Mothers who work as health care professionals — such as physicians, physician assistants and nurse practitioners — can reduce their stress levels and burnout significantly by participating in close supportive groups at work, according to a new study by researchers at Arizona State University and Mayo Clinic.
According to the study, “Fostering Resilience Among Mothers Under Stress: ‘Authentic Connections Groups’ for Medical Professionals,” the shared experiences in these support groups provide a wealth of nurturance for the women. The study results are published in the current issue of Women’s Health Issues.
Groups in the intervention provided “comfort, solace and advice, as needed, building what some called a ‘secret sisterhood’ of shared experiences with genuineness and reciprocity in the relationship,” said Suniya Luthar, a Foundation Professor of psychology at ASU and the lead author of the study. “These factors help build resilience for professional mothers who are under great daily stress, with substantial dual demands at work and at home.”
Dr. Cynthia Stonnington, associate professor, Mayo Clinic College of Medicine and Science, and chair of psychiatry at Mayo Clinic’s Arizona campus, is senior co-author and collaborator on the project. Other authors are Alexandria Curlee, an ASU graduate student; Susannah Tye, Department of Psychiatry and Psychology, Mayo Clinic; and Dr. Judith Engelman, a psychiatrist in private practice.
“Women medical professionals who are mothers often face the dual role of being the primary caregiver both for their patients and their children,” Stonnington said. “This puts them at higher risk for burnout than their male counterparts. Our study investigated how this supportive program might help mitigate stresses and promote their day-to-day health and well-being.”
The Authentic Connections Groups intervention involved weekly sessions at work over a three-month period. The researchers randomly assigned 40 women at Mayo to one of two groups ─ either the 12 weekly one-hour sessions of the Authentic Connections Groups or 12 weekly hours of protected time to be used as desired. The study was supported by seed funds from ASU to Luthar, and the Mayo Clinic contributed time to participate.
The study showed that those who participated in the Authentic Connections Groups significantly reduced their depression and other global symptoms of stress over those given free time (the control group). Secondly, relative gains were still more pronounced three months after the program ended. Follow-up assessments showed significant differences between the groups ─ not only on depression and stress, but also on almost all other central variables, including parenting stress, self-compassion, feeling loved and physical affection. Participants in the Authentic Connections Groups also showed more reductions in cortisol levels (a biochemical indicator of stress) than control moms after the intervention and at a three-month follow-up.
"Those who serve as first responders and offer so much tending for many others, must themselves be tended."
— Suniya Luthar, Foundation Professor of psychology at ASU
In explaining why this program worked, Luthar said the Authentic Connections Groups actively and continually fostered development of close, mutually supportive relationships, and the resulting shared experiences and bonding helped to lower participants’ stress levels.
“Resilience research clearly shows the critical protective power of reliable close relationships,” Luthar said. “In this program, our focus was on developing and strengthening what we called go-to committees for each woman. As topics were shared in the weekly group sessions over time, the moms each also shared them with their respective go-tos. By the end of three months, each woman had developed great closeness not only with other moms in their work setting, but also with at least two or three other women in their personal lives.”
A critical factor in enabling this effort was the institutional commitment to wellness. Stonnington reported that the Authentic Connections Groups program was implemented as part of an initiative begun in 2015 at Mayo Clinic’s Arizona campus to address burnout and turnover among female physicians.
“Another major reason for the success of this program is that the groups were implemented in the women’s everyday settings, during their regular workdays,” Luthar said. “That the Mayo administration gave them the one hour per week free time to participate was a critical consideration, given how very packed these women’s schedules can be.”
The U.S. surgeon general recently stated that efforts to promote the well-being of medical professionals must become a major priority among health care organizations. This study demonstrates that facilitated colleague support groups can provide a viable, low-cost preventive way to mitigate burnout among female medical professionals who also are mothers.
More broadly, the authors note that the Authentic Connections Groups program could be widely used in workplace wellness programs, given the high cost of worker stress and depression in contemporary America. Since completion of the Mayo project, Luthar and colleagues have completed groups with military mothers and now are offering it to women in the science, technology, engineering and mathematics disciplines, with both new projects implemented at ASU.
“It is our hope that, over time, the Authentic Connections Groups program will come to benefit women, mothers and other adults in salient caregiving roles, as they routinely give so much of themselves to others while experiencing high everyday stress,” Luthar said. “It just makes common sense. Those who serve as first responders and offer so much tending for many others, must themselves be tended — with this happening on a reliable and ongoing basis.”