Department of Anesthesiology/Critical Care Medicine
Quality and Safety Research Group
Johns Hopkins University School of Medicine
1909 Thames St., 2nd Floor
Baltimore, MD 21231
Dr. Janel Sexton is a research psychologist interested in sociomedical psychology, in particular how people cope with job-related upheavals. Her research involves two main areas. The first concerns the ways in which caregivers cope with traumatic events and how their coping styles affect the work that they do—with an eye toward patient safety. Dr. Sexton seeks to identify the sorts of mechanisms or interventions that can be put into place to help this very important healthcare group cope more effectively with traumas and upheavals. Such episodes can include conflicts with coworkers, loss of a patient with whom the caregiver developed a close relationship, stresses at home, or even more severe situations, from violence in the workplace to being part of or witnessing a sentinel event (involving a medical error) that is associated with guilt and shame.
The current practice in healthcare is that there is no practice. When someone dies, the bed and room get cleaned, and the next patient comes in. Although individual units/hospitals may have innovative programs, in general, the world of medicine has never given attention to this area. Most facilities have no mechanisms in place to help caregivers process their emotions, even in the event of straightforward suffering and dying of patients. As human beings, we cannot automatically make emotions go away, and if nothing is in place to process emotions in a healthy way, they may be processed in unhealthy ways. Further exacerbating this situation is the fact that nurses in the ICU see suffering that they never saw before because modern medicine has enabled the prolongation of life. Some healthcare workers struggle with the question of whether they are caring for patients or participating in their pain.
Dr. Sexton uses her skills and training to explore the use of expressive writing as a means of effectively coping with trauma and stress. With support from the Josie King Foundation, she is involved with an ongoing project called ”Care for the Caregivers” in which ICU nurses write their deepest thoughts and feelings about job stress and trauma. Dr. Sexton and her colleagues assess study participants at the beginning of the process to get a sense of individual situations, concerns, and needs, and at the end of the study, they will evaluate the effectiveness of the coping strategy. The goal is to identify an intervention that is easy to use and time and cost efficient and then to extend it to physicians and other caregivers.
Dr. Sexton’s second area of research involves health disparities, i.e., social stigma, identity, how people who are members of stigmatized groups view their membership, and how that in turn predicts physical and mental health. Another branch of this work addresses how caregivers’ attitudes toward stigmatized groups may affect the quality of the care they deliver. To conduct this research, Dr. Sexton has participants take an online Implicit Association Test (IAT), which evaluates people’s hidden prejudices. The IAT is a reaction-time test of unconscious prejudice that circumvents social desirability (i.e., political correctness). Because it is timed, it taps into implicit associations, and it renders a score that feeds back individual preferences. Dr. Sexton and her colleagues are using the IAT with caregivers in a few ICUs to assess baseline attitudes. They will try to develop interventions toward improving the quality of care delivered to all. They plan to explore whether they can change IAT scores with their interventions.
- American Psychological Society
- Society for Personality and Social Psychology
- Society of Behavioral Medicine
- Society for the Psychological Study of Social Issues
- Kaufman JC, Sexton JD. Why doesn’t the writing cure help poets? Rev Gen Psychol 10:268–82, 2006.
- Sexton JD, Kaufman JC. The power of the pen: The latest on expressive writing. Contemp Psychol 49:531–2, 2004.
- Oral G, Kaufman JC, Sexton JD. From empire to democracy: effects of social progress on Turkish writers. J Psychol 138:223–32, 2004.
- Sexton JD, Pennebaker JW. Non-expression of emotion and self among members of socially stigmatized groups: implications for physical and mental health. In: Nyklicek I, Temoshok L, Vingerhoets A, eds. Emotional Expression and Health. New York: Brunner-Routledge 321–33, 2004.
- Sexton JD, Pennebaker JW. The healing powers of expressive writing. In: Kaufman JC, Kaufman SB, eds. The Psychology of Creative Writing. Cambridge: Cambridge University Press (in press).
- Wu AW, Sexton JD, Pham JC. Healthcare providers: the second victims of medical error in patient safety. In: Patient Safety. Philadelphia: Wolters Kluwer, Lippincott Williams & Wilkins (in press).
- Kaufman JC, Baer J, Cole J, Sexton JD. A comparison of expert and nonexpert raters using the consensual assessment technique. Creativity Res J 20(2):171–8, 2008.
Sandra Swoboda, MS, RN
Peter Pronovost, MD, PhD
Bryan Sexton, PhD
Adil Haider, MD, JHU Department of Surgery
- Outstanding Professional Development, California State University, San Bernardino
- Department of Psychology (2002–2003)
- Dissertation Award, Society for the Psychological Study of Social Issues (2001)
- Magna Cum Laude (1992)
- Phi Beta Kappa (1992)
- Thurgood Marshall College Academic Honors Award (1992)
- Provost’s Honors (1988–1992)