Second year trainees given the opportunity to visit a support group for Asian service users
From 7th July to 29th September 2015, 12 trainees from the 2013-2016 Cohort of the University of Leicester (UoL) Doctorate in Clinical Psychology (DClinPsy) course shadowed seven fortnightly support group sessions with service users from Asian backgrounds at the Open Mind Service, Leicestershire Partnership NHS Trust. This pilot initiative was set up by the UoL Diversity Strategy Committee (DSC) in partnership with Dr Marcus Solanki MBE, Psychotherapist at the Open Mind Service and Chairperson of a Leicester-based voluntary sector organisation for Asian people with mental health problems and their carers.
A bit of background
Leicester is one of the most ethnically and culturally diverse cities in the UK, with the residents hailing from over 50 countries across the world. According to a census in 2011, nearly half of the population in Leicester City were non-White with 37% being from Asian origins. The Leicester DClinPsy course obviously places emphasis on training in cultural diversity and cultural competence. Teaching and placement opportunities are being developed so that trainees have competence when engaging with and serving clients from diverse communities. In addition, the UoL DSC has been liaising with key representatives of local organisations working with people from ethnic minority backgrounds, with one of its aims being to create community engagement opportunities for DClinPsy trainees. The present pilot initiative was one outcome of the discussions started between Professor Mike Wang, former Chairperson of the DSC, and Dr Marcus Solanki, and coordinated by Trisha Boodhoo, 2013-2016 Cohort trainee representative of the DSC.
Initial plan and field realities
In summer 2015, 12 out of the 14 trainees who expressed an interest attended the seven fortnightly sessions run by Dr Solanki at the Open Mind Service. The main aim was to provide an opportunity for trainees to observe and participate in support group sessions with Asian people with mental health issues. Prior to the sessions, Dr Solanki had discussed the implications of trainees’ involvement with the board members of the voluntary sector organisation and with the group members themselves. Relative to the larger group, they agreed that they would be comfortable with a limit of two new trainees per meeting and this was not felt as overwhelming to the service users. They welcomed this initiative as a mutual learning opportunity and sharing of experiences for both the group members and the trainees.
However throughout summer, attendance of the service users to the sessions considerably fluctuated, which limited the possibility for most trainees to observe group dynamics. This was due to a variety of reasons, mainly recent service changes faced by the voluntary sector organisation; some service users being away on holidays; and practical difficulties to get to the venue for some group members. Despite those constraints, Dr Solanki ensured that trainees could be given an opportunity to converse with the members present when possible. He also discussed about his role and diversity-related issues, and provided resources about the Open Mind Service to each trainee. The following section is a summary of trainees’ reflections on their experience of attending the sessions.
A summary of trainees’ reflections
“We felt that the group provided a unique shadowing experience for trainees to get a flavour of some of the diversity issues associated with mental health.”
One thing which seemed to have struck most trainees was the openness with which the group members talked about their experiences, including their personal struggles. They appeared to value the opportunity to share their story with the trainees. It was apparent that all the service users appreciated the support and purpose of the group, and how it had enabled them to move forward. One of them commented that being part of the group had opened her mind to the shared experiences of people with mental health difficulties and had found this to be an invaluable personal experience. Another member described the group as a ‘second family’, where she could be away from ‘pressures’ in her own family and ‘feel heard’ by Dr Solanki and the other members.
The service users’ insights into the challenges they faced within their community were particularly useful in furthering the understanding of trainees on how these might affect people from ethnic minority backgrounds in the context of experiencing mental health difficulties and help-seeking. They spoke about how culture and power can impact on a person’s ability to communicate their experiences to others, even health professionals. For instance, one group member shared how she could find it difficult to express herself during one-to-one interactions with mental health professionals. A couple of other group members felt that they had limited access to talking therapies and were more likely to be prescribed medication. One lady spoke about the negative attitudes within her family towards mental health, which made it hard for her to express her difficulties to her significant others. Dr Solanki and some members reflected that, although some people working in Asian community organisations have knowledge of mental health, there were uncertainties around their level of training and the interventions they used with service users.
In addition to providing a safe and contained space for the members to talk, Dr Solanki sometimes considered and used guided visualisation and other cognitive behavioural therapy-based techniques to help them manage their low mood and anxiety. This was supplemented by being offered literature and information on other services, such as details on employment and benefit support, that clients could take away and make use of. He also emphasised the importance of self-care among the group members.
“It was interesting to hear about the cultural influences within the group and how Dr Solanki manages different languages and cultural views coming together.”
The opportunity to observe and participate in the group provided an insight into mental health but also the use of language and cultural influences. For example, cultural factors regarding family support, the multiple languages spoken in India and how families grapple with the absence of teaching of their native tongue in some schools. The latter opened awareness to the inter-generational difficulties that can arise in families, when language is acquired in different ways. One trainee observed a session conducted in Gujarati by Dr Solanki, which he found helpful in that some ‘cultural practices’ were discussed and ‘ways of thinking’ which might have been different in his own culture of origin.
“Dr Solanki is lovely!”
Last but not the least, all trainees unanimously shared that meeting with Dr Solanki was a valuable learning opportunity in itself. It was evident that he had a well-established therapeutic relationship with the group members. He seemed to really care very passionately about what he was doing and that was refreshing to see. He appeared to adopt a service user-led approach and facilitated the conversations in a flexible and meaningful way to the group members. He had been very welcoming to all trainees and generously provided them with useful resources about the service. He was at all times keen to share his extensive knowledge of local services. He expressed his willingness to help trainees if they wanted to discuss further about relevant community issues; to shadow his work; or to visit community venues or faith groups within Leicester.
All trainees agreed that it would be beneficial to reconsider the timing of such an opportunity in the year to improve chances of observing group dynamics when attendance might be higher. This experiential learning appeared to compliment some diversity-related teaching on the course. Trainees are very keen to access more community engagement opportunities to inform their work with clients from a variety of ethnic minority backgrounds. Discussing links between faith and psychology, and their relevance to clinical settings were also of interest to trainees. The 2013-2016 DClinPsy cohort expresses their sincere gratitude to Dr Solanki and the group members for their valuable contribution to enhancing their training experience.
Trisha Boodhoo, on behalf of the 2013-2016 Leicester DClinPsy Cohor