of COVID-19. Int. J. Environ. Res. Public Health 18, 5566. doi: 10.3390/ijerph18115566
Donaldson, S. I., Lee, J. Y., and Donaldson, S. I. (2019). Evaluating positive psychology interventions at work: a systematic review and meta-analysis. Int. J. Appl. Positive Psychol. 4, 113–134. doi: 10.1007/s41042-019-00021-8
Forés, A., and Grané, J. (2008). La resiliencia: Crecer desde la adversidad. Barcelona: Plataforma Editorial.
Gilbody, S., Littlewood, E., Gascoyne, S., McMillan, D., Ekers, D., Chew-Graham, C. A., et al. (2021). Mitigating the impacts of COVID-19: where are the mental health trials? Lancet Psychiatry 8, 647–650. doi: 10.1016/S2215-0366(21)00204-2
Harvey, N (2020). Behavioral fatigue: real phenomenon, naïve construct, or policy contrivance? Front. Psychol. 11, 589892. doi: 10.3389/fpsyg.2020.589892
Hoffman, K., Cooper, G., Powell, B., and Benton, C. M. (2019). Cómo criar un niño seguro. Cómo el Círculo de Seguridad de los Padres puede ayudar a la formación de vínculos afectivos, a su resiliencia emocional y a la libertad de exploración. España: Editorial Medici.
Jans-Beken, L., Jacobs, N., Janssens, M., Peeters, S., Reijnders, J., Lechner, L., et al. (2020). Gratitude and health: an updated review. J. Posit. Psychol. 15, 743–782. doi: 10.1080/17439760.2019.1651888
Lakioti, A., Stalikas, A., and Pezirkianidis, C. (2020). The role of personal, professional, and psychological factors in therapists' resilience. Profess. Psychol. Res. Pract. 51, 560–570. doi: 10.1037/pro0000306
Laverdière, O., Kealy, D., Ogrodniczuk, J. S., Chamberland, S., and Descôteaux, J. (2019). Psychotherapists' professional quality of life. Traumatology 25, 208–215. doi: 10.1037/trm0000177
Litam, S. D. A., Ausloos, C. D., and Harrichand, J. J. S. (2021), Stress resilience among professional counselors during the COVID-19 pandemic. J. Counseling Dev. 99, 384–395. doi: 10.1002/jcad.12391
Mead, J., Fisher, Z., Tree, J., Wong, P., and Kemp, H. (2021). Protectors of wellbeing during the COVID-19 pandemic: key roles for gratitude and tragic optimism in a uk-based cohort. Front. Psychol. 12, 647951. doi: 10.3389/fpsyg.2021.647951
Meyers, M. C., van Woerkom, M., and Bakker, A. B. (2013). The added value of the positive: a literature review of positive psychology interventions in organizations. Eur. J. Work Organ. Psychol. 22, 618–632. doi: 10.1080/1359432X.2012.694689
Morin, C. M., and Carrier, J. (2020). The acute effects of the COVID-19 pandemic on insomnia and psychological symptoms. Sleep Med. 77, 346–347. doi: 10.1016/j.sleep.2020.06.005
O'Connor, K., Neff, D. M., and Pitman, S. (2018). Burnout in psychotherapists. Systematic review and meta-analysis of prevalence and determinants. Eur. Psychiatry 53, 74–99. doi: 10.1016/j.eurpsy.2018.06.003
Olashore, A. A., Akanni, O. O., Fela-Thomas, A. L., and Khutsafalo, K. (2021). The psychological impact of COVID-19 on health-care workers in African Countries: a systematic review. Asian J. Soc. Health Behav. 4, 85–97 doi: 10.4103/shb.shb_32_21
Patel, B. R., Khanpara, B. G., Mehta, P. I., Patel, K. D., and Marvania, N. P. (2021). Evaluation of perceived social stigma and burnout, among health-care workers working in covid-19 designated hospital of India: a cross-sectional study. Asian J. Soc. Health Behav. 4, 156–162. doi: 10.4103/shb.shb_54_21
Peterson, C., Park, N., and Seligman, M. E. (2005). Orientations to happiness and life satisfaction: the full life versus the empty life. J. Happiness Stud. 6, 25–41. doi: 10.1007/s10902-004-1278-z
Peterson, C., and Seligman, M. E. P. (2004). Character Strengths and Virtues. Washington, DC: American Psychological Association.
Rajabimajd, N., Alimoradi, Z., and Griffiths, M. D. (2021). Impact of COVID-19-related fear and anxiety on job attributes: a systematic review. Asian J. Soc. Health Behav. 4, 51–55 doi: 10.4103/shb.shb_24_21
Sánchez-Hernández, O (2020a). “Promoción de comportamientos saludables ante el confinamiento y pandemia del COVID-19,” in 13th International Congress of Clinical Psychology (Santiago de Compostela:España).
Sánchez-Hernández, O (2020b). “Eficacia del programa resiliencia y bienestar: ‘quédate en casa',” in 13th International Congress of Clinical Psychology (Santiago de Compostela: España).
Sánchez-Hernández, O., and Canales, A. (2020a). Eficacia y satisfacción del programa resiliencia y bienestar: quédate en casa. La Psicología en tiempos de Cuarentena y Pandemia. Revista de Psicoterapia 31, 381–398. doi: 10.33898/rdp.v31i117.389
Sánchez-Hernández, O., and Canales, A. (2020b). ¡Quédate en casa! Resiliencia y Bienestar. Psicología Aplicada a tiempos de Pandemia. Barcelona: Editorial UOC.
Sánchez-Hernández, O., and Canales, A. (2021). “Educando la resiliencia en las familias ante la crisis del COVID-19 en, La nueva normalidad educativa,” in Educando en Tiempos de Pandemia, eds M. A. Hernández-Prados and M. L. Belmonte (Madrid, España: Editorial DYKINSON),39–49.
Sánchez-Hernández, O., Canales, A., and Everaert, N. (2022). Resilience, well-being, and post-traumatic stress in the Spanish population in the lockdown and pandemic of COVID-19. Revista de Psicoterapia 33, 253–265. doi: 10.33898/rdp.v33i121.1103
Sánchez-Hernández, Ó., Méndez, F. X., Ato, M., and Garber, J. (2019). Prevention of depressive symptoms and promotion of well-being in adolescents: a randomized controlled trial of the smile program. Anales de Psicología 35, 225–232. doi: 10.6018/analesps.35.2.342591
Sánchez-Hernández, Ó., Méndez, F. X., and Garber, J. (2009). The promotion of students' curiosity to participate in a preventive programme. Anuario de Psicología Clínica y de la Salud 5, 29–39.
Sánchez-Hernández, Ó., Méndez, F. X., and Garber, J. (2016). Promoting resilience in children with depressive symptoms. Anales de Psicología 32, 741–748. doi: 10.6018/analesps.32.3.261671
Seligman, M. E. P (2002). Authentic Happiness: Using the New Positive Psychology to Realize Your Potential for Lasting Fulfillment. New York, NY: Free Press.
Seligman, M. E. P (2011). Flourish: A visionary new understanding of happiness and well-being. Free Press.
Seligman, M. E. P., Parks, A. C., and Steen, T. (2004). A balanced psychology and a full life. Philos. Trans. R. Soc. B Biol. Sci. 359, 1379. doi: 10.1098/rstb.2004.1513
Seligman, M. E. P., Reivich, K., Jaycox, L., and Gillham, J. (2005). Niños Optimistas. Barcelona: Random House Mondadori, S.A.
Shirali, G. A., Rahimi, Z., Araban, M., Mohammadi, M. J., and Cheraghian, B. (2021). Social-distancing compliance among pedestrians in Ahvaz, South-West Iran during the Covid-19 pandemic. Asian J. Soc. Health Behav. 4, 131–136. doi: 10.4103/shb.shb_74_21
Steger, M. F (2009). “Meaning in life,” in Oxford Handbook of Positive Psychology, 2nd Edn, eds S. J. Lopez and C. R. Snyder (New York, NY: Oxford University Press), 679–687.
Sun, P., Wang, M., Song, T., Wu, Y., Luo, J., Chen, L., et al. (2021). The psychological impact of COVID-19 pandemic on health care workers: a systematic review and meta-analysis. Front. Psychol. 12, 626547. doi: 10.3389/fpsyg.2021.626547
Yang, Y., and Hayes, J. A. (2020). Causes and consequences of burnout among mental health professionals: a practice-oriented review of recent empirical literature. Psychotherapy 57, 426–436. doi: 10.1037/pst0000317
Zayas, A., Merchán Clavellino, A., López-Sánchez, J. A., and Guil, R. (2021). Confinement situation of the Spanish population during the health crisis of COVID-19: resilience mediation process in the relationship of dispositional optimism and psychological well-being. Int. J. Environ. Res. Public Health 18, 6190. doi: 10.3390/ijerph18126190
Keywords: self-care, resilience, well-being, prevention, families, health professionals, pandemic, COVID-19
Citation: Sánchez-Hernández Ó, Barkavi-Shani M and Bermejo RM (2022) Promotion of Resilience and Emotional Self-Care in Families and Health Professionals in Times of COVID-19. Front. Psychol. 13:879846. doi: 10.3389/fpsyg.2022.879846
Received: 20 February 2022; Accepted: 07 March 2022;
Published: 29 March 2022.
Edited by:
Elkin O. Luis, University of Navarra, SpainReviewed by:
Elena Shmeleva, Russian State Social University, RussiaChung-Ying Lin, National Cheng Kung University, Taiwan
Viktorija Perepjolkina, Riga Stradiṇŝ University, Latvia
Copyright © 2022 Sánchez-Hernández, Barkavi-Shani and Bermejo. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Óscar Sánchez-Hernández, oscarsh@um.es