ACP-UK Rapid Response: Guidance for Clinical Psychologists in Mitigating the Impact of COVID-19 at Work

  • March 2020

  • Dorothy Frizelle, Director of Membership & Member Services

The following information is provided to help Clinical Psychologists prepare for and manage the threat of COVID-19 in their work and workplaces. As clinicians we have knowledge and skills that can help support the system now and also in the longer-term when the impact of a global pandemic on our collective psychological well-being may be realised. However, we also have to be considered and mindful in counterbalancing our professional responsibilities and feelings of moral obligation to contribute to the collective effort, with our own safety and physical and psychological well-being.

It is not the intention of this brief to prescribe how colleagues should or should not behave; we work across such diverse populations, systems and with so many communities of people that it would not make sense to do so. Rather, this brief is aimed at supporting colleagues in managing the balance (and the inevitable tensions) that will arise from wanting to protect the vulnerable, support the system and reduce risk Vs. worries and concerns related to a period of high work demand and change to normal activity both at work and at home.

We have developed this brief within the overall frame of ‘collective psychosocial resilience’ described by Drury et al, 2019 in their work related to public emergencies. Being aware of how to mitigate against threat to self as well as others, and counter-balancing this with our professional and moral obligation to ‘make a difference,’ may help Clinical Psychologists not only maintain their own resilience but also contribute to the capacity of colleagues and the people and communities we serve to remain resilient during uncertain and challenging times.

The brief is divided in to three main sections under the over-arching theme of collective psychosocial resilience. These are: responsibility to others, responsibility to self and managing professional (moral) obligations. The ideas and suggestions are not an exhaustive list and indeed we would encourage you to share other ideas across our community by writing a post for the ACP-UK website and sending it to [email protected] or interacting via any of our social media outlets (our Twitter handle is @UK_ACP and you can find us on Facebook and Instagram).

COLLECTIVE PSYCHOSOCIAL RESILIENCE

Responsibility to Others Responsibility to Self Professional (and Moral) Obligation
Seek advice from Infection Prevention colleagues on how to promote hygiene and reduce risk of infection within your unique work space Are you clear on how you self-care?

  • Use supervision to explore if self-care is a challenge
  • What can you continue to do to self-care even if activity is restricted and/or demands at home are higher?
 Are you personally and professionally clear on what you are prepared to do/not do in the event of escalating infection severity?

  • Use supervision to clarify this and make implicit personal and professional beliefs, explicit
  • Are you clear on the limits of your competencies and what you are able and prepared to do/not do in the event of redeployment?
Create a physically safe space at work:

  • Use of hand sanitisers
  • Signs to remind about hand-washing
  • Easy accessibility to latest and most up-to-date information
 Utilise evidence-based models to manage own anxiety/perceived threat; for example

  • CFT 3 Emotional Regulation systems – what system am I currently in and how is it impacting my decisions and behaviour?
  • Solution-focused – what are you doing well at the moment? How would you like things to be – now, next week, next month? How can colleagues/friends or family be helpful to me?
 Are you clear on what is required and expected from you by your organisation?

  • Review your Job Description and contract of employment
  • Meet with your service and line managers to agree and discuss in advance any redeployment plans
Create a psychologically safe space at work:

  • If you lead services, model care and compassion
  • In advance, discuss and agree with colleagues that distress, worry, anxiety and fear is an understandable and human response to threatening events
  • Ensure colleagues feel supported in being able to talk about worries and concerns – who can they speak with? Is there a reflective space?
  • Ensure colleagues who may be experiencing dissonance between commitments to service vs. responsibilities at home (e.g. childcare, fear for vulnerable family etc.) have opportunity to discuss these concerns and optimally resolve them in collaboration with colleagues
 Utilise mindfulness and/or other competencies to help manage emotions

  • Decision-points related to helping others vs. helping self may be easier if we are clear in advance of our values and how they may conflict
  • Mindful attention to own well-being – both physical and psychological may help with preventing exhaustion or burn-out
 As Clinical Psychologists we know that language matters and can feed in to stigma around a threat

  • Avoid terms such as ‘victim’; ‘carriers’, ‘infected’ etc.
  • See Drury et al (2019) for additional information on the power of facilitating a shared identity in groups
  • Review literature related to how stigma can sabotage social cohesion and promote ‘othering’ – what language are you using in relation to COVID-19 in your clinical work and in your service?
Develop a service ‘action plan’:

  • How will you communicate with service-users?
  • How can the service continue in alternative forms?­­ (e.g. telephone or online consultations)
  • Do you have a plan for managing caseloads and/or commitments in event of high levels of service sickness absence?
  • Do you have a plan for agreed operational cover?
  • Do you have a colleague communications plan set up in event of the necessity of social isolation?
  • What are the key roles in order of priority that need to be covered in event of staff shortages?
  • Undertake a caseload review and ensure mitigating action plan(s) for high risk service-users/groups
  • Ensure you/service is clear on your host organisations guidelines and requirements related to governance and confidentiality of notes and/or other information that may be required at home Vs. work
  • Check organisational guidelines regarding telephone and/or video and/or other forms of service-user contact
  • Ensure you have the necessary equipment (laptop, tablet etc.) and/or programmes or Apps to facilitate remote working
  • Share information and tips on managing anxiety with non-psychology colleagues
 What support can and do you access? How can you ensure this is available for you over the coming weeks? What steps will you take to ensure you ask for, access and receive good social and relational support?

See a recent article in the Lancet by Brookes and colleagues (2020) on the psychological impact of quarantine

Access ACP-UK website and other social media forum to make contact with colleagues

 Review literature and evidence-base related to impact of threat on psychosocial wellbeing; more specific ‘threats’ from COVID-19 include:

  • Risk of contracting the virus or passing on to others
  • Confusion between existing physical/psychological health ‘symptoms’ and overlap with COVID-19 symptoms e.g. fever
  • Impact of concerns related to childcare, care of elders etc.
  • Increased risk to vulnerable populations e.g. people who are homeless, people with concomitant immune-supressed health conditions and/or undergoing immuno-suppressive treatments such as chemotherapy
  • People with pre-existing fears related to contracting illness, hygiene, hand-washing, death or dying etc
Review if you/your service is able to provide support to frontline colleagues:

  • How can they be supported should they experience stigmatisation?
  • How can they be helped to manage long shifts necessitating high levels of attention and vigilance?
  • How can they be supported should they experience fears and/or distress?
 How do you cope? What do you need to support you to optimise your coping style and strategy?

  • Are you a ‘minimiser’? [Prefer not to have a lot of information]. If so, how can you maintain up-to-date knowledge and understanding of Government requirements whilst at the same time not leading yourself to feeling over-whelmed?
 Remembering to work in alignment with group norms and to be culturally and religiously sensitive

References

Drury, J., Carter, H., Cocking, C., Ntontis, E., Tekin Guven, S., & Amlôt, R. (2019). Facilitating collective psychosocial resilience in the public in emergencies: Twelve recommendations based on the social identity approach. Frontiers in Public Health, 7 (141). Access online 

Brooks , S.K., Webster, R.K., Smith, L.E., Woodland, L., Wessely, S., Greenberg, N., Rubin, G.J. (2020). The psychological impact of quarantine and how to reduce it: rapid review of the evidence. The Lancet Online rapid review, 395 (10227), pp. 912-920. Access online

World Health Organisation: Mental Health Considerations during COVID-19 Outbreak. Access online