‘We can support the engagement of the wider community to develop solutions…’

Ella Rhodes reports on the British Psychological Society's efforts to provide support and guidance around coronavirus.

In the last issue of The Psychologist we reported on the many activities of the British Psychological Society Covid-19 coordinating group. Ella Rhodes caught up with some of the lead members of its workstreams to see how the focus has shifted as we progress further into the pandemic – and perhaps towards a new normal.

Isolation and confinement
The Effects of Isolation and Confinement group has already published 14 pieces of work, including blogs about the needs of young offenders and refugees, two videos on the importance of play, guidance for schools which are re-opening on using psychological perspectives to encourage re-engagement, advice for key workers who have isolated themselves from their families, and guidance on how to support care-experienced children.

The group, led by Vivian Hill (UCL Institute of Education) and Glasgow City Council principal educational psychologist Alison Crawford, is also set to publish a number of other documents, including one on coping and building community resilience within schools.

Hill told me the group is also working on a paper discussing the psychological effects of lockdown on all of those who are shielding and their loved ones. ‘The other thing that we continue to work on is the social, emotional and mental health needs of children and young people. We’re acknowledging that their mental health needs, at this point of slow reintegration into school, is the initial level of response… but we’re likely to see, over time the medium term and longer term mental health consequences for those young people and their families. We are ready to work in partnership with schools and communities to address these needs as lockdown eases.’

The group is also continuing to look at the disproportionate impact of the pandemic on certain populations including those living in poverty, in overcrowded homes and the BAME community. ‘The pandemic has served to highlight the impact of social inequalities and helps to identify the levels of intervention that are needed going forward. This coincides with the BPS policy team’s focus this year on moving from poverty to flourishing. As we mentioned in our back to school paper we’re very concerned about the impact of digital poverty and making sure that all children and young people have access to, not only internet, but devices to work on. We acknowledge that easing lock down poses greater risks to some communities and that we need to work closely with them to understand their concerns and to develop specific tailored responses.’

Hill said her work with the group had been an ‘utterly unique’ experience. ‘I think what it has helped us to see is the value that psychology and psychologists can bring in times of stress, where there are high levels of uncertainty we can support the engagement of the wider community to develop solutions. What I have particularly enjoyed is working with other psychologists who work with different ages, different populations and a different focus to see the impact psychology can have at individual, group and community levels.’

Working differently
Chair Elect of the Division of Occupational Psychology, Janet Fraser, has been leading the Working Differently group in producing resources for organisations and workers as lockdown eases. They recently released a document outlining how employers and employees can prepare for the ‘new normal’ at work – suggesting employers should engage with employees, address their expectations and provide practical support. They are also about to publish advice to help people upskill, and future-proof their skills, in response to different ways of working; guidance for professionals supporting young people transitioning into work given the pandemic’s potential impact on youth unemployment; and advice to help employers and employees deal with distress and anxiety about returning to  workplaces.  

For those people who are still working from home Fraser and the group have created guidance for healthy and sustainable homeworking based on the ‘SHARE’ approach – Safe homeworking, Help yourself and others, Adapt to change, Relieve the pressure and Evaluate. Some of their key recommendations include adopting a flexible approach, good communication and taking steps to develop and maintain work-life balance.

Their most recent publication, aimed at those exposed to traumatising or distressing material, gives a step-by-step guide for organisations whose employees may be at risk of vicarious trauma while working from home. The guidance, ‘Taking trauma related work home – advice for reducing the likelihood of secondary trauma’, is based on five Rs – recognise, review, respond, refresh, respect – to help employers fulfil their duty of care to their employees. Fraser said it was a privilege to lead the group’s work. ‘The group’s commitment is outstanding and we all want to help by using psychology to make a difference in the Covid situation.’

Adaptations
In a similar vein the adaptations workstream has turned its attention to supporting psychological professionals back into the workplace and in working from home. Led by Consultant Lead Clinical Psychologist and chair elect of the Division of Clinical Psychology (DCP) Dr Roman Raczka, the group has issued advice on safety considerations for psychological professionals returning to the workplace.

The adaptations group has also released guidelines to support psychological professionals in completing psychological assessments, such as cognitive tests and questionnaires, remotely. The authors suggested considering several factors prior to using remote assessment including the accessibility, security and privacy of using remote assessments, maintaining confidentiality and the impact on a client of postponing or cancelling an assessment or adapting the method of conducting an assessment.

Raczka and his colleagues will also soon be publishing advice on using interpreters via online and videoconferencing approaches. They have also set up a sub-group to work on a document which will explore the dilemma of providing face-to-face therapy vs not providing therapy when remote working is not possible.  

The DCP Digital Healthcare sub-committee, of which Raczka is a member and co-author, have produced two guidance papers – Top-Tips for Video Therapy - Adult Patient Version as well as guidance for supervisors Digital Adaptations to Supervisions and Observations – which will be online soon. This sub-committee has also developed Digital Competences for Clinical Psychologists and Psychological Practitioners in IAPT (https://www.digitalhealthskills.com/) which will be used to inform training curricula and CPD.

Behavioural science and disease prevention
The behavioural science and disease prevention group is led by Dr Angel Chater (University of Bedfordshire), and has recently published a document on the Covid-19 tracing app. ‘Our group aims to bring to the attention of policy makers and communicators the things that they “don’t know they don’t know”, specifically around the determinants of human behaviour. With this, we hope to build capacity to use, or at the very least, consider, behavioural science in the prevention of infection and disease management during Covid-19.’

The recent document on behavioural science perspectives on the digital contact tracing app for Covid-19, led by Professor Madelynne Arden (Sheffield Hallam University), considers elements of behaviour which could have an impact on the app’s success. For the app to work people need to do four things – download the app, carry a working phone at all times, identify and report virus symptoms, and self-isolate if necessary. The authors pointed out that people would need sufficient capability, opportunity and motivation for those behaviours to occur.

The authors outlined some of the numerous barriers and facilitators for those behaviours including having knowledge of the app and what it is for, being able to identify Covid-19 symptoms, concerns over data use and privacy, and concerns about outcomes such as being told to self-isolate. The authors wrote that there was an urgent need for researchers and policy makers to address what the barriers and facilitators were for each app-related behaviour and how these differ by occupation, gender, socio-economic group, ethnic group, disability, age and level of risk for developing severe Covid-19.

The group is currently working on guidance for behaviours that may have been impacted on by Covid-19, while not being directly related to the disease, but may lead to further public health issues. Some of those behaviours include physical activity and sedentary behaviour, nutrition, substance use, sleep, and health-service use.

Diversity and Inclusion
Diversity and inclusion champion for this Covid-19 work, Layne James Whittaker – who is also a member of the BPS Diversity and Inclusion taskforce – has been advising the ‘working differently’ workstream on considerations it should take on people from BAME groups returning to work. She said she could see potential gaps in returning to work for the BAME community, particularly regarding possible anxiety about returning to the workplace due to a higher risk of dying from Covid-19. ‘There are also concerns that employers will have additional health and safety risks when their BAME staff return to work because of this [increased risk]. There is a fear of the possibility of a loss of job or not being hired because of the risks.’ James Whittaker added that the BPS Diversity and Inclusion Taskforce had recently discussed the anxieties that key workers may have about being viewed as lesser-skilled again once things return to some degree of normal.

‘One concern about returning to work after all these changes due to Covid-19 is Diversity and Inclusion, and the possibility that issue will be pushed aside when returning to work. There will be anxieties for a lot of groups of people that may need their employers to make sure they continue with their reasonable adjustments when returning to work. It will be important that disabled people have that extra support.’

Also a British Sign Language interpreter, James Whittaker has been helping the Working Differently workstream to consider upskilling for disabled people and disadvantaged groups. ‘I was asked to be involved in that so I could give more details on how this may impact those with Deafness. I have also made some suggestions with the working with interpreters subgroup of how best to work with British Sign Language interpreters remotely, I have sent over some tips and guidance that we use in our profession.’

Bereavement
Since our last edition the bereavement workstream, led by Professor Nichola Rooney, has been busy producing guidance on coping with the death of a colleague, death and grieving in a care home, continuing bonds and videos on digital legacies and saying goodbye online. Find more on the bereavement group’s work from Rooney, as well as more insights into those working regularly with grief and loss, in our summer edition.

Rehabilitation
The work of the psychological care and rehabilitation of patients group, led by David Murphy and Dorothy Wade, is now well into the implementation phase. NHS England guidance released in June cites the BPS guidance and Murphy has been representing the group on a national taskforce commissioned by NHS England to produce a public facing information website and a web-based multi-disciplinary rehabilitation package, which it is hoped will be available to support NHS services across all four nations.

Staff wellbeing
The staff wellbeing group has completed work focused primarily on actute hospital staff, but is continuing to consider wellbeing of psychologists and occupational health staff. The group’s co-lead Dr Julie Highfield has recently been appointed as National Director for Wellbeing for the Intensive Care Society [we hear from her in the summer edition].

David Murphy, who is continuing to chair the Coordinating Group as he moves from the President to Vice President role, reflected on the process behind the phenomenal impact the group has had, which he also focused on in his presidential address. ‘To have achieved so much in a relatively short space of time really has been remarkable, particularly as the BPS had been relatively late out of the blocks. We’ve agreed to take time to reflect on what helped the process and what could have been better, for our own benefit but also to contribute learning to the Society going forward. For me, the keys have been starting by mutually agreeing a shared purpose and ways of relating of working together, bringing members and staff together from across different silos, and providing the support they need.’

Find all the resources mentioned, and more, at http://bps.org.uk/coronavirus-resources

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