By Elizabeth Jenkinson with contributions from Richard Cheston, Christine Ramsey-Wade, Catherine Warner, and Adam Kishtainy
Covid-19 has presented challenges in the maintenance of good psychological health and well-being for all of us. As a consequence, the role of practitioner psychologists and therapeutic professionals in society has never been more vital. The Promoting Psychological Health theme of the Psychological Sciences Research Group here at UWE, Bristol includes Academic and Practitioner psychologists and those in training through our British Psychological society accredited Masters as well as our HCPC accredited Masters and Doctoral training programmes. This includes Health Psychology, Counselling Psychology and Music Therapy. Throughout the pandemic, we have mobilised our community of practice to respond directly to the challenges of Covid-19, applying our psychological knowledge and skills using psychologically informed approaches. Our insights have been applied across research, policy, consultancy and therapeutic practice.
Health Psychology and Covid-19
Our Health Psychology team led by Dr Liz Jenkinson are part of the Health Psychology Exchange project, a collaboration of UK Health Psychologists providing consultancy around COVID-19. The UWE team and Professional Doctoral students such as Natalie Garnett and Ella Guest have been pivotal in three rapid reviews exploring the effectiveness of public health messaging and interventions in driving health behaviours during pandemics, and in the development of guidance to local and national health organisations. Two of these reviews have already been developed into British Psychological Society guidance and are now informing Public Health efforts to communicate effectively with the public, particularly around vaccination. For example, our review examined existing research which measured public responses to health messages encouraging vaccination against infectious diseases in a pandemic or epidemic. We concluded that evidence suggests that in order to be effective messages need to be credible (from trusted official sources), use community-wide outreach and mixed methods, frame risk appropriately (rather than over or understating), be tailored to be personally relevant, short and highlighting the benefits of vaccination to society as a whole rather than to the individual. One key finding was that previous research and practice did not include the voice of those under-represented groups who are often least likely to uptake a vaccine. The review recommends co-production with communities in the design and dissemination of messaging to ensure they are acceptable and accessible. We are pleased to see that recent efforts have been addressing this, and that our work has been reaching a wide audience through initiatives such as Evidence Aid.
Dr Liz Jenkinson is also member of the British Psychological Society Behavioural Science and Disease Prevention Taskforce Health Behaviours Sub-group. Together with a team of Professional Doctorate in Health Psychology trainees including Shanara Abdin and Shenede Coppin, they have played a leading role in the development of guidance for public health officials in supporting health promoting behaviours such as sleep, stopping smoking and limiting alcohol consumption during Covid-19. Details of this work so far is featured on the UWE Covid-19 blog. The success of these roadmaps has led to the team working on a further set with the British Psychological Society around access to healthcare, adherence to medication and opioid prescribing.
Many of our health psychology trainees are also working on the frontline of the pandemic. From delivering vaccinations, to helping clients stay healthy during lockdown through to working in our local hospitals with clients with health conditions such as diabetes, pain and long term conditions, and now ‘Long Covid’, we are very proud to continue to supervise and support our trainees as they deliver this vital work at this difficult time.
Ageing Well in Older Adulthood
The pandemic has impacted disproportionately on older people with dementia – especially those living in residential care. PSRG members have contributed to building evidence in how best to support this vulnerable group during Covid-19. Prof. Rik Cheston and Emily Dodd carried out a survey of NHS staff to look at how the pandemic had impacted on their ability to deliver the LivDem intervention. This showed that none of the NHS trusts had established plans to reintroduce the course, and that there was widespread interest in developing an online intervention instead. Consequently, they hosted a webinar attended by a dozen clinicians in the UK and Ireland to identify best practice. In January, Emily and Rik hosted two online ‘taster’ sessions for LivDem which were attended by 60 clinicians based in the UK or Ireland. The team plan further introduction sessions for Clinical Psychologists in Yorkshire and Humberside, with intensive LivDem training to be rolled out through 2021 facilitated by Higher Education Innovation funding. Rik also contributed to an ARC West rapid review of the evidence base to identify effective primary preventative and secondary reactive approaches for staff to use when caring for people who walk with intent but are unable to leave residential care.
Counselling Psychology and online therapy
The challenges of the pandemic have presented unprecedented demand for therapeutic psychological support. Our counselling psychology staff and trainees had to swiftly pivot last year to providing some or all their clinical interventions online in line with government restrictions. This includes members of the teaching team working in private practice, and students working on placements, such as NHS departments and mental health charities such as Nilaari which provide culturally appropriate counselling for clients from the BAME community. This has created many unforeseen challenges – for example, how best to work with clients remotely. Video calling platforms may provide one solution but staff and students working with adults and young people have found that providing psychological therapy over the telephone can sometimes be more accessible than video calls over the internet, for example, as some clients struggle to access a safe and confidential space in their own home.
Senior Lecturer Christine Ramsey-Wade from the counselling psychology doctorate team has also been finding solutions to the challenges of delivering trauma-focused interventions remotely, such as Eye Movement Desensitisation and Reprocessing. These interventions are needed now more than ever, so some rapid research is being carried out into how best to translate these more physiological or experiential therapies online with Christine collaborating with EMDR UK on a new externally funded research bid to further investigate the effectiveness and client experience of different forms of EMDR when delivered online.
Music Therapy in education settings
Covid-19 has impacted the mental health and well-being of students at all stages of their journey through education. Adam Kishtainy, lecturer on the music therapy programme and lead for the music therapy clinic at UWE, is supporting two final year Masters students, Laura Wilson and Luke Howell, to run a music and wellbeing group at the UWE Centre for Music led by Kat Branch on the Frenchay campus. The music group makes use of active vocal and instrumental improvisation approaches, directly from music psychotherapy practice, as well as relaxation using music to encourage people to express themselves creatively and reflect on any mental health issues they are experiencing at the moment. Students from any programme can self-refer to this group. This team aim to provide a safe space to address immediate well-being issues through dynamic music making at this difficult time.
Adam is also running an outreach project, as part of the Glenside Clinic, in Bristol Metropolitan Academy and Briarwood Schools, taking in 6 of the Year 1 music therapy trainees on placement and delivering individual music therapy for their students. These schools have limited resources for psychological support and the opportunity to provide additional support for students at such a difficult time has been hugely appreciated.
PSRG psychologists and practitioners have risen to the challenge of Covid-19. We mobilised our community of practice to apply our psychological knowledge, skills and therapeutic approaches to promote good psychological health and well-being for our clients, through our research and through policy, consultancy and practice. Further challenges lie ahead, but the contribution of the psychological professions is clear. Psychology is front and centre in responding to the challenge of Covid-19.