Day2PanelJacquelineSparks

www.heartandsoulofchange.com June 18, 2010 Feedback & Social Justice You Say You Want a Revolution Something like this Barry ? I am sure that we all recognize that there are some things in our society, some things in our world, to which we should never be adjusted. - Martin Luther King, Jr., Invited Distinguished Address, APA, September 1967 1

www.heartandsoulofchange.com June 18, 2010 We must never adjust ourselves to racial discrimination and racial segregation. We must never adjust ourselves to religious bigotry. We must never adjust ourselves to economic conditions that take necessities from the many to give luxuries to the few. We must never adjust ourselves to the madness of militarism, and the self-defeating effects of physical violence. – Martin Luther King, Jr., APA, September 1967 Something like this Barry ? Many of us work day to day in contexts of dire oppression. We ALL hear stories of persons effected by injustice. 2

www.heartandsoulofchange.com June 18, 2010 What do we do with these stories? Do we help people become better adjusted to oppression? Do we unintentionally stifle the power of these stories to promote social change? Does “mental health” business as usual reinforce social injustice? Whether on the streets of Atlanta or behind the one-way mirror, our practice reflects the power structures of our like this Barry ? Something society. 3

www.heartandsoulofchange.com June 18, 2010 PLANET MENTAL HEALTH Something like this Barry ? POWER PSYCHO-THEORY PHARMA PROCEDURE PRACTICE POLICY Power is, by definition, embedded in “the helping relationship.” Something like this Barry ? Of all tyrannies, a tyranny sincerely exercised for the good of its victims may be the most oppressive. C.S. Lewis “There's a tremendous amount of progress in understanding bipolar disorder. It's a bad illness to have, but a good time to have it.” Kay Redfield Jamison, Ph.D. 4

www.heartandsoulofchange.com June 18, 2010 In the name of kindness and benevolence. . . Electro-shock: “Well, what is the sense of ruining my head and erasing my memory, which is my capital, and putting me out of business? It was a brilliant cure but we lost the patient….” Ernest Hemingway Psychosurgery: Gottlieb Burckhardt became the first known psychosurgeon. He removed cerebral tissue from six patients, hoping “the patient might be transformed from a disturbed to a quiet dement.” PSYCHO- PSYCHO-THEORY Something like this Barry ? It is the theory that decides what we can observe. Albert Einstein 5

www.heartandsoulofchange.com June 18, 2010 Something like this Barry ? “Mental illnesses are biologically based, meaning that chemicals or structures in the brain are not working as they are supposed to, resulting in symptoms that cannot be managed or overcome without treatment . . .” AAMFT Consumer Update To what extent does the linking Something like this Barry ? of distress to biology mask social problems that are the source of the distress – e.g., in schools, on the battlefield, or in impoverished neighborhoods? To what extent does the medicalization of human distress silence the voices of those who would seek fundamental change and rob them of critical energies to mount resistance? 6

www.heartandsoulofchange.com June 18, 2010 Diagnosis + Prescriptive Treatment = Cure or Symptom Amelioration PROCEDURE The script of psychological assessment and intervention can obscure the person, reducing him or her to a diagnosis or disorder, an array of problems and resistances that must be conquered via even more elaborate professional “treatment.” POLICY Something like this Barry ? Not just access to care, but what kind of care. Not just culturally-informed care, but care that is instigated, defined, and structured by those seeking help. 7

www.heartandsoulofchange.com June 18, 2010 Who’s Voice Counts ? • The psychiatric establishment? • The pharmaceutical industry? • Insurance companies? • Agency executives? • The consumers and clients of our services? Consumer-driven and resource-based practice are stressed as desired models of service delivery throughout mental health. Barry ? Something like this In practice, ways to operationalize these ideals are absent; standard training, procedures, and funding mechanisms (business as usual) pushes a strength and consumer focus to the margins. 8

www.heartandsoulofchange.com June 18, 2010 Unintended Consequences Without a formal way to ensure that those with whom we work have the largest say, we are in danger of replicating the abuses of the mental health system of the past and present . . . • Replacing local knowledge with expert knowledge • Reinforcing social identities and stratification based on dominant views of health and normality Barry ? Something like this • Submerging the social origins of distress and depleting the impetus for change • Engaging in practices that support a pharmaceutical industry that can cause greater harm. e.g., the well-intentioned response by “mental health” to Katrina often ignored natural support systems of community and church (Boyd- Franklin) 9

www.heartandsoulofchange.com June 18, 2010 “Thus, it may well be that our world is in dire need of a new organization, the International Association for the Advancement of Creative Maladjustment.” – Martin Luther King, Jr., Invited Distinguished Address, APA, September 1967 Allies and Inspiration Those who’s acts of courage Clients and persistence have Colleagues affirmed for me the value of my work and who have Students inspired me to do it better. They have resisted, despite the pressure to conform, shining a light on the way to transform Mental Health. 10

www.heartandsoulofchange.com June 18, 2010 Why Systematic Feedback is Revolutionary. . . . . . not simply reframing, accounting for cultural bias, being strength-focused, but rather overthrow of dominant infrastructure that fundamentally shapes the psychotherapy landscape and structures modes of interaction and intervention. Systematic incorporation of feedback. . . . . . provides a specific means to undermine the helper-helped, expert-lay, well-sick, privileged- disadvantaged hierarchy in the helping process. . . . creates true, dialogical partnerships that allow mutual growth and change. . . . privileges the experience of those with whom we work above and beyond theories and procedures, promoting socially just practice. 11

www.heartandsoulofchange.com June 18, 2010 Systematic incorporation of feedback. . . Levels the playing field and gives voice to those who might otherwise not be heard. Resistance On some positions cowardice asks the question, "Is it safe?"! Expediency asks the question, "Is it politic?" Vanity asks the question, "Is it popular?" But conscience must ask the question, "Is it right?” And there comes a time when one must take a stand that is neither safe, nor politic, nor popular. But one must take it because it is right. – Martin Luther King, Jr., Invited Distinguished Address, APA, September 1967 12

www.heartandsoulofchange.com June 18, 2010 . . .difference is not disease, nonconformity is not pathology, and uniqueness is not illness (www.gidreform.org) Mindfreedom Ghana, Mad Pride, Accra, Ghana Resistance always takes courage but acts of resistance can be both small and large. Resistance involves acting deliberately when it is easier to do nothing. The greatest threat to dominant structures of power lies in the realization of everyday persons that their actions can make a difference. 13

www.heartandsoulofchange.com June 18, 2010 There Must Be 50 Ways • Start using feedback measures • Introduce others to systematic feedback • Connect with colleague’s preferred views of selves as helpers • Be inclusive; avoid setting up correct/incorrect dichotomies • Find ways to bring client feedback into supervision, staff meetings, and policy discussions • Create forms and procedures that build in client feedback as routine Advocacy Is it enough to challenge mental health business as usual? Should mental health practitioners expand resistance to include the eradication of social injustice in those contexts repeatedly implicated in the stories of distress told by our clients? Should we work for change in social and political spheres? 14

www.heartandsoulofchange.com June 18, 2010 It is my deep conviction that justice is indivisible, that injustice anywhere is a threat to justice everywhere. Martin Luther King, Jr. 15

Day2PanelJacquelineSparks

by Barry Duncan on Jun 04, 2010

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Day2PanelJacquelineSparks — Document Transcript