Connect with us
Elysium

Opinion

Kindness in therapy and why it’s important

There have been lots of discussions on kindness in the past weeks – in the media, on social media, in life, writes Rachel Swanick, music therapist at Chroma.

Published

on

As healthcare professionals, we are always kind, right? We always look at both sides of the argument, never judge others or get frustrated with our clients… Well, maybe not. Of course, we are human and just as easily swayed by our foibles as the next person.

However, and this may sound obvious, when working with vulnerable clients and families as we do, there is an even bigger need for kindness to be at the core of our interactions.

It was whilst standing in the school yard with my children that I first started to really think about this. We spend maybe five or ten minutes each day in the yard all of the other parents.

Some we will give a friendly nod or a smile, with some we may make lasting friendships. An internet meme tells me to smile at others because we don’t know what is going on the lives of others. We project our own ideas on to the parents (and people) around us based on our life experiences.

The mum who is always impeccably dressed and organised – she is winning at life! The dad in his tracksuit – why is he not at work… And we really don’t know what happens behind their closed doors.

During a recent school drop off, one of the mums that I smile to was crying outside of the gates. I stopped to ask if I could help. Georgie opened up to me; one of her children was really struggling in school and he was not getting the support he desperately needed.

Georgie was worn out with the battle of asking for help and not getting anything back. She talked about teachers not listening to her, even though she knew that Alex was on the autistic spectrum. Their family GP had made a referral to an Educational Psychologist and CAMHS (child mental health service).

CAMHS had not returned any of her calls for weeks and the Educational Psychologist has been rude to her in a meeting, dismissing Georgie’s concerns as not important. Unfortunately, this story is not uncommon.

As I talked to the families that I work with as a music therapist for Chroma, most had similar stories of long waiting lists, overworked professionals not responding to them and, I think most importantly, of having their concerns and needs dismissed.

One family in particular stands out in my mind. I had met Joanne, an adoptive mother, a year before I started working with her child, Lucy.

Lucy was very high need: not only had she experienced childhood trauma and multiple care placements before being adopted, she also had physical difficulties. At the time of referral, Lucy was finding it hard to be heard in her mainstream school and had been excluded twice.

I realised quickly that the relationship between school and home was extremely strained and, just as quickly, I was drawn in to the dynamics of what was happening. I experienced the push and pull of a split in the relationship as both mum and school told me their experiences of each other.

The situation was not kind- on school, mum, me as the therapist and, most definitely, not on Lucy. The damage that had been done by this dysfunctional relationship between school and mum was making the therapy dangerous.

Lucy and Joanne were vulnerable and this could not be thought about within the network of professionals and any support being offered was rejected. There was nothing that I could do as the dynamics were affecting the safety of the therapy space so I stopped working with the family.

This feels like an extreme account of the impact of difficulties affecting the relationship between parent and professional but I think that it shows how damaging it can be when we, as professionals, are not thoughtful about how we conduct ourselves with clients.

If a mum has deep concerns about their child, we should listen as they will not be far wrong – they are living that life and we are not. As professionals, we could ask ourselves, are we judging instead of being kind? Is judgement the opposite of kindness?

As a music therapist, I often wonder about how we portray kindness to our clients and families through the music. When a child is experiencing developmental trauma, like Lucy here, it can be difficult for family members to communicate without feeling vulnerable, like Lucy’s mum, Joanne.

Daniel Stern, an American psychologist, has influenced the way most therapists work with clients with his model of attunement.

Attunement is based on the mother-child relationship. When the baby communicates their feelings through crying, vocalisations or body language, and the mother responds in an appropriate way; therefore, the mother attunes to the emotional and physical needs of her baby, helping the infant feel heard and looked after.

Not all attunements go well and the mother may need to repair the relationship somehow. In a home where the parents are not attuned to the needs of the child, development trauma happens.

The child has to learn to soothe themselves and there may even be cognitive damage, as well as we emotional and physical neglect. When the child is referred to therapy, the therapist can model the good enough parenting of attunement.

The format of the therapy relationship (and other healthy relationships) becomes attunement – misattunment – reattunement, with the reattunement being key to normal relationship development. In music therapy, where the emphasis is on nonverbal communication, the therapist can model the relationship through musical responses.

This could be listening to the client’s sounds and picking out melodies or themes, it could be mirroring the client’s music to help foster a sense of self, or it could be providing an accompaniment and containing the music of the client so that they feel safe.

The therapist is there to hear the client’s offerings and help them to make sense of that through the music: they kindly listen and respond, not judge the competence or sounds created in the therapy space.

Offering a parent or client who we are working with the chance to be heard might be the first experience of kindness they have had for a while and we could all take the time to offer someone we work with or know this space. So, in the spirit of Random Acts of Kindness, I offer you ‘The Therapist’s Tips for Kindness at Work”:

  • Ask someone how their day is going
  • Listen to the upset parent until they stop talking… smile, nod and offer tissues as necessary
  • If appropriate, send your client a text or postcard to say hello
  • Make a colleague a cup of something warm if they have had a bad day
  • Do something each day that makes YOU happy; a walk, a chat with a friend, a hobby
  • Give a compliment to your client or colleague – it could be around how hard they are working
  • Smile !

Continue Reading
Click to comment

Leave a Reply

Your email address will not be published. Required fields are marked *

News

Brain injury in the new normal: How to get a good night’s sleep during the pandemic

Consultant clinical neuropsychologist Dr Keith G Jenkins and Dr Jenny Brooks, consultant clinical psychologist on how to sleep well during the pandemic.

Published

on

Getting a good night’s sleep is important all of the time, as we know from our work with people with brain injury, but some people have seen their sleep pattern alter during the pandemic.

This change to the normal time people go to bed and fall asleep and/or wake up in the night, may be due to several factors, including changes to the way the person spends their day in terms of education, work, meeting up with family and friends, seeing support workers and / or attending rehabilitation sessions. Also they are perhaps exercising, playing sport or doing other activities less.

Lower mood, such as feeling sad, having worries or feelings of uncertainty, can also impact on your ability to get to and stay asleep.

Changes to our sleeping habits can lead to a poor sleep-wake cycle, otherwise known as our body clock. Not getting enough sleep, or good quality sleep, can cause fatigue and tiredness throughout the day. You might feel unwell as a result, and this can increase anxiety and worries further, making getting through the day more difficult. It might also mean that relaxing to sleep becomes harder, and a vicious downward spiral can follow.

Fortunately, there are some very simple things we can all do to support a good night’s sleep. These include going to bed and getting up at the same time each day to support your body clock, exercising during the day if you can safely do so and trying not to exercise too close to bedtime. Avoiding caffeine or nicotine close to bedtime – or reducing them if you can’t stop completely – can also help.

Be aware that alcohol might mean that you fall asleep faster, but it can disrupt the second stage of sleep, meaning that the quality of your sleep may be reduced, which can then lead to you feeling tired the next day.

It’s generally best to avoid things that may cause you upset or stress before your usual bedtime, like a difficult phone call or a scary TV programme. It is also important to reduce your exposure to blue light, for example from smartphones and laptops, before bedtime.

Blue light tricks your brain’s body clock into thinking it’s daytime and suppresses the production of melatonin. This is the hormone you need to feel sleepy.

Try to have a bedtime routine that supports you in winding down, whether that means a bath, listening to music or a relaxation CD. It’s also really important to ensure that your bedroom supports your sleep, so consider things such as lighting and temperature. Most people tend to find that a tidy bedroom can help the room feel more relaxing too.

Of course, many people with an acquired brain injury tend to experience fatigue and often find having a nap in the day can help them to manage this. But an afternoon nap should end before half past three in the afternoon at the latest, with your next sleep being in bed for the night. Headway has a very helpful section on its website regarding managing fatigue.

While bedrooms should predominantly be for sleeping, some people have been spending more time in them during the pandemic doing other things – perhaps using them as a quiet space to complete education or work.

For those in hospitals or care homes, increased bedroom time may be due to isolation procedures. If this is the case, perhaps consider having a chair or a beanbag to sit on, rather than lying on your bed during the day. Where possible, try to come out of your room for meals.

If you find it is taking a long time to get to sleep, try getting out of bed and doing something else, like reading a book or a magazine, and then return to bed when you are feeling sleepy.

The advice we have given here is in line with the recommendations on the NHS website.

A good night’s sleep is crucial to thinking at our best, which is especially important if you are working or being educated at home; and there are some other simple things that you can do to boost your productivity in these scenarios.

Firstly, make sure you have a shower and get dressed rather than working in pyjamas or dressing down. Getting dressed helps you to psychologically get into work mode. Have a designated workspace and, if possible, keep the area tidy.

Have a timetable of when you’re going to work and try to stick to it. As we’ve mentioned, writing a timetable down and ticking off jobs completed supports feelings of achievement. Make sure you schedule regular breaks during which you move away from the workspace. You might go into your garden or make a drink, for example.

Try to minimise distractions. That might mean moving your mobile phone out of reach, turning off the TV and considering where the quietest places are. If you live with other people, you might want to consider how to ensure they don’t disturb you. This might just mean letting them know what your work timetable is.

One distraction that can’t be ignored, however, is the need to wash our hands to prevent the spread of the virus.

We hope you have found this guide useful and wish you a safe and happy summer as we all continue to rise to the challenges presented by COVID-19.

This is one of five blogs in a series on living in the new ‘normal’ with a brain injury, based on a webinar produced for ABI London (ABIL). See below for links to other articles in the series. Dr Keith G Jenkins is consultant clinical neuropsychologist at St Andrew’s Healthcare and chair of Headway East Northants. Dr Jenny Brooks is a consultant clinical psychologist working independently and a director of The ABI Team. For any questions about this topic email update@standrew.co.uk. 

Fitting COVID-19 guidelines into your routine

Keeping a check on your wellbeing

How to keep in touch with loved ones during the pandemic

How to keep a routine during the pandemic

Continue Reading

News

Brain injury in the new normal: How to keep a routine during the pandemic

Consultant clinical neuropsychologist Dr Keith G Jenkins and Dr Jenny Brooks, consultant clinical psychologist on how to keep a routine during the pandemic.

Published

on

Daily structure has changed for us all during the COVID-19 pandemic and this can feel very unsettling. A regular structure and routine is important for many reasons.

First, it increases feelings of normality and control, as well as meaning and purpose; all of which can help to push back against low mood. Second, it can reduce feelings of stress and anxiety through distraction.

Finally, a structured timetable can reduce the burden associated with some of the behavioural and cognition issues that can occur after brain injury. These include difficulties in starting an activity, planning, organising and making decisions.

So what can structure and routine look like during the pandemic?

A daily routine could include a mixture of self-care activities, such as having a bath, shower, or pampering yourself, completing some household chores and keeping active through exercise. Doing something fun that you enjoy, such as an online live music event, a quiz or watching a favourite film or TV programme, could also be included.

Try focusing on those activities that you find uplifting, positive or funny. Also some find it helpful to limit their watching of the news about COVID-19 as it can lower mood and increase their worries. There are lots of ideas for activities you can do at home in our resource pack which can be viewed via the ABIL website.

Having a daily timetable written down can help to ensure that structure and routine become the norm. It can also be reassuring to be busy and have things to do.

Checking off activities completed, can support you in feeling that you’ve achieved and accomplished things throughout the day.

Furthermore, a written timetable can help you to manage your time effectively, and support variety in your day. If you have difficulties getting started on something, or beginning an activity, you could share your timetable with someone else and ask them to help you get started, perhaps through a phone call or a text.

If you prefer to do this yourself, you can set up reminders on your phone or use other devices, such as Alexa.

This is one of five blogs in a series on living in the new ‘normal’ with a brain injury, based on a webinar produced for ABI London (ABIL). See below for links to other articles in the series. Dr Keith G Jenkins is consultant clinical neuropsychologist at St Andrew’s Healthcare and chair of Headway East Northants. Dr Jenny Brooks is a consultant clinical psychologist working independently and a director of The ABI Team. For any questions about this topic email update@standrew.co.uk.

Fitting COVID-19 guidelines into your routine

Keeping a check on your wellbeing

How to keep in touch with loved ones during the pandemic

How to get a good night’s sleep during the pandemic

Continue Reading

News

Brain injury in the new normal: How to keep in touch with loved ones during the pandemic

Consultant clinical neuropsychologist Dr Keith G Jenkins and Dr Jenny Brooks, consultant clinical psychologist on how to stay social during the pandemic.

Published

on

While they’re in everyone’s best interests, COVID-19 restrictions have made life more difficult for some.

One area people are struggling with is the social isolation of not being able to visit loved ones, or socialise with anyone other than the other members of their household, if they have any.

Despite the many ways to stay in touch with family and friends – including letters, telephone and video calls and conferencing –  people may still feel lonely and isolated.

To help manage these feelings, it is worth scheduling regular days and times to have contact with specific family and friends and spreading these throughout the week. You could even ask your family and friends to make you video messages, which you could replay at any time.

Ensure, where possible, that you have time to socialise in your day, every day. Schedule a phone or video call, or ask others to organise a group chat with family, friends or colleagues.

If you have a day where you don’t have a scheduled call with friends or family, it may be helpful to use this day to go out and do your shopping or take a walk in your community if you are able to.

It may be helpful to consider what aspects of normal routine can be kept the same, modified, changed or replaced. In terms of modifying activities, it may be helpful to ask yourself questions such as could a regular meetup with someone now become a phone call? Could the pub quiz night now be a on a video call? Could a trip to a cafe or a restaurant now become a takeaway?

And for those people in residential settings and maybe having to isolate in their bedrooms, could interaction with others or groups take place in the corridor, allowing people to safely socially distance in their doorways?

It may be that some activities you enjoy can not be modified. Therefore, perhaps you could think about what it was about the activity that made it enjoyable and meaningful and consider what other activity could meet these needs.

For example, did you enjoy going for a swim at the leisure centre because it was a physical activity or because it was relaxing? Or perhaps you enjoyed the social element of it?

It’s important to remember that just because you can’t see your usual support circle, this doesn’t mean they’re not there, or that they’re any less contactable, during the pandemic.

This is one of five blogs in a series on living in the new ‘normal’ with a brain injury, based on a webinar produced for ABI London (ABIL). See below for links to all other articles in the series. Dr Keith G Jenkins is consultant clinical neuropsychologist at St Andrew’s Healthcare and chair of Headway East Northants. Dr Jenny Brooks is a consultant clinical psychologist working independently and a director of The ABI Team.

For any questions about this topic email update@standrew.co.uk.

Fitting COVID-19 guidelines into your routine

Keeping a check on your wellbeing

How to keep a routine during the pandemic

How to get a good night’s sleep during the pandemic

Continue Reading

Trending