Working with Patients Around the Holiday Season


The holidays can be a very challenging time of year for many.  As an Allied Healthcare Professional, you may see patients who are experiencing ongoing issues, and the holidays can add to this.  Consider the Physical Therapist who is treating a patient experiencing ongoing pain which impacts his life; the Speech Language Pathologist who is treating a patient for swallowing issues following a stroke; or the Play Therapist who is treating a child living in a foster home after being removed from her home due to her parent being unable to provide care.  All are patients who are experiencing challenges and add to this, the possible dynamics experienced during the holiday season.    

The holidays can: increase anxiety, increase depression, exacerbate issues, be financially draining and can be extremely difficult for many.  A survey indicated thirty-eight percent of people said that their stress level increased during the holiday season with the top stressors being: lack of time/money, commercialism, gift-giving pressures, and stress surrounding family gatherings.[1]  Holiday events can also increase potential for substance use.  Loss, loneliness, and shame can be powerful triggers for drug and alcohol use.[2]  It is important to be aware of changes in a patient’s affect and demeanor.  Where indicated, it may be important to assess suicidal/homicidal ideation or seek consultation if this is outside your scope of practice. 

There are a number of articles about the “holiday blues” which can be found online, including through Substance Abuse and Mental Health Services Administration (SAMHSA) and National Alliance on Mental Illness (NAMI).[3]  If patients express suicidal thoughts, you have an important responsibility to act.  You may need to encourage them to call 911, proceed to the nearest emergency department, or contact the National Suicide Prevention Lifeline - 1-800-273-TALK.  Be sure to consult with a professional colleague or supervisor to ensure you respond in the best way to protect the welfare of the patient.  Keep in mind that each patient has different stressors and needs.  During this time of year, and always, gauge some of these risk considerations:

  • Consider providing your patients with information on how to access help, should it be needed.
  • Assess the patient’s mental status - ask if he/she is safe.  
  • Remember to document any assessments of mental status, observed behaviors and changes, and consultation you receive. 
  • Be aware of signs that the patient may need additional evaluation or a higher level of care. 
  • Seek additional consultation, if necessary.
  • Be aware of significant changes in the patient’s presentation.
  • Determine whether you should consult with a risk management professional or attorney to obtain advice.  


[1] What We Know About the Holiday Blues.  Cornell University.  Evidence-Based Living. [last accessed December 17, 2019] citing an American Psychological Association study.

[2] Recognizing Holiday Triggers of Trauma.  SAMHSA. [last accessed December 17, 2019].



Kristen Lambert, JD, MSW, LICSW, CPHRM, FASHRM
Healthcare Practice and Risk Management Innovation Officer
Trust Risk Management Services, Inc.


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