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Resource Hub | Regional Workforce Website

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Connecting with others in a similar role can provide support both practically and emotionally.

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The UK NBCP drop ins will help you explore practical ways to implement the National Bereavement Care Pathways.

They are open to any professional in every UK nation involved in improving care for bereaved families experiencing pregnancy loss or the death of a baby.

Each session lasts 60 minutes from 12-1pm on the date listed and provides:

Insights from the latest research and guidance from leading third-sector organisations

A space to share challenges and solutions with colleagues

Opportunities to network with professionals across NHS Trusts and Boards

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Setting professional boundaries is an important way of delivering equitable bereavement care and ensure all families receive the same level of care and support.

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The professional bulletin is aimed at healthcare and other professionals working directly with families when a baby dies, and those with an interest in research, education, or policy in the field.

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Do:

Accompany parents on their grief journey

Try to separate your feelings to those of the parents/families

Acknowledge your own feelings, give yourself permission to feel and let go

Plan hand over/ end of care

Don't:

Try to ‘fix’ or ‘rescue’

Take on too much or before you feel ready

Take on responsibility for the emotions of others

Work alone or in isolation

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The NMC recognised Reflection is a critical and necessary part of nursing and midwifery practice. It enables students and registered professionals to make sense of a situation and understand how it has affected them, contributing to personal as well as professional development.

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NBCP standards and pathways recognise the importance of a healthy, supported workforce. It is vital that professionals supporting bereaved families also get the support they need.

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Talking through the care of a family with a team member or a trusted work colleague can help.

It is important to maintain confidentiality for the family and to focus on your needs.

This is often something that professionals do on an informal basis, and it can be useful to set aside time to reflect and talk about the challenges.

Acknowledge your own feelings, give yourself permission to feel and let go.

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Approaches to supporting staff wellbeing

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Trauma focused therapy for nurses and healthcare professionals | RCN Counselling Service | Royal College of Nursing

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The RCN Counselling Service is offering trauma-focused therapy to RCN members to help support nurses and healthcare workers in light of the COVID-19 pandemic.

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Sands - Stillbirth and neonatal death charity

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Losing a baby before, during or shortly after birth is one of the hardest things anyone can face. What takes many people by surprise is how strong the emotions can be, how they can change very quickly, and how long they last. People around you may think you should be 'back to normal' after a few weeks or months. At Sands we know that the grief journey can take you to a whole new vision of normality, where your baby's precious life is included.

Everyone grieves in a way that is unique to them.

We know that no-one can understand exactly what losing your baby feels like to you. But we do understand that it's sometimes easier to talk to someone outside of your friends and family about grief and the impact of bereavement of your life and this is why we offer the GriefChat service, alongside Sands' Helpline and our other support services.

GriefChat was created by bereavement experts and by clicking on the GriefChat box below, you can chat directly to a specially trained bereavement counsellor. GriefChat counsellors are experienced in supporting bereaved people and will listen to your story, explore how your grief is affecting you and help you to find any additional support you might need. GriefChat is a completely free service and is available Monday-Friday, 9am-9pm. You can email or message Sands or GriefChat outside of these hours.

GriefChat provides emotional support for bereaved people, access to trained bereavement counsellors and referral on to Sands' specialist bereavement services.

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How we offer support | Sands - Stillbirth and neonatal death charity

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Losing a baby before, during or shortly after birth is one of the hardest things anyone can face. What takes many people by surprise is how strong the emotions can be, how they can change very quickly, and how long they last.

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Professional Pause with Miscarriage UK and The Ectopic Pregnancy Trust

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Professional Pause with Miscarriage UK and The Ectopic Pregnancy Trust

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A monthly safe space for all healthcare professionals working in early pregnancy to discuss and reflect on challenging aspects of practice.

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At GriefChat, we believe professional bereavement support should always be accessible and free to those in need.

We support organisations in helping those dealing with grief by providing them with a safe space for bereaved people to be able to share their story, explore their feelings and be supported by a qualified bereavement counsellor. In addition to this, GriefChat can help bereaved people to consider if they need additional support and where to get this from...

When can I get GriefChat?

GriefChat is open Monday - Friday, 09:00 - 21:00 (GMT). In those hours, we provide a live instant chat service with a qualified bereavement counsellor, through our partners, that is free-to-user.

You don't need to face grief alone. We can help you to find one to one support either locally or remotely.

View or start an online In Memory page for a loved one, through GriefChat's MuchLoved page.

Become a GriefChat Partner

You can provide professional bereavement support that is free and immediate for anyone in need, anywhere in the world.

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GriefChat - Transforming Access to Bereavement Counselling

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At GriefChat, we believe professional bereavement support should always be accessible and free to those in need. We support organisations in helping those dealing with grief by providing them with a safe space for bereaved people to be able to share their story, explore their feelings and be supported by a qualified bereavement counsellor.

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Caring for you - Royal College of Midwives

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Caring for you Healthy and well rested midwives, maternity support workers and students are at the heart of providing safe, high-quality care for women and their families. Putting your heart into maternity care starts with Caring for You. This content is included in your RCM Membership This content is for RCM Members only The Charter […]

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Nursing staff need to look after themselves as well as others. If they lead an organisation or manage others the wellbeing of their staff is an added concern. Use this guide to find information resources about wellbeing, self care and resilience.

Key Resources

RCN: Managing stress

We have created resources for you, as an individual, to manage your own stress and access support along with information for managers and RCN reps who will be working, at an organisational level, to create safe and healthy workplaces.
View page

RCN: Healthy workplace, healthy you

This resource supports employers and RCN representatives to improve working environments. It also supports nursing staff to lead healthy lifestyles so they can maintain their physical and mental wellbeing.
View page

Royal College of Nursing (2016) Improving patient outcomes by improving staff health and wellbeing. London: RCN.

Royal College of Nursing (2015) Stress and you: a guide for nursing staff. London: RCN.

Trades Union Congress (TUC): Work and suicide

A guide to prevention for trade union activists
View page

NHS: Mental health

Find information and support for your mental health.
View page

Reading Well: Books on Prescription

Helps you to understand and manage your health and wellbeing using self help reading. The scheme is endorsed by health professionals and supported by public libraries.
View page

We would like to thank the RCN Counselling Service for their input into the development of this subject guide.

COVID-19

Books

Allen B and Fidderman H (2019) Your health at work: an indispensable guide to physical and mental wellbeing. London: KoganPage.

Battye A (2022) Self-care for allied health professionals: from surviving to thriving. London: Routledge, Taylor and Francis.

Boyd C (2023) Wellbeing strategies for nurses. 2nd edn. (Student survival series). Chichester: Wiley Blackwell.

Chowthi-Williams A (2023) Wellbeing and resilience for nursing, health and social care students. London: SAGE.

Chambers C and Ryder E (2018) Supporting compassionate healthcare practice: understanding the role of resilience, positivity and wellbeing. London: Routledge.

Drayton M (2021) Anti-burnout: how to create a psychologically safe and high-performance organisation. Milton: Taylor and Francis.

Hasson G and Butler D (2020) Mental health and wellbeing in the workplace: a practical guide for employers and employees. Newark: John Wiley & Sons.

Hughes R, Kinder A and Cooper C L (2018) The wellbeing workout: how to manage stress and develop resilience. Cham: Palgrave Macmillan.

Kuipers S (2021) The thriving giver: 7 principles for health professionals and caregivers to enhance self-care and prevent burnout. Tadley: Practical Inspiration Publishing.

Mealer M (2019) Coping with caring: a nurse's guide to better health and job satisfaction. Milton: Productivity Press.

Traynor M (2019) Stories of resilience in nursing: tales from the frontline of nursing. Milton: Taylor and Francis Group.

West M A (2021) Compassionate leadership: sustaining wisdom, humanity and presence in health and social care. The Swirling Leaf Press.

Book subject searches

Use these links to see details of books the RCN libraries hold on each topic.

Journals

Use these links for details of journal articles on each topic.

This subject guide relates to:

Caroline Lynch

Editor of this guide

RCN Library and Archive Service

Page last updated - 21/07/2023

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Wellbeing Self Care and Resilience | Subject Guide | Royal College of Nursing

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This guide has information resources about wellbeing, self care and resilience including books, reports and journal articles.

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This hub brings together resources and sources of support for wellbeing, mental health and legal advice.

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Summary

Who can benefit from talking therapy?

How do I know which kind of therapy is right for me?

Different types of talking therapy

How do I find a therapist?

What happens in talking therapy?

How do I choose a therapist?

What makes a good therapist?

What if I'm not happy with my therapist?

If you need to make a complaint

Talking therapy involves talking to a trained professional about your thoughts, feelings and behaviour. Describing what's going on in your head and how that makes you feel can help you notice any patterns you may want to change. It can help you work out where your negative feelings and ideas come from and why they are there.

Understanding all this can help you make positive changes, take greater control of your life and improve your confidence.

This page uses the word 'talking therapy', but you may also hear it referred to as talking treatment, counselling, therapy, psychotherapy or psychological therapy.

Who can benefit from talking therapy?

Talking therapy can help with:

It doesn't have to be a last resort or something you turn to in a crisis. If you think you could do with talking to someone in a safe space who won't judge you, then it's ok to try it.

How do I know which kind of therapy is right for me?

There are many different approaches when it comes to therapy. Therapists may train in one approach or use a number of different methods. Some use specialist techniques - for example, an art therapist would use art to help you explore your feelings. Others offer specialist treatment for specific issues such as addictions or eating disorders.

It can be easy to be overwhelmed by the number of different types of talking therapy out there. Don't let that put you off. We go through some different types below, but the most important thing is the relationship you have with your therapist. Trusting them and feeling comfortable opening up means you will get the most from your sessions, no matter what approach they use.

Different types of talking therapy

There are many different types of talking therapy, although your choice may be limited depending on where and how you access it.

The National Institute for Health and Clinical Excellence (NICE) recommends certain therapies for certain problems, but other therapies might work for you just as well.

Here are some of the main kinds of talking therapy.

Cognitive behavioural therapy (CBT)

This looks at how your thoughts and beliefs affect your feelings and behaviour. By changing how you react to your thoughts (for example, challenging negative thoughts) and how you behave (for example, trying new activities), you can start to feel better.

CBT was amazing - it was so simple. My diagnosis is bipolar disorder and I had very low self-esteem and lack of confidence in my future. I had about 15 sessions over a year. The psychologist showed me how to notice what I was thinking and then how I felt afterwards, and to realise you can choose your own thoughts. I thought they were just random thoughts there to make my life a misery. But I learnt that at any time I could stop and say: 'Why am I thinking that?'

I had a CBT therapist but I think she probably used lots of different things - in fact it didn't feel like she was 'using' anything - it felt like a natural process rather than anything very medical or clinical.

Dialectical behaviour therapy (DBT)

DBT is an adapted form of cognitive behavioural therapy (CBT) that can intensely help people who experience emotions. It teaches you how to live in the moment, cope with stress, regulate your emotions and improve your relationships.

What's unique about it?
'Dialectical' comes from the idea that bringing together two opposites - acceptance and change - can make a bigger difference than either one alone. Accepting yourself and changing your behaviour might sound like a contradiction, but your therapist will help you understand how this can bring about positive shifts in your life.

What can it help with?
It was originally designed to treat borderline personality disorder, but now it's also used foreating disorders, addiction, depression and problems such as self-harm or suicidal feelings.
Mind has more information onDBT.

Psychodynamic therapy

Psychodynamic therapy explores how your childhood experiences and unconscious mind influence your current thoughts, feelings, relationships and behaviour. Your therapist may use techniques such as:

free association - where you talk freely about whatever is on your mind, no matter how silly or illogical it might seem, to let your true feelings come to the surface

transference - where feelings you experience in other relationships, especially from childhood, are unconsciously projected onto your therapist. By recognising this, you can start to understand these feelings and past relationships

interpretation - your therapist will sometimes offer a new perspective on what you're talking about, aiming to help you broaden your self-awareness and self-knowledge.

What's unique about it?
Psychodynamic therapy focuses more on your past and your unconscious mind - the feelings and thoughts you're unaware of but that affect your choices and actions in the present day. It's often relatively long-term, lasting from several months to many years.

What can it help with?
Depression, anxiety, post-traumatic stress, long-term physical health problems, eating disorders and addictions. NICE recommends psychodynamic therapy for people experiencing depression alongside other complex illnesses.

I was quite severely depressed as a teenager. I tried various antidepressants and some CBT-based stuff, but nothing was helping. Finally, my GP suggested that I try psychotherapy at my local mental health unit.

At first I was sceptical. I couldn't see how sitting in a room with a stranger was going to help. I was quite a nightmare, trying to prove to my therapist and myself that the therapy would fail. But with psychodynamic therapy, the therapist is prepared to sit and wait out that part with you. She started helping me link the way I was thinking, feeling and behaving to what might have gone on when I was younger and that really made sense.

Humanistic therapy

Humanistic therapy lets you explore your whole self rather than just specific problems. It aims to help you grow, live your life to the full and be true to yourself. Your therapist will offer you empathy, warmth and genuineness to help you make these changes.

Person-centred therapy, Gestalt therapy and transactional analysis are all examples of humanistic therapy. The British Association for Counselling and Psychotherapy (BACP) has more information about them.

What's unique about it?
Humanistic therapy focuses on all of you. It's based on the belief that we are all capable of growth, but that life experiences may have blocked us from reaching our potential. Your therapist can help you identify and remove those blocks.

What can it help with?
Anxiety, depression, obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), personality disorders and more. A humanistic therapist will work with any issue causing difficulties in your life.

I was referred to a unit that deals with people who turn to alcohol because of psychological problems. I was in a state of constant panic and had been drinking to keep those feelings at bay. There wasn't a set formula to the sessions. We'd just go and get a cup of coffee and I'd talk about what was bothering me. With person-centred counselling the therapist steers you through finding out more about yourself and developing confidence.

How do I find a therapist?

You can find a therapist in different ways, although not all types of therapy will be available everywhere.

Through the NHS

Your GP or another health professional may refer you to a qualified therapist, or you can self-refer if you live in England. The therapy will be provided free on the NHS.

There are long waiting lists in many places, and you may not have much choice in who you see.

The National Institute for Health and Clinical Excellence (NICE) advises which treatments doctors should prescribe. NICE recommends certain therapies for certain problems, which may be easier to get on the NHS than others.

Go private

You can choose to pay for your therapy if you can afford it. Therapists may charge anything from £35 an hour and more depending on where you live, although some offer reductions to people on a low income.

To find a private therapist, it's a good idea to search via a website that only lists therapists who are registered with a professional body, such as:

Through your place of work or education

Some workplaces have Employee Assistance Programmes (EAPs) which may offer a limited number of free therapy sessions. Many colleges and universities offer free therapy services.

Other organisations

Some charities and community organisations offer free or low-cost talking therapies, sometimes by using trainees. Ask your GP if they know anywhere local, contact local counselling training centres, or try one of the following.

What happens in talking therapy?

Sessions usually last 50 minutes and take place at regular, planned times. They can be face-to-face, on the phone or online. How often you see your therapist and how many sessions you have will depend on the type of therapy you're having and your circumstances.

You might see a therapist on your own, in a group, as a couple or as a family.

In group therapy you don't just talk about yourself, you're listening to other people - that takes the burden off your problems. You realise you're not the only one.

During a session, you might talk generally about how you're feeling, or you might go through specific exercises, depending on your therapist's approach. What you talk about could include your childhood, your relationships, past and present life events, or stressful situations.

Your therapist will listen to you without judging you and help you explore your thoughts and feelings. They won't tell you what to do but will help you understand yourself better and think about the changes you may want to make.

Talking therapies are not therapies that are done' to you by someone else. You play an active part. That can be empowering at a time when you may feel you have lost control over part of your life. If you're determined to get the most from your therapy, it's more likely to work.

You need to be honest with yourself in therapy, which can be difficult. It may mean facing up to your fears, recalling distressing memories or talking about intimate topics and private thoughts and feelings. Think about whether you're ready to open up and talk to your therapist if you feel overwhelmed. Sessions should always go at your pace, so you don't feel rushed.

How do I choose a therapist?

You may already have questions to ask yourself or your therapist. Here are some to consider.

Questions you could ask yourself before you choose a therapist

What kind of therapy might suit me?

How much time and money do I have for therapy?

Do I want a particular therapist - i.e. a man or woman, someone who shares my racial background or sexuality, someone my age?

Questions you may want to ask a therapist

What are your qualifications?

What other training have you done?

Do you belong to a professional organisation?

What experience do you have of working with people with my particular issue?

What happens during a typical session?

How many sessions would I have?

What is the cost for each session? Do you offer any reductions?

When you meet a therapist for the first time (sometimes called an assessment), they will be working out if they can help you. That's your chance to find out about the therapist too. The British Association for Counselling and Psychotherapy (BACP) has an information sheet on what happens in your first session.

Ask yourself:

Do I feel comfortable talking to them?

Would I be able to trust and work with them?

What's my gut feeling about them?

Finding a therapist you connect with might take a few tries. Take your time to find someone who feels right so that you can get the most from your sessions.

What makes a good therapist?

Your relationship with your therapist is really important. A good therapist will listen to you, have your best interests at heart and help you learn how to change. They will check you're getting what you want from therapy and refer you to someone else if they can't help with your particular issue.

What I found really good was being able to talk about what was happening and have someone who was listening - she was really good at giving me space, listening to what had happened and discussing what might have caused it - not in a deep way but trying to help me piece the whole picture together.

A good therapist concentrates on what is important in your life, what you want to achieve, and what steps you could take to get there. They shouldn't tell you what to do. Your therapist may be highly trained and very experienced, but you are the expert.

Remember, therapy is a two-way process. If you have any questions, ask them. A good therapist will help you deal with your worries and work out how you will manage when therapy comes to an end.

What if I'm not happy with my therapist?

It can take time to build a relationship with your therapist and start to open up. Depending on what you've talked about, you may feel sad or frustrated after sessions. But if you're not happy with how the sessions are going, you can:

talk to your therapist to try and resolve any problems

ask your therapist if they can try a different approach

go back to your GP or referral service to ask if you can see someone else

find another private therapist

If you need to make a complaint

If you have a serious concern about your therapist, you can make a complaint.

You can contact the professional body your therapist is registered with and follow their complaints procedure. You can ask your therapist who they're registered with or see if it's mentioned in your contract if you have one. For example, you can complain about a BACP member or a UKCP member by following the steps on their websites.

The BACP has a 'get help with counselling concerns' service you can contact by phone or email. They can help you make sense of what you think has gone wrong and work out your next steps.

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Who can benefit from talking therapy, deciding which kind of therapy is right for you, the different types of talking therapy, finding a therapist, what happens in talking therapy, choosing a therapist and what to do if you're not happy with your therapist.

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The British Medical Association is the trade union and professional body for doctors in the UK.

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Vicarious trauma is a process of change resulting from empathetic engagement with trauma survivors.

Anyone who engages empathetically with survivors of traumatic incidents, torture, and material relating to their trauma, is potentially affected, including doctors and other health professionals.

Common signs of vicarious trauma

If you are currently or have recently been working with survivors of traumatic incidents or torture survivors, you should be aware of the following signs:

experiencing lingering feelings of anger, rage and sadness about patient's victimisation

becoming overly involved emotionally with the patient

experiencing bystander guilt, shame, feelings of self-doubt

being preoccupied with thoughts of patients outside of the work situation

over identification with the patient (having horror and rescue fantasies)

loss of hope, pessimism, cynicism

distancing, numbing, detachment, cutting patients off, staying busy. Avoiding listening to client's story of traumatic experiences

difficulty in maintaining professional boundaries with the client, such as overextending self (trying to do more than is in the role to help the patient).

If you are experiencing any of these signs, this could indicate that you are suffering from vicarious trauma.

Strategies for reducing risk of vicarious trauma

If you feel you may be suffering from vicarious trauma, try following these coping strategies to reduce the risks.

Increase your self-observation - recognise and chart your signs of stress, vicarious trauma and burnout.

Take care of yourself emotionally - engage in relaxing and self-soothing activities, nurture self-care.

Look after your physical and mental wellbeing.

Maintain a healthy work/life balance - have outside interests.

Be realistic about what you can accomplish - avoid wishful thinking.

Don't take on responsibility for your patients' wellbeing but supply them with tools to look after themselves.

Balance your caseload - mix of more and less traumatised clients, victims and non-victims.

Take regular breaks, take time off when you need to.

Seek social support from colleagues, family members.

Use a buddy system - particularly important for less experienced doctors.

Use peer support and opportunities to debrief.

Take up training opportunities.

If you need it, take up time-limited group or individual therapy.

There are also significant organisational factors that can increase the risk of a person being vicariously traumatised, which should be assessed and addressed.

Freedom from torture

This guidance was provided by Freedom From Torture who run bespoke and regular open-access training in self-care and vicarious trauma.
Find information on training days

Your wellbeing

We have a range of services to support you.

Counselling

Peer support

UK wellbeing support directory

Call our free and confidential helpline on 0330 123 1245

View our services

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Vicarious trauma: signs and strategies for coping

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How to cope with the aftermath of traumatic incidents and spot the signs of trauma in those who have been involved in caring for others.

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Add your details below to start receiving regular emails from Sands. These bulletins are aimed at healthcare and other professionals working directly with families when a baby dies, and those with an interest in research, education, or policy in the field.

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Audio Tracks for Professionals — Ellie’s Gift App

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Ellie’s Gift supports professionals working with bereaved families. Access baby loss staff mindfulness tracks.

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Build your own self-care kit list. Take some time to reflect on your work/life balance and where you might get support from. Different things work for different people; what works for you?

Psychological: self-reflection, debriefing, counselling, journaling

Spiritual: meditation, prayer, yoga

Personal: spend time with loved ones, read, write, cook, put time and energy into hobbies

Emotional: talking, crying, setting boundaries

Physical: exercise, being outdoors, sleeping, eating well

Professional: take holidays, ask for help, supervision

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Sands - Stillbirth and neonatal death charity

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Losing a baby before, during or shortly after birth is one of the hardest things anyone can face. What takes many people by surprise is how strong the emotions can be, how they can change very quickly, and how long they last. People around you may think you should be 'back to normal' after a few weeks or months. At Sands we know that the grief journey can take you to a whole new vision of normality, where your baby's precious life is included.

Everyone grieves in a way that is unique to them.

We know that no-one can understand exactly what losing your baby feels like to you. But we do understand that it's sometimes easier to talk to someone outside of your friends and family about grief and the impact of bereavement of your life and this is why we offer the GriefChat service, alongside Sands' Helpline and our other support services.

GriefChat was created by bereavement experts and by clicking on the GriefChat box below, you can chat directly to a specially trained bereavement counsellor. GriefChat counsellors are experienced in supporting bereaved people and will listen to your story, explore how your grief is affecting you and help you to find any additional support you might need. GriefChat is a completely free service and is available Monday-Friday, 9am-9pm. You can email or message Sands or GriefChat outside of these hours.

GriefChat provides emotional support for bereaved people, access to trained bereavement counsellors and referral on to Sands' specialist bereavement services.

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How we offer support | Sands - Stillbirth and neonatal death charity

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Losing a baby before, during or shortly after birth is one of the hardest things anyone can face. What takes many people by surprise is how strong the emotions can be, how they can change very quickly, and how long they last.

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Bereavement training - The Lullaby Trust

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Our bereavement training covers bereavement communication, supporting others, as well as understanding grief in a cultural context.

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A series of videos created for neonatal healthcare professionals exploring topics such as FICare delivery and health inequalities.

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Lullaby Trust - Understanding Grief in a Cultural Context

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Lullaby Trust - Understanding Grief in a Cultural Context

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PHA Staff Health and Wellbeing Resources

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PHA Staff Health and Wellbeing Resources

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Staff health and wellbeing | HSC Public Health Agency

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In support of our action against COVID-19, we must ensure that all staff and volunteers, irrespective of where they work, have access to the information and support they may need over the coming months and that everyone’s contribution is valued and appreciated. The Take 5 message is for everyone and has been adapted to help address staff and volunteer health and wellbeing needs.

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Guidance for social care employers on responding to racism

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The Department of Health has published guidance to support social care employers in identifying, preventing, and responding to incidents of racism in the workplace.

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Interactive training from the Miscarriage Association - a toolkit for practice and reflection. Modules include: Understanding Pregnancy Loss, Compassionate Communication, Effective Clinical Practice.

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Effective Communication for Pregnancy Loss Care Training

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Effective Communication for Pregnancy Loss Care Training

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https://www.futurelearn.com/courses/effective-communication-for-pregnancy-loss-care/1

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Bereavementcare@sands.org.uk

The NBCP team continues to develop resources to support implementation, assurance and improvement across England.

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Sands - Saving babies' lives. Supporting bereaved families.

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Sands - Saving babies’ lives. Supporting bereaved families.

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National Bereavement Care Pathway | Sands - Saving babies’ lives. Supporting bereaved families.