Engaging with distress: Training in the compassionate approach

Abstract

WHAT IS KNOWN ON THE SUBJECT?: Mental health nurses provide care within an environment that is often threatening. The environment is often threatening because: (a) patients' needs are complex and highly emotional, (b) nurses often do not have the time and resources they would wish for and (c) caring for patients can be emotionally exhausting and distressing. Compassionate care involves providing a welcoming environment, promoting bidirectional compassion, providing training in compassion and creating supportive organizations. To date, there is no study evaluating compassion interventions for the high-threat profession of mental health nursing and no study qualitatively evaluating compassion training and implementation. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: This study looked at what happens if compassion training delivered by the originator of Gilbert's model of compassion is given to mental health nurses. Nurses were interviewed 1 year later to see how relevant and useful the training was, and whether they had been able to use it in their daily work. Consistent with previous studies, the study found a reduction in professionals' self-criticism and an increase in self-compassion, which in this study extended to increased compassion and reduced criticism of colleagues and patients; and professionals applying the training directly to reduce patient self-criticism. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Nurses felt that more training and supervision was needed to build the confidence to use the training regularly at work. They felt it had been difficult to use the training because of the threatening environment in which they worked. Nurses recommended that the whole organization would need the training to make it part of their everyday work. ABSTRACT: Introduction Compassionate care involves providing a welcoming environment, promoting bidirectional compassion, providing training in compassion and creating supportive organizations. To date, there has not been a study evaluating compassion interventions for the high-threat profession of mental health nursing. Neither has there been a study providing an in-depth qualitative evaluation of training and implementation. The current study aims to address these gaps in the literature. Aim The aims were to evaluate Compassionate Mind Training-CMT for mental health nurses and to assess implementation. Method Focus groups were conducted (N = 28) 1 year later to evaluate CMT and implementation. Results Content analysis revealed four training themes: (a) Useful framework; (b) Thought-provoking and exciting; (c) Appreciation of person-centred approach; and (d) Need for ongoing training and supervision. Three implementation themes emerged: (a) Applied approach with patients and staff themselves; (b) Environmental challenges to implementation; and (c) Attitudinal challenges to implementation. Discussion Consistent with previous studies, professionals experienced reduced self-criticism and an increased self-compassion, which extended to increased compassion and reduced criticism of colleagues and patients; and professionals applying training directly to reduce patient self-criticism. Implications For successful implementation, formal adoption of compassion approaches is needed with strategic integration at all levels.

Keywords: burnout; compassion; health care; training; well-being.