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Objective: This study used semi-structured interviews with faculty and residents in psychiatry to inform a qualitative, process-based understanding of well-being and related concepts, as well as to identify and critically explore strategies for maintaining well-being in psychiatry. Methods: Using interpretive description as a qualitative research methodology, semi-structured phone interviews were conducted with 12 faculty (nine clinical and three non-clinical) and five residents in a Canadian psychiatry department between September and December 2019, prior to the onset of the COVID-19 pandemic. Interviews were transcribed, coded, and subsequently analyzed for themes by the research team. Results: Fourteen women and three men completed the study, consisting of nine faculty members, five psychiatry residents, and three non-clinical PhD scientists. Four themes were developed from the interview data: (1) The nature of working in academic psychiatry, (2) professional identity as a double-edged sword, (3) feelings of isolation and powerlessness in the system, and (4) strategies to support well-being. Conclusion: In the absence of many qualitative perspectives on well-being in academic psychiatry, the findings of this study can be used as a first step to inform future interventions and meaningful institutional change around well-being in psychiatry. The findings may help to enable conversations about well-being that embrace humanity and vulnerability as essential components of professional identity in psychiatry and provide opportunities for open discussion and support.

AbstractThis article describes an innovative, trauma-focused cognitive behavioral protocol, Transcending, to address the effects of minority stress on mental health among transgender and gender diverse individuals. The protocol merges minority stress and cognitive behavioral therapy models to provide a framework for (a) understanding the impact of minority stress (i.e., distal and proximal stressors) and (b) developing skills to address maintenance factors of associated psychological distress. The Transcendingprotocol is intended to provide a structured approach to filling an important gap in counseling services and increasing therapeutic competence with transgender and gender diverse individuals.