Helping Healers Heal

A study led by researchers at ChristianaCare found that a peer-support training program developed specifically for healthcare workers significantly improved participants’ ability to recognize signs of stress, support colleagues and connect them with resources.

The findings were published July 30, 2026, in the Journal of Clinical Psychology in Medical Settings in “Designing, Implementing, and Evaluating an Adapted Stress First Aid and Psychological First Aid Model in a Hospital Setting: Results from a Multi-year Study.”

The study evaluated ChristianaCare’s adapted Psychological First Aid (PFA) program, a customized training model that blends key elements of existing PFA and Stress First Aid programs into a more streamlined approach designed for busy clinical environments. Over two years, 942 caregivers and leaders completed the training.

“Healthcare workers routinely care for people during some of the most difficult moments of their lives,” said Katie Godfrey, PhD, co-author of the study and director of the Center for WorkLife Wellbeing at ChristianaCare. “That work is deeply meaningful, and it can also be emotionally demanding.

“This study shows that healthcare organizations can give caregivers practical tools to support one another and create a culture where conversations about stress and well-being are normal.”

Addressing an Urgent Need in Healthcare

Research has shown that healthcare professionals face elevated risks of burnout, anxiety, depression and other stress-related challenges because of the demands of their work. Yet many clinicians report barriers to seeking support.

To help address that challenge, ChristianaCare psychologists built their adapted PFA program around three simple actions:

• Recognize stress and signs of distress.
• Recover through supportive conversations and coping strategies.
• Refer colleagues to appropriate resources when additional help is needed.

The program also uses an adapted “stress continuum” framework that helps caregivers describe their well-being using a shared language.

“This study shows that healthcare organizations can give caregivers practical tools to create a culture where conversations about stress and well-being are normal.”—Katie Godfrey, PhD

Significant Improvements in Confidence and Skills

Researchers measured participants’ knowledge, confidence and perceived skills before and after training during ChristianaCare’s PFA training program between October 2022 and June 2024.

The study found statistically significant improvements across all measured learning outcomes. Among participants:

• 73% reported improved ability to provide information about support services available to stressed colleagues.
• 69% reported increased confidence in recognizing stress injuries.
• 63% reported increased confidence in checking in with a colleague experiencing stress.
• Nearly half reported improved ability to create safe environments for discussions about stress-related challenges.

Participants also responded overwhelmingly positively to the training experience. Between 95% and 97% said the material was useful, understandable and relevant to their work and said they would recommend the program to others.

Click here to connect with ChristianaCare’s Center for WorkLife Wellbeing.

Adaptable Model for Other Organizations

Unlike many established PFA programs, the ChristianaCare program was adapted to meet the specific needs, culture and workflow of a large health system. The researchers say the findings demonstrate that organizations can successfully adapt evidence-informed programs rather than adopting a one-size-fits-all approach.

“This work highlights the value of tailoring support programs to the realities of healthcare,” Jim Highberger, PhD, lead author of the study and senior research associate at the Center for WorkLife Wellbeing. “Every organization has its own culture and challenges. The goal is to equip people with practical tools they can use every day while helping reduce stigma around talking about stress and seeking support.”

“This reflects the idea that we are our brothers’ and sisters’ keepers, and that type of support and connection goes a long way in healthcare.”—Christina Watlington, PhD

Important Next Steps

The researchers note that the study measured self-reported confidence and skills rather than long-term outcomes such as burnout reduction, workforce retention or mental health improvements. Still, the authors believe the findings offer a valuable framework for health systems seeking practical ways to support caregivers and strengthen workplace well-being.

To examine if the PFA program resulted in measurable effects in how colleagues share support resources, a recent follow-up analysis of the PFA program explored changes in monthly referrals to the Care for the Caregiver program before and after PFA training was rolled out across the organization.

The results supported that rates of monthly referrals increased after the PFA training program was implemented, and this difference was statistically significant. Such findings demonstrate the positive influence the PFA training had on caregiver behavior around recognizing when colleagues may be experiencing moments of stress and responding by providing appropriate support resources..

“The most important outcome is not just the knowledge,” said Christina Watlington, PhD, study co-author and psychologist at ChristianaCare. “It’s the shift in behavior. It’s caregivers showing up for one another. We’ve seen PFA contribute to an increase in our Care for the Caregiver program referrals. This reflects the idea that we are our brothers’ and sisters’ keepers, and that type of support and connection goes a long way in healthcare.”