for limited clients
bernard widlake
bernardwidlake at btinternet.com
Mon Jul 17 06:09:41 CDT 2006
iWORKEDFOR12 YEARS AS MANAGER OF A THREE-QUARTER WAY HOUSE. tHIS WASFOR PEOPLEWHO NEEDED NOT TOOMUCH STAFF SUPPORT, BUT COULD NOT SURFVIVEIN THE COMMUNITY, AND NEEDED A THERAOPEUTIC COMMUNITY (WHICH i FACILITATED, FOR THE MOST PART AS ONLY STAFF). sORRY THIS HAS COME OUT IN CPAITALS, BUT i AM RUSHED AT PRESENT. iF YOU WANT TO KNOW MORE i AMHAPPY TO EMAIL LATER.
bERNARD
----- Original Message -----
From: Adam Blatner
To: list at grouptalkweb.org ; PATRICIA DESERT
Sent: Sunday, July 16, 2006 5:47 PM
Subject: for limited clients
Dear Patti, I've found that many people in supportive housing with schizophrenia are functionally in certain respects like folks with medium-high functioning developmental disabilities, in that their social problems and such need to be addressed in rather simple fashion. I wonder if Dan Tomasulo's two books might not have application in this setting, also? That is, limited and structured role playing to develop social skills.
In the 1970s, these were also used to counteract years of institutionalization, habits of passivity and so forth that were part of being in state hospitals for years; and then with the community mental health and de-institutionalization movement, many lost their bearings and their secure source of protection. But nowadays, I wonder what the socio-cultural background of patients in supportive housing--even that is a bit of an innovative idea--
we had halfway houses, sure; and day treatment...
Anyway, thanks for your participation. Warmly, Adam
----- Original Message -----
From: PATRICIA DESERT
To: list at grouptalkweb.org
Sent: Sunday, July 16, 2006 11:33 AM
Subject: Re: poor solution focussed therapy
I LOVE the idea of working with multi-families using psychodrama. Many years before I knew about psychodrama, in the early 90's, I directed multi-family groups as part of a Baltimore in-patient substance abuse tx program. My primary method was Yalom oriented. They were incredibly powerful, stimulating connections and understanding that had not been there before. Since learning about psychodrama, late 90's, I have not had the opportunity to work with multi-families. However, I work couple days a week at a psychosocial center for folks in supportive housing who are diagnosed with schizophrenia. Lots of conflicts arise between clients and their care providers. As these care providers are often the only family clients have I'm thinking a group to bring them all together would be very helpful. Thanks everyone for the ideas. Patti
----- Original Message -----
From: BARNETT WEISS
To: list at grouptalkweb.org
Sent: Thursday, July 13, 2006 8:29 PM
Subject: poor solution focussed therapy
Dear Rebecca and others:
What you are describing about solution focussed therapy sounds like very bad solution focussed therapy. Done well and elegantly, it is one of the most effective short term therapies that I have used or witnessed. I remember seeing a video of Inzoo working with a total street alcoholic and turning him around. When you watched it, you simply were amazed. What did she do? you would ask if you were not well versed in the work. How was it possible with so little seeming to be done that a total loser could turn around with so little intervention.
Those of you who knew the work of Mara Selvini Palazolli totally understand this sort of "miraculous" intervention. She actually formed a single constant intervention for schizophrenics that worked a lot of the time in one or two sessions. I experienced a form of it when I was younger and it had a hell of an impact. I wasn't schizy, but I was in trouble to say the least.
Finally, in well done solution focussed therapy, the families come out feeling like they really did it themselves, though they are certainly thankful for the support and assistance of the therapists. Many may not like the programming aspect of it, however, it was shown to be highly effective as researched both by the Milwaukee group and the groups at Paloalto.
Given the chance, I would prefer working with a group of families if possible similar to what Murray Bowen did when he actually hospitalized whole families and had conjoint families' therapy. It was powerful to say the least and to my mind not only more efficient, it was moving in the direction of community building which is ultimately where we must go if we are to be effective sociatrists. Has anyone done multiple family work using psychodrama?
Blessings, Bud
HV Psychodrama <hvpi at hvc.rr.com> wrote:
Adam, I agree with you. I think that short term solution focused therapy can be very effective. However, the way it is being taught is often based on teaching a lot of techniques. If the person says this, you say this, Try this assignment, Make that intervention. Nowhere are the students being asked to reflect on their own inner lives. No where are they being taught how to simply stay present when some one is expressing feelings. So they leave the psychodrama group and there is a rush to medicate or for them to use a coping mechanism to distract or contain. Because the therapists don't have the skill or the experience just to be with....and they infrequently have the time 'just to talk." Most of our students are social workers and the consensus is that it is psychodrama training that has taught them how to 'do therapy' even if they don't do psychodrama.
----- Original Message -----
From: Adam Blatner
To: list at grouptalkweb.org
Sent: Thursday, July 13, 2006 8:26 AM
Subject: Re: involuntary psychiatry
Hi Rebecca, Bernard and others.
The desire for short term work may not be due only to a "fear" or "threat" of emotionality. It's too easy to presume to know the motivations of others. While that might conceivably be valid, other possibilities also present themselves. (I feel like one of those detectives in a mystery novel.) Foremost is the simple question: What is the yield of this or that therapy. Can you demonstrate that as much as you think you're not re-traumatizing patients, that taking them into greater states of emotionality is really helping more in the long run as simply working on developing the strengths and coping skills that will re-stabilize? The problem is that it's not easy to make such a case. Yet when faced with two approaches, one significantly more expensive than another, it is not irrational to choose the less expensive one.
In a related way, there may be a point to Rebecca's noting the training of newer therapists, especially as it deals with the follow-up. In surgery, the pre-care and follow-up care to the operation may be as important or more important than the surgery itself. So what is the follow-up treatment, the post-sharing, post-leaving-the-group room ideal follow-up for a protagonist or even someone who's been moved by the enactment? In the olden days there used to be psychiatrists who would talk with patients, do real psychotherapy! (Yes! Can you believe it?)
Ah, well. Warmly, Adam
----- Original Message -----
From: HV Psychodrama
To: list at grouptalkweb.org
Sent: Thursday, July 13, 2006 5:55 AM
Subject: Re: involuntary psychiatry
Dear Bernard and others,
I have worked a total of twenty five years in inpatient psychiatric hospitals as a psychodramatist and expressive arts therapist. Mostly the former. For the last 21 years I have been at Four Winds Hospital, where I currently work with children and teenagers. It is owned by an MD who trained with Eugene Eliasoph in the 70's, and psychodrama has been a valued treatment modality for years. Recently, on one of the adolescent units, I was told to stop doing trauma work because their goal is to contain and help kids seal over. The other units want me to take kids as deep as they are willing to go.
I think that there is some validity to this with hospital stays sometimes less then a week. But I also think it is due to newer therapists, being trained primarily in short term, solution focused methods, are extremely uncomfortable with affect.
What do others think?
Rebecca
----- Original Message -----
From: bernard widlake
To: list at grouptalkweb.org
Sent: Thursday, July 13, 2006 6:07 AM
Subject: Re: involuntary psychiatry
I have spent twelve ears working as manager/therapist in a home for those recovering from mental helth problems. We did what psychodrama we cold, given my dual role. But we livd the drama every day. I am now seeking to set up a psyhodrama group in a local in-patient facility. So I am very interested. Also the person sho founded the organisation I worked for was Eli Jansen, who worked with R.D.Lang, Thoms Satz and others.The model of the therapeutic community we used was based upon work done at the Tavistock Institute. It helped form self help community, which brought out peoples ability to help each other, even though they had quite severe problems of there own. But it took time, sometimes the whole twelve years, for some people to be ready to r eturn to the communitiy. In the end it was cost effective, because the alternative of break-down and return to psychiatric hospital would be much more expensive, as well as t ragic for the individual.
So here is a first contact.
Best wishes,
Bernard.
------------------------------------------------------------------
Grouptalk mailing list
List at grouptalkweb.org
http://grouptalkweb.org/mailman/listinfo/list_grouptalkweb.org
--------------------------------------------------------------------
Grouptalk mailing list
List at grouptalkweb.org
http://grouptalkweb.org/mailman/listinfo/list_grouptalkweb.org
--------------------------------------------------------------------
No virus found in this incoming message.
Checked by AVG Free Edition.
Version: 7.1.394 / Virus Database: 268.9.10/386 - Release Date: 7/12/2006
----------------------------------------------------------------------
Grouptalk mailing list
List at grouptalkweb.org
http://grouptalkweb.org/mailman/listinfo/list_grouptalkweb.org
Grouptalk mailing list
List at grouptalkweb.org
http://grouptalkweb.org/mailman/listinfo/list_grouptalkweb.org
Grouptalk mailing list
List at grouptalkweb.org
http://grouptalkweb.org/mailman/listinfo/list_grouptalkweb.org
----------------------------------------------------------------------------
Grouptalk mailing list
List at grouptalkweb.org
http://grouptalkweb.org/mailman/listinfo/list_grouptalkweb.org
----------------------------------------------------------------------------
No virus found in this incoming message.
Checked by AVG Free Edition.
Version: 7.1.394 / Virus Database: 268.10.1/389 - Release Date: 7/14/2006
------------------------------------------------------------------------------
Grouptalk mailing list
List at grouptalkweb.org
http://grouptalkweb.org/mailman/listinfo/list_grouptalkweb.org
------------------------------------------------------------------------------
No virus found in this incoming message.
Checked by AVG Free Edition.
Version: 7.1.394 / Virus Database: 268.10.1/389 - Release Date: 14.07.2006
-------------- next part --------------
An HTML attachment was scrubbed...
URL: /pipermail/list_grouptalkweb.org/attachments/20060717/b259e22b/attachment-0001.html
More information about the List
mailing list