Clinicians: would you like to guide parents more effectively, so that they can better support their child?
Here’s a format I have developed for a one-day course to do just that — and parents who attend get the benefits first hand as well. I have piloted this course in South West Yorkshire NHS Trust and also in Lancashire Care NHS Trust, and I report here from the feedback received. Further down you can find out more about the content.
“My eyes were opened through all the different sections of the day. I’ve always had compassion and empathy for families, but this workshop has just added to it.”
Clinicians and parents rated the course highly and would recommend it to others
It’s all “Agree” and “Strongly agree” (except one “Neutral” answer) to:
- “I learned a lot”
- “I can see myself being more effective”
- “I am very glad I came”
- “I would recommend the course to others”
What most fired up people’s enthusiasm?
Here are examples of what keeps coming up in the written feedback:
The practicalities of feeding and dealing with resistance got a big thumbs up from clinicians and from parents
“Excellent advice about how to feed your child”
“Helpful to talk to parents about what they have found helpful when supporting child to eat.”
“If only I had had Eva’s books/website/YouTube when my daughter was first struggling, the NHS could have saved so much money.”
“Strategies for acute anxiety/aggression were helpful.”
” Loved the ideas on compassion and kindness in a context of firmness when needed”
“Compassionate persistence: very inspirational.”
“I feel I have gleaned a lot of helpful and useful advice and tips/information which I can take home with me to hopefully aid my child.”
compassion was a major focus of the course and clinicians totally got it
“Loved the model of over-arching compassion. Want to follow up myself with nonviolent communication literature.”
“Will be applying approach to everyday life and relationships.”
“Loved the compassion stuff”
“I will engage more compassionately.”
“We need to remain compassionate! And understand distress. Enjoyed the ‘chatterbox’ and compassion models”
“Self-compassion: something I will apply to my practice. Respect parents – be mindful of what works for them, don’t blame, don’t judge.”
“Today has given me the tools to be better at ‘compassionate'”
… and compassion was just right for the parents too
“Will help me feel more empathetic to my daughter. Gives me a better understanding of her plight. Found use of silent empathy powerful.”
“Perspective of the child: very illuminating”
“Feel you have given me permission to seek counselling for myself.”
PARTICIPANTS appreciated the chance to learn from each other
“Brilliant idea doing training with clinicians and parents together. So useful to hear parents’ perspective.”
“I feel that no matter how much we think the parents are struggling it is 100% more.”
“Good to hear from parents – helped me consider things I wouldn’t normally have thought about”
“Having parents’ experiences and perspectives was a massive help”
“It was comforting to hear other parents’ views/experiences.”
“Refreshing to see emphasis on the importance of family input, and support and need for clinician compassion for the family unit”
What kind of a speaker and course leader am I?
“Knowledge base excellent. Great delivery. Great enthusiasm and charisma.”
“Every word you had to say was fascinating and interesting and I will certainly be reading your book!”
“Regular sessions with Eva would be fantastic! Great teacher and inspiration.”
“Eva’s enthusiasm and style shone through.”
“Useful references to the current literature”
“I love the fact that you clearly know so much but do not make yourself out to be an ‘expert’ and are able to say ‘I don’t know'”
“I wish I had known your approach 5 years ago. Maybe we would not be where we are today. Still, I’m going to try!”
“Eva comes across as very knowledgeable and passionate about helping the children and ‘us’ parents.”
“Eva very warm and reflective”
“Lovely warm personality, very engaging”
Participants enjoyed the flow of the day
I use role-play demonstrations, puppets and other props, large-group games, role plays and discussions in small groups (taking care of people’s comfort and safety), question-and-answer times, times to hear from participants’ experiences, as well as good old lecture-with-slides.
“Lots of activities: very engaging.”
“Role play brought the reality of ED to the surface.”
“The ‘Agree or Disagree’ activity was very thought-provoking and interactive.”
“Good interactive group discussion”
“Very useful and supportive answering/debriefing”
“Very well put together and well presented”
“A good mix of activities (including moving)”
“Well constructed and informative throughout.”
“The balance of the theoretical and personal was really important. ”
“Glad it was a full day.”
The course created some impetus for change in the service
“I believe we can do more work in the community on supporting parents on meal support. I am going to suggest same in my team.”
“I will aim to provide individual sessions for parents without the child.”
“Helpful to discuss different people’s view points about treatments and service provision.”
“It has helped me think of ways to improve our ED service.”
The course touched and motivated clinicians
“Have left feeling very moved.”
“Will give me confidence to empower parents more.”
“Role play helpful as helped me identify with the client’s feelings.”
“So very grateful to parents coming and sharing their experiences and they must have felt very vulnerable. I am very appreciative of this. I hope I can be the best I can be for them in the future. “
… and it moved parents
“Thank you for giving me permission to stop blaming ourselves and for bringing hope.”
“I feel more confident and competent to help and support my daughter.”
“Made me more confident in knowing I am doing my best for my daughter and we will get there!”
“Thank you. I now have hope!”
” I have found it very helpful and therapeutic — and emotional!”
“I feel blessed to have been able to hear you today.”
A brief audio testimonial
From Graham Murphy, Lead Family Therapist at South West Yorkshire Partnership NHS Foundation Trust, who invited me to run a one-day course for parents and staff.
“Some colleagues of mine had heard you speak at the national (EDIC) conference. They were very enthusiastic…[What would you say to other heads / clinicians considering inviting me?] Go ahead…Definitely do it”
OK, so people loved the course. Next time I do this I will tweak some of it to make some aspects even more practical and smooth-going. I asked for detailed feedback for each section, I got it, I agree with it, and I’m going to use it.
So what’s covered?
- How to help someone with an eating disorder to eat
- Dealing with aggression and with extreme distress
- What it’s like for parents
- What it’s like for a young person
- How to make change happen with compassionate persistence
In the process we also look at:
- Fight-flight-freeze and when it’s not effective to go for logic, choice or motivation
- Compassion – the antidote to fight-flight-freeze: how to do it for oneself and others
- Compassionate communication: a framework to help you tackle difficult conversations
- Help or hardship: fun exercises to raise all sorts of questions about what constitutes an excellent evidence-based service.
Who is this course for?
For parents, without a doubt.
For clinicians who are already experts in treating eating disorders, or who are in the process of going through other sources of training on eating disorders and who are getting supervision to become experts. The day will deepen their understanding and empathy, and give them more tools to offer parents. The day should be equally useful to those in outpatient or inpatient settings. My field is children and adolescents, yet it looks like clinicians working with adults benefited just as much from the day.
How about clinicians who have no intention of specialising? Remember that children and adolescents in England should now only get their eating-disorder treatment from specialists, according to the Access and Waiting Time standards. But this course seems to be beneficial to those involved in the care of someone with an eating disorder even if they are not the main treatment provider. They get a better general understanding of what’s involved, and it may help provide a more consistent, systematic experience for patients, with everyone on the same page. There’s a big “but” though:
My concern with non-specialists who attend the course is that on no account should they consider that the course has made them competent to treat eating disorders. There’s a lot more training and supervision required before we can hope to “do no harm”.
Finally, whether they are specialising or not in eating disorders, everyone should benefit, both professionally and personally, from the course contents on communication and compassion. Initially I was worried that bringing training in empathy to a bunch of therapists would be like bringing coals to Newcastle, but clearly, staff loved it.
The course comes with a handout (a few pages), a dedicated web page (with links to further reading and to any research referred to during the day), and a link to the slides, so that people can remind themselves of the course or show visuals to their colleagues.
Is the course effective?
That’s what fires me up to give the course, and I wish I could study this.
Does attending a course result in measurable benefits for our children? For parents? For clinicians?
Can I even expect that the message I intend to give matches the message received by each participant?
My guess is that for this one-day course to most pay fruit (and to avoid the risks of anyone being over-confident) it needs to be part of ongoing supervision and learning work within the service.
Intended outcomes of the one-day training
I have planned the day with the following intention:
Young people get better faster
They get greater, more lasting improvements – preferably total recovery, because both clinicians and parents have more resources to support them.
parents who attend get better at supporting their child on the path to recovery because:
- You have some more tools to try at mealtimes
- You have some more tools to try in all your communications
- You have some more tools to keep yourself topped up emotionally
Clinicians are better able to help parents to help their child because:
- You have a greater understanding of the parent’s perspective: you understand their challenges, their hardships, and their strengths
- You have a greater understanding of our children, through the parents’ eyes
- You have more resources for parents who want help to feed their child
- You have a framework for parents to deal with resistance, fear, and aggression from their child
- The same resources will help you respond to the distress or resistance of parents
- You have some more tools to keep yourself topped up emotionally
Families survive and thrive
Parents are well – they have the practical and emotional support needed to avoid common carers’ pitfalls (depression, anxiety, PTSD, ill-health, marital breakdown). This makes them able to support the young person as well as their other children. This speeds up the young person’s recovery and reduces the burden on the health service. Parents get these benefits either from attending the day, or via the clinicians who do attend.
Clinicians increase their effectiveness and resilience
Clinicians deliver family-based treatment (and to some extent, also CBT for eating disorders), in the most effective way. They learn or consolidate skills and make best use of the tremendous resources that exist within a family. They get a deeper grasp of the demanding journey families are going through, and expand their capacity for empathy and regard for all family members – something central to effective family-based treatment. They have an increased repertoire of communication and compassion tools This benefits the young people they are treating, their families, themselves and other members of the service. Their own wellbeing and satisfaction increase as they find they are more effective and that there is increased teamwork and mutual support.
Parents and clinicians work hand in hand
By having parents and clinicians attend the day together, everyone has a common experience of the needs of all parties and of the resources they can draw on.
Different services work hand in hand
By having clinicians from a range of services (CAMHS, adult, inpatient, outpatient, voluntary sector, etc) there is a better understanding of needs and opportunities. So young people get seamless, efficient treatment, and the Trust makes best use of its resources. (The day may be more slanted towards children and young people because of my own experience, but most of it is likely to address needs of those caring for adults).
The service achieves more of the Access and Waiting Time standard
The standard requires a specialist eating disorders service, and staff must be trained in family-based interventions. This day focuses on exactly that.
If you’re interested, do get in touch with me.
To put your mind at ease, you may like to talk directly to the people who have invited me recently: Lynne Green (CAMHS Clinical Lead/ Consultant Clinical Psychologist at Lancashire Care NHS Foundation Trust) and Graham Murphy (Lead Family Therapist, South West Yorkshire Partnership NHS Foundation Trust).
For information on other events, see here.