Gratitude Journaling Boosts Wellness in Psychiatry Residents

Megan Brooks

May 23, 2019

SAN FRANCISCO — Gratitude journaling can improve quality of life in psychiatry residents by boosting feelings of well-being, new research suggests.

"I have found that gratitude journaling brings my rational brain online. It's a good stress reliever and makes me look for the good things in my life," Kemper Schumacher, MD, of the Harvard South Shore Psychiatry Residency Program, Harvard Medical School, Boston, Massachusetts, told Medscape Medical News.

The findings were reported here at the American Psychiatric Association (APA) 2019 Annual Meeting.

Concern about resident wellness is increasing, yet there are few tools to help promote wellness during residency training. Studies have shown that during the active practice of gratitude, there is improved functional connectivity in brain regions regulating emotion and motivation. The results suggest "cognitive reframing" with gratitude journaling, Schumacher said.

In a pilot study involving 12 psychiatry residents, Schumacher and two colleagues assessed the impact of gratitude journaling on residents' perceived quality of life. By nightly text message, participants were prompted to "write down 5 things from your day that you are grateful for," with a goal of 16 uses in the 1-month study period.

Gratitude journaling led to about a 7-point average increase in quality of life based on the Quality of Life Enjoyment and Satisfaction Questionnaire - Short Form (Q-LES-Q-SF).

Satisfaction with work, and interestingly, economic status, showed the greatest improvement, Schumacher said. "Residents who journaled were more satisfied with work and their perception of their financial status improved even though they didn't get a raise and nothing changed in their life, so journaling can change your perspective on things," Schumacher told Medscape Medical News.

"The challenge lies in getting residents to regularly journal about what they are grateful for. Everyone who did the journaling said they wanted to continue it but probably wouldn't," she added.

Taking Back Time, Control

"There is raised awareness around physician wellness and it is absolutely imperative that we start upstream," Edward M. Ellison, MD, co-CEO of The Permanente Federation, a national leadership and consulting organization for the eight Permanente medical groups composed of more than 22,900 physicians, told Medscape Medical News.

"Studies show that medical students have a higher sense of optimism, wellness, and resilience as they enter medical school than those entering any other graduate field of study — and yet by the time they graduate, their resilience, optimism, wellness is worse than graduates of other fields of study," said Ellison.

"There is a lot of work on gratitude in general and a lot of data that supports that just spending a few minutes a day journaling, or even just taking a few minutes a day and thinking of 3 things you are grateful for can make a difference in your emotional well-being," he added.

Other things that can help promote wellness and reduce burnout should not be overlooked, he added, including adequate sleep and exercise, healthy nutrition, and staying connected to the people and things that you love.

Finding ways to give physicians back "time and control" in their day and flexibility in providing care is also important, and use of telemedicine, virtual care, and training physicians on how to use electronic health records (EHRs) more efficiently should help achieve those aims, said Ellison.

"Physicians are taught basically to never ask for help, never admit weakness, just to stay strong and soldier on and clearly that is not okay. It's actually courageous to ask for help," said Ellison.

In terms of wellness, "psychiatrists fare pretty well," APA President Bruce Schwartz, MD, told Medscape Medical News. "Surveys show that psychiatrists suffer from less burnout than other specialties, but it's very important that we keep wellness in the forefront."

"We want our physicians to be productive and focused in terms of their own health. Wellness is a major focus because there is a not inconsequential suicide rate among physicians and to lose physicians to suicide is a waste and tragic," said Schwartz.

The study had no specific funding. Schumacher, Ellison, and Schwartz have disclosed no relevant financial relationships.

American Psychiatric Association (APA) 2019: Abstract 54. Presented May 20, 2019.

For more Medscape Psychiatry news, join us on Facebook and Twitter


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.