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Adjusting and Up-Skilling for Virtual Therapy

As a therapist I felt a strong responsibility to ensure I diversified my skills in order to offer clients the absolute best therapy possible over virtual means. This included attending various training webinars on adapting the main therapies I use in my practice; EMDR, Somatic Psychology, Parts Work, Brainspotting and yoga therapy online. This included training from leading experts in their fields, such as Mark Grixti, Arielle Schwartz, The EMDR Association and The Minded Institute. Alongside therapeutic adaptations, as part of my work for health and social care staff, and for clients who have experienced Covid-19 directly, there were various forms of training and development available on ICU matters, Psychological First Aid and Trauma work. I have been fortunate to access some of this as free training and am grateful for how much has been made available.

As part of this up skilling for online therapy, I have found using EMDR virtually to be extremely effective and have changed my way of delivering this, which I will likely continue for face-to-face sessions later. I am completely confident that I can offer as effective therapy online now as in person and this opens up many more opportunities, enabling greater choice for clients, rather than relying on those therapists available in their geographical location.

Factors to consider

There are different factors that therapists need to take into account for clients accessing virtual therapy in their own homes and these should be considered too. Clients usually have a journey to a different environment for therapy, perhaps a short wait in a waiting area where they can ‘arrive’ to their therapy session and a journey home afterwards to process before they enter their front door.  I have made efforts to check in with clients that their space is confidential and they feel ‘safe’ enough to benefit from virtual therapy, checking on their comfort, letting them have a few minutes to get their devices set up correctly and those kinds of more practical elements. In addition, it is more important to ground clients at the start of therapy, and I use short exercises for this, based around interoception and exteroception and some somatics. I also tend to ensure there is a transition out of therapy at the end of the session before they return to the realities of their lives.

Clients and I will discuss barriers or blocks which might be related to the environment openly just as we would discuss any other types of blocks in sessions, for example, if they have children in the house and feel distracted even if they are in a private space.

I have heard therapists concerns about ‘bringing clients trauma into their homes.’ Whilst I acknowledge this point around boundaries, I believe most clients already have their trauma intruding into their homes and the rest of their lives, through distressing memories, nightmares and in some cases flashbacks which is why they are seeking therapy in the first instance. I think to help people through this, be open and transparent, and use our skills responsibly and sensitively to help manage these boundaries with clients is much more valuable than to use it as a reason against online therapy. I believe clinically that therapy with masks is likely to be more triggering, activating the parasympathetic nervous systems threat response, especially in relation to some of the particular traumas clients may have experienced. Seeing others in a mask and feeling the constriction of wearing a mask could trigger very frightening memories of experiences in some.

Client Experiences during the Covid-19 Pandemic

During Covid-19, I have seen an increase in difficulties with alcohol, exacerbation of previous anxiety and control related conditions, including eating disorders, increased family and relationship stress, financial stresses, and new anxiety or depressive disorders triggered by the changes to lifestyle and health fears. In health and social care professionals and clients who have experienced trauma, in a minority of cases, Post Traumatic Stress Disorder (PTSD). I have also seen people using this opportunity of lockdown as a time to access therapy for things in their lives that have been problematic for a while. This is such a brave and beneficial choice to make and I commend them. For many, this has been a time of reflection and that includes looking at aspects of our lives which we want to change and if needed, reaching out for help to do this. I am privileged to often be in a position to support people with making these changes to their lives, and will continue to do so to the best of my ability, whether that be virtually or in person!

This was originally published on welldoing.org https://bit.ly/32moRWC

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A New Office Feels Like a New Beginning

How often do we ‘make do’ without even realising that is what we are doing?

I have had my home office space in a downstairs area for several years now. It was never ideal but was a compromise needed for the circumstances at the time. I’ve often berated myself (inner critic at work) for being disorganised with my filing, books and paperwork, when in fact having one corner of a multi purpose room is not conducive to running a small business and my consistent development needs.

In addition, I have not had a permanent internet cable so have relied on limited quality connectivity making quick and simple tasks much more difficult to achieve when the networks or Wi-Fi is busy.

The additional working from home and virtual therapy forced through COVID-19 has served as a catalyst for change. We have converted a small bedroom upstairs to my new office and I’m so excited to have a proper space all to myself.

It also makes online therapy so much more accessible, both for timings and a more guaranteed quality connection, and I will be taking advantage of this by offering people more flexibility and access options, and joining up with some innovative and exciting platforms.

But, the interesting aspect is that it is only as this has started to become a reality, that I’ve recognised the compromises I have been making and the added difficulty of working in the space I have had. To be honest, I even had some resistance to changing it (the pull of the familiar….those old behavioural patterns). Now, I cannot believe how well I have managed and can see how my ‘disorganisation’ was due to a lack of space. Though I do admit I can be cluttered, usually trying to do and read too many things at once.

Reflections…..

So, where are you ‘making do’ and are their other options reasonably easily available to you that could improve your quality of life and ease your stress levels?

Have you become too used to ‘making do’ and feeling that prioritising your own needs is not important, valid or relevant?

Is there a small thing that you could change in the near future (or even today!) which would make a big difference?

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Insight Timer

Excited to have contributed to my favourite meditation application, Insight Timer, as a Publisher. I like Insight Timer because there is such a varied choice of meditations, relaxations, poetry, or music that it really gives the user options. Most of these are free but you can pay a subscription to access courses covering specific themes over a number of days if you need a kickstart or some particular support in a more structured manner. There are some other benefits to subscribing but you can access my published audios free of charge!

I do appreciate that if you are new to meditation or mindfulness, the amount of choice available might seem overwhelming. If this is the case, I would advise you to search by a general theme, such as, Mindfulness or Yoga Nidra, and a time length. These two filters will reduce your options and enable you to be more confident in your choice. Remember, some teachers will work for you and some won’t and this is a very personal response. We respond better to certain voices and ways of guiding us through relaxation. Play around with an open mind and find a few you enjoy 🙂 It also takes practice to ‘relax’ or meditate if you are not used to it, and especially if you are someone who keeps yourself busy all the time, perhaps to avoid painful thoughts, feelings or memories or perhaps because you feel taking time out is ‘lazy’ or an indulgence you cannot afford. Taking time for ourselves and prioritising our own needs are very important to keeping our mental and physical wellbeing. Most people find that taking this time to recharge, refocus and restore actually improves their productivity and happiness and prevents or reduces sleep problems, overwhelming stress levels and physical symptoms such as pain.

So, I fully acknowledge that the audios approved so far on my publisher profile are not perfect. They both needed some more work/re-recording but I was keen to get something out there during these times and contribute to people’s wellbeing tools. If I had have waited to have the time to re-record, this would have held off my progress in moving forward with this goal. I reflected on whether it was better to publish something ‘good enough’ or to delay. Thankfully, some feedback on the Full Yogic Breath recording from my supportive and fabulous yoga teacher training colleagues gave e the confidence that ‘good enough’ was acceptable. This is something I would have found unacceptable years ago but in the Acceptance and Commitment Therapy spirit, I have got better at showing my imperfections and risking exposure to criticism.

Perfectionism traits have many benefits and often lead to success in areas of life, especially work. It is not a bad thing to want to do a job well. However, if we do not accept that we cannot always be perfect, this can lead to high stress or anxiety and hold us back from things we would like to achieve in life. Often these traits may stem from criticism in childhood/early adulthood or a particular experience(s) where someone has made you feel not ‘good enough’, worthless or devalued.

I am going to strive to be ‘good enough,’ and I encourage you to do the same.

That said……I am working on my next recordings! 😉

If you think my audios are beneficial, please leave a review/feedback and follow me on Insight Timer.

http://insig.ht/joablett79

http://insig.ht/gm_112666

http://insig.ht/gm_112171

Reflections……

Are there things that you would like to do but you put them off for fear of not being ‘good enough?’

Is it ok to be imperfect for you? Where might ideas to the contrary have come from?

Where could you practice showing a little vulnerability/risk of exposing imperfection? Start in small steps with supportive environments to build confidence.

Do you prioritise your own time/allow yourself space to reflect/restore/relax and refocus? Perhaps it’s worth giving this a try for a week and seeing what difference (if any) it makes to your wellbeing.

Look after yourselves,

Jo

About Jo Ablett, Professional Development

A New Post…

So, the time has come to say goodbye to a fantastic team at The Intestinal Failure Unit and Gastro Psychology at Salford Royal Hospital. A team that have supported me, fostered my development and many have become cherished friends after 9 years of working together in a challenging environment. I’ve been so proud to work with the Gastro-Intestinal team, and amazed at what we’ve achieved, developing a fully integrated and highly valued psychology service for patients with gastro-intestinal conditions, and we started the trend which has caught on Nationally and Internationally in psychology within Intestinal Failure services!

However, its time to take on a new challenge as Head of Psychology at St Helen’s & Knowsley Teaching Hospitals NHS Trust. Here, I will be clinically and operationally leading a clinical health psychology service within an acute Trust, working into several health specialties, such as, Cancer, Stroke, Burns, Plastics, Pain, Diabetes, Sexual Health, Gastro (of course!) and other conditions. I’ll be leading a team of dedicated applied psychologists and collaborating with other MDT members to continue to develop services and make services accessible to those in need. 

I am both nervous, and excited to get stuck in!