The COVID Trauma Response Working Group has been formed to help coordinate trauma-informed responses to the COVID outbreak. We are made of psychological trauma specialists, coordinators of the psychosocial response to trauma, wellbeing leads at NHS Trusts and people with lived experience of psychological trauma. The working group is being coordinated by staff at University College London and the Traumatic Stress Clinic at Camden and Islington NHS Trust. We are very grateful to our clinical and scientific colleagues in other NHS trusts and universities who are contributing to this work. We hope that this work be helpful to our colleagues and their patients affected by COVID.
Our trauma expert clinical academic panel includes
- Dr Michael Bloomfield, UCL and the Traumatic Stress Clinic
- Dr Talya Greene, UCL and University of Haifa
- Dr Jo Billings, UCL and the Foreign & Commonwealth Office
- Dr Mary Robertson, the Traumatic Stress Clinic
- Prof Chris Brewin, UCL
- Dr Nick Grey, Sussex Partnership NHS Foundation Trust and University of Sussex
- Dr Sharif El-Leithy, South West London and St George's Mental Health NHS Trust
-Dr Deborah Lee, Berkshire Healthcare NHS Foundation Trust.
-Dr Helen Kennerley, Oxford Cognitive Therapy Centre and University of Oxford.
-Dr Idit Albert, South London & Maudsley NHS Trust and Kings College London
-Dr Dominic Murphy, President of the UK Psychological Trauma Society
-Dr Nicky Gilbert, Sussex Partnership NHS Foundation Trust
Our Traumatic Stress Clinic specialist clinicians include:
Dr Jocelyn Blumberg
Dr Kim Ehntholt
Dr Chloe Gerskowitch
Dr Julia Gillard
Dr Hamodi Kayal
Dr Timothy Kember
Dr Laura Kemmis
Dr Livia Ottisova
Dr Rosanna Philpott
Dr Eileen Walsh
Our wellbeing expert group include:
Dr Lisa Monaghan, University College Hospitals NHS Trust
Dr Sarah Lunn, Whittington Health NHS Trust and Camden & Islington
NHS Foundation Trust
Dr Mari Campbell, Royal Free London NHS Foundation Trust
Dr Lorna Fortune, North Middlesex Hospital NHS Trust and Barnet Enfield & Haringey NHS Trust
Dr Bev Flint, Camden & Islington NHS Foundation Trust
COORDINATING THE RESPONSE
It is essential that the psychological response to the COVID outbreak is coordinated, trauma-informed and evidence-based. We will be posting information and resources on this website.
Supporting Hospital Staff During COVID-19: Early Interventions
Psychological Trauma and Moral Injury in Religious Leaders During COVID-19
Kings Fund Summary: Rapid Guidance on Responding to Stress Experienced by Hospital Staff working with COVID-19
Kings Fund Diagramme: Répondre au stress vécu par le personnel hospitalier travaillant au contact de patients atteints du COVID-19 : Guide pour la planification d’interventions précoces
Who helps the helpers? (This article first appeared in the January 2021 issue of Healthcare Counselling and Psychotherapy Journal, published by the British Association for Counselling and Psychotherapy. https://www.bacp.co.uk/bacp-journals/healthcare-counselling-and-psychotherapy-journal/ BACP 2021©)
Our current programme of research seeks to explore the impact of working during the COVID-19 pandemic on frontline healthcare workers and their experiences and views about psychosocial support that they have been offered or used.
Frontline health and social care workers’ views and experiences – one year on. We are interested in hearing from frontline health and social care workers to understand your experiences and views of working on the pandemic over the last 18 months. We want to hear about your experiences, how you coped and what you found helpful or unhelpful with regards to the support you were offered. Participation involves a one-off remote interview for about 45 minutes. If you are interested in taking part, or for more information, please contact email@example.com To view our recruitment poster, please click here.
Frontline health and social care workers’ family members’ views and experiences. We are keen to hear from the family members of frontline health and social care workers to better understand how the pandemic and your family member working on the frontline has affected you and your family. While attention has been paid to the impact on frontline workers themselves, no one has been paying attention to the impact on their families. We want to change this and would like to invite you to take part in a one-off remote interview for about 45 minutes. If you are interested in taking part, or for more information, please contact firstname.lastname@example.org. To view our recruitment poster, please click here.
Predictors and rates of PTSD, depression and anxiety in UK frontline health and social care workers during COVID-19.
Experiences of mental health professionals supporting front-line health and social care workers during COVID-19: qualitative study
- What support do frontline workers want? A qualitative study of health and social care workers’ experiences and views of psychosocial support during the COVID-19 pandemic.
Experiences of frontline healthcare workers and their views about support during COVID-19 and previous pandemics: a systematic review and qualitative meta-synthesis.
What symptoms best predict severe distress in an online survey of UK health and social care staff facing COVID-19: development of the two-item Tipping Point Index.
Recently completed research:
Frontline-COVID Survey: Over 1,200 frontline health and social care staff completed our baseline survey. Further follow up surveys have now been completed by frontline staff over the subsequent 12 months. Results from the first wave of data collection have now been published, please see Greene et al (2021) above in Our Publications. We will be making further findings available as soon as possible.
Interviews with frontline workers: We have completed in-depth interviews with 25 frontline health and social care workers from across the UK exploring their experiences and views about support. Results from this study have now been published, please see Billings et al (2021) above in Our Publications.
Interviews with mental health workers: We have completed in-depth interviews with 28 mental health practitioners who have been working to support frontline workers throughout the pandemic, exploring their own experiences, views and needs during the pandemic. Results from this study have now been published, please see Billings et al (2021) above in Our Publications.
We would like to say a huge thank you to everyone who has taken part and been involved in this crucial research!
Our guidance is collated from research, best practice guidelines and expert clinical opinion. Our guidance is not an exhaustive list of recommendations but is intended to inform planners, managers, team leaders, and clinicians of the organisational and psychological processes which are likely to be helpful, or unhelpful, in supporting survivors during and after the COVID pandemic.
Coordinating a trauma-informed response to COVID - What, why and how?
COVID Trauma Response Working Group Rapid Opinion: The case for a trauma-informed response to COVID-19
COVID Trauma Response Working Group Clinical Guidance: Psychological First Aid
COVID Trauma Response Working Group Rapid Guidance: Screening and active monitoring for post-traumatic stress disorder (PTSD) and other mental health consequences in people recovering from severe COVID-19 illness
COVID Trauma Response Working Group Clinical Guidance: Working with children, young people, and families to mitigate the impact of the Covid-19 pandemic
COVID Trauma Response Working Group Clinical Guidance: Clinical guidelines for delivering bereavement and grief support in the context of COVID-19
For Planners & Organisations:
Supporting Hospital Staff During COVID-19: Early Interventions (Occupational Medicine Editorial)
COVID trauma response working group rapid guidance for planners of the psychosocial response to stress experienced by hospital staff associated with COVID: Early Interventions
Kings Fund Summary of our rapid guidance on responding to stress experienced by hospital staff associated with COVID
Guidance for managers & decision makers in supporting care home workers during COVID-19
Supporting mental health staff working with children and young people through the COVID-19 pandemic: Guidance for services
Guidance on moral injury in healthcare workers associated with COVID-19
COPING WITH STRESS
Updated advice for health and social care staff coping with stress during acute phases of the COVID-19 pandemic
The entire health and social care workforce has been doing work that has been mentally, emotionally, and physically challenging for many months under extremely difficult circumstances.
As a member of this frontline workforce, there may be times when you feel you are coping well and times you feel that you are coping less well. You might have felt anxious, stressed, alone, scared, sad, overwhelmed, angry, helpless or even numb. You might have felt guilty about difficult decisions that you have had to make. Over time, you may feel like you are “running on empty”. You may have different reactions to this challenging period.
These are all normal responses to an extremely difficult situation. Everyone is different, and everyone will experience different emotions at different times.
There are things that you can do to take care of yourself.
Give yourself permission to take regular breaks during your shifts when possible. If you are a team leader or supervisor, it is helpful to role model this to your team. It is important to try to eat and drink properly. Make sure that you take some time out between shifts. Protect your sleep. It is being responsible, not selfish, to look after yourself. Try to think about and use or adapt strategies that have helped you in the past to cope with stressful situations.
Try to find ways to keep in touch and stay connected with the people who are important to you and give you support. Spend quality time with people in your household or in your bubble.
Engage in exercise and physical activity. Spend time outside when possible. Maintain a routine as much as you can. Plan regular activities that help you feel good. Avoid relying on unhelpful coping strategies like smoking, alcohol or other drugs.
Limit the time you spend watching, reading or listening to the news, including on social media. This can help you take a break from thinking about the pandemic.
Spend time deliberately engaged with focused activities that take your mind away from the current crisis. Any active task may help distract you, including baking, puzzles, and paint by numbers. There is even some evidence that distracting activities that make use of spatial skills can be helpful in reducing distressing memories, such as playing the computer game Tetris.
Be kind to yourself. Everyone makes mistakes from time to time, but being too self-critical can increase stress. Show the same compassion to yourself as you would to your friends, family and colleagues.
You are not alone in this situation – your colleagues are likely to be experiencing similar things to you, and you can support each other. Book in regular chat times. It is OK to say you are not OK.
If you feel overwhelmed, know that there are ways to get support. You could talk to your colleagues, your manager, or someone else that you trust about how you are feeling. Many organisations, including the NHS, are now offering additional dedicated psychological support services for health and social care staff. Check on your organisation’s website for more information. You can also speak to your own doctor about this.
Try and focus on what is in your control. Pay attention to things that are going well when you can - share and celebrate the successes or small wins. Some of the experiences you have had during this time are likely to have significance in your personal or professional journey. Hold on to your values and your beliefs. Remember the contribution that you are making. Aim to actively increase your awareness of experiences for which you can feel grateful. Even though this has already been a marathon, it will not last forever.
Guidance produced by the COVID trauma working group, an expert group of psychological trauma specialists based at UCL, the Traumatic Stress Clinic, and other leading trauma centres and universities www.traumagroup.org [05/02/2021]
Multilingual advice for hospital staff during the COVID pandemic:
Coping with stress - Advice in English
التّعامل مع التّوتُّر: توصيّات للعاملين في المستشفيات أثناء وباء كوڤد19
Stressbewältigung - Beratung auf Deutsch
Gestionar el estrés -Consejos en Español
Gérer votre stress - Conseils en Français
Gestire lo stress - Consigli in Italiano
Useful evidence-based resources for clinicians coordinating psychosocial responses to COVID
Living with the worry and anxiety amidst global uncertainty (Psychology Tools)
Simple activities for children and adolescents (National Child Traumatic Stress Network, USA)
Psychological First Aid (PFA) Guidance for Supporting Hospital & Community NHS Staff (HUH Foundation Trust & Talk Changes: Hackney & City IAPT)
For Planners & Organisations:
Evaluating staff wellbeing during COVID-19 (National COVID-19 Staff Support Evaluation Group)
Advice for sustaining staff wellbeing in critical care during and beyond Covid-19 (Intensive Care Society)
Addressing Mental Health and Psychological Aspects of COVID-19 Outbreak
Comment on psychological interventions for people in Wuhan suffering from COVID
COVID-19 and experiences of moral injury in front-line key workers (Williamson et al. 2020)
IAPT guidance: Supporting Frontline staff during COVID-19 (by Professor Barney Dunn)
Managing healthcare workers stress associated with the COVID-19 virus outbreak (National Center for PTSD, US Department of Veterans Affairs)
Managing mental health challenges faced by healthcare workers during covid-19 pandemic
Potential mental health consequences for workers in the Ebola regions of West Africa – a lesson for all challenging environments
Principles of Responding to people’s mental health needs after disasters (Royal College of Psychiatrists)
Psychosocial care for people affected by disasters and major incidents (NATO)
Scoping Review: Early Post-Trauma Interventions in Organisations
Systematic, thematic review on social and occupational factors associated with psychological outcomes in healthcare workers during an infectious disease outbreak
Top ten messages for supporting healthcare staff during the COVID-19 pandemic (Williams et al. 2020)
The psychological impact of quarantine and how to reduce it: rapid review of the evidence
For Health & Social Care Workers:
Guidance for health and social care workers on coping with stress
COVID-19 and experiences of moral injury in front-line key workers (Williamson et al. 2020)
COVID-19 & Mindfulness: Resources for Health & Care Staff (The Mindfulness Initiative)
Database of Trauma Resources (British Psychological Society)
Early interventions for trauma (British Psychological Society)
Guidance for psychological professionals during the Covid-19 pandemic (British Psychological Society)
Guidance for Volunteers Supporting Self-Isolators: Five tips to manage your own psychological and emotional wellbeing (Association of Clinical Psychologists UK)
Intervention in a Shared Traumatic Reality: A New Challenge for Social Workers (Dekel & Baum 2010)
Looking after doctors’ mental wellbeing during the covid-19 pandemic
Meeting the psychological needs of people recovering from severe coronavirus (Covid-19) (British Psychological Society
Organisational Wellbeing During the Covid-19 Pandemic: A Guidance Document (Royal College of Psychiatrists Faculty of Medical Psychotherapy)
Psychological First Aid (Medical Reserve Corps Field Operations Guide, USA)
Resources on remote delivery of psychotherapy and advice for frontline staff during COVID (Oxford Centre for Anxiety and Depression, OxCADAT)
For COVID19 Patients: