Young, Olivia
(2024)
The acceptability and feasibility of Acceptance and Commitment Therapy training to support work-related wellbeing for managers of homelessness services.
DClinPsy thesis, University of Nottingham.
Abstract
Introduction: Managers of homelessness services have an important role in implementing psychologically informed environments (PIEs), managing staffing levels, dealing with emergencies such as deaths in service and supporting their teams. Given these challenges, it is not surprising that they can be at risk of vicarious traumatisation, burnout, and poor wellbeing. Acceptance and Commitment Therapy (ACT) has been shown to be an effective workplace wellbeing intervention and could be offered to managers of homelessness services. Given the pressure that managers are under working with service pressures, high staff turnover and clients with complex needs it is appropriate they are provided with further support for their wellbeing. However, it is important to assess the feasibility prior to offering it more widely. At present there are no studies which have investigated ACT-based training for managers in homelessness services. Therefore, the aims of this current study were to assess the acceptability and feasibility of an ACT-based training for managers of homelessness services. The training was intended for participants to learn to use ACT to support their work-related and personal wellbeing. Secondary objectives were to assess participant recruitment, retention rates, measure completion and signal efficacy.
Method: a mixed methods pre/post design was employed. Participants were managers within homelessness services from across England who were recruited to either face-to-face or online training. Both the face-to-face and online sessions followed the same format, following the training for staff wellbeing detailed in Flaxman et al (2013). This training offers 3 sessions of ACT based exercises aimed at increasing psychological flexibility and wellbeing. Validated Outcome measures were given at baseline and following each session and an adapted Change interview (Elliot & Rodgers, 2008) was completed post-training. Measures of wellbeing, workplace quality of life, psychological flexibility, feasibility and acceptability indices and group alliance were used. Quantitative analysis included reliable change analysis and a linear mixed model analysis. Qualitative data was analysed using content analysis. Measures of group alliance and feasibility were descriptively analysed.
Results: A significant increase was found on the CompACT Valued action subscale and on the SWEMWBS measure of general wellbeing. A marginally significant decrease was found on the Proqol-5 Secondary traumatic Stress Scale (STS). There was no significant difference across the other measures. Effect sizes ranged from small to large across measures. Themes developed from qualitative analysis include engagement with training, beyond training, implementing skills and behavioural change or intention to change. Participants shared that they found the training useful, engaging and made changes because of the training. However, attrition was high and measure completion was poor.
Discussion: Overall, the current study demonstrated some promising initial findings for work-related wellbeing for managers of homelessness services. Participants shared via change interviews that they found the training useful, interesting, and accessible. However, attrition was high and so there needs to be adaptations to the training to increase feasibility. With regards to signal efficacy Valued action, and general wellbeing increased post-training which is consistent with prior research in this area. However, the lack of a significant change in overall psychological flexibility contrasts with prior literature, which has generally found increases in psychological flexibility post-intervention and that this change mediates changes in various measures of wellbeing. Future research reassessing the training, would be beneficial and it may be helpful to gain buy-in from services so that the managers are supported to be able to fully engage with the training. Furthermore, incorporating suggested adaptions in a trial would evidence whether these increase engagement and benefit.
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