As is often the case, the Journal of Behavioural and Cognitive Psychotherapy (May, 2020 just arrived ) has some great articles. One of which discusses chronic depression and its treatment with rumination focused CBT. Ed Watkins is best associated with it and his book on rumination was a revelation. It helped me understand the process of over-general memory and its links with unhelpful labels. This explains how people can describe themselves in unhelpful ways like “I’m lazy” “I’m useless” “I’m a failure” and why helping people to be more descriptive starts to break down such mood lowering short-cuts.
I am on a mission at the moment to encourage the effectiveness of clinical supervision by blending compassion focused work with techniques that encourage descriptive reflection with the hope of reducing rumination, blame and guilt and ultimately the mental health of nursing staff.
For far too long nurses have been dismissive of the restorative power of clinical supervision which is often viewed with suspicion and considered as just another task to tick off the long “To Do” list. Now is the time to at least plan to learn techniques that stabilise the nursing workforce through a frequently side-lined activity.
Clinical supervision has lost its credibility resulting in the proliferation of alternative support processes which frequently fail to take off for the same reasons – its another initiative, we haven’t got time, its another management tool to get management off the hook. I think it would be a safe bet, to say that the people who are currently accessing effective support are the ones in least need – sophisticated and psychologically minded and committed to trying the techniques that might help.
Try getting a busy staff nurse, who arrives home after a gruelling shift and to a family whose lives are on hold, to sit down, relax and reflect. Oh, and fit in some mindfulness exercises whilst you are at it.
Nurses do need support but they also need the time to access a process that needs to mature and that in need of enhancement of its restorative value through adding techniques that work. Wallbank (2016) makes a good case for the restorative aspects of clinical supervision as one that enhances self compassion and compassion for others, and that cant be a bad thing. The majority don’t need additional and new support mechanisms that seem alien and imported, so lets be grateful for what we already have.
Wallbank, S. 2016, “Restorative Supervision Implications for Nursing”. In: A Hewiston & Y Sawbridge (eds.) Compassion in Nursing: Theory, evidence and Practice. Palgrave, London.
Watkins, E. & Moulds, M. 2005, “Distinct Modes of Ruminative Self-Focus: Impact of Abstract Versus Concrete Rumination on Problem Solving in Depression”, Emotion, vol. 5, no. 3, pp. 319-328.
Watkins, E.R. 2009, “Depressive Rumination: Investigating Mechanisms to Improve Cognitive Behavioural Treatments”, Cognitive behaviour therapy, vol. 38, no. sup1, pp. 8-14.
Watkins, E.R. 2016, Rumination-Focused Cognitive-Behavioral Therapy for Depression, Guilford Publications Inc. M.U.A, New York