Evidence-based research and high standards of practice are more important than ever,
says Kiren Sweetman
Kiren Sweetman is a person-centred counsellor and a registered member of the British Association for Counselling and Psychotherapy (BACP).She is also a director of ACTO. In this article, Kiren reflects on the ACTO conference held in November 2022.
Friday evening’s panel discussion: taking stock
On the Friday evening there was an interesting and thought-provoking panel discussion involving many of the founding figures of online therapy. At the end of the discussion, a short debate took place on the subject of taking stock and consolidating our work.
This talk made me think about my own experiences.
After qualifying as a counsellor, I felt that I needed to get as much CPD under my belt as possible and to do as many workshops as I could. Actually, now I feel that it would have been far more productive to just reflect on my existing learning, and to refine that rather than rushing towards new training. I wish I had known this sooner.
Adult Autism: Unexplored Territory
I found that the presentation on autism by Vauna Beauvais and Eoin Stephens has really peaked my interest in finding out more about neurodivergent clients. The comparison to being left-handed in a world geared towards right-handed people really hit home for me.
Music Imagery Therapy – Helen Mason
I knew nothing about Music Imagery Therapy before the Conference and was fascinated about how music can be applied to the therapy space, and how imagery may assist clients and the therapeutic relationship.
Overall reflections
I was pleased that the Conference focused in some part on innovation and creativity but it also emphasised the need for evidence-based research – and for high standards of practice moving forwards.
Well done to the presenters and organising team. It was a highly productive event and extremely informative. I can’t wait for next year’s conference!
Kiren
Missed this year’s conference?
You can view the full recording of the workshop at your leisure for just £24.99 (ACTO members: £20).
Come back to the recording at any time and pick up where you left off.
Watch the video as many times as you wish to deeply embed the learning.
View the whole video to access a Continuing Professional Development (CPD) Certificate. The Certificate is proof of your commitment to continuing and deepening your learning as a practitioner.
The Queen’s death last week has received worldwide coverage and started a period of state, national and, in some cases, international mourning. At ACTO, we have been reflecting on loss and grief, and the effect that losing public figures can have on people.
Of course, it’s not just the death of a monarch that may affect us – we have lived through some difficult times recently, with reminders of the fragility of our existence all around us – the Covid pandemic, the Grenfell Tower disaster (the fifth anniversary having recently been remembered on 14th June this year), and further afield the events in Ukraine, flooding in Pakistan and wild fires and other natural disasters, wars and terrorist events around the world. Sometimes, lately, it feels as though the world is full of suffering and tragedy.
Deaths, disasters, emergencies can be poignant reminders of loss and the unpredictable nature of life.
Two days after the news of the Queen’s death a friend remarked “I am not enjoying this sombre music on the radio, even though I completely understand and support the reason. I have relied on light, happy programmes to keep me sane since my wife’s passing.” Another friend talked about the Queen being a contemporary of her mother, and how the news is making her more aware of the reducing amount of time they have left together. Both have been rocked by the news, but in different ways – to one it has been a reminder of what he has lost; to the other it has given a sense of foreboding, of what is to come.
According to Mastrangelo and Wood (2016), Grief is:
“a reaction to any form of loss … [It] encompasses a range of feelings from deep sadness to anger; and the process of adapting to a significant loss can vary dramatically from one person to another, depending on his or her background, beliefs, relationship to what was lost, and other factors.”
Loss is an inescapable part of life – from the death of loved ones or pets, the ending of relationships, the loss of mobility, the loss of connection to others through disease or illness, moving away from people we love, to job losses or the changes in circumstances that move our lives from the predictable to uncertainty. All of these, and many more, are forms of loss that we find ourselves having to adapt to, sometimes moving closer to inevitable goodbyes of one sort or another.
And so, as we recognise that change and endings are an inevitable aspect of life, we are aware that this might be a difficult time for many. 24/7 news coverage of tragic events can affect the way we see the world and, in turn, turn our focus towards our own lives and relationships. As therapists we will encounter loss, or the fear of loss, from our clients in many forms. We will also have our own emotions on the subject to consider. Let’s not forget the importance of this – and perhaps to think about how we look after ourselves in periods of mass mourning, sadness or grief.
Kiren Sweetman is a person-centred counsellor and registered member of the British Association for Counselling and Psychotherapy (BACP). Kiren is also a director of ACTO.
Why a business risk assessment is important for your practice
Cyber security experts Mel Wilson and Dave Holden recently gave an informative presentation to ACTO members as to why a business risk assessment is important for counsellors and therapists.
Mel and Dave emphasised that risk assessment is about making choices based on the level of risk we are comfortable with, and how we are operating our businesses/private practices.
We may need to include safeguarding, data breaches, supporting overseas clients, our infrastructure (data processing/privacy laws) as well as our clients and what type of environment or culture they are working within. The main question to ask ourselves regarding clients is ‘who are we interacting with’ and what do we know about them and their environment.
In assessing risks we are not aiming to eliminate all risks, but to find the risks that we are comfortable with, and those we are not.
Risk assessment can be broken down into three main areas:
people
processes
technology
FIND OUT MORE….
If you are an ACTO member, you can click onto a recording of the webinar on the ACTO website Members Area. During the webinar, Mel and Dave explained how to assess risks in each of these areas (people, processes & technology) together with tips on social media, screen sharing and more.
To find out how to join ACTO, please get in touch.
Therapeutic groups in schools can be a fantastic way for children to develop empathy, find peer support, and process feelings and experiences. The recent pandemic has not only disrupted children’s usual support network and school experience, but also created the need for developing new ways of enabling social connection and group experiences. When physical distancing is imperative the online therapeutic school group can become a means of providing much needed social support, space for processing of feelings and experiences, and an outlet for children and young people to express themselves facilitated by the supportive presence of attuned adults.
Hybrid models of working, specifically where the therapist is online, and participants are together in person can enable groups placed in ‘bubbles’ access to expanded resources and experiences using digital technology. This blog post will give a taste of how a group intervention with an online therapist can provide a therapeutic opportunity and support children and young people with their wellbeing. This blog post is adapted from a longer and more detailed article A moveable Feast: Logistic and therapeutic considerations for the online school therapy group.
Aims of the intervention
To provide a 6 session block of weekly therapeutic group sessions for primary age children with the aim of supporting emotional regulation, peer support and processing of emotions and experiences. A hybrid model where the therapist is attending online with a group of children together, can allow for children and young people to access an interactive and attuned therapist through digital means. Additionally, in line with their digital rights, and involvement and empowerment with their developing digital skills, a wellbeing intervention experienced digitally has the potential to enhance children and young peoples’ understanding of how online interventions can support them.
The premise
The online therapist develops a therapeutic group with up to ten children and an ‘in person’ learning assistant with the aim of supporting group members with emotional regulation, peer support and a safe space to share experiences and feelings.
In this situation the therapist collaborates with the school to facilitate the group remotely during the school day. Key considerations for this include the quality of internet connection and appropriate technology, the expertise of the therapist in online working, suitable referrals and aims, the use of a consistent private space, and the suitability of the supporting adult who will be present with the children.
Communication
Before starting, communication between the school and the therapist is very important to make sure a thorough assessment is conducted. An agreement must be in place to meet the requirements necessary for the work to be a success, and any adaptations needed voiced and established before starting. A working alliance and understanding of the aims of the group must be developed between the therapist and the learning assistant before starting, to agree approaches in response to specific situations, such as if a child becomes dysregulated. Safeguarding procedures must be established and suitability of referrals assessed in line with group aims.
Connection
Connection of both technology, and of the felt experience of the group ‘connection’, is of great importance if the group is to be effective in achieving its aims. For this reason, tests of the equipment and internet must be carried about before starting. In order to foster connection in the group, the therapist, attending remotely and as such relying more heavily on tone of voice, screen presence and facial expression must make additional adaptations to their delivery style and structure of their intervention.
Outcomes
If assessed properly and set up with core conditions met, this type of group can very successfully support young people with their mental health and wellbeing. This is partly because consultation shows children and young people don’t tend to separate the online world, and in person world as ‘real’ and ‘not-real’. In this way, the online therapist is not interpreted as less impactful as an in person one. Key factors in the therapist being impactful while attending remotely is in their modification of their practice to compensate for factors which come to play online. These factors include understanding and mitigating for dissociation or the disinhibition effect, knowing how to amplify screen presence, and being able to design the intervention appropriately. The therapist who successfully undertakes this work will dedicate time to communicating and collaborating with the school to set the work up properly, and will also dedicate time to preparing the learning assistant who will be in the room recognising their importance in supporting the children in the space.
Conclusion
I hope I have given you a flavour of how a remote therapeutic group can be fantastic opportunity for additional support to children and young people. Those who are already working online, or with a hybrid approach blending in person and online therapy may be interested in learning more about this iteration of the hybrid model. Those who are currently not working digitally, or with groups, however are curious to find out more about possibilities may also have found some content of interest in this post or inspiration for further research and training.
Biography
Elle Gilbertson is an art therapist working with adults, young people and children in private practice and in the third sector. In her private practice she is also a clinical supervisor working with other therapists. She holds an MSc in Art Psychotherapy, and a diploma in online therapy. She has a special interest in mind/body interventions, and when appropriate integrates her training in embodied practices into her art therapy practice to support clients regulate, process feelings and foster healing. She is excited about the combined potential for art therapy and online therapy to facilitate therapeutic change.
You can find out more at www.ellegilbertson.com, or contact her directly at ellegilbertson@proton.me
Qualified Counsellor Ellie Finch explores the benefits & key considerations when using video games for working with younger clients.
Perhaps, like me, you’ve experienced the children and young people you work with talk with enthusiasm about games like Minecraft or Fortnite – and could see how much using a video game therapeutically could engage them in counselling?
I’ve been using video games in my private practice with children and young people for the past 2 years and have found it to be a great way to engage children and young people. Sometimes I simply talk about a child’s favourite video game with them; I might ask them what character they like to play, and this can lead to an exploration of their identity. Sometimes I watch a child play and might reflect back to them what I observe. For example, a child with low self-esteem might do something kind for another character in a game and I reflect back to them what I’ve seen of them in the game. Often, I will play the game with the child and together we might play hide and seek, battle monsters, build a castle among many other things.
Games I’ve played with clients include Roblox, Fortnite, Among Us and Animal Crossing. But the game I’ve found most safe, accessible and useful therapeutically is Minecraft.
Before starting to use video games in your practice, there’s a number of important points to consider. I shall map these considerations to the ACTO CYP competences:
ACTO CYP Competency: Psychological Processes relevant to Online Therapy
Ever since I started using Minecraft in my practice I’ve been bombarded with enquiries from parents who can instantly see how it would engage their child in counselling. Often the parents have children who would otherwise not have engaged in counselling if it hadn’t been for Minecraft. However, it’s important to recognise that using a particular video game in sessions might not be suitable for all children. For example, if the child has been struggling with coming off a game to take part in other activities at home, they may struggle with the end of counselling sessions. This can actually be a great opportunity to explore the reasons why they find it hard to come off the game but you may also need to work on setting boundaries around use of games in sessions. In addition, if a client is struggling with not feeling contained in their life, then you will want to consider the landscape of the game you play. For example, Minecraft worlds are enormous and in order to create a more contained space, almost like a sandtray, I provide a physical boundary such as an island or a wall around the space we work in.
I always ask my clients to create a safe place in the game in their first session. This is a place they can come back to at any time if they need to. A safe place can be anything, a cave, a house, a castle…
It also helps to understand the culture of video games and the video game you chose to play itself. For example, terms like ‘griefing’ are useful to know; griefing is a type of online bullying. In Minecraft griefers are players that destroy other players creations. When using Minecraft therapeutically however you can create a private world just for your clients so this can’t happen. In addition, the social side to gaming can be really important to players and the relationships they have through the game are just as significant as their in-person relationships.
ACTO CYP Competency: Assessment of clients for online therapy
Factors to consider when working online using a video game are:
Does the place where the child will be having their counselling have good enough internet connection to run the game as well as a video platform such as Zoom?
Is the child already playing the game online with other people? If not, you need to work with the parent/carer and child to educate them on online gaming safety, playing on servers with strangers etc. Minecraft Education has an in-built game called ‘Cybersafe: Home Sweet Hmm’ that takes the player through some internet safety challenges and helps the player to come up with strategies to keep safe online: https://education.minecraft.net/en-us/lessons/cybersafe-home-sweet-hmm (This game is available on Minecraft Education and Bedrock editions)
ACTO CYP Competency: Contracting and Boundaries
Having an agreement with the client around the use of a video game (or any digital therapy tool or resource) is essential.
My contract, for example, contains the following:
Information about the potential benefits of using Minecraft therapeutically as well as the potential challenges.
What they can expect a session using Minecraft to be like.
Boundaries such as the way we will communicate, how I will ‘unfriend’ them after each session and that I won’t be inviting anyone else into their private Minecraft world.
What we will do if we can’t connect in the game or lose connection.
I’m also clear about my level of competency in the game (please don’t feel you need to be an expert player – you need to be familiar with game controls, but most important is that you know how to keep your clients safe in the game).
ACTO CYP Competency: Data Protection
It’s essential to clearly explain any potential data protection risks of each game you play to a client.
I provide a clear, age-appropriate explanation of what ‘data protection’ and ‘GDPR’ mean, along with information about security standards (i.e. does the game have an ISO27001 certificate), where the location data is stored (i.e. outside of the UK, outside of EU, or in the US, for example, where they have different data protection laws).
It’s also important to clearly state how you will take steps to protect your client’s data in relation to the game and the limitations of this.
For example, I save a copy of the world after each session which is saved locally on my computer (and backed up to an external, encrypted hard-drive). My computer is password protected and I have installed anti-virus and firewall. I run updates on my computer regularly to ensure the security measures are up to date.
ACTO CYP Competency: Communication in online therapy
I do not advise using the communication channels within a video game. Instead, I use my usual video platform or the telephone (you may find using the telephone helps with internet connection issues).
I ask my clients not to use the chat function in the game. I also ask my clients to not write anything on signs or boards etc in the game that discloses personal information such as names, locations etc.
You will also need to get used to the idea that if you are embodying a character in a game alongside your client then your movements and body language as that character will be forming part of your communication with your client – much in the same way as our body language in real life forms part of our communication.
ACTO CYP Competency: Creativity in Online Therapy
Video games provide a great online resource for adapting in-person therapeutic resources.
For example, I use Minecraft much like a sandtray by asking clients to create scenes using items and characters in the game which they can select from a vast inventory (a bit like having rows of miniatures on shelves in your therapy room).
I also have a family tree activity where I ask clients to select different coloured and textured blocks to represent themselves and their family and place them in a tree.
Here are some links to resources and publications about my work:
I have made a 10-minute video for parents introducing them to how I use Minecraft therapeutically by taking them on a journey around my Minecraft island that can be viewed on my website here: https://www.elliefinch.co.uk/counselling-using-minecraft
I have a free webinar also available on my website where I introduce how I use Minecraft therapeutically: https://www.elliefinch.co.uk/events
ACTO CYP Competency: Managing Risk and Safeguarding Issues
Top tip: There are three main editions of Minecraft: Java Edition (available on Mac and Windows), Bedrock/Windows Edition (available of PC, iPhone and iPad, Android, and a range of games consoles including Switch, PlayStation and Xbox) and Education Edition (available on Windows, Mac, iPad, and Chromebook)
Just like working online creates more issues around safeguarding and risk; video games can add a few more to consider. You want to be sure that you are familiar with the video game’s security and privacy settings and have them enabled for yourself and have also advised the client and their parent about how to enable these settings. For example, many video games, including Minecraft (excluding Minecraft Education Edition) are part of social media networks like the Xbox Network. This means that unless you have enabled certain privacy settings your clients may be able to see your friends list, see when you are online, what games you are playing and with who etc. I have written two extensive blog posts for parents about keeping their child safe in Minecraft which is also useful for practitioners using Minecraft Bedrock and Java editions: https://www.elliefinch.co.uk/post/essential-steps-for-keeping-your-child-safe-when-they-are-playing-minecraft-bedrock-edition
Last year Minecraft Education Edition became more widely available to purchase and this is exciting news for therapists as, due to it being designed for use in school settings, it is a lot safer to use with clients than Java and Bedrock Editions. I’ve also written a blog post about the pros and cons of using Minecraft Education Edition: https://www.elliefinch.co.uk/post/why-i-m-using-minecraft-education-from-now-on
Playing video games with clients, can provide a great opportunity to talk about online safety and check in with them about their online life. It is essential you do some training in online safety if you haven’t done so already.
ACTO CYP Competency: Endings and Supervision
Endings in video games can be incredibly poignant and meaningful – whether it be taking a screenshot of your characters together one last time or planting a tree together in the client’s world. I ask permission to take screenshots of the client’s work in the game, you can create a document together and use it to review the work at any time, including in the final sessions. It’s also something they can keep.
I’d advise practitioners looking to start using video games therapeutically to seek consultancy and training before starting to work using video games and connect with professional peers already working in this area.
It’s also important that you have a supervisor that either uses video games in their own practice or is open to learning about using video games alongside you.
As you can see, there’s a lot to consider when incorporating video games into your practice. There’s also additional factors to consider that sit outside the ACTO CYP competences such as making sure you are working within the terms and conditions of the video game license terms and conditions.
I’ve been inundated with enquiries from parents telling me their children are actually excited about the idea of counselling using Minecraft. And, seeing the huge amount of interest there is amongst counsellors and other professionals in using video games like Minecraft therapeutically, I have been training other professionals and organisations in how to use video games therapeutically and safely with their clients.
You don’t need to be a gamer to use video games therapeutically, but you do need to have some confidence using technology so that you can troubleshoot any technical issues that arise. My Getting Tech-Savvy in Minecraft webinar can help you get to grips with the technical side of using Minecraft therapeutically: https://www.elliefinch.co.uk/shop
I also provide 1-to-1 and small group consultations, bespoke training to organisations as well as an upcoming training course on using Minecraft therapeutically.
Ellie is also part of the team of ACTO CYP therapists who have just updated the ACTO competences for CYP online therapists which were used throughout this blog post
All images used are taken by the author. Ellie Finch’s services are NOT AN OFFICIAL MINECRAFT PRODUCT. NOT APPROVED BY OR ASSOCIATED WITH MOJANG OR MICROSOFT.
Two autistic members of ACTO challenge all of us to think differently
This blog post is written by two autistic members of ACTO, with over thirty years of experience between us. We both became therapists before we knew we were autistic, and discovering something so essential about the selves we truly are has proved enlightening in understanding the way we work as therapists. But this post is not about Vauna and Max. On Autism Awareness Day it’s about autistic people in general and autistic counsellors and psychotherapists in particular.
The watchword of Chris Bonnello, an autistic educator, advocate and author, is “play to your strengths”.
That applies to everyone. Beisser’s Paradoxical Theory of Change says that therapeutic change occurs when one becomes what one is, not when one tries to become what one is not. (1) The more we play to the strengths we actually have, rather than chasing those we haven’t, the more we will thrive and grow.
So it also applies to us as autistic, and to us as autistic therapists.
The traditional view of autism
Autism has traditionally been seen / defined as a collection of deficiencies. The traditional view is this:
“Autism spectrum disorder (ASD) is an early onset neurodevelopmental condition that is associated with diverse social, occupational and educational challenges. ASD is characterised by impairment in qualitative social communication and interaction, alongside rigid, repetitive, routine, ritualistic behaviours and adverse sensory responses to certain stimuli.” (2)
An alternative view of autism
However, there are other ways of seeing it.
For example: autism is a way of being, a way of experiencing the world: not in itself a disorder, simply a difference. Many autistic people regard it as not unlike a culture: we have trouble understanding the non-autistic world because it is not our culture, just as the bloggers, born in England, might have trouble understanding the culture of Japan. And non-autistic people have equal trouble understanding our culture. This has been demonstrated very nicely by Crompton et al in their “diffusion chain” experiment (3), is at the heart of Damian Milton’s Double Empathy theory (4), and underpins the neurodiversity model (5): just as the world is biodiverse – and the more biodiverse the better – so humans are neurodiverse. Autistic people are not in any sense inferior, simply neurodivergent – they diverge from the majority, just as a jumping spider that lives on vegetables might be described as bio divergent. It may be unusual, but it’s the one that will survive in a time of food shortage.
The graphic above is Chris Bonnello’s list of autistic strengths (6). Of course, we do not all have all these strengths to the same degree, and people who are not autistic may also have many of them. But it is a useful corrective to the deficiency model.
For anyone used to the traditional view of autism it may seem counterintuitive that an autistic person should choose to become a counsellor, and unlikely that we should be effective in that field. However, looking at the list of strengths above, it may seem a little less unlikely.
Autism awareness: a perspective
Many autistic people feel uncomfortable about autism “awareness”. Surely, they say, we deserve better than mere awareness? Acceptance at least, if not appreciation? We certainly appreciate our autistic minds and our autistic senses, even if at times they disable us in a society – a world – that is designed by and for people who are not like us.
However, as therapists we know that awareness is not something superficial. When we talk about something being in awareness we mean a full experiencing of that thing, not just a cognitive understanding of it. So maybe on this World Autism Day, rather than reading a theoretical piece on autism as a disorder, read or listen to an actually autistic person talking about our life, our perception and processing of our world.
Why not start with Naoki Higashida’s “The Reason I Jump”? (7) In the words of that so-called low-functioning Japanese thirteen-year-old you will find one of the clearest depictions of the autistic world. That is his world, and that is our world. Come and meet us.
To finish, just to throw some doubt on the stereotype that autistic people are not creative and have no empathy, here’s a wee poem written by one of us about the inner world of a client. The English is a loose translation of the Gaelic.
Cho trom an t-saoghal.
Tha’ n cù a’ teum le muirn
Tha mi’ n dùil, mi’ n dùil.
So heavy the world.
The dog nips in ecstasy
Oh, I wish, I wish.
Authors: Max Marnau and Vauna Beauvais
Max is an autistic therapist and clinical supervisor, artist and poet living in the Scottish Borders and working with neurodivergent and neurotypical adults.
Vauna Beauvais is an autistic psychotherapist and clinical supervisor, and a coach for adults with ADHD.
1. A. Beisser (1970) The Paradoxical Theory of Change. In: Fagan, J. and Shepherd, I.L., Eds., Gestalt Therapy Now, Harper & Row, New York, 77-80.
2. E. Nicholson, ‘How do you know if your client has autism?’ Healthcare Counselling and Psychotherapy Journal,April 2020
3. C.J Crompton et al, ‘Autistic peer-to-peer information transfer is highly effective’, Autism vol 24 (7), 2020, pp. 1704-1712
4. D. Milton, ‘On the ontological status of autism: the ‘double empathy problem’’, Disability & Society, 27 (6), 2012, pp. 883-887
5. Term probably coined by Judy Singer in her thesis, later published as “Why Can’t You be Normal for Once in Your Life?”in Disability Discourse, Mairian Corker Ed., Open University Press, 1999. A discussion can be found in N. Walker ‘Towards a neuroqueer future, an interview with Nick Walker’, Autism in Adulthood, vol 3 no 1, 2021. See also J. Singer, ‘NeuroDIversity – the Birth of an Idea’ Amazon, 2017
ACTO’s CYP team wish to bring awareness to Neurodiversity Celebration Week, which supports changes in attitude and understanding. Sienna Castellon, the founder of Neurodiversity Celebration week www.neurodiversityweek.com and a real innovator, has worked hard since 2018 to change minds and narratives from her own experiences, to ensure that we all move forward in a more enlightened and educated way. ACTO support this.
Here are some links about experiences from different celebrities who challenge stereotypes and help us to create an open forum for support, learning and of course, celebration.
The following links may help CYP, parents and practitioners. We acknowledge that for families who had have to flee other war torn areas, these events may be triggering for them and their children. We also want to acknowledge that this may feel like another disaster after the last two years of isolation and loss with Covid-19.
It is important though that if children and young people are asking questions, we answer them as openly and honestly as we can – with a response appropriate to their age. We also recognise the sense of not knowing may impact the overriding feelings of anxiety for both adults and young people.
We therefore feel that finding ways to ground children, young people and ourselves will help to process the emerging information about the invasion of Ukraine.
We hope that you find these resources useful.
Anxiety reduction and calming/grounding strategies
Talking to Teenagers about the invasion in the Ukraine
Anna Freud also complied some useful suggestions with BBC Bitesize for parents and carers.
The UK Trauma Council, founded by the Anna Freud Centre has a range of information for families and professionals. A resource page on how to support refugee and asylum-seeking children from all parts of the world who have experienced trauma. Reports are emerging on lone children crossing borders from Ukraine, this information may be of particularly beneficial for professionals. Here is a list of their support resources to help professionals get started. They also have training available.
Doing What Matters in Times of Stress (who.int) – A free stress management guide for coping with adversity. The guide aims to equip people with practical skills to help cope with stress. It has been translated into 19 languages, including Arabic, Chinese, Dari, Farsi, and French.
Refugee Council | Children and young people – The Refugee Council offers support to all unaccompanied refugee children who arrive alone in England. They provide asylum and welfare support, help trafficked children and those whose age has been disputed, as well as provide mental health therapy. They offer a range of free resources for practitioners and refugees on their website.
ACTO Inclusion & Diversity director Olivia Djouadi gives her views on the NHS’ equality objectives
NHS England and NHS Improvement has six objectives (see in the table below) which seek to improve equality and specifically to ensure that there is a better overall experience for patients and staff alike within the NHS.
In this article, I will explain what each of the goals are – and why they are relevant.
The equality objectives for NHS England and NHS Improvement for 2020/21 addressed our role as an NHS system leader, commissioner and our own role as an employer. The seven overall objectives are:
1. To improve the capability of NHS England’s commissioners, policy staff and others to understand and address the legal obligations under the PSED and duties to reduce health inequalities set out in the Health and Social Care Act 2012.
2. To improve disabled staff representation, treatment and experience in the NHS and their employment opportunities within the NHS.
3. To improve the experience of Lesbian, Gay, Bisexual and Transgender People (LGBT+) patients and improve LGBT+ staff representation.
4. To reduce language barriers experienced by individuals and specific groups of people who engage with the NHS, with specific reference to identifying how to address issues in relation to health inequalities and patient safety.
5. To improve the mapping, quality and extent of equality information in order to better facilitate compliance with the PSED in relation to patients, service-users and service delivery.
6. To improve the recruitment, retention, progression, development and experience of the people employed by NHS England to enable the organisation to become an inclusive employer of choice.
7. To ensure that the equality and health inequality impacts of COVID-19 are fully considered and that clear strategies are developed and implemented for the NHS workforce and patients. To ensure that the proposed NHS People Plan and patient focused strategies reflect this and make an effective contribution to advancing equality for all protected characteristics and to reducing associated health inequalities.
The PSED requires all public authorities including the NHS to consider whether they should take action to meet these needs or reduce the inequalities.
In its assessment, the PSED observed that there were inequalities evident – especially during the pandemic. During this time, most staff in the NHS were overwhelmed by the impact of the health crisis and therefore were focused on trying to provide the best care that they could in the circumstances. Patient care had also shifted in unexpected ways with waiting lists growing exponentially. So, objectives and goals were agreed to attempt to ease some of the discrimination that had been identified.
Review of the Objectives
Objective 1: This aims to help the NHS to gain a better view of the current situation and areas that need improvement. This would enable staff to reduce inequalities and understand their legal duties.
Objective 2: The second goal concerns staff with disabilities and how advancements were possible. This would mean better treatment and not being passed over when those with disabilities get an equal opportunity to other staff.
Objective 3: This aims to help staff feel more supported at work and improve the LGBTQI+ patient experience. This can also assist to lower the additional barriers that may cause some to shy away from healthcare in the UK and go abroad.
Objective 4: The fourth objective relates to the language barriers that impact on patient safety and health inequality. Interpreters are not always immediately available and family members may not always be able to translate medical or psychological information.
Objective 5: This goal explains the importance of making information about the legal duty for inequality available for everyone. It also needs to be understandable to staff and patients alike, with copies available for those that do not have internet access.
Objective 6: This final objective seeks to improve staff morale and reduce the numbers of people leaving the NHS. Many staff members have left due to exhaustion. Despite the pandemic, the NHS continues through to provide a full schedule of appointments, arguably helped by the high numbers of people vaccinated against COVID-19.
To help to understand what it has been like for staff during the pandemic I recommend reading Life, Death and Biscuits by Anthea Allen published 17 February 2022. Please feel free to get in touch with me with your views on this crucial area.
We have been listening to you and we would like to give the members more input. Over the next two months the website will be completely overhauled by a professional designer. We want to do this well, so we are forming a small website working group. It will be headed up by me, the webmaster. It will include a few of your directors but we would also like to include some members.
Tasks would include:
Go through the current web content and select what stays and what goes
Help to think of a menu structure to make it easier to find your way around the website
Help setting the parameters for the new improved directories
Help thinking about images and new content for the website
Help thinking of what benefits we can add for members
If that appeals to you (It will involve several meetings with the working group and will take some hours of your time) and you want to help make the ACTO website better please email me at webmaster@acto-org.uk as soon as possible.
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