Blog

Leadership through a lens of health and wellbeing….

This blog, written by our co-founder Claire, is a summary of the work we have just completed on behalf of the NHS North West Leadership Academy, exploring the development of a healthy leadership behaviour framework #NWHealthyLeadership

https://www.nwacademy.nhs.uk/discover/offers/healthy-leadership-framework

Back in spring 2020 we were commissioned by the NHS North West Leadership Academy (NHSNWLA) to support them with their Health and Wellbeing Strategy, with a particular focus on identifying the leadership behaviours which promote and detract from employee wellbeing at work.  The reason for wanting to develop a framework was:

  • to raise awareness of the impact that leadership behaviours have on wellbeing at work,
  • to gives leaders a remit to discuss and promote wellbeing at work (which is aligned with the requirement of the NHS People Plan to ensure from September 2020 that everyone has a  wellbeing conversation)
  • to show what leaders can do behaviourally to promote wellbeing at work
  • to support the development of interventions to help leaders develop healthy leadership behaviours that promote wellbeing at work

The approach we took was to:

  • Identify from the academic and practitioner literature which leadership behaviours are associated with employee wellbeing (click the link for a flipping book outlining the evidence base)
  • Ask employees and managers across the public sector to tell us which leadership behaviours support and detract from their wellbeing at work
  • Develop a healthy leadership behavioural framework which highlights leadership behaviours which have a positive and negative impact on employee wellbeing at work (click the link to access the framework)

The resulting framework contains three competencies / clusters (identified from the stakeholder discussions):

  • How I am (being) Actively engage with opportunities to understand and enhance positive mental and physical health for self and others, sharing own experience, being authentic
  • What I do (doing) Actively support and empower others to manage work and how it’s done
  • What we do together (enabling) Actively empower an inclusive healthy wellness culture that mutually enables us all to bring our whole selves to work

Each competency / cluster contains both positive and negative leadership behaviours (examples given below):

  • How I am (being)
    • Positive – being open, honest and transparent (authentic)
    • Negative – lacking empathy
  •  What I do  (doing)
    • Positive – trusting individuals and teams, giving them the autonomy and control to do their jobs (empowerment)
    • Negative – making decisions without consulting others (e.g., authoritarian /autocratic /command and control/directive style)
  • What we do together (enabling)
    • Positive – creating an emotionally supportive and psychologically safe work environment (positive, caring and supportive climate where people can speak out)
    • Negative – micromanaging others and disempowering them

The framework could be used in a number of ways including:

  • Recruitment – integrating the framework into role profiles, assessment processes
  • Development – integrating the framework into PDR, appraisal, 360, training, induction
  • Day to day – integrating the framework into 1:1 and team conversations
  • Strategy – including the framework in Board discussions to support the HWB guardian role in providing governance around health and wellbeing leadership behaviour

We would welcome your views about how you could use the framework in your organisation, so please do get in touch with us.

Health and wellbeing conversations – are we having them?

This blog, written by our co-founder Claire, is a reflection, 10 months on, from her original blog in April 2020 about how we can support front line workers during the pandemic.

Back in April last year (2020) we wrote a blog about moral injury, which, at that time was often highlighted as the overlooked stressor for healthcare workers.  Moral injury is caused by the distress experienced when circumstances clash with our moral or ethical code. Nearly a year on, we hear many accounts of moral injury and inevitably those who suffer moral injury are at risk of developing a range of mental health issues.  Two good resources have been published about moral injury, both highlight the importance of conversations:  

Health and wellbeing conversations are integral to the NHS people plan and from September last year (2020) every member of the NHS should have a health and wellbeing conversation and develop a personalised plan.  Your own organisation may be supporting you to have wellbeing conversations with people in your team.  A good starting point for how to have a wellbeing conversation can be found on the MIND website.

So are you having them?  If so, how are they helping? If not, what is getting in the way?

We would love to hear your views.

How exercise helped support my wellbeing during lockdown….

This blog, written by our co-founder Claire, is a look back on how exercise has supported her during an unexpected lockdown.  It builds on her original blog from May 2020.

We at HWBInspiration have written several blogs on how being active has helped us:

  • Wyn, our guest HWB Ninja, has written about the head runs and how they have helped him be present and supported his mental health
  • Su has written about how becoming more active led to the discovery and successful treatment of breast cancer in 2018
  • I wrote about how exercise had boosted my wellbeing and is one of the 10 keys to happier living

9 months on, I have re-read my blog from May 2020 and I read it with a smile on my face.  At the time I didn’t know I was pregnant and oh how the world has changed in a wonderful way since welcoming Joseph into our lives last December (2020).

Back in May I wrote about how maintaining my exercise may be a challenge due to competing priorities. When I found out I was pregnant I decided to stop cycling and re-start running.  I set myself a goal to run at least 2 times per week.  I continued to run up week 36 of my pregnancy.  I became much slower in pace and had to shorten the distance that I ran, however, the sense of achievement I had in doing what I love to do was immense.  I recently took a look at my Strava account and realised that I clocked up over 220 miles of running from June – November.  I was the fittest I had ever been during my pregnancy, I was eating healthy, I wasn’t drinking alcohol and I was getting out running.  My overriding goal was to be physically and mentally healthy and fit to be able to look after the new little man in our lives when he arrived and it certainly paid off. 

Last weekend, 7 weeks after Joseph arrived and 10 weeks after having to hang up my trainers, I took a run in my local park with Joseph in the pram.   It was great, I loved it. Again, my pace was slow and my distance was reduced. However being able to run and talk to Joseph about the deer’s in the park was a moment I will always remember. I was present, I was with Joseph and it was amazing.

Five tips to become a workplace health and wellbeing Ninja

This blog, written by our co-founder Su, is a reflection on what can help us to have a mindset that brings HWB conversations into the workplace.  It builds on an original blog from 2017.

How can I become a HWB Ninja?

HWBInspiration was co-founded in 2017 as a result of work that Claire and I were commissioned to lead on behalf of the Manchester’s Health and Wellbeing Board.  Health and wellbeing in the workplace has become evermore important.  The pandemic has ‘shone a light’ on we need to pay attention to if we are to remain healthy, well and lead fulfilling lives.  2020 has brought many things into sharp relief, and we’ve been more reflective about the workplace factors and conditions that need to be in place to promote positive health and wellbeing.

I’ve been writing blogs over the last 3 years.  It’s interesting to look back at some of my earlier posts. I realise that some of the tips and hints for health and wellbeing still hold true despite the sense that the world has been ‘tipped’ on its axis.  I’m being cheeky and reusing some of the tips from a previous blog to encourage us all to think about the small habits that we can put in place to focus on our health and wellbeing in 2021.

Back in 2017, I reminded myself that we all need to have knowledge, skills and expertise to support each other in our health and wellbeing endeavour.  When I think someone has mastered a particular mind set or skill, an image of a Ninja pops into my head. I was delighted to see that the informal definition of Ninja is “a person who excels in a particular skill or activity’.   We’ve taken this concept further over the years and it has become part of who we are and how we think. 

Glimmers of Brilliance (GOB)

This year we developed our #GOB21 calendar with two of our fully-fledged HWB Ninja’s, Jess and Matt.  #GOB21 has hints, tips and resources to support individual and team HWB activities and ideas.  If you would like to become a fully-fledged HWB Ninja, share a blog, case studies or resource with us.  Until then see if you can find the HWB Ninja Apprentice behind the one of the tiles.  Enjoy the hunt.

Practical Ninja Moves

Here is a reminder of some of the practical ways that you can apply Health and Wellbeing activities in the workplace.

TipMe (Ninja)My teamMy manager/organisation
1Find your healthily work life blend and take breaksEncourage the team to discuss their work life blend, have lunch together, scrutinise all the meetings the team attendsRole model good management practice – take breaks, avoid sending e-mails ‘out of hours’ or let people know that you don’t expect a response ‘out of hours’
2Avoid presenteeism (coming to work when unwell)Discuss what presenteeism means as a team – especially now that we are using digital platforms and experience ‘back to back’ phenomenonMake it clear that you expect people to stay at home when they are unwell (that it’s not a badge of honour to come to work when you are unwell) Review sickness absence policies to support people to return to work
3Develop health and wellbeing objectives for yourselfSupport colleagues with positive HWB behaviours by developing team health and wellbeing objectivesBuild in time to discuss health and wellbeing – simply ask how people are and celebrate positive health and wellbeing behaviours
4Be active, use the stairs, move around from your desk, use apps to encourage you to get up and walkHave team meetings standing up or while walking, pedometer challenges.  You can still do this despite the restrictions.Develop options to support people to be active at work such as virtual walking groups, running groups, yoga
5Keep yourself healthy and ask for help when you need itEncourage the team to ask each other for help when they need it and how to support each other when specialist help may be neededEnsure that people have access to excellent occupational health, rapid access to counselling, physio, MOT’s

Go well into 2021 and I’m hopeful that we can find a path through this together.

How creativity can boost your wellbeing

How creativity can boost your wellbeing

This blog from our resident HWBI Ninja, Matt Worden, reflects on how he has used his artistic skill with groups to boost health and wellbeing. We’ve been working with Matt for over 2 years and he has the amazing ability to bring our ideas and concepts to life. He has constantly given us inspiration and works tirelessly to help people to tap into their potential.

Health and wellbeing interventions in healthcare

Health and wellbeing interventions in healthcare

This blog summarises a rapid review of health and wellbeing interventions in healthcare, published by the Institute for Employment Studies (IES).

Last week Zofia Bajorek and Jenny Holmes from the Institute for Employment Studies published their rapid review of health and wellbeing interventions in healthcare. The review captures papers published in the last 10 years which focussed specifically on wellbeing interventions (both physical and mental wellbeing) in healthcare settings. They review two types of intervention; those focussing on treatment (e.g. once a health and wellbeing issue has been identified) and those focussing on prevention (e.g. interventions to prevent a health and wellbeing issue). Below is a summary of findings taken direct from the executive summary, its well worth a read. To find out more take a look at their paper (https://www.employment-studies.co.uk/resource/health-and-wellbeing-interventions-healthcare)

Treatment

  • timely access to face-to-face physiotherapy treatment resulted in a reduction of self-reported pain and increased productivity
  • early access to a telephone-based sickness absence management service which provided quick access to interventions also led to reported reduced levels of sickness absence by those who used the service
  • interventions that focussed on both the promotion of physical exercise and improved nutrition were reported to result in positive changes in health behaviours
  • stress management tools delivered via a web-based programme was seen to reduce self-reported nurse stress, with participants who spent more time on the programme reporting greater improvement
  • in some cases ‘psychological based’ interventions could improve mental wellbeing, including more ‘person-directed’ approaches to reducing burnout, and mindfulness-based stress reduction courses

Prevention

  • studies suggested that a ‘whole-systems’ approach (i.e. focussing on a number of different schemes to address different aspects of employee wellbeing) could be beneficial for improving both quality of work and wellbeing outcomes
  • developing appropriate ‘spaces’ in the physical healthcare environment (for example, rest, sleep and eating facilities) helped healthcare staff feel valued and supported by their organisations
  • a range of ‘group-based’ mental health interventions were also identified to provide safe spaces for staff to openly reflect and share the various challenges they experience within their role (e.g. Schwartz Center Rounds’)
  • other mental health interventions thought to be helpful include those that focussed on ‘wider aspects’ of work, including team interactions, flexibility and autonomy, and interventions that healthcare staff actually ‘want’ and think will be effective

The authors highlight the variability in quality of evidence and methodology and conclude “The results indicated that there is currently limited evidence of a ‘best-practice’ intervention, and there may not be a one-size fits all solution to wellbeing interventions. However, the interventions that did have positive uptake and where positive wellbeing outcomes were reported were those that included a ‘whole-systems’ approach where healthcare staff could engage with the interventions that best suited their needs”. (p3)

How to boil a frog….

How to boil a frog….

This blog from our HWBI Ninja, Rob Sanderson considers what we can do to spot stress and practical things we can do to acknowledge it and minimise the negative impact on our health and wellbeing.

What?!! I hear you ask, why would anyone want to do that? Firstly, I don’t condone boiling frogs, please don’t try this! I love frogs and even built a pond for them at the bottom of the garden, so, to be clear, it’s not something I have tried or intend to.

So how do you boil a frog?

It shouldn’t be at all possible. Frogs are sensitive to temperature. Regardless of this, in 1872, scientist, Heinzmann experimented and concluded if you increase the heat of the water very gradually, the poor frog doesn’t notice until it’s too late.

What has this got to do with health and well-being?

Firstly, I wanted to be sure I had your attention (you are still reading, right?) and secondly because it’s an excellent metaphor for the point of this post:

Just like our ill-fated frog, millions of people are [metaphorically] boiling themselves alive with stress and anxiety. The rise in this pressure is so gradual they don’t realise until it suddenly gets too much.

As a psychotherapist and clinical hypnotherapist, the most common conditions I help people with, are stress and anxiety, related. While many people recognise stress or anxiety, a surprising amount do not. Symptomatically, it’s evident when people are experiencing stress and anxiety, yet they don’t realise it. People explain, “I don’t suffer from stress, I just want to stop biting my nails,” or “I don’t have stress, I drink too much,” “eat too much,” “can’t sleep,” “have headaches,” “anger issues,” etc. sure signs of stress. Surprisingly, some clients have been so unaware of their extreme stress levels until it manifested itself physically when they were rushed to hospital with a suspected heart attack. I call this stealth anxiety.

How can I spot the warning signs?

Some of the physical signs of stress and anxiety include poor sleep, frequent need to use the loo, stomachache, sudden weight gain or loss, breathlessness, headaches, palpitations, sweats, tiredness and fatigue. The effects on mental health can include, panic attacks, lack of concentration, anger, feeling uneasy, depression and low mood.

It’s not too late, act now to turn the heat down or jump out!

Being positive is a natural defence against stress, anxiety and depression. As a Solution-Focused therapist, people are encouraged to look for the solution rather than focusing on the problem. Being solution-focused is powerful against stress and anxiety because finding solutions reduce stress. One way of doing this is by practising what we call the 3 p’s, which are to think positively, be active in a positive way, and to interact positively. When we do this, we create patterns in the brain that are proven to help fight stress, anxiety and depression.

On a positive note, here’s a happy ending!

In 2002, Victor H. Hutchison, a zoologist reveals, that more recent experiments show as the water is heated, the frog tries to escape, and eventually jumps out.

If you are worried about stress, anxiety or depression, you can talk to your GP or arrange an appointment with a talking therapist. If you have any further questions, feel free to contact me using the link below.

Rob Sanderson

Clinical Hypnotherapist and Psychotherapy

Help Hypnotherapy | Liverpool & Merseyside

https://www.helphypnotherapy.co.uk/

Photo by Darko Pribeg on Unsplash

What would inspire you to get active?

What would inspire you to get active?

Last week was Great British Week of Sport The campaign is intended to provide inspiration and help us all find ways to get active to boost our health and wellbeing.  We are about to land in October, which is Breast Awareness Month. This blog, written by our co-founder Su, is a personal account of how becoming more active led to the discovery and successful treatment of breast cancer in 2018.  If it hadn’t been for Couch to 5K the outcome could have been very different.

Runner… me? Friends that provided inspiration.

In 2018, I was counting myself very fortunate.  I had a job that I enjoyed, a network of great friends and a loving family.  Generally speaking, I was fit and healthy, did most things to lead a healthy lifestyle and had taken it upon myself to step up the exercise.  During a trip to Eire with friends (both runners), I stated that I would “love to take up running”. But thought I was “passed it”.  My friends pointed out my self-limiting beliefs. Within 3 months I had signed up and completed the Couch to 5K with my running buddy (husband).  We were rather proud of our achievement and decided to step it up to 10K during the autumn.

How running saved my life.

Any of you that have taken up running will know that there are consequences. The odd toenail may have to be sacrificed and various muscles ache.  So, when I felt breast tenderness and a lump, I thought that I just needed a better sports bra.  Just to be on the safe side, I thought I would get checked by my GP, who reliably informed me I was difficult to assess as my boobs were ‘lumpy’ anyway.  He referred me to a ‘one-stop clinic’ at St Helen’s and Knowsley NHS Trust.  I had all the tests in one day and within three weeks of my GP appointment, I was diagnosed as having breast cancer and on a treatment pathway.

It was an emotional roller coaster.  I will blog a little more about that and what helped me get through in the future.  But for now, the focus is on ‘why get active’.  I believe if I hadn’t started running, become more acutely aware of my physical health and body, I wouldn’t have gone to my GP. This would have delayed the necessary investigations and successful treatment. 

We know the health and wellbeing benefits of being more active. Yet, finding the time and inspiration can be a struggle.  The tips on the NHS Better Health website help to see that small changes can be achievable and really beneficial.  The three that helped me:

  • Track your progress – I never knew I was so competitive
  • It’s better together – having an exercise buddy
  • Find something you enjoy – running is great, find your own pace

Maintaining the habit

I’ve never regretted going for a run or long walk.  I’ve been frustrated with myself when I haven’t. I’ve joined Strava, an App that links you to an online community for support, inspiration and encouragement.  I would heartily recommend the Couch to 5K App.  It seems to have inspired many during the pandemic to get out.  If running is not for you, any small/regular amount of exercise has positive health benefits. 

There are so many people to be thank. I’m hugely grateful to my fantastic family, friends and work colleagues who supported me through the treatment period and beyond.  I’m especially grateful to all the health care professionals that were involved in my treatment, health care assistants, health care scientists (radiotherapy physicists), nurses, consultants, receptionists and all.

Writing to boost health and wellbeing – Try reaching for the pen rather than your digital device.

Writing to boost health and wellbeing – Try reaching for the pen rather than your digital device.

This blog from out HWBI Ninja, Rob Young and co-founder Su, considers how writing can boost your health and wellbeing.

Two perspectives – writing to improve health and wellbeing and writing to give voice and connect.

Next time that you feel under pressure or stressed it might be better to reach for the pen than reaching for the digital device.  The digital device may be a great displacement activity but may not be as good for your health and wellbeing.  There is a growing body of evidence that shows that writing can:

  • Encourage mindfulness
  • Help you to find perspective on difficult issues
  • Provide an opportunity for storytelling for self-exploration
  • Foster clarity and insight
  • Releases creative potential
  • Release anxiety or stress
  • Expand your creative abilities and work through blocks

A study by Robinson (2000) explores the connections between writing and wellbeing.  He discovered a number of studies that demonstrated how writing can have positive psychological and clinical benefits.  One study Robinson referenced, (Smyth, Stone et al 1999) found that participants who were asked to write about stressful life experiences for 3 consecutive days for a week reported 47% improvement in their clinical symptoms verses a control group who were asked to write about their general plans for the day, this group reported a 24% improvement.  Robinson goes on to explore if the quality of writing is also important….. perhaps for another blog in the future. 

Our Super HWBInspiration Ninja, Rob Young has brought his thoughts and experience of writing, not just for health and wellbeing, but also to give voice and communicate complex and often difficult subject matter.  He helps service users, clinicians and leaders find ways to communicated to engage, connect and no doubt to heal.  What follows is Rob’s account and hope you enjoy and take inspiration.

What good is a writer? By Rob Young

To answer that question, we must first ask ourselves, what writing is and more importantly, what it isn’t.

The ability to write is not a gift from on-high, it can be learned.  I have taught the craft of writing to a truly diverse range of participants from heart surgeons to ‘tower block kids’ some of whom were illiterate (the kids, that is!) yet their stories were sublime.

Writing is not something you take up when you retire. We do it every day, in texts, emails, notes, reports and so on.  Every time we speak, we are telling someone a story, yet we never learn the craft.

Writing is not just a hobby, a frivolous add-on once the ‘real work’ is done. It is our most efficient way of communicating what it is to be human. We can never truly relate to another person’s experience because even if we both stare at the same view; what we see is unique. The best that we can do is relate with the generic human condition and that is… a struggle.

We like to watch people struggle; it is how we learn to survive. From folk tales to Hollywood, lectures to books, the same format applies: the protagonist is dealt a problem, they investigate it, then find a solution. The old joke being, that in healthcare research, you don’t find an answer, you find ten more questions, but the basic format remains: we fail, we learn, we “grow some resilience”.

We watch our heroes fail and flounder, as they search for innovative ways to battle their demons. If their enemy is huge, they use speed. If their enemy is fast, they use stealth. And so on. They try, fail then try something else until they succeed. Time and time again its leftfield-thinking that saves the day. This valuable lesson is burned upon our retina as we all spend approximately 2 years of our lives watching movies, so the concept of innovation is embedded deep within our psyche. It is there for a reason, to help us survive.

As a writer, my ‘day job’ is helping people to communicate. The vast majority of my clients are intelligent, articulate professionals who are fluent in their craft. So why do they need me?

The questions they ask are often simple:

“Why don’t people come to my meetings?”

“Why is my PowerPoint so dull?”

“My specialist subject makes people wince but seriously, what can I do?”

Invariably, the answer lies with a fresh point of view.

Let’s take a look at the challenge. How is your meeting advertised? On what format? What is the hook? What will I gain from attending? These are all reasonable questions that require a perky response. If one way doesn’t work, then let’s try another. That’s all there is to it. We try, we fail, we try something else.

We have all sat through “Death by PowerPoint”, that sleep-inducing slideshow full of tiny text, meaningless pie-charts and 1980’s Clip Art, so please, let’s not do that. Let’s do something better.

What I find particularly interesting is the third question, because it is important. There are some issues in healthcare that are so dark, our natural response is to flinch, withdraw and ‘change channels’. It is understandable but it also a dangerous one because before we can even begin to solve the issue, we must open up a conversation. The challenge here is how to welcome people into a world that they find abhorrent.

Here are two examples of ways I’ve been able to help:

Giving voice

I met a clinician who did wonderful work helping victims of Female Genital Mutilation. Whenever she presented at conference, the audience were reticent, bracing themselves for an hour of upset and gore, while some did not attend at all.

The traditional way to approach this subject is to focus on the condition.  We decided to change that view. Working with the clinician, we refocussed her presentation to pay tribute to the shy, fragile women who she treats every day.  We told the story in their voices, not ours.  Excerpts of verbatim text were read from behind a hospital screen.  The images we revealed were of crisp white cotton sheets that spoke of innocence and dignity.  In everything we did, we did not once mention anything dark until humanity had been given the priority it deserved.

The subsequent performance reduced many veteran clinicians to tears and post-talk, the doctor was surrounded by many admirers praising her work.  Though my part was minimal, I felt an immense sense of pride that we had shown respect for the patients, the work and the audience in a new and innovative way.

Helping people to connect

Perhaps the greatest challenge I have faced as a writer was to communicate the concept of pain. It is something that you cannot see, hear, examine or compare as every pain is unique.

Professor Bernie Carter is a former Great Ormond Street nurse who has devoted her life to helping children with chronic complex pain issues. It is a subject so dark that it makes you wince just to think of it, so to open up a conversation is a challenge in itself.

As the concept of pain is so universal, we decided to concentrate on one particular moment in time – when a child with chronic complex pain is brought into A&E. In this moment, three separate languages come into play: the informed language of the clinician, the silence or scream of the child and her mother who speaks in metaphor, “She’s like a rabbit in the headlights / I can see the pain in her eyes”. The fact that these three language styles almost, but don’t quite connect is as much of an issue about communication as it is about healthcare.

Together, we looked at this moment in time from a plethora of viewpoints, from families to clinicians, charity workers to theologians, we even worked with a contortionist. We recorded their voices and played them via rotating mobiles in a huge, dark room, so the voices swirled above your head, almost but never quite connecting. We premiered our work in a theatre, not a conference, where again, many people were reduced to tears, not because we were gunning for sympathy but the fact that they had ‘got it’. They understood the challenge and agreed, wholeheartedly, that something must be done.  

It is a personal bugbear of mine that many people raise awareness without acting upon it.  I was determined that would not be the case with our pain project. Based upon the success of our presentation, we were able to acquire Arts Council funding to tour pain conferences as far afield as South Africa. We created downloadable brochures and the animation below:

What strikes me about the project, looking back upon it now, is another axis point, another moment in time – the one where art meets science, when the heart of the clinician meets the brain of the artist to clash, flirt and tango. It is a thrilling moment in time when magical things can happen.

I have worked with Su and Claire (my HWBInspiration Ninja colleagues) for many years now and have always been impressed by the fact that they see the arts as a liberating force, in healthcare and beyond.  They value the role that the arts can play in communicating issues from management to research, leadership to personal empowerment.  The stories they tell are told in a voice that is warm, welcoming and accessible to all and in today’s noisy world, but their voice rings true as clear and authentic.  If you have a challenge, they can help.

Thank you for reading and good luck in telling your story.

To contact or follow Rob

Twitter:   @R0BY0UNG       

Website:   http://robyoung.info

Email:   rob@robyoung.info

Facebook:   https://www.facebook.com/rob.young.587

Instagram: rob.the.writer

References

Robinson, M. Writing well: health and the power to make images.  Journal of Medical Ethics: Medical Humanities.  2000: Vol 26. p79-84.

Smyth JM, Stone AA, Hurewitz A, Kael A. Effects of writing about stressful experiences on symptom reduction in patients with asthma or rheumatoid arthritis. Journal of the American Medical Association 1999;281:1304-9.

HWBInspiration co-founders, Su & Claire, are grateful to our Associate HWBI Ninjas for sharing their knowledge, skill and insights.