Working in an inpatient treatment and assessment unit for learning disabilities is a very rewarding experience. It is an extremely challenging environment as people are usually admitted into hospital amidst a crisis. Many patients coming to the unit often have difficulties regulating their emotions, which subsequently affects their well-being and interactions.
To help manage this, psychology developed a plan for an emotional literacy intervention group to help patients identify, name, and understand their feelings and emotions more effectively. It is an adapted cognitive-behaviour therapy group which also aims to teach patients on how to make links between their thoughts, behaviours and feelings. The goal is to help patients to understand better what they are feeling and why, and also to provide information and strategies on how manage distressing feelings and develop coping skills to deal with different problems which may arise.
Co-facilitating the group has been an enjoyable experience requiring much creativity
in the delivery of the sessions. An example was adapting one of the sessions for a patient who had difficulty in talking about distressing situations by inviting him to think about favourite comic book characters. This entailed getting the patient to draw a character and use them to talk about his thoughts and experiences. The patient was able to engage in a discussion about different coping strategies when experiencing difficult emotions such as anger.
Due to the varying ability of the patients attending, much time is spent considering their individual needs and ensuring they are met where possible. It is rewarding when you notice the members utilising the skills gained from the group. In order to ensure that information provided in the sessions is accessible, where possible resources provided are in Easy Read format.
One of the challenges in facilitating a group for people with learning disabilities in this context is that some may present with challenging behaviour. At times it could be difficult whilst managing conflict and incidents which occur during the session to maintain therapeutic alliance and group cohesiveness. Similarly, it is even more difficult to run a group with clients who do not interact well together, but would benefit from the intervention of the group. For this reason, our 'feelings group' can become a 'feelings space', to enable inclusivity and therapeutic benefit to all who want to participate and can use the format. Patients who consent to attending the group can be offered either individual sessions, or work in pairs, with enough facilitators.
Like all interventions, the group is not immune to attrition. Especially being an inpatient unit, it is not uncommon for patients to transition to community placements before completing the sessions. However, all members will receive a post-group review and be awarded an attendance certificate. This is a great way to boost self-esteem and encourage engagement with groups in the future.
Intervention groups such as these are great for interdisciplinary working as they enable an opportunity to merge psychology and nursing team skills. When running group interventions for clients with learning disabilities, it can be beneficial to plan the resources so that each participant has their own individual facilitator to maximise engagement but also ensure that session pace is maintained. This is a great opportunity to include frontline staff who support the patients on a daily basis to assist and apply some psychological ways of working with clients.
Specialist Psychology Support Worker
Adult Learning Disability Service
Oxleas NHS Foundation Trust