Coach (Tier2) Practice Guidelines

Last Updated 17 July 2020

IMPORTANT NOTICE!

It is critical that you ensure that emails from 'no-reply@project5.org' do not go into your SPAM inbox - as these will contain the details of sessions NHS Staff have booked with you!

Coach : Guidelines for your practice in Project5 work:

Wellbeing Specialists and Coaches : Guidelines for your practice in Project5 work:

Contents

  • NHS Staff predicted / possible experiences

  • Project5 practice model

  • Coaching (you)

  • Wellbeing Specialists

  • Psychological First Aid Principles

  • Key Training Resources

  • Response to Risk of Self-Harm or Harm to others

  • Your Supervision

  • Note Taking

  • Standards of Practice

  • Support

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What NHS staff may experience

It is predicted that during the COVID-19 crisis, NHS frontline staff may travel through (or even cycle) between states of being to solve problems at personal cost and a state of exhaustion and disillusionment (BPS, 2020)

When in a state of heroics or surges towards a solution, the following may be observed/experienced in frontline NHS Staff:

  • Increased camaraderie as staff cross boundaries and work together.

  • Sense of rising to a challenge.

  • Staff may respond on instinct and are more prone to error.

  • They may lack the headspace to see all options.

  • Frustrations and role confusion as people try to adapt quickly within current system design.

  • Staff witnessing things they have never seen before and feeling out of control.

  • Disagreement between groups over sense of urgency.

  • Staff lose usual boundaries over working hours and breaks and start to over-work. Work-life tensions arise as family life also becomes unsettled.

  • Social norms and niceties slip and behavioural responses may causes difficulties for others.

  • Focus on ‘getting things done’ which may lead to poor communication and silo working.

This state is not sustainable in the long term, due to the high adrenaline, experiences of loss, fear, stress etc.  Over sustained periods, staff can transition towards states of disillusionment and exhaustion:

  • The period of highest psychological risk. 

  • Staff are in ‘full go mode’ with high levels of adrenaline and on ‘automatic pilot’.

  • They may then experience sudden exhaustion.

  • They may neglect physical and psychological selfcare as they feel it is not a priority.

  • Moral distress and injury are a risk as healthcare becomes limited and people are unable to act or respond within their own moral or ethical code and death and dying may not be handled in the way it usually is (with family etc.).

  • Staff may begin to feel emotionally disconnected from the work, experience compassion fatigue, and may engage in avoidant or unhelpful coping.

  • Tensions at home and within the wider family may over-run work life.

  • Stress has a cumulative effect and smaller things trigger reactions.

  • Staff with pre-existing vulnerabilities are at higher risker of crisis and suicidality

Project5 Practice Model:


Services for frontline staff have been divided into four Tiers, where Tier 1 is education, Tier 2 is solution focused coaching, Tier 3 is specialist wellbeing support and Tier 4 is recommendation to access local mental health services.


Project5 volunteers will provide frontline NHS staff with Tier 2 and Tier 3 levels of service. The level of support and intervention that the staff member enters will be based on their own perceived personal need in our booking system – which will then automatically book sessions into the diaries of appropriate volunteers. So, NHS staff self-triage by selecting the Tier level of support based on personal identification of need. 


Coaching (Tier 2) – 2 sessions of support. (THIS IS THE TIER YOU ARE SUPPORTING)


Coaching support and intervention constitutes Tier 2, where NHS staff members are not in a state of distress but need to stand back and appraise their decision making or they may have a block as to how they might plan practically for perceived pending dilemmas. These sessions will be provided by qualified coaches or trained mental health professionals who will follow solution focussed coaching guidelines.

 
A solution focussed coaching approach will be used to support NHS workers over two sessions to find solutions to professional dilemmas rather than investigate problems. The approach focusses on building strengths rather than investigating weaknesses, it aims to find positive ways forward, and on overcoming barriers to desired objectives. 

It is important to recognise that you are not supporting distressed staff.  If staff appear distressed in response to any frontline experiences, please kindly suggest that they may benefit from support with their distress by selecting the option that refers to being distressed (option 3) in the booking system for Project5, they will need to cancel their bookings to re-access these options.  You can offer to listen to them for the session and be a light support, but it is important to not try to work with the distress in this context.

Please access your guide and session plan here.


Wellbeing interviews (Tier 3) – 3 sessions of support


Wellbeing interviews will be accessed by NHS staff when they have experienced high levels of distress which threatens to impede their decision making and clinical practice. These three interviews constitute Tier 3 and will be conducted by experienced Wellbeing Specialists who have backgrounds as mental health professionals with a knowledge of NHS clinical teams and the demands placed on them. The first and second interviews will be crisis intervention focussed, while the third will follow-up from the earlier interviews and provide further intervention to foster resilience.


Crisis intervention is an immediate and short-term psychological approach aimed at assisting individuals in dealing with the psychological consequences they face after making critical decisions and actions. This type of intervention initially attempts to restore emotional stability and allow the individual to be able to process the situation, think through their decisions, learn from the experience, and consequently reduce the potential for the individual to become psychologically traumatised. 


Promoting resilience becomes possible when the NHS staff member has become stable and better able to reflect on their wellbeing.  It aims to maintain and promote capabilities and the use of strategies to reduce the potential to experience high levels of distress should similar crisis events occur in future. The second session will support NHS staff to engage in activities that promote good physical and psychological wellbeing. This might include stress management, exercise, regular sleeping hours, healthy eating, ensuring breaks during the working day, regularly de-briefing with colleagues, and gaining support and advice from identified senior colleagues.

Psychological First Aid Principles


Both Coaching and Wellbeing sessions should be delivered within an approach that is informed by the practice of Psychological First Aid, which is advised for those returning from crisis experiences.  This is not unfamiliar for mental health practitioners, but is stated here to reassure you of the core skills you have that are valuable in engaging the appropriate relationship with your client.

In response to a very stressed staff member your role is to promote calm, self-efficacy and hope:

PROMOTE: 

Promote Calm by


■ Listen attentively to NHS Staff who wish to share their stories and emotions and remember there is no wrong or right way to feel.
■ Being warm and compassionate even if people are being difficult.
■ Offering accurate information about the disaster or trauma, and the relief efforts underway to help victims understand the situation. 

Promote Connectedness by
■ Helping NHS staff to identify supportive friends or loved ones.

 

Promote Self-Efficacy by


■ Identifying areas of pre-existing strengths and personal resources.

 

Promote Hope by


■ Promote connecting with peer support, family members, friends etc as a way of getting support.
■ Reflect on other countries where the crisis has calmed down.
■ Promote re-engagement with positive experiences outside of work, exercise, good diet and consider how these might help resilience.

AVOID: 

■ Persuading NHS staff to share details of the stressful event. They need to be calm and given time to describe this at the right time.  

■ Giving simple reassurances like “everything will be OK” or “at least you survived” (statements like these tend to diminish calmness).
■ Telling people what you think they should be feeling, thinking or doing now or how they should have acted earlier (this decreases self-efficacy).
■ Telling people why you think they have suffered by alluding to personal behaviours or beliefs of victims (this also decreases self-efficacy).
■ Making unrealistic promises the hope of reducing their distress. (un-kept promises decrease hope).
■ Criticising existing services or relief activities in front of people in need of these services (this undermines an environment of hope and calm).

Key Training Resources

Please familiarise yourself with:


Response to Risk of Self-Harm or Harm to others

In the event of any disclosure of self-harm or harm to others, NHS staff must be advised to call 999 if it is an emergency, else their GP.  There is no need to freeze or panic about what to do next, your role is simply to point out that this needs the right type of help.  This should be via 999 if it is an emergency (e.g. statement of a planned intent to self-harm or commit suicide) or a choice of support that fits their needs, much of which is listed on our suicide link at the top of this website.  You should familiarise yourself with this also.  Recommending GP, 111 and/or Samaritans contact is helpful in a none emergency.  

Your Supervision

Both Coaches and Wellbeing Specialists are required to book supervision once every 6 weeks using the supervision booking system (this will be launched at the end of April, 2020).  You must maintain your own supervision during this programme, as the supervision provided by Project5 will only serve your work with NHS staff and must not be related to any coaching provided elsewhere.

Your Note Taking

You are strongly advised to take succinct and clear ANONYMISED notes of every session.  Date, time and the initials of the NHS Staff member.  A summary of what was discussed - particularly if you gave any advice to contact 999 or their GP.  These must be kept safe and secure.  These should form your reference point for discussion in supervision.  Standard practice guidelines apply.  These can be destroyed once the work is completed.  These are clinical notes - not records or reports.  

Standards of Practice

Project5 is built on the promise to NHS staff of a high quality service with our volunteers, this will include:

 

  • To communicate quickly with newly booked clients your methods of linking up (see below for detail on this)

  • To check your email account (and Spam) regularly for booking confirmations, from NHS Staff.

  • A commitment to adhere to time.  So, to be on time for sessions and to stick to a 1 hour model and not overrun.  

  • To communicate direct to clients any changes in your circumstances that require a session cancellation / reschedule.  

  • To respect confidentiality about all of your discussions, only disclosing these (if required) in a supervision context.

  • To adhere to the ethics standards of your professional membership body.

  • To provide your remote support from a private and confidential space and not in listening distance of others.

  • To not digitally record the session or part of the session.

  • To value and respect differences of race, sex, gender,sexuality, socioeconomic status and the diversity in general.    

  • To book supervision with the Project5 booking system (coming at the start of May) every 6 weeks.

  • To adhere to the recommended practice guidelines (provided above).

  • Using the booking system – your responsibilities

  • There will be times when you need to cancel bookings or edit your availability, please adhere to:

  • Communicating with any NHS Staff member before you cancel any of their booked sessions in the Project5 booking system.

  • Cancelling sessions in the system if an NHS Staff member requests this.

  • Providing available slots weekly – as our booking system offers weekly multiple session bookings and you will be unlikely to receive a booking if your availability has significant gaps within.

  • To maintain your own consenting process.  NHS Staff are referred to you as a professional.  If you have T&Cs or a consent process, you can email this to the staff member ahead of meeting them.

  • To avoid any reference or invitation to your paid services.  This is a volunteer service - if a client asks you for continued support, this can be explored.  Be aware, that staff will be asked to feedback on whether professional services were offered to them without prompt.  

 
The Booking System - What happens when a client books in
 
The NHS staff view is very similar to yours.  They select the dates and times they would like to meet you and then you are both emailed with calendar invites, so that you can block these in your own calendar.
You are provided the email address of the NHS Staff member.
Please email the NHS Staff member prompty, to confirm how you'd like to connect with them.   This is your choice, as Project5 simply connects NHS Staff to your professional service, as voluntarily offered by you.
We find that offering a Zoom appointment with a dial in option (which is a feature of zoom) is easiest, but it is your own choice.
Project5 cannot cover any costs of this connection software or telephone calls.  
 
Use of the Project5 brand / logo

 

Volunteers are encouraged to share social media brand material (brand pack) to raise awareness off the service for NHS staff.

Volunteers are not authorised to use the logo / brand for any other purposes without express permission.  This includes promoting / linking Project5 to any other pro bono offers or commercial services.   

All involvement with Project is done without any expectation of direct or indirect financial reward through association with us.

This is critical to avoid any confusion for NHS staff or any NHS reputational risk. 

Any breach of these terms may result in  a volunteer being removed from the system with all rights to use our logo removed.

Supervision Guidelines

 

Guidelines available here


Support

If you need support from the Project5 team please contact support@project5.org with the subject line “Support Request”

Training feedback

We are currently developing a mixed media training course, with CPD points.  For now, we'd appreciate your feedback on the training we have provided here.  Please complete our very brief feedback form.

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