Partner Spotlight: Perinatal Support Washington

One of GPS’s longest-running partnerships is with Perinatal Support Washington, a nonprofit organization that has run support groups using the GPS model for the past six years. In the organization’s most recent annual report for GPS groups offered during 2022 – 2023, participants reported experiencing high levels of engagement and satisfaction with the groups and felt strongly that they made an important difference in their life.

“Thank you, because in this place I felt supported, listened to and above all I was able to express my feelings,” wrote one parent in a post-group survey.

“We rarely talk about mental health in our community so it’s interesting to see and learn from you guys,” said another participant.

One parent said simply, “It gives me something to look forward to each week.”

In developing our Perinatal Support Groups, GPS drew upon a body of research including a study showing group-based parenting programs that used behavioral, cognitive-behavioral, or multimodal approaches were associated with short-term improvements in depression, anxiety, stress, anger, guilt, confidence, and partner relationship satisfaction.

Another study on which we have relied showed that a series of four interpersonal group therapy sessions was successful in preventing post-partum depression in low-income women at risk for the condition.

Some of these results were reflected by Perinatal Support Groups participants in Perinatal Support Washington’s annual report. Fifty-five percent of participants reported that their feelings of anxiety and depression had improved, while fifty-eight percent reported they felt less stressed about responding to their baby’s needs. Fifty-three percent of group members said their satisfaction as a parent/caregiver had improved.

“I love the connection to my baby, we are one. This group has shown me that parenting isn’t easy, but there’s ways to help you get through it when it seems rough and there’s people to talk to,” said one parent.

Another described the group as “a godsend,” adding, “I’m a first time mom of color and not only does the group get me and baby out of the house, it gives me a chance to connect with other parents of color, and my baby a chance to socialize as well!”

Learn more about Perinatal Support Washington here. Learn more about our customized curriculums for perinatal parents and other groups here.

MASStrong for Healthcare Workers

The on-going impact of the pandemic and post-pandemic years to the mental health and well-being of clinicians and caregivers cannot be overstated. Healthcare workers are grappling with pandemic-related trauma including PTSD, exhaustion, personal loss, moral injury, burnout, isolation from colleagues, job-related illness or injury, wages that are not keeping up with the cost of living, and difficulty accessing and/or prioritizing mental health. As a result, healthcare institutions across systems of care are struggling to fill positions. All of which weakens the Commonwealth’s ability to meet the healthcare needs of its residents.

Recognizing this danger, the state used $1 million in federal American Rescue Plan Act funds in 2021 to launch MASStrong for Healthcare Workers, a pilot program offering group-based mental health support to frontline healthcare workers including nursing home aides, long-term care aides, personal care attendants, home health workers, and residential counselors. All of the pilot program participants said they would like to attend more groups and 93% of participants said that they found the groups helpful.

When asked what was most helpful about the groups, feedback ranged from simply “being able to talk about being in healthcare” and “being listened to” to “learning about and gaining knowledge about self care” and “receiving a reflection from someone who was genuine.” What we learned in the pilot was that the power of MASStrong for Healthcare Workers is that it contradicts isolation by showing other healthcare workers that they’re not alone. By promoting personal resiliency, self-efficacy, and empowerment, participants learn to prioritize self care — which is, ironically, a very difficult skill for many caregivers to learn and adopt. Ultimately, sessions reinvigorated compassion and reduced burnout.

Based on this success, MASStrong for Healthcare Workers was expanded last year with $5 million from the Commonwealth’s Behavioral Health Trust Fund to reach additional health care workers including pharmacists, nurses, physicians, and social workers. The pilot and its expansion would not have happened with the support of legislators who champion mental health and mental health parity, including Senator Majority Leader Cynthia Creem and State Representative Ruth Balser.

Today, MASStrong for Healthcare Workers is administered by GPS Group Peer Support (GPS) in partnership with the Betsy Lehman Center for Patient Safety. The program acts as a first line of defense in the mitigation of trauma, grief, moral injury and burnout, fostering resilience, and increasing retention of the healthcare workforce. Massachusetts-based organizations that support MASStrong for Healthcare Workers include the Home Care Alliance of MA, MA Association of Behavioral Health Systems, MA Association of Emergency Nurses, MA Association of Physician Assistants, MA Assisted Living Association, MA Hospital Association, MA Nurses Association, MA Physicians Assistants, MA Senior Care Association, and 1199 SEIU.

MASStrong for Healthcare Workers utilizes the GPS model of group-based social support and mental health care, which incorporates mindfulness-based stress reduction, cognitive behavioral therapy, motivational interviewing, peer-to-peer support, psychosocial education, and other evidence-based modalities. A growing body of evidence shows that this form of care consistently reduces feelings of loneliness, anxiety, and depression and increases feelings of hope. Studies show that it has been effective with populations as diverse as parents dealing with postpartum depression, residents of rural areas living with chronic conditions, health care professionals who’ve made mistakes resulting in harm to patients, people living with schizophrenia, and people dealing with substance use disorder. It can be delivered by mental health clinicians or trained, non-clinical workers with relevant lived experience.

Another vital benefit of this form of care is that it addresses systemic inequities in healthcare treatment and services. It is just as effective when delivered online as in person. It can be easily tailored for culturally and linguistically diverse communities when groups are led by trained peer specialists who are also members of that community. This is vital for racial and ethnic minorities, people who are LGBTQIA+, people who are living with disabilities, refugees and new immigrants, and others who do not often find themselves openly represented in the ranks of mental health care professionals.

Healthcare professionals are invited to learn the model and bring it to their practice, community, and/or other providers. If you are interested in running a MASStrong for Healthcare Workers group, you will be paid while you are trained in the model and paid for group facilitation. Email MASStrong@grouppeersupport for more information.

Biology isn’t destiny: healing is possible

As our country grapples with a mental health crisis, there’s been much interest of late in intergenerational trauma—the idea that the effects of a traumatic event can be passed down through generations by both genetics and environmental factors like learned behaviors.

This field is known as “epigenetics,” or the study of how one’s environment, experiences, and behaviors—including traumatic events and trauma responses—can cause changes that affect the way their genes work. Genetic trauma can impact both physical and mental health.

A recent—and growing—body of research shows that trauma and one’s response to it can be passed down genetically.

This PsychCentral article references a handful of studies, including research on twins that suggests some aspects of trauma may be inherited and a study indicating that trauma possibly impacts DNA and gene function. Most notably, a 2015 study of Holocaust survivors for the first time showed how exposure to trauma prior to conception can have an effect on offspring.

In that study, researchers compared the blood samples of Holocaust survivors with those of Jewish people living outside of Europe during World War II. Through molecular analysis researchers discovered that mothers who were exposed to the Holocaust showed changes in the activity of a segment of DNA that is involved in regulating stress responses. The children of these survivors, who were not directly exposed to the events of the Holocaust, also showed these changes. Subjects in the control group did not experience such changes.

The researchers have since replicated their study.

But biology isn’t destiny, as the (scientifically proven) saying goes. While genetics certainly shape our lives and identities, our brains can change as we learn new skills and absorb new information, thus enabling us to heal from trauma. Environmental factors can also aid in healing and building resilience — PsychCentral recommends engaging with “positive surroundings healthy relationships where your needs can be met. There’s a good chance these efforts might impact your future children.”

Indeed, healing is possible. We see it everyday in GPS groups. That’s because the GPS model of group peer support is accessible, evidence-based, and trauma-informed. It incorporates mindfulness-based stress reduction, cognitive behavioral therapy, motivational interviewing, peer-to-peer support, psychosocial education, and other evidence-based modalities. GPS groups are deliberately judgment and advice-free zones where people can be listened to with respect. Our support groups provide a place for participants to address challenging situations, have courageous conversations, receive support in times of crisis and tragedy, discuss environmental stressors such as racism, and build resilience against burnout and workplace fatigue, among other benefits. Participants heal, find their strength and connect with their courage to take conscious steps to create the lives they want to live.

Learn more about GPS support groups or register for a group here:

Group-based mental wellness support on campus

It’s no secret that there is a mental health crisis on college campuses across the U.S. fueled, in part, by lingering effects of the COVID-19 pandemic. As a result, students report experiencing high rates of depression, anxiety, and isolation.

The consequences of this crisis were laid out in painful detail in a recent New York Times Magazine article on the experience of Worcester Polytechnic Institute (WPI), where seven students died—six of them by suicide—in a span of six months beginning in July 2021. As the WPI community struggled to care for students and manage the crisis, it fell to faculty and staff members to try and shore up student mental health, which took its toll: among faculty—especially junior members, women, and professors of color—burnout was a consistent topic of discussion.

As Assistant Professor Katherine Foo told the Times, “It was a very dark time on campus. Faculty were being asked to take on a role that I think historically we haven’t been asked to play.”

The school ultimately took a multi-pronged approach to the problem, including hiring more mental health counselors and expanding social programming for students to help them feel more connected to the campus community.

As colleges and universities grapple with how to manage the on-going crisis, group-based mental health support should be a part of the conversation.

GPS Group Peer Support (GPS) offers accessible, evidence-based, and trauma-informed mental wellness group support to individuals and communities during times of stress, challenge, and change. The GPS model incorporates mindfulness-based stress reduction, cognitive behavioral therapy, motivational interviewing, peer-to-peer support, psychosocial education, and other evidence-based modalities. It has been implemented in diverse populations including parents dealing with postpartum depression, residents of rural areas living with chronic conditions, people dealing with substance use disorder, refugees, survivors of war — and college students. It can be delivered by mental health clinicians or trained, non-clinical workers with relevant lived experience, including students.

In 2018, GPS launched a pilot program in partnership with Westfield State University Department of Social work. GPS trained students of social work as well as students, academic partners and professionals from the school’s TRIO program in how to facilitate the GPS model. As the pilot progressed, the GPS model was adapted to ensure that it was appropriate, well-accepted, and culturally responsive to students’ needs. Evaluation of the pilot strongly suggested that the GPS model of group-based support would be successful with students.

As one participant said, “This model really allows students to come to a safe place and feel like they’re … not alone.”

Indeed, there is a strong and growing body of research, including a groundbreaking study recently published by the American Psychological Association, demonstrating the benefits of support groups on emotional wellness, resilience, behavioral change, recovery from trauma and success with sustaining recovery from substance use, among other positive outcomes.

GPS can be an important tool for colleges and universities to support student and staff mental health. Most importantly, the model is easily scaled, so students and faculty can be easily trained and quickly begin using this effective and evidence-based approach to mental health on their campuses.

MASStrong for Healthcare Workers Participant Shares Story

‘Having that group was incredible’:

In her work as a home health care aide, Latoya Cromartie works closely with her clients, assisting them with vital daily tasks such as bathing, dressing, and preparing meals. It is physical work to be sure, but it is emotionally taxing, too. Most of her clients are elderly, living with disabilities, or recovering from illness or injury.

During the worst years of the COVID-19 pandemic, in 2020 and 2021, most of her clients were completely isolated from their family members and other loved ones. Oftentimes, Latoya, who works for an agency that supports the efforts of people with disabilities to live as independently as possible, was the only other person they would see in the course of a day. As a result, she became an even more important presence in their lives, and took on the task of listening to her clients’ frustrations and fears.

“I tried to stay positive for them, but it was stressful,” she says.

Although she occasionally thought of parting ways with more demanding clients, she never did.

“I knew if I left them they probably wouldn’t have anybody else anytime soon, and I didn’t want to see them go without care.”

The desire to remain emotionally available to her clients while also managing the stress it causes led Latoya to take part in the MASStrong for Healthcare Workers pilot program, which provided group-based mental healthcare support to approximately 60 nursing home aides, home health workers, personal care attendants, and long-term care aides working in Massachusetts in November and December 2022.

The pilot consisted of three group-based mental health sessions using the GPS model, an evidence-based model of group care that draws on cognitive behavioral and interpersonal therapies, mindfulness-based stress reduction, motivational interviewing and psycho-social education. The sessions were led by two facilitators certified in using the GPS model. Offered in partnership with the Betsy Lehman Center for Patient Safety, MASStrong for Healthcare Workers is funded by the Commonwealth with funds from the American Rescue Plan Act of 2021. The program was launched to mitigate the toll of the COVID-19 pandemic on frontline healthcare workers, who have experienced elevated rates of depression, PTSD, insomnia, and other mental health issues and dramatic increases in their rates of job-related illness and injury and moral injury that have resulted in steep staffing shortages that continue to persist throughout the healthcare industry.

“Having that group, even though we just met three times, was incredible,” says Latoya, who works in Greater Boston and attended the sessions via Zoom. “It was good to have my own little group of friends who understood exactly where I was coming from.”

Latoya says that worrying about the mental health of her clients, especially those that don’t have much contact with family, takes a toll. “I know they aren’t going to hurt themselves, but I do sometimes worry that they will fall into depression, so I just try to give them positive ways to look at life,” she says.

“Sometimes when I’m giving them that advice I think I should take it myself,” she adds, laughing. “I know I’m a lot stronger than they are, but sometimes it just weighs on me.”

The ability to discuss the hazards of the job—the risks to her own health during the pandemic before vaccines were available, the vulnerability associated with visiting patients alone in neighborhoods that feel unsafe, the dilemma of what to do when she needed to take a sick day but knew if she did her client would likely go without care that day—was helpful, said Latoya.

“I think it’s very important to have support like that,” she says. “Being able to share my stories with people who get it and were going through similar things was so helpful. Even when I didn’t have problems to talk about, I looked forward to meeting with a group of people that I could relate to. I would think that maybe that week I was going to cheer somebody else up. Because cheering someone else up also feels good.”

Several times, Latoya recalls, other group members would be in tears as they shared work-related challenges they did not feel they could discuss elsewhere. “That time where they could just dump a lot of stuff out, it was just like, ‘Wow, this is really serious.”

When asked how she would have improved the program, Latoya has a quick answer: “Offer more sessions!”

MASStrong for Healthcare Workers is now enrolling up to 1,300 frontline healthcare workers in a new round of group-based mental health support sessions that will be offered via Zoom. Sessions will be available in English and Spanish. Each session will last 90 minutes and participants who complete a survey after each session will be given a gift card. . Information on how to register will be posted to our website soon.

MASStrong for Healthcare Workers Participant Shares Story

‘It was like getting on a Zoom call with co-workers to talk about the day’:

Like many frontline healthcare workers, Karleen Winter experienced unprecedented levels of stress in her life during the first year of the pandemic. As a personal care attendant (PCA) and certified nursing assistant (CNA), Karleen assists people living with disabilities in bathing, getting dressed, housekeeping, preparing meals, and managing medical tasks such as changing catheters and administering insulin. Applying her skills in clients’ homes means that they’re able to live safely at home rather than in congregate care or an institution.

During the pandemic, 60-hour work weeks became the norm as Karleen picked up additional hours to cover shifts left vacant by colleagues who weren’t able to keep working during the pandemic. One of Karleen’s clients, who relied on four PCA’s for daily care, lost two of them in the first months of the pandemic. Karleen worked extra hours to ensure that the woman received the care she needed to remain living at home.

While Karleen appreciated the extra money she made working overtime—it enabled her to finally buy her own home—it also meant that her daughter needed to move in with her father “because I was working so much that I was never home,” Karleen said.

Such stressors led Karleen to take part in the MASStrong for Healthcare Workers pilot program, which provided group-based mental healthcare support to approximately 60 nursing home aides, home health workers, personal care attendants, and long-term care aides working in Massachusetts in November and December 2022. In the groups, she found the support she needed to process the upheaval caused by the pandemic.

“It was helpful to get things off my chest and talk to people who dealt with loss throughout the pandemic,” Karleen said. “I think the group helped people that had a lot of, I guess, emotional trauma through the pandemic.”

Karleen said she treated the groups as therapy sessions. She appreciated the structure provided by the facilitators, who led them in relaxation exercises and set out ground rules that encouraged everyone to speak up. “I really liked that we had rules and we would let each other express ourselves without interrupting,” said Karleen.

She also liked that participants were discouraged from downplaying or minimizing their experiences by saying that they’re no different than any other group members. “Everybody’s experience is different, even if it’s just a little bit, because every client is different,” said Karleen. “But we still had a lot of the same things in common that we go through, so it was nice not to feel alone in some of those aspects.”

Although the groups are structured, they offered enough flexibility that Karleen likened the sessions to “getting on a Zoom call with your co-workers to talk about your day.”

In a job where she largely works alone and does not have co-workers to vent to about the daily frustrations common to working as a PCA or CNA, Karleen said the group-based support helped her emotionally. Not only would she attend future sessions, but she would also recommend them to others in her field.

“The main reason I liked the group is because I don’t have anybody in my life who experiences the same thing as me. I don’t have anybody to say, ‘Oh, I’ve been cleaning somebody’s house all day, now I gotta go home and do my own,’ Like, nobody gets it,” Karleen said, laughing. “I mean, of course I talk to my husband. He’s a great support, but he doesn’t get it. He’s an exterminator. He does not do what I do. I mean, I keep people alive in their homes and he goes into homes to get rid of things! It is the exact opposite of what I do.”

The MASStrong for Healthcare Workers pilot program consisted of three group-based mental health sessions using the GPS model, an evidence-based model of group care that draws on cognitive behavioral and interpersonal therapies, mindfulness-based stress reduction, motivational interviewing and psycho-social education. The sessions were led by two facilitators certified in using the GPS model. Offered in partnership with the Betsy Lehman Center for Patient Safety, MASStrong for Healthcare Workers is funded by the Commonwealth with funds from the American Rescue Plan Act of 2021. The program was launched to mitigate the toll of the COVID-19 pandemic on frontline healthcare workers, who have experienced elevated rates of depression, PTSD, insomnia, and other mental health issues and dramatic increases in their rates of job-related illness and injury and moral injury that have resulted in steep staffing shortages that continue to persist throughout the healthcare industry.

MASStrong for Healthcare Workers will soon be enrolling up to 1,300 frontline healthcare workers in a new round of group-based mental health support sessions that will be offered via Zoom. Sessions will be available in English and Spanish. Each session will last 90 minutes and participants who complete a survey after each session will be given a gift card. Information on how to register will be posted to our website soon.

 

Group Peer Support