Efficacy of Short Course Cognitive Behavioral Therapy on Stress Reduction Among First-Year Surgical Residents

To determine the efficacy of cognitive behavioral therapy (CBT) on stress, anxiety, burnout, and depression in surgical interns and to determine the optimal timing of CBT. Our hypothesis was that CBT could improve each of these measures and that skills learned in the first semester could be sustained throughout the remainder of the intern year.

A full course of CBT was delivered in 3 sessions, every 2.5 hours, with participants randomized to receive CBT early in the internship (EARLY group, July to December) or after 6 months of internship (LATE group, January to May). Residents were surveyed at baseline (June/July), at the midpoint (November/December), and near the end of intern year (April).

General Surgery Residency, University of Colorado School of Medicine, Aurora, CO, USA. Tertiary Medical Center.

This study included 25 surgical interns.

While neither group was found to have a significant change in burnout or anxiety before and after CBT, there was a statistically significant decrease in depression scores in both EARLY and LATE groups when comparing baseline to endpoint. There was also a significant decrease in stress in the LATE group. No significant differences were observed in subgroup analyses for race/ethnicity, gender, or relationship status, though there was a temporary decrease in stress among non-White participants who underwent CBT.

Burnout, anxiety, stress, and depression remain prevalent among surgical interns, and CBT may be a useful individual intervention for interns experiencing depression and stress. This tool may be of particular benefit for interns who experience additional challenges and stressors related to race/ethnicity.