Search results

The purpose of this study is to outline a process-oriented psychology informed view of the impact of ever-increasing acuity within an adult inpatient system and conceptualise how an integrated therapies team (ITT) can work with the chaos that this brings.

A reflective scientist-practitioner based approach was used over a two-year period.

Several factors lead to “chaos” in an inpatient unit, including societal inequality, the trauma and adversity it creates and the impact of this at a systemic, interpersonal and intrapersonal level. Chaos is one means of coping and can dominate inpatient working, whereas understanding the underlying distress is often marginalised. Developing an ITT can support working with chaos. The ITT holds the therapeutic perspective for the wider multi-disciplinary team (MDT) and therapeutic and facilitation skills are central to how it operates. Processing the chaos and working with the underlying distress is its overarching function.

Developing an ITT offers a robust structure for evolving inpatient MDT working to cope with increasing acuity in a psychologically informed way.

The chaos in question is often viewed as patients’ issue but from a collectivist perspective it is something that all members of society are responsible for.

To the best of the authors’ knowledge, this is the first paper to conceptualise the chaos on an inpatient ward as a process needed by the system as a way of coping and propose the addition of an ITT to inpatient working.

This paper aims to outline the process of supporting frontline inpatient mental health staff in developing ways of coping with COVID-19.

A whole system approach was used in formulating and developing support structures with particular focus on relationship-focused coping.

Interventions were developed to support staff in coping with problem-focused (e.g. systemic changes) and emotion-focused challenges (e.g. deaths of colleagues). These included psychoeducation, mindfulness-based meditation and rituals to mark the deaths of colleagues. Staff SPACE (Stopping to Process and Consider Events) sessions were used to support staff in managing the many emotions they were experiencing. Positive psychology-based interventions were used to keep morale up and help people to stay motivated. The process of seeking feedback and making changes was introduced to support staff in feeling heard and having a voice. The maternal or master intervention within each of the above was the relational component.

This work aimed to boost the emotional and psychological literacy of the system. This will be important in the aftermath of the pandemic and could have many benefits thereafter.

The post-COVID-19 health-care workforce will experience significant challenges in terms of readjustment and recovery. It is important that appropriate measures are put in place to ameliorate this.

An innovative systemic formulation of the impact of COVID-19 on frontline staff, and a coordinated way of dealing with this, is outlined.