Reflections on my first year of training as an educational psychologist

By Dawn Dance

Finding our more about the role

In my previous working life I had never met an educational psychologist despite working for nearly ten years in a Post 16 and secondary school setting. As part of my application I had the chance to talk to some educational psychologists and to read about the role but I struggled to make sense of what that meant in practice. Being on the course and my placements has shaped my understanding of the role of an educational psychologist. Here I want to share some of the key aspects of my learning during my first year of training.

Early Days

During my first weeks of lectures I began to realise that educational psychologists don’t just do tests! I was introduced to dynamic assessment and other models that offer alternative ways to gather information to help me to connect with and understand a child or young person. This is important to me, because some children and young people just don’t ‘do’ tests (there’s a reason why we’re advocating for them). I can see that some tests might have a role in educational psychology practice, but they don’t have to be the first port of call.

When I started my first placement I was concerned about needing to appear to have all of the answers to hand (I do wonder if some of my ideas might have stemmed from other professionals’ perception of educational psychologists). My first placement supervisor (in particular) helped me to understand that my strategies don’t all have to work as  that I can re-visit them. This was a great relief!

Other Reflections on my Learning

Communication: One thing I quickly realised is the necessity of being observant and a good communicator! Communication underpins the role of the educational psychologists, who must connect very quickly with people from all backgrounds and professions.

Consultation: Before my first placement, I imagined consultation as having a ‘chat’, but have since discovered that consultation isn’t just a series of conversations, it’s purposeful. It’s structured and designed to gather information that will help to think about the problem that has been raised.

Problem solving: This concept spans multiple contexts and the use of frameworks for practice are recommended for trainees (the Interactive Factors Framework is a favourite tool of mine to use). This is to help them to consider all aspects of the systems that sit around the child. The more I use the frameworks, the more it helps me to intentionally reflect on what I’ve observed and heard.

Voice of the Child: I’ve always considered the voice of the child to be important to my practice and quickly realised that a person-centred approach is paramount to the EP role. The role of the educational psychologist is to ensure that the voice of the child is woven through the assessment process and reflexively checking that the child’s or adult gatekeeper’s voice permeates every part of our work.

Training: I had the opportunity to train local authority employees in the use of applied psychology and this was a great feeling. Firstly, because if they apply what they learned we are able make a difference to the lives of the children and young people that they support. Secondly, we’re demonstrating our commitment, as outlined in the SEND Code of Practice (2015) to working with other professionals.

Research: I was able to contribute to a small-scale study investigating the evolving role of EPs in a local authority service during COVID-19. This is intended to inform future practice in the service and has shown me how educational psychologists can be part of influencing systemic change.

Final thoughts

My experiences in Year 1 of the training course have given ‘life’ to the picture that I had in my head about what an educational psychologist does. I’ve begun to realise that we have the capacity to work holistically, from an individual to systemic level, so that all children and young people can benefit from our applied psychology.

An educational psychologist has many tools that they can use to promote children’s development and learning, but how this is done is very much a professional and personal decision. To quote Shakespeare: “This above all: to thine own self be true”. and my newly acquired understanding of the educational psychologist has given me the opportunity to do so.

Dawn is a Year 2 trainee on the initial training course at the University of Birmingham.

 

 

How to Avoid the Silence: Supporting Race Talk in Educational Psychology Practice – Part One

handwritten text on paper

Photo by Vlada Karpovich on Pexels.com

 

 

By Dr Anjam Sultana, Dr Cherelle McDonald, Dr Maninder Sangar, Dr Sasha-Louise Simon and Dr Sidra Aslam

George Floyd’s murder has caused the resurgence of strong emotions of hurt, anger, and loss with recollections of racism in the UK and within our local contexts. It has taken its toll on Black educational psychologists (EPs) emotionally, physically and mentally. Many have articulated feelings synonymous with grief, burnout and anxiety. Black and ethnic minority EPs, within safe spaces, have articulated their inherent feelings of distress and disappointment as they returned to work where silence resounded. This lack of acknowledgement perpetuated the realisation that their hurt and pain; their wellbeing; their experiences of racial trauma were not worthy of recognition. Colleagues of colour want to experience empathy; a sense of belonging; and to know that their emotions are recognised and validated.

This blog is Part One, of two blogs, that aim to address this silence, firstly by defining six key concepts relevant to understanding racism in the hope it will raise awareness, educate and empower more EPs to engage in race talk within their EPSs. For each concept a variety of follow resource are recommended for you to explore.

  • What is racism?

To define racism, we must understand the concept of ‘race’. Historically, the concept of ‘race’ is rooted in the desire to classify people into distinct biological groups, typically based on their skin colour. Today, we know classifying humans into ‘races’ based on physical characteristics is crude and problematic, as we know there is greater genetic variation within ‘racial’ groups than between them. So, we understand ‘race’ as a social construct; however, a construct that continues to affect people’s lives in the form of racism. Racism refers to discrimination and prejudice against someone because of their ‘race’ and is underpinned by the belief that some ‘races’ are superior to others.

Resources: race and racism:

  • Podcast: Talking Race (2020) presented by Professor Vini Lander and Dr Daniel Kilvington: this podcast includes interviews with leading academics in the area of race and racism including Professor Kehinde Andrews and Professor David Gillborn
  • Books:
    • Saini, A., (2019) Superior: The return of race science, Harper Collins, London.
    • Rutherford, A., (2020) How to argue with a racist: history, science, race and reality, Weidenfeld and Nicolson, London
  • What is institutional racism?

Institutional racism or ‘systemic racism’ refers to policies, processes or practices within an institution or organisation which discriminate against, and disadvantage Black and ethnic minority people. These practices can be unintentional and a product of thoughtlessness or racial stereotyping. In the UK, this concept was used in the 1999 Lawrence Report by Macpherson to explain the failings of the police in their investigation into the racist murder of Stephen Lawrence. As EPs this concept is important in considering how practices or procedures within educational settings or EPSs may be institutionally racist.

Resources: institutional racism

  • What are racial microaggressions?

Microaggressions are the incivilities that happen in everyday life, including the workplace, that are linked to an individual’s perceived racial group membership, age or gender. Racial micro-aggressions are a form of discrimination that subtly signal to individuals that they do not belong and are not welcome by highlighting a difference from the ‘majority’ group (Kandola, 2018). What makes micro-aggressive comments and acts so traumatic are their subtle and ambiguous nature, often made by well-intentioned people. Within the workplace common micro-aggressions include (but are not limited to): being ignored or interrupted by White colleagues in meetings, not given eye contact, incorrect pronunciation of names and comments based upon stereotypical judgements about an individual’s ‘perceived race’ (Weston, 2020). The accumulation of these ‘micro’ acts over time can have a detrimental impact on an individual’s psychological wellbeing.

Resources – racial microaggressions

  • What is Unconscious/Implicit Bias?

Unconscious or implicit bias (the terms are used interchangeably) refers to the attitudes and beliefs that we hold outside of our conscious awareness. Our biases develop through our experience and learning of stereotypes and associations within society. Biases affect our perception, attention, memory and actions, and they are implicit when they are outside of our explicit awareness or deliberate expression. We all have implicit biases. Implicit racial biases occur when we attach attributes to different racial groups based on stereotypes pervasive in society. The challenge of implicit racial bias is that it can lead to decision making, thinking and actions that are more/less favourable towards different groups. To address implicit bias, we firstly need to be aware that we have it and that it affects us.

To understand and address implicit racial bias is to become starkly aware of the stereotypes and associations that exist within our society, actively take steps to challenge them, and be more conscious in our decision making, thinking and actions.

Resources: implicit bias

  • Videos:
    • Implicit Bias – Concepts unwrapped: This US video (University of Texas at Austin) further explains implicit bias
    • Biased: a short extract from a Royal Society of Arts lecture delivered by Professor Jennifer Eberhardt, and introduces how implicit bias affects us all
  • Articles:
    • ‘Bias in Britain’: This series of reports from the Guardian newspaper examines implicit bias in a range of areas in UK society
  • Books:
    • Agarwal, P. (2020) Sway: Unravelling Unconscious Bias. London: Bloomsbury Sigma.
    • Eberhardt, J. L. (2019) Biased: The New Science of Race and Inequality. London: William Heinemann.
  • What is Aversive Racism?

Aversive racism builds on implicit racial bias, to describe the prejudice experienced when an individual outwardly professes an egalitarian view and regards themselves as non-prejudiced, yet implicitly experiences negative feelings and beliefs in relation to a racial group (Pearson, Dovidio, and Gaertner, 2009). Aversive racism is subtle and indirect, and leads to discrimination in situations where there are ambiguous social norms, as behaviours can then be rationalised as being due to factors other than race.

Resources: aversive racism

  • What is White privilege?

Coined in the 1930s by the famous Black civil rights activist William Du Bois, White privilege is a concept based on an institutional set of benefits granted to those of who, by race, resemble the people who dominate the powerful positions in our institutions (Robin, 2018). White privilege can be hard to see for those who have it, as it is ascribed from birth. It encapsulates a whole host of social advantages that come with being a member of the dominant race. The concept came to further prominence when antiracism activist, Peggy McIntosh, shared her experiences as a White woman about the invisible unearned conditions she could rely on:

  • I can, if I wish, arrange to be in the company of people of my race most of the time
  • I can go shopping alone most of the time, pretty well assured that I will not be followed or harassed
  • When I am told about our national heritage or ‘civilisation’, I am shown that people of my colour made it what it is

(p.2, McIntosh, 1988)

In her book, ‘Me and White Supremacy’, Saad (2020) encourages self-reflection to questions like:

  • In what ways do you hold White privilege? Study the list from Peggy McIntosh and reflect on your own daily life.
  • What negative experiences has your White privilege protected you from throughout your life?
  • What positive experiences has your White privilege granted you throughout your life (that Black, indigenous and people of colour do not have)?
  • What have you learned about your White privilege that makes you uncomfortable?

(p. 39, Saad, 2020)

Resources: White privilege

  • Video: illustrates the concept of White privilege: The $100 Race
  • Article: Peggy McIntosh (1988) White Privilege: Unpacking the invisible knapsack
  • Books:
    • Angelo Robin (2018) White Fragility: Why It’s So Hard for White People to Talk About Racism, Boston: Beacon Press.
    • Saad Layla (2020) Me and White Supremacy: How to Recognise Your Privilege, Combat Racism and Change the World,  London: Quercus Books

Anjam, Cherelle, Maninder, Sasha and Sidra are educational psychologists working in the West Midlands who all completed their training on the initial training course for educational psychologists at the University of Birmingham

Thinking about trans-cultural supervision and working with difference

By Haley Fong, Tara Janda and Anita Soni

man wearing white top in front of woman wearing blue long sleeved top

Photo by Christina Morillo on Pexels.com

 

 

In this blog post we explore the concept of trans-cultural supervision and how we have used this in our practice. The context of the supervision is between Anita who is an academic and professional tutor and two of her Year 1 trainees: Haley and Tara. Here they share their use of experiences of trans-cultural supervision.

Background

Anita: Tara, Haley and I have been exploring trans-cultural supervision in our sessions through undertaking an activity together from Hawkins and Shohet (2012) to help us become more aware of our own and each other’s cultural perspectives and to work in a culturally sensitive way. Hawkins and Shohet remind us to bear in mind the following;

  1. It is important to become conscious of our own culture.
  2. All cultures are equally valid, but as we operate within different cultures we may hold different values and assumptions. Habitual ways of thinking can arise from cultural assumptions.
  3. It is good to be sensitive and open to the differences that may arise, by both taking an interest in other cultures and areas of difference, whilst never assuming we understand the cultural world of another person. This means we start with an interest in finding out from the others whilst accepting our own not knowing.

The Activity

In order to explore our cultures we used the following activity:

Person A explain to Person B What I would like you to know about my cultural background is… (where cultural background is interpreted in the widest sense and so can include many aspects of a person’s life that they think is relevant).

Person B listen carefully to Person A and recounts what they have heard.

Person A listens to Person B and clarifies, corrects any misunderstandings, adds further information

Person B then reflects how this may relate to the supervisory relationship.

The roles are then reversed and Person B then explains to Person A about their cultural background, and the following steps are repeated.

The discussion ends with considering what might be the same about each other, and where there are overlaps.

Haley, Tara and I tried this activity towards the end of their first term in university and have reflected on how it felt. Initially we all felt unsure and apprehensive but decided to give it a go.

Reflections

Haley:

Once I heard Anita share freely about various aspects of her life, it made me feel comfortable and confident that it was a safe space for me to do likewise. This sets the tone so that we know we can share our thoughts and background without being judged. I think being able to share aspects of what makes me ‘me’ is so important to enable understanding my values and thinking. Also, it made me consciously aware of what was important to me in terms of culture. It is important for me to be aware of my assumptions so that I can be accepting and sensitive to others too.

After hearing both Anita and Tara sharing their culture, I felt that I was able to begin to understand their background and what brought them to where they are today and gained insight into their cultures although far from knowing it all! Although it was really useful to explore which areas of our cultures were similar, it was even more interesting to explore what areas were different. This is because during future supervision, it can help to highlight why we may have different interpretations of the same concept or situation. In that sense, we can learn from other points of views and engage in thought-provoking discussions based on these. Therefore, it elevates supervision to another level as we can be reflective of our own thoughts and reasons as well another person’s thoughts and reasons.

Tara:

I valued listening about both Haley’s and Anita’s culture and the aspects they considered to be important to them. It gave me insight into their unique journeys to their current positions. Additionally, I gained understanding into aspects of their life they deemed significant and through the discussion was able to compare and contrast this with my own experiences. Listening to both Haley’s and Anita’s accounts made me aware of how much I could learn from them as their experiences differed from my own.

The experience was a structured and safe method in which I could share aspects of my life, such as my school experience, previous jobs, and my family’s religious background of my life, I wanted to be known. The discussion made me aware of how my experiences and culture impacted my views and beliefs, and how these have changed over time.

I enjoyed the experience very much though discussion with friends and colleagues has suggested that some people may find it difficult to reflect on their culture. This is something that resonated with me as everyone has a culture, it just may be that some cultures are embedded in the norms of society which some may see as harder to recognise. I believe that trans-cultural supervision would help colleagues to recognise their culture and how they may impact on professional and academic practice.

We all valued trying out the transcultural supervision activity, helping us reflect on how aspects of our lives have impacted on our views and values which in turn influences on each of our practices, both professionally and academically. We agreed it was an activity we would engage in again!

Tara and Haley are in the first year of the initial training course at the University of Birmingham. Anita is one of the course tutors.

Reference

Hawkins, P. and Shohet, R. (2012) ‘Supervision in the helping professions’ (3rd ed) Maidenhead: McGraw-Hill

A rapid literature review of how to support the psychological well-being of school staff during and after Covid-19

By Amber Bhardwaj, Catherine Byng & Zoë Morrice

Editorial Note from Julia Howe, Course Tutor

This is a slightly different blog post from those that we normally publish. It is a piece of work commission by Dudley Educational Psychology Service (EPS) from the Year 1 trainees on the initial training course for educational psychologists at the University of Birmingham. The trainees were asked to complete a Rapid Review of literature from previous epidemics in order to provide evidence based guidance for the EPS on how to support school staff during and after the current pandemic. As mentioned in the review this guidance has been extrapolated from research mainly conducted with health care workers and in this respect it needs to be treated with caution. It has not been peer reviewed but we hope that it is still useful in supporting the work of local authorities and other services. For the practical reason of length I have taken out the table that provides an overview of the research studies and their methodologies but I can provide this if you contact me.

Introduction

people wearing face mask for protection

Photo by cottonbro on Pexels.com

 

 

In light of Covid-19, this rapid literature review aims to examine what psychological support may be helpful for school staff during and after the pandemic. As there is very little evidence in relation to school staff this review will also examine the literature into what support is helpful for frontline healthcare workers during and following epidemics in order to consider how this can be applied to workers in other areas.

Summary of findings

Within the literature on how best to support staff during and after an epidemic, the key overarching principles were strengthening resiliency and empowerment by building on and mobilising existing resources. The literature identifies that within any support or intervention it is crucial to consider culture. This means that a ‘one size fits all’ approach would not be beneficial. Furthermore, the importance of a stepped approach was evident as the literature highlighted most individuals are highly resilient and do not require psychological intervention. Ensuring normal reactions to the situation, such as responses to grief and high stress, are not pathologized is therefore important. Key factors highlighted within these stepped approaches were first ensuring basic practical support needs were meet before considering emotional support.

The empowerment of individuals through the identification and development of coping/self-help strategies and psychoeducation about stress and anxiety, were evident within many papers. Furthermore, the importance of looking at the wider community systems in order to strengthen connectedness, belonging, and identify resources was highlighted. Social support was identified to be a key protective factor and measures implemented during epidemics such as social distancing were found to reduce social connectedness and support. Consideration of how to rebuild connectedness between families, friends, employers and colleagues is therefore important.

The most common programmes used within the literature to support frontline workers were Psychological First Aid and the Mental Health Gap Action Program (WHO, 2010). However, there is a distinct lack of evidence into the long-term outcomes of interventions in this area. So, some caution is necessary as there is not a clear understanding of how to intervene effectively.

In terms of how best to support workers during or following an epidemic from an organisational perspective the literature identifies key factors to be visible leadership, clear communication and open discussions, and building team cohesion. Furthermore, allowing individuals time to reflect and utilise peer support or supervision has been suggested as being helpful.

A needs assessment identifying what support individuals found helpful and what ongoing support staff would like may also be useful. Additionally, identification of individuals who may be ‘at risk’ of greater psychological difficulties to allow for monitoring and extra support if needed should be considered.

The literature indicates risk factors for greater psychological distress during or following an epidemic to be previous mental or physical health difficulties, personal impact of the epidemic (e.g. bereavement, loss of housing/income), low socio-economic status, and poor self-perceived social support. Finally, continual support for staff members development and learning, such as acknowledging reflective conversations as useful learning opportunities, is suggested to enhance resilience. Training staff on how to support others (e.g. peer support groups) has also been shown to not only support those receiving the help but also to be beneficial to the helpers’ wellbeing, however ensuring staff have an awareness of when to seek further help or supervision is key.

 Guidance

Based on the findings of this rapid literature review, the following recommendations for supporting frontline workers in the education sector have been provided:

Culture and context

  • EPs will need to gain knowledge of the existing systems of support that are already in place in settings. This can be achieved through multi-agency working and collaboration with key stakeholders.
  • Strong systems of support within the workplace during/after the pandemic may mitigate some of the potential adverse psychological outcomes for staff.
  • It is important to understand the individual characteristics of the staff who do require support, whilst also taking into consideration the complex dynamics of the organisation’s culture.
  • EPs should encourage visible leadership, clear communication and open discussions within settings, to enhance team cohesion.

Organisation and individual factors

Peer support/supervision and rebuilding connectedness   

  • EPs should support leadership to provide staff with the time to reflect on experiences, offer opportunities for ongoing peer support, and praise staff for their response to the situation.
  • If appropriate to the setting, EPs should consider setting up weekly peer support groups to create a safe space for staff to discuss emerging issues in the wake of the COVID-19 pandemic.
  • Peer support groups may also incorporate discussions and exercises with staff that focus on the development of coping strategies and enhancing resilience, to minimise the risk of burnout.
  • It may be necessary for EPs to facilitate open discussions between staff and senior leaders to encourage reciprocity of decision-making within organisations and encourage sensitivity to ethical and cultural considerations.
  • EPs should make use of the technology available to stay connected with schools, social workers and families throughout the period of social distancing and look to strengthen social connectedness within and between settings.

Assessment of individual needs

  • Individual and psychological support should be offered to members of staff who are considered to be ‘at-risk’ of greater psychological difficulty, and who may be displaying maladaptive responses/ coping strategies.
  • Factors that may place an individual at greater risk are; bereavement or illness of a relative or close friend, exposure to the COVID-19 outbreak at work, perceived level of risk at work, being quarantined, loss of housing/income, lower socio-economic status, and poor self-perceived social support.
  • For individuals requiring psychological support, action plans will need to be holistic, informed by evidence and make use of implementation strategies that are focused on sustainable, long term outcomes.
  • EPs will need to ensure they are only delivering mental health care that is within the boundaries of their competence. It may prove worthwhile for the whole service to engage in Psychological First Aid training.

Resiliency and empowerment

  • It will be important to consider how staff resilience can be continually promoted to develop protective factors that will facilitate personal empowerment and the ability to cope with both the personal and professional challenges of living and working through a time of crisis.
  • EPs can support leadership teams to encourage help-seeking amongst their staff and promote continual learning and development to enhance staff resilience.
  • It may be useful for EPs to determine suitable interventions to enhance staff resilience e.g. Psychological First Aid, and tailor these approaches to school staff.

Psychological Interventions

  • EPs should consider both the personal and professional burdens of school staff to establish the area of greatest need (e.g. practical vs personal) before planning an intervention.
  • Consultation, review and responsiveness should be embedded into the decision- making process before any intervention is carried out/continued, and ongoing evaluations conducted to ensure best practice is being achieved.
  • Formal psychological intervention should take a stepped approach. This includes ensuring basic practical needs are met before considering emotional support. This type of approach is addressed through the Psychological First Aid program.

 

Psychological First Aid (PFA)

  • PFA provides a programme of interventions that can be utilised by EPs to support staff and pupils during and after the pandemic e.g. building social support, normalising grief.
  • It may be appropriate for experienced EPs to train school staff and to deliver PFA within their own settings, incorporating interventions that focus on self-help/ coping strategies that can be used in their work to support one another.
  • Using a ‘train the trainer’ approach (EPs training school staff) may help staff by empowering them, as well as benefiting pupils.
  • EPs could offer supervision and/or facilitate the set-up of peer support networks within settings, e.g. buddy systems, to ensure staff who are implementing PFA have connection with social supports.
  • Important aspects of PFA may include supporting with/ teaching self-help strategies (e.g. relaxation techniques), practical support, psychoeducation about COVID-19, looking at community systems, normalisation of an anxiety response and knowing when to seek further help.

Methodology

Search strategy

We searched the literature using a range of databases including PubMed, Google Scholar & FindIt@Bham. We used the key words keywords “Ebola” OR “SARS” OR “MERS” OR “Covid-19”AND “Mental health” OR “Intervention” OR “Mental health intervention” OR “Psychological intervention” OR “Psychosocial intervention” OR “Social intervention” OR “Mental health program” AND “Frontline worker” OR “Frontline staff” OR “Education” OR “Teachers”.

Selection criteria

Studies were included if they addressed the mental health of frontline staff. Studies focused on children or patient groups were excluded. We included any type of study design, report or review and included guidance from major organisations involved in responses to epidemics and pandemics such as the World Health Organisation.

Caveats

The findings and guidance in this review needs to be viewed with caution because of the short timeframe and the less systematic approach to searching the literature. The synthetisation of evidence in this rapid review is not as rigorous as a systematic review would be. This may mean that evidence has been missed as our search is not as comprehensive as a systematic review. Our findings also need to be interpreted cautiously as we have extrapolated the data from frontline workers, usually healthcare workers during and after previous epidemics and used the findings to offer guidance to support school staff and social workers during the current pandemic. It may not be appropriate to extrapolate the data from one population to another. Some of the literature included was guidance from major organisations based on psychological principles but was not rigorous evidence based on experimental studies which may limit some of our findings.

 

References

BPS. (2020). The psychological needs of healthcare staff as a result of the Coronavirus pandemic. Retrieved from https://www.bps.org.uk/sites/www.bps.org.uk/files/News/News%20-%20Files/Psychological%20needs%20of%20healthcare%20staff.pdf

Brooks, S. K., Dunn, R., Amlôt, R., Rubin, G. J., & Greenberg, N. (2018). A systematic, thematic review of social and occupational factors associated with psychological outcomes in healthcare employees during an infectious disease outbreak. Journal of occupational and environmental medicine, 60(3), 248-257.

Cénat, J. M., Mukunzi, J. N., Noorishad, P.-G., Rousseau, C., Derivois, D., & Bukaka, J. (2020). A systematic review of mental health programs among populations affected by the Ebola virus disease. Journal of Psychosomatic Research, 131, 109966. doi:https://doi.org/10.1016/j.jpsychores.2020.109966

Duffield, & O’Hare. (2020). Teacher resilience during coronavirus school closures. Retrieved from http://www.bps.org.uk/sites/www.bps.org.uk/files/Member%20Networks/Divisions/DECP/Teacher%20resilience%20during%20coronavirus%20school%20closures.pdf

Hughes, P. (2015). Mental illness and health in Sierra Leone affected by Ebola: lessons for health workers. Intervention, 13(1), 60-69.

IASC. (2015). Mental Health and Psychosocial Support in Ebola Virus Disease Outbreaks. A Guide for Public Health Programme Planners. In: Reference Group on Mental Health and Psychosocial Support in Emergency ….

Jacobs, G. A., & Meyer, D. L. (2006). Psychological first aid. Psychological interventions in times of crisis, 57-71.

Kahn, D., Jeffrey, J., Weissberger, A., Jalloh, S., Von Villa, E., & Williams, A. (2016). Evaluation of a support group for Ebola hotline workers in Sierra Leone. International Journal of Culture and Mental Health, 9(2), 164-171. doi:10.1080/17542863.2016.1153121

Kuriansky, J. (2016). The Psychosocial Aspects of a Deadly Epidemic: What Ebola Has Taught Us about Holistic Healing: What Ebola Has Taught Us about Holistic Healing: ABC-CLIO.

Maunder, R. G., Lancee, W. J., Balderson, K. E., Bennett, J. P., Borgundvaag, B., Evans, S., . . . Hunter, J. J. (2006). Long-term psychological and occupational effects of providing hospital healthcare during SARS outbreak. Emerging infectious diseases, 12(12), 1924.

Maunder, R. G., Leszcz, M., Savage, D., Adam, M. A., Peladeau, N., Romano, D., . . . Schulman, R. B. (2008). Applying the lessons of SARS to pandemic influenza. Canadian Journal of Public Health, 99(6), 486-488.

McMahon, S. A., Ho, L. S., Brown, H., Miller, L., Ansumana, R., & Kennedy, C. E. (2016). Healthcare providers on the frontlines: a qualitative investigation of the social and emotional impact of delivering health services during Sierra Leone’s Ebola epidemic. Health Policy and Planning, 31(9), 1232-1239.

Serero, L. I. E. (2009). Support needs of high school educators directly affected by the HIV/AIDS pandemic. North-West University, Vaal Triangle Campus,

Srivatsa, S., & Stewart, K. A. (2020). How Should Clinicians Integrate Mental Health Into Epidemic Responses? AMA J Ethics, 22(1), 10-15. doi:10.1001/amajethics.2020.10

Tam, C. W., Pang, E. P., Lam, L. C., & Chiu, H. F. (2004). Severe acute respiratory syndrome (SARS) in Hong Kong in 2003: stress and psychological impact among frontline healthcare workers. Psychological medicine, 34(7), 1197-1204.

Taylor, M. R., Agho, K. E., Stevens, G. J., & Raphael, B. (2008). Factors influencing psychological distress during a disease epidemic: data from Australia’s first outbreak of equine influenza. BMC public health, 8(1), 347.

The Lancet, P. (2020). Send in the therapists? The Lancet Psychiatry, 7(4), 291. doi:https://doi.org/10.1016/S2215-0366(20)30102-4

Torda, A. (2006). Ethical issues in pandemic planning. Medical journal of Australia, 185(S10), S73-S76.

Waterman, S., Cole, C. L., Greenberg, N., Rubin, G. J., & Beck, A. (2019). A qualitative study assessing the feasibility of implementing a group cognitive–behavioural therapy-based intervention in Sierra Leone. BJPsych International, 16(2), 31-34. doi:10.1192/bji.2018.7

Wood, L., Ntaote, G. M., & Theron, L. (2012). Supporting Lesotho teachers to develop resilience in.                   the face of the HIV and AIDS pandemic. Teaching and Teacher education28(3), 428-439.

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