The journey of 'Living with Pain': A feasibility study of the development and running of a collective narrative group.

INTRODUCTION: Chronic Pain is increasingly affecting young people, their quality of life and wellbeing including education, social life and mental health. Current Western approaches to psychological support for Chronic Pain often focus on 'pain management' and learning skills and strategies from professionals, making use of Cognitive Behavioural Therapy (CBT), Acceptance and Commitment Therapy (ACT) and psychoeducation approaches in individual and group interventions. As a Paediatric Psychology service, we have trialled groups running over multiple weeks informed by these approaches and experienced low attendance rates. METHOD: This paper describes a feasibility study of an alternative group intervention; the 'Living with Pain group', which combines the 'Journey of Life' (Denborough, 2014) with collective narrative and liberation psychology approaches. RESULTS: Thirty three young people and eight parents / carers attended the intervention. Attendance rates, quantitative and qualitative feedback from one face-to-face group for young people and parents and two online groups for young people showed increased access and acceptability of the group. CONCLUSION: The findings from this study have shown that a 1-day collective narrative group intervention is feasible, suitable and acceptable and has increased access to our group intervention. Future directions include co-creation with young people and families, community engagement to increase accessibility of our groups and developing partnerships to respond to young people's hopes to raise awareness.

Peer reflective groups: Creating a nurturing and safe community for aspiring clinical psychologists to build their collective voice.

Assistant Psychologist (AP) and Honorary Assistant Psychologist (HAP) roles provide an opportunity to gain the experience needed to progress onto the Clinical Psychology doctorate, making them very competitive to obtain. Nationally, there have been reports that people fulfilling these roles can face a number of challenges including poorly defined job descriptions, difficulty developing a voice within hierarchical organisation structures and balancing competing demands on time. This paper tells the story of a peer reflective group set up for APs and HAPs in the paediatric health psychology team, to provide a supportive space for aspiring psychologists to meet together. The evolution of the group and its impact are discussed, and recommendations for setting up similar groups in other services are made.

Developing groups in a paediatric psychology service: Centring the voices of children and young people.

There is growing evidence for the benefits of therapeutic groups for children and young people living with chronic health conditions. As a paediatric health service, we regularly run 12 different groups, most of which are informed by a Narrative Therapy approach, with new groups routinely created to respond to the changing needs of children and young people. In this paper, we describe how we have stayed connected to our vision and values in developing and delivering group interventions, sharing our process which integrates different methods of participation and involvement to ensure young people's voices are centred. We use three of our recently introduced groups to illustrate these ideas.

Evaluating the beads of life groups: hearing from our participants.

INTRODUCTION AND AIMS: The Beads of Life (BOL) approach uses a narratively informed methodology 'to enable children and young people to make sense of their cancer journey in ways that make them stronger'. We will share feedback from BOL groups and reflect on changes made over time. METHOD: Between 2014 and 2019, we have run 14 groups. Participants were aged 13-25, had received a diagnosis of cancer and were either on or had completed treatment. Quantitative and qualitative feedback was gathered at each workshop and 1 month later, with qualitative data then being analysed using thematic analysis. RESULTS: 106 young people attended the groups. Young people reported that sharing experiences of cancer was useful, that they enjoyed the group and that they were highly likely to recommend it to others. Feedback remained consistent a month post-intervention. Qualitative feedback showed the value young people placed on meeting others, sharing their stories and on things they learnt about themselves from the group. DISCUSSION: Themes support the intention of the intervention to provide a safe space for young people to share and reflect on their cancer journey, to connect with others and to enable peer support and mutual learning.

The development of a cognitive rehabilitation and psycho-social group programme for teenage and young adult survivors of brain tumours: A feasibility study.

INTRODUCTION AND AIMS: Treatment for childhood and adolescent brain tumours is often intensive, with significant neurocognitive and psycho-social late effects (Zeltzer et al., 2009). This feasibility Study aimed to inform the development of a cognitive rehabilitation and psycho-social group intervention for Teenage and Young Adult (TYA) survivors of brain tumours. METHODS: A group-based intervention incorporated ideas from the current evidence base, including psychoeducation and compensatory strategy training, with a focus on real-life goals and improving quality of life. Participants (N = 19, 13-24 years) were recruited from the University College London Hospital TYA Oncology Service. Participants had received treatment for a malignant brain tumour and had completed their treatment at least 1 year prior to participation. Four group-based, whole-day interventions ran every 3 months throughout a year. Feasibility criteria were established to answer questions about acceptability of the intervention and recruitment. RESULTS: Qualitative and quantitative feedback from all four groups demonstrated acceptability and suitability of the intervention with regards to the content, structure and delivery. Recruitment presented more of a challenge with 35% fewer referrals than expected. DISCUSSION AND CONCLUSION: Feedback suggests that the intervention is suitable and acceptable, whilst limitations include numbers of referrals and referral pathways. Future directions are discussed.

Business as usual? Psychological support at a distance.

The impact of COVID-19 has challenged the long accepted 'norm' in delivery of psychological therapy. Public policies designed to reduce transmission have made it extremely difficult to meet with service-users safely in the traditional face-to-face context. E-therapies have existed in theory and practice since technological progress has made them possible. They can offer a host of advantages over face-to-face equivalents, including improved access, greater flexibility for service-users and professionals, and cost savings. However, despite the emerging evidence and anticipated positive value, implementation has been slower than anticipated. Concerns have been raised by service-users, clinicians, and public health organisations, identifying significant barriers to the wide spread use of e-therapies. In the current climate, many clinicians are offering e-therapies for the first time, without prior arrangement or training, as the only viable option to continue to support their clients. This paper offers a clinically relevant review of the e-therapies literature, including effectiveness and acceptability dilemmas and challenges that need to be addressed to support the safe use and growth of e-therapies in psychology services. Further research is needed to better understand what might be lost and what gained in comparison to face-to-face therapy, and for which client groups and settings it might be most effective.