Creative Psychological Intervention for NHS staff affected by COVID-19
Research type
Research Study
Full title
A multi-levelled evidence-based creative psychological intervention to support NHS clinical staff affected by the COVID-19 pandemic: a feasibility study
IRAS ID
311004
Contact name
Vicky Karkou
Contact email
Sponsor organisation
Edge Hill University
Duration of Study in the UK
0 years, 4 months, 1 days
Research summary
Research Summary
This study will evaluate a three level creative psychological intervention for NHS clinical staff affected by the Covid-19 pandemic in Liverpool University Hospitals NHS Foundation Trust (LUHFT).
The intervention is an adaptation of the Arts for the Blues project (https://artsfortheblues.com) which saw the development of a new creative psychotherapy model, piloted within IAPT services and mental health charities for patients with depression and other co-morbid mental health issues. In collaboration with NHS senior staff members responsible for staff psychological support and service improvement in the NHS, this model was diversified to meet the needs of staff affected by the pandemic.
The intervention will have three levels targeting both prevention and treatment:
• Level 1: One-off short sessions for stress relief and improved wellbeing,
• Level 2: Psycho-educational workshops with teams to strengthen relationships,
• Level 3: 12 psychotherapy sessions for those in greater need of psychological support.All levels will be facilitated by psychotherapists trained in the Arts for the Blues model. Creative methods alongside talking and sharing will be used throughout, such as creative writing, song and music making, drawing and meditation, movement and dance, role playing and drama. It is expected that creative methods will support engagement, enable non-verbal opportunities for recovery and contribute towards the attractiveness, acceptability, and value of the intervention. The study will be evaluated using process and outcome evaluation methods.
Summary of Results
With thanks to the clinical healthcare staff who participated in this study and gave their time to joining the interventions and completing questionnaires, interviews and outcome measures.
Lay summary: This study was carried out by researchers at Edge Hill University and University of Salford and was funded by Edge Hill University’s Research Investment Fund. The study was developed in collaboration with a patient and public involvement and engagement group who were consulted about the study design and the data collection process. The study took place in a large NHS trust in the North-West in 2023-24.
This study was designed to offer creative interventions to clinical healthcare staff within their workplace. It evaluated whether creative psychological and wellbeing provision would be acceptable and useful for healthcare staff who have been affected by the COVID-19 pandemic. It adapted an existing creative therapeutic model, Arts for the Blues, into three levels of intervention for healthcare staff as follows:
Level one: Drop-in creative activities for tension relief and wellbeing.
Level two: Team workshops for clinical teams for wellbeing, resilience, and team building.
Level three: Twelve creative psychotherapy sessions for in-depth psychological support.The study considered the following question:
How can the Arts for the Blues model be adapted for use with NHS clinical staff, considering best practice and current psychological needs?All three levels of intervention were offered across the trust both in the hospitals and community services. Participants were from a variety of professional settings, including in-patient and community care, and included healthcare assistants, nurses, junior and senior medical staff, and allied health professionals. Over the three levels of intervention, 54 participants took part in the study.
Qualitative data was collected via evaluation forms at all levels and via interviews at level three. Qualitative findings demonstrate that Arts for the Blues, adapted for NHS staff, was an acceptable intervention. Qualitative data is presented in terms of what was helpful and less helpful for participants.
At level one participants noted that they felt their mood was improved, they had been able to relax and release tension, and they appreciated the mental break from work and the opportunity to try something new. They also recognised that there was only a short period of time to engage with the drop-in session due to time pressures at work.
Reported helpful factors at level two included the opportunity to build team relationships through creative sharing, personal benefits of grounding and relaxation, and benefits to the team in reflecting on the needs and strengths. Some participants reported that it was challenging to work creatively in a work environment.
Participants at level three noted an appreciation for the manualised intervention with specific topics to focus on each week. They reported as equally helpful: the creative aspects of the therapy, the support from facilitators and other group members, and the personal benefits of attending creative therapy to their sense of self. At this level the only unhelpful factor noted was the online delivery of the therapy that had some challenges to engaging creatively.
Quantitative data was collected via pre- and post-intervention measures at each level. Levels of moral distress in relation to work environment was measured at all levels. At level two participants also completed questionnaries that measured resilience, general wellbeing and anxiety. At level three participants’ anxiety, depression and PTSD symptoms were measured.
Quantitative data analysis suggested that there was a statistically significant decrease in moral distress across the entire sample, and particularly at levels one and three. At level two the most statistically significant results were the increases in wellbeing and resilience. At level three, all scores on for anxiety, depression and PTSD symptoms decreased.Recruitment for the project required extensive resources and participation depended on managerial support to attend sessions. Participant retention was good, except for level three where some participants referred to the group had challenges preventing them from agreeing to participate, including time constraints from work and home. However, the group began with five members and only one dropped out after the first session. The remaining four completed both the therapy and all outcome measures. Participants who completed reported that the outcome measures were appropriate and manageble.
This study has benefitted the clinical healthcare staff that participated by improving wellbeing through creative interventions. It has also helped the researchers understand how to implement creative interventions with clinical healthcare staff and the challenges of working with participants who are under time pressures in the work environment.
Further research is needed on specific professions and in specific contexts, units or departments. Further research is also needed to address effectiveness and to identify the primary outcome measure. The researchers are planning to use the results from this study to inform future research to test the effectiveness of creative interventions for the wellbeing of clinical healthcare staff.
The results from this study have been submitted for publication.
REC name
West of Scotland REC 5
REC reference
22/WS/0048
Date of REC Opinion
12 May 2022
REC opinion
Further Information Favourable Opinion