1.1.8 1615 tracey sloan
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1.1.8 AWHN Conference 6 2010 Federation: A Socially Sensitive CBT-Based Model For Working at the Intersections of Gender, (Past) Interpersonal Violence and Abuse and Mental Health/Illness
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1.1.8 1615 tracey sloan
- 1. A Socially Sensitive CBT-Based Model For Working at the Intersections of Gender, (Past) Interpersonal Violence and Abuse and Mental Health/Illness Tracey Sloan, Women’s Health Statewide Zhila Javidi, Centre for Anxiety and Related Disorders
- 2. Service Reorientation > Mental health effects of violence and abuse Anxiety Depression Complex post traumatic stress disorder Eating disorders Substance misuse Self harming > Incorporation of cognitive behaviour therapy framework > Established evidence base for • Anxiety and depression • Range of other mental health conditions.
- 3. Feminism and Primary Health Care > The importance of the quality of the therapeutic relationship > A social view of mental health and illness • Contextualise development and maintenance of problems • Gender is a key health determinant (WHO 2000) • Race, education, access to technology, ability, socioeconomic status, sexuality > Violence and abuse • Gender-based nature of violence • Detrimental effects of violence and abuse on health • Experiences of violence are common for women
- 5. > Politico-social forces impact on thinking, feeling, behaviour and physiology Weakness of our framework: > Inadequate frameworks and tools for responding to psychological, physiological effects of social forces > Society doesn’t necessarily care • Slow and reluctant to change as it involves renegotiation of relationships of privilege and power > Current clients need an effective intervention right now!
- 6. Practice Framework > Establishing and maintaining a positive therapeutic relationship • Trust, physical & psychological safety • Needs to be experienced by client > Understanding the person and the problem in their social-political context • The problem is the problem, not the person > Assessment/ problem identification > Individualised intervention plan > Ongoing feedback and review
- 7. Cognitive Behavioural Core > Motivational interviewing • Establishing readiness for change > Pyschoeducation • Gender and mental health • Effects of violence and abuse on mental health • Anxiety, depression, complex PTSD • Treatment methods > Distinguishing between normal and problem anxiety > Cognitive interventions • Negative automatic thoughts, thinking biases • Core beliefs > Graded exposure therapy for anxiety-related avoidances > Behaviour activation for depression related inactivity > Mindfulness • Negative automatic thoughts, thinking biases • Maintaining overall mental health and wellbeing (Re)EstablishingSafety
- 8. Women’s Health Emphasis > Maintaining overall mental health and wellbeing and preventing relapse • Understanding the impact of gender in this • Self care > Linking individual service provision to broader therapeutic, policy and social change initiatives
- 9. Model has been developed and documented Training coming from the model ½ day training components > Values and skills in establishing an enabling therapeutic relationship > Gender and mental health > Impact of violence and abuse on mental health and the development of mental illness > Recognising and responding to disclosures of abuse when working with mental health problems > Working with complex post traumatic stress disorder and substance use > Establishing safety when using exposure therapy for traumatic memory > Worker mental health, wellbeing and self care
- 10. THANKS!
Editor's Notes
- Ask people to introduce themselves + where they are from What are they hoping to gain from presentation, learn, contribute Acknowledge people’s knowledge Permission to interrupt and ask questions or contribute A lot of information to cover
- This slide appeals to my sense of humour and captures the wisdom inherent in feminism and other social justice movements, that our mental health and mental illness is strongly tied to the realities of our lives, and that our response is not necessarily a crazy response, but possibly a sane response to a crazy, untenable situation In keeping with this, Historically, much of the counselling work undertaken at WHS has revolved around women whose well-being has been adversely affected by violence and abuse, often in childhood. Our approach has emphasised the importance of the quality of the therapeutic relationship, a social view of health and mental health and an understanding of the effects of violence and abuse on women’s mental health and wellbeing, mental health service utilisation and the client-practitioner relationship. This framework provides many skills enabling the validation of women’s experience, of course you’d be dissociating, of course you’d be anxious having being through these things, anxiety, depression and complex trauma are common effects of having been subjected to violence and abuse, and sometimes this would be enough - but in my experience we didn’t always have the specialist tools and knowledge to support women to manage the actual disabling symptoms of anxiety or depression.