WELLNESS TOOLKIT

Wellness Toolkit

As part of HOPE-WWR, our team has developed a wellness toolkit consisting of short training and skill videos with content focused on transitioning burnout into resiliency within the workplace.

We strive to help future and current health care workers overcome hardships as well as help organizations promote wellness throughout their place of employment.

These toolkits consist of evidence-based practices to prevent and overcome burnout within the healthcare industry.

The three types of trainings - student, community practitioners, and leadership - will be delivered virtually; however, to continue the impact and push for wellness in the workplace, the University of South Carolina, College of Social Work created and continues to update this wellness toolkit.

Cold Facial Immersion (Dive Reflex)

The immediate effects of cold facial immersion are promising in reducing the symptoms of panic and anxiety. This video demonstrates how to try the technique.

Below are articles that speak to its success in clinical trials.

Kyriakoulis, P., Kyrios, M., Nardi, A. E., Freire, R. C., & Schier, M. (2021). The implications of the diving response in reducing panic symptoms. Frontiers in Psychiatry, 12, 784884.

Keptner, K.M., Fitzgibbon, C., & O'Sullivan, J. (2021). Effectiveness of anxiety reduction interventions on test anxiety: a comparison of four techniques incorporating sensory modulation. British Journal of Occupational Therapy, 84(5), 289-297.

Cold Facial Immersion

Paired Muscle Relaxation

Use this skill when you feel strong anxiety or emotion that you cannot control. Progressive muscle relaxation (PMR) is a deep relaxation technique that has been effectively used to control stress and anxiety, relieve insomnia, and reduce symptoms of certain types of chronic pain.

Paired Muscle Relaxation combines PMR with Paced Breathing. In this video you pair tensing and relaxing muscles with inhalation and exhalation.

Note: if this exercise does not relax you, you’ll still get the benefit of noticing your degree of tension and relaxation.

Paired Muscle Relaxation-Long Version

Ganjeali, S., Farsi, Z., Sajadi, S. A., & Zarea, K. (2022). The effect of the demonstration-based progressive muscle relaxation technique on stress and anxiety in nurses caring for COVID-19 patients: a randomized clinical trial. BMC psychiatry, 22(1), 791. https://doi.org/10.1186/s12888-022-04456-3

Ozgundondu, B., & Gok Metin, Z. (2019). Effects of progressive muscle relaxation combined with music on stress, fatigue, and coping styles among Intensive Care Nurses. Intensive and Critical Care Nursing, 54, 54–63. https://doi.org/10.1016/j.iccn.2019.07.007

Toussaint, L., Nguyen, Q. A., Roettger, C., Dixon, K., Offenbächer, M., Kohls, N., Hirsch, J., & Sirois, F. (2021). Effectiveness of progressive muscle relaxation, deep breathing, and guided imagery in promoting psychological and physiological states of relaxation. Evidence-Based Complementary and Alternative Medicine, 2021, 1–8. https://doi.org/10.1155/2021/5924040

Model for Understanding How Emotions Impact Us
This Dialectical Behavior Therapy Model of Emotions is a helpful tool to begin to identify how our emotions are shaped by things like our vulnerabilities, thoughts, urges, our body's physiological response, and what we actually end up doing.

Jiménez-Picón, N., Romero-Martín, M., Ponce-Blandón, J. A., Ramirez-Baena, L., Palomo-Lara, J. C., & Gómez-Salgado, J. (2021). The relationship between mindfulness and emotional intelligence as a protective factor for healthcare professionals: systematic review. International Journal of Environmental Research and Public Health, 18(10), 5491.

Katana, M., Röcke, C., Spain, S. M., & Allemand, M. (2019). Emotion regulation, subjective well-being, and perceived stress in daily life of geriatric nurses. Frontiers in Psychology, 10, 1097.

Model of Emotion

Diaphragmatic Breathing

Diaphragmatic breathing helps regulate your nervous system and bring your heart and respiration into alignment. Use this method of breathing when you feel stressed or before entering a situation that you expect to be stressful.

In this type of breathing, you exhale for a couple of counts longer than you inhale. Ideally, you will reach the capacity to inhale for 4 counts and exhale for 6 counts. This pace is about six breaths a minute. If this pace is uncomfortable, try 2 or 3 counts in and 4 or 5 counts out.

Kim, J., Gray, J. A., & Johnson, H. (2021). The effect of a web-based deep breathing app on stress of direct care workers: Uncontrolled intervention study. The Journal of Alternative and Complementary Medicine, 27(10), 876–883. https://doi.org/10.1089/acm.2020.0541
Tavoian, D., & Craighead, D. H. (2023). Deep breathing exercise at work: Potential applications and impact. Frontiers in Physiology, 14. https://doi.org/10.3389/fphys.2023.1040091

ZAHRA M.H. SERRY, Ph.D.*, S. T. M., & YOUSSEF M.A. SOLIMAN, M.D., E. M. I. (2021). Effect of deep breathing on functional capacity among healthcare workers wearing FFP2/N95 filtering facepiece respirators. The Medical Journal of Cairo University, 89(9), 1699–1706. https://doi.org/10.21608/mjcu.2021.195997

Diaphragmatic Breathing

Safe-Place Visualization

The Safe-Place Visualization is an advanced distress tolerance skill. In this audio-only visualization, you use all of your senses to create a place where you can relax. This can be a real place where you feel safe or an imagined place. You can build on the short visualization we provide to add more details to your safe place. Before you begin the visualization, have your place in mind.

deLeyer-Tiarks, J., Gammie, L., Bray, A. M., & Moriarty, S. (2020). Relaxation and guided imagery for mind–body health. Promoting Mind–Body Health in Schools: Interventions for Mental Health Professionals., 173–186. https://doi.org/10.1037/0000157-012

Parizad, N., Goli, R., Faraji, N., Mam-Qaderi, M., Mirzaee, R., Gharebaghi, N., Baghaie, R., Feizipour, H., & Haghighi, M. M. (2021). Effect of guided imagery on anxiety, muscle pain, and vital signs in patients with COVID-19: A randomized controlled trial. Complementary Therapies in Clinical Practice, 43, 101335. https://doi.org/10.1016/j.ctcp.2021.101335

Safe-Place Visualization

Imagine Yourself as a Stone on a Lake
This mindfulness exercise helps your awareness of your calm, clear center. We all have a calm core at the center of our being, but daily life events challenge our access to it. In this exercise, we’ll use our focus and attention to imagine ourselves like a stone on a lake.

Sanadgol, S., Firouzkouhi, M., Badakhsh, M., Abdollahimohammad, A., & Shahraki-vahed, A. (2020). Effect of guided imagery training on death anxiety of nurses at covid-19 Intensive Care Units: A quasi-experimental study. Neuropsychiatria i Neuropsychologia, 15(3–4), 83–88. https://doi.org/10.5114/nan.2020.101290

Imagine Being Stone on Lake

Notice Let Go of Judgment

Mindfulness Exercise: Noticing and Letting Go of Your Judgments
Recent research shows that an inability to let go contributes to feelings of ill-ease, depression, and anxiety. In this meditation, you breathe and relax your mind and body. As you become relaxed, you’ll remember a past judgment. You’ll notice how you feel, and then let go of the judgment. (You practice not judging the judgments).

Caswell, JR., Duggirala, AN., Verhaeghen, P. (2022). Letting Go as an Aspect of Rumination and Its Relationship to Mindfulness, Dysphoria, Anxiety, and Eudemonic Well-Being. Behavioral Sciences, 12(10),369. doi: 10.3390/bs12100369. PMID: 36285938; PMCID: PMC9598947.

Ho, M. Y., Worthington, E., Cowden, R., Bechara, A. O., Chen, Z. J., Gunatirin, E. Y., VanderWeele, T. (2023, March 3). International REACH Forgiveness Intervention: A Multi-Site Randomized Controlled Trial. OSFPreprints. https://doi.org/10.31219/osf.io/8qzgw

Belly Breathing
As we experience stress, our breathing changes to prevent deep relaxation. In this exercise, we’ll re-learn how to breathe correctly and deeply by using belly breathing, also known as diaphragmatic or belly breathing. As you practice breathing, it can become a skill that calms and centers you quickly. In this exercise, you’ll notice many aspects of breathing, including your physical and physiological reactions.

Conversano, C., Ciacchini, R., Orrù, G., Di Giuseppe, M., Gemignani, A., & Poli, A. (2020). Mindfulness, compassion, and self-compassion among health care professionals: What's new? A systematic review. Frontiers in Psychology, 11, 1683.

Belly Breathing

Mindful Exercise: Body Scan-short version

Use this skill to soothe yourself when you feel strong anxiety or emotion that you cannot control. You can also use this exercise to strengthen your mindfulness skill. The short version addresses the upper body. The long version addresses the entire body.

You can do this exercise lying on your back on the floor or sitting in a chair.

Body Scan - long version

Gan, R., Zhang, L., & Chen, S. (2022). The effects of body scan meditation: A systematic review and meta‐analysis. Applied Psychology: Health and Well-Being, 14(3), 1062–1080. https://doi.org/10.1111/aphw.12366

Lomas, T., Medina, J. C., Ivtzan, I., Rupprecht, S., & Eiroa-Orosa, F. J. (2018). A systematic review of the impact of mindfulness on the well-being of healthcare professionals. Journal of Clinical Psychology, 74(3), 319–355. https://doi.org/10.1002/jclp.22515

Body Scan

Intensive Exercise

Intensive Exercise with Demonstration
Research has shown that exercise impacts the severity of anxiety and depression. This DBT TIPP skill, Intensive Exercise, can increase positive emotion when you raise your heart rate up to 55-70% of the maximum heart rate for your age. Intense exercise increases the activity of the parasympathetic nervous system and decreases the activity of the sympathetic nervous system, known as “fight or flight.”

NOTE: If you have heart or respiratory challenges, talk with your doctor before beginning intensive exercise.

Mayo Clinic Staff. Exercise intensity: How to measure it. https://www.mayoclinic.org/healthy-lifestyle/fitness/in-depth/exercise-intensity/art-20046887

Martland, R., Mondelli, V., Gaughran, F., & Stubbs, B. (2019). Can high-intensity interval training improve physical and mental health outcomes? A meta-review of 33 systematic reviews across the lifespan. Journal of Sports Sciences. 38(4), 430-469, DOI: 10.1080/02640414.2019.1706829

Grazia Maugeri, G. Castrogiovanni P., Giuseppe Battaglia G., Pippi R., D'Agata V., Antonio Palma, A., DiRosa M., & Musumeci, G. (2020). The impact of physical activity on psychological health during Covid-19 pandemic in Italy. Heliyon. 6 (6), Published online: June 24, 2020. doi: 10.1016/j.heliyon.2020.e04315

Noticing Your Thoughts and Letting Go

One of the first steps in mindfulness is recognizing your thoughts. We continually generate thoughts that pull us away from the present moment. In this meditation, you’ll practice breathing, noticing your thoughts, labeling the thoughts, and letting go of the thoughts.

Schuman-Olivier Z, Trombka M, Lovas DA, Brewer JA, Vago DR, Gawande R, Dunne JP, Lazar SW, Loucks EB, Fulwiler C. (2020) Mindfulness and behavior change, Harv Rev Psychiatry,28(6):371-394. doi: 10.1097/HRP.0000000000000277.

Segal ZV,Dimidjian S, Beck A, Boggs JM, Vanderkruik R, Metcalf CA, Gallop R, Felder JN, Levy J. (2020). Outcomes of online mindfulness-based cognitive therapy for patients with residual depressive symptoms: A randomized clinical trial, JAMA Psychiatry. 77(6):563-573. doi: 10.1001/jamapsychiatry.2019.

Notice Thought Let Go

Mindfulness Exercise: Focusing Attention
The practice of mindfulness guides us to be present in the moment. One piece of this practice is to develop the skill to focus attention. This mindfulness exercise relaxes your mind and body and allows you to focus. This focus can refresh you when you’re distracted or overwhelmed.

Focus Attention

Struggling with Managing Your Emotions?

The skills presented in the video are used to recognize and accept your emotions during stressful or overbearing situations so that you can approach or react to the situation consciously and appropriately.

Bomyea, J., Ball, T. M., Simmons, A. N., Campbell-Sills, L., Paulus, M. P., & Stein, M. B. (2020). Change in neural response during emotion regulation is associated with symptom reduction in cognitive behavioral therapy for anxiety disorders. Journal of affective disorders, 271, 207–214. https://doi.org/10.1016/j.jad.2020.04.001

Rolston, A., & Lloyd-Richardson, E. (2017). What is emotion regulation and how do we do it. Cornell Research on Self-Injury and Recovery, 1, 1–5.

Manage Emotions 1

Minfulness Work Tips

How to Be More Mindful at Work
This video provides mindfulness tips to practice at work or on the way home from work to help you be fully aware in the present moment.

Lomas, T., Medina, J. C., Ivtzan, I., Rupprecht, S., & Eiroa-Orosa, F. J. (2018). A systematic review of the impact of mindfulness on the well-being of healthcare professionals. Journal of clinical psychology, 74(3), 319–355. https://doi.org/10.1002/jclp.22515
https://youtube.com/shorts/YnaLiVXnqQs

Effective Communication with DEAR MAN

Effective communication in the healthcare workplace is known to lead to more effective work practices and increase patient safety. DEAR MAN is an interpersonal effectiveness skill that helps you maintain relationships with others. In this video, we focus on saying no when you’re not able to help.

Brown, Yu, M., & Etherington, J. (2021). Listening and interpersonal communication skills as predictors of resilience in occupational therapy students: A cross-sectional study. The British Journal of Occupational Therapy, 84(1), 42–53. https://doi.org/10.1177/0308022620908503

Dietl, Derksen, C., Keller, F. M., Schmiedhofer, M., & Lippke, S. (2023). Psychosocial Processes in Healthcare Workers: How Individuals’ Perceptions of Interpersonal Communication Is Related to Patient Safety Threats and Higher-Quality Care. International Journal of Environmental Research and Public Health, 20(9), 5698–. https://doi.org/10.3390/ijerph20095698

The Health Occupations Providing Excellence in Workforce Wellness & Resiliency Program

WELLNESS TOOLKIT