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Publication Acceptance and commitment therapy based psychological skills training for oncology and palliative care staff(2020-02-20) Banwell, Lizzy; Inman, Lucinda; Huish, Ellen; Raynes, Jonnie; Olivia, Donnelly; Savory, Sue; Osborn, Mike; Jenkins, Kate; Pollock, Jennifer; Lewis, Paul; Worswick, Louise; Savory, Sue; Additional Professional Scientific and TechnicalBackground: NICE Oncology and Palliative Care (2004) guidelines outline a four-level model of psychological care. Level 2 comprises staff training in patient psychological assessment and intervention, with ongoing psychological skills supervision. Developments in therapeutic support within physical health settings include using third wave approaches, e.g. Acceptance and Commitment Therapy (ACT) which increases psychological flexibility and values-based behavioural changes. Prior to the current project, no Level 2 training drawing predominantly on ACT was being delivered across the SWAG region. Aims: To support staff to improve the personalised care of patients with mild-moderate psychological distress by delivering Level 2 psychological skills training to oncology and palliative care staff within seven of the SWAG cancer alliance Trusts by March 2020 and to develop a sustainable model for future use. Methods: Nineteen, 2.5 day training courses delivered to ~200 staff members across SWAG between February-December 2019. Evaluation data was drawn from quantitative confidence and knowledge ratings (adapted from Jenkins et al., 2010), and qualitative evidence of impact on clinical practice. Results: Staff reported a significant increase (p < 0.001) in knowledge and confidence to support patients experiencing psychological concerns post training. This significantly increased (p < 0.001) by one month follow-up. Qualitative data indicated staff felt better equipped to provide personalised care to patients, drawing on ACT-based interventions. Conclusions: Preliminary data indicates this training is effective in improving Level 2 staff knowledge and confidence supporting patients experiencing mild-moderate psychological distress. Six month follow-up data (available January 2020) will provide evidence of development of knowledge, confidence and use of Level 2 skills in practice.Publication How might the evidence from group interventions of compassion focused therapy for shame and self-criticism be applicable to the treatment of self-harm(The British Psychological Society, 2022) Lawson, Amy; Lawson, Amy; Allied Health ProfessionalPurpose Treatment for self-harm remains limited despite research indicating the need to address underlying functions (Slee et al., 2008). Shame and self-criticism are pathogenic processes linked to self-harm (Gilbert & Irons, 2005) therefore CFT (compassion focused therapy) which is designed for shame and self-criticism could be an effective treatment. Method This review aimed to synthesise the literature on group based CFT for mental health difficulties with underlying shame and self-criticism and conceptualise how CFT group treatment could be effective for self-harm based on evidence from the papers. A systematic literature search was undertaken and 11 papers were reviewed according to the inclusion criteria which limited references to peer reviewed journal articles in English, from the year 2000 and those pertaining to group based CFT in adult clinical populations. A thematic synthesis was conducted after applying some key questions to the papers. Findings Four key themes emerged from the thematic synthesis and were discussed with reference to questions around the effectiveness and acceptability of group CFT for addressing shame and self-criticism. The themes were, ‘moving from self-criticism to self-compassion’, ‘aversion to compassion’, ‘group process’ and ‘skills development’. Discussion Evidence from the papers around CFT group interventions were discussed with reference to their application to the treatment of self-harm in terms of building affiliative connections with others and the development of compassion as an adaptive coping mechanism, decreasing distress and reducing the need to engage in self-harm.Publication Evaluation of a compassionate mind group for self-harming behaviour within a secondary mental health service(The British Psychological Society, 2022-12) Lawson, Amy; Lawson, Amy; Additional Professional Scientific and TechnicalObjectives This service evaluation study aimed to evaluate a pilot Compassionate mind (CM) group for self-harming behaviour with participants experiencing mental health difficulties who struggled with shame and self-criticism. Methods The study was a within-subjects design using pre and post measures for five participants attending a 20 session CM group in a community mental health setting. Validated self-report questionnaires were administered before and after the group intervention and evaluation feedback questionnaires were given at the end of the group. Results The data were analysed using descriptive statistics and the non-parametric Wilcoxon signed rank test. There was a significant increase in ratings on the Self-compassion scale (SCS) (z=2.023 p<.043), a significant decrease in the depression (z=−2.032 p<.042), anxiety (z= −2.060 p<.039) and stress (z= −2.032 p<.042) subscales within the Depression Anxiety Stress Scales (DASS), a significant decrease in The Other as Shamer Scale (OAS) (z=−2.023 p<.043) and decreases in impairment in functioning as measured by the Work and Social Adjustment Scale (WSAS) (z=−2.023 p<.043). There was also a significant increase in reassured self (z=2.032 p<.042) and significant decreases in the inadequate self (z=2.023 p<.043) and hated self (z=2.070 p< .043) domains on the Forms of Self-Criticising/Attacking and Self-Reassuring Scale (FCSRS) and in the self-persecution (z= −2.023 p<.043) and self-correcting (z=−2.023 p<.042) domains on the Functions of Self-Criticising/Attacking Scale (FSCS). Results should be interpreted with caution given the small sample size. Conclusions This study provides preliminary evidence that the pilot CM group for self-harming behaviour has a beneficial impact for participants around reductions in shame and self-criticism and increases in self-compassion, resulting in reductions in self-harm. Limitations, recommendations for improvement and future research are discussed.Publication Experiences of Social Isolation for First-Time Mothers with Pre-existing Anxiety During the COVID-19 Pandemic: An Interpretative Phenomenological Approach(Association for Prenatal and Perinatal Psychology and Health, 2022) Haselhurst, Jessica; Heyes, Jo; Carty, Stephanie; Carty, Stephanie; Additional Professional Scientific and TechnicalThis study aimed to explore experiences of social isolation for first-time UK mothers with pre-existing anxiety during the COVID-19 pandemic. Six interviews were completed between July and November 2021. Interpretative Phenomenological Analysis revealed four superordinate and twelve subordinate themes reflecting experiences of new motherhood and social isolation during the COVID-19 pandemic, and their influence on mental health, coping, and accessing support. Findings contribute to the understanding of the experiences of this population during and beyond pandemic restrictions, with implications for how gestational parents are supported in the aftermath of the pandemic and similar future crises.Publication Improving the provision of emotional support for patients following major lower limb amputation(BMJ Publishing Group, 2024-10-14) Clapp, Joanne; Firkins, Ashlyn; Owen, Ray; Carty, Stephanie; Clapp, Joanne; Firkins, Ashlyn; Carty, Stephanie; Additional Professional Scientific and TechnicalMajor lower limb amputation (MLLA) is a lifesaving but life-altering surgical procedure. Psychological distress is common and typically heightened in the acute postoperative period. Despite the negative impact that poor psychological functioning can have on the health outcomes of this population, there is a lack of high-quality guidance outlining how to best support the psychological needs of individuals post-MLLA. The aim of this project was to develop practical and feasible interventions for improving the provision of emotional support for all patients on the vascular surgical ward post-MLLA. Adapted from the Holistic Needs Assessment Adversity-Restoration-Compatibility framework used within oncology services to provide holistic care to patients, the project included two key interventions. The primary intervention involved developing a model for an 'emotionally supportive conversation' (ESC), which was delivered by a member of the vascular surgical team under supervision of a Clinical Psychologist. During the 6-month implementation phase, 27 patients received an ESC, an average of 8 days post-MLLA. The secondary intervention involved training for vascular surgical ward staff, led by a Clinical Psychologist. This focused on raising awareness of common signs of distress, building skills and confidence in responding to distress and providing information on where to signpost patients for further support. Prior to the primary and secondary interventions, 43% of patients reported receiving sufficient information from hospital staff on how they would feel postoperatively and 57% stated they had received sufficient support from staff during their stay. Post-implementation, these figures increased to 86% and 71%, respectively. This project represents a novel, creative and cost-effective way for psychological services to add value to the quality of care provided to vascular surgical patients during the inpatient phase post-MLLA.