Hazel Wilcock is a Senior Counsellor at St Ann’s Hospice in Greater Manchester. Here she tells ehospice about developing a psychological support service to reach more people during the pandemic.
As a hospice, our role is far from over when someone dies. Our therapy service, Let’s Talk, supports people to come to terms with loss or process their illness by offering psychological support to patients, carers, friends and family.
We have continued to offer counselling, bereavement and psychological support over the telephone or via video calls throughout the pandemic. Initially, some clients preferred to wait until we could offer face-to-face services again. However, as restrictions continue, we are seeing more people get back in touch as we all accept that we need to acclimatise to making connections in a different way.
Broadening our reach
For a lot of people, the grieving process has been affected by lockdown, such as not being able to visit someone you care for at home or in hospital, or go to their funeral. Over the past few months we have seen an increase in demand for our services. As we are all processing loss and changes in our lives, this increase in need has not surprised us.
We have also broadened our reach to make support more widely available to people who would not normally engage with us. This includes people in the local community who have not had a family member cared for by the hospice, and other local health and social care professionals.
Not everyone will feel ready to get in touch directly, and some people do not have a connection with the hospice, so we have shared free resources online to support people processing grief and loss of any kind, with signposting to our services if they feel these are right for them.
A new model of support
As well as the increase in demand, we’ve seen a change in the needs of our clients and the way they access our support. We have used this as an opportunity to innovate and adapt. This means not simply replicating our face-to-face support ‘virtually’, but shaping a new model of support that is flexible and lets people receive the most appropriate service.
We now have a three-tier model, with a single point of access for all referrals. This means that referrals from other professionals, or clients who self-refer only need to contact one service. From there we undertake an initial assessment to ensure every individual receives the right treatment, at the right time and in the right way. The tiers are as follows:
• Tier I is undertaken by all social care and health professionals within and external to the hospice. They will recognise general psychological needs and provide information on general emotional care, referring on to Let’s Talk if appropriate.
• Tier II psychological interventions are provided by health and social care professionals, such as our Assistant Mental Health Practitioner. These services include an assessment for psychological distress, bereavement support and specific low-level psychological strategies, such as problem-solving, sleep hygiene and cognitive restructuring.
• Tier III interventions are provided by qualified counsellors and psychotherapists. They will also undertake initial assessments but work with complex grief reactions including difficult issues relating to end of life and entrenched depression and anxiety. A range of interventions are offered including cognitive behavioural therapy (CBT).
Ready for the future
We are collaborating with other organisations to train and develop counsellors who understand hospice care and are committed to making mental health a priority for patients, families, carers and friends, both now and in the future.
We’re working with Health Education England (HEE) and the University of Bolton to train an Assistant Practitioner in Mental Health. We’re also providing training opportunities for student counsellors who need a placement to complete 100 hrs of face-to-face counselling. We work with the British Association for Counselling and Psychotherapy (BACP) to ensure that there is consistency and standards appropriate for working within palliative care.
We aim to raise awareness of palliative care with students to challenge some of the myths around hospice care and highlight the importance of counselling in this setting.
By extending the reach of our services, creating a new model of support, and training future counsellors in palliative care, we feel we are ready to continue meeting the needs of people as they evolve over the coming months. We understand that the impact of the pandemic is far from over, and we will continue to highlight our services to reach more people who need our support.