Front Matter
Publication: Professional Well-Being: Enhancing Wellness Among Psychiatrists, Psychologists, and Mental Health Clinicians
Professional Well-Being
Enhancing Wellness Among Psychiatrists, Psychologists, and Mental Health Clinicians
Professional Well-Being
Enhancing Wellness Among Psychiatrists, Psychologists, and Mental Health Clinicians
By
Grace W. Gengoux, Ph.D., BCBA-D
Sanno E. Zack, Ph.D.
Jennifer L. Derenne, M.D.
Athena Robinson, Ph.D.
Laura B. Dunn, M.D.
Laura Weiss Roberts, M.D., M.A.
Note: The authors have worked to ensure that all information in this book is accurate at the time of publication and consistent with general psychiatric and medical standards, and that information concerning drug dosages, schedules, and routes of administration is accurate at the time of publication and consistent with standards set by the U.S. Food and Drug Administration and the general medical community. As medical research and practice continue to advance, however, therapeutic standards may change. Moreover, specific situations may require a specific therapeutic response not included in this book. For these reasons and because human and mechanical errors sometimes occur, we recommend that readers follow the advice of physicians directly involved in their care or the care of a member of their family.
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Copyright © 2020 American Psychiatric Association Publishing
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First Edition
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Library of Congress Cataloging-in-Publication Data
Names: Gengoux, Grace W., author. | American Psychiatric Association, issuing body.
Title: Professional well-being : enhancing wellness among psychiatrists, psychologists, and mental health clinicians / by Grace W. Gengoux, Sanno E. Zack, Jennifer L. Derenne, Athena Robinson, Laura B. Dunn, Laura Weiss Roberts.
Description: First edition. | Washington, D.C. : American Psychiatric Association Publishing, [2020] | Includes bibliographical references and index.
Identifiers: LCCN 2020001995 (print) | LCCN 2020001996 (ebook) | ISBN 9781615372294 (paperback) | ISBN 9781615373086 (ebook)
Subjects: MESH: Burnout, Professional | Psychology | Mental Health | Psychiatry | Self Care
Classification: LCC RC455 (print) | LCC RC455 (ebook) | NLM WM 62 | DDC 616.89—dc23
LC record available at https://lccn.loc.gov/2020001995
LC ebook record available at https://lccn.loc.gov/2020001996
British Library Cataloguing in Publication Data
A CIP record is available from the British Library.
To my family, for inspiring me to do work that matters.—G.W.G.
To my DBT Team, who strive every day to make well-being their cornerstone and without whom I could not thrive. Thank you for your generous hearts. And to Ed, my forever partner in the work-life balance two-step. With love.—S.E.Z.
For all the wonderful colleagues, patients, and trainees who educate me every day, and remind me to practice what I try to teach.—J.L.D.
For my esteemed colleagues and the clients we have been honored to work alongside. And to Jeffrey, for your endless support.—A.R.
For Jim, always.—L.B.D.
For my colleagues, professionals who give so much of themselves for the benefit of others.—L.W.R.
Contents
About the Authors
Preface
Laura Weiss Roberts, M.D., M.A.
Part I
Well-Being and Wellness
An Emerging Imperative for the Health Professions
1 Healthy Clinicians, Healthy Patients
2 Professional and Personal Developmental Milestones
3 Burnout and Clinician Mental Health
4 Approaches to Mental Health Care for Fellow Clinicians
5 Special Challenges for Clinicians-in-Training
6 Systems and Supports for Clinician Wellness
7 Legal and Ethical Issues in the Context of Impairment and Recovery
Part II
Well-Being and Positive Self-Care
Practical Approaches for Psychiatrists and Mental Health Professionals
8 Preventive Health Care Strategies: Fostering Positive Self-Care and Resilience
9 Mindfulness and Spiritual Well-Being
10 Nutrition and Physical Activity
11 Sleep
12 Relationships and Social Connection
13 Psychiatric Care and Psychotherapy
14 Meaningful Professional Contributions
Index
About the Authors
Grace W. Gengoux, Ph.D., BCBA-D, is a Clinical Associate Professor in the Department of Psychiatry and Behavioral Sciences at the Stanford University School of Medicine in Stanford, California.
Sanno E. Zack, Ph.D., is a Clinical Associate Professor in the Department of Psychiatry and Behavioral Sciences at the Stanford University School of Medicine in Stanford, California.
Jennifer L. Derenne, M.D., is a Clinical Professor in the Department of Psychiatry and Behavioral Sciences at the Stanford University School of Medicine in Stanford, California.
Athena Robinson, Ph.D., is Chief Clinical Officer, Woebot Labs, Inc.
Laura B. Dunn, M.D., is a Professor in the Department of Psychiatry and Behavioral Sciences at the Stanford University School of Medicine in Stanford, California.
Laura Weiss Roberts, M.D., M.A., is Chairman and Katharine Dexter McCormick and Stanley McCormick Memorial Professor in the Department of Psychiatry and Behavioral Sciences at Stanford University School of Medicine; Chief of Psychiatry Service at the Stanford Hospital and Clinics, Stanford, California; and Editor-in-Chief, Books, at American Psychiatric Association Publishing in Washington, D.C.
Disclosure of Competing Interests
The following contributor to this book has indicated a financial interest in or other affiliation with a commercial supporter, a manufacturer of a commercial product, a provider of a commercial service, a nongovernmental organization, and /or a government agency, as listed below:
Laura Weiss Roberts, M.D., M.A., serves as the Chairman and Katharine Dexter McCormick and Stanley McCormick Memorial Professor in the Department of Psychiatry and Behavioral Sciences at the Stanford University School of Medicine. She owns Terra Nova Learning Systems (TNLS), a small company that develops science-based educational products.
Dr. Roberts has received federal funding for competitive, peer-reviewed research grants and competitive, peer-reviewed small business grants and contracts. The key stakeholders, such as Stanford University and the NIH, are fully aware of this arrangement and have given prior approval for this set of professional commitments. In addition, she often serves as a consultant for federally funded scientific projects with collaborators across the United States.
Dr. Roberts is the Editor-in-Chief, Books, at American Psychiatric Association Publishing. Funds associated with these duties are provided to Stanford University. Dr. Roberts does not receive direct funding from pharmaceutical companies for her work, and she is not on “Speakers’ Bureaus” of any kind. She does give academic and public/community talks for which she receives honoraria.
Dr. Roberts has published books and receives royalties. These royalties represent a very small proportion of Dr. Roberts’ overall income
The following contributors have indicated that they have no financial interests or other affiliations that represent or could appear to represent a competing interest with the contributions to this book:
Jennifer L. Derenne, M.D., Laura B. Dunn, M.D., Grace W. Gengoux, Ph.D., BCBA-D, Athena Robinson, Ph.D., and Sanno E. Zack, Ph.D.
Preface
Very early one morning as a second-year medical student, I went to the Coronary Care Unit at a university-affiliated hospital. I was hoping to find a patient willing to tell his story—of developing heart disease, of experiencing a cardiac event, of living with chronic heart failure—because I had a write-up due later that afternoon. On the whiteboard on the wall, a patient’s initials were scrawled next to the letters “TCA OD.”
Instead of finding that those initials belonged to a stranger admitted to the unit, I discovered, by accident, that they belonged to a friend. A classmate. A wonderful colleague who had attempted suicide with tricyclic antidepressants the night before. For confidentiality reasons, the clinical team planned on transferring him to another hospital, but they hadn’t yet been able to stabilize him. I had arrived too early in the morning. He was still there. He saw me see him, and he read my concern. An understanding quickly passed between us.
I had another classmate, a brilliant guy who drank vodka each day, the bottle hidden in the gross anatomy laboratory, the telltale scent of vodka masked by the smell of cadavers. Another classmate’s Crohn’s disease wasn’t diagnosed until he nearly bled to death from a ruptured ulcer. His doctor previously had said that his symptoms were stress related (probably “medical student syndrome”). Then, there is my own story. I had a baby during medical school. And, inevitably, I had complications, and—thankfully—salutary outcomes, both for my daughter and for myself.
The classmate with depression graduated with honors a few years later, as did the one with the vodka habit. The one with Crohn’s left medicine altogether.
And I went on to become a psychiatrist. Caring for the physical and mental health of medical students, residents, and health care professionals has been an important part of my work each day since those formative experiences in medical school. It has been a great joy to engage clinically with my colleagues as well as to develop and oversee novel health programs for physicians, physicians-in-training, and other health professionals. Conducting research has been especially compelling and inspiring.
We are learning that clinicians do not need to be superhuman to be good doctors. Clinicians with an understanding of their own health needs may be more attuned and compassionate toward their patients, and clinicians with strong personal self-care habits may be more attentive to the preventive health and health-related behaviors of their patients. Clinicians who are mindful of their own vulnerability, resilience, and strength may be especially gifted in taking care of patients, living with a deep sense of purpose and using their experiences in the service of health professions.
Together, we are seeking to create a new culture and a new way of being. This new culture includes ways of being organized and ways of doing things that are supportive of the health and well-being of health professionals and the health and well-being of the patients and populations we serve. Creating this new culture, replete with new expectations of ourselves and one another, is not easy, but it is essential. The mental health professions are overwhelmed by the needs of patients throughout the world, as well as those of our colleagues and learners in the clinics, laboratories, classrooms, and communities that surround us. To do all that we can, we must endeavor to care for ourselves and to align our strengths with the work that we are called to do.
This book is the result of a close collaboration of several psychiatrist and psychologist colleagues in the Department of Psychiatry and Behavioral Sciences in the School of Medicine at Stanford University. Each of the collaborators has brought an important perspective and a wealth of expertise and experience working in the area of mental and physical health of clinicians and clinicians-in-training. I offer my gratitude to this wonderful collaborative team for our work together. On behalf of all of the coauthors, I also offer our heartfelt thanks and appreciation to Michelle Lau, who transformed this manuscript with her editing expertise, and to Lingfei Ni, Ann Tennier, Gabrielle Termuehlen, and Tenzin Tsungmey for their outstanding work in the development of this manuscript.
Laura Weiss Roberts, M.D., M.A.
Stanford, California
July 2019
Information & Authors
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Professional Well-Being: Enhancing Wellness Among Psychiatrists, Psychologists, and Mental Health Clinicians
Pages: i - xii
History
Published in print: 24 March 2020
Published online: 5 December 2024
© American Psychiatric Association Publishing
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