Action planning

Managing psychosocial risks

Co-designing interventions with the workforce

Spotting signs of struggle

Recognising and tackling mental health stigma

Making a commitment to mental health at work

Having inclusive conversations about stress

Enhancing line managers’ stress management competencies 

Holistic wellbeing interventions

Supporting mental health at work

Recognising moral injury and moral distress

Wellness action plans

Tackling presenteeism

Work-life Balance

Agile and hybrid working

Supporting lone working

Tackling bullying and harassment

Building a culture of self-compassion

Recognising and challenging thinking errors

Using self-care audits and action plans

Self-care for leaders

A resilient organisation prioritises the wellbeing of its workforce and takes a systemic approach to reducing stress and enhancing job satisfaction. The Key foundational principle Wellbeing is defined as where: 


<p>Wellbeing covers a range of issues, such as how satisfied people are with their lives, whether they feel what they do is worthwhile, their everyday emotional experiences, and the state of their general mental and physical health. Promoting workforce wellbeing is the fifth Key Foundational Principle (KFP).</p>



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<p>This is an important step towards preventing work-related stress and implementing change in your organisation. Normalising conversations about stress can also reduce stigma and encourage people to speak out. </p>



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<p>The Health, Safety and Environment (HSE)  have developed a ‘<a href="https://www.hse.gov.uk/stress/assets/docs/stress-talking-toolkit.pdf" target="_blank" rel="noreferrer noopener">talking toolkit’</a> to help leaders have conversations with workers about stress, with different templates for conversations based on the six key areas included in the HSE Management Standards Framework. For example, for control, employers could ask people the following questions:</p>



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<ul class="wp-block-list">
<li>Do you feel involved in how decisions about your job are made? Think about whether you feel listened to and trusted, how you are consulted and any opportunities for input.</li>
</ul>



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<li>Do you feel your skills are used to good effect? How could they be used more effectively?</li>
</ul>



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<li>Do you feel you have a say in how your work is organised and undertaken?</li>
</ul>



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<ul class="wp-block-list">
<li>What improvements or support is needed to help with any of the issues you have talked about?&nbsp;</li>
</ul>


Having conversation about work-related stress


<p>It has been estimated that leaders spend up to 60 per cent of their time trying to resolve workplace conflict. While some degree of conflict is unavoidable, and can even enhance individual and group effectiveness, it can have a major impact on wellbeing and job performance. Interpersonal conflict at work is more negative, enduring and pervasive than other types of stress, so it must be carefully managed.</p>



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<p><strong>Six steps to managing conflict</strong></p>



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<p>Step 1.  Consider how to achieve a mutually desirable outcome. Be aware that one party ‘losing’ to the other is likely to escalate conflict rather than resolve it. Perceived loss encourages people to try to re-establish a sense of fairness through competition, criticism or disengagement.</p>



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<p>Step 2:  Encourage people to communicate human to human. Recognise that conflict compromises people’s fundamental need for respect, autonomy, feelings of competence and social status. Encouraging one party to see that the other is ‘just like them’ will encourage trust and the use of positive language and behaviour.</p>



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<p>Step 3:  Anticipate people’s reactions and rehearse your responses to them. Before having a difficult conversation, thinking through how the other person might react to your argument can expose its weaknesses. It can also help ensure your message will be received in the way that is intended without the other party becoming defensive.</p>



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<p>Step 4:  Substitute blame and criticism with curiosity. Blame will escalate conflict, encourage defensiveness and lead to disengagement, whereas adopting a learning mind-set will inspire people to explore potential solutions where both parties can win.</p>



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<p>Step 5:  Ask for feedback on how you managed the conflict situation. Showing fallibility can disarm opponents, as this is a quality that inspires trust in leaders. Ask people how you could have handled the situation more effectively.</p>



<p></p>



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<p>Step 6: Assess psychological safety in your organisation. Conflict is much less likely if people feel able to make mistakes or raise issues without fear of criticism or retribution. A <a href="https://staging.isort-frontend.pages.dev/toolkit/secure-base/maiores-quod-praesentium-asperiores" target="_blank" rel="noreferrer noopener">psychologically safe</a> environment <strong> (</strong><a href="https://staging.isort-frontend.pages.dev/toolkit/learning" target="_blank" rel="noreferrer noopener">KFP3 Learning Organisation</a>) that encourages moderate risk-taking and curiosity, and which enables tolerance of uncertainty, will make conflict resolution easier for all.</p>



<p></p>


Building conflict resolution skills


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<h3 class="wp-block-heading"><strong>Using Wellness Action Plans</strong></h3>



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<p>Wellness Action Plans (WAPs) are valuable tools for leaders to support the mental health and wellbeing of employees, fostering a supportive team environment and enhancing support in teams. </p>



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<p>Wellness Action Plans are personalised and practical tools, applicable to all individuals, whether or not they have a mental health problem.</p>



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<p><strong>They can assist in the following:</strong></p>



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<ul class="wp-block-list">
<li>Factors that enhance personal wellbeing: WAPS prompt individuals to identify the factors that contribute to their personal wellbeing at work. They may include specific work conditions, support systems, and coping strategies.</li>
</ul>



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<ul class="wp-block-list">
<li>Recognising stressors: WAPS help individuals recognise potential stressors or triggers that may impact their mental health. This enables targeted interventions and support to be implemented.<br></li>
</ul>



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<ul class="wp-block-list">
<li>Addressing mental health challenges: Individuals using WAPS can identify specific challenges related to their mental health and outline practical steps to address them. This may include strategies for managing stress, improving work-life balance, and seeking support when needed.</li>
</ul>



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<ul class="wp-block-list">
<li>Identifying signs of struggle: WAPS can help managers and colleagues identify the personal ‘early warning signs’ suggesting individuals are struggling and need support. Signs might include changes in behaviour and attitudes, emotional outbursts, and deterioration in quality of work.</li>
</ul>



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<ul class="wp-block-list">
<li>Communication and conversations: WAPS encourage open and constructive conversations between employees and managers. These conversations can help identify specific actions to enhance wellbeing and address potential challenges.</li>
</ul>



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<ul class="wp-block-list">
<li>Returning to work after absence for mental health: WAPS provide a structured framework for identifying the necessary support mechanisms and adjustments required for a successful and sustainable return to the workplace.</li>
</ul>



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<ul class="wp-block-list">
<li>Remote and hybrid working: WAPS offer guidance on identifying the unique challenges and opportunities associated with remote and hybrid work arrangements. This includes strategies for maintaining social support and personal connections, managing workload, and fostering a healthy work environment.</li>
</ul>



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<figure class="wp-block-image size-large is-resized"><img loading="lazy" decoding="async" width="1024" height="396" src="https://isort-backend.s14staging.uk/wp-content/uploads/2024/06/wellness-quickwins-1024x396.jpg" alt="" class="wp-image-2212" style="width:746px;height:auto" srcset="https://isort-backend.s14staging.uk/wp-content/uploads/2024/06/wellness-quickwins-1024x396.jpg 1024w, https://isort-backend.s14staging.uk/wp-content/uploads/2024/06/wellness-quickwins-300x116.jpg 300w, https://isort-backend.s14staging.uk/wp-content/uploads/2024/06/wellness-quickwins-768x297.jpg 768w, https://isort-backend.s14staging.uk/wp-content/uploads/2024/06/wellness-quickwins-1536x594.jpg 1536w, https://isort-backend.s14staging.uk/wp-content/uploads/2024/06/wellness-quickwins-2048x792.jpg 2048w" sizes="(max-width: 1024px) 100vw, 1024px" /></figure>



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<p>There are guides on setting up WAPS for<a href="https://www.mind.org.uk/media-a/5761/mind-guide-for-line-managers-wellness-action-plans_final.pdf" target="_blank" rel="noreferrer noopener"> line managers</a> and <a href="https://www.mind.org.uk/media-a/5760/mind-guide-for-employees-wellness-action-plans_final.pdf" target="_blank" rel="noreferrer noopener"> employees</a>, and WAPS for those <a href="https://www.mind.org.uk/media-a/6020/22078_work-from-home-wap.pdf" target="_blank" rel="noreferrer noopener"> working at home</a> and in a<a href="https://www.mind.org.uk/media/12143/mind-wellness-action-plan-hybrid-work.pdf" target="_blank" rel="noreferrer noopener"> hybrid style</a></p>


Using Wellness Action Plans


<p></p>



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<h3 class="wp-block-heading"><strong>Doing a work-life balance audit</strong></h3>



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<p>To enhance work-life balance, it is important for people to think about the amount of time and energy they spend on the different aspects of their life, and consider how closely this is aligned to their personal values.</p>



<p></p>



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<p>Make a list of the most significant work and non-work elements in your life. These may include career; education, training or personal development; relationship with partner; relationships with children, other family members and friends; health, exercise and nutrition; fun and recreation; hobbies and interests; community activities; creative pursuits; emotional wellbeing and personal growth; and spirituality or religious commitments. </p>



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<p>Then, plot each element on a wheel based on the amount of attention you currently give to each aspect, allocating scores of between 1 and 5, as illustrated below, where the inner circles stand for low scores and the outer circles for higher scores. A low score (1 or 2) suggests that you are not giving much consideration to this aspect, whereas a score of 5 indicates that you give it a great deal of attention. </p>



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<p>It is important to show how you actually allocate your time and energy rather than how you think this ‘ought’ to be.  Indicative scores are shown by the green line in the example below.</p>



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<p><em>Work Life Balance wheel (example)</em></p>


<div class="wp-block-image">
<figure class="aligncenter size-full"><img loading="lazy" decoding="async" width="700" height="486" src="https://isort-backend.s14staging.uk/wp-content/uploads/2024/05/new-bal.png" alt="" class="wp-image-2216" srcset="https://isort-backend.s14staging.uk/wp-content/uploads/2024/05/new-bal.png 700w, https://isort-backend.s14staging.uk/wp-content/uploads/2024/05/new-bal-300x208.png 300w" sizes="(max-width: 700px) 100vw, 700px" /></figure></div>


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<p>The next step is to consider the level of attention you would like to give to each aspect of your life. Provide a second set of scores for each dimension on the same wheel: as above, a low score (1 or 2) means that this aspect is not very important to you, whereas a high score (4 or 5) indicates that it is very important. </p>



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<p>The example below shows these scores as a red line. Finally, compare any discrepancies between the two sets of scores and ask yourself questions such as: “where are the biggest differences?”, “to what extent is my current work-life balance aligned with my personal values?” and “are there aspects of my life I wish to devote a considerable proportion of your time and energy to, but I am currently investing a small amount?”  </p>



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<p>In the example you can see that the individual who is drawing up their wheel is spending considerable time and energy at work, and having sufficient money is also a key focus. Health and sports are getting much less attention than desired. Is this sustainable in the long term? What could they do to change this?</p>


Improving work-life balance


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<p>Some practical, evidence-informed tips for improving work-life balance are:</p>



<p></p>



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<ul class="wp-block-list">
<li>Have regular breaks away from your desk: This will help reduce the intensity of work and get you in the habit of switching off. Micro breaks (two or three minutes focused on something other than work) can improve concentration and reduce stress. Regular breaks from a computer screen each day are vital for visual and musculoskeletal health. Short bursts of exercise are beneficial, but wherever possible try to get outside to exercise during the day in natural settings.</li>
</ul>



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<ul class="wp-block-list">
<li>Establish an unwinding ritual: For the last 30 minutes of your working day, only start jobs that you can complete easily. Alternatively, spend time clearing your desk.</li>
</ul>



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<ul class="wp-block-list">
<li>Write a daily exit list: Jotting down what you need to do the next day will help clear your mind and provide a sense of control and resolution. Mentally prepare yourself as you review your activities the following day.</li>
</ul>



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<ul class="wp-block-list">
<li>Identify a corridor between work and home: People who do emotionally demanding work often need to ‘decompress’ before moving into their personal life. Consider how you can transition between work and home, physically and mentally: change your clothes, have a shower, cook a meal, or go for a run. Mindful walking can be a good way to switch off. It helps you become more aware of your bodily sensations and encourages you to tune into your environment as you walk. (Information on mindfulness apps can be found <a href="https://www.villagegym.co.uk/blog/the-top-5-free-mindfulness-apps/"> here</a>.)</li>
</ul>



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<ul class="wp-block-list">
<li>Find a restorative place: Spend 15 to 20 minutes somewhere you feel happy and relaxed. This could be a favourite chair or a place in the garden.</li>
</ul>



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<ul class="wp-block-list">
<li>Switch off when you commute home: Try not to see commuting as extra work time; read a book or talk to a fellow passenger if you are on public transport or listen to music in the car. If you are working at home, use a ‘virtual commute’ such as meditation, yoga or a go for a walk, to unwind before and after the working day.</li>
</ul>



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<ul class="wp-block-list">
<li>When you think about work after the working day, are you are problem-solving or ruminating? Problem-solving can provide solutions and insights, whereas ruminating will drain your mental and physical energy. So, try to make sure any thoughts about work are restricted to the former.</li>
</ul>



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<ul class="wp-block-list">
<li>Do something different: It is particularly replenishing to use a totally different skillset during leisure time. So, for example, take up a craft, join a choir, or learn a foreign language. See guidance on increasing flexibility earlier in this section.</li>
</ul>



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<ul class="wp-block-list">
<li>Use your diary to schedule activities that you enjoy: Planning your leisure time well in advance will help make sure you get opportunities to switch off.</li>
</ul>



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<ul class="wp-block-list">
<li>Practise self-compassion and self-kindness: avoid the punitive self-talk that can encourage you to work longer and more intensively. See guidance on using CBT techniques later in this section.</li>
</ul>



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<ul class="wp-block-list">
<li>Get another perspective: Regular input and advice from a mentor or a coach can be liberating. Anticipating opportunities to talk about concerns with a trusted person can help people contain difficult emotions and to switch off.</li>
</ul>



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<ul class="wp-block-list">
<li>Disconnect: Switching off from the outside world for a while will help you recoup your energies.</li>
</ul>


Tips for a healthier work-life balance


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<p>Engaging with email has become one of the most stressful activities in the workplace. People spend a high proportion of their working time on email (<a href="https://www.independent.co.uk/news/office-workers-uk-email-time-a9149121.html" target="_blank" rel="noreferrer noopener">Hearn, 2019</a>), particular for people who work remotely. As email use increases, productivity worsens and the risk of burnout and disengagement rises.</p>



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<p>There is also growing awareness that failing to switch off from email during evenings, weekends and holidays can be a major threat to practitioners’ work-life balance and wellbeing. Many organisations now offer guidelines on managing emails in a healthy way. Below are examples of strategies that can be implemented at the organisational and individual level.</p>



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<p><em><strong>How to be ‘e-resilient’</strong></em></p>



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<ul class="wp-block-list">
<li>Develop an organisational policy on email use and etiquette, with input from practitioners.</li>
</ul>



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<ul class="wp-block-list">
<li>Remember that email is a key part of the job, particularly when people are working at home, so should be included in job descriptions and when estimating workload.</li>
</ul>



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<ul class="wp-block-list">
<li>Lead by example: leaders are powerful role models for email behaviour. Unless it is an emergency, do not send emails out of hours (or use the delay function).</li>
</ul>



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<ul class="wp-block-list">
<li>Consider limiting (or even banning) the use of the ‘reply all’ function.</li>
</ul>



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<ul class="wp-block-list">
<li>Limit the use of ‘OK’ and ‘thank you’ emails – instead, use ‘thank you in advance’.</li>
</ul>



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<ul class="wp-block-list">
<li>Encourage people to review their email strategies – are they purposeful and efficient, or reactive and habitual?</li>
</ul>



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<ul class="wp-block-list">
<li>Process and clear an email whenever you check it, rather than intend to return to it later.</li>
</ul>



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<ul class="wp-block-list">
<li>Switch off email notifications – they can cause stress and anxiety.</li>
</ul>



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<ul class="wp-block-list">
<li>Be aware that ‘switching’ between email and other types of work can add up to two hours to your working day.</li>
</ul>



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<ul class="wp-block-list">
<li>Use blocks, filters and folders and keep up with digital housekeeping (e.g. maintaining folders, deleting files, etc.)</li>
</ul>



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<ul class="wp-block-list">
<li>Manage other people’s expectations: an ‘out of office’ notification should mean just that.</li>
</ul>



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<ul class="wp-block-list">
<li>Consider picking up the phone if emails are &gt;3 paragraphs, or if messages fill the screen (&gt;2 paras).</li>
</ul>



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<ul class="wp-block-list">
<li>Remove email from your phone and other personal devices, or else have a separate phone for work.</li>
</ul>



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<ul class="wp-block-list">
<li>Develop ‘rules of engagement’: set boundaries and decide when you will read emails and when you will switch off.</li>
</ul>



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<ul class="wp-block-list">
<li>Take email vacations – disconnect for half a day a week, or even longer.</li>
</ul>



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<p>Based on a systematic review of research studies,<strong> </strong><a href="https://doi.org/10.1111/joop.12462" target="_blank" rel="noreferrer noopener">Russell et al</a><strong>. (2023)</strong> highlighted some key actions to inform best practice in managing emails to mitigate the risks to wellbeing and job performance.</p>



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<p>These involve communicating and adhering to work-email access boundaries (e.g. uses automatic replies, delay send functions out of hours, and removing pressure for employees to respond to emails out of hours), regularly triaging emails (e.g. checking and dealing with email often and explicitly providing employees with time to deal with work email), sending work-relevant email (e.g. providing training on good work-email practice), and being clear and considerate in email exchanges (e.g. being polite, concise with clearly actionable points and intentions).</p>


Managing technology


<p></p>



<p>Many people spend a considerable amount of their working time online. This is set to continue as a high proportion of organisations move to permanent remote working, or hybrid working patterns. Regular ‘check ins’ with practitioners who work remotely can provide routine and structure as well as reassurance and support. Opportunities to connect informally with colleagues are also effective. Nonetheless, a full day of remote meetings and video calls can make us feel drained and fatigued – far more so than after a day of face-to-face meetings.What has become known as ‘Zoom fatigue’ reflects the additional demands we experience during online meetings. </p>



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<p>Firstly, we need to concentrate more intently on conversations online to absorb the same amount of information. </p>



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<p>Secondly, the temptation to multitask during meetings means we can easily lose focus. </p>



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<p>Thirdly, online meetings can be stressful due to technological difficulties and the distractions of family and pets. </p>



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<p>Finally, online conversations can be particularly challenging as we are less able to pick up non-verbal cues, may struggle to follow the points arising, and the potential for misunderstandings is increased. Evidence that Zoom fatigue can have an adverse impact on people’s psychological, social and technical functioning and threaten their work performance highlights the need for interventions (<a href="https://doi.org/10.1108/INTR-07-2021-0499" target="_blank" rel="noreferrer noopener">Li &amp; Yee, 2022</a>).</p>



<p></p>



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<p><a href="https://www.scie.org.uk/care-providers/coronavirus-covid-19/social-workers/building-rapport-with-technology">Guidance</a> is available to help social care practitioners build rapport and establish meaningful relationships using technology, with input from people who access services. This will also be relevant for people working in healthcare. </p>



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<p>The first thing to consider is, do you really need to hold a meeting? Could the outcomes and aims could be met another way: e.g. by having a one-to-one phone call, or by using email to review and feedback on a document. A decision tree can be helpful for this – see <a href="https://www.wrike.com/blog/meeting-infographic-decision-tree/">here</a>. </p>



<p></p>



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<p><strong>Some research-informed tips on reducing Zoom fatigue are:</strong></p>



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<ul class="wp-block-list">
<li><em>Avoid multitasking:</em> although it is tempting to use the opportunity to do more in less time, there is evidence that switching between tasks takes more time and effort and we risk making errors. Close any programmes or tabs that may distract you (e.g. your email inbox) and remain present in the meeting.</li>
</ul>



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<ul class="wp-block-list">
<li><em>Avoid scheduling back-to-back calls, build in breaks:</em> ensure that there is enough time between online meetings to get up and move around and try not to schedule meetings during lunchtimes.</li>
</ul>



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<ul class="wp-block-list">
<li><em>Agree an end time for the meeting and stick to it:</em> ensure that meetings do not over-run. Sharing an agenda in advance of the meeting can be helpful.</li>
</ul>



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<ul class="wp-block-list">
<li><em>Do not feel obliged to turn your camera on.</em></li>
</ul>



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<ul class="wp-block-list">
<li><em>Make online social events optional: </em>after a long day of online meetings, people may not want to join in.</li>
</ul>



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<p>For more information, see <a href="https://hbr.org/2020/04/how-to-combat-zoom-fatigue">here<strong>.</strong></a><strong></strong></p>


Managing online meetings


<p></p>



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<p><strong><em>Increasing opportunities for support: reverse mentorship and matching mentors for diversity</em></strong></p>



<p></p>



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<p>Various options for enhancing support have been discussed in other Key Foundational Principles. These include<a href="https://staging.isort-frontend.pages.dev/toolkit/learning/schwartz-rounds" target="_blank" rel="noreferrer noopener"> Schwartz Rounds</a><strong>, </strong><a href="https://staging.isort-frontend.pages.dev/toolkit/learning/peer-coaching" target="_blank" rel="noreferrer noopener">peer coaching</a><strong> </strong>and<strong> <a href="https://staging.isort-frontend.pages.dev/toolkit/learning/reflective-leadership" target="_blank" rel="noreferrer noopener">supervision.</a></strong>  Some other strategies that are likely to be effective are outlined below:</p>



<p></p>



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<ul class="wp-block-list">
<li>Reverse mentorship, also known as reciprocal mentoring, involves less experienced or younger individuals providing guidance and insights to more experienced or senior colleagues. This is in contrast to traditional mentorship, where the more experienced individual typically mentors the less experienced one. Reverse mentorship can also enhance the mentee’s cultural and inclusion competencies by exposing them to diverse perspectives. It is an effective way to build genuine awareness of the barriers faced by practitioners from an ethnic minority, and can improve their engagement, overall experience, and retention. While reverse mentorship has potential benefits, its success depends on open communication, mutual respect, and a commitment to learning, ultimately creating a more cohesive and collaborative workplace culture. More information on reverse mentoring can be found <a href="https://www.bitc.org.uk/fact-sheet/what-is-reverse-mentoring/">here</a>.</li>
</ul>



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<ul class="wp-block-list">
<li>Matching mentors for diversity at work is a strategy that involves intentionally pairing individuals from underrepresented groups with mentors who can provide support, guidance, and opportunities for professional development (Deng et al., 2022).  When planning such initiatives, it is crucial to identify goals and objectives, promote volunteerism by highlighting the benefits for both mentors and mentees and celebrating success stories, implement opportunities for learning for both parties, and use a matching system that considers their preferences, goals and backgrounds. It is also important to recognise the intersectionality of individuals’ identities, considering factors such as race, gender, ethnicity, sexual orientation, and disabilities when making matches.</li>
</ul>



<p></p>


Increasing support for diversity


<p></p>



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<p><em><strong>Identifying barriers to accessing support</strong></em></p>



<p></p>



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<p>Recognising barriers to accessing support within your organisation is essential for encouraging uptake and shaping intervention strategies. Several potential barriers that should be considered when planning interventions, although some may be specific to your organisation. It is crucial to ask employees themselves about the barriers and facilitators of accessing support in your organisation, as well as the type of support they find most helpful.</p>



<p></p>



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<ul class="wp-block-list">
<li>Time:  Employees may feel they do not have the time to access support</li>
</ul>



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<ul class="wp-block-list">
<li>Awareness:  Lack of awareness regarding the support available and where and when it can be accessed.</li>
</ul>



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<ul class="wp-block-list">
<li>Lack of trust:  Concerns that accessing support may be disclosed to managers or colleagues, with negative consequences</li>
</ul>



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<ul class="wp-block-list">
<li>Feeling overwhelmed:  Feeling too tired or overburdened to consider the support they need and take action to access it.</li>
</ul>



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<ul class="wp-block-list">
<li>Denial:  Reluctance to admit the need for help or support</li>
</ul>



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<ul class="wp-block-list">
<li>Technical issues:  Problems with IT or signing up for apps may hinder accessing support online</li>
</ul>



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<ul class="wp-block-list">
<li>Too much on offer: overwhelming options for support, causing uncertainty about what might be suitable.</li>
</ul>



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<ul class="wp-block-list">
<li>Difficulty finding out what is available:  Information on support options and how to access them may be provided in different places or across different platforms </li>
</ul>



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<ul class="wp-block-list">
<li>Not needing support:  Some individuals may feel they do not need support from their workplace, as they can seek it from family or friends.</li>
</ul>



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<ul class="wp-block-list">
<li>No barriers: employees being comfortable accessing the available support for health and wellbeing</li>
</ul>


Barriers to gaining support


<p></p>



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<p>Research findings show that people who regularly engage in expressive writing (also known as journalling) tend to feel happier and more satisfied. Writing about negative feelings and life experiences can help us reduce stress, depression and anxiety and discourage unhealthy rumination; it can even improve immune system functioning and physical health. There is also evidence that writing about positive experiences can be beneficial for wellbeing.</p>



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<p>Research with social work students (<a href="https://doi.org/10.1080/02615479.2014.891012" target="_blank" rel="noreferrer noopener">Grant et al., 2014</a>) found that writing about their emotional reactions to practice in diary form significantly improved their reflective ability and empathy and reduced feelings of distress. Studies (e.g. <a href="https://doi.org/10.1179/096992609X12455871937620" target="_blank" rel="noreferrer noopener">Sexton et al., 2009</a><strong>; </strong><a href="https://doi.org/10.23750/abm.v89i6-S.7452" target="_blank" rel="noreferrer noopener">Tonarelli et al., 2018</a>) have also found similar benefits for the mental health and wellbeing of healthcare professionals.</p>



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<p>Several mechanisms are thought to underlie the benefits of expressive writing – as it involves thinking about experiences as well as expressing emotions, writing helps people process their thoughts and give meaning to their experiences. There is also evidence that expressive writing can improve emotional regulation skills, which is a key aspect of resilience for practitioners.</p>



<p></p>



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<p>To get maximum benefit, people should write every day, but it need not take up much time. Studies suggest that expressing emotions in writing for only a few minutes a day can improve wellbeing <strong>(</strong><a href="https://doi.org/10.1348/135910707X250910" target="_blank" rel="noreferrer noopener">Burton &amp; King, 2008</a><strong>)</strong>.</p>



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<p><em>There is no one ‘correct’ way to do this, but these tips may help:</em></p>



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<ul class="wp-block-list">
<li>Try writing in the third person to give you some distance and even a new perspective.</li>
</ul>



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<ul class="wp-block-list">
<li>Write about your emotional responses to specific situations: i.e. those that evoked negative feelings (e.g. fear, confusion, embarrassment or frustration) and those that were positive (e.g. satisfaction, pride or a sense of meaning).</li>
</ul>



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<ul class="wp-block-list">
<li>Make a note of what you were doing and who you were with; this can help you identify patterns to your emotional reactions to different situations and individuals and can encourage a more in-depth understanding of your emotions.</li>
</ul>



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<p>Although writing about emotions can be helpful, it may not be effective for people who are experiencing ongoing or serious mental health challenges. Any personal reflections on emotional reactions to work experiences should always be kept in a secure location.</p>


Using expressive writting/journalling


<p></p>



<p><em><strong>Mindfulness is the basic ability to be fully present, aware of where we are and what we are doing, and not overly reactive or overwhelmed by what is going on around us.</strong></em></p>



<p></p>



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<p>Many studies have demonstrated the positive effects of mindfulness, particularly for people working in health and social care (<a href="https://www.nice.org.uk/sharedlearning/using-mindfulness-to-support-mental-wellbeing-at-work-for-children-s-social-care-front-line-practitioners" target="_blank" rel="noreferrer noopener">NICE, 2020</a>); <a href="https://doi.org/10.1016/j.nedt.2018.03.018" target="_blank" rel="noreferrer noopener">van der Riet et al., 2018</a>) highlight the effectiveness of mindfulness for the wellbeing of healthcare practitioners, and research by <strong><a href="https://doi.org/10.1093/bjsw/bcz073" target="_blank" rel="noreferrer noopener">Kinman et al. </a>(2019)</strong> found wide-ranging benefits for the wellbeing and resilience of social workers.</p>



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<p><a href="https://doi.org/10.1093/bjsw/bcz073" target="_blank" rel="noreferrer noopener">Kinman et al</a><strong>.</strong> found that an eight-week mindfulness training course increased emotional self-efficacy and reduced compassion fatigue and distress. Interviews with participants revealed that mindfulness can benefit many aspects of wellbeing.</p>



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<p>In particular, it enhances work-life balance by helping people ‘switch off’ from work concerns and enabling them to replenish their energy and motivation.</p>



<p></p>



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<p class="has-text-align-left"> This study also found mindfulness can help improve job performance:</p>



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<ul class="wp-block-list">
<li>When experiencing pressure, we are more aware of the options we have available to manage it.</li>
</ul>



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<ul class="wp-block-list">
<li>We are able to sharpen our focus and prioritising skills.</li>
</ul>



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<ul class="wp-block-list">
<li>We become more adept at identifying what we can and cannot control in high-stakes situations.</li>
</ul>



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<ul class="wp-block-list">
<li>We carry more energy by reducing wasted effort and enhancing recovery processes.</li>
</ul>



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<ul class="wp-block-list">
<li>We are less judgmental towards others and ourselves, more patient, and trust in our intuition and authority.</li>
</ul>



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<p><em><strong>Learning to be mindful</strong></em></p>



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<p>Several apps are available that introduce people to mindfulness principles and offer guided meditations; these can be customised to individual needs and contexts. For example, ‘one-minute mindfulness’ exercises can help people recover after difficult meetings and switch off from work when they get home.</p>



<p></p>



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<p><strong>Some brief mindfulness techniques include:</strong></p>



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<ul class="wp-block-list">
<li>Mindful eating:&nbsp;Paying attention to the taste, sight and textures of what you eat. For example, when drinking a cup of tea or coffee you could watch the steam that it gives off or focus on how hot and liquid it feels on your tongue. Mindful eating can also help us avoid over-eating by making us aware that we are full.</li>
</ul>



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<ul class="wp-block-list">
<li>Mindful walking: If possible, find a quiet space outside to walk. Notice the feeling of your body moving. You might notice the air against your skin, the feeling of your feet on the ground, and the different sights, smells and sounds that are around you.</li>
</ul>



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<ul class="wp-block-list">
<li>Body scan:&nbsp;This involves moving your attention slowly through different parts of the body. Start at the top of your head and gradually move down to your toes. You could focus on feelings of warmth or relaxation of different parts of your body.</li>
</ul>



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<ul class="wp-block-list">
<li>Mindful meditation: Sit quietly and focus on your breathing, your thoughts, your bodily sensations, and what you can hear around you. You might choose to do a systematic body scan (as above), or you could choose to explore bodily sensations randomly as they occur. If your mind wanders, simply notice this is happening and gently try to focus yourself back on the present.</li>
</ul>



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<p><strong>Grant and Kinman recommend:</strong></p>



<ul class="wp-block-list">
<li><a href="https://buddhify.com/">Buddhify</a>&nbsp;</li>
</ul>



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<ul class="wp-block-list">
<li><a href="https://www.headspace.com/">Headspace</a></li>
</ul>



<p>Both require subscriptions, but others are available free of charge. At the time of writing this workbook, NHS workers have free access to several wellbeing apps (including Headspace). See <a href="https://www.england.nhs.uk/supporting-our-nhs-people/support-now/wellbeing-apps/">here</a> for details.</p>


Mindfulness


<p></p>



<p>Radical self-care refers to a concept of self-care that goes beyond routine or conventional practices and involves making significant, intentional, and transformative changes in one&#8217;s life to prioritise well-being (<a href="https://doi.org/10.1332/204986020X15945755847234" target="_blank" rel="noreferrer noopener">Nayak, 2020</a>) It emphasises a deep commitment to self-preservation, mental health, and overall personal flourishing.</p>



<p></p>



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<p><strong>Key elements include:</strong></p>



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<ul class="wp-block-list">
<li>Setting boundaries to protect personal time and energy and learning to say ‘no’.</li>
</ul>



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<ul class="wp-block-list">
<li>Embracing authenticity and self-expression without fear of judgement.</li>
</ul>



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<ul class="wp-block-list">
<li>Cultivating mindfulness practices and engaging in inner work to understand and address underlying issues or trauma.</li>
</ul>



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<ul class="wp-block-list">
<li>Accepting oneself fully, including both strengths and vulnerabilities.</li>
</ul>



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<ul class="wp-block-list">
<li>Challenging societal norms and expectations that may contribute to stress or burnout.</li>
</ul>



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<ul class="wp-block-list">
<li>Advocating for one’s needs, both personally and professionally, and seeking support where necessary.</li>
</ul>



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<ul class="wp-block-list">
<li>Prioritising physical health, nourishment and rest.</li>
</ul>



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<ul class="wp-block-list">
<li>Building and nurturing supportive communities that encourage and uplift.</li>
</ul>



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<ul class="wp-block-list">
<li>Committing to continuous growth.</li>
</ul>



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<p>More guidance on radical self-care practices can be found <a href="https://www.forbes.com/sites/bryanrobinson/2022/11/03/7-ways-to-practice-radical-self-care-when-your-mental-health-is-at-stake/">here</a> and <a href="https://www.psychologytoday.com/gb/blog/lifetime-connections/202010/radical-self-care-protect-your-overall-well-being">here</a>.</p>


Using radical self care to make changes

Make improvements that are visible, no or low cost to implement and contribute to organisational, team or individual resilience quickly

Wellbeing

Quick Wins

Core Actions

Definitions