Society comes together while apart

In the last issue of The Psychologist we reported on the formation of a British Psychological Society Covid-19 coordinating group. In the short space of time since, the group, bringing together psychologists and senior managers from the BPS, led by President David Murphy, has produced more than 20 sets of guidelines, advice, webinars and videos. They cover a vast array of psychological topics relevant to the coronavirus crisis, across eight workstreams (with diversity and inclusion as a consideration across all of them). 

Behavioural science and disease prevention

Dr Angel Chater, a health psychologist and Reader in Health Psychology and Behaviour Change at the University of Bedfordshire, has been leading a workstream focused on behavioural science and disease prevention – bringing together psychologists from health, clinical, social, sport and exercise, policy and public health arenas. So far the group has produced guidance on behavioural science considerations relevant to public health strategies to prevent the spread of Covid-19, and offered volunteers from the health psychology workforce. This document has been shared with the Independent Scientific Pandemic Influenza Group on Behaviours (SPI-B) which feeds into the government's Scientific Advisory Group for Emergencies (SAGE), Public Health England, local authorities and Health Education England. 

Chater explained that the offer of voluntary expertise from health psychologists was being coordinated under a collective 'hive' called the Health Psychology Exchange which includes many members of the BPS Division of Health Psychology (DHP), managed by a small team including Chater, Dr Lucie Byrne-Davis (DHP Communications Lead) and Professor Jo Hart (DHP Past Chair). Organisations can be signposted to this by contacting the DHP with the subject title Covid-19 at [email protected]

Over the coming months Chater's group are looking into translational materials which may help local authorities and public health teams to use the guidance at a practice level, and are exploring potential issues in the future which may benefit from behavioural science input. 'One of our teams of volunteers have just completed a rapid review on the use of apps, both in relation to Covid-19 and other health behaviours that may be helpful to support future track and trace app development, uptake and engagement. Three of our taskforce are also members of the Psychological Government steering group, and so we are looking at further ways to support government… We will be hosting a webinar in due course to bring all of this work together.'

Staff wellbeing

Leading the staff wellbeing workstream, along with BPS president David Murphy, is Dr Julie Highfield – a Consultant Clinical Psychologist in Wales' largest Critical Care Unit in Cardiff. Highfield has been working with an expert reference group of 11 people which managed to produce BPS guidance on the psychological needs of healthcare staff, aimed at leaders and managers of healthcare services, over the course of a weekend. The BPS has been working with the NHS to influence the response at a national level and psychologists have been able to use this work to guide their local NHS response to the crisis.

The guidance includes ten recommendations for responding to the coronavirus crisis at the organisational, management and individual levels and points to some of the potential psychological reactions to the crisis, as well as what might be needed to help people recover psychologically. 'The guidance produced by the group were really well received,' Highfield said. 'I've had many people come back to me thanking me for the timely response, and the direction from the BPS. I think there has been a surge to action, and not all thought through. The guidance provided an evidence-based way of steering these responses.' The publication of this guidance was followed by a webinar on the same topic which was watched live by 1,300 people and was viewed over 12,000 times during the following week alone.

Adaptations

Consultant Lead Clinical Psychologist and chair elect of the Division of Clinical Psychology (DCP) Dr Roman Raczka has been leading a group tackling adaptations to psychological practice and training in our current state of lockdown and beyond. The group has been focusing on a number of key areas including professional practice, digital approaches, remote working, apps, social media, leadership, resilience and wellbeing, supervision, reflective practice, community psychology approaches, training, research and longer-term adaptations to practice.

Raczka, who has also been working on the DCP Covid-19 task force developing a strategy for clinical psychologists' response to the pandemic, has previously worked on the DCP's Digital Health Care sub-committee developing digital training standards and digital competencies for clinical psychologists. He said the BPS adaptations workstream aimed to support psychologists working across all sectors and areas of practice to adapt in facing the unprecedented challenges presented by Covid-19, while continuing to work in a way which was effective and professionally safe.  

The group has recently released Adaptations to Psychological Practice: interim guidance during Covid-19 pandemic a guidance document to support psychologists in adapting their practice to meet the unique circumstances created by Covid-19. It covers professional practice, working remotely, digital approaches, redeployment and wellbeing as well as longer term adaptations to practice. The group has also produced a webinar which includes tips for practitioners carrying out therapy via video. 

Diversity and inclusion

Layne James Whittaker has been working as the diversity and inclusion champion across all of the Society's Covid workstreams – highlighting areas where marginalised groups should be considered given the different impact Covid-19 has had, and will have, on such groups. As well as being a psychology undergraduate student at the Open University James Whittaker is also a British Sign Language (BSL) interpreter, and she has highlighted the importance of the deaf community having good access to information presented in BSL throughout the pandemic. 'The majority of the Deaf community are British Sign Language users as their first language, yet there has been no consistent BSL interpreters present for live announcements or daily briefings. All material that is released is not accessible in BSL. Deaf native BSL key workers may have also missed out on vital information as there has been no access via interpreters. Deaf patients, both native BSL users and those that do not use BSL but rely on lip-speakers and lip reading, will have no access once admitted to hospital if staff are unaware of how to contact the relevant companies to access BSL interpreters or lip speakers.' 

James Whittaker pointed out to the bereavement and confinement and social distancing workstreams that the BAME community may be facing increased fear and worry due to the recent, and disproportionate, increase in deaths of BAME people. She also said that guidance should consider those with different first languages who may be struggling to access information at present and language interpreters who will be under increased pressure at present – helping to deliver news on loved ones who may have died or helping comfort a person who is dying. While Covid-19 has thrown up many challenges for marginalised groups, James Whittaker said it had been an amazing opportunity to help. 'I feel really fortunate and privileged to be part of this, they are a great team.'

Effects of confinement

Educational psychologist Vivian Hill (UCL Institute of Education) and Alison Crawford, Glasgow City Council principal educational psychologist, have been leading a group considering the effects of confinement and social isolation. They told me a key focus of their work was on the impacts of lockdown on vulnerable groups.

The group has already produced guidance for schools ahead of their closure in late March, a document on resilience in teachers, advice for older people and people with dementia, and they are currently working on advice for children and young people with experience of being in care. Another key strand to their work, which will be published soon, is giving advice on transitions – for younger children moving from the family home into nursery or primary school, children going back to school and young people moving from school to college or university. Hill said she and the group were keen not to pathologise anyone who was struggling with the impact of lockdown. 'We've been keen to recognise that it's a completely adaptive response to an extraordinary, completely unprecedented, phenomenon which nobody really had chance to think about or prepare for.'

Hill said she thought cross-divisional working, bringing together the expertise of educational, health and clinical psychologists, had been very constructive. 'We're all learning together, we're all taking these initial steps forward together. The primary concern is to keep people safe and to save lives and as psychologists I think we've got a lot to say about supporting people's behavioural responses – when people are uncertain their behaviour is much more unpredictable, whereas when there is a degree of certainty about next steps and the ability to plan for them then I think we see a much better public reaction.'

Bereavement and care of relatives

The UK is on course to have one of the highest death rates in Europe from Covid-19, bringing with it many thousands of families experiencing unexpected deaths and grief. The nature of COVID also means that families will be unable to see their loved ones at the time of their death and won't be able to carry out normal rituals such as large funerals and wakes.

Consultant Clinical Psychologist Professor Nichola Rooney has been leading a group in creating a toolkit of resources for coping with grief. One of these resources, Supporting Yourself and Others – Coping with death and grief during the Covid-19 pandemic, gives advice on the emotions and behaviours which may result from grief, ways to cope and complicated grief – which describes a situation when people are unable to 'bounce back' after a bereavement. There is also advice available on talking to children about coronavirus, and plans to publish advice on advance care planning, death and dying in a care home, supporting staff who have lost a colleague to Covid-19, and adapted ways to carry out bereavement rituals after a death. 

Working differently

Janet Fraser, chair elect of the BPS Division of Occupational Psychology, and a group of psychologists from occupational, educational, clinical, health, counselling, sport and exercise, and health and safety practice, have been considering the ways the world of work has changed in recent weeks. The 'working differently' group is planning to produce guidance and podcasts covering remote working, furlough and redeployment, employee and manager wellbeing, and the transition to post-lockdown workplaces for employers, organisations, unions and employees. 

Fraser said people were experiencing lockdown working in both positive and negative ways. 'On the one hand they're avoiding the commute and have flexibility while working from home. On the other hand they might be experiencing cognitive dissonance – juggling different roles such as supervising home schooling while meeting work deadlines, attending virtual meetings and experiencing uncertainty. It's been ok for some but we need to remember that it hasn't been easy for many. There's been a lot of anxiety as well as huge inequalities. Making the transition to post lock-down working will throw up significant challenges and we need to prepare for this. We can also learn from adaptions to working practice during the lockdown and apply the lessons to the way we organise work in the future.'

Rehabilitation

President of the BPS David Murphy and Dr Dorothy Wade, a health psychologist who works in critical care (University College Hospital), have taken a focus on rehabilitation along with a group of experts. Their group includes clinical psychologist Dr Anne-Marie Doyle who also works in critical care, clinical health psychologists Dr Simon DuPont and Dr Dorothy Frizelle, academic health psychologists Professor Val Morrison and Professor Rona Moss-Morris, clinical neuropsychologists Professor Martin Bunnage and Dr Jessica Fish and Dr Hannah Murray – a research Clinical Psychologist specializing in PTSD. Outside of psychology Paul Twose, a critical physiotherapist, and critical-care occupational therapist Penelope Firshman, have also been on hand to support the group. 

The group has produced guidance on the psychological needs of people recovering from severe Covid-19, with support from patients and relatives from the organisation ICUSteps, and have held a webinar on the same topic. The guidance is aimed at GPs, nurses, allied health professionals and others involved in supporting patients to recover from severe Covid-19 as well as their relatives. Murphy said the work had been well-received by health professionals including the Chartered Society for Physiotherapy, and it was highlighted in the GP-magazine Pulse. Since its release Murphy has been invited to represent the BPS on an NHS England group which is developing a rehabilitation package for those recovering from Covid-19.  

Community action and resilience

The Community Action and Resilience workstream is led by Dr Sally Zlotowitz, Clinical and Community Psychologist and Director of Public Health and Prevention for MAC-UK, and Dr Carl Harris, a Consultant Clinical Psychologist and committee member of the BPS Community Psychology Section. They will be considering the ways in which psychology can inform, support and amplify community level responses to Covid-19 and recovery from the pandemic. 'We want to recognise and honour the important role that communities and community organisations have played in looking after each other and our essential workers, whether that's through mutual aid groups, holding local and national government to account or advocating for marginalised groups. We hope to ensure that the BPS speaks up for the importance of strengthening communities and inclusive participation processes as we try to #buildbackbetter from the impacts of this pandemic.' 

To read all of the resources mentioned here, as well as many others, please see www.bps.org.uk/responding-coronavirus

See also our own collection of perspectives on coronavirus.