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At SIG, we work with a cohort of participants and residents with very complex needs. This requires our staff to have very robust personalities or to be well trained to handle the many complex issues which they manage daily. Dr Brett Greller spoke with us about his company’s support of SIG through facilitation of Reflective Practice sessions, what it is and its benefits.

SIG introduced Reflective Practice for all staff teams in 2019 as a follow up to their training in Psychologically Informed Environments (PIE) and Trauma Informed Care, which started in 2016. Reflective Practice is deemed to be a cornerstone of PIE.

Reflective practice is an activity where a group of people come together in a protected and confidential space in which they can think about and reflect on their work. It’s aims are:

• To create a confidential space in which participants can reflect on the emotional impact of the work, including the tensions inherent in working with people in distress and with high levels of need.
• To provide an opportunity to present client work from participant’s caseloads and to provide a framework to think about the work, and the interaction between staff and clients, the organisation, and the wider societal context.
• To share good practice and positive outcomes regarding participants who staff are struggling with.

Reflective Practice helps staff to regulate their emotions, exploring concepts such as burn out and how to work with burn out and moral injury. Reflective practice does not take away pressures but helps staff to recognize what they are and that they exist and, that it’s understandable that they feel the way they do. It is an emotional support for people and can be educative in terms of finding different ways of working with clients. It leads to an increased sense of self efficacy and self confidence in staff and its key elements include:

As people become better at reflecting on their practice, with time they become better at reflecting in practice. (Donald Schon 1983 ‘The Reflective Practitioner’)). According to the BGPS website, the benefits of reflecting in groups are:

• It prevents isolation
• It prevents burnout
• It offers different perspectives
• It develops our understanding of practice
• It helps us to be creative
• It prevents stagnation
• It helps us process our emotions
• It helps us question our assumptions
• It helps us cope with stress and build resilience
• It reduces absenteeism and presenteeism.

In a much broader sense, research demonstrates that organisations that have Reflective Practice in place has less incidences of sickness, less presenteeism, greater reported wellbeing and less turnover.

SIG’s Reflective Practice sessions are facilitated by BGPS as it is important for them to be led by a trained facilitator. Our sessions are scheduled for the same time every month – 90 minutes for every service.

Post-incident debriefs

When very serious incidents occur, BGPS are requested to conduct post- incident de-briefing sessions. They offer psychological debriefings with the teams and one-to-one support for those who need it. Debriefings allow staff to find a shared narrative of what happened and support each other.

Purpose of the post-incident debrief

• Debriefing is specific technique designed to assist others in dealing with the physical

or psychological symptoms that are generally associated with exposure to traumatic incidents.

• Debriefing allows those involved with the incident to process difficult elements of the event, reflect on the personal meanings and come up with a shared team narrative.

on its impact.

• The space , allows for the ventilation of emotions and thoughts associated with the crisis even, without fear of blame or judgement.
• Ideally, debriefing should be conducted where team members feel safe and will be undisturbed by the activities at the project.
• Debriefing should take place as soon as possible after the event and where possible within one week. Arrangements should be made to ensure all staff working at the project where the incident took place, can attend.  (https://bgpsych.com – Post-Incident Debriefs – guidance – 2022[BG1] )

The largest emerging theme from the evaluation of Schwartz Rounds – a group reflective practice forum for clinical and non-clinical professionals to reflect on the emotional aspects of working in health care, concluded that for participants, it was a relief to be able to express negative emotions around patients and care situations, in an accepting, validating and non-judgemental environment. November 2011 b. Participants commented on how the Rounds had helped them feel able to express both negative and positive feelings they held towards the service users under their care. Another theme emerging from the study was how enlightening, helpful, and validating it was to listen to perspectives from colleagues across the service and to realize that they held similar emotions and experiences in common. In particular, participants felt relief and deshaming when sharing negative emotions and distressing experiences and realizing they had felt and experienced similar emotions, thoughts, and motivations. (The Schwartz Centre Rounds: Supporting mental health workers with the emotional impact of their work Deborah Allen et al)

As the number of incidents across the social care sector have increased in recent times, it has become increasingly difficult for staff to manage. It is not unusual for ambulances and the police not to show up when called or for people in crisis to be rejected by CMHTs and social services. These can be directly linked to our collapsing social care system. This means that it is vitally important for services to have the tools and support needed in a crisis. ‘Improving healthcare professionals emotional support at work is an important objective to contribute to their well-being, resilience, and, ultimately, patient satisfaction.’ International Journal of Mental Health Nursing (2020).

The Social Interest Group will continue to provide staff with the training and support needed to be effective in their roles and most importantly, to provide the best care possible for Participants and Residents.

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