Intended for healthcare professionals

Letters Covid-19: psychological effects on healthcare workers

Covid-19: recording their stories provides emotional benefit to healthcare workers

BMJ 2020; 369 doi: (Published 29 June 2020) Cite this as: BMJ 2020;369:m2536
  1. Paul Bennett, professor of clinical health psychology1,
  2. Rachael Hunter, senior lecturer1,
  3. Steve Johnston, head1,
  4. David Jones, consultant in intensive care2,
  5. Simon Noble, Marie Curie professor of supportive and palliative medicine3
  1. 1Department of Psychology, Swansea University, Swansea SA2 8PP, UK
  2. 2Prince Charles Hospital, Merthyr Tydfil, UK
  3. 3Cardiff University, Cardiff, UK
  1. p.d.bennett{at}

Kisely and colleagues’ meta-analysis reinforces the expectation that healthcare workers might experience substantial distress as a consequence of working with covid-19.1 One response to this is the use of “clinical debriefing.”

Although clinical debriefing might seem to give immediate benefit, it can increase risk for post-traumatic stress disorder as a result of directing participants to engage with elements of trauma that they would rather avoid.2 In addition, it might not be easily accessible, and recipients might be reluctant to explore situations in which they made judgments that could be questioned.

Accordingly, any intervention should ensure that disclosure is controlled by the individual and is at a time that they choose. One simple vehicle for venting and exploring emotions might be talking aloud or writing about events in an uncensored manner to a confidential recipient. This recipient need not be a “live” person.

We are piloting a process called Covid Confidential (, which permits users to confidentially record their stories about the care of patients with covid-19 in either spoken or written form to a website. This might provide the immediate emotional benefit of offloading negative experiences and a repository of frontline stories, enabling identification of the immediate and most important concerns faced by its users. To date, over 70% of users reported a moderate or greater benefit from offloading their experiences after recounting them. Over 60% reported benefit in terms of their immediate mood and would use it again; 80% would recommend the website to colleagues.

Covid Confidential has the potential be a cost effective intervention both in terms of costs, resources, and the time users spend engaged with it. It will never replace more formal therapeutic approaches but can be of immediate benefit to healthcare workers and others involved with the covid-19 pandemic.


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