By Barbara Wren | August 31, 2023
Last Updated on September 7, 2023
Barbara Wren, Consultant Psychologist and Director of Barbara Wren Psychology, helped to develop a series of reflective groups to support social care leaders and social care staff deal with the emotional impact of working during the pandemic. In this article, Barbara shares insights from the groups and the highlights the need for safe spaces to aid recovery.
The impact of the COVID-19 crisis on social care staff has been profound and traumatic. The recent covid-19 inquiry has deepened our insight into what care workers withstood in the most terrifying of circumstances, and the context of uncertainty, confusion, and political hesitation within which they were required to provide care and keep their clients safe. How did they manage to persevere? What have been the personal and professional consequences? What was it like to lead and manage social care services at this time, to ask staff to put themselves in danger with so few certainties and to watch them bear the pain of losing much loved residents? What price have leaders paid for feeling torn between the need to keep the focus on caring for clients while worrying about the risks to staff? How much time have they had to process complex experiences that needed to be filed away to ensure the work got done? And what space have staff and managers had for recovery or resolution?
In my work as a psychologist, I have been heavily immersed in making sense of the psychological impact of the covid catastrophe on health and social care staff in order to design and deliver responsive psychological interventions to meet their different needs at each stage of the pandemic. I have written about this work for a chapter in a recently published book exploring the meaning of the COVID-19 pandemic[1]. In this writing I make the case for the vital need for facilitated safe spaces to process pandemic experiences in the interests both of personal and professional wellbeing and effectiveness, as well as systemic resilience.
Time for reflection
As we began to emerge from the COVID-19 crisis I was invited to provide psychological consultancy to the Keeping Well Service in South- East London[2], which was established to provide psychological support to health and social care staff. It was one of many national hubs funded by monies released to respond to realistic worry about the impact of the COVID-19 crisis on the mental health of these staff. As part of my work with this service I developed a series of reflective groups which were offered to social care leadership groups and social care staff.
The groups were championed by Margaret Sharpe, Locality Manager at Skills for Care, who supported them, generating huge interest and ensuring their success. All groups were held online in 2022 and early 2023 and were very well attended. Many staff initially came out of a sense of curiosity, unsure what to expect but left feeling grateful that their organisations had created these spaces and with a renewed sense of community and connection to each other, as well as greater self-compassion.
The aim of the groups was to create a safe and containing psychological space within which each attender could share their pandemic experience, explore the variety of individual and role challenges, describe how they had persevered and what had sustained them in this time, both personally and professionally. Each group lasted for two hours and began with a clear orientation toward reflection, (staff were encouraged to let go of any pressure to learn, problem solve or take responsibility for others) and an invitation to all attenders to reconnect to the human experiences that had been borne within a professional role. An overall aim of the groups was to encourage staff to now attend to these experiences, to give them permission to think and feel and to share memories. A striking outcome of the response to this invitation was the depth of emotion that was released that had previously been suppressed or denied. This had been necessary because staff had needed to stay on task and put others (their clients, their families, the staff they managed) first. However, what had been necessary in the crisis had become habitual.
A huge personal cost
At the end of each group staff consistently expressed their surprise at how much had emerged in the session, how useful it was to release it and how much of their experience was unprocessed. They became more in touch with how profoundly they had been affected and aware of the value of naming this. Each individual revelation or shared memory created permission in the group for other memories to be shared. Some of these memories were harrowing. They included the loss of many residents in one care home, the terror and fear of bringing infection home – which led some staff to stay in hotels away from families including young children – and the guilt and fear in leaders who had asked staff to take risks without certainty about their safety. One leader said, ‘I feel guilty just thinking about it, I haven’t been able to speak about it until now’. Another said, ‘We are all still grieving, the pandemic has changed work in ways that feel permanent’.
The groups were intensely poignant and profoundly moving to facilitate; not least because of the deep humility with which intense experiences were shared (there was a tendency to discount the magnitude of the suffering experienced and the sacrifices made) and the evident level of commitment to the work, and to individual clients despite the huge personal cost, and the cost to the families of staff members.
There has been no real recovery time in social care. As the crisis began to subside the collateral damage became apparent and services needed to respond with agility to their clients’ needs and quickly pick up work which had to be paused in the height of the crisis. But there has been collateral damage to staff too. Being able to design and facilitate these groups was profoundly meaningful and reinforced my belief that creating space for staff to regroup, recover and repair themselves in such turbulent times is vital to protect their future wellbeing and effectiveness and to ensure the sustainability of their work.
Visit the Skills for Care website for more information on support for leaders and managers. https://www.skillsforcare.org.uk/Support-for-leaders-and-managers/Managing-people/Wellbeing/Wellbeing.aspx
[1] Wren, B. (2023) Despair and Endurance: The experience of NHs staff during the Covid Crisis. In Brunning, H. and Khaleelee, O. (Eds) The Covid Trail, Psychodynamic Explorations. Phoenix Publishing House.
[2] This innovative service was led by Dr. Helen Winter, Consultant Clinical Psychologist at South London and Maudsley NHS Foundation Trust, and the social care work was led by her colleague Dr. Claire McGoldrick, Clinical Psychologist. The funding was discontinued in March 2023 and the service sadly ended in April 2023.