Evaluating the experiences of a staff equality, diversity and inclusion reflective space

Figures & data

Figure 1. Key themes, concerns and suggestions of the service user consultation.

Figure 2. Timeline of development, content and evaluation of the EDI reflective space.

Graph 1. Implications of the EDI group reflective space 3-month data 12-month data.

Table 1. 3-month free text responses.

Finding	Description	Quote
Barriers to bravery and safety	Whilst group size, and varying seniorities were barriers to safety and bravery for some, facilitators helped foster a safe environment, allowing members to feel brave.	‘I was “somewhat fearful” because of having more senior clinicians in the space, I worried something I said may make me look incompetent’. ‘The facilitators’ approach was welcoming and warm; it definitely helped to feel ‘safe & brave’’.
Relevant reading	Optional recommended reading helped facilitate discussions but prevented participants from feeling pressured to prepare.	‘I enjoy starting with a stimulus then moving onto discussion. I think the “no pressure” approach to pre-session reading materials is great, as many of us enjoy attending but may not always have time to prepare’.
Open group format	Whilst some found the open group format impacted safety, others felt the benefits outweighed this. No one suggested changing the format.	‘I think the large group makes it harder for me to feel brave/safe, but having a diverse range of people makes it helpful and inclusive’
Breakout rooms	Participants suggested using breakout groups to improve safety and bravery.	‘I believe it would be good to create smaller groups, so that every participant (even the shyest/less talkative ones) can have the time and space to express their thoughts’.

Table 2. 12-month free text responses.

Construct	Finding	Quote
Helpfulness of the EDI space	Participants highlighted the helpfulness and novelty of the EDI dedicated reflective space.	‘I found sessions incredibly helpful to reflect on current, important EDI issues that I may not have otherwise had the time or space to consider’. ‘Opened up conversations I’ve never had before. Extremely interesting’.
Positives of the group format	All responses stated the group format was working well. Participants reflected on the usefulness of optional reading.	‘I find the current format very engaging, safe, and informative. I enjoy the summary of the stimuli at the start of each session, as this means the space is accessible to all, regardless of whether or not we have had time to look through the text’
Breakout rooms	Breakout rooms improved perceptions of safety. Having time for both smaller breakout rooms and one larger group was preferred.	‘I enjoy using breakout rooms to facilitate safe open conversations, and then coming back into the larger group for overall summaries. I enjoy the mix of having in-depth discussions in smaller groups, and hearing from a wider range of people, across groups’.
	Breakout room usefulness depended on the size of the EDI group, and were detrimental to smaller groups.	‘One large group allows sharing of different perspectives. If groups are too small, they become an echo-chamber and perspectives are missed’
Positionality of identities and	Participants attending sessions relevant to their identities reported this as restorative and validating.	‘Although I was initially nervous about possibly feeling pressured to self-disclose an identity I have only shared with a couple of people at work, I felt validated in the space, and at no point felt I had to share anything I was not comfortable with’
Gratitude for the EDI space	Participants consistently reported benefits of the space and gratitude.	‘Thank you for hosting this excellent reflective group. It was incredibly validating of my own identities, and provided a safe space to have open conversations with colleagues about important issues that affect not only our clients, but our staff, too’. ‘Absolutely amazing to have EDI spaces. I am so grateful. It makes me feel empowered’.

Table 3. Theme/sub-theme descriptions and quotes.

Themes/sub themes	Description	Quotes
Benefits of the EDI space
Improved clinical skills	The space helped develop clinical skills and cultural-sensitivity when working with diverse clients. Clinicians were more confident and likely to initiate discussions related to EDI with clients, and reflect on EDI related issues within formulations.	‘It empowered me to ask more questions … and consider it in formulations’. ‘It highlighted the importance of making sure there is an open conversation when the clients need it’
Learning	Clinicians benefitted from learning and developing their EDI knowledge, and took this forwards into their new teams.	‘In the team I’m working in, they don’t always understand what impacts some of these injustices have on people. I’ve tried to be more vocal’.
Restorative	The space was restorative and enjoyable. Clinicians described the environment as friendly, helpful and validating.	‘It was a cathartic space’ ‘It’s something that’s important to have, and should be more the norm’ ‘I really enjoyed it. I’m pleased to hear it’s been carrying on’
Challenges of the EDI space
Concerns of evaluation	Clinicians expressed fears of judgment and evaluation. This was within the specific context of being a Trainee Clinical Psychologist as they felt that their performance was constantly evaluated by supervisors as a competency measure, to be used during trainee reviews.	‘At the end of placement your clinical supervisor is going to evaluate you, so you can’t be open and honest’ ‘When you’re a trainee you’re very conscious all the time of what you’re saying in meetings. Did that sound right? Did I say something wrong?’
Group size	Whilst a larger group size was helpful for prompting reflections and development, this at times increased anxiety.	‘I realised afterwards a smaller group might have helped me to be more comfortable to make mistakes’
Sensitive topic	The sensitivity of topics could make the environment uncomfortable at times, but this highlighted the importance of the discussion.	‘The fact it was uncomfortable at times that’s the nature of it, that’s how it has to be if I want to improve’ ‘At times it could be awkward, I don’t think that’s a bad thing. When that comes up, it’s usually indicative of something important being talked about’.
Need for the EDI space
Developing a culturally-sensitive psychological workforce	Clinicians reflected on the need for clinical psychology to become more culturally sensitive, and how an EDI reflective space within teams can help achieve this.	‘The field has to become more comfortable with diversity in the room, not just race and culture but everything, class, disability’
Lack of EDI spaces	Clinicians reflected on the lack of EDI spaces within mental health services and the value of accessing them.	‘It’s great that such a space even exists because it doesn’t in a lot of services and it’s something that I’ve quite missed’. ‘I think the main strength is that it’s actually happening, it isn’t really happening In my other placements, It just doesn’t exist’.
Requirements for an effective EDI space
Safe space	A strength of the space was the safe atmosphere, leading to more meaningful reflections.	‘If you only have an hour it can be difficult to get into this space, make it feel safe and contained, and then get to a deep enough level to actually make a meaningful conversation and then debrief afterwards. Because this was regular and with a safe group of people, we were able to contain that within an hour but still make it meaningful’.
Service buy-in	Clinicians asserted that the service leadership viewed the reflective space as important and relevant as the EDI space was separate, dedicated and delivered regularly. Clinicians felt this was intrinsic to the success of the reflective space.	‘The time was given highlighted that the service wants to do even better, even more’ ‘Having that monthly space is quite different. I’ve been to others before, but they were usually a lot more, irregular or it might just come up as a point of any other business in the team meeting rather than actually having a dedicated protected space every month to talk about it’
Team buy-in	Having a team which are invested in exploring issues relating to EDI helped to increase engagement with the EDI reflective space.	‘It seemed like a lot of the team were really interested in EDI’. ‘It was a great idea well taken by the team’.
Differing seniorities	Although having an EDI reflective space open to all staff at every seniority could lead to some staff feeling unsafe or intimidated, clinicians reflected on how this format increased opportunities for learning.	‘If your supervisor is in the room, there is power imbalance. But it isn’t something I would remove because I learned so much from all the qualified clinicians’. ‘I still remember one qualified clinician really being open with what they were feeling about that topic, which was really touching seeing that it was OK, it’s a journey for everyone’. ‘I liked that we were all different positions, it meant we could learn from each other’.
Structure	Using a semi-structured approach, including optional relevant reading to introduce the topic and spark reflections and discussions, was a strength of the space.	‘It’s great to have the paper beforehand for us to read and inform our thoughts beforehand, that was very good’. ‘I also appreciated the fact it was a bit structured, not too structured but not completely unstructured, which helped moderate the session’.
Topic variety	Clinicians described how the variety of topics and ability to adapt topics to the current social and geopolitical context was helpful	‘It was a much wider variety of stuff than what you would cover in reflective spaces’.

Figure 3. Recommendations for developing an effective EDI group reflective space.

Table

0 - not at all important

50 - somewhat important

100 - very important