Dr. Holland

Report finds burnout prevalent in health care community

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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

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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.

Bullying prevention study highlights a healthy need to belong

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A sense of belonging among youth prevents bullying

A supportive community environment reduces likelihood of bullying in children

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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.

Dark chocolate may positively affect mood and relieve depression

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Eating dark chocolate may positively affect mood and relieve depressive symptoms, finds a new UCL-led study looking at whether different types of chocolate are associated with mood disorders.

Dark chocolate associated with reduction of depressive symptoms

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Eating dark chocolate may positively affect mood and relieve depressive symptoms, finds a new UCL-led study looking at whether different types of chocolate are associated with mood disorders. The study, published in Depression and Anxiety, is the first to examine the association with depression according to the type of chocolate consumed. Researchers from UCL worked in collaboration with scientists from the University of Calgary and Alberta Health Services Canada and assessed data from 13,626 adults from the US National Health and Nutrition Examination Survey. Participants' chocolate consumption was assessed against their scores on the Patient Health Questionnaire, which assesses depressive symptoms.

Dark chocolate positively affects mood

In the cross-sectional study, a range of other factors including height, weight, marital status, ethnicity, education, household income, physical activity, smoking and chronic health problems were also taken into account to ensure the study only measured chocolate's effect on depressive symptoms. After adjusting for these factors, it was found that individuals who reported eating any dark chocolate in two 24-hour periods had 70 per cent lower odds of reporting clinically relevant depressive symptoms than those who reported not eating chocolate at all. The 25 per cent of chocolate consumers who ate the most chocolate (of any kind, not just dark) were also less likely to report depressive symptoms than those who didn't eat chocolate at all. However researchers found no significant link between any non‐dark chocolate consumption and clinically relevant depressive symptoms. Depression affects more than 300 million people worldwide, according to the World Health Organisation, and is the leading global cause of disability.

Lead author Dr Sarah Jackson (UCL Institute of Epidemiology & Health Care) said: "This study provides some evidence that consumption of chocolate, particularly dark chocolate, may be associated with reduced odds of clinically relevant depressive symptoms. "However further research is required to clarify the direction of causation -- it could be the case that depression causes people to lose their interest in eating chocolate, or there could be other factors that make people both less likely to eat dark chocolate and to be depressed. "Should a causal relationship demonstrating a protective effect of chocolate consumption on depressive symptoms be established, the biological mechanism needs to be understood to determine the type and amount of chocolate consumption for optimal depression prevention and management."

Chocolate is widely reported to have mood‐enhancing properties and several mechanisms for a relationship between chocolate and mood have been proposed. Principally, chocolate contains a number of psychoactive ingredients which produce a feeling of euphoria similar to that of cannabinoid, found in cannabis. It also contains phenylethylamine, a neuromodulator which is believed to be important for regulating people's moods. Experimental evidence also suggests that mood improvements only take place if the chocolate is palatable and pleasant to eat, which suggests that the experience of enjoying chocolate is an important factor, not just the ingredients present.

While the above is true of all types of chocolate, dark chocolate has a higher concentration of flavonoids, antioxidant chemicals which have been shown to improve inflammatory profiles, which have been shown to play a role in the onset of depression.

Story Source:

Materials provided by University College London. Read this article on Science Daily -University College London. "People who eat dark chocolate less likely to be depressed." ScienceDaily. ScienceDaily, 2 August 2019. www.sciencedaily.com/releases/2019/08/190802145458.htm.

Dr. Holland's Perspective

"Researchers point out in a 2007 study that the mood changes associated with chocolate last only about 3 minutes. Cocoa, the main ingredient in chocolate, causes the brain to release these ”feel good” chemicals (endorphins). While chocolate may give your mood a small boost, its short term effects emphasize why - for chronically depressed people in particular, it is important to find other ways to work with depression as well."

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.

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.

A simple practice of kindness can help to improve your mood

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Extending loving-kindness to others worked equally well to reduce anxiety, increase happiness, empathy and feelings of social connection.

Offering kindness to others reduces anxiety and increases happiness

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We all have a remedy -- a glass of wine or a piece of chocolate -- for lifting our spirits when we're in a bad mood. Rather than focusing on ways to make ourselves feel better, a team of Iowa State University researchers suggests wishing others well.

"Walking around and offering kindness to others in the world reduces anxiety and increases happiness and feelings of social connection," said Douglas Gentile, professor of psychology. "It's a simple strategy that doesn't take a lot of time that you can incorporate into your daily activities."

Gentile, Dawn Sweet, senior lecturer in psychology; and Lanmiao He, graduate student in psychology, tested the benefits of three different techniques intended to reduce anxiety and increase happiness or well-being. They did this by having college students walk around a building for 12 minutes and practice one of the following strategies:

  • Loving-kindness: Looking at the people they see and thinking to themselves, "I wish for this person to be happy." Students were encouraged to really mean it as they were thinking it.
  • Interconnectedness: Looking at the people they see and thinking about how they are connected to each other. It was suggested that students think about the hopes and feelings they may share or that they might take a similar class.
  • Downward social comparison: Looking at the people they see and thinking about how they may be better off than each of the people they encountered.

The study, published in the Journal of Happiness Studies, also included a control group in which students were instructed to look at people and focus on what they see on the outside, such as their clothing, the combination of colors, textures as well as makeup and accessories. All students were surveyed before and after the walk to measure anxiety, happiness, stress, empathy and connectedness.

A simple practice of kindness to improve your mood

The researchers compared each technique with the control group and found those who practiced loving-kindness or wished others well felt happier, more connected, caring and empathetic, as well as less anxious. The interconnectedness group was more empathetic and connected. Downward social comparison showed no benefit, and was significantly worse than the loving-kindness technique.

Students who compared themselves to others felt less empathetic, caring and connected than students who extended well wishes to others. Previous studies have shown downward social comparison has a buffering effect when we are feeling bad about ourselves. ISU researchers found the opposite.

"At its core, downward social comparison is a competitive strategy," Sweet said. "That's not to say it can't have some benefit, but competitive mindsets have been linked to stress, anxiety and depression."

The researchers also examined how different types of people reacted to each technique. They expected people who were naturally mindful might benefit more from the loving-kindness strategy, or narcissistic people might have a hard time wishing for others to be happy. They were somewhat surprised by the results.

"This simple practice is valuable regardless of your personality type," Lanmiao He said. "Extending loving-kindness to others worked equally well to reduce anxiety, increase happiness, empathy and feelings of social connection."

Social media comparisons

Social media is like a playground for comparisons: he makes more money than I; she has a nicer car. While the study did not look specifically at social media, Gentile says the results demonstrate that comparison is a risky strategy.

"It is almost impossible not to make comparisons on social media," Gentile said. "Our study didn't test this, but we often feel envy, jealousy, anger or disappointment in response to what we see on social media, and those emotions disrupt our sense of well-being."

Comparison works well when we are learning something or making a choice, Gentile said. For example, as children we learn by watching others and comparing their results to ours. However, when it comes to well-being, comparison is not as effective as loving-kindness, which consistently improves happiness.

Story Source:

Materials provided by Iowa State University. Read this article on Science Daily ---> Iowa State University. "A simple strategy to improve your mood in 12 minutes." ScienceDaily. ScienceDaily, 27 March 2019. www.sciencedaily.com/releases/2019/03/190327112705.htm.

Dr. Holland's Perspective

Dr. Jenny Holland, Psy. D."Several studies reported in the 1990s and early 2000s that mindfulness based treatments can be effective for a range of psychological problems, particularly those associated with anxiety and mood disorders. A study Published by NCBI found that Loving Kindness exercises were effective for self-critical individuals for reducing self-criticism and depression and improving self-compassion along with positive emotions.

"Studies also have shown that when people think about, observe or practice a kind act, that act of kindness stimulates that vagus nerve, which is helpful to the heart, and is thought to be be closely connected to the brain’s receptor networks for oxytocin, (a naturally occurring soothing hormone involved in bonding). A well functioning vagus nerve is also associated with greater social and psychological skills covering everything from the ability to empathize to those related to memory and concentration. Practicing kindness also triggers the reward system in our brain’s emotion regulation center releasing dopamine, the hormone that’s associated with positive emotions and the sensation of a natural high."

Dr. Jenny Holland provides cutting edge, integrative and evidence-based care, proven effective with depression and anxiety, life transitions; pregnancy, parenting, ageing, loss and caring for a parent or loved one during a health crisis or decline. To schedule an appointment call 707-479-2946.