Table 6 Examples of change objectives, theoretical methods and practical applications for the programme outcome: Distress Brief Intervention Level 1 frontline staff have the skills, competencies and confidence to deliver a Level 1 intervention
Change objectives | Theoretical methods | Practical applications |
|---|---|---|
Understands that different feelings or attitudes about distress might influence their approach and practice to Distress Brief Interventions | Prompt reflection of past behaviour Credible source Provide information about health and emotional consequences | Reflective activity: encourage reflection of personal attitudes and their impact on recent experiences responding to distress. Record in journal or discuss Provide evidence-based information describing the impact of negative staff attitudes on the experience and outcomes of those in distress |
Recognise that distress may present in various forms, including medically unexplained symptoms | Credible source Provide information about behaviour-health link Provide information about health and emotional consequences | Present evidence-based information and different examples of distress presentations Present written quotes from individuals with lived experience of distress |
Awareness of important influences on distress (e.g. individual, social, cultural and environment) including stigma | Credible source Provide information about behaviour-health link | Present evidence-based information, and varied examples of potential influences on distress including health inequalities, social determinants, stigmatising attitudes, trauma experiences Provide theoretical framework for understanding interplay of factors that contribute to distress e.g. stress-vulnerability diathesis |
Understands the value, and skills involved in an empathic frontline assessment of a person in distress Understands how to undertake empathic assessment in context of a frontline response to distress | Credible source Provide information about health and emotional consequences Instruction on how to perform a behaviour | Provide evidence-based information demonstrating the importance of interactions conducted sensitively and with empathy to those in distress, for example during psychosocial assessments Activity: encourage consideration of potential benefits of adopting empathic approach for: (i) a person in distress, (ii) frontline service staff responding to the person. Record in journal or discuss Provide guidance and examples of interpersonal communication and behaviour that facilitate clear and sensitive communication, for example: acknowledging and validating; paying attention; open questioning; body language and nonverbal behaviour; checking understanding; sensitive probing Handout/Aide memoire: provide concise evidence-based information, guidance and tips to support frontline staff to identify and explore distress presentations including self-harm |
Understands the importance, key skills and attributes of a compassionate frontline response Understands how to use compassion skills and attributes in the context of a frontline response to distress | Credible source Provide instruction Provide information about health and emotional consequences Problem solving Reduce negative emotions | Provide information defining compassion and clarifying the core attributes and skills involved in providing a compassionate response to distress Reinforce importance of compassionate response using quotes from individuals with lived experience of distress Provide evidence-based information on the beneficial outcomes of responding with compassion for those in distress and frontline services workers Show video content, featuring those with lived experience of distress reporting negative experiences of frontline service conversations and offering advice on how future experiences can be improved Reflective activity: encourage reflection on frontline service worker’s experience responding to distress, with and without with compassion, and the reasons for this Provide information on several challenges or obstacles to responding with compassion: compassion fatigue, burnout, vicarious traumatic stress. Encourage practices consistent with self-compassion: self-kindness, common humanity, mindfulness |
Able to explain the purpose, nature and value of referral to the Distress Brief Intervention Level 2 for the person in distress Understand how to make a referral to the Distress Brief Intervention Level 2 service | Credible source Provide information about behaviour-health link Instruction on how to perform a behaviour | Provide written information and advice on introducing and explaining the referral and potential benefits of accessing the Distress Brief Intervention Level 2 service Provide written information on seeking consent; accessing the referral form; recording accurate and informative referral information; sending the referral form to the Distress Brief Intervention Level 2 service according to the agreed protocol Provide example referral form, with annotation and tips provided Provide written information on steps following referral so that these can be communicated to the person in distress Handout/Aide memoir: provide summary of key steps and prompts for offering and executing the referral to the Distress Brief Intervention Level 2 service. |