Conversations with branches
In September 2019 I had a telephone call with Jenny [Young, Director of Blue Cabin] to discuss a self-referral pathway into psychological therapy for creative practitioners involved in their ‘All About Me’ sessions. This developed into a wider conversation about the importance of having the space and the frameworks to make sense of experience in order to learn from it, and about the power of psychoeducation as a prophylactic (treatment) against burn-out, ‘compassion fatigue’ and ‘vicarious traumatisation’. These are all recognised risks for practitioners working with others who have experienced trauma and attachment disruption.
Indeed, a significant body of literature exists regarding the risks to emergency workers, medical staff and psychological therapists who are routinely first on the scene of incidents, who work closely with victims of trauma in the immediate aftermath, or who help survivors to process these experiences and reclaim their lives. Less has been written about the possible impact of the emotional labour on non-clinicians, such as creative practitioners facilitating interventions with similarly traumatised individuals which do not fit the description of formal therapy. Further, little has been written it seems about the role supervision may play in such a context. For me as a psychological therapist whose entire career has been founded upon psychological models (namely, Cognitive Behavioural Therapy) and regular supervision, the key question was whether practitioners with no formal psychological training may in fact be at greater risk than those with it, owing to being exposed to similar levels of trauma whilst not necessarily being familiar with frameworks to help normalise reactions, maintain reflective distance, conceptualise experience, and otherwise stay safe and effective.
My conversations with Jenny led to Blue Cabin commissioning a bespoke one-day training for the creative practitioners working directly with care-experienced children and their identified adults in the ‘All About Me’ sessions, and for others in the organisation involved indirectly.
‘All About Me’ is a stage in Richard Rose’s Therapeutic Life Story Work model. In partnership with Child Trauma Intervention Services, South Tyneside Council, Supanaught and Associate Artists Nicola Golightly, Elena Miller, Michelle Wood (Sea tern Print), Pady O’Conor (MeeMee Theatre) and Curious Monkey, the All About Me stage has been re-imagined into a series of Creative Experiences.
A good opportunity
My full-time NHS role involves me working with adults who suffer daily with the lasting effects of attachment disruption, psychological and physical trauma, and/or neglect. An invitation to provide training in trauma, on how to work with difficult material and to facilitate a reflective space for practitioners felt like a real opportunity. And there was something poetic about it, too: a chance to work – albeit at one degree of separation – with those children who otherwise might become my future clients; this was a opportunity to work with practitioners who have a real chance to alter the course of the lives of young people, to help repair trust, and foster curiosity and selfhood. As the critical analysis of the now widely-known Adverse Childhood Experiences (ACEs) literature emphasises, having a difficult start in life may make children more likely to have future emotional, physical and social problems, but these are not inevitable and nor are they irreversible. All About Me is all about hope.
‘Push it where it moves’
I approached the day expecting to deliver material on trauma and attachment theory, to have some time for reflection and linking this to practitioners’ experiences, and then to talk self-care in the afternoon. Within the first ten minutes as we had a round of introductions, I was aware that this was going to run differently. This was a group who already were knowledgeable, highly reflective, emotionally intelligent, and beginning to come to terms each in their own separate way with the emotional labour they were doing. The feeling in the room was that the day needed to be about sharing experiences, as well as normalising the challenges and finding ways to maintain effectiveness and wellbeing going forward. Attachment problems and trauma occur in relationships. Healing from them must occur in relationships. Connection within a team is also vital to practitioner wellbeing, although much of the popular writing on ‘self-care’ focuses on solo activities. The emphasis of the day shifted to facilitating towards sharing of experiences, and integrating them with the theory attendees already had a gist of; the aim was to figure out what works and what doesn’t and to conceptualise these experiences so they can be intentionally replicated or avoided in future all in the context of a team. There was a palpable sense of safe, open collaboration across the day, which was truly wonderful to be part of.
A thin line
The main thing I learnt from the day was that the line between therapy and creative facilitation may be thinner than we think. In other words, whether you are delivering a formal psychological therapy in weekly 50-minute sessions, or promoting curiosity, reflection and emotional processing though facilitation of play and creative tasks, there is a cost to the practitioner. These roles require emotional labour, which must be counterbalanced with self-reflection and sense-making, and attending to one’s own wellbeing in order to remain safe, efficient and effective. This resonated so strongly with a personal philosophy of mine that supervision is vital in so many roles besides clinical ones.
The team delivering ‘All About Me’ and those in Blue Cabin who scaffold and support them are an inspiration. In a care system so often criticised for its lack of attention to the individual, to emotions and to major transitions, Blue Cabin’s work is a beacon of hope and empathy. Given that they are in their relative infancy with this unique project, there is exciting scope for ongoing development and revision. It seems that one potential area for development is the integration of structured supervision.
With its three-pronged approach: restorative (processing the impact of the work, attending to own reactions and feelings), normative (ensuring adherence to policy and procedure, ensuring safe practice), and formative (developing the practitioner), supervision is essential for practitioner longevity and development, the key to which is space to reflect and conceptualise our experiences. Distinct from training (the intentional development of specified knowledge skills and attitudes relevant to one’s role) and personal therapy, supervision has to potential to ensure safety, efficiency and effectiveness both at the individual practitioner level and the wider organisational level.
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BABCP Accredited CBT Therapist
Member of EMDR UK & Ireland