Lea Jabbarian has been working at the GGZ institution Misi NeuroPsy in Rotterdam for almost 2 years. She works as a psychologist in the Misi team and is also training to become a GZ-psychologist at Erasmus MC in Rotterdam. When Misi NeuroPsy decided to get started with NiceDay, Lea took it upon herself to implement this new way of working in the team. In her team, they work according to the NiceDay the MiSi Way; the NiceDay Way with a touch of MiSi. We interviewed her about her experience with the implementation, the NiceDay MiSi Way, how she guided her team through this change and what she thinks of online or blended treatment.
Can you tell us more about MiSi NeuroPsy?
MiSi is a mental health care institution with a unique setting. We are an institution that accepts care within the BGGZ as well as the SGGZ. So we’re taking on more complex casuistry and simpler casuistry. In addition, our focus is mainly on the multicultural aspect of society. We have both practitioners and patients from different international or cultural backgrounds. This diversity within the practice is very important to us; after all, Rotterdam is also a very diverse city! I am not only talking about the place of origin, but also differences in socioeconomic status, literacy, physical and/or cognitive functioning or ideology/religion. This is MiSi’s mission: “Because everyone deserves the best care and attention!”.
Why did you switch to NiceDay?
The switch to NiceDay went naturally, like with so many other mental health care institutions; the corona crisis pushed us over the tipping point. Everyone had to switch to video calling and so did we. My first impression of NiceDay was that it was a great video calling feature, but I soon learned that it was much more than that! It was very different from what I was used to; I knew online forms of therapy with modules, but those aren’t interactive. As a psychologist, despite all the possibilities, I was a bit sceptical at first; how can you gain more insight into the lives of your patients online? Contact in between sessions can also feel very suffocating for the patient. But I’m completely converted!
How do you feel about NiceDay now?
A 100% online treatment does not work for everyone. At first, I was also hesitant about everything having to be online. But I soon found out that it adds so much to the treatment that I couldn’t have achieved without NiceDay. Because I can have contact with my patients in between sessions, I gain insights that I did not have before. Normally, if you give a client a Thought record, for example, it is quite difficult to immediately fill it in once a situation arises. You’ll have to search your bag for that piece of paper your therapist gave you and a pen to immediately fill in the Thought record. With the NiceDay app on the phone, the patient has everything directly at hand. During my flexible time, I can respond to the registration or try to offer some support. This immediately gives the patient a positive boost! Or if I notice certain patients are having a hard time, I can respond to that by sending a quick chat message. This takes me 10 – 15 minutes, but means so much to the patient!
In this way, the patient’s mood remains stable. Without contact via the NiceDay app, their mood might have dropped. That means I would have had to devote most of the next session to get their mood back up. This is perhaps one of the most important aspects of NiceDay; you try to avoid only discussing current events during treatment because things will continue to happen. During sessions, you want to optimally use the time to follow the therapeutic process. With NiceDay you can catch up on current affairs in between sessions. This makes the sessions and the process much more efficient.
In addition, NiceDay does not force you to treat your patients 100% online but gives you the freedom to determine this yourself. I have patients where I do everything online and that works perfectly well for them. But for others, this isn’t suitable and it would be strange and inefficient to force a 100% online treatment on them. NiceDay is more about flexible and effective treatment, rather than completely online or blended.
You call your way of working the NiceDay the MiSi Way, what is that exactly?
The NiceDay Way, as set up by you, concerns, among other things, a proven effective treatment with accessible contact between the patient and the professional, more control for the patient, real-time insight for the professional and flexible and personal treatment. That last part is very important at MiSi; our approach is very patient-oriented. We look at what our patients need. This can be a session on location one moment and online the next. We treat patients from all walks of life and not everyone has a large house or apartment where you can retreat for a session with your psychologist. In that case, there may be a need for a face-to-face session on location.
Therefore, at MiSi, we look at all the functionalities and possibilities NiceDay offers and how we can best use this for each patient. This is the MiSi touch; the personal touch to every treatment. You can look at what works best for each patient. For example, some patients prefer it if you respond to registrations during sessions and give a little bit of encouragement. Others don’t like that. When you notice that patients are more dependent, it can be good not to constantly support them via the app. They should be able to do it themselves, without us encouraging them. NiceDay gives you the freedom to use any functionality as you think is appropriate for the treatment. The freedom and flexibility goes hand in hand with the vision of a patient-oriented treatment of MiSi NeuroPsy.
How did you experience the implementation?
The implementation went quite smoothly. NiceDay already has the whole package ready. You provide the training, have an extensive psycho-education library, regularly e-mail useful information and have a good and thoughtful support department. Support was always accessible and helpful and tried to think along with solutions. This also helped a lot during the implementation process. When my colleagues had questions during intervisions, I forwarded these to NiceDay. Hearing and noticing that their questions and feedback were being picked up felt good for my colleagues! It became an “us” story instead of a “them and us” split. I also think this sets you apart from other ‘providers’.
The challenge in the implementation was that everyone has their way of providing therapy, especially because we treat both BGGZ and SGGZ. That is why, in addition to being patient-oriented, we are also colleague-oriented. During our intervisions, we constantly try to look at the way of working of a professional and how we can shape this with NiceDay. For that reason, we have also kept intervisions small, with a maximum of three or four people, in which we look at what works and what does not work per person.
During the intervisions, we use the dashboard that we have set up in collaboration with NiceDay. Here we can see several data, such as the use of meeting notes, trackers or, for example, video calling. We see what each practitioner uses, not what patients use, because of privacy of course. We don’t use this dashboard to check on our professionals, but to discuss and share experiences. If I notice that someone makes little use of, for example, Thought schedules, I can ask why that person does not. We can discuss how others use it or why it may or may not work for them. This is also a very handy tool for me and the organisation; this gives us insight into what is happening and the space to respond to this.
What is your vision for the future of mental health care?
A patient-oriented treatment. If we look at current mental health care from the MiSi vision, patient-oriented care, there are still several challenges. We know that certain population groups, not only different ethnicities but also people with a certain socioeconomic status or religious groups, are less likely to reach out for mental health care. We also know that certain treatments are less effective. There is a challenge in mental health care to make care standards not only for the average native Dutch person but for society as a whole. I think we should bring personal and patient-oriented care back into healthcare, instead of treating everyone the same through protocols.
This is also why I think that everyone should have the option to use blended or flexible treatment. Ensuring that, using registrations and contact in between sessions, the patient continues to be involved in the therapeutic process, also outside of sessions. That is blended care to me. I also notice a clear difference between ‘regular’ treatment and this new way of working, because I work with and without NiceDay. When I work without NiceDay, I always advise patients to download the app. It’s just a shame I don’t have any insight into their registrations! We have to talk about it during sessions and that takes the efficiency out of it.
Do you have tips for other organisations that want to start using NiceDay?
I can recommend that the organisation team takes the NiceDay training first and then think about how you can best implement the NiceDay Way into your organisation. Make sure you have a clear vision about this, before informing the rest of the organisation. NiceDay already has the entire implementation package ready: the training, the library, the blog workshop. However, don’t think that, because the whole implementation package is already there, your organisation is ready too. As an organisation, you have to be on top of it.
In addition, the intervisions using the dashboard that I mentioned earlier are very useful. Here you can ask your team 1 on 1 why someone is not using a certain functionality at all, for example. This can be about very practical things. For example, someone on my team didn’t use the Thought schedules because she thought you had to fill out the entire form right away. I and my colleagues informed her that this is not necessary at all and that it is also possible for your patient to only fill in the first step. By talking about experiences, my colleague was able to get started with the Thought schedules!
We hold intervisions every six weeks. We go through the dashboard, discuss the latest developments and new functionalities. I’m the connection between NiceDay and the team. That’s what I like about NiceDay; it is not an anonymous company that provides a product and that we transfer money to every so often. It is a collaboration in which we try to strengthen each other and make treatment as personal and efficient as possible for the patient.