This document discusses crisis intervention and the importance of connection. It argues that viewing crises solely through a medical lens can be unhelpful and lead to further confusion and social control rather than treatment. The authors propose exploring the subjective experience of those in crisis and building trust and mutual understanding. This allows crises to become opportunities for creating new meaning and respectful relationships. The authors provide an example of successfully supporting a woman experiencing distress by sharing experiences and building an ongoing relationship of empathy and support rather than assessment. Proactive crisis planning and peer support programs that challenge traditional practices can transform experiences and offer new approaches to crisis response.
This document summarizes two explanations for the bystander effect in helping behavior: diffusion of responsibility and social norms. It then describes a study that was conducted to test which model better explains the bystander effect. The study found that helping behavior increased both when a bystander was present and even more so when the bystander modeled helping behavior. This contradicts the typical finding of decreased helping with more bystanders and instead supports the social norms explanation.
The pandemic has taught us that its OK to not be OKDavidCutrano
The COVID-19 pandemic has helped reduce the stigma around mental health issues. As everyone experiences increased stress, anxiety, and feelings of not being okay due to the pandemic, people are more willing to openly discuss their mental health struggles. Experts believe this "collective trauma" makes it easier for people to understand mental health issues and feel compassion for those experiencing them. Prior to this, mental health issues were highly stigmatized due to misunderstandings and beliefs that those with issues were somehow flawed. The pandemic has shown that struggling with mental health is normal and human.
- Early stage theories of grief that proposed a predictable progression through stages like denial, anger, bargaining, depression, and acceptance have been empirically rejected. Research shows grief follows multiple trajectories rather than universal stages.
- Recent research has moved beyond a focus on emotions to consider cognitive, social, cultural and spiritual dimensions of grief. Maintaining bonds with the deceased is now seen as potentially healthy rather than requiring "letting go."
- Resilience is the most common response pattern following loss, while chronic grief and depression are less common complications that may relate to pre-existing dependency or lack of preparation for the loss. Multiple paths of adaptation exist rather than standardized stages or tasks of grieving.
Spiritual Transformation in Claimant Mediums / PA Presentation June 2016William Everist, PHD
This document discusses spiritually transformative experiences (STEs) and claimant mediums. It provides definitions of STEs, claimant mediums, and discarnate beings. The purpose and methodology of the study is to understand the initial and subsequent experiences of novice mediums and how they relate to spiritual transformation. The results found the STE of claimant mediums is a developmental process, with encounters with spiritual entities that may be considered guides. Acceptance of these experiences depended on social support systems and spiritual perspectives. Pursuing mediumship as a career depended on adjusting to initial experiences and available support.
This presentation discusses empathy research and its applications to technology. It defines empathy as having both cognitive and affective components, including perspective-taking and feeling another's emotions. Studies show empathy increases with familiarity, similarity, learning, past experience, and salience. However, online interventions to increase empathy have mixed results and may paradoxically increase bias when perspective-taking is forced. The presenter's own research found the distraction condition reduced bias most, while empathy interventions increased self-centeredness. Moving forward, the presenter advocates reducing narcissism, strengthening self-esteem, and using collaboration to expand self-interest and create a sense of common humanity when designing empathy interventions online.
The document discusses the history and development of hospice care. It originated from the work of Cicely Saunders in 1948 who sought to relieve the anxiety of dying patients. Today, hospice organizations provide palliative care to ensure patients can die with dignity. The document also examines the stages of death proposed by Kubler-Ross and how families experience similar stages of grief. It notes sitting with a dying loved one can be agonizing as their ability to communicate is lost. The grieving process has no timeline and is impacted by one's relationship with the deceased and mode of their death.
The document discusses the bystander effect, which is the tendency for individuals to not help or intervene in an emergency situation when other people are present. It describes how the likelihood of help decreases as the number of bystanders increases. However, the effect may be reduced in dangerous emergencies when help is urgently needed. The document also explores factors that influence whether bystanders help, such as their relationship to the victim, awareness programs, and characteristics of the situation. It highlights examples of people who did intervene like Dominik Brunner and programs aimed at reducing the bystander effect.
This document summarizes two explanations for the bystander effect in helping behavior: diffusion of responsibility and social norms. It then describes a study that was conducted to test which model better explains the bystander effect. The study found that helping behavior increased both when a bystander was present and even more so when the bystander modeled helping behavior. This contradicts the typical finding of decreased helping with more bystanders and instead supports the social norms explanation.
The pandemic has taught us that its OK to not be OKDavidCutrano
The COVID-19 pandemic has helped reduce the stigma around mental health issues. As everyone experiences increased stress, anxiety, and feelings of not being okay due to the pandemic, people are more willing to openly discuss their mental health struggles. Experts believe this "collective trauma" makes it easier for people to understand mental health issues and feel compassion for those experiencing them. Prior to this, mental health issues were highly stigmatized due to misunderstandings and beliefs that those with issues were somehow flawed. The pandemic has shown that struggling with mental health is normal and human.
- Early stage theories of grief that proposed a predictable progression through stages like denial, anger, bargaining, depression, and acceptance have been empirically rejected. Research shows grief follows multiple trajectories rather than universal stages.
- Recent research has moved beyond a focus on emotions to consider cognitive, social, cultural and spiritual dimensions of grief. Maintaining bonds with the deceased is now seen as potentially healthy rather than requiring "letting go."
- Resilience is the most common response pattern following loss, while chronic grief and depression are less common complications that may relate to pre-existing dependency or lack of preparation for the loss. Multiple paths of adaptation exist rather than standardized stages or tasks of grieving.
Spiritual Transformation in Claimant Mediums / PA Presentation June 2016William Everist, PHD
This document discusses spiritually transformative experiences (STEs) and claimant mediums. It provides definitions of STEs, claimant mediums, and discarnate beings. The purpose and methodology of the study is to understand the initial and subsequent experiences of novice mediums and how they relate to spiritual transformation. The results found the STE of claimant mediums is a developmental process, with encounters with spiritual entities that may be considered guides. Acceptance of these experiences depended on social support systems and spiritual perspectives. Pursuing mediumship as a career depended on adjusting to initial experiences and available support.
This presentation discusses empathy research and its applications to technology. It defines empathy as having both cognitive and affective components, including perspective-taking and feeling another's emotions. Studies show empathy increases with familiarity, similarity, learning, past experience, and salience. However, online interventions to increase empathy have mixed results and may paradoxically increase bias when perspective-taking is forced. The presenter's own research found the distraction condition reduced bias most, while empathy interventions increased self-centeredness. Moving forward, the presenter advocates reducing narcissism, strengthening self-esteem, and using collaboration to expand self-interest and create a sense of common humanity when designing empathy interventions online.
The document discusses the history and development of hospice care. It originated from the work of Cicely Saunders in 1948 who sought to relieve the anxiety of dying patients. Today, hospice organizations provide palliative care to ensure patients can die with dignity. The document also examines the stages of death proposed by Kubler-Ross and how families experience similar stages of grief. It notes sitting with a dying loved one can be agonizing as their ability to communicate is lost. The grieving process has no timeline and is impacted by one's relationship with the deceased and mode of their death.
The document discusses the bystander effect, which is the tendency for individuals to not help or intervene in an emergency situation when other people are present. It describes how the likelihood of help decreases as the number of bystanders increases. However, the effect may be reduced in dangerous emergencies when help is urgently needed. The document also explores factors that influence whether bystanders help, such as their relationship to the victim, awareness programs, and characteristics of the situation. It highlights examples of people who did intervene like Dominik Brunner and programs aimed at reducing the bystander effect.
This document summarizes a qualitative study that interviewed 14 physicians about their experiences discussing end-of-life care with patients. The study used interpretive phenomenology to identify themes in the physicians' narratives. Key themes included rupture/interruption of normal practices, connection with patients, openness/vulnerability, presence with the patient, understanding as situated within a particular context, and what really matters to patients. The study found that recognizing personhood over medicalization and being open to patients' lived experiences can help physicians provide better end-of-life care.
This document discusses moving the NSW homelessness sector towards trauma-informed care. It notes that homeless populations experience high rates of trauma, especially women. Trauma-informed care focuses on safety, control, strengths and compassionate engagement through listening. Training teaches the impacts of trauma, complex trauma, and uses a neuroscience lens. It emphasizes relationship-building, predictability, stability and right-brain interactions over explicit trauma memory work. The goal is cultural change to better support consumers in a trauma-informed manner.
Chapter from the book, Duped by Kottler and Carlson. Clients who taught Barry the value of believing clients and even the therapeutic impact of a big fat lie.
This document is a psychology paper about the bystander effect written by Gustavo Duarte Viana from Kursk State Medical University in 2012. It discusses the classic example of bystander effect in the murder of Kitty Genovese, where 38 witnesses failed to help or call police. It also analyzes notorious cases like the murders of Shanda Sharer, Ilan Halimi, and Yue Yue where victims died while bystanders did nothing. The paper explores factors that can lead to the bystander effect and compares the three murder cases to show how responsibility was diffused among witnesses.
The word “trauma” originated in the late 17th century from the Greek language. The literal translation is to “wound or damage.” The Greek word was specific to physical injury and has been used in medical terminology since.
1) The document discusses solution-focused approaches to working with bereaved children and young people who may be experiencing distress or engaging in risky behaviors like self-harm following the death of a loved one.
2) It provides statistics on child bereavement and outlines some key considerations for taking a solution-focused approach, such as validating the child's experience of grief, focusing on possibilities and exceptions, and empowering children by giving them choice and control.
3) Solution-focused approaches aim to help children find ways to accommodate grief into their lives while making space for new experiences and possibilities for the future, rather than focusing only on diminishing grief over time.
An overview of the theories and practice principles relating to loss and bereavement. Content has kindly been provided by Barbara Beard, senior lecturer at Sheffield Hallam University, specialising in supportive and palliative care.
Providing Care
Following Sudden Death:
The Practice of Viewing
ABSTRACT
En règle générale, à la suite d’une mort subite, il faut décider s’il devrait y avoir une exposition en maison funéraire ou non. De nombreuses contradictions existent dans les lignes directrices de la pratique et il y a un manque manifeste de données
probantes à l’appui de l’exposition et de son incidence sur le processus du deuil dans son ensemble. En outre, il faut examiner les rôles et les attitudes des professionnels les plus immédiatement impliqués à la suite d’une mort subite, car, d’ordinaire, il n’y a pas d’exposition sans l’implication de professionnels. Les travailleurs sociaux sont souvent
les premiers professionnels appelés à répondre aux besoins de personnes vivant un deuil subit; ils peuvent jouer un rôle clé de représentation relativement aux besoins de ces personnes et les aider à composer avec leur peine. Cette étude qualitative s’est penchée sur les perspectives et l’expérience de personnes subitement endeuillées, concernant l’exposition en maison funéraire. Les résultats de cette étude sont regroupés sous trois
thèmes : les éléments particuliers afférents à l’exposition, les réactions psychiques des personnes touchées et les interactions professionnelles. On s’intéresse principalement ici aux interactions professionnelles.
I watched and I was ignored by everyone. I was ignored. The ambulance workers did their job. The police walked in and out. The fireman walked in and out. They looked at me. No one sat with me. No one acknowledged me, with the exception of one ambulance worker who came up to me and said, “We’re doing everything we can.” He was the only person that acknowledged me at all, and that pisses me off now (Louise1, bereaved spouse).
The bystander effect occurs when the presence of others inhibits an individual from helping someone in need. The greater the number of bystanders, the less likely it is that any one of them will help. According to the document, as more people witness an emergency, each individual is less likely to take responsibility and intervene. Examples are given of incidents where many people failed to help victims in distress, including the murder of Catherine Genovese and the death of a toddler run over by vans in China.
This document discusses domestic violence perpetrators and the challenges in treating them. It notes that perpetrators are a diverse population with varied disorders, backgrounds, and potential for change. Successful treatment requires skillful collaboration across disciplines and a change in approach by human services professionals. Specifically, professionals must evaluate their attitudes, avoid confrontation, and focus on building rapport, empathy, self-worth and strengths in clients to improve motivation and outcomes. Treating this population is complex but respecting perpetrators as human beings seeking change is important to making a positive difference.
This document provides an overview of a presentation on victims of trauma and substance abuse. It discusses victimology and the psychological impact of trauma, including the impact, recoil, and reorganization stages victims may experience. It describes how trauma can lead to maladaptive coping behaviors like substance abuse. The document then addresses sex trafficking and the trauma it inflicts, noting that it is the second largest criminal industry and involves torture. Victims are often emotionally and financially dependent on traffickers in a cycle of coercion and abuse.
The document summarizes a study that explored family members' perspectives on viewing or not viewing the body of a loved one after a sudden death. Sixteen family members who experienced the sudden death of an immediate family member between 1-65 years old were interviewed. Results were clustered into three themes: viewing specifics, intrapersonal responses, and professional interactions. The literature review discusses guidelines around viewing but notes a lack of research directly studying viewing and its effects on the bereavement process.
This document summarizes Gareth Jones' master's research on exploring and integrating one's own pain for self-care and more authentic therapeutic relationships.
The research involved rediscovering Gareth's own past through a heuristic methodology. This led to personal insights and understanding of his own journey of growth. It also benefited his self-awareness and well-being. Gareth interviewed two co-researchers who had experienced loss to understand how they found meaning and growth.
Common factors that emerged included experiencing existential isolation and crisis that led to surrender, epiphanies, and growth. All three recognized the fluid nature of authenticity and engaged in self-monitoring. Rediscovering one's past through heuristic research can provide "personal treasures
Article 2 Direct And Indirect Intergroup Friendship(Real I Hope)socialprejudice2008
The article examines how direct and indirect intergroup friendships can moderate prejudice based on whether prejudice has predominantly affective or cognitive bases. Three studies found that:
1) Direct friendships more strongly reduced prejudice towards groups eliciting affective responses, while indirect friendships more strongly reduced prejudice towards cognitively-based groups.
2) Direct friendships reduced prejudice more for individuals with affective prejudice bases; indirect friendships reduced prejudice more for those with cognitive bases.
3) A third study of Catholics and Protestants replicated these moderation effects on measures of trust and action tendencies, providing further support. Intimate contact through both direct and indirect friendships can benefit intergroup relations.
1) Palliative care aims to improve quality of life for patients facing life-threatening illness through pain relief and prevention of suffering. It addresses physical, psychosocial, and spiritual problems.
2) High-quality palliative care is competent, compassionate, and well-coordinated across different care settings and disease stages. It treats the whole person.
3) Effective pain management for cancer patients requires a holistic, interdisciplinary approach that treats both physical pain and psychosocial suffering using pharmacological and nonpharmacological methods. The goal is to relieve suffering and improve quality of life.
This document discusses social cognition in individuals with bipolar disorder. It begins by defining social cognition and outlining its key dimensions. It then reviews studies comparing social cognition abilities in individuals with bipolar disorder versus healthy controls. The studies show impairments in areas like theory of mind, emotion processing, and attributional biases. Differences are also seen between bipolar type I and II. While some social cognition abilities are preserved, deficits tend to be more pronounced than in individuals with schizophrenia. Overall, the document analyzes research on social cognition challenges in bipolar disorder.
This document outlines Tracee Pockett's personal philosophy of nursing. It discusses how a nursing philosophy guides a nurse's practice and interactions with patients. Pockett believes nursing requires both clinical skills and understanding patients' experiences. She discusses the importance of being fully present with patients, embracing change to improve care, and facing life and death realities in nursing. Jean Watson's caring theory also influences Pockett's view that nurses and patients influence each other through caring relationships.
This document summarizes key points about interpersonal relationships from a presentation. It discusses how relationships can form between family, friends, coworkers and in other social settings. It also outlines several relationship theories and factors like communication patterns, passion, intimacy and commitment that influence relationships. The document stresses that good relationships are built on understanding another's needs and communicating effectively throughout the stages of a relationship.
Casra supervisor peer provider core competency training flyer, finalSunrays of Hope, Inc
This document provides information about a supervisor track training program for peer provider core competencies. The program includes in-person trainings on August 13th, 2015 and February 11th, 2015 at the Red Lion Hotel Eureka in California as well as teleconference calls on October 22nd, 2015, December 17th, 2015, April 28th, 2015 and June 23rd, 2015. Participants must make their own hotel reservations by August 1st. The program aims to provide information, support and consultation to supervisors of peer providers through face-to-face meetings and teleconferences.
SB 614 is a bill authored by California Senator Mark Leno that would establish a certification program for peer and family support specialists working in behavioral health. It would require the Department of Health Care Services to collaborate with stakeholders to implement the certification program and allow it to seek any necessary waivers or amendments to do so. If passed, the Office of Statewide Health Planning and Development would oversee the certification procedures. The bill aims to standardize and improve the qualifications of peer support workers in California's behavioral health system.
This document summarizes a qualitative study that interviewed 14 physicians about their experiences discussing end-of-life care with patients. The study used interpretive phenomenology to identify themes in the physicians' narratives. Key themes included rupture/interruption of normal practices, connection with patients, openness/vulnerability, presence with the patient, understanding as situated within a particular context, and what really matters to patients. The study found that recognizing personhood over medicalization and being open to patients' lived experiences can help physicians provide better end-of-life care.
This document discusses moving the NSW homelessness sector towards trauma-informed care. It notes that homeless populations experience high rates of trauma, especially women. Trauma-informed care focuses on safety, control, strengths and compassionate engagement through listening. Training teaches the impacts of trauma, complex trauma, and uses a neuroscience lens. It emphasizes relationship-building, predictability, stability and right-brain interactions over explicit trauma memory work. The goal is cultural change to better support consumers in a trauma-informed manner.
Chapter from the book, Duped by Kottler and Carlson. Clients who taught Barry the value of believing clients and even the therapeutic impact of a big fat lie.
This document is a psychology paper about the bystander effect written by Gustavo Duarte Viana from Kursk State Medical University in 2012. It discusses the classic example of bystander effect in the murder of Kitty Genovese, where 38 witnesses failed to help or call police. It also analyzes notorious cases like the murders of Shanda Sharer, Ilan Halimi, and Yue Yue where victims died while bystanders did nothing. The paper explores factors that can lead to the bystander effect and compares the three murder cases to show how responsibility was diffused among witnesses.
The word “trauma” originated in the late 17th century from the Greek language. The literal translation is to “wound or damage.” The Greek word was specific to physical injury and has been used in medical terminology since.
1) The document discusses solution-focused approaches to working with bereaved children and young people who may be experiencing distress or engaging in risky behaviors like self-harm following the death of a loved one.
2) It provides statistics on child bereavement and outlines some key considerations for taking a solution-focused approach, such as validating the child's experience of grief, focusing on possibilities and exceptions, and empowering children by giving them choice and control.
3) Solution-focused approaches aim to help children find ways to accommodate grief into their lives while making space for new experiences and possibilities for the future, rather than focusing only on diminishing grief over time.
An overview of the theories and practice principles relating to loss and bereavement. Content has kindly been provided by Barbara Beard, senior lecturer at Sheffield Hallam University, specialising in supportive and palliative care.
Providing Care
Following Sudden Death:
The Practice of Viewing
ABSTRACT
En règle générale, à la suite d’une mort subite, il faut décider s’il devrait y avoir une exposition en maison funéraire ou non. De nombreuses contradictions existent dans les lignes directrices de la pratique et il y a un manque manifeste de données
probantes à l’appui de l’exposition et de son incidence sur le processus du deuil dans son ensemble. En outre, il faut examiner les rôles et les attitudes des professionnels les plus immédiatement impliqués à la suite d’une mort subite, car, d’ordinaire, il n’y a pas d’exposition sans l’implication de professionnels. Les travailleurs sociaux sont souvent
les premiers professionnels appelés à répondre aux besoins de personnes vivant un deuil subit; ils peuvent jouer un rôle clé de représentation relativement aux besoins de ces personnes et les aider à composer avec leur peine. Cette étude qualitative s’est penchée sur les perspectives et l’expérience de personnes subitement endeuillées, concernant l’exposition en maison funéraire. Les résultats de cette étude sont regroupés sous trois
thèmes : les éléments particuliers afférents à l’exposition, les réactions psychiques des personnes touchées et les interactions professionnelles. On s’intéresse principalement ici aux interactions professionnelles.
I watched and I was ignored by everyone. I was ignored. The ambulance workers did their job. The police walked in and out. The fireman walked in and out. They looked at me. No one sat with me. No one acknowledged me, with the exception of one ambulance worker who came up to me and said, “We’re doing everything we can.” He was the only person that acknowledged me at all, and that pisses me off now (Louise1, bereaved spouse).
The bystander effect occurs when the presence of others inhibits an individual from helping someone in need. The greater the number of bystanders, the less likely it is that any one of them will help. According to the document, as more people witness an emergency, each individual is less likely to take responsibility and intervene. Examples are given of incidents where many people failed to help victims in distress, including the murder of Catherine Genovese and the death of a toddler run over by vans in China.
This document discusses domestic violence perpetrators and the challenges in treating them. It notes that perpetrators are a diverse population with varied disorders, backgrounds, and potential for change. Successful treatment requires skillful collaboration across disciplines and a change in approach by human services professionals. Specifically, professionals must evaluate their attitudes, avoid confrontation, and focus on building rapport, empathy, self-worth and strengths in clients to improve motivation and outcomes. Treating this population is complex but respecting perpetrators as human beings seeking change is important to making a positive difference.
This document provides an overview of a presentation on victims of trauma and substance abuse. It discusses victimology and the psychological impact of trauma, including the impact, recoil, and reorganization stages victims may experience. It describes how trauma can lead to maladaptive coping behaviors like substance abuse. The document then addresses sex trafficking and the trauma it inflicts, noting that it is the second largest criminal industry and involves torture. Victims are often emotionally and financially dependent on traffickers in a cycle of coercion and abuse.
The document summarizes a study that explored family members' perspectives on viewing or not viewing the body of a loved one after a sudden death. Sixteen family members who experienced the sudden death of an immediate family member between 1-65 years old were interviewed. Results were clustered into three themes: viewing specifics, intrapersonal responses, and professional interactions. The literature review discusses guidelines around viewing but notes a lack of research directly studying viewing and its effects on the bereavement process.
This document summarizes Gareth Jones' master's research on exploring and integrating one's own pain for self-care and more authentic therapeutic relationships.
The research involved rediscovering Gareth's own past through a heuristic methodology. This led to personal insights and understanding of his own journey of growth. It also benefited his self-awareness and well-being. Gareth interviewed two co-researchers who had experienced loss to understand how they found meaning and growth.
Common factors that emerged included experiencing existential isolation and crisis that led to surrender, epiphanies, and growth. All three recognized the fluid nature of authenticity and engaged in self-monitoring. Rediscovering one's past through heuristic research can provide "personal treasures
Article 2 Direct And Indirect Intergroup Friendship(Real I Hope)socialprejudice2008
The article examines how direct and indirect intergroup friendships can moderate prejudice based on whether prejudice has predominantly affective or cognitive bases. Three studies found that:
1) Direct friendships more strongly reduced prejudice towards groups eliciting affective responses, while indirect friendships more strongly reduced prejudice towards cognitively-based groups.
2) Direct friendships reduced prejudice more for individuals with affective prejudice bases; indirect friendships reduced prejudice more for those with cognitive bases.
3) A third study of Catholics and Protestants replicated these moderation effects on measures of trust and action tendencies, providing further support. Intimate contact through both direct and indirect friendships can benefit intergroup relations.
1) Palliative care aims to improve quality of life for patients facing life-threatening illness through pain relief and prevention of suffering. It addresses physical, psychosocial, and spiritual problems.
2) High-quality palliative care is competent, compassionate, and well-coordinated across different care settings and disease stages. It treats the whole person.
3) Effective pain management for cancer patients requires a holistic, interdisciplinary approach that treats both physical pain and psychosocial suffering using pharmacological and nonpharmacological methods. The goal is to relieve suffering and improve quality of life.
This document discusses social cognition in individuals with bipolar disorder. It begins by defining social cognition and outlining its key dimensions. It then reviews studies comparing social cognition abilities in individuals with bipolar disorder versus healthy controls. The studies show impairments in areas like theory of mind, emotion processing, and attributional biases. Differences are also seen between bipolar type I and II. While some social cognition abilities are preserved, deficits tend to be more pronounced than in individuals with schizophrenia. Overall, the document analyzes research on social cognition challenges in bipolar disorder.
This document outlines Tracee Pockett's personal philosophy of nursing. It discusses how a nursing philosophy guides a nurse's practice and interactions with patients. Pockett believes nursing requires both clinical skills and understanding patients' experiences. She discusses the importance of being fully present with patients, embracing change to improve care, and facing life and death realities in nursing. Jean Watson's caring theory also influences Pockett's view that nurses and patients influence each other through caring relationships.
This document summarizes key points about interpersonal relationships from a presentation. It discusses how relationships can form between family, friends, coworkers and in other social settings. It also outlines several relationship theories and factors like communication patterns, passion, intimacy and commitment that influence relationships. The document stresses that good relationships are built on understanding another's needs and communicating effectively throughout the stages of a relationship.
Casra supervisor peer provider core competency training flyer, finalSunrays of Hope, Inc
This document provides information about a supervisor track training program for peer provider core competencies. The program includes in-person trainings on August 13th, 2015 and February 11th, 2015 at the Red Lion Hotel Eureka in California as well as teleconference calls on October 22nd, 2015, December 17th, 2015, April 28th, 2015 and June 23rd, 2015. Participants must make their own hotel reservations by August 1st. The program aims to provide information, support and consultation to supervisors of peer providers through face-to-face meetings and teleconferences.
SB 614 is a bill authored by California Senator Mark Leno that would establish a certification program for peer and family support specialists working in behavioral health. It would require the Department of Health Care Services to collaborate with stakeholders to implement the certification program and allow it to seek any necessary waivers or amendments to do so. If passed, the Office of Statewide Health Planning and Development would oversee the certification procedures. The bill aims to standardize and improve the qualifications of peer support workers in California's behavioral health system.
Communication is dynamic and evolves over time based on context rather than being static; how and what we communicate changes as contexts change and communication always occurs within a specific context relative to the situation rather than against any external standard.
The document provides information and guidance for organizing and operating a local affiliate of NAMI, including governance structures like boards of directors and committees, basic operational procedures, and program opportunities in areas like support, education, and advocacy. It addresses legal matters, communications, funding, and involvement with the state and national NAMI organizations. The intended audience is those interested in creating or improving a local NAMI affiliate.
This document is a peer employment training application that requests information from applicants. It provides instructions for submitting the application via email, fax, or mail. It requests contact information, languages spoken, demographic information, and requires the applicant's signature agreeing to program requirements and commitment. The application consists of 6 parts that ask for information about the applicant's work/volunteer experience, job interests, strengths, needs, potential challenges and ways to address them to meet attendance and assignment requirements. The goal is to evaluate applicants' suitability for the peer employment training program to become peer support specialists.
Este documento resume las mujeres importantes que aparecen en los primeros capítulos del Éxodo y su papel en la identidad del pueblo de Israel. Incluye las parteras egipcias que salvan a los niños hebreos, la madre y hermana de Moisés que lo salvan de morir, la princesa egipcia que adopta a Moisés y las hijas de Reuel con las que Moisés se casa más tarde. Todas estas mujeres desempeñan un papel fundamental en los orígenes del pueblo de Israel y su liberación de Egipto
This document discusses how volunteering can help advance your career. It defines volunteering as helping out or offering assistance, which builds trust when commitments are fulfilled. Volunteering provides opportunities through charitable organizations, professional societies, schools, and more. Skills developed through volunteering include leadership, project management, and marketing. Benefits include expanding one's network, gaining recognition, developing career-advancing skills and experience, and personal satisfaction. The document provides steps for getting started like identifying activities, committing time and effort, and simply taking action.
Heidi Ambler - Drive Business with IBM Connections Content ManagerLetsConnect
The document discusses how IBM Connections can help drive business value through social collaboration. It notes that employees currently spend many hours searching for information rather than reusing existing knowledge. IBM Connections provides a single integrated platform that brings together social, mobile, cloud and people capabilities. When used across six key areas like knowledge sharing and customer insights, social business patterns can deliver proven benefits like increased revenue, new business and reduced time to market. The presentation encourages organizations to start with social capabilities now for long term business impact.
2014 Continuous Improvement Forum SlidesArturo Pelayo
September 2014, JumpShift invited me to speak at the 2014 Continuous Improvement Forum in Auckland . I shared my insights on designing corporate training of Continuous Improvement Tools.
The presentation that I gave has a simple-yet-powerful approach to the development of training around Continuous Improvement Tools -and any type of training for that matter.
How to hug educational design and make meaningful learning experiences.Arturo Pelayo
The document discusses the benefits of exercise for mental health. Regular physical activity can help reduce anxiety and depression and improve mood and cognitive functioning. Exercise causes chemical changes in the brain that may help protect against mental illness and improve symptoms.
Production capacity – planning and controlSonali Garwal
The document discusses production capacity planning and control. It describes capacity planning as determining long-term capacity needs and how to satisfy them. It also discusses determining plant capacity, strategies for capacity planning including strategic, tactical, and operational decisions, and the phases of planning and control which include planning, action, and control.
El documento describe el aprendizaje autónomo, que implica que el estudiante asume la responsabilidad de planificar sus objetivos, procedimientos y evaluación a su propio ritmo. También requiere que el estudiante aporte conocimientos y experiencias previas para lograr un aprendizaje significativo. El aprendizaje autónomo necesita del apoyo de tutores y una infraestructura tecnológica adecuada. El estudiante autónomo desarrolla capacidades como la iniciativa, el análisis de información y la resolución
Este documento resume los principales artículos de la Ley de Comercio Electrónico, Firmas Electrónicas y Mensajes de Datos. Reconoce la validez jurídica de los mensajes de datos y establece disposiciones sobre propiedad intelectual, confidencialidad, conservación de información escrita y mensajes de datos, protección de datos personales, procedencia e identidad de los mensajes, envío y recepción, y duplicación de mensajes.
The Future of Aboriginal Relations: Engaging Saskatchewan’s Fastest Growing P...fuzeconf
Engaging the First Nations and Métis population isn’t just good for business – it’s the right thing to do for the future of Saskatchewan. A lawyer and member of Kawacatoose First Nation, Leanne Bellegarde is dedicated to overcoming decades of misunderstanding and works daily building new relationships with our province’s youngest and fastest growing population. In this talk, Leanne will discuss PotashCorp’s highly successful Aboriginal engagement and community investment initiatives.
Narrative Therapy by Michael White & David EpstonPrateek Sharma
Narrative therapy belongs to the postmodern approaches to therapeutic interventions. Drawing from the seminal work of David Epston and Michael White, I bring out an introductory outline of narrative approaches and their application in clinical psychology.
Upon meeting someone new, people seek to reduce uncertainty about the other person through communication. Common strategies include asking questions to learn about their background, finding out information indirectly from others, or passive observation. Reducing uncertainty allows people to better predict another's behavior and feel more comfortable in the interaction.
Colleague 1identify and describe the diverse population and th.docxrichardnorman90310
Colleague 1
identify and describe the diverse population and the unique characteristics and/or the distinctive needs of the population in 3–4 brief sentences.
The agency that I did my field experience with I was able to work with a very diverse population. The population included both children and adults and many ethnicities. In this case the individual that I worked with was a 17-year-old African American female who had lost three very close relatives in a short period of time.
Explain how you would use the life model to help the client understand and describe their challenges.
I would use the life model to help the client understand and describe her challenges by improving her ability to manage stressor(s) through more effective personal and situational appraisals and behavioral skills (Turner, 2017). This will allow my client to manage and cope with the stress that she has in her life.
Explain how the problem-solving model can help the client address their challenges.
Using the problem-solving model, I can help my client address her challenges by making her aware of her surroundings and those who are there to help her. A person’s social environment is beneficial and has a great significance on human behavior (Turner, 2017).
How is the client using defense mechanisms, and how is that impeding the ability to problem solve and move forward in the life model?
In this case the client had quite a few defense mechanisms. First, she was shutting out the people who were the closest to her, her family and friends. She had stopped talking to her primary friend group and was closing herself up in her room and not communicating with anyone in her family. When she communicated with her family it was angry. She was acting as though she wanted nothing to do with them. She had also stopped eating and doing any of her normal activities. With her shutting everyone out it has impeded on the ability to problem solve and move forward in the life model. If she is unwilling to work with and talk to the people in her social circle it is going to be hard to get her to recognize that those in her environment are there to help her.
Identify where the gaps are in applying the life model for this population.
In order for the life model to work the client must be open and willing to participate. One of the gaps when dealing with a young population is that they may not want to get the help they need because they may feel as though it is unnecessary and that they don’t need. Another gap is that the parents may not consent to some of the help that is being offered to the child.
When looking at the gaps, explain which theory might be helpful in filling the gaps of the life model when working with this population.
The theory that I would use to fill the gaps in the life model when working with this population is cognitive behavioral theory. The cognitive behavioral theory would be helpful because it focuses on the relationship between thoughts, feelings.
Severe Mental Illness (Topor Etal2006)[2]guest499423
This article examines the role of social relationships in the recovery process for individuals with severe mental illness based on qualitative interviews. Three key findings are discussed:
1) Social relationships play a central role in recovery. All interviewees described being involved in relationships and their importance to managing their illness.
2) Beneficial relationships are not dependent on a helper's formal training, as professionals, family, and friends all contributed.
3) Beneficial relationships have certain common characteristics, including "standing alongside the person," "being there" for practical support, and helping "move on with recovery." Family and friends in particular provided continuity, advocacy, and assistance with daily living challenges.
6 responses neededeach set of 2 has its own set of instructions.docxpriestmanmable
This document discusses several posts by peers on the topics of culture, communication theories, and confidentiality as they relate to human services.
Monica's post defines culture and explains how factors like individualism/collectivism and power distance influence communication between cultures. Tameka also defines culture and discusses how it is passed down. Alicia analyzes how constructivism and communication accommodation theory can be applied in human services. Tammy discusses the importance of confidentiality, privacy, and privileged communication for human services workers, as well as the differences between duty to warn and duty to protect. Korie further explains these concepts of confidentiality, privacy, and privileged communication.
Chapter 12the weak and the orphaned are deprived of justic.docxcravennichole326
Chapter 12
the weak and the orphaned are deprived of justice all the foundations of the earth are shaken. Ps. 82.3–5 Leininger (1988) maintains that caring is the essence of humanity and is essential for human growth and survival. She contends that care is one of the most powerful and elusive aspects of our health and identity and must be the central focus of nursing and the helping and healing professions. Similarly, Roach (1987) claims that care is the basic constitutive phenomenon of human existence and thus ontological in that it constitutes man as man. She points out that all existentials used to describe Dasein’s self have their central locus in care. Roach states, “When we do not care, we lose our being and care is the way back to being. Care is primordial, the source of action and is not reducible to specific actions” (1987, p. 15). Although Roach (1984) claims that caring is the human mode of being, she wonders how convincing the view is that caring is the natural expression of what is authentically human when there is so much evidence of lack of caring, both within our personal experiences as well as in the society around us. Roach points out that we live in an age where violence is commonplace and where atrocities are committed against individuals and communities everywhere. To compound the effect of such violence on the broader social body, many incidents enter our living rooms through the press, radio, and television often as quickly as they occur. As a result, modes of being with another in our world involve both caring and uncaring dimensions. What, then, are the basic modes of being with another? By analyzing two of my own studies on clients’ (patients’ and students’) perceptions of caring and uncaring encounters (Halldorsdottir, 1989, 1990), as well as related literature, I have determined that there are five basic modes of being with another as follows: life-giving (biogenic), life-sustaining (bioactive), life-neutral (biopassive), life-restraining (biostatic), and life-destroying (biocidic) (see Figure 12.1 and Table 12.1). In this chapter, I describe the five basic modes of being with another through examples of caring and uncaring encounters in hospitals as experienced by former patients, my co-researchers in the former study (Halldorsdottir, 1989). The phenomenological perspective of qualitative research theory guided the methodological approach to the studies analyzed, involving the use of theoretical sampling, intensive unstructured interviews, and constant comparative analysis. TABLE 12.1 Five Basic Modes of Being With Another Life-destroying (biocidic) mode of being with another is a mode where one depersonalizes the other, destroys the joy of life, and increases the other’s vulnerability. It causes distress and despair and hurts and deforms the other. It is transference of negative energy or darkness. Life-restraining (biostatic) mode of being with another is a mode where one is insensitive or indifferent to the ...
Responsibility of a Critical Thinker in Contemporary Society 1 .docxjoellemurphey
Responsibility of a Critical Thinker in Contemporary Society 1
RESEARCH PAPER 3
Responsibility of a Critical Thinker in Contemporary Society
Dominique Noble
General Education Capstone
Candy Henry
11/23/2014
Domestic violence, depression and obesity are issues that are of most concern in any single community. This has been so due to the level of sensitivity that accompanies these issues. Every society therefore, has a survival tactic on how to handle the effects of this issues which can lead to adverse effects on a person`s self-esteem if not properly handled. Critical thinkers however have a huge role in controlling the effects of such issues.
Domestic violence is the pattern of human behavior that follows a series of violence or any other form of abuse from one person to another domestically. This involves intimate relationships, marriage or courtship and involves violence in form of battery, domestic abuse or spousal abuse. Through this violence one may acquire physical, sexual or psychological harm by physical aggression and assault that is, kicking, biting, hitting, strangling, burning or amputating.
Depression is a psychological condition mostly associated with deep thoughts and stress. It is defined as the state of having low mood leading to distractions while carrying out daily routine, behavior and feeling. This condition makes a person feel hopeless, worthless, increased anxiety and high level of irritability and restlessness. The side effects associated with depression are; one suddenly losses interest in activities that were pleasurable to him or her may experience weight loss and may even at times have loss of appetite or increased appetite.
Obesity on the other hand is a condition that is medically described as the accumulation of excess body lipids or fats to an extent of causing health problems or to an extreme of reducing the life expectancy of the patient. This condition is achieved when the body mass index exceeds 30kg/m2, with limits between 20-30 kg/m2 being considered as overweight. This condition increases the person`s risk of contracting various diseases such as heart attack, some types of cancer and even diabetes.
Literature Review
In a move to reduce the growth of the above contemporary issues, the government and concerned parties such as the activists are creating awareness on the issues. This involves ways in which to overcome situations when faced by these challenges. One of the best ways of doing so is through educating the citizens on these issues, which is done through previous published works in line with other methods. The following is a detailed literature review into the finding of other scholars on this contemporary issues discussed above and the responsibility of critical thinkers in the control of this issues.
Wilson (2009) found out that 74 percent of the women ...
SOCW 60 and 61 response to students and professorSOCW 60week.docxwhitneyleman54422
This document discusses how violence is portrayed in video games. It notes that while many games involve killing large numbers of anonymous enemies, this type of violence can become boring. Two games from 2013, The Last of Us and BioShock Infinite, are compared. The Last of Us uses violence purposefully to further the story and leave the characters emotionally scarred, while the violence in BioShock Infinite feels gratuitous and does little to further the plot or character development. The document argues that personal, specific violence like torture is difficult for games to portray in a meaningful way.
Running head Caring and the human experience in society1Caring.docxhealdkathaleen
This document provides an overview of an interview conducted to understand a person's meaning of caring. The interviewee, a teenager, described caring as involving love and wanting to be there for others. They gave the example of parents caring for children by providing for their needs. The interviewee's view of caring was shaped by their early experience of being cared for after foot surgery by family members. They recognized the idea of "natural caring" from scholar Nel Noddings' work. The interviewee believed a caring, nonviolent society would have less conflict and emphasized eliminating discrimination. The interview provided insights into how understanding of caring can vary by age and experience.
Gordon McManus Ch 11, 12 ,13 'From Communism to Schizophrenia'Andrew Voyce MA
This document summarizes chapters from the book "From Communism to Schizophrenia and Beyond". Chapter 11 discusses nomothetic and ideographic approaches in psychiatry. Chapter 12 discusses the importance of employment in recovery from mental illness. Unemployment can worsen mental health conditions and lead to social exclusion. Chapter 13 emphasizes the power of personal narratives and stories in the recovery process for both patients and practitioners. Chapter 14 discusses how one man's recovery journey can inspire others and the need for both medical and recovery-focused approaches in mental healthcare.
A critical assessment of the research literature that explores the disclosure...GERATEC
Being diagnosed with dementia can impact on an individual’s emotional, vocational, spiritual, physical, social, intellectual and personal dimensions of wellness (Montague, 2013). The stigmatisation that comes with the diagnosis can be as devastating as the disease itself. For this reason alone, seeking a diagnosis when suspecting that there could be something wrong with one’s cognitive functioning, is not a simple or easy decision.
Christine Bryden, in her book “Dancing with Dementia” (2005), makes the statement “It took me three years before I could speak openly about my diagnosis, overcoming the hopelessness and depression that exacerbated my dementia and took me on a downward spiral of dysfunction” (Bryden, 2005, p39).
The psychological impact of a diagnosis (Lee et al., 2014) is severe, taking some individuals up to six months to adjust and cope with the feelings of loss before they can start to create new coping strategies and mechanisms of living with dementia.
Dementia diagnosis in lesser developed countries like those on the African continent, where research is scarce and stigmatisation can put lives in danger (Kalula and Petros, 2011), is in itself problematic. Bunn et al. (2010) allude to the transferability of research findings that are mostly geographically limited, implying that the disclosure of a diagnosis might be even more complex in non-western cultures.
Not disclosing a diagnosis raises ethical concerns (Rai, 2009) that seem to be missing in much of the research.
A Naturalistic Study Of Narrative Exploring The Choice And Impact Of Adversi...Bryce Nelson
This study investigated the topics participants chose to write about in a values-narrative program and how that related to their perceptions of the program's impact. The study found that:
1) Almost half of participants wrote about an adverse experience, while others wrote about personal stories or experiences not related to adversity.
2) Participants who had more exposure to victimization were more likely to write about adversity.
3) Those who wrote about adversity and shared their narratives reported more positive impacts from the program.
4) Encouragement and more time writing were also associated with better outcomes.
Reply 1 Effects of Illness on Womens RelationshipsIn addition.docxcarlt4
Reply 1 Effects of Illness on Women's Relationships
In addition to affecting the lives of those who are ill, illnesses may also profoundly affect the spouses or partners who care for those who are ill. Anxiety and depression may increase as caregivers adjust to new realities and expectations. On the other hand, intimacy and closeness may increase as partners solidify their relationships in the face of illness. Though every relationship is unique, there are some trends that can be seen across relationships when, for instance, in a heterosexual relationship the man is the caregiver, and alternatively when the women is the caregiver. Lesbian relationships, too, are impacted when one partner is ill, sometimes in similar patterns to heterosexual relationships, and sometimes in different ways.
To prepare for this Discussion, consider how illness might affect a life partner relationship under these different relationship configurations.
Women's Health
Reply 1– Effects of Illness on Women’s Relationships
In a relationship, when one becomes very ill and requires a caregiver, it can significantly impact the relationship. In some instances, it can make the relationship stronger, however, there are many challenges from the perspective of both male and female. Alexander and Wilz (2010) state that family caregivers have to develop coping skills to deal with issues that could arise daily. Taking care of someone poses different challenges, resulting in different types of stressors so caregivers need to be conscientious of those challenges to be prepared to deal with them when they come up. Additionally, being a caregiver for a loved one can be very taxing and cumbersome, resulting in decreased mental and physical health (Alexander & Wilz, 2010).
Fekete et al. (2007) states that emotional support has a significant influence on an individual with a chronic illness. Emotional support provides a more positive outlook for an individual, which, can impact their mental state and also influence their health (Fekete et al., 2007). Additionally, caregivers or spouses of individuals with chronic illnesses are more susceptible to health implications and psychological stress, resulting from lifestyles changes, assuming the responsibilities of their loved one, limited time for social events, and most importantly, lack of self-care (Fekete et al., 2007). Fekete et al. (2007) also states that women and men differ on how they support each other and how they interpret that support.
According to Umberson et al. (2016), various factors should be considered in thinking about how individuals interpret and respond to relationships. Social contexts influence the way in which men and women deal with illness. For example, men are typically encouraged to be strong, independent, and inattentive regarding physical illness or pain, therefore men are more likely to avoid accepting or looking for help whereas women are perceived to be delicate and feeble (Umberson et al., 2016)..
This document discusses the need for a new approach to supervision for therapists working with trauma survivors. It notes the paradox that relationship is key to healing trauma, but supervision often focuses on productivity over relationships. It proposes adapting the Sanctuary Model, which redefines therapists, supervisors, and supervision to provide better support for trauma therapists. The model aims to address the "gaping hole" left by evidence-based practices that fail to consider meaning, purpose and social context in healing complex trauma.
This chapter discusses theories and research on helping behavior and prosocial behavior. It defines key concepts like altruism and prosocial behavior. It outlines four main theoretical perspectives on helping: evolutionary, sociocultural, learning, and decision-making perspectives. It also discusses who helps including the influence of mood, empathy, personality, gender, and environmental factors. Finally, it covers bystander intervention, volunteerism, caregiving, and perspectives on receiving help.
A large no of people volunteer their time to help other people each year as seen in Ram Krishna Mission.
What is it that moves a person to give up their time, money, and even safety to relieve another person's suffering?
Compassion is the key.
Human suffering is inevitable, but our ability to understand and sympathize with the plight and circumstances of other people can play a major role in whether we take action to relieve this suffering.
Compassion is also a highly valued quality.
Religions stress the importance of compassion, while people often list characteristics such as "kind" and "compassionate" as what they look for in a potential partner.
This Free Printable Alphabet Chart Is Perfect To Help YouJessica Oatis
This document provides instructions for requesting writing assistance from HelpWriting.net. It outlines a 5-step process: 1) Create an account with a password and email. 2) Complete a 10-minute order form providing instructions, sources, and deadline. 3) Review bids from writers and choose one based on qualifications. 4) Receive the paper and ensure it meets expectations before authorizing payment. 5) Request revisions until fully satisfied, with the guarantee of a refund for plagiarized work. The process aims to ensure high-quality, original content that fully meets the client's needs.
Write a two to three-page paper (excluding APA title page and refe.docxodiliagilby
Write a two to three-page paper (excluding APA title page and reference pages), comparing Freud, Mahler, and Adler. Compare and contrast the developmental models of Freud and Mahler; then, contrast these two developmental theories to Adler’s theory. Be sure to also address the following:
1. A brief description of each theory. Which perspective appeals to you more, and why?
2. What are some ways that the Adlerian approach can be applied to group counseling? What are some advantages of using a group format with this approach?
3. What concepts from these psychoanalytic approaches do you see as being potentially useful in your work as a nurse psychotherapist? Describe.
Adier's Need to Belong as the Key for Mental Health
Rachel Shifron
Abstract
According to Adier's (1932) Individual Psychology the inability to belong or to
connect with others results in pathology. In this essay the author presents several
case studies that highlight the need to belong as a primary issue in therapy. The case
descriptions include therapy with an individual, a couple, a client with addiction
issues, a cross-cultural couple, and a mother and daughter-in-law. The case materi-
als presented in this article reveal that individuals with psychological disorders can
lessen their psychopathology by learning more effective methods to promote belong-
ing. Adlerian methods and interventions to promote belonging are discussed.
In Adier's (1932, 1991) Individual Psychology every child is born with
the need to belong and with the ability to connect with others. Acquiring
the methods of connecting involves a learning process. This kind of learning
is the key for well-being. It is essential that one belongs and is connected
to three significant groups in one's circle of life. I expand Adier's descrip-
tion of the life tasks (Dreikurs, 1950) to refer to these significant groups as
being family, friends, and work associates. Feeling a sense of belonging to
these groups is the primary universal issue of mental health. Individuals with
psychological disorders can lessen their psychopathology by learning more
effective methods to belong.
This article reflects my many years of counseling and therapy from an
Individual Psychology perspective (Shifron, 2006, 2008). My clinical experi-
ences have shown me the universality of the need to belong, and I believe
this paper offers an exceptional opportunity for clinicians from different
theoretical approaches to learn more about Adier's optimistic and brilliant
perspective. Adier's Individual Psychology is based on the conceptualization
that psychopathology results from the lack of feeling belonging. This is an
optimistic view, because the absence of feeling belonging is a curable situ-
ation. According to Adier's theory (Ferguson, 2006), every individual makes
choices. In this paper I focus on the belief that every individual is capable
and creative and that by making different kinds of choices, each person can
learn how to feel belongi ...
Discussion Week 3 Discussion 1 2Top of Form.docxwrite30
This document discusses two discussion prompts related to mental health and midlife crises. For the first discussion, colleagues provide responses about a case involving a returning soldier experiencing mental health issues. They describe how psychoeducation could be used with the soldier and his family. For the second discussion, colleagues characterize midlife crises and how social workers can help individuals through this transition period.
1. 1
Crisis and Connection
Shery Mead, MSW
David Hilton, MA
Correspondance:
Shery Mead, MSW
302 Bean Rd
Plainfield, NH 03781
Phone: (603-469-3577)
Fax: (603-469-3577)
Mead2@earthlink.net
Crisis and connection
1
2. 2
Abstract
Psychiatric interventions for crisis care lie at the center of the conflict between forced
treatment and recovery/wellness systems in mental health services. Though crisis can
mean completely different things to people who have the experience, the general public
has been taught a unilateral fear response based on media representation. More and more
this has led to social control but is erroneously still called treatment This does nothing to
help the person and in fact further confuses people already trying to make meaning of
their experience.
This paper offers a fundamental change in understanding and working with psychiatric
crises. Rather than objectifying and naming the crisis experience in relation to the
construct of illness, people can begin to explore the subjective experience of the person
in crisis while offering their own subjective reality to the relationship. Out of this shared
dynamic in which a greater sense of trust is built, the crisis can be an opportunity to
create new meaning, and offer people mutually respectful relationships in which extreme
emotional distress no longer has to be pathologized. The authors, who have had personal
experience with psychiatric crises, have provided this kind of successful crisis counseling
and planning and have designed and implemented peer support alternatives to psychiatric
hospitalizations that support this model.
2
3. 3
Crisis and connection
Sarah had been a recipient of mental health services for most of her life. She had been
diagnosed with bipolar disorder and because of her history she was told to expect
periodic episodes of mania. She was so accustomed to this schedule that she virtually
prepared herself for hospitalization every year. This year, at the beginning of August, she
came to the local peer center. She described not sleeping, racing thoughts, images of
death and blood, and an urgency about running into the woods with a knife. Rather than
calling her case manager I talked with her about having often felt like this as well and
told her how terrified I had been. We talked a lot about our images of death and blood
and shared related experiences. We both talked about histories of past violence. She
finally told me the story of an August where she had been kidnapped, held in an
outhouse, and repeatedly raped. When she had finally been released she ran through the
woods for a long time, not knowing where she was or what she should do. Many years
later, just before August, when she finally brought it up to her case manager, she was told
to put the past behind her. That’s exactly what she did, always one step behind her. Out
of her sight but not out of her experience.
The day we met we put both our pasts into the ‘conversation.’ We shared strategies and
ideas. Mostly we built a relationship that was not based on assessment but rather on
shared truths and mutual empathy. Each year since then Sarah has asked people to “wrap
around” her in August. She talks to people and they talk to her. Her experience is not
named, it is witnessed. She no longer has delusions, she has strong feelings. She doesn’t
see herself as out of control but rather in great pain. This pain now has meaning for her. It
is her history and her experience and she has begun to transform it. She now helps others
develop plans and strategies to move through crises differently or even to prevent them
all together.
Mutual relationships have generally been extremely helpful in allowing people to
reconstruct and rename their experiences and take control of their own recovery from
mental illness (Mead et. al 2001). People are able to share their stories with each other
and challenge the extent to which their “learned” stories have been based on social
constructs or imposed “truthes” (Mead & Hilton, 2001). Rather than either person
analyzing or assessing the meaning of the other’s story, both people are engaged in a
mutually enriching dialogue. From genuine connections with others, old patterns can be
revealed and what previously felt out of control for one person is now part of the
conversation (Evans & Kearny, 1996). When old patterns do arise both people can
support each other’s changes. Both people can offer perspective when either one seems
stuck and each can offer support in a way that allows for mutual growth, shared risks, and
an opportunity for mutual empathy and a deepening relationship. Through re-telling and
sharing stories in community (as in peer support programs), people can begin to
challenge the dominant discourse, come up with new language and finally create
environments that offer supports for people without the more restrictive use of emergency
based services.
3
4. 4
Peer support programs have been at the cutting edge of exploring new practices. They are
grounded in the knowledge that neither person is the expert, that mutually supportive
relationships provide necessary connection, and that new contexts offer new ways of
making meaning. Peer communities have demonstrated again and again that challenging
traditional practices leads to personal, relational and cultural transformation as will be
exemplified throughout this paper. This way of being with people can offer the field of
mental health new ways of thinking about responses to crisis, both pro-actively and
reactively.
Throughout this paper we will offer personal experiences we’ve had that model some of
these changing practices. We will demonstrate that peer support is at the heart of new
trends emerging in crisis interventions. More specifically, the paper will first focus on the
importance of proactive planning, second, a new ‘reactive’ response to crisis and finally,
some recommendations for evaluation and research.
Crisis Planning
Proactive planning is best in all circumstances. When people are allowed the time and
the non-judgmental atmosphere to talk about the things they have been through, they can
often begin to identify some of the things that helped them learn and grow from particular
situations and they can also begin to identify the things that have kept them stuck in old
patterns and old ways of relating to people. Crisis planning should be an interactive
process. In this process the goal is for two people to try to understand how the other has
learned to make meaning of their experience. In that, it is useful to ask questions that
might lead to a new perspective for both people. Rather than the typical compliance and
risk assessment kinds of questions for example, people might explore how they think
others would describe their crisis (Pearce, 1998). This vantage point allows people to step
outside of the traditional rhetoric and observe themselves “being” in crisis. Rather than
assuming that symptom language has the same meaning for everyone, it is useful to think
about what clinical terms mean for both people, or to stay away from pathology language
altogether. Sharing similar experiences also helps to break down people’s sense of
isolation and supports the conversation towards moving past traditional constraints
(guessing what to say to get what you need but not saying too much so you don’t get
locked up). Without this dialogic process, and this struggle to deeply understand the other
person’s lived experience, two people fall into the traditional rhetoric of illness and
treatment (Bentz, 1989; White, 1990).
It was cathartic when I (S.M.) was able to tell a peer about my experience with cutting (a
process I was tremendously ashamed of and secretive about). Instead of labeling it the
other person said she had gone through similar kinds of things and had found ways to
learn from it and consequently was able to express her pain differently. For the first time,
I felt some hope. I felt like less of a “crazy person” with bizarre behaviors, and more able
to think about gaining new resources toward change. It also allowed me to think about
pain in a language that had a relationship to my past history of violence rather than pain
as symptomatic. Over time this knowledge has led me to understand contextually some of
the difficult experiences I’ve had. It has also supported my ability to be in relationship
through crisis without falling into the patient role.
4
5. 5
It is also relevant to set up some guidelines about how the relationship will work in this
interactive interview process. These guidelines are useful to minimize power issues can
be minimized (Ellis et al, in Hertz, 1997) and to ensure safety for both people. When
people set up plans that are respectful of the relationship, difficult times (even when there
are incongruent realities) can be negotiated. For example one person might see
him/herself as entirely incapable of controlling their behavior when they’re having a
difficult time and the other person might remind her that it’s hard to stay with someone if
she’s scaring you to death. Both people, talking from their experiences, can come up with
some ideas about strategies they will both use to maintain the safety of the relationship
and use it as a guideline if difficulties should arise. As trust builds in the relationship and
both people feel valued, new ways of thinking and doing become possible.
This was exemplified when a young man who had a long history of hospitalizations
around psychotic experiences wanted to get through these times without being in the
hospital and without increasing his medication. During his interview, we talked in detail
about the kinds of things we both were willing to sit with and what might feel intolerable.
He was also studying eco-psychology and wanted to use our respite program as a
structure for thinking about psychosis from that perspective. The unfortunate time did
come when he needed to use the program. His doctor advised him that taking the risk of
not increasing his meds might lead to involuntary treatment and he was told that he was
much too vulnerable to be going through this with his “peers.” In spite of this advice, my
friend did use the respite program. He stayed up for 4 days straight talking to his peers;
each person sharing their own similar experiences and unique perspectives. He and his
peers also worked with the guidelines from his crisis plan so that they could remind each
other of sharing in the responsibility. No one was afraid of “bizarre behaviors,” or strange
ways of thinking and no one told him what it meant. After nine days of respite (with
several days just catching up on sleep) he left respite…without increasing his medications
and without forced treatment. In fact he went back to school and wrote about his
experience. Some of the things he said were very interesting. For instance, he (Crocker,
1998) wrote,
It was really terrific being with all different people who knew me in different ways and who all had their
own versions of these kinds of experiences. Through all these conversations I could take the things that
were important to me and throw out the rest as just “crazy” thinking. As I learn more about what happens
for me and the kinds of things that feel important I can begin to understand what kinds of events might
contribute to these situations and what kinds of things might help me take a different path.
He also stressed on another issue that is so important but overlooked in traditional care.
He wrote,
What was really great was having had all these intense conversations, I could stay in touch with people and
continue to work through some of the conversations. I could learn from some of the things they had each
experienced and I could also be a new valued support person in their lives when they were struggling
because we’d built up such reciprocally trusting and empathic relationships
Crisis Without a Plan
What happens when people are already in crisis? Here, engagement takes on an urgent
need to interact in a way that helps people feel safe, connected, comfortable, and in the
company of people who understand what is happening to them, but who may not be in
5
6. 6
the same reality. In the absence of a pre-crisis negotiated plan, this supports the
establishment of mutually responsible and respectful relationships that will be crucial to
the ability for people to accept help or even engage in relationship. This process must:
• Be respectful of the “story” being told. Maintain non-judgment and listen
deeply for themes that might allow for a mutually enlightening conversation.
• Maintain awareness of where fear/discomfort tends to push either person into
power and control issues.
• Negotiate ways of being with the person to work towards safety for all
(safety: feeling comfortable, supported and connected enough to get through
emotionally charged experience).
• Make room the development of a new “shared” story. Build a relationship
where the processes of both people contribute to a richer understanding of the
experience without either person imposing their meaning. Create new ways of
understanding (for both people) that leads to the development of a more
trusting relationship and offers the opportunity to use the crisis as a growth
experience.
When people experience states of extreme emotional distress, regardless of cause,
attempts to negotiate and engage are strained by the tear in usual use of language and
communication (Pearce, Littlejohn, 1998). Understanding that crisis events are full blown
flights of fright, no matter what the presenting story may be, grounds the supporters in
understanding that the first priority is to help the person feel welcome, safe and heard.
Contradiction, challenge or refutation build unhelpful power dynamics, and create
relationships that are embedded in pathology and lead to secrecy and control. Rather, it
becomes essential in the early stages of engagement to allow a person to talk about their
perception of the experience in as much detail as is necessary without having it labeled,
assessed, or interpreted. Loren Mosher, from the Soteria project (Mosher in Warner,
1995) describes this not as a “treatment or a cure but rather a phenomenologic approach,
attempting to understand the psycho tic person’s experience and one’s reaction to it,
without judging, labeling, derogating or invalidating it” (pg.113).
At the same time the support person is listening deeply, she/he must be willing to be
engaged in critical self-reflection and notice the extent to which they really understand
vs. interpreting or reacting. If the two people are unfamiliar with each other and their first
interaction occurs when one is in crisis, it is crucial to build the basis for a relationship
that doesn’t foster old dynamics. Traditionally with ‘expert/ patient’ roles, both people
end up stuck. The person in crisis may either feel alienated or dependent and the support
person finds that they are no longer present but that their “skills” and book learning have
taken over. The process of stepping in while stepping back is at the core of building new
responses to crisis. It provides an opportunity to mutually explore the “essence” of the
experience relationally while creating the groundwork for a meaningful relationship
oriented towards the learning and growing of both people (Jordan, 1992).
An example of this occurred at an inpatient setting with a friend of mine who was
working as a mental health worker. Over the course of a week, one of the patients had
become more and more distressed over the light from the smoke detector in his room. He
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told the staff that it was an FBI microphone and that he needed to swallow all his pills in
order to “keep from talking.” When he was relatively calm the staff would remind him
that this was just a paranoid delusion. If he became agitated they would increase his
medications and if they became frightened that he might overdose, they removed him
from his room and put him in seclusion. These reactions only served to disconnect the
man from everyone on the unit. The longer he was there, the more his stress increased.
Finally, he was screaming much of the time about the fact that the red light was really
from a space ship that wanted to carry him away. He was terrified and no matter how
much medication he was given, his fear would not abate. Finally my friend had a shift on
the unit. She’d been “briefed” about the gentleman and was clearly discouraged by the
other staff from engaging with him. The staff, in fact, joked with her about the space ship
and referred to him as “the alien.” Though my friend wanted to “do” the right thing as a
new junior staff member she was also keenly aware of what it was like to be invalidated
and labeled. She had had her own experience with this kind of fear and kne w that having
her experience discounted had been damaging. When she finally got a chance to go in
and visit the gentlemen, he was seriously distressed. He screamed at her to watch out for
the space ship while virtually in tears from his terror. She sat with him; aware of her own
discomfort but listened deeply and calmly and asked him questions about his experience.
As he talked and was validated for his feelings, he began to calm down. He went on to
explain that the light from the spaceship (or FBI micropho ne) made him feel unsafe. My
friend offered a story of her own in which people had not listened to her and instead had
named her fears as an over-reaction. Finally she suggested that together they cover up the
light. He enthusiastically agreed. No increase in medications, no particular evaluation,
but the beginning of a relationship in which negotiation and respect would frame their
mutual progress. Bringing a sense of who you are to the relationship provides the other
person with the sense that they are not in this alone. Building this mutuality and
connection is the single most important aspect of fostering healing relationships. Judith
Jordan (1992) writes, “when people feel the sense of safety that true validation elicits,
they are able to make a connection with the support person that allows both people to
impact the direction of the crisis (pg.9).”
Fear, Discomfort and Power
Implicit in our culture is the message that we should constantly move away from
discomfort. We drug strong feelings, we try to “calm people down,” and we only feel
competent if we “make someone feel better.” We are not a culture that has any tolerance
for pain, difficult feelings or unusual affective expressions. In that, discomfort tends to
compel us to eliminate difference, pull people into our worldview and see things as
normal only when we ourselves are once again comfortable. A very common example is
what happens in a public place when someone is acting “differently.” People go out of
their way to stay far away, ignore the situation or even call someone in authority to take
care of it. This really hit home with me in the grocery store several years ago. A man was
wandering up and down an isle, clearly talking to himself in a rather emphatic way. He
seemed to be upset, but not violent. People avoided the aisle he was in like the plague.
The whole tone in the store was tense. You could almost see people taking their children
far away so as not to provoke any questions and you could guess that someone was
already thinking about calling the police. Finally, I went up to the man and said that he
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looked very upset. I asked what was wrong and if there was anything I could do. I also
mentioned to him that I had had trouble in grocery stores. He started crying and said he
didn’t know what to do. He said that he needed to get out but didn’t know how. I helped
him find the door and locate his bicycle. Though I’m not sure where he went from there
or what the outcome was, he thanked me and told me that he appreciated my concern.
Although I couldn’t help but worry, I could feel the connection that a simple act of caring
elicited.
Although most support people don’t go into a crisis situation determined to control the
other person, their own sense of discomfort may make them become overly directive and
controlling, driving the direction of the interactions while building a power-imbalanced
framework for future interactions. At its worst crisis response is controlled by a fear of
liability. Support workers may be more concerned with a lawsuit (or reprimands from a
supervisor) than thinking about how to build a mutually enhancing relationship. Even
when in good faith the person in distress is told that some treatment is “for their own
good,” or is asked to sign a safety contract, they are no longer part of the dialogue. They
are seen as a walking liability and may even begin to see themselves as out of control, or
they may disconnect completely. When relationships are entirely built on assessment of
risk, they are by nature controlling and disempowering (White, 1995). It is crucial that
support people maintain a rigorous self-awareness of their own need to “fix it,” “do it
right,” or unilaterally determine the outcome. It is also crucial that the support person
maintain an awareness of the inherent power dynamics in a helping relationship. Whether
subtle or explicit, power dynamics create an imbalance and drive the direction of the
experience while setting the stage for future power imbalanced interactions.
Safety and Risk
Clearly suicide or homicide are the ultimate risk and not surprisingly, events that evoke a
sense of powerlessness and fear. I have found through years of training both peer support
workers and professionals that, no matter how much people promote choice, that when it
comes to the topic of suicide (even if they are just stated feelings) people tend to
withdraw from the dialogue and start to analyze everything. Now when the person in
crisis says she is feeling worthless and tired of it all, she is seen as being in imminent
danger. Whe n feelings are all seen through the lens of risk the support person screens her
own comments fearing that the “wrong” thing will trigger a suicide response. Whether
there is a subtle shift in the power or whether someone is involuntarily committed, fear
has driven the outcome. The relationship is no longer mutual and the possibilities for
making new meaning of the experience are halted.
One of the more subtle ways of taking power is the use of the “safety contract.” These
documents are often mandated when a person talks about feeling suicidal or like hurting
themselves but give the “impression” that there is still negotiation in the relationship.
This author would argue that the document is really a means of controlling the support
person’s discomfort with the conversation. In other words, “I can’t really engage with
you unless you sign on the dotted line.” To that end, the language of safety has strayed
far from its intended meaning (feeling accepted and validated) and has turned into risk
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management. The outcome, once again, becomes prescriptive and controlled by the
support person, leaving the person with the concerns feeling unsure that she is capable of
making good decisions. In spite of the fact that most people have felt suicidal (at least at
one point in their lives), in the context of a “helping” relationship, talking about these
feelings continues to be taboo. Interestingly, most people in the mental health system,
having extreme histories of trauma and abuse find that suicidal feelings are congruent
with the messages they received as children “(You should be dead.” “You never should
have been born, “I’ll kill you if you tell,” etc.). They have become a patterned, coping
response to feeling out of control or powerless. Signing a safety contract rather than
talking about the painful feelings is just another way of generating powerlessness.
Many years ago I called a crisis hotline. I was feeling really horrible, had moved into my
patterned response of wanting to cut and wondered how bad it would be if my life just
ended now. I’d had a hard time driving home and had lost my way, only getting home to
remember that my children were due to arrive in a couple of hours. I had called the local
hotline to do some venting so that I would be in better shape when my children arrived.
Not knowing the crisis worker, I was careful with my choice of words but it wasn’t long
before she started the standard suicide risk protocol. Do you feel safe? Are you thinking
about suicide, do you have a plan? I said that I always had suicidal feelings and that I was
calling so that I wouldn’t keep obsessing with thoughts of self- harm. The hotline worker
never even asked what was going on in my life. Never bothered to find out that I was in a
heated custody battle, that my psychia tric records were being used as a threat, or that I
was a full time graduate student working ½ time and single parent of three young kids.
To her I was just “at risk.” She asked me to contract with her around my safety. I
immediately began to shrink from the conversation. I began to wonder if my feelings
were more dangerous than I knew. I began to wonder if I was being naïve and this
woman knew something I didn’t. I agreed to contract with her knowing that she would
probably call the police if I didn’t and assured her that I was fine and would call her if I
felt distressed later. I thanked her profusely, got off the line and fell apart. What was
simmering before had turned into a full boil and I thought I might surely die. Now there
was no place for the feelings to go and I became further convinced of my inabilities. She
had a contract that I’m sure made her feel like she’d done a good job and I was left
carrying the affect for both of us.
Rather than reaching for safety contracts we need to become more able to “sit with
discomfort.” I wonder for example, what would have happened if this woman had started
the conversation with “what happened?” vs. “what’s wrong?” or if she had been able to
look for the metaphor in my urges to cut and simply “be” with my pain. I wonder how it
would have been different if this woman had said that she was scared but would hang in
there with me. And finally I wonder what would have happened if she crossed that ever-
rigid boundary and said that she had had a similar experience and had had similar
feelings. Even when people don’t have shared experiences, building mutually empathic
relationships is the only way that people can build a “new, shared” story.
Building Mutuality, Creating New Outcomes.
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Narrative theorists (White, 1990, 1995) have used the concept of “re-storying” for many
years and with much success. More than a cognitive restructuring exercise, this practice
uses the framework of the relationship to negotiate new meaning for people’s
experiences. Considering that all of us have patterned and predictable responses to our
experiences, it is only through relationship that new ways of perceiving can begin to
question our historic assumptions (McNamee & Gergen, 1999). This process is most
dramatic in crisis when one person is teetering between total disconnect and chaos, and
yet it is the most crucial time. It is a time of potential transformation. Judith Jordan
(1992) writes: “Unlike resilience, transformation suggests not just a return to a previously
existing state, but move ment through and beyond stress or suffering into a new and more
comprehensive personal and relational integration (pg. 9).”
One of the methods of supporting a new story is the narrative approach of externalizing
the problem (White 1990, 1995). Even in extreme states of emotional distress, most
people find that connecting with others through a process of dialogue enables a different
vantage point to the current situation and offers an opportunity to take action against the
“problem” rather than being controlled by it. White (1990) offers example after example
of situations in which people in crisis are asked to look at the influence of the problem on
their lives right now. The dialogue is oriented towards what the support person and the
person in crisis can do to not let the problem ‘win’ (White, 1990, p.?). From this
perspective people may be able to muster the ability to separate themselves from the
problem and its power over them, doing something on their own behalf, and coming out
of the situation with what White (1990) refers to as a “unique outcome (p. 15).”
White (1995) also invites people to explore the meaning of the problem within a socio-
political context. He writes, “the discourses of pathology make it possible for us to ignore
the extent to which the problems for which people seek help are so often mired in the
structures of inequality of our culture, including those pertaining to gender, race
ethnicity, class, economics, age, and so on…(1995, pg. 115). This new framework
allows both people to analyze the extent to which these messages affect whole
populations of people and promotes an advocacy approach to the elimination of the
problem rather than the traditional approach of simply analyzing and medicating the
person.
This really hit home for me recently when I was asked to spend some time with a woman
labeled with schizophrenia who was being threatened with involuntary treatment. As she
wrung her hands and literally wailed as a reaction to the demeaning voices, I listened to
the shame and guilt that was driving her “crazy.” The voices were telling her that she was
a horrible mother and that everyone knew it. The message was that she should kill
herself before she could infect her children anymore. Furthermore, her experience in the
most recent voluntary hospitalization had included daily 10 minute rounds with a team of
doctors and medical students who all tried to convince her that she must accept her
illness, take all the medications they prescribed (without telling her anything about the
side effects) and suggested that perhaps she was too “fragile” to be a parent at this stage
in her life. When she became afraid that the prescribed medications would only further
infect her children, the doctor’s suggested involuntary treatment with forced medication.
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As I listened to her story I felt her intense pain. There is not much worse for most
mothers than being threatened with the loss of their children, and there is not much more
damaging than being told you are a bad parent. We began to wonder toge ther (as I
learned more of her recent experiences) how it is that single mothers who work are
blamed for neglecting their children and are accused of abusing the system if they don’t.
We wondered how this oppressive message had been internalized and what she might do
now to stand up to it. As she began to think about actions to take, I told her a story similar
to her own in which staff on a psychiatric unit told me that I was in denial of my illness
and that the stress of parenting was triggering my symptoms. I shared with her how it
almost killed me until I realized that much of what had kept me alive and energized was
being with my children. We began to cry together, about our pain, our shame and guilt
AND our gift of having wonderful children. A week later she was back home and
beginning to venture back out into her community with the support of myself and another
single mother. The transition between hospital and getting back into life, which is
considered as the most dangerous time for people in the psyc hiatric system (Warner,
1995), may have less to do with moving out of the “safe environment” of a hospital and
more to do with negotiating both the internalized and external stigma of being labeled
with a mental illness.
Creating a new, shared story invo lves a willingness to take risks in relationship even
when we are uncomfortable with the situation. In that we must realize that we come into
a situation not only with our own “stories” and our own perceptions but also with a
prescribed role that tends to reinforce further imposition of meaning on the other person
(e.g diagnosing or pathological interpretation) (Gergen, 1991). Finally if we can both go
back and have a discussion after the crisis is over about what it was that we both learned
we can develop a new “crisis” plan that will contribute to preventing future crises and
offer us more opportunities to learn and grow together.
Research and Evaluation
Research in the arena of mental health has been heavily influenced by research in all the
“natural” sciences. We are desperately seeking “cures” for biological defects and trying
to find causal relationships between biology and “symptoms” and then “treatment” and
“symptoms” Rather than thinking about multiple levels of systems (as some of the other
human sciences are doing) we are looking at genetic predisposition, cognitive functioning
and symptom management. As with the rest of the positivist/naturalist debate, there is
little to no interest (or corresponding funding) in understanding the meaning certain
actions and behaviors have to individuals, families or communities, there is no
consideration to the context within which the meaning is made, and there are no
indicators for changing cultural practices or beliefs (Bentz & Shapiro, 1998; Bleicher,
1982; Bray et al.2000; Denzin, 1997; Fetterman et al., 1996; Gergen, 1982; Holstein &
Gubrium, 2000). Further, for many people who are subjects of the research symptom
reduction is only what is visible to the outside world. What becomes hidden from the
discussion is the extent to which medications leave people with virtually no feelings, a
sense of numbness and more insidiously, the reinforcement of the identity of a mental
patient. In other words, rather than working towards transformation and recovery our
research continues to support maintenance and social control.
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Among some of the methods that attempt to study change from an ecological or systemic
vantage point are ethnography, hermeneutic, phenomenological, narrative and action
research. I became particularly interested in ethnographic study many years ago when I
read Sue Estroff’s, Making it Crazy (1981). As opposed to the clinical research I’d read
on mental illness, Estroff lived and participated in a community mental health program.
Her conversations and interactions were with clinicians and recipients of services with
the goal of understanding the mental health culture. She worked at developing a deeper
understanding of the context in which relationships took place, the extent to which that
context had meaning for all involved, and the difference between people’s conversations
when they were role dependent (e.g. clinician/recipient or recipient/recipient). Further,
she was very mindful of how her relationships changed with each of the participants as
there were interpretations and reinterpretations made of her role and her assumptions
about the project. In this powerful example, Estroff shows us that through building an
understanding of the cultural dynamics, not only was she able to engage in discussions
with people about what she saw, she was able to document her own changes and
perceptions about mental health treatment and outcomes.
This kind of study has tremendous implications for evaluation of alternative crisis
responses. Not only does it provide a birds eye view of mental health culture, it allows
practitioners, recipients and researchers to engage in a dialogue about system’s change.
Recipients can reflect on how their own interpretation and consequent actions have
changed in relation to their previously told “story,” clinicians can reflect on their
changing assumptions and practices and both can share changes they’ve experienced
based on their new relational dynamics. This conversation offers challenges to the whole
“boundaried” professional practices that have kept people locked into action/reaction
responses. Finally, as these mutually responsible relationships become more normative
we may find dramatic shifts in the ways in which the general public understands
psychiatric crisis.
It is clear that there are tremendous advantages to practicing alternative approaches to
what is labeled psychiatric crisis. Judith Jordan (1992) eloquently writes,
Joining others in mutually supporting and meaningful relationships most clearly allows
us to move out of isolation and powerlessness. Energy flows back into connection,
joining with others is a powerful antidote to immobilization and fragmentation. It is thus
an antidote to trauma. Moreover, the ability to join with others and become mobilized can
further effo rts towards a more just society (Pg. 9)
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