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 | Main theoretical approaches | References | Main applied content |
|---|---|---|---|
| 1. Resilience | Psychoeducation Motivational Interview Positive Psychology | Forés and Grané, 2008; Sánchez-Hernández et al., 2009 | Accept and understand that it is normal to have doubts. Find out from reliable sources (professionals and health centers...) and follow their recommendations. Doing so is a sign of social altruism. Choose some time of the day to update the information avoiding unnecessary excess information. Identify and reflect on the helpful factors that promote personal and family resilience. |
| 2. Family Strengths | Behavioral Activation and Positive Psychology | Peterson and Seligman, 2004; Sánchez-Hernández et al., 2019 | Keep doing pleasant activities and move your body (sports, dance, listen to music...) establishing a schedule to do them. Keep socializing, following the health recommendations. Identify and use personal and family psychological strengths. Take care of your diet, healthy sleep habits and sunbathe from your terrace, balcony or window. |
| 3. Emotional management | Emotional Education | Sánchez-Hernández et al., 2019 | Accept and understand all your emotions (and those of others), both negative and positive. Regulate your emotions with deep breathing, positive imagery, powerful postures, calming self-talk, mindfulness, and sharing them with trusted people. |
| 4. Love and Secure Attachment | Positive Psychology, attachment, and Cognitive-Behavioral Therapy | Seligman et al., 2005; Hoffman et al., 2019; | Make time to play and connect with your loved ones. Kindly welcome and embrace the emotions of your loved ones. Encourage constructive communication with your family and friends. |
| 5. Hope | Positive Psychology and Acceptance and Commitment Therapy | Snyder, 2000; Ciarrochi et al., 2016 | Reflect on strengths, supports, skills and abilities that you have used in challenging situations in the past, which will help generate hope. Be grateful and appreciate what you have and what happens in your day to day. |
| 6. Optimism | Positive Psychology and Cognitive Therapy | Seligman et al., 2005; Sánchez-Hernández et al., 2016 | The naive optimist denies reality and tends to recklessness. The exaggerated pessimist becomes blocked and makes others uncomfortable. The intelligent optimist sees reality and has a plan of action to deal with it. You can schedule limited time for excessive worrying and debating catastrophic thoughts. |
| 7. Life Sense | Positive Psychology | Steger, 2009 | How can we improve as a society from this experience? In the future, when all this happens… How would you like to relate to your grandchildren the attitude with which you faced all this? What values would be important to you at this time? |
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.”
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.
Statements
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.
References
1
Al-HumadiS.BronsonB.MuhlradS.PaulusM.HongH.CácedaR. (2021). Depression, suicidal thoughts, and burnout among physicians during the COVID-19 pandemic: a survey-based cross-sectional study. Acad. Psychiatry14, 1–9. 10.1007/s40596-021-01490-3
2
AmmarA.ChtourouH.BoukhrisO.TrabelsiK.MasmoudiL.BrachM.et al. (2020). COVID-19 home confinement negatively impacts social participation and life satisfaction: a worldwide multicenter study. Int. J. Environ. Res. Public Health17, 6237. 10.3390/ijerph17176237
3
BoellinghausI.JonesF. W.HuttonJ. (2014). The role of mindfulness and loving kindness meditation in cultivating self-compassion and other-focused concern in health care professionals. Mindfulness5, 129–138. 10.1007/s12671-012-0158-6
4
CénatJ. M.Blais-RochetteC.Kokou-KpolouC. K.NoorishadP. G.MukunziJ. N.McInteeS. 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. 10.1016/j.psychres.2020.113599
5
CiarrochiJ.HayesL.BaileyA. (2016). Sal de tu Mente y entra en tu vida Para Adolescentes. Bilbao: Desclée De Brouwer.
6
DaghririT.OzmenO. (2021). Quantifying the effects of social distancing on the spread of COVID-19. Int. J. Environ. Res. Public Health18, 5566. 10.3390/ijerph18115566
7
DonaldsonS. I.LeeJ. Y.DonaldsonS. I. (2019). Evaluating positive psychology interventions at work: a systematic review and meta-analysis. Int. J. Appl. Positive Psychol.4, 113–134. 10.1007/s41042-019-00021-8
8
ForésA.GranéJ. (2008). La resiliencia: Crecer desde la adversidad. Barcelona: Plataforma Editorial.
9
GilbodyS.LittlewoodE.GascoyneS.McMillanD.EkersD.Chew-GrahamC. A.et al. (2021). Mitigating the impacts of COVID-19: where are the mental health trials?Lancet Psychiatry8, 647–650. 10.1016/S2215-0366(21)00204-2
10
HarveyN (2020). Behavioral fatigue: real phenomenon, naïve construct, or policy contrivance?Front. Psychol. 11, 589892. 10.3389/fpsyg.2020.589892
11
HoffmanK.CooperG.PowellB.BentonC. 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.
12
Jans-BekenL.JacobsN.JanssensM.PeetersS.ReijndersJ.LechnerL.et al. (2020). Gratitude and health: an updated review. J. Posit. Psychol.15, 743–782. 10.1080/17439760.2019.1651888
13
LakiotiA.StalikasA.PezirkianidisC. (2020). The role of personal, professional, and psychological factors in therapists' resilience. Profess. Psychol. Res. Pract.51, 560–570. 10.1037/pro0000306
14
LaverdièreO.KealyD.OgrodniczukJ. S.ChamberlandS.DescôteauxJ. (2019). Psychotherapists' professional quality of life. Traumatology25, 208–215. 10.1037/trm0000177
15
LitamS. D. A.AusloosC. D.HarrichandJ. J. S. (2021), Stress resilience among professional counselors during the COVID-19 pandemic. J. Counseling Dev. 99, 384–395. 10.1002/jcad.12391
16
MeadJ.FisherZ.TreeJ.WongP.KempH. (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. 10.3389/fpsyg.2021.647951
17
MeyersM. C.van WoerkomM.BakkerA. 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. 10.1080/1359432X.2012.694689
18
MorinC. M.CarrierJ. (2020). The acute effects of the COVID-19 pandemic on insomnia and psychological symptoms. Sleep Med.77, 346–347. 10.1016/j.sleep.2020.06.005
19
O'ConnorK.NeffD. M.PitmanS. (2018). Burnout in psychotherapists. Systematic review and meta-analysis of prevalence and determinants. Eur. Psychiatry53, 74–99. 10.1016/j.eurpsy.2018.06.003
20
OlashoreA. A.AkanniO. O.Fela-ThomasA. L.KhutsafaloK. (2021). The psychological impact of COVID-19 on health-care workers in African Countries: a systematic review. Asian J. Soc. Health Behav.4, 85–9710.4103/shb.shb_32_21
21
PatelB. R.KhanparaB. G.MehtaP. I.PatelK. D.MarvaniaN. 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. 10.4103/shb.shb_54_21
22
PetersonC.ParkN.SeligmanM. E. (2005). Orientations to happiness and life satisfaction: the full life versus the empty life. J. Happiness Stud.6, 25–41. 10.1007/s10902-004-1278-z
23
PetersonC.SeligmanM. E. P. (2004). Character Strengths and Virtues. Washington, DC: American Psychological Association.
24
RajabimajdN.AlimoradiZ.GriffithsM. D. (2021). Impact of COVID-19-related fear and anxiety on job attributes: a systematic review. Asian J. Soc. Health Behav.4, 51–5510.4103/shb.shb_24_21
25
Sánchez-HernándezO (2020a). “Promoción de comportamientos saludables ante el confinamiento y pandemia del COVID-19,” in 13th International Congress of Clinical Psychology (Santiago de Compostela:España).
26
Sánchez-HernándezO (2020b). “Eficacia del programa resiliencia y bienestar: ‘quédate en casa',” in 13th International Congress of Clinical Psychology (Santiago de Compostela: España).
27
Sánchez-HernándezO.CanalesA. (2020a). Eficacia y satisfacción del programa resiliencia y bienestar: quédate en casa. La Psicología en tiempos de Cuarentena y Pandemia. Revista de Psicoterapia31, 381–398. 10.33898/rdp.v31i117.389
28
Sánchez-HernándezO.CanalesA. (2020b). ¡Quédate en casa! Resiliencia y Bienestar. Psicología Aplicada a tiempos de Pandemia. Barcelona: Editorial UOC.
29
Sánchez-HernándezO.CanalesA. (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.
30
Sánchez-HernándezO.CanalesA.EveraertN. (2022). Resilience, well-being, and post-traumatic stress in the Spanish population in the lockdown and pandemic of COVID-19. Revista de Psicoterapia33, 253–265. 10.33898/rdp.v33i121.1103
31
Sánchez-HernándezÓ.MéndezF. X.AtoM.GarberJ. (2019). Prevention of depressive symptoms and promotion of well-being in adolescents: a randomized controlled trial of the smile program. Anales de Psicología35, 225–232. 10.6018/analesps.35.2.342591
32
Sánchez-HernándezÓ.MéndezF. X.GarberJ. (2009). The promotion of students' curiosity to participate in a preventive programme. Anuario de Psicología Clínica y de la Salud5, 29–39.
33
Sánchez-HernándezÓ.MéndezF. X.GarberJ. (2016). Promoting resilience in children with depressive symptoms. Anales de Psicología32, 741–748. 10.6018/analesps.32.3.261671
34
SeligmanM. E. P (2002). Authentic Happiness: Using the New Positive Psychology to Realize Your Potential for Lasting Fulfillment. New York, NY: Free Press.
35
SeligmanM. E. P (2011). Flourish: A visionary new understanding of happiness and well-being. Free Press.
36
SeligmanM. E. P.ParksA. C.SteenT. (2004). A balanced psychology and a full life. Philos. Trans. R. Soc. B Biol. Sci.359, 1379. 10.1098/rstb.2004.1513
37
SeligmanM. E. P.ReivichK.JaycoxL.GillhamJ. (2005). Niños Optimistas. Barcelona: Random House Mondadori, S.A.
38
ShiraliG. A.RahimiZ.ArabanM.MohammadiM. J.CheraghianB. (2021). Social-distancing compliance among pedestrians in Ahvaz, South-West Iran during the Covid-19 pandemic. Asian J. Soc. Health Behav.4, 131–136. 10.4103/shb.shb_74_21
39
SnyderC. R (2000). Handbook of Hope. Orlando, FL: AcademicPress.
40
StegerM. 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.
41
SunP.WangM.SongT.WuY.LuoJ.ChenL.et al. (2021). The psychological impact of COVID-19 pandemic on health care workers: a systematic review and meta-analysis. Front. Psychol. 12, 626547. 10.3389/fpsyg.2021.626547
42
YangY.HayesJ. A. (2020). Causes and consequences of burnout among mental health professionals: a practice-oriented review of recent empirical literature. Psychotherapy57, 426–436. 10.1037/pst0000317
43
ZayasA.Merchán ClavellinoA.López-SánchezJ. A.GuilR. (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 Health18, 6190. 10.3390/ijerph18126190
Summary
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
Volume
13 - 2022
Edited by
Elkin O. Luis, University of Navarra, Spain
Reviewed by
Elena Shmeleva, Russian State Social University, Russia; Chung-Ying Lin, National Cheng Kung University, Taiwan; Viktorija Perepjolkina, Riga Stradiṇŝ University, Latvia
Updates
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
This article was submitted to Health Psychology, a section of the journal Frontiers in Psychology
Disclaimer
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.