News

Report finds burnout prevalent in health care community

Posted on by Dr. Holland

Addressing clinician burnout will require a deliberate and substantive health care system redesign

Clinician burnout is affecting between one-third and one-half of all of U.S. nurses and physicians, and 45 to 60% of medical students and residents, according to a National Academy of Medicine (NAM) report.
Vanderbilt University Medical Center is among 32 institutions and foundations that sponsored the 296-page report, "Taking Action Against Clinician Burnout: A Systems Approach to Professional Well-Being," which investigates the causes of widespread clinician burnout and offers solutions to address the problem at its source.

"There's an all too direct connection between clinician burnout and health care safety and quality. While clinician burnout isn't a new problem, its worsening prevalence and impact are due to system factors inherent in the modern health care system," said Matthew Weinger, MD, professor of Anesthesiology and Norman Ty Smith Chair in Patient Safety and Medical Simulation at VUMC, and a member of the NAM authoring committee for the new report.

"The Committee came to realize that addressing clinician burnout will require a deliberate and substantive health care system redesign with a focus on those activities that deliver the most value to patients while enabling and empowering clinicians to deliver high-quality care," he said.

The report discusses key issues that need to be addressed:

  • Clinician burnout needs to be tackled early in professional development and special stressors in the learning environment need to be recognized. Leaders in health care and health professions education have a responsibility to foster, monitor and continuously improve work and learning environments.
  • While some health care technologies appear to contribute to clinician burnout (poorly designed electronic health record systems, for example), there is real potential for well-designed and implemented technologies to help reduce burnout.
  • Federal and state governments, other payors and regulators and the health care industry itself have important roles to play in preventing clinician burnout. Increasing administrative burdens and distracting clinicians from the care of their patients can directly affect burnout.
  • Medical societies, state licensing boards, specialty certification boards, medical education and health care organizations all need to take concrete steps to reduce the stigma for clinicians seeking help for psychological distress and make assistance more easily available.

The report concludes with goals and recommendations centered on creating more positive work and learning environments, reducing administrative burden, enabling technology solutions, providing more support to clinicians and learners, and investing in research to address clinician burnout.

Story Source: Materials provided by Science Daily ---> Note: Content may be edited for style and length. Vanderbilt University Medical Center. "Consensus report shows burnout prevalent in health care community." ScienceDaily. ScienceDaily, 23 October 2019. www.sciencedaily.com/releases/2019/10/191023172121.htm.

Dr. Jenny Holland"On the job burnout reduces productivity and saps energy, causing feelings of being helpless, hopeless, cynical and resentful. The negative effects of burnout will eventually spill over into every area of life—including home, work and social life. Burnout can also cause long-term physical changes and increased vulnerability to illnesses like colds and flu. Because of its many consequences, it’s important to work through feelings of burnout with a counselor."

Dr. Holland works with professionals suffering from burnout by connecting the dots between symptoms and the root of the problem. She will help you to creatively work with your situation to help you discover new meaning in your work and offer ways you can stay healthy. Dr. Holland will help you learn how to help yourself so you can continue to do the work you love of helping others.

Contact Dr. Holland to get help with these problems today.

Grief Support Group Available

Posted on by Dr. Holland
Support group meeting

After the loss of a loved one, a wide variety of feelings and emotions naturally emerge. While family and friends are important during the grieving process, unless they have experienced a close personal loss, they most likely don’t fully “get it.” This is where a support group can become a valuable resource. Grief support groups offer companionship and understanding from others who have experienced a similar loss and are experiencing similar challenges that living with grief brings.

Dr. Jenny Holland, PsyD announces a new weekly support group for those who are grieving the death of a loved one. This group is open to anyone who has lost someone they love. Together we will explore, validate and support feelings and experiences that often accompany loss. Dr. Holland will guide the group through techniques that help to ease emotional pain.

Each group member will have time to share memories while discovering new ways to honor their loved one and themselves through the process. This group is limited to a small number of participants, to facilitate intimate conversation and safe sharing.

The Grief Support Group starts November 8, 2019 and will be held every other Friday from 10:30 a.m. to 12:00 p.m. at Dr. Holland’s office located at 621 Cherry St., Santa Rosa, California. To reserve your seat call Dr Holland at 707-479-2946. Participants will be pre-screened to qualify, and a sliding scale fee is offered.

Physical activity found to be protective for people at risk for depression

Posted on by Dhyana Kearly

Physical activity can influence depression in a positive way

Scroll Down for Dr. Holland's Perspective on this article

Increased levels of physical activity can significantly reduce the odds of depression, even among people who are genetically predisposed to the condition, according to a new study from researchers at Massachusetts General Hospital (MGH). In a paper published in the journal Depression and Anxiety, the team reported that individuals who engaged in at least several hours of exercise each week were less likely to be diagnosed with a new episode of depression, even in the face of high genetic risk for the disorder.

Drawing on genomic and electronic health record data from nearly 8,000 participants in the Partners Healthcare Biobank, the new study is the first to show how physical activity can influence depression despite genetic risk. Researchers followed patients who filled out a survey about their lifestyle habits (including physical activity) when they enrolled in the Biobank. They then mined millions of electronic health record data points over the next two years and identified people who received diagnoses related to depression. They also calculated genetic risk scores for each participant, combining information across the entire genome into a single score that reflects a person's inherited risk for depression.

What they found was that people with higher genetic risk were more likely to be diagnosed with depression over the next two years. Significantly, though, people who were more physically active at baseline were less likely to develop depression, even after accounting for genetic risk. In addition, higher levels of physical activity were protective for people even with the highest genetic risk scores for depression.

"Our findings strongly suggest that, when it comes to depression, genes are not destiny and that being physically active has the potential to neutralize the added risk of future episodes in individuals who are genetically vulnerable," says Karmel Choi, PhD, of MGH and the Harvard T.H. Chan School of Public Health, and lead author of the study. "On average, about 35 additional minutes of physical activity each day may help people to reduce their risk and protect against future depression episodes."

The researchers found that both high-intensity forms of activity, such as aerobic exercise, dance and exercise machines, and lower-intensity forms, including yoga and stretching, were linked to decreased odds of depression. Overall, individuals could see a 17 percent reduction in odds of a new episode of depression for each added four-hour block of activity per week.

Depression represents the leading cause of disability worldwide. Despite its massive health burden, strategies to combat depression remain limited and the public's understanding of robust and modifiable protective factors is incomplete. "We provide promising evidence that primary care and mental health providers can use to counsel and make recommendations to patients that here is something meaningful they can do to lower their risk even if they have a family history of depression," says Choi.

Senior author Jordan Smoller MD, added, "In general our field has been lacking actionable ways of preventing depression and other mental health conditions. I think this research shows the value of real-world healthcare data and genomics to provide answers that can help us to reduce the burden of these diseases."

Beyond physical activity, the MGH team continues to leverage the Partners Biobank and other large-scale studies to explore modifiable ways that individuals might reduce their risk of depression. "We believe there may be many factors could be part of an overall strategy for improving resilience and preventing depression," emphasizes Choi. "The magnitude of depression around the world underscores the need for effective strategies that can impact as many people as possible."

Materials provided by Massachusetts General Hospital. Note: Read this article on Science Daily ---> Massachusetts General Hospital. "Physical activity may protect against new episodes of depression." ScienceDaily. ScienceDaily, 5 November 2019. www.sciencedaily.com/releases/2019/11/191105113510.htm.

Dr. Holland's Perspective

"Studies have repeatedly shown that the most effective treatment for depression is cognitive behavioral therapy. This type of therapy addresses problematic thought patterns by effectively disengaging attention from the repetitive negative thoughts that often set in motion the downward spiral of mood. Certainly, physical activity combined with cognitive therapy is a positive way to approach depression. In addition to the positive effects of exercise mentioned in this study, evidence also shows that regular mindfulness meditation, on its own or combined with cognitive therapy, can also help stop depression before it starts."

Therapy for Depression

  • Do you find yourself feeling sad, empty tired, guilty or hopeless. Are you to the point where nothing makes you happy?
  • Have you become more isolated or lonely than usual, and feel like you can’t reach out to people?
  • Does life seem like more trouble than it’s worth?

Everyone experiences the blues sometimes. But clinical depression is more than just feeling down, unhappy or a sad feeling. Major depression is not a simple emotion. It is a medical disorder that affects more than 10 percent of adults annually. Women are twice as likely to get depression as men. The earlier treatment can begin, the more effective it is and the greater the likelihood that recurrence can be prevented.

With depression, you may feel sad and hopeless and you may not understand why you feel this way. Unlike sadness or the blues, depression is actually a biochemical disorder that can affect just about every area of a person's life. Some people with depression may even have had self-destructive or suicidal thoughts. If this is your experience, it is crucial that you seek help.

Contact Dr. Holland for more information and to get help with depression.

New study says narcissism diminishes as a person matures

Posted on by Dhyana Kearly

Level of narcissistic trait development depends on early career and relationship choices

The belief that one is smarter, better looking, more successful and more deserving than others -- a personality trait known as narcissism -- tends to wane as a person matures, a new study confirms. But not for everyone, and not to the same extent.

The study, reported in the Journal of Personality and Social Psychology, finds that the magnitude of the decline in narcissism between young adulthood and middle age is related to the specific career and personal relationship choices a person makes.

The research tracked participants across two time points. The first occurred when they were 18 and just starting out as freshmen at the University of California, Berkeley. The second was 23 years later, when participants were 41 years old. Of the original 486 participants, 237 completed a new round of evaluations.

Participants at both time points answered questions from a survey designed to assess their narcissistic traits. For the follow-up study, researchers also asked about relationship and employment history, job satisfaction, and health and well-being.

"We looked at the different facets of narcissism in adults at age 18 and again at 41," said Eunike Wetzel, a professor of psychology at Otto-von-Guericke University in Magdeburg, Germany, who led the research with University of Illinois psychology professor Brent Roberts; Emily Grijalva, an organizational behavior professor at Washington University in St. Louis; and Richard Robins, a psychology professor at the University of California, Davis. "We focused on participants' vanity, the belief in their own leadership qualities and their tendency to feel entitled."

Each facet of narcissism was associated with several negative -- and in a few cases, positive -- outcomes for the individual, the researchers found. Those who had higher levels of vanity at age 18 were prone to unstable relationships and marriages, and were more likely to be divorced by middle age. But they also reported better health at age 41. In contrast, those who felt the most entitled as young adults reported more negative life events and tended to have lower well-being and life satisfaction at middle age.

"We originally hypothesized that the leadership facet of narcissism would increase," Roberts said. "In fairness to my co-authors, that hypothesis was mine, and it turns out I was wrong."

Leadership is associated with goal persistence, extraversion, self-esteem and a desire to lead. It is considered one of the least pathological elements of narcissism, Roberts said.

"We know from past research that another component of personality, assertiveness, tends to increase during this time of life," he said. "So, I thought it was reasonable to hypothesize a similar increase in the leadership facet. This either means the past research is wrong, or our read of the leadership component of narcissism is wrong -- it may actually be more negative than we thought. We have to figure this out in future research."

Vanity appeared to be most strongly linked to life events, the researchers found. For example, vanity declined more in those who entered into serious romantic relationships and those with children. But vanity declined significantly less in middle-aged adults who had experienced more negative life events than their peers.

"We also found that narcissistic young adults were more likely to end up in supervisory jobs 23 years later, suggesting that selfish, arrogant individuals are rewarded with more powerful organizational roles," Grijalva said. "Further, individuals who supervised others decreased less in narcissism from young adulthood to middle age -- meaning that supervisory roles helped maintain prior levels of narcissism."

Despite the differences between individuals, most of the participants who responded to researchers' questions again at age 41 saw a decline in narcissism as they matured, the researchers found.

"Very few people, only 3% of participants, actually increased in overall narcissism between the ages of 18 and 41," Wetzel said. "And some remained just as narcissistic at age 41 as they had been when they were 18 years old."

"The findings should bring comfort to those who are concerned that young people are problematically narcissistic," Roberts said. "With time, it seems most people turn away from their earlier narcissistic tendencies."

Read this article on Science Daily: Materials provided by University of Illinois at Urbana-Champaign, News Bureau. Note: Content may be edited for style and length. University of Illinois at Urbana-Champaign, News Bureau. "Narcissism tracked from young adulthood to middle age." ScienceDaily. ScienceDaily, 11 September 2019. www.sciencedaily.com/releases/2019/09/190911113019.htm.

Smartphone Use Not Associated with Mental Health Issues in Teens

Posted on by Dhyana Kearly
Study of 400 teens finds little evidence linking excessive smartphone use and mental health outcomes

A new study, published in the journal Clinical Psychological Science, suggests that the time adolescents are spending on their phones and online is not that bad. The study tracked young adolescents on their smartphones to test whether more time spent using digital technology was linked to worse mental health outcomes. The researchers -- Candice Odgers, professor of psychological science at the University of California, Irvine; Michaeline Jensen, assistant professor of psychology at the University of North Carolina at Greensboro; Madeleine George, postdoctoral researcher at Purdue University; and Michael Russell, assistant professor of behavioral health at Pennsylvania State University -- found little evidence of longitudinal or daily linkages between digital technology use and adolescent mental health.

"It may be time for adults to stop arguing over whether smartphones and social media are good or bad for teens' mental health and start figuring out ways to best support them in both their offline and online lives," Odgers said.
"Contrary to the common belief that smartphones and social media are damaging adolescents' mental health, we don't see much support for the idea that time spent on phones and online is associated with increased risk for mental health problems," Jensen said.

The study surveyed more than 2,000 youth and then intensively tracked a subsample of nearly 400 teens on their smartphones multiple times a day for two weeks. Adolescents in the study were between 10 and 15 years old and represented the economically and racially diverse population of youth attending North Carolina public schools.

The researchers collected reports of mental health symptoms from the adolescents three times a day and they also reported on their daily technology usage each night. They asked whether youth who engaged more with digital technologies were more likely to experience later mental health symptoms and whether days that adolescents spent more time using digital technology for a wide range of purposes were also days when mental health problems were more common. In both cases, increased digital technology use was not related to worse mental health.

When associations were observed, they were small and in the opposite direction that would be expected given all of the recent concerns about digital technology damaging adolescents' mental health. For instance, teens who reported sending more text messages over the study period actually reported feeling better (less depressed) than teens who were less frequent texters.

Story Source:

Materials provided by University of California - Irvine. Note: Read this article on Science Daily --> University of California - Irvine. "Tech time not to blame for teens' mental health problems: Study of 400 teens finds little evidence linking excessive smartphone use and mental health outcomes." ScienceDaily. ScienceDaily, 23 August 2019. www.sciencedaily.com/releases/2019/08/190823140736.htm.

Each phase of a child's development brings specific challenges as children mature. They tend to work through these as normal a part of growing up. Mental health conditions can make these challenges harder. They may come up due to events in a child’s life. These could have been traumatic events, such as being bullied. They can also be routine, like moving to a new home.

Therapy is a place for you to connect and process your thoughts and feelings in a safe place. Dr. Holland can help you develop effective tools to cope with what is going on. However bad you think it is right now, we can face it together.  I believe that forming a strong personal identity is an important aspect of your growth and development, leading to a brighter future.

Contact Dr. Holland to learn more and to schedule an appointment or call 707-479-2946.

Bullying prevention study highlights a healthy need to belong

Posted on by Dr. Holland
A sense of belonging among youth prevents bullying

A supportive community environment reduces likelihood of bullying in children

Scroll Down for Dr. Holland's Perspective on this article

Research has shown that, despite great efforts, one in three children continue to experience bullying in school. However, research also has indicated that environmental and psychological factors might play an important role in minimizing bullying behaviors.

Now, researchers at the University of Missouri have found that students who feel a greater sense of belonging with their peers, family and school community are less likely to become bullies. Their findings suggest that parents and teachers should consider ways to create a supportive and accepting environment both at home and at school.

Christopher Slaten and Chad Rose, associate professors in the MU College of Education, along with Jonathan Ferguson, a graduate candidate in the counseling psychology program, analyzed survey responses from more than 900 middle school students from rural schools throughout the U.S. The survey addressed their sense of belonging among peers, family and school community as well as bullying behavior. For example, they were asked if they upset others for the fun of it or if they spread rumors.

The results indicate that the more a student feels like they belong among their peers and family, the more likely they will feel like they belong at school. In addition, the more they feel like they belong within their school community, the less likely they were to report bullying behaviors. This indicates that parents might be able to play a proactive role in increasing their child's sense of belonging at school by focusing on improving family belongingness. Slaten suggests that one of the ways parents can increase a child's sense of family belonging is to organize activities that cater to every child's interests.

"If you have children with varying interests, it might be beneficial to suggest the whole family get together to attend each other's events and activities, even if it doesn't please the whole crowd every time," Slaten said. "By encouraging siblings to support each other, parents can help their children feel like their interests are accepted and that they fit within the family unit."

Rose adds that teachers and school leaders also should consider techniques and programs that create a supportive environment for students. Some examples include starting clubs for students with various interests, offering to lend an ear to students who need someone to talk to and consider community-building events.

"What we have found is that students' perceptions of how supportive and accepting their school environment is has the power to alter bullying behavior," Rose said. "This means that even acts of simple compassion and efforts to create an accepting and supportive space for students can help prevent bullying in schools. This is empowering news for teachers, students and their families."

"Understanding the relationship between youths' belonging and bullying behavior: An SEM Model," was published in Emotional & Child Psychology.

Story Source: Read this article on Science Daily - Materials provided by University of Missouri-Columbia. University of Missouri-Columbia. "Students with a greater sense of school-belonging are less likely to become bullies." ScienceDaily. ScienceDaily, 30 July 2019. www.sciencedaily.com/releases/2019/07/190730125331.htm.

Dr. Holland's Perspective

Bullying is a behavior pattern that expresses as harming and humiliating others. Bullies typically seek out those who appear to be more vulnerable than themselves. In the real world, bullying is not the same thing as aggression; it is a deliberate and repeated attempt to cause harm to others who are more vulnerable. In our digital environment electronic bullying has also become a significant problem, an attractive alternative for bullies as this type of harassment can often be carried out anonymously.

Adults have a very important role to play in making children bully-proof, and that involves empowering children with self-confidence and a sense of belonging, as this article highlights. Parents who model healthy assertiveness to their children at home are taking the correct measures to prevent bullying. It is also important to make sure that children know how to, and feel free to speak up for themselves both at home an when in public.

Therapy for tweens, teens and their parents

Every child responds differently to life changes. Some events that may impact a child or teen’s mental health include:

  • The birth of a sibling
  • The death of a loved one, such as a family member or a pet
  • Physical or sexual abuse
  • Poverty or homelessness
  • Natural disaster
  • Domestic violence
  • Moving to a new place or attending a new school
  • Being bullied
  • Taking on more responsibility than is age-appropriate
  • Parental divorce or separation

Therapy is a place for you to connect and process your thoughts and feelings in a safe place. Dr. Holland can help you develop effective tools to cope with what is going on. However bad you think it is right now, we can face it together.  I believe that forming a strong personal identity is an important aspect of your growth and development, leading to a brighter future.

Contact Dr. Holland to learn more and to schedule an appointment or call 707-479-2946.