Anna Lindberg Cedar and Dr. Elizabeth Horevitz discuss burnout among healthcare workers, emphasizing the unique stresses in primary care, especially during the pandemic. They highlight pre-existing issues like excessive charting and low pay, exacerbated by the pandemic's resource constraints and personal risks. Dr. Horowitz shares her personal experience with burnout and moral injury, noting the importance of self-care and systemic changes. They discuss the overlap between burnout and vicarious trauma, the stigma of seeking help, and the need for leadership to address these issues. Practical strategies include problem-solving therapy, mindfulness, and advocating for policy changes.

Episode originally recorded in March 2022. 

• Anna Lindberg Cedar introduces the podcast and her background in nonprofit community services, emphasizing her burnout prevention practice launched after the 2016 election.
• Anna Lindberg Cedar introduces Dr. Elizabeth Horevitz, highlighting her extensive career in community services, current role as Chief Behavioral Health Officer at Marin Community Clinics, and her expertise in problem-solving therapy and trauma-informed care.
• Dr. Horevitz discusses the unique stresses faced by healthcare workers, particularly in primary care settings, including excessive charting burdens, pre-approval requirements for medications, and the challenges of working with underserved populations.
• Dr. Horevitz explains the impact of the pandemic on burnout, exacerbating existing systemic issues and creating a high-stress, low-pay profession.

• Dr. Horevitz describes the dual reality experienced by healthcare workers during the pandemic, where they faced the risk of infecting their families while trying to provide essential care.
• Anna Lindberg Cedar and Dr. Horevitz discuss the emotional toll of the pandemic on healthcare workers, including the lack of recognition and support despite their continued efforts.
• Dr. Horevitz emphasizes the importance of mission-driven work and the challenges of balancing personal well-being with the demands of the job.
• The conversation highlights the systemic issues that contribute to burnout, such as lack of resources, unrelenting surges, and the inability to provide adequate care due to constraints beyond control.

• Anna Lindberg Cedar and Dr. Horevitz discuss the overlap between burnout and vicarious trauma, noting that many healthcare workers fit the diagnostic criteria for PTSD due to their exposure to trauma.
• Dr. Horevitz shares her personal experience of recognizing her own burnout and moral injury during the pandemic, emphasizing the importance of self-care and seeking help.
• The conversation explores the stigma around seeking mental health support, particularly for physicians, and the challenges of finding accessible and affordable therapy.
• Dr. Horevitz highlights the need for systemic changes to address the root causes of burnout and moral injury, including better support systems and policies that prioritize provider well-being.

• Anna Lindberg Cedar and Dr. Horevitz discuss the concept of systemic burnout and the need for individual and systemic interventions to address it.
• Dr. Horevitz emphasizes the importance of recognizing personal values and aligning them with professional goals to prevent burnout.
• The conversation explores the role of leadership in creating a supportive work environment and the need for organizations to adopt policies that prioritize provider well-being.
• Dr. Horevitz shares her approach to problem-solving therapy, which involves breaking down large problems into smaller, manageable tasks and focusing on personal values to guide decision-making.

• Dr. Horevitz provides practical strategies for healthcare workers to advocate for themselves and foster a sense of safety and respite in their work environment.
• The conversation highlights the importance of self-care, mindfulness, and seeking support from colleagues and friends.
• Dr. Horevitz shares her personal experience of using meditation and mindfulness practices to manage burnout and improve overall well-being.
• The discussion emphasizes the need for systemic changes to address the root causes of burnout and the importance of individual efforts to prioritize self-care and well-being.

• Dr. Horevitz reflects on her own journey of recognizing and addressing burnout, including the challenges of seeking help and the importance of self-compassion.
• The conversation explores the role of advocacy in addressing systemic issues and the need for broader policy changes to support provider well-being.
• Dr. Horevitz emphasizes the importance of community support and the need for healthcare workers to support each other in addressing burnout and moral injury.
• The discussion concludes with a focus on the importance of personal values and self-care in preventing and managing burnout, and the need for systemic changes to support provider well-being.

• Dr. Horevitz discusses the need for environmental changes in addition to individual self-care.
• The pandemic has highlighted the potential of telehealth and hybrid work schedules as beneficial for both patients and providers.
• Speaker 2 mentions the challenge of healthcare being a business and the impact of payment reform on burnout.
• The importance of leadership in organizations addressing burnout and creating a supportive environment is emphasized.

The Role of the Environment in Burnout

• Dr. Horevitz discusses the need for environmental changes in addition to individual self-care.
• The pandemic has highlighted the potential of telehealth and hybrid work schedules as beneficial for both patients and providers.
• Speaker 2 mentions the challenge of healthcare being a business and the impact of payment reform on burnout.
• The importance of leadership in organizations addressing burnout and creating a supportive environment is emphasized.

Various Therapeutic Modalities

• The speakers share their preferences for DBT, mindfulness-based work, and Acceptance and Commitment Therapy.
• Anna Lindberg Cedar inquires about the starting point for someone who has been in the profession for 20 years versus someone just entering it.
• Dr. Horevitz emphasizes the importance of identifying personal values as a foundation for addressing burnout.
• The conversation touches on the flexibility and seasonality of values as individuals progress in their careers.

Practical Steps in Problem Solving Therapy

• Dr. Horevitz explains the process of problem-solving therapy, including breaking down big problems into smaller, manageable components.
• The importance of starting with a smaller, more manageable problem is highlighted.
• Dr. Horevitz shares a personal example of starting with a simple exercise routine to build momentum for larger changes.
• Anna Lindberg Cedar relates a common scenario where someone feels overwhelmed and needs to start with something pleasurable and enjoyable.

Personal Experience with Burnout

• Dr. Horevitz shares their personal experience with burnout, including recognizing the symptoms and overcoming stigma around help-seeking.
• The difficulty of finding a therapist during the pandemic and the concept of the "donut hole" in insurance coverage are discussed.
• Dr. Horevitz emphasizes the importance of self-care practices like meditation and the impact of a specific meditation practice on their well-being.
• The conversation highlights the need for therapists to prioritize their own well-being and the importance of advocating for systemic changes in mental health care.

Advocating for Systemic Changes

• Dr. Horevitz discusses the broken mental health care system and the need for universal mental health care.
• The importance of supporting each other in help-seeking and overcoming stigma is emphasized.
• Dr. Horevitz shares their experience of turning up their meditation practice and the impact of a specific mantra on their well-being.
• The conversation touches on the importance of diversifying professional activities to avoid over-identifying with one role.

Practical Tips for Burnout Prevention

• Anna Lindberg Cedar and Speaker 2 discuss practical tips for burnout prevention, including starting with small, manageable changes.
• The importance of recognizing and addressing burnout early is highlighted.
• Dr. Horevitz shares their experience of finding a therapist and the impact of therapy on their well-being.
• The conversation emphasizes the need for patience and the importance of addressing burnout one step at a time.

Promoting Self-Care in the Workplace

• Anna Lindberg Cedar promotes the idea of "the great resignation" applying to individuals who want to resign from certain aspects of their job.
• The importance of finding activities that bring joy and balance is emphasized.
• Dr. Horevitz shares their experience of opening a private practice to diversify their professional activities and find joy in their work.
• The conversation highlights the importance of self-care and the need for organizations to support their employees in maintaining well-being.

Conclusion and Resources

• Anna Lindberg Cedar thanks Dr. Horevitz for their insights and emphasizes the importance of personalizing burnout prevention practices.
• Dr. Horevitz expresses appreciation for Anna's work and the importance of supporting each other in addressing burnout.
• Anna Lindberg Cedar shares examples from Therapy for Real Life's workplace workshops on burnout prevention and self-care.
• The conversation concludes with a reminder of the importance of self-care and the need for systemic changes in addressing burnout.

The Role of the Environment in Burnout

• Dr. Horevitz discusses the need for environmental changes in addition to individual self-care.
• The pandemic has highlighted the potential of telehealth and hybrid work schedules as beneficial for both patients and providers.
• Speaker 2 mentions the challenge of healthcare being a business and the impact of payment reform on burnout.
• The importance of leadership in organizations addressing burnout and creating a supportive environment is emphasized.

Various Therapeutic Modalities

• The speakers share their preferences for DBT, mindfulness-based work, and Acceptance and Commitment Therapy.
• Anna Lindberg Cedar inquires about the starting point for someone who has been in the profession for 20 years versus someone just entering it.
• Dr. Horevitz emphasizes the importance of identifying personal values as a foundation for addressing burnout.
• The conversation touches on the flexibility and seasonality of values as individuals progress in their careers.

Practical Steps in Problem Solving Therapy

• Dr. Horevitz explains the process of problem-solving therapy, including breaking down big problems into smaller, manageable components.
• The importance of starting with a smaller, more manageable problem is highlighted.
• Dr. Horevitz shares a personal example of starting with a simple exercise routine to build momentum for larger changes.
• Anna Lindberg Cedar relates a common scenario where someone feels overwhelmed and needs to start with something pleasurable and enjoyable.

Personal Experience with Burnout

• Dr. Horevitz shares their personal experience with burnout, including recognizing the symptoms and overcoming stigma around help-seeking.
• The difficulty of finding a therapist during the pandemic and the concept of the "donut hole" in insurance coverage are discussed.
• Dr. Horevitz emphasizes the importance of self-care practices like meditation and the impact of a specific meditation practice on their well-being.
• The conversation highlights the need for therapists to prioritize their own well-being and the importance of advocating for systemic changes in mental health care.

Advocating for Systemic Changes

• Dr. Horevitz discusses the broken mental health care system and the need for universal mental health care.
• The importance of supporting each other in help-seeking and overcoming stigma is emphasized.
• Dr. Horevitz shares their experience of turning up their meditation practice and the impact of a specific mantra on their well-being.
• The conversation touches on the importance of diversifying professional activities to avoid over-identifying with one role.

Practical Tips for Burnout Prevention

• Anna Lindberg Cedar and Speaker 2 discuss practical tips for burnout prevention, including starting with small, manageable changes.
• The importance of recognizing and addressing burnout early is highlighted.
• Dr. Horevitz shares their experience of finding a therapist and the impact of therapy on their well-being.
• The conversation emphasizes the need for patience and the importance of addressing burnout one step at a time.

Promoting Self-Care in the Workplace

• Anna Lindberg Cedar promotes the idea of "the great resignation" applying to individuals who want to resign from certain aspects of their job.
• The importance of finding activities that bring joy and balance is emphasized.
• Dr. Horevitz shares their experience of opening a private practice to diversify their professional activities and find joy in their work.
• The conversation highlights the importance of self-care and the need for organizations to support their employees in maintaining well-being.

Conclusion and Resources

• Anna Lindberg Cedar thanks Dr. Horevitz for their insights and emphasizes the importance of personalizing burnout prevention practices.
• Dr. Horevitz expresses appreciation for Anna's work and the importance of supporting each other in addressing burnout.
• Anna Lindberg Cedar shares examples from Therapy for Real Life's workplace workshops on burnout prevention and self-care.
• The conversation concludes with a reminder of the importance of self-care and the need for systemic changes in addressing burnout.

The Role of the Environment in Burnout

• Dr. Horevitz discusses the need for environmental changes in addition to individual self-care.
• The pandemic has highlighted the potential of telehealth and hybrid work schedules as beneficial for both patients and providers.
• Speaker 2 mentions the challenge of healthcare being a business and the impact of payment reform on burnout.
• The importance of leadership in organizations addressing burnout and creating a supportive environment is emphasized.

Various Therapeutic Modalities

• The speakers share their preferences for DBT, mindfulness-based work, and Acceptance and Commitment Therapy.
• Anna Lindberg Cedar inquires about the starting point for someone who has been in the profession for 20 years versus someone just entering it.
• Dr. Horevitz emphasizes the importance of identifying personal values as a foundation for addressing burnout.
• The conversation touches on the flexibility and seasonality of values as individuals progress in their careers.

Practical Steps in Problem Solving Therapy

• Dr. Horevitz explains the process of problem-solving therapy, including breaking down big problems into smaller, manageable components.
• The importance of starting with a smaller, more manageable problem is highlighted.
• Dr. Horevitz shares a personal example of starting with a simple exercise routine to build momentum for larger changes.
• Anna Lindberg Cedar relates a common scenario where someone feels overwhelmed and needs to start with something pleasurable and enjoyable.

Personal Experience with Burnout

• Dr. Horevitz shares their personal experience with burnout, including recognizing the symptoms and overcoming stigma around help-seeking.
• The difficulty of finding a therapist during the pandemic and the concept of the "donut hole" in insurance coverage are discussed.
• Dr. Horevitz emphasizes the importance of self-care practices like meditation and the impact of a specific meditation practice on their well-being.
• The conversation highlights the need for therapists to prioritize their own well-being and the importance of advocating for systemic changes in mental health care.

Advocating for Systemic Changes

• Dr. Horevitz discusses the broken mental health care system and the need for universal mental health care.
• The importance of supporting each other in help-seeking and overcoming stigma is emphasized.
• Dr. Horevitz shares their experience of turning up their meditation practice and the impact of a specific mantra on their well-being.
• The conversation touches on the importance of diversifying professional activities to avoid over-identifying with one role.

Practical Tips for Burnout Prevention

• Anna Lindberg Cedar and Speaker 2 discuss practical tips for burnout prevention, including starting with small, manageable changes.
• The importance of recognizing and addressing burnout early is highlighted.
• Dr. Horevitz shares their experience of finding a therapist and the impact of therapy on their well-being.
• The conversation emphasizes the need for patience and the importance of addressing burnout one step at a time.

Promoting Self-Care in the Workplace

• Anna Lindberg Cedar promotes the idea of "the great resignation" applying to individuals who want to resign from certain aspects of their job.
• The importance of finding activities that bring joy and balance is emphasized.
• Dr. Horevitz shares their experience of opening a private practice to diversify their professional activities and find joy in their work.
• The conversation highlights the importance of self-care and the need for organizations to support their employees in maintaining well-being.

Conclusion and Resources

• Anna Lindberg Cedar thanks Dr. Horevitz for their insights and emphasizes the importance of personalizing burnout prevention practices.
• Dr. Horevitz expresses appreciation for Anna's work and the importance of supporting each other in addressing burnout.
• Anna Lindberg Cedar shares examples from Therapy for Real Life's workplace workshops on burnout prevention and self-care.
• The conversation concludes with a reminder of the importance of self-care and the need for systemic changes in addressing burnout.

The Role of the Environment in Burnout

• Dr. Horevitz discusses the need for environmental changes in addition to individual self-care.
• The pandemic has highlighted the potential of telehealth and hybrid work schedules as beneficial for both patients and providers.
• Speaker 2 mentions the challenge of healthcare being a business and the impact of payment reform on burnout.
• The importance of leadership in organizations addressing burnout and creating a supportive environment is emphasized.

Various Therapeutic Modalities

• The speakers share their preferences for DBT, mindfulness-based work, and Acceptance and Commitment Therapy.
• Anna Lindberg Cedar inquires about the starting point for someone who has been in the profession for 20 years versus someone just entering it.
• Dr. Horevitz emphasizes the importance of identifying personal values as a foundation for addressing burnout.
• The conversation touches on the flexibility and seasonality of values as individuals progress in their careers.

Practical Steps in Problem Solving Therapy

• Dr. Horevitz explains the process of problem-solving therapy, including breaking down big problems into smaller, manageable components.
• The importance of starting with a smaller, more manageable problem is highlighted.
• Dr. Horevitz shares a personal example of starting with a simple exercise routine to build momentum for larger changes.
• Anna Lindberg Cedar relates a common scenario where someone feels overwhelmed and needs to start with something pleasurable and enjoyable.

Personal Experience with Burnout

• Dr. Horevitz shares their personal experience with burnout, including recognizing the symptoms and overcoming stigma around help-seeking.
• The difficulty of finding a therapist during the pandemic and the concept of the "donut hole" in insurance coverage are discussed.
• Dr. Horevitz emphasizes the importance of self-care practices like meditation and the impact of a specific meditation practice on their well-being.
• The conversation highlights the need for therapists to prioritize their own well-being and the importance of advocating for systemic changes in mental health care.

Advocating for Systemic Changes

• Dr. Horevitz discusses the broken mental health care system and the need for universal mental health care.
• The importance of supporting each other in help-seeking and overcoming stigma is emphasized.
• Dr. Horevitz shares their experience of turning up their meditation practice and the impact of a specific mantra on their well-being.
• The conversation touches on the importance of diversifying professional activities to avoid over-identifying with one role.

Practical Tips for Burnout Prevention

• Anna Lindberg Cedar and Speaker 2 discuss practical tips for burnout prevention, including starting with small, manageable changes.
• The importance of recognizing and addressing burnout early is highlighted.
• Dr. Horevitz shares their experience of finding a therapist and the impact of therapy on their well-being.
• The conversation emphasizes the need for patience and the importance of addressing burnout one step at a time.

Promoting Self-Care in the Workplace

• Anna Lindberg Cedar promotes the idea of "the great resignation" applying to individuals who want to resign from certain aspects of their job.
• The importance of finding activities that bring joy and balance is emphasized.
• Dr. Horevitz shares their experience of opening a private practice to diversify their professional activities and find joy in their work.
• The conversation highlights the importance of self-care and the need for organizations to support their employees in maintaining well-being.

Conclusion and Resources

• Anna Lindberg Cedar thanks Dr. Horevitz for their insights and emphasizes the importance of personalizing burnout prevention practices.
• Dr. Horevitz expresses appreciation for Anna's work and the importance of supporting each other in addressing burnout.
• Anna Lindberg Cedar shares examples from Therapy for Real Life's workplace workshops on burnout prevention and self-care.
• The conversation concludes with a reminder of the importance of self-care and the need for systemic changes in addressing burnout.

The Role of the Environment in Burnout

• Dr. Horevitz discusses the need for environmental changes in addition to individual self-care.
• The pandemic has highlighted the potential of telehealth and hybrid work schedules as beneficial for both patients and providers.
• Speaker 2 mentions the challenge of healthcare being a business and the impact of payment reform on burnout.
• The importance of leadership in organizations addressing burnout and creating a supportive environment is emphasized.

Various Therapeutic Modalities

• The speakers share their preferences for DBT, mindfulness-based work, and Acceptance and Commitment Therapy.
• Anna Lindberg Cedar inquires about the starting point for someone who has been in the profession for 20 years versus someone just entering it.
• Dr. Horevitz emphasizes the importance of identifying personal values as a foundation for addressing burnout.
• The conversation touches on the flexibility and seasonality of values as individuals progress in their careers.

Practical Steps in Problem Solving Therapy

• Dr. Horevitz explains the process of problem-solving therapy, including breaking down big problems into smaller, manageable components.
• The importance of starting with a smaller, more manageable problem is highlighted.
• Dr. Horevitz shares a personal example of starting with a simple exercise routine to build momentum for larger changes.
• Anna Lindberg Cedar relates a common scenario where someone feels overwhelmed and needs to start with something pleasurable and enjoyable.

Personal Experience with Burnout

• Dr. Horevitz shares their personal experience with burnout, including recognizing the symptoms and overcoming stigma around help-seeking.
• The difficulty of finding a therapist during the pandemic and the concept of the "donut hole" in insurance coverage are discussed.
• Dr. Horevitz emphasizes the importance of self-care practices like meditation and the impact of a specific meditation practice on their well-being.
• The conversation highlights the need for therapists to prioritize their own well-being and the importance of advocating for systemic changes in mental health care.

Advocating for Systemic Changes

• Dr. Horevitz discusses the broken mental health care system and the need for universal mental health care.
• The importance of supporting each other in help-seeking and overcoming stigma is emphasized.
• Dr. Horevitz shares their experience of turning up their meditation practice and the impact of a specific mantra on their well-being.
• The conversation touches on the importance of diversifying professional activities to avoid over-identifying with one role.

Practical Tips for Burnout Prevention

• Anna Lindberg Cedar and Speaker 2 discuss practical tips for burnout prevention, including starting with small, manageable changes.
• The importance of recognizing and addressing burnout early is highlighted.
• Dr. Horevitz shares their experience of finding a therapist and the impact of therapy on their well-being.
• The conversation emphasizes the need for patience and the importance of addressing burnout one step at a time.

Promoting Self-Care in the Workplace

• Anna Lindberg Cedar promotes the idea of "the great resignation" applying to individuals who want to resign from certain aspects of their job.
• The importance of finding activities that bring joy and balance is emphasized.
• Dr. Horevitz shares their experience of opening a private practice to diversify their professional activities and find joy in their work.
• The conversation highlights the importance of self-care and the need for organizations to support their employees in maintaining well-being.

Conclusion and Resources

• Anna Lindberg Cedar thanks Dr. Horevitz for their insights and emphasizes the importance of personalizing burnout prevention practices.
• Dr. Horevitz expresses appreciation for Anna's work and the importance of supporting each other in addressing burnout.
• Anna Lindberg Cedar shares examples from Therapy for Real Life's workplace workshops on burnout prevention and self-care.
• The conversation concludes with a reminder of the importance of self-care and the need for systemic changes in addressing burnout.