Psychological Professionals

Integration of psychological practice

There is a great deal of need for the integration of psychological practice within physical healthcare. We know that infants are critically vulnerable during their first 1001 days and need thoughtful, mental health and wellbeing-orientated support. Families and staff working in neonatal units also need nurturing, supporting and developing. This is recognised in the Neonatal Critical Care Review, the Getting it Right First Time (GIRFT) Neonatology Workforce Report and powerfully in the Ockenden report.

Admission to a Neonatal Unit (NNU) has many negative psychological consequences for the parents, the neonate, siblings and the parent-baby relationship. There are significantly higher rates of mental health difficulties in parents who have babies in neonatal care when compared to the general perinatal population and higher rates for the babies themselves. We also know that attending to wellbeing and supporting mental health results in better adherence to treatment or support plans and better engagement with unit professionals.

Psychological interventions provided within the NNU have been shown to improve these difficulties for families during their admission, as well as following discharge from the unit.

The potential negative psychological impact of working in critical care for staff has also been shown and this has an understandable impact on staff retention (see Managing the impact of neonatal work). Psychological interventions led by practitioner psychologists embedded within NNUs have demonstrated significant reductions in stress-related illness for staff. We also know that teaching staff about the challenges and how to look after themselves and their team, results in staff better equipped to cope with the emotional impact of the neonatal environment.

Psychological practitioners on units provide support to infants, support the parent-infant relationship and offer support to parents, siblings and wider family. Where there is enough provision they also support staff through 1:1 and group sessions, debriefs, reflective practice and teaching.

Psychological practitioners may be:

  • Clinical or Counselling Psychologist (both can be grouped under the heading ‘practitioner psychologist’) and are HCPC registered, as well as often being dual registered with the British Psychological Society (BPS) or the Association of Clinical Psychologists (ACP-UK))
  • Child and Adolescent Psychotherapist – follow an NHS approved training course and are registered with the Association of child psychotherapists (ACP)
  • Other types of psychotherapists and counsellors also work on neonatal units. When recruiting it is important to work alongside the lead psychologist to ensure that the candidates have the right level of professional training and expertise and appropriate, robust professional registration.

Useful Resources

The Neonatal Psychology staffing standards
Psychologists | British Association of Perinatal Medicine (bapm.org).

Maximising the impact of psychological practice in physical health care file (ppn.nhs.uk) and
Psychological practice in physical health care (2023) file (ppn.nhs.uk)

The Ockenden report, particularly chapter 3 on supporting families:
Final report of the Ockenden review – GOV.UK (www.gov.uk)

The Psychological professions network has useful information about the different groups of psychological professionals file (ppn.nhs.uk)

Some recommended books

Surviving prematurity
by Nadia Leake (personal perspective on the triggers and trauma that parents can encounter during a neonatal stay)

Intensive parenting
surviving the emotional journey through the NICU by D. Davis (develops emotional coping skills)

The resilient clinician
by Robert Wicks (offers an overview of mindfulness and meditation as it applies to the clinician’s own life)

Mothership
by Francesca Segal (perspective of the NICU from a mother)

Early: An intimate history of premature birth and what it teaches us about being human
by Sarah DeGregoria (Blend of memoir and well-researched story of neonatology)

Books from other psychological professionals

Special care babies and their developing relationships
by Anne McFadyen (explores institutional, cultural and family beliefs about prematurity)

Sent before my time
by Margaret Cohen (an exploration of the workings of a neo natal intensive care unit)

The compassionate mind approach to postnatal depression: using compassion focused therapy to enhance mood, confidence and bonding
by Michelle Cree ( a self-help book using compassion focused therapy to enhance mood, confidence and bonding)

A Treasure Box for Creating Trauma-informed organisations
by Karen Treisman (using understandings of trauma into your daily practice)

The lead psychologists for the ODN

The lead psychologists for the ODN supports the psychological professionals across London, and supports the development of psychologically informed care in all units. The are two local ‘hub’ psychologists for NCEL and South London who support this work.

The lead psychologist facilitates peer supervision, CPD events and business meetings for the London Neonatal Psychological Professionals (LNPP) group.

The lead psychologist works with units to support the development of workforce planning, advising on staffing recommendations and developing business cases.

The hub psychologists support the units in their sector with activities to develop psychologically informed care on units including clinical support to LNPPs, education and training and support with data capture.

And finally, some thoughts:

  • Look after yourself. To be compassionate we need to be ok in ourselves and this takes time and energy too.
  • Where you can, be kind. Remember sometimes people are unreasonable, illogical or rude when they are struggling. This includes your colleagues and the parents you work with.
  • Notice when someone is struggling. Say ‘I wonder how you are because I’ve noticed that…(you look sad/you seem angry/you aren’t yourself today)’. Then wait and see what comes up. Don’t give up too easily if they tell you they are fine.
  • If you don’t know what to say or how to help, say that too. It’s better to say something than ignore someone in pain. They will be grateful for your honesty. Remember people don’t always want help or solutions, sometimes they just want to be seen and heard.
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