How can a Compassion Focused Model help Felindre Ward?

by Baz Van de Vegte – Wards' Psychology Student

The Felindre Ward is an acute facility in Bronllys Hospital perched on the hills of Brecon’s countryside. The ward welcomes patients to its beds who maybe experiencing a significant crisis in their mental health. The staff who dedicate their time to supporting the patients vary from nurses, doctors, occupational therapists, health care support workers, domestics, clinical psychologists and students. Time and care go into interventions such as nursing assistance, community support, psychological therapies and engagement with activities towards the improvement of well-being.

The Journey of Psychology on Felindre

Felindre introduced its first dedicated psychologist on the ward in September 2021. I was fortunate to be given the opportunity to join the psychologist within Felindre Ward in October 2021. At this point we were just starting to build relationships across the teams and establish the potential role for psychology on the ward. It was clear from the start that staff and patients alike were tired and weary from the ongoing Covid-19 pandemic, which drastically impacted the processes in place for patient and staff safety.

Getting to know the Team

We wanted to find out what staff most appreciated whilst working on the ward. We shared a survey with staff, asking questions such as ‘what do you most like and dislike about your role on the ward?’. The overwhelming response was that staff mostly loved spending time with patients and caring for their needs. 

It also highlighted that staff mostly disliked it when tasks got in the way of this time with patients. This told us that interacting with patients played a vital role in staff wellbeing and role satisfaction. However, it felt as if we were all on autopilot and somehow that core passion was worn out from the ongoing tiredness of the pandemic. We wondered ‘how we could reintroduce that important sense of connection between staff and patients?’.

Introducing Mindfulness

Shortly after our research, we developed daily mindfulness sessions that are now being run for patients and staff to explore breathing techniques, notice bodily sensations and engage in group activities. 

Mindfulness is a way to focus one’s mental state on the here and now and away from memories in the past or anxieties in the future. It expands awareness of what we are doing, how we are feeling and what’s going on around us. By practicing techniques that helps ground oneself to the present, anxiety levels can reduce creating feelings of calm and wellness. Daily mindfulness sessions have proven to be well received by patients who started to practice calming techniques when under stress. 

However, whilst staff also engaged in the sessions we noticed that they some seemed to struggle to allow themselves this luxury on their shifts.

A Compassion Focused Model enabled us to understand why this could be.

Baz Van de Vegte – Wards' Psychology Student

A Compassion Focused understanding

We used a Compassion Focused Model to help us understand why staff showed some resistance to practicing mindfulness. According to a Compassion Focused Model, there are three systems in the brain that are in sync helping us makes sense of how and why our brain triggers the arousal of emotions - we call these the threat, drive and soothe systems.

Our drive system is what we depend on to keep ourselves motivated to achieve, complete that short-term goal or stay active with our hobbies. We then get rewarded for such activities by the release of dopamine which in turn drives us to keep motivated. 

The soothe system is what we rely on to keep relaxed when we get overstressed or full of anxiety. The system regulates any feelings of threat and keeps us relaxed so that we can think rationally to reduce levels of anxiety. 

Our threat system tells us when we feel under threat so that we can try and self-protect from a given situation. It’s closely linked with our flight, fright and freeze responses when under stress - causing hormones like adrenaline to be rushed through the body. As a result, this activates as a safety mechanism to help us avoid any immediate danger.

How does this apply to Felindre Ward?

Ideally for our emotions to be regulated efficiently, all three systems need to be evenly active in our everyday lives. As staff go through ongoing stressors, the threat system can grow out of proportion and tower over the soothe and drive systems. The threat system can be activated by perceived threats as well as actual threats. Therefore factors such as staff shortages, environmental noise, too many demands, could act as possible threats. 

Prolonged periods in threat mode can result in burnout, reducing energy and motivation. In order to reduce the threat system it is essential to increase the soothe system. This can be done by mindfulness for example, which can increase self-compassion and rekindling energy for the drive system. 

We knew that if staff were able to increase their own self-compassion and self-care, this could have a direct influence on patient care. The idea of introducing the Compassionate Focused Model to Felindre could be an opportunity to establish compassionate thinking and keep an evenly balanced soothe, drive and threat system amongst our fantastic team.

Our Pathway to Compassion

Now that we are starting to understand how compassion has an incredibly important role in the lives of our patients and staff alike, we can start to build towards a more compassionate focused direction. By allocating tasks to staff members which are closer in line with their interests and values, tasks could be more rewarding than stressful. 

Introducing staff training to help with these tasks could help drive our team to expand their knowledge and bring the best services to their patients. More time spent on reflecting with patients and staff would also help us understand ongoing changes in attitudes and passions so that we can adjust to accommodate all. Taking the time to join mindfulness sessions would also really ground staff members who may benefit from a moment of self-compassion or who generally need to destress from a busy morning. 

By introducing the more compassionate focused practices to the ward, we could help guide our patients and staff to think and reason compassionately by behaving caringly and kindly to themselves and others.

Psychology Notice Board – Felindre Ward

“Compassion is the courage to descend into the reality of human experience.”

Paul Gilbert - founder of Compassion Focused Model