take heART: how art and creativity can enhance staff wellbeing - with Dr Rachel Chater

SPEAKERS

Paula Redmond, Rachel Chater

Paula Redmond: 00:04

Hi, I'm Dr Paula Redmond, a clinical psychologist, and you're listening to the When Work Hurts podcast. On this show, I want to explore the stories behind the statistics of the mental health crisis faced by health professionals today and provide hope for a way out through compassion, connection and creativity. This season is brought to you by the Association of Clinical Psychologists, the representative professional body for clinical psychologists in the UK. Join me as I talk to inspiring clinical psychologists about their work in this field, and learn how we can support ourselves and each other when work hurts. One of my favourite things to talk about is how art and creativity are good for the soul both in and out of work. So it was a great pleasure to spend time with clinical psychologist Dr Rachel Chater, discussing her inspiring work with the take heART project, which aims to enhance the well being of staff, patients and visitors to the Bedfordshire Hospitals through the arts. In this episode, she describes how this more unusual psychology role took shape, and how it's made a difference at multiple levels within the system. She tells us about some of the lovely art projects they've worked on, and how these have been informed by psychological theory and formulation. We also talk about the challenges in this work and Rachel gives lots of great pragmatic advice for anyone who might be inspired to try something similar. I began by asking Rachel to introduce herself.

Rachel Chater: 01:48

I'm Rachel Chater, I'm a clinical psychologist and I'm working in a staff health and wellbeing role for Bedfordshire Hospitals NHS Foundation Trust, and this is in partnership with East London NHS Foundation Trust. I work as part of the clinical health psychology services in Bedford Community Services. Sorry, it's quite a mouthful. And I am one of the founding members of take heART, which is a wonderful group of staff and community partners that seek to enhance the well being of patients, staff and visitors to the hospitals through the arts.

Paula Redmond: 02:25

Great. And I really wanted to get you on the show, Rachel just to talk about that and to tell us about your work with take heART and yeah, how you got into it. So...

Rachel Chater: 02:37

Well, yeah, thank you for inviting me. I mean, yes, it feels like a real treat to talk about something that I really do enjoy doing and brings me a great deal of professional and personal pleasure. I think it's also part of a really important set of conversations to be had, particularly at the moment about staff health and well being, I think it's probably more crucial than ever to think about this. We know about the impacts of things like the winter pressures and I know the chronic demands and resources staff are under at the moment, and the aftermath of the pandemic all come together to really speak to the needs of supporting staff to support them to do the work that they so desperately want to do. But there's some real challenges, I think to reaching staff in really busy and stretched and stressed systems and so I think there's a real invitation to try and do something a little bit different. And I'm hoping that this work with take heART speaks to this. I'm going to hopefully share some work of my colleagues, it feels like a real team effort, and I'm excited to talk about it but a little bit nervous. A sense of imposter almost for me, because I'm just so aware, having dipped my toe in this, how much else is out there. There's a lot of incredible initiative around staff health and well being and the impact of bringing art to that, you know, art and creativity and I guess what I hope this conversation adds to what is already out there is an attempt to talk about how to implement this in the real world. We're still, we've got lots to talk about in terms of what we've achieved, but we're still in the early stages. So hopefully some reflections and learning about yeah, what to do in the real, everyday busy world that we operate in.

Paula Redmond: 04:22

Yeah, brilliant. And I think, I guess that sense of being held back by impostor syndrome is very familiar. And I think it is so important to have these conversations.

Rachel Chater: 04:33

It's what makes us human, doesn't it? I mean, I think it's that shared human experience that we all probably navigate.

Paula Redmond: 04:41

Yes, and a sense that it's possible, you know, that we can do important things that make a difference with what we already have, we don't need more to do it. So maybe you could tell me and the listeners about what drew, what drew you to working in this way? How did you come to get involved in this project?

Rachel Chater: 05:08

Yes. Well, actually, I was just thinking about you talking about impostor syndrome. And I guess almost the things we tell ourselves, we can and can't do. And I was thinking that, that one way of explaining and maybe giving a bit of context to how I've come to do this is actually to sort of rewind a bit, much before this project started, in fact, much before my career started. So telling you a bit of a story if that's okay, about, about how this started for me, quite some years ago. So I guess I'm going to bring some sort of professional and personal thread to this. So chapter one, if you like, of the story is, I'm a child, I'm probably about eight or nine, and I was really enthusiastic, I can remember quite vivid memories of being really enthusiastic around fashion. I loved, not necessarily what I was wearing, but what I like to see in others, so it might have been a magazine, I loved drawing fashion, I would sit sort of in my bedroom, in my own quiet private space, doing loads of drawings, I really enjoyed it. And I guess as a child, I found myself, as lots of children do, kind of trying to navigate that in the kind of classroom, those less private spaces. And I attempted GCSE art. And it was fine. I was doing okay, and I think outside in, I looked like I was someone that could draw. But I think I look back now, and what was starting to happen internally for me is I was sort of eroding some confidence around my ability to draw, to be creative. It's almost like the you know, the corrosion of kind of comparison, we're looking at what everyone else is doing and it's almost like paint by numbers, if I don't get this right, you know, then I'm not going to get an A or B or whatever it was I was aspiring to do. And so I was sort of starting to navigate that, while I think continuing to be really drawn to things that inspired creativity in me. And I suppose moving, fast forwarding to kind of being an adult, I found myself as a patient myself and a hospital, so I was in my mid 30s, I was engaging in some regular medical treatment in a hospital. And I was doing a lot of waiting, actually, during this time, I guess maybe quite a few people can relate to this, you're sitting, you're waiting, you're in a waiting room, we're in a waiting room with other people waiting. And I found myself finding that wasn't a very helpful space to be in. So I sort of took myself away from that to a sort of brighter, lighter, more relaxing space and sort of sat quite proudly on the wall was this artwork, I think it was a depiction of some cells, but a sort of bit of abstract work. And I just found myself being really drawn to that. I found on a good day, it was really beautiful on a bad day was slightly painful. But it was really yeah, it was really distracting, it was quite an open and honest depiction, I think of what was happening within those hospital walls, a kind of a reflection of my biological, if you like, and my emotional journey. And I tell this first part of the story, because I think, for me, the work with take heART is a personal endeavour, as well as a professional one. And it's been really helpful for me to connect with and understand my relationship to creativity, the stories that I tell myself about, you know what I can and can't do. It's made me curious about the stories other people tell themselves, what prevents them from maybe engaging in anything creative. And I think with that curiosity, I've been able to look through that lens and think, you know, how, how do we engage the kind of typical person that walks around, maybe even unconsciously holding the story about 'that's just not for me'. Yeah, so that's the kind of childhood and kind of more early adult experience. And then just moving to kind of more recently my connection with this particular project and role. So two or three years ago, I made a bit of a transition, like I guess a lot of people do in their career, I'd been working in acute mental health for quite a while and really enjoyed it, but it was a point in my life where I realised it was the right job wrong time, there was no longer a good fit for me and I wanted to do something different. And it was around the time of the pandemic. And you know, one of, one of the things I suppose the pandemic dis for me, there were lots of very difficult and, and challenging things for people around the pandemic, but it gave this opportunity to work in staff support and wellbeing. So there were a few doors opening professionally for psychologists, I'd never really done this before and I realised that in all the jobs I'd worked in, up until that date, there was something around staff health and wellbeing but it was never sort of front and centre. And I felt like actually it is a really worthwhile thing to focus on, but having it as a role in itself just felt a real opportunity. So started working initially, in critical care, actually, I mean, you know, if I'm going to make a transition into physical healthcare, it's quite a transition in the middle of the pandemic, so critical care respiratory medicine in Bedford Hospital with just some wonderful, wonderful people who made me feel very welcome. But I was invited, I think, not explicitly, but the role invited me to be creative immediately. For anyone that's navigated the pandemic, particularly professionally, particularly within the NHS, I would imagine that with all the challenges that come with, comes with it, there's an invitation to really change the way we think about doing things, whether that's practically, emotionally, in terms of processes. And I think that was my first opportunity to really think in a different way and to bring creatively quite explicitly to my role, and the permission to do that. So my wonderful supervisor, Sara Rassool, she has really championed and supported the work, the MDTs I've worked with. And that then led in to a second part of my role, which is the trust wide staff health and wellbeing role for the Bedfordshire Hospital Trust with my really great colleague, Amanda Spong, so we make up one full time equivalent of a psychologist, across the whole trust, which has several thousand staff. We very quickly worked out that we needed to have a sort of spectrum of offers, that we could reach as many staff as possible. But we needed to maybe work not just with individuals, but also with teams and systems, think about being proactive, as well as reactive and responsive. And here was a sort of fertile ground, if you like for take heART. So I'm sat, I think virtually on a call with a group of staff who were part of an implementation group. So staff health and wellbeing implementation group. I'm pretty new, I'm enthusiastic. And my wonderful colleague, Sheena McLaggan, was there. So she's a consultant radiologist, and a trust wellbeing representative. And we had only just met, but I think I look back now and actually, it was just, you know, two people coming together and being curious about the same thing, surrounded by very supportive individuals who gave us permission to go off and try something different. So we had loads of discussions about other initiatives around staff health and wellbeing but what I was struck by and I think probably Sheena was, there's loads going on out there around staff health, wellbeing, patient wellbeing when it comes to art and creativity, but it wasn't necessarily something we were talking about in this meeting. So we said, can we, you know, can you let us go off and have a think about this. And that's how the group was born, we linked up with a couple of, several other staff and a couple of artists in the community. So a lovely woman called Kayte Judge, she's a, an art producer, community art producer, and Anne-Marie Abbate, who's a community artist. And Anne-Marie is a wonderful person, she has been with us the whole time and she set up in a gallery quite a while ago, on one of the hospital sites. So she was a bit of a trailblazer and it was things like that, that really inspired us to start this group. And we're now at a point where we well, we've got several projects that have been on the go, but I think early on we decided to just develop some aims, some simple and clear aims. So we've got three aims to our project. So one of them is to enhance wellbeing of patients, visitors and staff through the arts. It's a nice broad aim, and I think really speaks to what we're generally trying to do. But we also thought about two aims that very much reflected the kind of local context of the hospital, the trust. We wanted to reflect and align ourselves with those priorities. So one of them was to create parity across the two hospital sites. So a little bit of local context, the trust is now made up of two hospitals that historically worked independently of each other; Bedford Hospital and Luton and Dunstable Hospital. And we recognised that, you know, some parts of those hospitals were, had more artwork, for example, more going on for them than others. But we also realised there was something about bringing those two parts of the system and the organisation together and an aspiration to do that through the arts, and to reflect local communities. So our staff just as our patients are the community, and we wanted to make sure that was reflected.

Paula Redmond: 14:29

Yeah, lots of, lots of kinds of thoughts being sparked off there and I guess, I was just thinking about when you were first talking, you know about your experience being a patient in the hospital and I think that's an experience that I often have and forget that I have, about when you do go and you know, go to an art gallery or even I find that you know, if I'm like watching Repair Shop or I guess Bake Off or something like that where you can be really inspired by people, ordinary people making beautiful things. And there is something really hopeful and a sense of awe about that, which I guess when that's happening in a context of anxiety and fear, and you know, some of those really dehumanising systems that staff and patients can find themselves in, in those kinds of contexts that it's such a beautiful antidote to.

Rachel Chater: 15:27

Absolutely, yeah. I mean, the word that came to mind was contagious. It's almost like we, and excuse the pun, because but there's something about yeah, the nature of just the project that the group itself and what we've been able to achieve, but also the kind of ripple effect of that is really powerful. I was just thinking of a really wonderful moment a couple of weeks ago, where I bumped into someone, a patient in the hospital, who was looking at, in fact, his Anne-Marie's Art Gallery, and just sort of taking in and I was taking pictures. And I was almost like the proud, you know, the proud colleague, and we had this conversation about the, how this had touched this patient, but also it had touched the relative that had visited her. So it also connected, it was something for them to talk about, it was a place for them to go. I think there's something about how to carve out places and spaces, in an environment that whichever way you look at it, most people don't want to be in hospital. Our threat systems are triggered left, right and centre. And there's something about what can we... what are those moments that we can create in someone's everyday life? And from a staff members point of view, it's almost doing that walk for them, you know, when they're off the busy environment, where are they going? They're sitting, you know, they're sitting in the staff changing room, they're going to the canteen or going to the toilet, you know, where are the moments that we can really reinforce that sense of calm? That sense of tranquillity, I guess mitigate against some of the sort of threat drive that's kicking in for people. And I agree with you, I think, you know, it's so, it's so powerful sometimes to do that, in a way that's around helping people to connect with creativity, even if actually, this isn't a very conscious process for people.

Paula Redmond: 17:11

So tell me about some of those initial projects.

Rachel Chater: 17:14

Oh, gosh, I almost feel like a proud parent, you know, I'm going to talk about it with such, please interject, but, so I think you can have loads of great ideas right, and then and then you've got to turn them into reality. So, we were lucky and, I guess a bit of a reflection about kind of getting started, I think, obviously, you need a bit of money, you need resource. So we were really lucky, we were able to apply for some funding through the, our local charity, so our Bedfordshire Hospitals NHS charity, and it was called I think, pump priming, which I've never heard of before, but it was a small amount of money to help us to get off the ground and from our perspective, I think to raise our profile, we wanted to create the sort of virtuous cycles, you know, for us to put something up that was kind of visible, engaging, to get people curious and then to get people involved. We just thought if we can do this, it will be a way of getting the momentum going. So the questions we had to ask ourselves were with this small amount of money, how do we, you know, give your bang for your buck, you know, what you how are we going to make this really good value. So we decided to start with staff as a focus, we could have started anywhere. Staff, I think is an incredibly important and valuable place to start. Of course, I'm going to say that I came at this from the perspective of a psychologists working in staff health and wellbeing, I'm going to be flying that flag and advocating, but I think we all don't probably need to be convinced of this, but good staff support, care and enabling them to do the job, you know, quality patient care follows. We also thought visual arts was a really good place to start. And again, I don't know this, this is just our take, but a tip for me would be you know, think about the art, you know, where you might get most impact. So visual is obviously high impact in terms of people being able to see it and demonstrate change, but I think also what might feel acceptable and accessible. You ask someone about art, you know, what did they say probably something visual comes to mind. And also to think about how we might also do this. So a kind of quick way of thinking about what we might do is we had kind of one or two kind of quick wins or you know, and then maybe one, we wanted one sort of slow burner if you like because sometimes really important projects take a while but you also need to demonstrate you're doing something with the money and get people interested. So project one was focusing on getting some artwork quickly up on the wall. So we decided we wanted posters, we thought that was a quick way to do it. You can get some really relatively inexpensive poster frames, you can put them up on the walls. This carves out space I suppose already to quickly swap in new bits of artwork and it's very cheap to print a poster. It fitted with our first aim which was about enhancing people's wellbeing, and this was particularly through the environment, and we were going to do this on both hospital sites, we're gonna kind of link the hospitals if you like with this artwork. And so we approached an organisation called In Good Company Leeds. So they've made it their mission to try and transform the city into a bit of an evolving gallery. And they had, during the pandemic, they had a posters for people project, which some people might be aware of, some artists coming together to create some sort of graphic design around messaging around support for key workers. We got them up onto the walls, and they were donated, we were prepared to pay for them, they got donated, it was a wonderful, kind of kickstart. And then what followed was another project which linked to the idea of parity across our sites. So we had one hospital site that just needed a bit more love in terms of art and stuff on the walls. And so we paired up with and contacted an organisation called Paintings in Hospital. And some people might be aware of it, if you're not, it's a very good place to start. So they do lots of different things. They aim to use kind of world class art to inspire better health. And they do lots of things, but they do a bit of a one stop shop for acquiring and getting artwork onto the wall, so they insure it, they instal it. And for us, again, if you're starting a project, you've got a bit of money, we had some money, but not much time, and we certainly didn't have much experience. So we thought, actually, let's pair with an organisation that knows what they're doing. They, they, we want to start to vote on these images, so they have a mechanism to do that. And we got the art up pretty quickly and we have developed this link was a really amazing organisation. So that's been really nice. And then our third project, still in progress, but very close to completion, which links to the aim of reflecting our community. So it's an archival project that aims to reflect the kind of multicultural workforce of the trust, and therefore, of course, our community. So we're trying to route it in historical context. And we've got some really wonderful stories from staff, some lovely photographs, some historical images. And that's due to go up quite soon. So that's our kind of slow burn, if you like.

Paula Redmond: 22:07

And what about more, more recent projects? And I guess how that has linked with your role in staff wellbeing?

Rachel Chater: 22:18

Yeah, I'm just trying to think. There's, I mean, there are a number of things we've managed to do. But I think something that I've realised quite early on in all of this work is a bit of a lesson for me is that ability to just let go a little bit and allow things to naturally evolve and develop, I don't know if you're anything like me, but a personal quality, but maybe it also comes from my profession, you know, that that sense of planning, and things, you know, needing to know where things are and forward thinking. And so these projects will represent an attempt to find a balance between having some intentions around what we're going to do, but also seeing where it goes, if that makes sense. So, and so one of the things we did was, I suppose we started to think about, yeah, how we could sort of have high impact with our, with our staff. So working in the staff health and wellbeing psychology role, me and Amanda have worked with a number of teams and different parts of the hospital, and I think the several kinds of themes that have come up and these I think, in hindsight, I look back, these are sort of themes and principles that are starting to underpin how we've commissioned if you like, started some of these art projects, and hopefully they kind of run through some of what we've done. So one of them, one of the things is around helping people to connect with or reconnect with their values. So when people are working in those high demand, low resource areas, I think staff can often feel like they would like to do a better job. They're doing the best they can, but often there's a danger that people are losing sight of their values. I mean, I'm a real advocate of ACT as a kind of particular professional and theoretical framework and that idea of losing contact with and not being able to be in touch with the values, or, you know, actually we do get in contact with our values as staff do but often at times of distress and difficulty. It's the stuff that destresses people, that's also the stuff that matters to them. And so one of the intentions behind I think, well certainly starting to inform some of the work was you know, how do we help people to really connect with what matters to them, including the care that they offer? And linked to that I think really importantly, was something around appreciation. So certainly the theme that's come up because of us as human beings, our human minds are just very good at jumping on the kind of the problems, the difficulties, I describe it as the kind of velcro of the mind. So I have many conversations with teams and individuals about you know, what's not gone well, what they can't do, not dissimilar to my own stories about creativity in the kind of can't, shouldn't, why haven't I? It can be really difficult for appreciation to sort of sit for people, it slips almost between people's fingers so quickly. And so there was an idea about how, you know, we need to embody appreciation, and I guess if we can help people to do it for others, we as human beings are quite good at appreciating each other, maybe, just maybe some of that magic will kind of show up for people in themselves. And yeah, appreciation just is a wonderful opportunity to mitigate against all sorts of difficult experiences, including trauma. So, you know, a really valuable starting point. And then coming back to your reflection, I think around kind of, you know, finding ourselves in hospital. It's a really fast, busy environment, I guess, unless you're sitting and waiting, but for staff, it just feels relentless. So that idea of pausing and slowing down and grounding people, but very few opportunities, so how can we create things in hospitals that that invite people, just gently nudge them to just to slow things down a bit? And therefore, linked to that, when we're trying to trigger people's soothe systems, how do we get people to connect with each other a bit more? There are just so many times when I've listened to people talk about how they're at work, but they do feel on their own with something. And I guess it's how can the art work and what we're doing connect people and give them a sense of connection, not just with each other, but with our projects, the community as well.

Paula Redmond: 26:23

I guess what I'm hearing is, I mean, and this is stating the obvious, but a very psychologically informed approach to the project. And I guess that's, you know, framing them in a way, you know, talking about that connection with values. This, you know, all that kind of activating of the soothing system through slowing down and connection with others and I guess, yeah, it's just helpful to hear that so clearly articulated.

Rachel Chater: 26:56

Oh, good. I mean, some of this is, you know, there's an element of reflecting back and thinking, because I think we, it's the bread and butter of what we do. I was just thinking about my partner, you know, my partner talks to me about a conversation I've had, and goes 'God, how did you manage it like that?' And I'm like oh... And I don't know, I think we undersell the skills, we live and breathe, don't we, those skill sets that just are so ingrained in us? But some of it, I think, does sit there, but you're speaking to a really important point, which is what is our role? And I think sometimes our role in those less conventional positions, you know, in our sort of professional roles is to articulate. To articulate what probably is already happening or could be happening, but to explain the kind of why if you like, not just the what we're doing. Yeah, and I'm hopefully, if I give a couple of examples, it sort of runs through kind of the process as well, as in how do you start a piece of work? How do you speak to the work? How do you advertise the work? I think psychology can thread through that quite nicely. There's a good fit, if you like.

Paula Redmond: 27:54

And I'm sitting here thinking oh, like, how do you operationalize that? How do you go from, you know, these, these, you know, really core ideas into, you know, something that can happen out there in the real world. So.

Rachel Chater: 28:09

Okay, well, I've got you sitting comfortably. Human Touch was our first project. That's the, that's it’s title and, yes, I'm really proud of it. It was our first externally funded project. So a real achievement for us as a group of staff. So it was funded by Arts Council Let's Create Jubilee Fund. So we were able to find a pot of money and we were linked in with this by a community foundation. So Bedfordshire and Luton Community Foundation have also given us a bit of support, and I was navigating whole space and field around, you know, how do we do this and our charitable funds department also have done a brilliant job at helping us to start to sort of navigate that grant application process. It's hugely time consuming, it can be soul destroying, anyone that's done this. But we were lucky, we've got some money. And so we wanted to think about a project that, bear in mind, the timing of this was sort of peak kind of starting to come out the tail of the pandemic, there was still, I think, an appetite for and a need to recognise the incredibly, incredibly difficult work that staff had been doing, and were continuing to do. And so we wanted to think about kind of recognition and appreciation of staff during the pandemic. And so we started to sort of think about, okay, how can we do this? So we started with a bit of a collaboration with Kayte Judge, who I have already mentioned, who's a community arts producer, again, a role I wasn't aware of, but incredibly talented. So she really thought about how to sort of project manage this through a kind of creative lens, and then Anne-Marie Abbate, our local artists collaborator. And we also had someone called Shaun Armstrong, who is a photographer who was sort of bought in. And we, there were different strands to this project, so the bit that makes me really proud about this, and speaks to that idea of how do we engage people was we initially had the artist herself, who, I guess we had an initial consultation if we're going to use that sort of framework, met with her, talked a bit, Sheena and I, we all met, Sheena was there, we talked about some of the challenges that staff were facing, just the themes, of course, to help orientate her. And she then went away, and that was the leap of faith, two kind of world, two cultures kind of coming together. And, you know, there I was thinking oh I'm formulating this, I hope it goes away, and does this, actually having that leap of faith and giving her the free rein to, to do what she does really well, and she did it brilliantly. So she came back and said, look, we, I can't know exactly how this happened, but we want to also use the poem 'These Are The Hands' by Michael Rosen, who was formerly the children's Poet Laureate, and he has been a massive, he's an author and a massive advocate of the NHS. And he wrote this poem quite a long time ago, pre-pandemic, but it's taken on a whole new kind of meaning during the pandemic. And if you haven't read the poem read it, it's brilliant. But it talks about the different parts of the hospital, the bits that maybe are less visible. And so we had a kind of something very concrete to sort of capture people's attention, the written word, but around that was, with this sort of more abstract work. So Anne-Marie went away and thought about human touch, and the touch receptors on our fingers, actually, as a sort of literal interpretation, that these lovely kind of multimedia pieces of artwork that were sort of 3D, and then Shaun, our photographer, he came in and did these amazing photographs and zoomed right in. And we got these wonderful vinyls then printed out, which are quite sort of low cost and easy to put up, very impactful alongside the artwork. That was strand one. So the second strand was art workshops, we wanted to engage staff with a sort of light touch. So people coming in their breaks and just trying something, any of the methods she'd used. And then we had some more kind of structured workshops, where staff actually created similar pieces of artwork to hers. And they are hung alongside her art work with these vinyls. And then the final amazing strand, which came I think, from a bit of a creative conversation with the, the artists and ourselves was, we had a sort of, I think it's been described as a cascade of kindness. So around the time that we were doing all of this, we thought we want to get a buzz going, you know, what are we going to do? It's Jubilee weekend, this is hard, staff are really struggling. So we got some Kayte, the art producer, she went and contacted local organisations, companies, we got lots of nice little treats and things put in paper bags, and those were, and gifts, and they were wrapped and they were given out on certain days in a random fashion to staff. And the bags were given out as pairs. So you would, as a staff member, potentially receive a bag with an intention to just, no strings attached, you know, just, the reactions or staff were amazing, 'What are you doing?' You know, just totally unexpected, but then that opportunity to explain to them that there was also an opportunity for them to go and to give a bag to someone that they thought might need it. So that was yeah, that was a really wonderful project that I think had, speaks to the kind of, excuse the pun, but the creativity sometimes around a project, you know, it doesn't just have to be the artwork itself. It could also be the different elements.

Paula Redmond: 33:43

Yeah, and those different strands, that's really interesting to hear about, involving people at different levels. There's something about being seen, in lots of ways there about, is it Karen? Who is being seen beyond her role in work, you know, in a broader humanity, there's something about people being able to see themselves and their work and their humanity being visible in, you know, a very dehumanising system, often. But also the process of hearing what people want, and acting on that. Their choices being seen and heard.

Rachel Chater: 33:51

Yeah, yeah. And I think something about coming back to sort of that idea of what matters to people, and what can unintentionally get taken away when people are put under enough pressure. And there's something about that idea of compassion I suppose, you know, we hear a lot about the word compassion, don't we? But I think sometimes it can be misunderstood, and it's seen as a bit of a sort of transaction, and actually, it's, it's more a flow, isn't it? And so, we're trying to create that flow from self to other, and then other back to self, but also self to self. And we know, don't we, as psychologists probably, we're quite well placed to know that we are not so great at showing that towards ourselves as human beings. But there's a way in, there's a brilliant way in when we're working with staff because they have compassion in the bucket loads for everyone else. So there's a bit of like, well, if we can just tap into that, and people start to feel appreciation and compassion towards others, maybe there's an opportunity for them to start to hold some of the same pride and appreciation of what they're doing and trying to do. So at another project that links to that really, which was working with a staff member called Karen Reep, who's now a retired paediatric nurse, and she was doing some line drawings, quietly and brilliantly throughout the pandemic. And people just caught wind of what she was doing and there would be a little bit of a flurry of activity and someone would say have you seen Karen's work, it's brilliant? Have you heard Karen? Got to meet this Karen person. And she's such a generous person. So she had, she, we got in contact with her and this is how it evolves naturally, right, you hear the kind of positive gossip going on and we thought actually, this is fitting for stuff, this is landing really well. And so an extension, if you like, of what we'd been trying to do with the human touch project, but maybe more organically, kind of driven by what staff was interested in, was the idea of, sp we call it our People Capturing Moments. So it's a series of images that Karen had drawn during the pandemic, of staff in lots of different places and spaces. Some of them were very kind of associated with the pandemic, there was lots of people in PPE, but then the, the organisation, the trusts also commissioned her, if you like, asked her, if she could do some drawings beyond the pandemic, so there's some really lovely images of those day to day moments, taking a break, you know, being outside, laughing, fancy dress. So that collection of work was then shared as a long list with staff at an engagement event. And then what's, you know, a thread through what we do is, you know, ask staff, what do you want to see? So we got people to vote, it was so popular, you know, everyone that walked past these images voted, I think, pretty much. And we have this wonderful collection of artwork that's now up on the, on the walls, which, you know, is an evolution if you like, it's a reflection of what staff wanted. And that's what they were saying, you know, we like to see some of this up, but we want to see our own people represented here. Which is, I mean, they've got it right. Okay. It's inspiring, and it's about someone that's also done that, has walked the walk, has done the journey so incredibly, when that went up, I was, you know, just it was... And actually hearing what they don't want, because we did ask staff and some of the stuff we were initially doing, actually, we got, we got people saying, you know, we like, some people liked it, some, you know, it pushed a button for them. And, but then what we got from that, what we got from it was some really important feedback, because it's genuine, isn't it? If you're, you asked for feedback, you know, you're not asking just for the positive stuff, you're asking for what people really feel. And then people need, then people need to see that in action. And we talk about, don't we, you know, you said, we did, you know, well we said and we did, that's what's happening here, I think. And then, I suppose one of the things that evolved our, I keep using the word evolved don't I, but one of the things that sort of really helped us get our momentum was some some collaboration, sort of, we were initially working within the system, looking around quite rightly at how we might do that. But we also wanted, really wanted to collaborate with the community. And just through the brilliance of networking, and people knowing people, we were linked in with a couple of local schools, who, so Dunstable Icknield School and Bedford Road Primary School collaborated with another brilliant artist called Katie Allen, who ran some workshops for children, because I think there was also a bit of an appetite for within the community, a connection with different parts... the pandemic created a sense of isolation, didn't it? But the flip side of that was how people wanted to come together almost as an antidote to that sense of isolation. And I guess riding that kind of wave of momentum around that we, we and this was something that really organically evolved, and we thought, oh, I don't know if this you know, let's just see, let's see how this evolves. So we, we quickly kind of came up with this idea of, historic, previously there'd been a staff engagement event where we'd use sort of appreciative inquiry, I think this was one of Amanda's brilliant ideas to, and some of our other colleagues, to use appreciative inquiry to ask questions, you know. So we ask the question, what would you say to a colleague who's struggling, really tapping into, you know, what do I say to someone else? Because of course, that might help you. And we got these amazing, yeah, really touching phrases, sentences, sentiments. And so we, it was all anonymised, we took the sort of themes, the main quotes, and we shared that with the schools, and the artist. And they then created these really beautiful kind of engaging graphics, big posters. And they replaced the previous posters, so we got them up. And, I mean, the one that always gets me is 'you're good enough', Yeah, that does always get me and, and also, yeah, it was just a wonderful opportunity to sort of showcase an opportunity, yeah showcase that ability to link in with our local community. And then, and then some of the children from the schools came and visited, to see their artwork up on the wall. I mean, that must, I'd hope, that was a really nice experience. And there's nothing like telling people that story about the school. I did that a couple of days ago and I got a really sort of tearful staff member, I think it was in a positive way, really touched by the story behind that. So it just, it shows the power of connection beyond just the hospital, I think, really powerful.

Paula Redmond: 41:32

So I mean, they, you know, they all sound really beautiful projects. But I'm curious about what the challenges were and the barriers you faced?

Rachel Chater: 41:44

Yes, because I'm also aware that I'm telling these stories, and they all seem overly polished in a way, because I guess I've got the hindsight of sort of hanging them together. Yeah, that was definitely challenge. So I suppose there's two or three things that come to mind. One was just physical space. I think this is something that most people are going to come up against. Hospitals are busy, their walls turn out to be quite busy too. Nothing like a busy wall to unintentionally trigger our threat system. Busy with lots of stuff that's got great intention, signage, information. But I think we quickly learn, we need to carve out spaces. So the poster frames are a really good example, getting vinyls on the wall, that's really like low impact, you don't need to sort of necessarily drill holes into walls. You can even project artwork onto walls, which is a really sort of innovative way of doing it. I think there's a really a bit of a important learning point for us and a really helpful practical tip maybe, is we linked quite early with our wonderful estates teams on both sites, have a really good relationship with them. And they're incredibly stretched, but they have been brilliant at helping us with the installations, because that is absolutely essential in terms of literally getting stuff up on the walls. So that's been really important. And I think also something about the importance of not just what is displayed, but what isn't. So a recognition that maybe, and it's a work in progress, but how do we carve out spaces in places for the other stuff, you know, the signage. And I've noticed, interestingly, and this is anecdotal, a couple of staff recently talking to me about, you know, we're taking out all the sort of info from the back of toilet doors, and someone actually decluttering if you like, the kind of wall space in a staff room. And I think that's a really good sentiment, you know, actually, there's something going on there isn't about people recognising what is helpful and unhelpful. There's a, there's a psychological thread there that people may be not aware of, but I think it's, it speaks to the idea of, you know, how do we create a kind of, a more soothing environment. And maybe a really good exercise would be to do the walk. So walk through a hospital or an environment that you normally work in as a patient, that strikes me as a really good process to understand where the places and spaces might be, and opportunities, but also as a as a staff member, other places and spaces, for example, staff rooms that we might want to be thinking about to enhance.

Paula Redmond: 44:14

That reminds me of, I have a confession to make. One of my NHS jobs, about there being at the back of their staff toilets, the Bristol Stool Chart on the back of the door. So you'd have to look at that every time you went to the loo. And I found that so... lots of feelings about that just like unpleasant, what are we supposed to do with that information? Quite infantilizing. And one day, I was obviously feeling something else and covered it up with a whole bunch of stools as in furniture, differently designed stools which was much nicer to look at!

Rachel Chater: 45:02

Oh Paula, what a moment of creativity. I mean, it is, isn't it? That is brilliant!

Paula Redmond: 45:08

It didn't last, it was noted disapprovingly. But yeah, there is something about, you know, just the environment, the messages that are, you know, that that gives out in our spaces that yeah, you know, people have a reaction to. Yeah. And I guess though, that there's all that about resource. Did you come up or have you come up against resistance that's not about resource, that's about the value of the work?

Rachel Chater: 45:30

They do. And I think it's something also about intention. So I think most people have got good intention. They're not sitting there thinking, how can I stress them out further? But sometimes, I just think about your example, I think sometimes it's like, how do you, you know, how do you, is it in our job description? I don't know. But in my job description, particularly thinking about this project, I, you know, it sits a bit more comfortably with me. So how do you have those conversations with people that validates the intention? You know, why, why, why is this here? Why are you putting this up here? Okay, so if that's what you want to achieve, maybe it will be better placed here? So it's the right information in the wrong place, or at the wrong time. Because that, that information, just like the information on the walls in a hospital, is all about trying to promote behavioural change, making someone go that way, not that way, making someone turn up for I don't know, an event, it's all... but I just think people do it, because they think that's the best way to do it. And if we can validate the intention, and then understand where it comes from, we can maybe help them to think about or we can think about where we might put the right things in the right places and create space. So I think less is more sometimes with, with art, with creative stuff on the walls. And I think the other major challenge for, you know, a project like this, that sort of feels relatively fledgling in its stage of development, is keeping the momentum going, and sustaining, having a sustainable model for delivery. So in terms of our lifecycle, I guess we're still early stages, but we've done quite a lot of work with a relatively small amount of resource. But that starting of the work, you know, I'm not giving, I'm not doing justice to the sort of frustration. I'm thinking of conversations, you know, Sheena and I have about, with everyone trying with their best intentions with things not working out, or things taking longer, like always add 30, 40% longer to anything. You want to put a poster up, and you think it's going to take a day, it's going to take three weeks, so just let yourself off the hook. But in the meantime, all the things you do to get that poster on the wall, will stand you in good stead for the next project. Because for us, every thing we did meant connecting and developing relationships with the hospital, different parts of hospital knowing, you know, how do we do things around here, or that's where I go, those are the people I talked to, there's a bit of a kind of promotion, low level promotion of who we are, and getting a bit of a momentum going about galvanising, if you like people's energy, so that in terms of participation, as I was saying earlier, people can participate in any way they want, but sometimes we're actually our invitations, could you help me with some printing? Or can you help me with a room booking for this or? That sparks their interest, you can book the room and come to the event, would you like? You know, this is just that, you know, that kind of going on. So getting started, difficult. And then getting to a point, I think where you know you've done enough, but you shine a light not just on what you've done, but what you could do if you have more resource. So I think thinking about how you make a bit of a case for additional resources is really important and recognising, I mean this is with any kind of service development or quality improvement initiative, it's that kind of, okay, we've got this going. But now, there are gaps here that we could try and fill but at what cost? So practical suggestions, you know, logging the amount of time it takes for a project, logging on, you know, requests, because there will be, people will start thinking oh you're the person that might be able to help with this, that would be great, but I don't have capacity, but making a log of that. I think also, when we get little bits of money, and we're doing a project, we now think about actually making sure that some money is ring fenced for things like installation of artwork, you know, or project management, that's not necessarily our job. And then what additional resource might look like will be different for different trusts, different organisations, different teams, but it could be anything from kind of a bit of admin support through to it can be nice to have, we've got a really great relationship with our comms team, who do a lot of the sort of promotion of what we do. We've got to know them, but you know, if you have one dedicated person who maybe is also interested in this, it becomes a sort of something that they enjoy, a kind of personal connection through to I guess, for some trusts, having a paid role in terms of overseeing, you know, these initiatives, whether that's an artist in residence, an Art Manager, there are roles out there like that. So that's, I think that's really important. That's an interesting question. Not explicitly. I haven't come up against people saying, oh, you know, why are you using this money or... not explicit messages, no. I think resistance is the wrong word. But I think the other challenge is around capacity of others. So if our target audience if you like, if our focus is staff, it's not, it's not necessarily I think that staff are saying, oh this is not for me, but if it's not, they vote with their feet, maybe if they can, I just think it's more how it's delivered. So I think sometimes, there's a challenge about you want to, one of the sort of frameworks I hold in mind for accessibility is you need to invite people off the busy environment, to take them out of sort of threat drive mode, if you like, but also have opportunities to kind of inreach. You need to go where staff are at, actually, it feels really important. And I think sometimes, there's a challenge if you're inviting people to come kind of off, you know, so like, the workshops with the Jubilee Project, The Human Touch, it was challenged, a challenge to engage staff, not because I don't think there was an interest, but there wasn't an interest, but actually how, how do we get staff who, you know, might be massively down on numbers, it almost feels like, you know, promoting that at the wrong time could land kind of awkwardly, you know. So I don't think the intention behind what we were doing was ever, has ever been something that people have struggled with. But maybe unintentionally, we, it could come across as insensitive or unrealistic. There was a lovely way of trying to address that, which was the artists and our producer came up with the idea of these, I mean, they were pizza boxes, so I don't know whether this promoted some raised expectations and, and a little bit, because it wasn't pizza in the boxes, we had these lovely boxes, they I guess, looked a little bit like pizza boxes, and they would get delivered out during the workshops to pinch points in the hospital. But we'd only know the pinch points on the day, so they only get delivered on the day. But what a lovely way of thinking about, and I remember a moment where I delivered one to one of the main sort of areas, and it was to one of the kind of leads in that area. And she'd wanted to give it to someone she knew would really like it and want to take, y'know it was a box of sort of creative bits and pieces that people could do the the activity at home. And it was a real classic example of I assume the person themselves was going to benefit but the fact that she could come back having visited herself, knowing that were people that just couldn't leave that environment and be able to do that for her staff. You know, we're almost mitigating aren't we against that kind of that stuff we talked about earlier, which is when people want to do something, not just for their patients, but for each other and they can't.

Paula Redmond: 53:28

I mean, I'm feeling like envy. You know, I guess it's quite an unusual opportunity that you've had in doing this work. But also, you know, really exciting and I guess, I'm sure there'll be people listening who feel very inspired, other clinical psychologists. And I'm just wondering, how you think this has on the type of work, has or could impact how the role of clinical psychologists is seen by ourselves or others?

Rachel Chater: 54:08

Well, I think if I'm really honest, because of the sort of nature of the initial intentions around the project, I think it wasn't my initial intention to think, oh, how are we going to raise the profile, but actually, I think there was a wonderful valuable consequence, partly because of where the work went. So I think it's been a really good opportunity to shine a light on what psychology can do in those less conventional spaces. And I'm not just talking about take heART, I'm talking about, you know, staff health and wellbeing roles. There's a real invitation to work at a different level isn't there, like, you know, a team or system level to have influence at that level? I'm not sure how good as a professional group, we are promoting ourselves. You're nodding. So, we've use this word before, but I think operationalizing it is a really good way to bring it to life I think, and if you've got visual arts, it's a really nice, concrete way of doing this. So I think there's something about showcasing what we can do in very concrete terms, you know, whether that's engagement in collaboration in a particular way, and we can articulate why we're doing what we're doing in that way, or whether it's communication of kind of complex ideas and issues in easy to understand ways and working systemically around quality improvement, I think we are showcasing that. I guess for me, sometimes it's about getting better at articulating that and linking those, because you might, I guess the question might be, why have a psychologist doing this work? But I think what it does is it also for me, given the nature of my role, it really has enabled me to feel absolutely genuinely embedded within the fabric of the organisation I work in. So I've developed so many relationships, had so many brilliant, insightful conversations with parts of the organisation that I just would not normally have maybe traditionally found myself. And there is, you know, I wouldn't do the kind of team of people that have helped to get these projects off the ground justice if I sort of tried to list everyone, but it's everyone from kind of the comms department to the print room to our charitable funds to, you know, the people that book rooms, you know, the volunteers, there's so many parts of the organisation. And a part of the organisation I haven't mentioned so far, but it's really important is our senior exec. So quite early on, we had some interest, you know, we were, we were operating sort of within that level anyway, in our staff health and wellbeing role, but once we became a bit more visible, and once we started to articulate what we were doing, it was, it was really encouraging to see the support of everyone within a senior exec, you know, lots of people within the senior exec team, including the chief executive of the Bedfordshire Hospitals Trust, supporting and thinking in very practical ways about how to do that. And so starting to, you know, have conversations with different parts of the organisation that would have influence in different ways, it almost felt like, where the momentum was picking up was, we were starting to have conversations about, you know, from both perspectives on the ground, day to day, but also other parts of the organisation where we know there is influence in terms of moving things forward. And then of course, those relationships outside the organisation as well. So we, we have a little bit of media interest around some of the work., you've invited me to talk here! I mean, these are opportunities that are definitely out, they're definitely outside my comfort zone. I am not used to doing this. But I think there's so much benefit to promoting that and moving the agenda on a little bit and helping people think about, you know, what we could do, it's the bit of the work that excites me. I mean, I still obviously draw on my kind of clinical skills, my knowledge, but actually, whether it's take heart or the kind of trust wide, you know, staff health and wellbeing role, it's about an invitation to kind of inform and shape systems. And sometimes a lot of that work doesn't, it's meaningful, but it doesn't maybe have some concrete outcomes initially. But take heART does a lot of that, there's a lot of heart to it I suppose.

Paula Redmond: 58:35

And you've given lots of useful advice and tips that people will be making notes of, I'm sure, but if we were to try and distil some of that advice for people who might be listening to this, thinking, oh, I'd love to do something. I've got no money right now, no resource, what could I do? Where could you start?

Rachel Chater: 58:58

Well, they've already started right, they're listening to this, even if you've fast forwarded to the end. So that spark is all you need I think, that's what I started with, I didn't really start with knowing any more. I hope that doesn't sound overly optimistic, but I think that can be enough. Finding one other person. I mean, the power of partnership is really incredible. I've got the wonderful opportunity to work with Amanda and Sheena and, you know, that brings me a lot of pleasure, but also gives me that opportunity, especially with take heART, Sheena and I, I think have often been a bit of a support for each other when, certainly in the early days when things have felt, you know, more difficult to get off the ground. A bit of a mantra of mine a little bit is you know, think big, like allow yourself to think big, but start small. And maybe allow yourself to do the big thinking, you know, what, what would I love to see? Where are the examples of this and other organisations? You know, what's, where's the place I'd love to go? And then the start small, I think is absolutely is thinking about where there might be a pocket of resource. So I suppose If there is no money and you're thinking, what do I do? Looking around at your, your team. So one of the, one of the ideas was around sort of away day, I don't know if I've mentioned this, but a sort of a pilot around away days, so how you might be able to, one of the things we're thinking is how do you bring art and creativity to staff when there is very little budget, and also staff really do struggle to take themselves away from that busy environment? So one idea is we started to collaborate with our OD department who often get requests for could you support around an away day. People often actually aren't particularly sure about... they want engagement, they want something that's fun, and, and feels a little bit different to sort of day to day, kind of work tasks. But what's that going to look like? So we've now created a list of local artists, and we're pairing them up with, potentially gonna pair them up with, with teams. The reason I say this is because there's often a bit of an internal budget, so even if it's your own team, and we've tried to make this cost effective, so you know, we've asked artists to come and we pay them for their time, hopefully, you know, a reflection of the value they bring, but we're then going to, those away day projects often lead to a piece of artwork that staff have created together, that could go up on a staff wall, suddenly, you know, you might take some photographs that art, you might want to make some postcards out of that. You could do a lot with a, with a small amount. But I guess you find your people, you find a little pocket of money. I think it's really important to yeah, don't over stretch yourself, especially if you feel you're pretty much on your own with this. Yeah.

Paula Redmond: 1:01:37

And I guess I mean, you know, it's lovely to hear you talk with, you know, such passion and energy for this work. And I'm wondering, apart from the impact it's had in the hospitals, what it's brought you personally and professionally?

Rachel Chater: 1:01:57

Oh, yes. A lot. I mean, I'm very Tigger like about this, you know, there's a lot of bounce and energy, which I think says a lot about the people I work with as well. Yeah, a lot. In fact, I had this conversation with Sheena, who has played a very large role in sort of helping me, or between us, we've done, you know, helping me in terms of thinking about what, you know, sustaining me in this project, but we've certainly developed this together. And I did gently encourage her to send me a couple of words about what it brought to her, because I have heard the story before and I just wanted to share it with you. So she said 'For me taking part in take heART project has been a great example of how I'm doing something that I am passionate about can be hugely fulfilling. It has utterly transformed the way that I feel about my work life in general. It has brought me connections, joy, pride and personal growth. I have rediscovered my work mojo'. So I remember hearing a sort of similar reflection a while ago and yeah, it kind of got me. It got me because that's what we're trying to do and we are the staff. It got me because I think, yeah, I also have a similar feeling. I think we're maybe socialised sometimes to downplay what we're proud of. But I do, I personally have gained a huge sense of pride and its collective pride. I think pride in how people can come together. And if you create the right conditions, just amazing things can happen, both within in between people. And my relationships, yeah, have also benefited. So like Sheena, I would say my relationship to my work has changed quite a bit. I have this kind of newfound confidence, which is a kind of relatively quiet, but considered confidence. So I feel like I've got a bit more courage to just try something, go slightly off piste, sometimes massively out of my own comfort zone, and I think I've had permission to do that along the way. So I'm really fortunate. I've got a supervisor that's incredibly supportive, a team that around me that you know, also have faith in letting me sort of get on with what I hope will come of this but appreciating that sometimes we don't know how something's going to work out. And my daughter, who's now six, but when she was about, it was about three or four months ago, when she was five, she saw me working hard one day and she said 'oh mummy, it doesn't have to be perfect'. I thought, oh my goodness, there is wisdom distilled. And I have never forgotten that, and people have heard me quote this before, but I just mummy, you know, so it doesn't have to be perfect, so I'm not striving for the thing that we don't really need anyway. And in fact, sometimes it's quite good to just get a little bit more immersed in the messiness, because creativity often comes from that. And then of course, yeah, all the relationships I've developed, we've talked about that, we've talked about, you know, the different people, but also the quality of relationships, Sheena and I have developed this great working relationship. She's a really good friend now and we know each other well enough to know where we can complement each other in our skills and our personal qualities. And maybe, yeah, the final thing would be the stories that I tell myself. So we started with a whole load of stories. We've thought maybe about the stories that staff, patients, visitors, anyone, any human being might tell themselves, particularly about what they can't do. But I've, this sort of sounds a bit corny, but I do feel like I've started rewriting my stories because of this work. I feel that I'm able to say I can, or I might, or I d'you know what, I'm gonna give this a go. And maybe also a bit of a story around feeling hopeful about stuff. So there are definitely many times, I don't want to sound overly optimistic at a time when someone might be listening to this, who either themselves or through their work or in their personal lives is navigating something hugely difficult, it is an incredibly difficult time to exist as a human in lots of ways, but I think I'm no longer, you know, there's not a learned helplessness kicking in here, I think there's almost like a learnt hopefulness, you know, that idea that yeah, you can come together, it has to be with others, but create those places and spaces and of course, there's cultures that just carry and support people, particularly staff, who are working in our wonderful NHS services in hospitals.

Paula Redmond: 1:06:58

Thank you for listening. If you've enjoyed this episode, please support the podcast by sharing it with others, posting about it on social media, or leaving a rating or review. I'd love to connect with you. So do come find me on LinkedIn or at my website, and do check out ACP-UK and everything it has to offer. All the links are in the show notes. Thanks again, and until next time, take good care.