Shahar Lev-Ari

Intensive programs such as retreats and workshops are widely promoted for occupational burnout, but their evidence base is limited and fragmented. This critical narrative review searched PubMed, Google Scholar, and APA PsycInfo for peer-reviewed studies published from January 2000 to March 2026. Eligible studies evaluated structured, high-dose interventions delivered in a condensed format, reported burnout or closely related outcomes, and involved adult working or occupationally relevant training populations. Evidence was organized by four immersion dimensions: contextual containment, dose density, experiential multimodality, and social density. Forty studies met the criteria: 22 residential retreats and 18 non-residential intensives. No virtual synchronous program qualified, so adjacent virtual evidence was appraised narratively. Studies commonly reported short-term gains in stress and well-being and high satisfaction, but effects on validated burnout measures were less consistent. Most studies were small, uncontrolled, and drawn from healthcare and student samples, with little long-term follow-up; controlled trials yielded more conservative results. No study compared the same curriculum across formats. Delivery format may itself be an active ingredient, with facilitated social connection the best-supported candidate. Three testable pathways are proposed: contextual containment as a reset for exhaustion, shared group experience and communitas for disengagement and cynicism, and dose density as a catalyst for professional fulfillment and efficacy. Head-to-head format comparisons, standardized burnout measures, longer follow-up, and economic evaluation are needed.

Importance: The postpartum period presents heightened vulnerability to stress and anxiety, particularly during wartime. While pregnancy interventions are well-studied, postpartum mental health requires targeted approaches. Inquiry-Based Stress Reduction (IBSR), combining mindfulness with cognitive reframing, has reduced depression and stress in various populations and could provide postpartum women with stress management tools during prolonged conflict. Objective: To evaluate the effects of IBSR on anxiety and perceived stress in postpartum women during armed conflict. Design, Setting, and Participants: This randomized clinical trial comprised an 8-week intervention and 4-week follow-up, conducted from June 9, 2024, to January 19, 2025. Participants included women aged 18-45 years up to 2 years postpartum with no psychiatric history, recruited via social media. Interventions: Participants were randomly assigned (1:1) to either an 8-week IBSR group-based intervention or a waitlist control group. The IBSR program included weekly 3-hour group sessions and 1-hour guided home practice sessions. Main Outcomes and Measures: Primary outcomes were anxiety (Generalized Anxiety Disorder 7-item scale [GAD-7]) and perceived stress (Perceived Stress Scale [PSS-10]). Secondary outcomes included emotional regulation, psychological well-being, quality of life, resilience, and perceived social support. Assessments were conducted at baseline (T0), postintervention (T1), and 4-week follow-up (T2). Results: Among 105 randomized participants (mean [SD] age, 31.9 [6.2] years), 91 (86.7%) completed all assessments. Thirty percent of intervention participants (12 of 40) dropped below the clinical anxiety threshold (GAD-7 score <8) vs 7.7% of controls (5 of 65) (χ² = 9.01; P = .002). The intervention group showed greater reductions in anxiety (Cohen d = −0.55; 95% CI, −1.00 to −0.10; P < .05) and perceived stress (Cohen d = −1.09; 95% CI, −1.56 to −0.62; P < .01), maintained at follow-up. Cognitive reappraisal improved significantly (Cohen d = 0.99; 95% CI, 0.52-1.45; P < .01). No significant differences emerged for psychological well-being, resilience, quality of life, or social support. Conclusions and Relevance: IBSR significantly reduced anxiety and stress in postpartum women during wartime, with effects maintained at 4-week follow-up. This intervention offers a scalable nonpharmacological approach for conflict-affected settings. Trial Registration: ClinicalTrials.gov Identifier: NCT06490094

Background: Pain self‐management (PSM) programs have demonstrated effectiveness as a pain management strategy, yet evidence remains scarce for patients with chronic pain treated with medical cannabis. We aimed to explore feasibility aspects and practical applications of developing and implementing a group‐based PSM intervention in this context.Methods: Twenty‐two semi‐structured qualitative interviews were conducted with 10 chronic pain patients treated with cannabis and 12 clinicians from a range of expertise.Results: Overall, the interviewees believed that the proposed intervention is feasible; yet it is essential to consider the following aspects during program planning and implementation. Inductive thematic analysis of interview transcripts identified five major themes. The first is that the program enablers include the intrinsic benefits of therapeutic group dynamics, aligning expectations, and setting individual goals at program initiation. The second theme is the program barriers. These include expected challenges for participants due to behavioral and mental changes that necessitate high commitment, the challenge for the group leader in delivering an appropriate response to each participant's emotional narrative; and managing logistical issues. The third theme is the psychological experience of living with pain, with an emphasis on addressing patients' emotional perspectives within the program's framework, namely, their perceptions of pain, fear of pain, and the relations of such to past experiences. The fourth theme is the psychoeducation on pain and cannabis use, including the brain‐pain connection and informed guidance regarding cannabis use. The fifth theme is the integration of guided movement and relaxation techniques in pain management, thus underscoring the importance of practice during the group sessions.Conclusions: Our findings suggest key elements that may inform planning PSM‐approach therapy groups, tailored to the particular needs of patients with chronic pain using medical cannabis.

Background: The transition through pregnancy, childbirth, and postpartum significantly impacts maternal mental health, influencing both individual and family well-being. While social support and emotion regulation serve as protective factors generally, their role and impact during periods of conflict remains understudied. Methods: We conducted a cross-sectional study of 400 Jewish mothers (up to two years postpartum) from a representative sample in Israel during a period of conflict. Participants were recruited through the Sekernet platform, a validated online survey tool in Israel. The study population included Jewish mothers up to two years postpartum, aged 18–45, without a history of diagnosed mental health disorders. Inclusion criteria specified mothers aged 18–45 and within two years postpartum, while exclusion criteria included mothers under 18, over 45, more than two years postpartum, or with a history of diagnosed mental illness or psychiatric disorders. Using validated instruments, we assessed psychological well-being (PWB), anxiety (GAD-7), perceived stress (PSS), resilience (CD-RISC), emotion regulation strategies (ERQ), quality of life (WHO-5), social support (MSPSS), and post-traumatic stress symptoms (PCL-5). Additionally, exposure to conflict-related media and direct exposure to war events were measured using self-reported questionnaires evaluating frequency and type of exposure during the conflict period. Results: Cognitive reappraisal and resilience positively correlated with psychological well-being (p < 0.01), while expressive suppression and general stress negatively correlated with both psychological well-being and quality of life (p < 0.01). Mediation analysis revealed that social support significantly mediated the effects of stress on psychological well-being (β = −0.060; p < 0.05) and quality of life (β = −0.05; p < 0.05). Additionally, exposure to conflict-related media and post-traumatic stress symptoms correlated with reduced well-being and increased anxiety. Conclusions: Our findings emphasize the vital roles of social support systems and adaptive emotional regulation strategies during the postpartum period, particularly in conflict settings. Healthcare providers should implement interventions that strengthen social support networks and teach adaptive emotion regulation skills to postpartum mothers in conflict zones.

Background: Attention Deficit Hyperactivity Disorder (ADHD) is a pressing concern in pediatric public health, with its prevalence rising among children and teenagers. This study explored the relationship between group-based physical activity and the well-being, resilience, and distress levels of Israeli youth, with a specific focus on those with ADHD symptoms. Methods: This cross-sectional study surveyed 699 Israeli teenagers, assessing their participation in three types of physical activities: unorganized, structured, and the “Five Fingers” program. Data were collected through an online platform and analyzed using ANOVA, t-tests, and multivariable regression models to identify predictors of resilience. Results: Structured, group-based sport activities are associated with higher resilience (p < 0.01) and lower distress (p < 0.01) in adolescents. Adolescents with ADHD symptoms exhibited lower resilience (p < 0.001) and well-being (p < 0.001), and higher distress (p < 0.001). However, those with ADHD symptoms who participated in group-based activities fared better in terms of distress (p < 0.01) and well-being (p = 0.018) than those who did not. Participation in any sport activity, older age, male gender, and a higher socio-economic status predicted greater resilience in youth, generally. Conclusions: This study presents the potential of structured physical activities that involve psychosocial and group integration training to improve the mental health of adolescents, especially in the context of ADHD symptoms.

Background: Asymptomatic SARS-CoV-2 infection can significantly increase the spread of the COVID-19 pandemic. We aimed to investigate the epidemiological and clinical predictors of occult serologically confirmed SARS-CoV-2 cases among the general population during the fourth vaccination era in Israel. Methods: We conducted a cross-sectional study among individuals aged ≥18 years who had not been tested for COVID-19 in the preceding 5 months. Occult serologically confirmed cases were based on the presence of anti-N IgG antibodies. Potential risk factors were examined. Multivariable regression analysis identified independent predictors of subclinical SARS-CoV-2 infection. Results: This study included 504 participants. The prevalence of occult serologically confirmed SARS-CoV-2 was 12.5%. Chronic disease was found to be an independent predictor for the absence of occult disease (aOR) 0.4 [95% (CI): 0.18–0.87], p-value = 0.02). No significant differences were observed in age, sex, marital status, number of children, vaccination status, or exposure to COVID-19 infection between participants with and without SARS-CoV-2 sub-infection. Conclusions: We found a lower prevalence of occult serologically confirmed SARS-CoV-2 cases, compared to previous reports, and a negative correlation between chronic disease and occult SARS-CoV-2. Continued research, surveillance, and intervention strategies are needed to optimize long-term health outcomes and provide valuable insights for public health policymakers and clinicians.

Despite breakthroughs in the scientific understanding of how stress affects psychological and biological systems in ways that, over time, lead to disease and disability, non-communicable disorders ...

Background Attention Deficit Hyperactivity Disorder (ADHD) is a pressing concern in contemporary pediatric public health, with its prevalence rising among children and teenagers. This study explored the relationship between group-based physical activity and the well-being, resilience, and distress levels of Israeli youth, with a specific focus on those with ADHD. Methods This was a survey-based, cross-sectional study that included 699 Jewish Israeli teenagers aged 16 to 19. In addition to quantitative questionnaires that examined sociodemographic factors, resilience, distress, and well-being levels, the youth were asked about participation in group-based physical activities and the significance they ascribe to various facets of the activities. Results Our findings indicated that structured and group-based physical activities, especially the Five Fingers program which emphasizes psychosocial development and leadership skills, are associated with higher resilience (p<.01) and lower distress levels (p<.01) in adolescents. Generally, Israeli adolescents with ADHD exhibited lower levels of resilience (p<.001) and well-being (p<.001), and higher levels of distress (p<.001) compared to their counterparts. However, adolescents with ADHD who participated in group-based activities fared better in terms of distress (p<.01) and well-being (p=.018) than adolescents with ADHD who did not participate in organized sports. Further, participation in any form of sport activity, older age, male gender, and a higher socio-economic status predicted greater resilience in youth generally. Conclusions The study presents the potential of structured, engaging physical activities that involve psychosocial training and group integration activities to improve the mental health of adolescents, especially in the context of ADHD.

Despite great interest in how dynamic fluctuations in psychological states such as mood, social safety, energy, present-focused attention, and burnout impact stress, well-being, and health, most studies examining these constructs use retrospective assessments with relatively long time-lags. Here, we discuss how ecological momentary assessments (EMAs) address methodological issues associated with retrospective reports to help reveal dynamic associations between psychological states at small timescales that are often missed in stress and health research. In addition to helping researchers characterize daily and within-day fluctuations and temporal dynamics between different health-relevant processes, EMAs can elucidate mechanisms through which interventions reduce stress and enhance well-being. EMAs can also be used to identify changes that precede critical health events, which can in turn be used to deliver ecological momentary interventions, or just-in-time interventions, to help prevent such events from occurring. To enable this work, we provide examples of scales and single-item questions used in EMA studies, recommend study designs and statistical approaches that capitalize on EMA data, and discuss limitations of EMA methods. In doing so, we aim to demonstrate how, when used carefully, EMA methods are well poised to greatly advance our understanding of how intrapersonal dynamics affect stress levels, well-being, and human health.