December 13, 2022
By OnCall Thought Leader Carrie Singer, Psy.D, Licensed Psychologist and Executive Director, Quince Orchard Psychotherapy
What if December isn’t the most wonderful time of the year for everyone? Loneliness, stress, pressure, comparisons, financial strain, family dysfunction, and cold cloudy weather can all compound into the perfect storm of distress for people during the holidays. According to one NAMI study, 64% of those with mental illness said the holidays made their symptoms worse. Care for these vulnerable populations requires extra planning, especially if you’re a provider of mental health services. This is especially true as inpatient and outpatient settings tend to have their biggest volume surges in the winter.
As a behavioral health provider and business owner myself, I intricately understand these challenges. To help you manage your patients and staff better during the holidays, I’ve put together a list of tips to assist you as you continue to deliver care during the winter months, especially during the holidays. I use these tactics with my own patients and staff, and they work wonders in this challenging time.
To prepare your business for the holidays, arrange for emergency coverage whenever possible and make sure patients are aware of local crisis resources and telehealth options and when to use them. For example, my clinic utilizes not only quick telehealth check-ins, but staff assign readings and homework to patients that may benefit from continuous engagement between appointments. We’ve also used monitoring apps for some patients to help de-escalate and self-soothe when their own providers are taking a much needed vacation. Keep in mind that many patients travel out of state during this time to jurisdictions your staff may not be licensed to provide telehealth in. This means that it’s essential for staff to create a contingency plan ahead of time, especially for more unstable patients who need continuous monitoring and appointments. The plan may include connecting the patient with a colleague in another state just in case emergency services are needed, or ensuring the patient knows where their local hospital or clinic is so they can seek help if needed.
Encouraging patients to engage in interim self-care plans that may include finding safe spaces away from stressors like overeating, overspending, and substance use can help. We often advise patients to ensure they have a point person among family or friends they can seek solace in and debrief with when their therapist is not available. Remind the patient that although this person is not their therapist, they can still seek out care through this person that is different from traditional therapy. It’s also okay to remind patients to set boundaries, including declining invitations to occasions that may be detrimental to their mental health. Feeling pressure to buy the perfect gift, report on one’s love life to extended family, or grieving the loss of a deceased relative in the previous year are all emotionally fraught circumstances for a patient whose stress tolerance is already maxed out. Our providers always remind patients that it’s okay to create new traditions and ways of connecting that better align with their needs and values.
A short-term break from therapy enables patients to practice skills they have internalized from appointments and apply them in real life settings. Perhaps your patients have learned to say no to harmful questions from their family. A great place to continue practicing this in a support group setting outside of their formal mental health appointments. Many recovery communities increase free programming throughout the holiday period, which gives patients the opportunity to meet new people, practice their skills in a safe space, and continue engaging with their care in a new way. Given that the holidays are a prime-time for relapse, most mental health programs have meetings around the clock leading up to New Year’s. There are many options for patients to seek out support groups, and for your patients traveling to a different state, we recommend providing a list of support groups they can choose to connect with during the holiday season.
From a staff perspective, this is the time of year that many businesses show their appreciation, so it’s important to consider ways to engage your own staff during the holidays. If your budget allows, bonuses, extra paid-time-off, and nice gifts help improve not only retention but morale. If budget doesn’t allow it, write each staff member a personalized note of appreciation with specifics on why they are a great asset to your organization. Kind words go a long way, and I find that it really is the thought that counts when it comes to connecting with staff during the holiday season.
Statistics show that the most resignations in the year tend to come in Q4 as staff think about their professional goals for the new year and if where they are working is the best fit. I suggest finding ways to implement changes according to employee feedback you’ve collected over the year. You can start collecting feedback through frequent check-in meetings that help keep your finger on the pulse of your staff’s pain points. Then, find ways to ensure your staff know about the changes and optimizations being made so they feel their input matters.
As is often the case, therapists juggle their clients’ emotions and stressors with their own. Therapists are not immune from experiencing difficult emotions. Many are actually drawn to the field after experiencing their own mental health struggles or dealing with those of a family member. If a client’s circumstances parallel your own, it can be hard to stay objective. You may be experiencing burnout if you have trouble maintaining empathy, feel overextended by your work, feel more ineffective with clients, or start to self-disclose more in ways that are not helpful to the client. I encourage all leaders to tell staff that the holiday season is a good time to take time off and seek out personal counseling and peer supervision. Don’t beat yourself up, almost every healthcare provider experiences burnout at times. I always encourage my staff to introduce boundaries in their own work lives so they can enjoy their personal lives even more. We ensure that documentation is always completed during working hours and that staff have access to additional training and courses if they feel they need some extra assistance. I make sure staff use the holiday season and their own time off to unwind, reflect on their own lives, and think of new ways they can improve their work-life balance in the new year. It’s helpful to include these questions and considerations in staff yearly reviews, so their own needs are considered along with their patients.
The holiday season can be difficult for everyone. I encourage all behavioral health leaders and staff to proactively ensure their patients are set up for success during this time, so they can enjoy their own families and celebrations, too. Although celebrating may not always be everyone’s cup of tea, the holidays are a time for introspection and reflection, so a lot of individual and self-soothing work can be done to improve the patient mindset—and even staff mindset—coming into the new year. We have a long way to go when it comes to improving mental healthcare for all and 2023 may bring new challenges that we have yet to face. Together, with the support we all need, we can bring new skills and experiences into the new year that can help us all with our mental health.