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.

Are mindfulness groups more mindful face to face or online? A comparison of delivering a mindfulness based well-being group for parents of children with a chronic health condition.

INTRODUCTION AND AIMS: Mindfulness has been shown to be an effective group intervention for adults and children living with a range of medical conditions. Recently, research has also explored the impact of mindfulness interventions offered to parents of children with health conditions. Few studies have examined whether the mode of delivery (face-to-face vs online) has an impact on outcomes. METHODS: Four mindfulness based wellbeing courses for parents (MBWP) of children with a chronic medical condition were run (two face to face and two online). All parents (N=37) completed the WHO Well-being Questionnaire and Neff Self-Compassion Scale Questionnaire-Short Form at the beginning and end of each course. Parents' experience of the course was also explored using a semi-structured interview 6 weeks after completing the course, with their responses analysed using Thematic analysis. RESULTS: The groups had a statistically significant positive impact on both parent well-being and self-compassion and were equally effective face-to-face or online. All parents reported incorporating informal mindfulness practices into their day-to-day lives 6 weeks post-course The qualitative analysis highlighted improvements in present moment focus, kindness to self, and family relationships. DISCUSSION AND CONCLUSION: Parents valued connecting with other parents of young people with both similar and different medical conditions, within both face-to-face and online groups, increasing the accessibility of MBWP.

Online adaptations of tree of life and beads of life groups alongside sustaining our community of peer trainers.

Collective Narrative practices, such as Tree of life and Beads of life groups, have intentions of bringing people together to share their specialist knowledge and build a sense of community. We wanted to respond to the COVID-19 pandemic through making these groups accessible online to young people living with health conditions in order to counter the social isolation and disconnectedness created by the pandemic. This paper discusses our specific online adaptations for both these groups as well as online 'Peer training' events. Young people who have participated in a group are invited to join the project as peer trainers who help facilitate, engage group participants, witness their stories and consult to the project. We have included the voices of two of our peer trainer consultants on their experiences. We also briefly reflect on the recent development of trialling hybrid groups.

Morning Connections: How do you support hospital staff working remotely during a global pandemic without providing 'staff support'?

When lockdown was announced in the United Kingdom, kitchen tables transformed into offices overnight, as many National Health Service (NHS) workers adapted to new ways of working from home. To respond to the developing situation, we established a programme of weekly 'Connections' meetings where staff could be together, remotely. This article describes the evolution of our Morning Connections and Oncology Connections virtual meetings, including the content of sessions, how they were evaluated and whether they met their intention to support colleagues during a particularly challenging time, both personally and professionally, for NHS staff.

Narrative therapy approaches to team away days: Creating communities.

'Away Days' in the National Health Service are a protected time away from usual tasks where a team comes together. They can have different intentions, including connecting team members and establishing team bonds. This paper describes using a Narrative Therapy approach called "The Journey of Life" to run away days. It involves thinking about the journey a team has been on and what has helped them along the way. It invites a team to think about their future directions and how they use skills they have learned when they face obstacles in the road ahead. The importance of preparing for away days, including establishing intentions, creating a feeling of safety and thinking about the role and positioning we adopt as team members ourselves is highlighted. We also outline the benefits we have observed, including a sense of community emerging through the process.

Keeping young people connected during COVID-19: the role of online groups.

The COVID-19 pandemic has had a profound impact on young people, disrupting education, routines, hobbies and peer interactions and there is concern for longer term effects on physical and mental health outcomes. Young people living with chronic health conditions face additional challenges including reduced or no face-to-face contact with medical teams, shielding and the increased stressors of being in 'at-risk' groups and social isolation. In a climate of social isolation and disconnectedness, online groups could provide a method of delivering healthcare and support that strengthens social connectedness and reduces isolation. Despite the technology being available, uptake and evidence for online groups is limited. This article shares learnings from a paediatric and adolescent psychology service delivering online groups for young people with chronic health conditions and their healthcare teams. Ideas for how to transfer group process to online platforms are considered, with examples and tips. With sufficient staffing, preparation, thought, creativity and innovation, it is possible for face-to-face groups to successfully be offered online. Caution should be exercised trying to run online groups without these provisions in place, as the safety, comfort and experience of young people could be jeopardised. Further research is needed to better understand group processes online and to consider what is lost and what is gained when comparing online to face-to-face groups.

Unaccompanied asylum-seeking children and young people - Understanding their journeys towards improved physical and emotional health.

In 2018, approximately 20,000 unaccompanied children and young people applied for asylum in a European Union country. Unaccompanied asylum-seeking children present with significant emotional and physical health needs. These needs are likely the result of the situation that led them to leave their home, the difficult journeys they make to reach safety and their living circumstances after arriving at their destination. Maintaining engagement with both screening and therapeutic health services is challenging. A stepwise approach to delivery of services is recommended so as not to overwhelm them. Case studies and personal practical experience are used to highlight key learning points.

Supporting young people living with cancer to tell their stories in ways that make them stronger: The Beads of Life approach.

This article describes the 'Beads of Life' approach--a five-part methodology informed by narrative therapy to enable children and young people to make sense of their cancer journey in ways that make them stronger. Young people are invited to use beads as prompts to tell preferred stories of their identity to create a safe place to stand from which to story their cancer journey. The approach positions young people as experts in their lives. It aims to change their relationship with cancer to reduce its negative impact on life by lessening isolation. By enabling medical staff to get to know the young person apart from the cancer, this approach aims to create hope for the future and improve quality of care.