Volume 8 No 2 Maret 2023

p-ISSN: 2460-8750 e-ISSN: 2615-1731

https://doi.org/10.26858/talenta.v8i2.44841

Hubungan Antara Harga Diri Dengan Perilaku Cyberbullying Pada

Remaja

Nur Mawaddah Adam1, M. Ahkam Alwi2*

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Fakultas Psikologi, Universitas Negeri Makassar. Indonesia

Email: m.ahkam.a@unm.ac.id

©2018 –JPT Fakultas Psikologi Universitas Negeri Makassar. Ini adalah artikel dengan
akses terbuka di bawah licenci CC BY-NC-4.0 (https://creativecommons.org/licenses/by-nc/4.0/ ).

ABSTRACT

Cyberbullying is a phenomenon that is often found in social media users, especially teenagers.
Cyberbullying is aggressive behavior that is carried out continuously against other people using social
media. One aspect that can influence adolescents to do cyberbullying is self-esteem. Adolescents who
cannot judge themselves well are likely to do cyberbullying to increase their self-esteem. The purpose
of this study is to determine the relationship between self-esteem and cyberbullying behavior in
adolescents in Parepare City. The measuring instrument used in this study is the self-esteem scale which
is based on the self-esteem aspects of Coopersmith (1967) and the cyberbullying scale which is based
on the behavioral aspects of cyberbullying Willard (2007). Sampling is purposive sampling according
to the characteristics determined by the researcher. The data analysis technique in this study was
Spearman's correlation which was processed using SPSS 25. The results showed that there was a
negative relationship between the variables of self-esteem and cyberbullying, which means that the
higher the self-esteem of adolescents, the lower the tendency of adolescents to become perpetrators of
cyberbullying.

Keywords: Adolescents, cyberbullying, self-esteem

ABSTRAK

Cyberbullying merupakan fenomena yang sering ditemui pada pengguna sosial media, khusunya
remaja. Cyberbullying merupakan perilaku agresif yang dilakukan terus menerus terhadap orang lain
dengan menggunakan sosial media. Salah satu aspek yang dapat mempengaruhi remaja untuk
melakukan cyberbullying adalah harga diri. Remaja yang tidak dapat menilai dirinya dengan baik maka
memungkinkan untuk melakukan cyberbullying untuk meningkatkan harga dirinya. Tujuan penelitian
ini yaitu untuk mengetahui hubungan antara harga diri dengan perilaku cyberbullying pada remaja di
Kota Parepare. Alat ukur yang digunakan dalam penelitian ini yaitu skala harga diri yang disusun
berdasarkan aspek harga diri Coopersmith (1967) dan skala cyberbullying yang disusun berdasarkan
aspek perilaku cyberbullying Willard (2007). Pengambilan sample yaitu purposive sampling sesuai
dengan karakteristik yang telah di tentukan oleh peneliti. Teknik analisis data dalam penelitian ini yaitu
korelasi spearman yang diolah dengan menggunakan SPSS 25. Hasil penelitian menunjukkan bahwa
terdapat hubungan yang bersifat negatif antara variabel harga diri dan cyberbullying, yang berarti
semakin tinggi harga diri remaja maka semakin rendah kecenderungan remaja menjadi pelaku
cyberbullying.

Keyword: Cyberbullying, harga diri, remaja

PENDAHULUAN
Kehidupan manusia di zaman sekarang mendapatkan manfaat dan kemudahan melalui
perkembangan teknologi di era globalisasi saat ini. Salah satu manfaat dari berkembanganya
teknologi adalah individu dapat dengan mudah mengakses segala sesuatu seperti informasi
sehingga menjadi lebih dekat dan efisien melalui internet. Survei yang dilakukan oleh Asosiasi
Penyelenggara Internet Indonesia (2019) bahwa di tahun 2019-2020 ada 196,71 juta orang
Indonesia menggunakan internet dari total populasi 266,91 juta penduduk Indonesia. Pengguna
internet yang paling aktif yaitu kelompok usia remaja 13-18 tahun yang mencapai 75,50%.
Pengguna internet sebagian besar digunakan untuk mengakses layanan chatting (komunikasi
lewat pesan) sebesar 32,9% dan media sosial sebesar 51,5%.
Remaja yang mendominasi penggunaan internet dalam mengakses aplikasi chatting dan
media sosial memiliki kesempatan untuk melakukan penyimpangan penyalahgunaan layanan
yaitu cyberbullying (Riswanto & Marsinun, 2020). Menurut Willard (2007) mengatakan bahwa
cyberbullying merupakan tindakan kejam terhadap orang lain dengan mengirim atau
memposting materi berbahaya dan terlibat dalam bentuk agresi sosial menggunakan internet
atau teknologi digital. Cyberbullying dilakukan melalui sosial media seperti email, twitter,
facebook, instagram, email, pesan teks, gambar atau video yang diambil melalui
ponsel/webcam dan obrolan grup.
Willard (2007) mengemukakan bahwa ada tujuh bentuk cyberbullying yaitu: (a)
Flaming, perilaku mengirimkan pesan, komentar atau gambar yang berisikan kalimat yang
kasar dan penuh amarah; (b) harassment, perilaku mengirimkan pesan atau komentar secara
berulang yang berisikan kalimat yang tidak sopan, menghina, mengganggu dan menyakiti
korban; (c) denigration, perilaku mengumbar rumor atau hal buruk orang lain di sosial media
agar nama baik dan reputasi individu rusak dan tidak baik lagi dimata orang lain; (d)
impersonation, perilaku memalsukan identitas atau berpura-pura menjadi orang lain dengan
tujuan membuat individu tersebut dalam masalah, seperti mengirimkan pesan atau komentar
yang kasar dan buruk menggunakan identitas orang tersebut; (e) trickery dan outing, trickery
merupakan perilaku membujuk atau menghasut individu agar mengungkapkan rahasia atau
informasi pribadinya seperti foto pribadi dengan tujuan tertentu. Outing merupakan perilaku
menyebarkan rahasia atau informasi pribadi orang lain di media sosial seperti foto memalukan;
(f) exclusion, perilaku mengucilkan seseorang di grup percakapan online tertentu secara
sengaja; dan (g) cyberstalking, perilaku menguntit secara intens dan berulang di media sosial
sehingga menimbulkan ketakutan pada korban.
Sari, Nauli dan Utomo (2020) dalam penelitiannya menemukan indikasi remaja
melakukan perilaku cyberbullying. Hasil penelitiannya yaitu pada 250 responden yang berusia
15-19 tahun terdapat 137 responden atau sebesar (54,8%) menunjukkan tingkat kecenderungan
menjadi pelaku cyberbullying. Hasil penelitian Sumarlin (2018) diketahui bahwa bentuk
cyberbullying yang terjadi pada remaja di Kota Palopo yaitu pengucilan, komentar kasar,
pengeluaran dari grup obrolan, impersonation dan sent upsetting image dengan rentang nilai
berkisar 38-68%.
Berdasarkan hasil data awal peneliti pada remaja di Kota Parepare menggunakan survei
cyberbullying yang disebarkan melalui google form sebanyak 40 remaja, didapatkan hasil
bahwa usia 14 tahun sebesar 13%, 15 tahun sebesar 60%, 16 tahun sebesar 12%, dan 17 tahun
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sebesar 15% melakukan bentuk cyberbullying yaitu mengirimkan pesan, komentar atau gambar
yang berisikan kata-kata kasar sebanyak 28%, mengeluarkan seseorang dari grup online dengan
sengaja sebanyak 27%, membuat stiker dari foto aib orang lain sebanyak 25%, membuat
gambar atau video yang dapat membuat malu orang lain dan memposting di media sosial
sebanyak 9%, berpura-pura menjadi orang lain lalu mengirimkan pesan buruk sebanyak 5%,
mengirim pesan teks yang bersifat mengancam secara berulang sebanyak 2%, terdapat angka
yang sama dengan membuat atau memposting berita hoax atau rumor orang lain sebanyak 2%,
dan membuat atau memposting berita hoax atau rumor orang lain sebanyak 2%.
Berdasarkan hasil penelitian Anggraeni, Hasanah dan Nurhakki (2016) diketahui
bahwa remaja SMK DDI Parepare yang menggunakan sosial media dapat melakukan
penyebaran kata-kata kasar dan penggunaan kata-kata baru atau gaul yang tidak sesuai seperti
kata “fuck”. Perilaku cyberbullying yang terjadi memiliki dampak negatif pada pelaku.
Sourander (Campbell, Slee, Spears, Butler & Kift, 2013) mengemukakan bahwa pelaku
cyberbullying menghasilkan emosi negatif seperti rasa malu dan ketakutan. Ketika pelaku
cyberbullying terungkap maka pelaku akan merasa malu dan takut untuk bertemu dengan
individu lain dilingkungannya seperti teman di sekolah karena akan banyak yang ikut
menyalahkan pelaku akibat perbuatan cyberbullying yang dilakukan kepada korban.
Tindakan cyberbullying yang remaja lakukan dapat dipengaruhi oleh faktor internal
maupun faktor eksternal. Salah satu faktor internal remaja melakukan cyberbullying adalah
harga diri (Mayangsari, 2015). Menurut Otstowsky (Mayun, 2019) mengemukakan bahwa
harga diri rendah yang dimiliki individu lebih memungkinkan melakukan perilaku
cyberbullying. Harga diri merupakan penilaian yang dibuat individu terhadap dirinya dan
interpretasi yang di terima individu dari lingkungannya seperti penghargaan, penerimaan dan
perlakuan (Coopersmith, 1967). Adapun aspek-aspek dari harga diri yaitu kekuasaan,
keberartian, kebajikan dan kemapuan. Coopersmith (1967) mengemukakan bahwa terdapat tiga
kategorisasi harga diri, yaitu: (a) Harga diri tinggi, individu dengan harga diri tinggi
mempunyai sifat superioritas, bangga dengan diri sendiri, menerima diri sendiri dan cinta diri.
Dalam lingkungan individu dengan harga diri tinggi mampu bergaul dengan baik dan
mempunyai kepribadian kuat; (b) harga diri sedang, individu dengan harga diri sedang memiliki
tindakan dan sifat yang hampir sama dengan individu yang mempunyai harga diri tinggi.
Perbedaan ini terletak pada individu dalam menilai dirinya, intensitas keyakinan diri yang
dimiliki dan bagaimana bentuk penerimaan lingkungan yang didapatkan; dan (c) harga diri
rendah, individu dengan harga diri rendah memiliki sikap rendah diri, takut, membenci diri
sendiri, kurangnya penerimaan diri dan kepatuhan. Kemauan individu untuk bisa menghadapi
kelemahannya sendiri sangat rendah tidak merasa bergaul dengan lingkungannya.
Tingkat harga diri individu dipengaruhi oleh interaksi individu dengan lingkungan
sekitarnya serta penghargaan, penerimaan dan pengertian yang di dapatkan dari orang lain
terhadap dirinya (Mayun, 2019). Hasil penelitian Haura dan Ardi (2020) menemukan bahwa
ada korelasi antara harga diri dengan cyberbullying yaitu -0,977. Dapat dilihat bahwa terdapat
korelasi searah yang negatif dengan kategori sangat tinggi antara harga diri dengan
cyberbullying. Semakin tinggi harga diri maka semakin rendah pula perilaku cyberbullying.
Menurut Kowalski, dkk (Haura & Ardi, 2020) mengemukakan bahwa individu
termotivasi untuk melakukan cyberbullying sebagai sarana pemenuhan kebutuhan untuk
meningkatkan harga diri berupa kekuasaan, menemukan kepuasan dalam menyebabkan
penderitaan dan luka pada orang lain, pelaku dihargai atas perilakunya dalam bentuk materi
seperti uang dan lain-lain serta pengharagaan psikologis berupa peningkatan harga diri dan
status sosial yang tinggi. Dengan demikian, peneliti tertarik untuk meneliti untuk mengadakan
penelitian mengenai hubungan antara harga diri dengan perilaku cyberbullying pada remaja di
Kota Parepare. Maka hipotesis yang diajukan dalam penelitian ini adalah apakah ada hubungan
antara harga diri dengan perilaku cyberbullying pada remaja di Kota Parepare. Diharapkan
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penelitian ini dapat memberikan kontribusi terhadap bidang psikologi sosial dan psikologi
perkembangan serta diharapkan dan dapat memberikan kontribusi dalam penelitian mengenai
harga diri dengan kaitannya terhadap perilaku cyberbullying.

METODE PENELITIAN
Metode penelitian yang digunakan dalam penelitian ini adalah metode penelitian
kuantitatif. Populasi dalam penelitian ini adalah remaja yang menempuh pendidikan Sekolah
Menengah Atas/Sederajat di Kota Parepare. Adapun, teknik pengambilan sampel yang
digunakan adalah purposive sampling. Purposive sampling merupakan teknik pengambilan
sampel yang memiliki kriteria sesuai dengan karakteristik yang ditentukan oleh peneliti
sebelumnya (Azwar, 2012). Kriteria khusus peneliti dilihat dari frekuensi subjek yang
melakukan perilaku cyberbullying seperti pada penelitian Chairani, Suryadi dan Wahyuni
(2018) bahwa frekuensi terjadinya perilaku cyberbullying dalam 1 tahun yaitu 1-5 kali hingga
> 20 kali.
Adapun kriteria subjek yang akan diteliti yaitu: (a) subjek merupakan remaja
SMA/SMK Sederajat yang berdomisili di Kota Parepare; (b) pengguna sosial media; dan (c)
pernah melakukan perilaku cyberbullying di sosial media berdasarkan pengalamannya sesuai
dengan kriteria khusus. Teknik pengumpulan data dalam penelitian ini menggunakan metode
skala. Masing-masing skala yang digunakan menggunakan instrument skala model likert yang
terdiri dari 4 pilihan jawaban yaitu Sangat Setuju, Setuju, Tidak Setuju dan Sangat Tidak Setuju.
Skala harga diri terdiri dari 12 item yang disusun berdasarkan aspek dari Coopersmith (1967)
dan skala cyberbullying terdiri dari 34 item yang disusun berdasarkan Willard (2007). Teknik
analisis data yang digunakan dalam penelitian ini yaitu teknik analisis korelasi Spearman.
Korelasi Spearman digunakan jika data tidak terdistribusi normal sehingga dilakukan analisis
koefisien korelasi dari statistik nonparametrik (Siregar, 2013).

HASIL DAN PEMBAHASAN

Hasil
Tabel 1. Kategorisasi dan Interpretasi Variabel Harga diri
Interval Skor Frekuensi Persentase Kategori
X>36 43 21,5% Tinggi
24<=X<36 145 72,5% Sedang
X<24 12 6,0% Rendah
Total 200 100,00%

Dapat dilihat pada tabel 1 diatas diketahui bahwa dari 200 responden, terdapat 43
remaja yang berada dalam kategori harga diri tinggi (21,5%), terdapat 145 remaja mengalami
harga diri dengan tingkat sedang (72,5%) dan terdapat 12 remaja yang memiliki harga diri
rendah dengan persentase (6,0%).

Tabel 2. Kategorisasi dan Interpretasi Variabel Cyberbullying

Interval Skor Frekuensi Persentase Kategori
X>102 7 3,5% Tinggi
68<=X<102 79 39,5% Sedang
X<68 114 57,0% Rendah
Total 200 100,00%

Dapat dilihat pada tabel 2 diatas diketahui bahwa dari 200 responden, terdapat 7 remaja
yang berada dalam tingkat perilaku cyberbullying yang tinggi (3,5%), terdapat 79 remaja
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dengan tingkat sedang (39,5%) dan terdapat 114 remaja dengan tingkat perilaku cyberbullying
yang rendah (114%).

Tabel 3. Hasil Uji Normalitas

Kolmogorov-Smirnov
Harga Diri Cyberbullying
Asymp.Sig. 0,008 0,032
(2-tailed)

Dapat dilihat pada tabel 3 diatas diketahui bahwa menunjukkan nilai signifikansi pada
variabel harga diri sebesar 0,008 dan variabel perilaku cyberbullying sebesar 0,032. Nilai
signifikansi < 0,05 maka data penelitian dinyatakan tidak terdistribusi normal.

Tabel 4. Hasil Uji Hipotesis

Variabel r P Keterangan
Harga Diri- -0,354 0,000 Hubungan negatif
Cyberbullying

Dapat dilihat pada tabel 3 diatas, diketahui bahwa korelasi antara variabel harga diri
dengan cyberbullying menunjukkan nilai koefisien sebesa -0,354. Signifikansi 0,000 kurang
dari 0,05 maka kesimpulannya adalah hipotesis diterima (Priyatno, 2013). Angka korelasi
negatif yang dihasilkan menunjukkan terjadinya hubungan negatif artinya semakin tinggi harga
diri remaja maka semakin rendah kecenderungan remaja menjadi pelaku cyberbullying.
Begitupula sebaliknya, semakin rendah harga diri maka semakin tinggi kecenderungan remaja
menjadi pelaku cyberbullying.

Pembahasan
Pada hasil kategorisasi variabel harga diri lakukan terhadap 200 responden terdapat 43
remaja tergolong dalam harga diri tinggi, 145 remaja tergolong dalam harga diri sedang dan 12
remaja tergolong dalam harga diri rendah. Sehingga, dapat dilihat bahwa remaja dalam
penelitian ini cenderung bergerak pada kategori sedang. Hal ini sama dengan dengan penelitian
harga diri remaja yang telah dilakukan oleh Prakoso (2019) menunjukkan hasil bahwa sebanyak
254 remaja (99,6%) memiliki harga diri sedang. Harga diri sedang yang dimiliki oleh individu
artinya berada diantara harga diri tinggi dan harga diri rendah.
Perbedaan dari individu yang memiliki harga diri sedang ini dilihat dari intensitas
keyakinan diri, penerimaan sosial lingkungannya dan bagaimana individu menilai diri
pribadinya (Coopersmith, 1967). Menurut Budi dan Tina (2016) kepercayaan atau keyakinan
diri merupakah salah satu aspek yang terpenting dalam kehidupan manusia. Kepercayaan diri
ini dipengaruhi oleh masa perkembangan yang sedang dilalui individu terutama bagi remaja
yang kepercayaan dirinya mudah berubah.
Kepercayaan diri yang baik pada remaja maka akan dapat bersosialisasi dan membaur
dengan baik di masyarakat serta tumbuh secara maksimal. Akan tetapi, remaja saat ini banyak
mengalami krisis kepercayaan diri dan dapat hal ini dapat menimbulkan dampak yang kurang
baik pada pribadi remaja yang sedangan menghadapi masa transisi dalam pencarian jati diri
(Ambarwati, 2021). Menurut Mullai, Macaj dan Kotherja (2017) mengungkapkan bahwa harga
diri mencakup keadaan emosional seperti kebanggaan dan keputusasaan serta kepercayaan
terhadap diri sendiri.
Remaja ketika memiliki penerimaan sosial yang baik maka dapat diterima dan diakui
individu yang berada dalam suatu kelompok sosial serta mendapatkan kegiatan kelompok yang

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ditunjukkan dengan keberhasilan dalam bekerja sama atau berinteraksi (Purwanti, 2019).
Menurut Hurlock (1980) aspek penerimaan sosial terbagi menjadi tiga yaitu perlakuan yang
diterima dari teman lain, umpan balik dari teman dan popularitas. Ketika remaja tidak
mendapatkan penerimaan sosial yang baik maka dapat mempengaruhi harga diri sehingga bisa
saja menempatkan tingkatan harga diri remaja di tingkatan sedang maupun rendah.
Penurunan harga diri yang dialami remaja bisa saja berlangsung dari awal transisi atau
pertengahan hingga akhir sekolah menengah atas (Santrock, 2007). Mayoritas responden dalam
penelitian ini adalah remaja yang berusia 15-17 tahun. Menurut Baldwin dan Hoffman
(Santrock, 2007) bahwa harga diri menurun pada perempuan di usia 12-17 tahun dan laki-laki
meningkat pada usia 12-14 tahun akan tetapi menurun hingga usia 16 tahun.
Pada hasil kategorisasi variabel cyberbullying terhadap 200 responden terdapat 7 remaja
tergolong dalam perilaku cyberbullying tinggi, 79 remaja tergolong dalam perilaku
cyberbullying sedang dan 114 remaja tergolong dalam perilaku cyberbullying rendah.
Sehingga, dapat dilihat bahwa perilaku cyberbullying pada remaja dalam penelitian ini
cenderung bergerak pada kategori rendah. Hal ini sama dengan hasil penelitian Sari Rumra dan
Agustina Rahayu (2021) bahwa responden penelitiannya rata-rata berada pada kategorisasi
rendah pada perilaku cyberbullying dengan persentase 78,9%.
Hipotesis dari penelitian ini adalah adalah untuk mengetahui hubungan antara harga diri
dengan perilaku cyberbullying pada remaja di Kota Parepare. Berdasarkan dari hasil analisis
korelasi Spearman menunjukkan bahwa terdapat hubungan antara harga diri dengan perilaku
cyberbullying pada remaja di Kota Parepare. Hasil yang diperoleh nilai (r) sebesar 0,000 yang
lebih kecil dari 0,050 maka hipotesis diterima. Hipotesis dalam penelitian ini adalah terdapat
hubungan negatif antara harga diri dengan perilaku cyberbullying pada remaja. Semakin tinggi
harga diri remaja maka semakin rendah kecenderungan remaja menjadi pelaku cyberbullying.
Begitupula sebaliknya, semakin rendah harga diri maka semakin tinggi kecenderungan remaja
menjadi pelaku cyberbullying. Dapat dilihat juga dari angka korelasi yang menunjukkan -0,354,
hal ini menunjukkan korelasi negatif namun hubungannya lemah.
Hasil penelitian ini sejalan dengan penelitian Hidayati dan Indrijati (2019) bahwa
terdapat hubungan negatif dan signifikan dari variabel harga diri dengan perilaku cyberbullying
pada remaja yang dilakukan di Instagram. Hasil penelitian ini menunjukkan bahwa semakin
tinggi atau semakin baik harga diri individu maka semakin kecil kemungkinan untuk
melakukan perilaku cyberbullying. Hal yang sama juga didapatkan pada hasil penelitian Haura
dan Ardi (2020) bahwa terdapat korelasi searah yang negatif. Dari hal ini dapat diketahui bahwa
harga diri merupakan faktor yang dapat mempengaruhi perilaku cyberbullying pada individu.
Menurut Papalia (Hidayati & Indrijati, 2019) bahwa individu yang memiliki harga diri rendah
dapat melakukan agresi dengan harapan bahwa dapat dihargai oleh lingkungannya sehingga
individu tersebut percaya dengan efektifitas agresi. Agresi yang dilakukan remaja dalam
penelitian ini yaitu cyberbullying. Cyberbullying merupakan salah satu bentuk agresi, tetapi
tidak semua agresi adalah cyberbullying (Bayraktar, Machackova, Dedkova, Cerna &
Ševčíková, 2014). Harga diri terbentuk dari hasil interaksi individu terhadap lingkungannya
sehingga perlakuan ini membentuk penilaian individu terhadap dirinya sebagai bentuk berarti
atau berharga (Alwi et al., 2020; Istiqomah, N., & Alwi, 2022).(Prakoso, 2019). Cyberbullying
dalam penelitian ini sebagai bentuk interaksi negatif antar remaja menggunakan sosial media.

KESIMPULAN
Simpulan penelitian ini adalah hasil penelitian ini menunjukkan terdapat hubungan
negatif antara harga diri dengan perilaku cyberbullying pada remaja di Kota Parepare. Remaja
yang memiliki harga diri rendah maka berpeluang menimbulkan perilaku cyberbullying.
Adapun saran yang diberi peneliti adalah sebagai berikut:
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 Bagi remaja pengguna media sosial, peneliti mengharapkan remaja sebagai penerus
bangsa dapat menggunakan sosial media dengan tepat dan baik serta digunakan untuk hal yang
positif. Kegiatan yang disaran kepada remaja untuk mengurangi penggunaan sosial media
seperti membaca buku yang dapat meningkatkan pengetahuan dan karakteristik dalam diri atau
menjadi relawan dalam membantu individu lain.
Bagi pihak sekolah, peneliti mengharapkan bagi pihak sekolah dapat memberikan
sosialisasi kepada remaja mengenai cyberbullying misalnya seperti dampak yang akan
ditimbulkan dari cyberbullying. Guru di sekolah juga diharapkan dapat memberikan perhatian
dan kepedulian kepada remaja secara baik dan benar. Guru dapat memberikan informasi seperti
bagaimana penggunaan media sosial yang baik sehingga dapat berguna sebagaimana
semestinya.
Bagi peneliti selanjutnya, peneliti selanjutnya diharapkan dapat mempertimbangkan
untuk mengukur faktor lainnya dan juga dapat melakukan penelitian dengan menggunakan
skala alat ukur yang baik dan benar sehingga dapat mengukur variabel penelitian dengan tepat.

DAFTAR PUSTAKA
Alwi, M. A., Suminar, D. R., & Nawangsari, N. A. F. (2020). Support Related to Schools and
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54
 European Journal of Psychotraumatology

ISSN: (Print) (Online) Journal homepage: https://www.tandfonline.com/loi/zept20

Psychological support for healthcare workers

during the COVID-19 pandemic: a mixed methods
study involving support providers

Kevin F. W. Dyer, Ciaran Shannon, Luke McCann, Sinead Mitchell, Keith

Kerrigan, Rebecca McClements, Ciara Kelly & Julie-Ann Jordan

To cite this article: Kevin F. W. Dyer, Ciaran Shannon, Luke McCann, Sinead Mitchell,
Keith Kerrigan, Rebecca McClements, Ciara Kelly & Julie-Ann Jordan (2022) Psychological
support for healthcare workers during the COVID-19 pandemic: a mixed methods study
involving support providers, European Journal of Psychotraumatology, 13:2, 2151282, DOI:
10.1080/20008066.2022.2151282

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EUROPEAN JOURNAL OF PSYCHOTRAUMATOLOGY
2022, VOL. 13, 2151282
https://doi.org/10.1080/20008066.2022.2151282

CLINICAL RESEARCH ARTICLE

Psychological support for healthcare workers during the COVID-19 pandemic:

a mixed methods study involving support providers
Kevin F. W. Dyera,b, Ciaran Shannona, Luke McCanna,c, Sinead Mitchella, Keith Kerrigana,
Rebecca McClementsa,c, Ciara Kellyb and Julie-Ann Jordana
a
IMPACT Research Centre, Northern Health and Social Care Trust, Antrim, Northern Ireland; bPsychological Therapies Service, Northern
Health and Social Care Trust, Antrim, Northern Ireland; cSchool of Psychology, Queen’s University Belfast, Belfast, Northern Ireland

ABSTRACT ARTICLE HISTORY

Background: Healthcare staff represent a high-risk group for mental health difficulties as a Received 13 February 2022
result of their role during the COVID-19 pandemic. A number of wellbeing initiatives have Revised 7 October 2022
been implemented to support this population, but remain largely untested in terms of their Accepted 10 October 2022
impact on both the recipients and providers of supports.
KEYWORDS
Objective: To examine the experience of staff support providers in delivering psychological COVID-19; pandemic;
initiatives to healthcare staff, as well as obtain feedback on their perceptions of the psychological supports;
effectiveness of different forms of support. healthcare staff;
Method: A mixed methods design employing a quantitative survey and qualitative focus psychological wellbeing
group methodologies. An opportunity sample of 84 psychological therapists providing
psychological supports to Northern Ireland healthcare staff participated in an online survey. PALABRAS CLAVE
Fourteen providers took part in two focus groups. COVID-19; pandemia; apoyos
psicológicos; personal
Results: The majority of providers rated a number of supports as useful (e.g. staff wellbeing
sanitario; bienestar
helplines, Hospital In-reach) and found the role motivating and satisfying. Thematic analysis psicológico
yielded five themes related to provision of support: (1) Learning as we go, applying and
altering the response; (2) The ‘call to arms’, identity and trauma in the collective response; 关键词
(3) Finding the value; (4) The experience of the new role; and (5) Moving forward. COVID-19; 疫情; 心理支持;
Conclusions: While delivering supports was generally a positive experience for providers, 医护人员; 心理健康
adaptation to the demands of this role was dependent upon important factors (e.g. clinical
experience) that need to be considered in the planning phase. Robust guidance should be HIGHLIGHTS
• Providers of wellbeing
developed that incorporates such findings to ensure effective evidence-based psychological
supports to healthcare
supports are available for healthcare staff during and after the pandemic. staff during COVID-19
viewed them as useful and
Apoyo psicológico para trabajadores de la salud durante la pandemia de the role satisfying.
• Key factors (e.g. clinical
COVID-19: un estudio de métodos mixtos que involucra a proveedores experience) should be
de apoyo considered to make the
role manageable.
Antecedentes: El personal de salud representa un grupo de alto riesgo para las dificultades de salud • Guidance should be
mental como resultado de su papel durante la pandemia de COVID-19. Se han implementado varias developed to ensure
iniciativas de bienestar para apoyar a esta población, pero permanecen ampliamente sin ser appropriate supports are
probadas en términos de su impacto tanto en los receptores como en los proveedores de apoyo. delivered.
Objetivo: Examinar la experiencia de los proveedores de apoyo al personal en la entrega de
iniciativas psicológicas al personal de atención médica, así como obtener retroalimentación
sobre sus percepciones de la efectividad de diferentes formas de apoyo.
Método: Un diseño de métodos mixtos que emplea una encuesta cuantitativa y metodologías
cualitativas de grupos focales. Una muestra de oportunidad de 84 terapeutas psicológicos
brindando apoyo psicológico al personal de atención médica de Irlanda del Norte participó en
una encuesta en línea. Catorce proveedores participaron en dos grupos focales.
Resultados: La mayoría de los proveedores calificaron una serie de apoyos como útiles (p. ej.,
líneas de ayuda para el bienestar del personal, al alcance del Hospital) y encontraron que el rol
era motivador y satisfactorio. El análisis temático arrojó cinco temas relacionados con la
provisión de apoyo: (1) Aprendiendo sobre la marcha, aplicando y alterando la respuesta; (2) El
‘llamado a las armas’, identidad y trauma en la respuesta colectiva; (3) Encontrar el valor; (4) La
experiencia del nuevo rol; y (5) Avanzando.
Conclusiones: Si bien la entrega de apoyos generalmente es una experiencia positiva para los
proveedores, la adaptación a las demandas de este rol dependió de factores importantes (p. ej.,
experiencia clínica) que deben ser considerados en la fase de planificación. Debiera desarrollarse
una guía sólida que incorpore dichos hallazgos para garantizar que haya apoyo psicológico
efectivo basado en evidencia disponible para el personal de atención médica durante y después
de la pandemia.

CONTACT Kevin F. W. Dyer kevin.dyer@northerntrust.hscni.net IMPACT Research Centre, Northern Health and Social Care Trust, Antrim, Northern
Ireland
Supplemental data for this article can be accessed online at https://doi.org/10.1080/20008066.2022.2151282.
© 2022 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group
This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (http://creativecommons.org/licenses/by-nc/4.0/), which
permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
2 F. W. DYER ET AL.
COVID-19 疫情期间对医护人员的心理支持：一项涉及支持提供者的混合方
法研究
背景：医护人员因其在 COVID-19 疫情中的角色，是心理健康困难的高危人群。已经实施了
一些身心健康扶助计划来支持这一人群，但对支持的接受者和提供者的作用大体上仍未得
到检验。
目的：考查员工支持提供者向医护人员提供心理扶助的经验，并获得他们对不同形式支持
有效性的看法反馈。
方法：采用定量调查和定性焦点小组方法的混合方法设计。一个由为北爱尔兰医护人员提
供心理支持的 84 名心理治疗师组成的机会样本参与了一项在线调查。十四个提供者参加了
两个焦点小组。
结果：大多数提供者将一些支持评为有用（例如，员工身心健康热线、手边医院），并发
现该角色给与他们动力和满足感。主题分析产生了与提供支持相关的五个主题：1）边走
边学，应用和改变反应； 2) 集体反应中的‘战斗号召’、身份和创伤； 3）寻找价值； 4）新
角色的经历； 5) 前进。
结论：虽然提供支持对提供者来说通常是一种积极的体验，适应这一角色的需求取决于规
划阶段需考虑的重要因素（例如，临床经验）。应制定纳入这些发现的稳健指南，以确保
在疫情期间和之后为医护人员提供有效的循证心理支持。
The COVID-19 pandemic has had a significant impact
on the psychological wellbeing of healthcare workers.
Recent studies estimate that staff have experienced
clinical levels of depression, anxiety, post-traumatic
stress, insomnia, and other mental health difficulties
(Jordan et al., 2021; Kang et al., 2020; Olff et al.,
2021). Potential antecedents for these issues include
a number of stressors also faced by the wider public
during the pandemic (e.g. social isolation, deprivation
of liberties, reduced access to everyday wellbeing
activities) as well as specific occupational challenges
associated with working in the health service
(McGlinchey et al., 2021). Increased exposure to
patients with COVID-19, excessive clinical and man-
agerial demands during pandemic surges, as well as
more nuanced psychological sequelae associated with
their health provider roles, most notably moral injury,
have been cited as risk factors for psychopathology in
this population (Jordan et al., 2021; Lamb et al., 2021).
While the research literature has drawn attention to
the potentially overwhelming negative mental health
consequences of COVID-19 for healthcare staff and
wider society, it should be acknowledged that some
observed effects have been more complex. An inter-
national study of mental health helpline usage
reported an increase in helpline calls pertaining to
loneliness, anxiety, and isolation during the pandemic,
but a concomitant decrease in the topics of relation-
ship issues, violence, and suicidal ideation. The
findings also suggested that the prevalence of these
more severe forms of mental health difficulties were
mitigated by adequate provision of supports (Brulhart
et al., 2021). Such a dynamic conceptualisation is
reinforced by traumatogenic models that emphasise
the buffering role of social support and cognitive
‘meaning-making’ in moderating the development of
post-traumatic stress symptoms, as well as fostering
alternative positive sequelae such as post-traumatic
growth (Cohen & Wills, 1985; O’Donnell & Greene,
2021; Tedeschi & Calhoun, 2004). In this vein, if rel-
evant protective factors and social supports are acces-
sible to individuals before, during, and after profound
negative life experiences such as the COVID-19 pan-
demic, this can offset the impact on their mental
health (Li et al., 2021; Olff et al., 2021).
In response to this theoretical rationale and the vul-
nerability to psychological distress facing healthcare
workers, a number of staff wellbeing guidance frame-
works were launched to promote positive mental health
among the workforce. The British Psychological Society
COVID-19 Staff Wellbeing Group (2020) published a
document outlining a series of stepped care strategies
for staff support (e.g. psychological first aid). Moreover,
Cole-King & Dykes (2020) provided a regularly updated
online matrix containing advice on practical self-care
strategies that could be implemented to support individ-
ual staff and teams (e.g. ‘Buddy’ systems, Staff Huddles).
In Northern Ireland, content from both these texts and
recommendations from the wider literature base were
used to develop a regional Staff Wellbeing Framework
(Department of Health, 2020) with supports that fell
under five broad categories:
Staff Wellbeing Helpline: A triage and psychological
first aid phone line available in each Northern Ireland
HSC Trust.
Drop-In Centres: A Psychological Therapist avail-
able on-site to signpost staff towards supports, self-
help materials, as well as provide psychological first
aid.
Hospital In-reach Support: A service where Psycho-
logical Therapists engage with hospital teams to
develop bespoke support plans for staff employing

relevant psychological supports (e.g. consultation;
reflective practice with teams; mindfulness sessions; etc.)
Community Out-reach Support: A service where
Psychological Therapists engage with community ser-
vices (e.g. care homes) to develop bespoke support
plans for staff employing relevant psychological sup-
ports similar to Hospital In-reach Support
General Wellbeing Initiatives: General self-help sup-
ports are made available on public health websites and
HSC Trust Intranets (e.g. relaxation sessions, wellbeing
apps, wellbeing webinars, resilience sessions).
Wellbeing supports during the COVID-19 pan-
demic have been positively-received by healthcare
staff and provided some useful findings relating to
their implementation. At the height of the pandemic,
32% of healthcare staff reported using staff wellbeing
supports and 36% of those who did not access these
interventions nevertheless felt supported knowing
these services were available (Shannon et al., 2020).
However, evidence for the clinical impact of specific
forms of support remains lacking. A review by Buselli
et al. (2021) examined the extant research base on
healthcare staff wellbeing interventions in healthcare
settings. The authors concluded that few international
studies published the content of their healthcare staff
support protocols, and, as such, it was not possible
to discern the useful elements within these support
packages. Even more concerning was the lack of
robust outcomes assessment, as it hinders the develop-
ment of future intervention guidelines and limits the
measurement of individual support effectiveness
(Buselli et al., 2021; Siddiqui et al., 2021).
A further omission in the literature base is the lim-
ited understanding of how the unique stresses and
demands of support roles impact on the wellbeing of
psychological therapist providers. Recent evidence
has shown that mental health workers represent a
further at-risk population within healthcare services,
exhibiting increased irritability and loneliness relative
to other clinical staff (Brillon et al., 2021). In addition
to providing potential support roles, mental health
staff have also had to adjust to a number of unique
modifications in practice, including a change in inter-
vention delivery models (e.g. remote therapy), while at
the same time demonstrating a well-documented ten-
dency to neglect their own needs and self-care
(Rokach & Boulazreg, 2020).
The specific risk factors, both personal and organis-
ational, that contribute to how effectively therapists
have adapted to the pressures of new roles during the
pandemic presents as an important new avenue of
investigation. Clinician characteristics such as level of
experience and post-qualification training have been
shown to contribute to capacity in managing work
demands (Kjellenberg et al., 2014; Kumar et al., 2019).
Understanding the salient variables relevant to the
experience of providing staff supports may be highly
EUROPEAN JOURNAL OF PSYCHOTRAUMATOLOGY 3
beneficial for the development of future psychological
wellbeing pandemic response guidelines.
Taking a qualitative approach, Billings et al. (2021)
completed one of the few studies in this area. The
authors conducted a reflexive thematic analysis of
interviews from 28 mental health professionals deli-
vering wellbeing initiatives, identifying six themes. A
‘stepping up’ theme outlined how mental health clin-
icians were highly motivated to contribute to the
COVID-19 response and support their front line col-
leagues. However, an ‘uncertainty, inconsistency, and
lack of knowledge’ theme stressed that clinicians felt
ill-prepared at times in terms of the formal training
required to provide the supports, and experienced
concomitant anxiety as a result. The qualitative analy-
sis did not focus on the providers perceptions of sup-
port acceptability and effectiveness; although the
authors commented that more research needs to target
these outcomes. Moreover, further exploration of
specific clinician and organisational factors was not a
focus of the study.
The present study followed on from Billings et al.
(2021) by utilising a mixed methods approach to
examine the experience of staff support providers in
delivering psychological supports to healthcare staff,
as well as the role of clinician factors relevant in
their adjustment to this role. In order to inform future
development of robust intervention frameworks, sup-
port providers also gave feedback on the effectiveness
of different forms of support, most notably perceived
usefulness and suggestions for improvement of deliv-
ery. It was hypothesised that practitioner clinical and
demographic factors would be significantly related to
their experience of delivering supports (e.g. stress
levels, ability to manage demands of the role). More-
over, it was predicted that types of wellbeing support
would differ significantly on provider ratings of per-
ceived usefulness.
1. Method
1.1. Design and participants
The cross-sectional study employed a convergent par-
allel design, wherein qualitative and quantitative data
were collected in parallel (Fetters et al., 2013). Quanti-
tative data was analysed first, with the findings used to
inform the focus of the qualitative analysis. Several
integration methods were used including connecting
and merging (Fetters et al, 2013). Specifically, the
qualitative sample was drawn from a subpopulation
of participants who were invited to participate in the
survey, and the questions of the surveys and interviews
were carefully designed to facilitate merging post
analysis. All 208 psychological therapists in Northern
Ireland providing psychological supports to health
and social care staff during the COVID-19 pandemic
4 F. W. DYER ET AL.
as part of the HSC Regional Staff Wellbeing Frame-
work were invited to take part in the Staff Support
Provider Survey. A total of 84 psychological therapists
participated in the survey (response rate = 40%).
Psychological support providers within one specific
HSC Trust, the Northern Health and Social Care Trust
(NHSCT), were also invited to take part in focus
groups. Focus groups were the chosen mode of quali-
tative data collection since providers were already
engaging in reflective practice groups in relation to
their support role. It was decided that this forum
would provide a familiar and comfortable setting for
staff to have free-flowing discussions about their
experiences. Of the 60 psychology support providers
approached, 21 staff volunteered (35%). Booking sys-
tems were established to identify suitable time slots
for the two focus groups: (1) for those who both pro-
vided and managed the psychological supports for
staff; (2) for those who provided psychological sup-
ports to staff only. In total, 14 psychological support
providers who varied in terms of years of experience,
specialisation, and gender were available to participate
in the focus groups (7 per group). No renumeration
was provided to the focus group participants as staff
were allowed to take part during normal working
hours.
1.2. Measures
1.2.1. Staff support provider survey
This survey included a range of demographic ques-
tions (e.g. gender, clinical specialism, clinician senior-
ity, clinician years’ experience). The remainder of the
questionnaire asked about experiences of providing
wellbeing supports. Respondents were asked which
of the 5 provision types they had delivered (i.e. Staff
Wellbeing Helpline; Drop-In Centres; Hospital In-
reach Support; Community Out-reach Support; Gen-
eral Wellbeing Initiatives) and to rate those supports
on the following dimensions using a five-point Likert
scale: usefulness (1 = not useful; 5 = very useful); qual-
ity of the support and guidance provided (1 = very
poor; 5 = very good).
Table 1. Joint display of mixed methods data collection.
Overarching theoretical
construct Quantitative data measurement area/analyses
Thoughts/feelings before Anxiety levels prior to undertaking their new role
providing support
Experience of providing Usefulness ratings of supports
support Quality of the support and guidance ratings
How challenging it was to manage the demands of their job role
How challenging it was to maintain a work-life balance
Stress levels during provision of supports
Confidence levels in providing supports
Level of job satisfaction
Future provision Recommendations for improvement of staff support delivery
recommendations Predictors of provider experience (i.e. gender, specialism, clinician
years’ experience, clinician seniority, and number of supports
provided)
A further section asked respondents general ques-
tions about their experiences of providing staff
psychological supports, including: (a) anxiety levels
prior to undertaking their new role (1 = not anxious;
5 = very anxious); (b) confidence levels in providing
supports (1 = not confident; 5 = very confident); (c)
stress levels during provision of supports (1 = not
stressful; 5 = very stressful); (d) how challenging it
was to manage the demands of their job role (1 = not
challenging; 5 = very challenging); (e) how challenging
it was to maintain a work-life balance (1 = not challen-
ging; 5 = very challenging); and (f) level of job satisfac-
tion (1 = not satisfied; 5 = very satisfied).
A final section provided respondents with a menu
of actions that could potentially improve delivery of
psychological supports. Participants were asked to
click on options that would have improved their
experience of providing these initiatives.
1.2.2. Semi-structured interview
This interview schedule (Appendix 1, supplemental
data) contained focus group questions pertaining to
the following: (a) types of support participants had
provided; (b) how often and for how long they had
provided support; (c) thoughts and feelings they had
about providing support before starting the role; (d)
their experience of providing supports; (e) challenges
faced in delivering staff psychological support; (f)
aspects of provision that worked well and those that
could be improved. A joint display depicting how
the theoretical constructs measured by the qualitative
and quantitative data sources is shown in Table 1.
1.3. Procedure
The Staff Support Provider survey was completed
online via the Survey Mechanics platform. All psycho-
logical therapists in Northern Ireland involved in the
provision of HSC Regional Staff Wellbeing Frame-
work supports were issued an email invite to take
part in the Staff Support Provider survey; the survey
ran from 11–24 January 2021. Focus groups were
Qualitative Data Questions
What thoughts and feelings did you have about
providing the support before starting your role?
What was the experience of providing the
supports like for you?
What challenges did you face in delivering staff
psychology support?
What aspects of the provision did you think
worked well?
Have you any suggestions for how to improve
psychological support services for staff?
 EUROPEAN JOURNAL OF PSYCHOTRAUMATOLOGY 5

conducted via zoom in December 2020 using a semi- Table 2. Demographic variables from the Psychology Support
structured interview format. Provider Survey sample.
The research was approved by the West of Scotland Descriptive
Variable Statistic
Research Ethics Service (REC reference 20/WS/0122),
Gender, n (%)
and was conducted in compliance with the Helsinki Male 18 (21.43%)
Declaration of 1975 (revised in 2013). Participants Female 66 (78.57%)
Clinical specialism, n (%)
provided informed consent after receiving a full expla- Adult Mental Health 29 (34.52%)
nation of the study and anonymisation procedures. Child and Adolescent Mental Health Services 6 (7.14%)
Health 16 (19.05%)
Intellectual Disability 5 (5.95%)
Neuropsychology 6 (7.14%)
2. Data analysis Occupational Health/Staff Wellbeing 6 (7.14%)
Other specialist services 11 (13.10%)
There were no missing values in the survey dataset as Other 5 (5.95%)
Clinician years experience, n (%)
all questions were designated ‘required’ in the survey 0–5 years 18 (21.43%)
platform. Bootstrapped bias-corrected multiple 6–10 years 12 (14.29%)
11–15 years 15 (17.86%)
regressions with simultaneous entry were used to 16 + years 39 (46.43%)
examine the relationship between five independent Clinician seniority, n (%)
Pre-qualification clinical staff (assistants, associates, 11 (13.10%)
variables (gender; clinical specialism, clinician years’ trainees)
experience; clinician seniority and amount of supports Psychological therapist/Clinical or Counselling 16 (19.05%)
provided) and the dependent variables of prior Psychologist
Specialist Clinical/Counselling Psychologist/ 23 (27.38%)
anxiety, stress levels, confidence levels, job satisfaction, Psychological Therapist
ability to manage demands of job role, and work-life Consultant Clinical Psychologist 24 (28.57%)
Other 10 (11.90%)
balance. Clinical specialism was recoded into adult Support provided, n (%)
(reference category), non-adult, and other for the pur- Staff Wellbeing Helpline 63 (75.00%)
Drop-In Centres 28 (33.33%)
poses of regression analyses. Number of supports Hospital In-reach Support 18 (21.42%)
provided was the sum of support types clinicians Community Out-reach Support 18 (21.42%)
General Wellbeing Initiatives 25 (29.76%)
had been involved in delivering (range 1-5). Both clin-
ician years’ experience and clinician seniority were
treated as continuous variables in the regressions. Par-
ticipants whose seniority was classified as ‘other’ were drop-in centres, in-reach, out-reach, and general well-
excluded from these analyses, meaning the regression being initiatives.
models were run on a sample of 74. This sample size
yielded sufficient power to detect a medium effect
size (f2 = .21) using 6 predictors with a power level 3.2. Experiences of providing each support type
of 80%, alpha = .05. Two chi-square analyses were
The majority of support providers rated helplines (79%),
conducted comparing types of wellbeing support on
Hospital In-reach (78%), Community Out-reach (83%)
their perceived ‘usefulness’ and ‘support and guidance
and general wellbeing initiatives (88%) as being useful
provided’ for their delivery. Qualitative data were ana-
or very useful (Figure 1). By contrast, fewer than half
lysed via thematic analysis in accordance with the pro-
of those involved in the drop-ins considered them to
tocol outlined by Braun and Clarke (2006). A number
be useful or very useful (43%). Good to very good ratings
of integration strategies were used during the mixed
were assigned by most respondents to the support and
methods analysis including explaining and corrobor-
guidance provided to them: drop-ins (71%); helpline
ating (Fetters, 2013). For example, in relation to the
(86%); in-reach (61%); out-reach (67%); general well-
perceived usefulness of different support types, the
being initiatives (68%; Figure 2).
qualitative and quantitative findings were compared
Due to assumption violations, the ‘usefulness’ and
to see if they supported the same conclusions, with
‘support and guidance provided’ variables were
qualitative findings being used to provide an expla-
recoded dichotomously (e.g. very useful/useful vs
nation for the usefulness ratings.

3. Results Table 3. Provider experience ratings from the Psychology

Support Provider sample.
3.1. Survey Sample characteristics Variable Mean (SD)
Number of supports provided 1.81 (1.10)
Demographic characteristics of the Staff Support Pro- Prior anxiety 2.43 (0.94)
vider survey sample and their means on specific provi- Stress levels 2.01 (0.86)
Confidence levels 3.93 (0.82)
der experiences are presented in Tables 2 and 3. Most Job satisfaction 3.89 (0.92)
respondents were involved in providing helpline sup- Ability to manage demands of job role 2.69 (1.13)
Work-life balance 2.25 (1.34)
port (75%), with fewer (21-33%) being involved in the
6 F. W. DYER ET AL.
Figure 1. Provider ratings of staff support usefulness.
not/moderately/slightly useful) to support chi-square
analyses. Type of wellbeing support differed signifi-
cantly on ratings of ‘usefulness’, χ2(4) = 19.77, p
= .001, Cramer’s v = .36, but not on ‘support and gui-
dance provided’ χ2(4) = 7.42, p = .116, Cramer’s v
= .22. Post-hoc z-tests were conducted to compare col-
umn proportions, revealing that the proportion view-
ing the drop-ins as being useful or very useful was
significantly lower compared to the other four pro-
vision types.
3.3. Factors related to experience providing
support
Table 3 provides the mean ratings given by clinicians
on their experiences of providing staff psychological
supports. In terms of Likert rating endorsements,
only a small proportion of staff reported feeling
anxious or very anxious before providing the support
(11%) or being stressed or very stressed while working
a staff support provider (5%). The majority of respon-
dents reported feeling confident or very confident
(70%) and having good or very good job satisfaction
(71%) while providing the supports. Around one
quarter, found it challenging or very challenging to
manage the demands of their job role (27%) or to
maintain a work-life balance (25%)
Bootstrapped bias-corrected multiple regressions
(n = 74) were used to examine the relationship
between the independent variables of gender, special-
ism, clinician years’ experience, clinician seniority,
Figure 2. Provider ratings of support and guidance given to
assist delivery of each staff.
and number of supports provided, and each of the
six support staff provider experience dependent vari-
ables (Table 4). No significant relationships were
found between the independent variables and prior
anxiety or ability to manage job role demands.
Those from a non-adult specialism reported signifi-
cantly higher levels of stress while providing psychol-
ogy supports compared to those from an adult
specialism, although overall the model only explained
a very small amount of variance (model adjusted R2
= 2%). Higher levels of confidence while providing
psychology supports was associated with a greater
number of years having worked as a clinician; the
overall model explained a considerable amount of
variation in confidence levels (model adjusted R2 =
34%). Those who had served as a clinician for a
greater number of years and had lower clinician
seniority reported better levels of job satisfaction
(model adjusted R2 = 14%). Finally, being from non-
adult specialism and being involved in a greater num-
ber of provision types was significantly associated
with difficulty maintaining a work-life balance
(model adjusted R2 = 27%).
3.4. Recommendations for improvement
Figure 3 contains the percentage of support providers
who endorsed specific recommendations that would
have improved their experience of delivering staff
wellbeing interventions. The recommendations most
commonly selected were (1) Improved communi-
cation regarding the overall staff wellbeing strategy
(54%); (2) Improved organisation of staff psychologi-
cal supports (49%); and (3) Increased availability of
support materials for staff users (42%).
3.5. Qualitative findings
Focus group participants responses to questions on
their experiences of providing psychological staff sup-
ports clustered around five themes, namely: (1) Learn-
ing as we go, applying and altering the response; (2)
The ‘call to arms’, identity and trauma in the collective
response; (3) Finding the value; (4) The experience of
the new role; and (5) Moving forward. Evidence sup-
porting all 5 themes emerged in both focus groups.
Theme 1: Learning as we go, applying and alter-
ing the response. Providers reflected on the evolution
of staff support roles throughout the pandemic. Par-
ticipants initially described a response of reacting
without thinking, in which they were propelled into
‘action mode’ (FG2, S3, p. 6), and felt emotionally
compromised by being unable ‘to think around it …
I was able to do … ’ (FG2, S6, p. 15). This was attrib-
uted to personal factors (e.g. internal desires to help
and be useful) and organisational factors (e.g. to be
seen to respond to the needs of staff, urgent need to

Table 4. Factors associated with experience providing psychology support to health and social care staff.
Prior anxiety Stress
B (SE) β B (SE)
Gender (male = reference)
Female −.04 (.27) −.02 −.21 (.23) −.10
Clinical specialism (adult = reference)
Non-adult −.12 (.25) −.06 .45 (.22)
Other .33 (.51) .08 .15 (.64)
Years as a clinician −.23 (.15) −.29 −.13 (.11) −.18 .42 (.08) .63*** .46 (.12) .60*** −.01 (.19) −.01 −.11 (.19) −.10
Job position seniority .08 (.14) .09 .13 (.13)
Number of provision types −.14 (.13) −.16 .01 (.09)
Note: *p < .05, **p < .01, ***p < .001.
establish psychological supports). This initial reaction
was followed by a process of learning and ‘discovering
as we were doing it’ (FG1, S1, p. 12), where it took time
to understand the most effective supports. The low
uptake of some supports originally provided, particu-
larly drop-in supports, was believed to be due to early
drives to react to the novelty of the pandemic in the
absence of reflection:
Looking back at it now there has been a beautiful
evolution here of what is helpful and what isn’t … .
We threw everything at it at the start … then we
had data to look at … the staff voted with their feet
… I think there’s been a lot of learning. (FG2, S6, p. 7)
Theme 2: The ‘call to arms’, identity and trauma
in the collective response. Participants described the
‘call to arms’ (FG1, S5, p. 5), with volunteers mobilised
to fulfil new roles at a time of uncertainty. Individuals
shared their willingness to offer support during the
crisis but considered this in the context of personal
fears, compromised safety, and heightened responsi-
bilities in the service of others. Participants reflected
on the personal battles associated with trying ‘to
help people process the pandemic while you hadn’t
quite processed it yourself’ (FG1, S1, p. 5):
… there was a real sense of urgency … when I rode
that wave I felt less vulnerable … I wonder if maybe
that was reflective of what staff were doing as well
… ? Were they riding the wave of ‘this is easier than
feeling brittle and vulnerable and exposed’ … . (FG2,
S2, p. 7)
A collective identity was portrayed with individuals
‘proud to be part of the effort’ (FG1, S6, p. 7). Yet,
guilt and shame were shared among those who per-
ceived that support had been ‘rejected’ (FG2, S5,
p. 13) along with fears that the right intervention
had not been offered. Others reaffirmed the role of
psychology in the crisis, noting the importance of pro-
viding space for staff who may need this type of
support.
Theme 3: Finding the value. Participants com-
pared the quality, quantity, and value of staff supports.
While drop-in sessions were associated with limited
staff engagement, participants stated that there was
some ‘value in those sessions’ (FG1, S4, p. 15) on the
EUROPEAN JOURNAL OF PSYCHOTRAUMATOLOGY 7
Job role
Confidence Job satisfaction demands Work-life balance
Β B (SE) β B (SE) β B (SE) β B (SE) β
.33 (.18) .18 .02 (.25) .01 .03 (.35) .01 −.13 (.36) −.04
.25* .22 (.15) .12 .02 (.23) .01 .33 (.31) .14 .95 (.29) .33**
.04 .34 (.36) .10 .71 (.40) .17 .30 (.49) .06 −.67 (.32) −.11*
.16 −.02 (.10) −.03 −.33 (.14) −.37* .13 (.22) .12 .29 (.20) .23
.01 .03 (.06) .05 .11 (.11) .13 .01 (.14) .01 .48 (.14) .39**
few occasions they were used. Nevertheless, the low
uptake was deemed to outweigh the need for this
form of intervention. Helpline services were viewed
as more helpful and adopted to a greater degree by
staff. Providers who experienced repeat helpline con-
tact with staff members described feeling reassured
that the support provided was ‘obviously something
that was helpful’ (FG1, S5, p. 11). Hospital In-reach
and Community Out-reach interventions were viewed
as the most valuable supports, and were a key con-
sideration for the tailoring of psychological support
as the pandemic progressed:
… the input for managers is really important … being
able to provide something to them to help them do
their job in containing and holding their team … I
think that would be really useful going forward.
(FG2, S3, p. 17)
Theme 4: The experience of the new role. Provi-
ders described the challenge of ‘stepping back from
what we’re trained to do’ (FG1, S2, p. 11) when deli-
vering supports. Clinicians who normally practiced
in child services, intellectual disability services, and
high intensity specialist mental health teams had to
adapt to delivering low intensity supports to an
adult population. Providers voiced concerns regard-
ing consistency of practice, with a belief that training
could have been given on Psychological First Aid to
establish ‘a shared vision for what we actually should
have been doing’ (FG1, S1, p. 17). Participants also
struggled with feelings of frustration and resentment
when supports were not used. This added to the
pressure of maintaining a dual role (e.g. both Sup-
port Provider to staff and Clinical Psychologist in
a child service) as ‘services had to keep going … ’
(FG2, S5, p. 18) and participants felt a need to com-
plete their normal job duties when supports were
not accessed. At the time of interview, a number
were no longer providing psychological support
due to the changing need for specific interventions,
and had returned to standard duties:
I was quite relieved when they wound down … it was
hard to sustain. Initially our demand-capacity balance
changed quite a lot … then that sort of wore off, the
referral rate crept up. How are we going to juggle
8 F. W. DYER ET AL.
Figure 3. Percentage of providers endorsing specific recommendations for improvement of staff support delivery.
this with everything else that I’m meant to be doing?.
(FG2, S2, p. 5)
Theme 5: Moving forward. Participants discussed
experiences following the alteration or discontinu-
ation of staff supports, reporting a range of emotions
including relief and ‘guilt at feeling the relief whenever
we didn’t have to provide it anymore’ (FG2, S5, p. 17).
Ongoing uncertainty was reflected in their comments
with some acknowledging that the pandemic had
become more severe, and moving forward required a
commitment from volunteers to remain available
should they be needed in the future:
… things are actually worse … this situation is totally
different. There’s a lot more pressure on the wards.
The hospital staff are under a lot more pressure
than they were back then … . (FG2, S4, p. 17)
This resulted in negative consequences for providers,
as they felt unable to balance the usual demands of
their professional role with additional requests for
delivering staff support. Participants acknowledged
greater self-care was required when fulfilling their pro-
vider roles going forward:
I don’t think we did well enough to look after our-
selves. I don’t think as a psychology service we
thought our own staff are going to find this really
difficult, and we just put another level of stress
upon them by asking them to [provide support].
(FG2, S1, p. 19)
4. Discussion
This study used a unique mixed method approach to
examine the views and experience of staff providers
in delivering psychological supports to healthcare
staff. As hypothesised, there were significant differences
in the perceived usefulness of the wellbeing sup-
ports. Participants reported that a number of social
support interventions developed during the first
year of the pandemic were useful, most notably
staff wellbeing helplines, Hospital In-reach, Commu-
nity Out-reach and general wellbeing initiatives.
Difficulties associated with the new role of support
provider were also identified. While overall staff
anxiety/stress was relatively low and satisfaction
levels high, a small proportion of providers found
the role challenging. The hypothesised contribution
of clinician factors to this adjustment process was
confirmed, with more experienced clinicians likely
to have higher levels of confidence and satisfaction
in the new role. Prominent factors associated with
a negative experience included lower levels of clini-
cal experience; higher clinician seniority; higher
number of supports provided; and practicing in a
non-adult specialism.
There was clear similarity between the themes
identified in the present study and those found in
the only other qualitative study to have evaluated
staff support providers’ experiences (i.e. Billings
et al. 2021). Support providers were proud to be part
of a ‘call to arms’ response aimed at helping fellow
healthcare workers maintain their wellbeing. How-
ever, even though staff were highly motivated and
quick to move into ‘action mode’ as providers, they
reported concomitant feelings of uncertainty and a
lack of preparatory training. ‘The experience of the
new role’ theme stressed the need for additional train-
ing to ensure consistency of support implementation
and highlighted the considerable challenges faced by
providers in maintaining a manageable job role bal-
ance. Quantitative fundings further reinforce this
point with 42% of providers reporting that the

increased availability of support materials would have
improved their ability to deliver interventions.
The fundamental issues of staff unpreparedness,
workload demands, and the need for appropriate
advance training in support functions have been
raised in recent studies and previous pandemic
research (Billings et al., 2021; Forbes et al., 2011;
Maunder et al., 2008). A key interpretation is that
job-planning, skills development, supervision, and
resource allocation should be prioritised when assign-
ing psychological therapists to support provider roles.
In times of crisis and reactive planning, it can be taken
for granted that staff will easily generalise clinical skills
and knowledge (e.g. assumptions of quick adaptability
of ‘non-adult’ specialisms to an adult population), but
this may, in fact, be challenging in heightened circum-
stances and require enhanced support to ensure provi-
der wellbeing and intervention effectiveness.
Support staff described substantive learning
throughout the process of providing wellbeing inter-
ventions. Converging evidence from all strands
suggests that over time staff developed an awareness
of the utility, or lack thereof, of specific social sup-
ports. Drop-In Centres were viewed to have low levels
of staff engagement and significantly less utility. Early
drives to provide this type of intuitively helpful inter-
vention were seen to represent the oft-cited, well-
intentioned need to be responsive during a pandemic
in the absence of reflection or clear evidence of effec-
tiveness (Buselli et al., 2021; Jonker, Graupner, & Ros-
souw, 2020). While it was acknowledged that the small
number of staff attending drop-ins may have benefited
from this approach, the present study re-affirms the
necessity of evaluating ongoing interventions, since
results from such studies may conflict with pre-exist-
ing anecdotal assumptions of their value.
The ‘finding the value’ theme and high usefulness
ratings for specific interventions suggest that a
mixed model of evidence-based low intensity general
supports available to all staff (e.g. helplines, wellbeing
website, self-help materials) and high intensity tai-
lored supports targeting specific teams in need (e.g.
Hospital In-Reach, Community Out-Reach) might
be a helpful, basic organisation of supports. In terms
of the latter, the ‘finding the value’ theme revealed
that, over the course of the pandemic, support provi-
ders came to the conclusion that these systemic
approaches were more useful than initially considered.
Hospital In-Reach was highly rated due to the empha-
sis on equipping line managers with the skills to sup-
port their team in a variety of meaningful bespoke
ways. It also increased accessibility and uptake in
frontline teams as support was specifically configured
via an engagement process to be delivered to staff at a
convenient time (e.g. during their shift) and place (e.g.
on a designated ward). In contrast, general supports
such as helplines had their value in being openly
EUROPEAN JOURNAL OF PSYCHOTRAUMATOLOGY 9
available to all, with the capacity to provide low inten-
sity supports to a wide range of staff. Broader organis-
ational factors, specifically improved communication
and co-ordination of supports, were highlighted as
important means to ensure this form of multifaceted
delivery, influences that have also been noted in
other empirical studies (see Maunder et al., 2008; Jor-
dan et al., 2021).
4.1. Implications
Providers highlighted the utility of a number of social
support interventions in mitigating the impact of
COVID-19 pandemic stressors on staff wellbeing,
while also stressing the need for appropriate prep-
aration, co-ordination, communication, and delivery.
The findings show there is a clear role for psychologi-
cal services to be more involved in disaster planning,
particularly the development of evidence-based
psychological wellbeing pandemic response guidelines
for the wider public and specific at-risk populations
(i.e. healthcare staff). While helpful, current pandemic
protocols were developed ad hoc and limited in both
detail and training advice. More robust guidelines
should include best practice recommendations gath-
ered from the wider evidence base, including provider
studies. For example, the current findings suggest that
staff wellbeing response preparation should take into
account professional background of the provider
(e.g. clinician experience, seniority, adult vs non-
adult specialism), wider job responsibilities, and train-
ing needs to create an individualised provider job plan
and resource package to ensure effective delivery of
evidence-based wellbeing supports (e.g. Psychological
First Aid; Shah et al., 2020).
4.2. Limitations
The present study had number of methodological
limitations, partly due to practical issues of conducting
the investigation during the COVID-19 pandemic.
The focus groups were delivered via Zoom and low
numbers were obtained; however, there was evidence
to suggest saturation had been reached as all five
themes emerged in both focus groups. The quantitat-
ive sample was also small, restricting both interpret-
ation and capacity to perform more powerful
multivariate analysis. Moreover, the investigation
examined the perspective of a relatively niche popu-
lation involved in the pandemic response (i.e. staff
providers), whereas a more comprehensive analyses
of the views of providers, recipients, managers, and
commissioners of staff wellbeing initiatives would
allow more substantive conclusions to be drawn as
to support effectiveness. The online survey was also
cross-sectional and used a force-choice format in
some items, which, although useful in gaining a
10 F. W. DYER ET AL.
comprehensive data set, has received criticism regard-
ing response bias (Dhar & Simonson, 2003). In spite of
these shortcomings, the findings still provide useful
insights into the wider understanding of staff well-
being provision during the COVID-19 pandemic
and a foundation for the development of large-scale
studies using more rigorous indices of effectiveness.
5. Conclusion
The research highlights the importance of supporting
healthcare workers and wellbeing providers in the
most effective way possible during and beyond the
COVID-19 pandemic. Providers reported several
staff wellbeing initiatives as useful and were highly
motivated to support the needs of their colleagues.
However, their adaptation to the demands of this
role was dependent upon professional and training
factors that need to be addressed in bespoke job
plans. Disaster planning guidance should be devel-
oped that incorporates these types of findings and
other psychological perspectives to ensure the rollout
of evidence-based psychological wellbeing initiatives
for the wider public and healthcare staff.
Acknowledgements
The authors would like to thanks all of the health and social
care staff who took part, and to those staff at the participat-
ing Health and Social Care Trusts who disseminated infor-
mation about the study.
Disclosure statement
No potential conflict of interest was reported by the author(s).
Funding
This research was supported by the HSC R&D Research
Fund, Northern Health and Social Care Trust under Grant
number NT20-285956-07, and the HSC Research & Devel-
opment Division, Public Health Agency under Grant num-
ber COM/5602/20.
Data availability statement
The data that support the findings of this study are available
from the corresponding author (KD), upon reasonable
request. The data are not publicly available due to privacy
and ethical restrictions.
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