“Be Well to Manage Well”: Clinical Project Managers’ Well-Being in the Pandemic and Beyond

Clinical Researcher—February 2022 (Volume 36, Issue 1)


Zoran M. Pavlovic, MD


A growing interest in workplace well-being demands a paradigm shift in how society thinks about and treats employees—not just as they go about their jobs, but as they manage all aspects of their lives. Such interest is prompted, in part, by studies showing that physically and mentally healthy workplaces can lead to more engaged, committed, and productive workers and an organization’s sustainability, despite ongoing economic turbulence caused by the COVID-19 pandemic.

According to Duran and Sanchez,{1} there are five factors (the “five Cs”) that influence and reinforce employee engagement since the start of the so-called “New Normal” of pandemic conditions. All of them are either direct or indirect moderators of workers’ well-being:

  • Conciliation: reconciling work and home life, with remote working and flexibility acquiring considerable importance;
  • Cultivation: development schemes for employees;
  • Confidence: through the health and safety of employees, as well as through hands-on leadership;
  • Compensation: rewarding employees’ efforts and covering the additional costs of these difficult times; and
  • Communication: achieving employee participation and engagement.

Reasons for Investing in Workplace Well-Being Interventions

  • When an intervention to raise subjective well-being is utilized, performance and productivity can improve.

  • The productivity difference between high and low well-being employees can be significant.

  • Gains in employee well-being and engagement have been linked to increases in annual per-employee productivity.

  • Organizations with satisfied employees do better on the stock market.

  • Happiness at work is contagious. The mood of one employee might affect the mood of others. The happiness of close contact enhances a person’s chances of happiness.

  • Absenteeism is linked to low well-being. Mental health issues such as stress account for many missed days. Similarly, improving an employee’s well-being can cut health absenteeism costs.

  • Low personnel turnover is linked to high well-being. Employee turnover costs are reduced significantly when employees are happier at work.

  • Employees having higher well-being are promoted more quickly.

  • Well-being is linked to positive working connections. The quality of one’s professional relationships affects one’s mental health.

  • Presenteeism is typically manifested by symptoms of poor mental health such as depression, anxiety, and work-related stress. Its costs are much higher than absenteeism, and employers have reported a significant return on investment from spending on mental health promotion activities.

  • People who have high psychological well-being are far less likely to develop a cold.

  • People with high psychological well-being are less prone to cardiovascular illness.

  • Happy people are healthier and live longer.

Now let’s look at a number of factors affecting project managers’ well-being and how to overcome them.

Skills Gap

According to an Australian Institute of Management survey of project managers (PMs), the most significant negative impact of the skills gap on PMs’ well-being and productivity is related to increased levels of stress (71 %), followed by lower morale (56%), loss of high-performing employees (48%), and reduction in customer service standards (41% ).{2} The same survey reported that the most prominent skill gap was in “leadership,” which affected 46% of interviewed PMs.

Another well-being survey of project professionals by the Association of Project Management{3} in 2019 showed that the most underdeveloped skill was communication. Therefore, training that includes upskilling project-related leadership and communication capabilities would be the most beneficial for individuals, teams, and organizations. This training can also serve as an effective stress management and well-being enhancement strategy.

The same survey also identified crucial high-risk areas impeding PMs from experiencing a sense of wellness compared to the general working population (norm group). In the following eight sections, I have selected those that, in my opinion, have the highest priority in terms of affecting the PM’s well-being and suggested types of training that aim to mitigate these risks.

Job Control

From the 2019 survey, the most concerning item related to job control was “the account not taken of ideas and suggestions about the job.” Such perceived lack of control, or decision latitude, over how people choose to do their work or whether they feel able to influence their situation can be a leading source of stress and decreased psychological well-being.

The perception of control over their situation empowers PMs to make active attempts to resolve problems and encourages them to approach their work positively. High internal locus of control can also safeguard against the adverse effects of other pressures, such as work-life imbalance and heavy workloads.

Job control could be increased through participatory, organizational-level interventions. These would concentrate on improving work policies, practices, and procedures where managers and employees collaboratively decide on the intervention’s method (design and implementation) and content (changes to work policies, practices, and procedures). On the individual level, PMs could enhance their self-directed behavior and autonomy through various types of self-leadership training.

Work/Life Balance

Project professionals were worse off than the norm group due to poor work/life balance and increased workload. When individuals can maintain a good work/life balance, they are less inclined to get overstressed and more likely to enjoy their work, and thus feel happy about what they do.

Organizational factors that promote this balance include synergies of work-family practices and job crafting, flexible working hours, job sharing, part-time work, compressed workweeks, and access to programs that encourage physical and mental fitness. Provision of training opportunities, rewarding and praising for good performance, organizational justice, trust in leadership, and promotion significantly affect employees’ perception of company efforts to help workers balance work and family.

Personal resources such as psychological capital (i.e., HERO: Hope, (Self-)Efficacy, Resilience, and Optimism), including trait and state mindfulness and high emotional intelligence, positively predict better work/life balance. These facts indicate that the employer’s imperative is to improve the PM’s coping strategies and psychological resilience by providing mindfulness, behavioral monitoring, and emotional intelligence training, thus enabling positive, “spill-over” effects between their working and family roles.

Work Relationships

Certain work relationships measures (including those involving such themes or issues as “a boss/manager–aggressive management style,” “unclear what boss expects,” “boss forever finding fault,” “support/relations with colleagues–support from others,” “isolation at work,” and “poor relations with colleagues”) were found to be high-risk items among PMs compared to the norm group, except for an item on “others not pulling their weight,” which was approaching high risk.

Good relationships at work can be energizing and contribute to high levels of engagement and satisfaction, helping people cope with work pressure and maintain performance under challenging conditions. The employer should initiate emotional intelligence training and enable the engagement of PMs in interventions based on the ASPIRE (Agency, Safety, Positivity, Inclusion, Respect, and Equality) framework. These programs would help identify counterproductive behaviors and improve upon skills tied to social situations, self-awareness, interpersonal relations, and conflict management, leading to better working relationships and improving associated psychological, emotional, and social well-being parameters.

Sense of Purpose

The “sense of purpose” subscale of the psychological well-being scale was approaching high-risk among PMs compared to the norm group, meaning that project professionals found job goals to be less well-specified than those in the general working population. Similarly, job goals and objectives were less clear, resulting in a relatively lower commitment to achieving them.

A sense of purpose enhances the effect of positive emotions (positive emotions were aligned with the norm group in this survey), so this finding indicates the PMs’ underachievement of overall psychological well-being due to a diminished sense of purpose and direction. PMs could gain better insights into their unique individual goals through organization and human resources–initiated personal development activities, supporting them in taking appropriate/value-congruent actions at the workplace and in their private lives.

Organizational culture must enable clear vision and mission sharing at all levels, serving as a compass for all employees to make decisions and choose goals. In this respect, interventions that increase affective, normative, and continuance commitment, as well as a sense of belonging and citizenship behavior, are strongly encouraged. Self-awareness and self-reflection exercises can also help PMs find their sense of purpose. Other practices that strengthen social bonds and work relationships, thus building a shared sense of purpose, could also positively impact PMs’ well-being.

Personal Growth and Career Prospects

Two studies that directly assessed the happiness of PMs reported that the opportunity for personal growth{4} and career prospects{5} significantly affect PMs’ happiness levels. Personal growth initiative (PGI) refers to active and voluntary engagement in personal growth as the primary driver of individual development. PGI includes both cognitive and behavioral aspects related to intentional personal development. People with high PGI consciously intend to develop and actively find and utilize developmental opportunities.

Robitschek, et al.{6} identified four components of personal growth, including readiness for change, planfulness, using resources, and intentional behavior. Strengths-based training that promotes the acquisition of new cognitive-behavioral habits leads to increases in readiness for change (preparedness for undertaking self-change), planfulness (planning for the necessary processes and implementing self-change), the wise use of resources (adapting resources outside oneself to help self-change), and intentional behavior (purposeful engagement in behavior for self-change). Such training is particularly effective in driving personal growth in work environments.

Strain On Physical Health

Getting back to the 2019 Association of Project Management survey, project professionals were aligned with the norm group regarding strain on physical health, but the item “feeling sick” was high risk, with significantly more women than men reporting it. Additionally, PMs spend most of their time in sedentary activities, positively correlated with cardiovascular and metabolic morbidity (overweight, obesity, and type 2 diabetes mellitus) and mortality risks.

These harmful effects could be mitigated or even eliminated by engagement in regular, brief physical activities. For instance, training such as that found in 10-minute Workout Anywhere from the American Heart Association during lunch break could be one of the options. Other types of more passive exercises that primarily involve a mental component, such as mindful walking, yoga, and positive emotion-focused stress management programs like Inner Quality Management®, were proven to decrease blood pressure in hypertensive individuals.

Wellness experts from the Mayo Clinic also recommend discussing barriers to exercising, such as overcoming self-defeating cognitions like “I do not have time for exercising” or “exercising is boring,” especially if physical activity is performed remotely.

Strain On Psychological Health

Only three of the 11 items in the “strain on psychological health” subscale were not high risk compared to the norm group, indicating that PMs experience a high level of pressure on their psychological health mainly because of the stressful working environment. Employers should enable PMs’ participation in programs that increase mental toughness, psychological resilience, and grit. Stress management programs should use simulation-based “learning by doing” exercises to mimic various stress-inducing, work-related scenarios. This type of training would empower PMs to learn “situation-specific” stress management approaches, thus minimizing their “real-life” stressful experiences more efficiently.


The results on the “engagement” subscale put PMs in the approaching high-risk category compared to the norm group. Three causes of this can be identified by the items “put myself out for the organization,” “committed to achieving job goals,” and “committed to organization,” which indicate that PMs were less inclined to agree with these statements than the norm group.

The relatively low level of engagement is a huge problem, given the link between engagement and individual/organizational performance outcomes. Classroom and on-the-job training that promotes the development of agile and entrepreneurial skills boosting persistence, self-starting and future-oriented behaviors, and gaining knowledge and experience about synchronizing their individual with pro-team and pro-organizational proactivity should be considered central to the learning and development strategy.

Future Directions

The development of a PM’s agile, entrepreneurial, mindful, and compassionate leadership skills will take precedence over coaching on traditional leadership styles such as “transformational” and “authentic” due to the better alignment of the former four with business models showing superior performance in today’s VUCA—V(olatile)U(ncertain)C(omplex)A(mbiguous) economy. Concerning the wellness programs, training and access to holistic wellness services encompassing physical, nutrition, self-management, psychological, and spiritual well-being domains will become an integral part of a PM’s benefits package.


  1. Duran M, Sanchez J. 2021. Employee Engagement and Wellbeing in Times of COVID-19: A Proposal of the 5Cs Model. Int J Environ Res Public Health 18(10):5470. https://www.mdpi.com/1660-4601/18/10/5470
  2. https://www.news.com.au/finance/work/skills-gaps-put-staff-under-stress/news-story/a2ea8f80c8575b32e06dfa9413185644
  3. Cheung C, et al. 2019. The Wellbeing of Project Professionals. Association for Project Management. https://www.apm.org.uk/media/43892/apm_av_wopp_19.pdf
  4. Cheung C, et al. 2017. Happiness for Project Managers: Framework and Empirical Analysis. http://pm.umd.edu/wp-content/uploads/2017/09/Happiness-for-project-managers-Framework-and-empirical-analysis-2017-ARCOM-vf-2-FINAL.pdf
  5. Cui Q, et al. 2016. How Happy Are Project Managers in Their Jobs? http://pm.umd.edu/wp-content/uploads/2017/09/How_Happy_Are_PM_in_Jobs.pdf
  6. Robitschek C, et al. 2012. Development and Psychometric Evaluation of the Personal Growth Initiative Scale-II. J Couns Psychol 59(2):274–87. https://psycnet.apa.org/record/2012-04573-001

 Zoran M. Pavlovic, MD, (heruka.innovations@gmail.com) is a psychiatrist, psychotherapist, and executive coach for life science leaders on agile, entrepreneurial, and mindful leadership with Heruka Lifescience and Health Innovations. He also is a creator of 4-H States of Wellness (SWELL)® Self-Care and LEO (Leader, Employee, and Organization) ResilienceTM training.