"Mental Health
issues are NOT disorders BUT a transient and often functional response to an
accumulation of stressors in a young persons life." (Dave Traxson -
Chartered Educational Psychologist)
FEATURES OF THE HPP MODEL
"What we need is a holistic narrative of need for young people NOT a dysfunctional discussion of dubiously diagnosed disorders!" Dave Traxson 2012.
- A multi-dimensional discursive approach -
challenging the dominant 'within child' biomedical model of Mental Illness that currently drives the majority of practice with Psychiatry and related CAMHS professionals.
- An optimistic
approach to understanding and resolving Mental Health needs that uses a Humanistic Psychological
perspective to generate thinking and solutions for a client.
- It provides an Aide Memoire to professionals in a multiagency meeting to
stimulate discussion about areas that might be impacting on a young person’s
world and also stimulates creative solutions involving them to resolve their
current difficulties.
- Colleagues using it
have reported that it promotes Reflection on the young persons’ needs and helps to ‘unstick’ bio-medical ‘log
jams’ or ‘cul de sacs’ that can often result from only looking at the situation
from a rational scientific angle.
- A blank Proforma allows summary notes to be taken of the discussion that can then be formulated into an Action Plan to help avoid the need for psychotropic medication to be used with the child.
- A blank Proforma allows summary notes to be taken of the discussion that can then be formulated into an Action Plan to help avoid the need for psychotropic medication to be used with the child.
INSTRUCTIONS FOR USE OF THE PROFORMA:
1)Place the detailed table of the HPP Model within easy reach.
2)Use the prompts, as appropriate, under each heading to elicit discussion with all professionals of the child’s holistic circumstances and needs.
3)Make brief notes of the key points of the discussion in the right column of the proforma.
4)Formulate a 'working hypothesi based on the collated information.
5)Then use it to help select appropriate strategies to meet the child’s specific and unique needs.
6)Monitor the success of the Action Plan and Review the hoped for improvements in the child’s Mental Health and Wellbeing.
SOME QUOTES RELATED TO THE MODEL:
"The promotion of holistic assessments and
self-directed behaviour in young people is more effective than treating
them as mentally ill or as patients that the health system acts upon in
either a hopefully beneficial or sadly all too often a harmful
way.” ( Dave Traxson)
"Child
Psychiatry is so very subjective and idiosyncratic that it would be better to
use Social Sciences Methodologies not the current Medical Science Protocols in
order to better Safeguard Children from
harm.” (Dave Traxson )
“An individual
child's mental health can not be separated from the health of all the many
interacting strata that constitute a rich and diverse society in our modern
world. It starts with the family and wider community in which they are nurtured
or not as the case may be." (Dave Traxson)
“ The Paramount
responsibility of any childcare worker is Safeguarding the welfare and the
emotional wellbeing of the children with whom they work,” as stated by many
Directors of Childrens’ Services in the U.K.
“Formerly, when religion was strong and science weak, men mistook magic
for medicine; now, when science is strong and religion weak, men mistake
medicine for magic.”(Thomas Szasz)
PROFESSOR THOMAS SZASZ
"Giving a child a label of mental illness
for behaviour is STIGMATISATION not diagnosis.
Giving a child a psychiatric drug is POISONING not therapy."
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“No further evidence is needed to show that 'mental
illness' is not the name of a biological condition whose nature awaits to be
elucidated, but is the name of a concept whose purpose is to obscure the
obvious.”(Thomas Szasz)
CLICK ON LINK ABOVE TO GET THE PROFORMA
CLICK ON LINK ABOVE TO GET THE PROFORMA
THE FORMULA :
TOTAL PERFORMANCE =
(POTENTIAL + PERSONALITY)
- INTERFERENCE + SUPPORT
SO, A HUMAN BEING'S
TOTAL PERFORMANCE
IS THE INTERACTION OF THEIR INNER
POTENTIALS
AND THEIR UNIQUE
PERSONALITY
MINUS THE INTERFERENCE
FROM MANY FACTORS
PLUS SUPPORT
(WHAT WE CAN DO AS A SOCIETY)
Optimal
Performance
|
Personality
|
Potential
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Interference
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Support
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Personal Characteristics
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Human / Personal
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Openness
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Environment / Ecology
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'Human Bridge' relationships
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Interpersonal Skills
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Physical/Coordination
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Curiosity
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Education quality / Teachers
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Play Therapy / Playing
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Physical Skills
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Intellectual
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Creativity
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Toxicity /Pollution: Air/Water
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Art Therapy / Painting
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Cognitive Skills
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Political / Spiritual
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Conscientiousness
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Biological (genetic, health,
diet, sleep, physique etc)
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Music Therapy / Playing
Drama Therapy /Performing
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Emotional Skills
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Emotional Articulacy
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Organisational ability
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Interpersonal /Social
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Alternative Curriculum
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Psychological Skills
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Literacy ability
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Efficiency
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Spiritual/Political beliefs
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Social Pedagogy (N.European)
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Resilience
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Numeracy ability
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Outgoing
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Loss/Migration/Bereavement
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‘Life Coaching’ / Mentoring
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Happiness
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Logical ability
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Energy / Focus
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Behaviour/Thoughts/ Feelings
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Talking Therapies/Counselling
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Confidence
Stability
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Thinking abilities
Receptivity to ideas
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Friendliness
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Historical (norms in family)
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Sport / Physical outlets
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Independence
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Memory
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Kind / Caring
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Patterns (habits, routines,
biorythms, 'family dances')
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Find 'Exceptions to Rules' /'Rays of Sunshine'
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Self-Esteem/ Self-Efficacy
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Creativity
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Self - awareness
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Cultural / Ethnic / Gender
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‘Reframing’ possibilities
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Relationships
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Artistic ability
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Assertive
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Sexualised behaviour
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Solution Focussed ideas
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Self-Management of Stress
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Sporting ability
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Altruistic
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Poor/ Broken attachments
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Developing self-control
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Mental Health
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Leisure/ Reading
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Compassionate
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Physical - including abuse Emotional - including abuse
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Relaxation training
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Altruism
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Humour /Mood
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Sensitivity
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Screen time / Sensory load
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Breathing exercises ('7:11')
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Cooperation
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Coping strategies
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Security / Stability
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Aesthetic/ Media/Sub-culture
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Yoga / Mindfulness
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Mood / Humour
Receptivity
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Helping others
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Vision for future
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Bullying / Intimidation
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Meditation:T.M./Benson etc.
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Reflexivity
Humanity
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Solution Focussed
Thinking Ability
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Optimism / Hope
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Oppression / Prejudice
Level of urban/rural deprivation
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'Repunctuation of day'
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Contribution to Society
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Motivation / Drive
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Class, Race, Gender, Age
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Using Creative Strategies + 'Whatever floats child's boat'
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TRY THE PROFORMA AND MAKE NOTES UNDER EACH CATEGORY TO HELP YOU FORMULATE YOUR PROFESSIONAL -
WORKING HYPOTHESIS.
HOLISTIC
there are a multitude of
interactive factors or variables that impinge on individual children
and can either support their healthy growth or interfere with the positive
development of their 'identity' and their 'integration of self. '
Just a few are:
ENVIRONMENTAL e.g. deprivation, poverty, exercise, locality, air quality including crop spraying and sound pollution.
EDUCATION e.g. positive expectations of children, personalised programme
quality, personal relevance + alternative curriculum, and quality of teaching /
inpirational teachers.
TOXICITY e.g. relationships, abuse, medications, cultures, environmental
pollution and dietary additives or deficiencies.
BIOLOGICAL e.g. physical and mental health, genes, diet, obesity, toxins,
metabolic rate and 'recovery rate.'
INTERPERSONAL e.g. 'interpersonal transactions', ‘family dances,’ friends, social
networks and social dynamics.
SPIRITUAL e.g. beliefs, dogma, ‘inner peace of mind,’ spiritual
ideation, mediatation, metaphsical variables and personal relevance.
POLITICAL e.g. oppression , class, ideology, ‘mind set,’ class,
elites, status, power relationships, prejudice and personal relevance.
BEHAVIOURAL e.g. learnt responses, traits, behavioural patterns and reinforcers
(external and intrinsic)
HISTORICAL e.g. family norms, parenting, support for education and the individual,
family traits and successes.
PATTERNING e.g. routines, established patterns, family 'dances,' responses and
biorhythms.
EMOTIONAL e.g. loves - hates, hopes - fears, ‘emotional articulacy’ or
E.Q., handling relationships and feelings.
INTELLECTUAL e.g. interests, hobbies, reading interests, self- expression, response
to challenge and stimulation.
AESTHETIC e.g. music, colours, arts and crafts, architecture, environmental
stimuli e.g. light, smells, or auditory.
All of these
dimensions have Positive and
Negative elements. The aim of mental health work is simply
to ameliorate where-ever possible some of the Negative ones and to promote the
psychological benefits of increasing the person’s development of their chosen
positive ones in many and varied ways.
Mental
wellbeing will then automatically improve within the individual child and also
within their circle of influence i.e.their family friends and colleagues.
POLITICO
that all individuals live in and
their 'mind set' is fundementally affected by a 'social world' within
which they either succeed / thrive or struggle / decline.
It is an essentially political ecosystem where it is often normal for power to be unequally distributed with the powerful always striving to maintain their dominance.
They consequently further diminish the influence of the 'disempowered' and 'underclasses' in order to 'profit' from them or 'abuse' their power over those individuals. Subcultures within the greater society that the individual chooses to join or is coerced to belong to can also impact greatly at this level e.g gangs, secret societies or evangelising groups of any faith or political persuasion.
It is an essentially political ecosystem where it is often normal for power to be unequally distributed with the powerful always striving to maintain their dominance.
They consequently further diminish the influence of the 'disempowered' and 'underclasses' in order to 'profit' from them or 'abuse' their power over those individuals. Subcultures within the greater society that the individual chooses to join or is coerced to belong to can also impact greatly at this level e.g gangs, secret societies or evangelising groups of any faith or political persuasion.
PSYCHOLOGICAL
that an individual's mind and
will are the strongest determinant of their 'empowerment' or success in life
and should not be impeded by the "toxic labelling" of unnecessary
categorisations and scientifically dubious judgements made by
professionals.This would the help to reduce unnecessary "toxic prescribing"
of drugs that may not be in the person's short or longer term best interests.
Labelling with a new
category of mental illness using the DSM5 in 2013 is increasingly unacceptable
to more and more members of society.
"The good it does
is temporary. The harm it does can be permanent.”(Ghandi)
We therefore need to maximise
appropriate SUPPORT
and reduce areas of INTERFERENCE to
help people achieve their 'POTENTIAL' and
use their unique PERSONALITY to SUCCEED
with their TOTAL PERFORMANCE both
mentally, socially and physically.
So simply put as a
society we must find nurturing, relevant, empathic, creative and motivational
ways of supporting people who are struggling to succeed or experiencing
temporary states of alienation, fear and disempowerment in their current state
of being.
Performance is the total response
of a human being both mentally and physically to the demands placed on them and
to the world around them.
Mental health teams should be working towards achieving and maximsing these shared outcomes with individualised approaches that suit a persons current wants, their self-determined needs and their current situation, starting with where they are at and not where society or professionals think they are or 'should' be.
The aim of the metaphor is to help people identify and reduce the 'teaspoons','cupfulls' and 'kettlefulls' of stress to help give people more self-control, enabling them to stay calm - Traxson 1993.
Mental health teams should be working towards achieving and maximsing these shared outcomes with individualised approaches that suit a persons current wants, their self-determined needs and their current situation, starting with where they are at and not where society or professionals think they are or 'should' be.
The aim of the metaphor is to help people identify and reduce the 'teaspoons','cupfulls' and 'kettlefulls' of stress to help give people more self-control, enabling them to stay calm - Traxson 1993.
THE SUPPORT OFFERED COULD INCLUDE:
"Human Bridge" activities :
- Social Pedagogy - an intensive North European approach using regular psychologically based life -coaching, by highly qualified professionals, for vulnerable and 'Looked After' YP e.g. of positive outcomes of the model is that 6 out of 10 get into University that have had this approach compared to 6 out of 1,000 in the U.K.
- Trusting relationships with key adults - who act as a 'social interpretor' and 'learning coach' to support YP through the school day etc.
-"Positive Targetting" - key adults arrange regular appointments with YP to motivate them and discuss concerns, helping to problem solve situations. They have 'meaningful conversations' with the YP about the 'relative progress' they are achieving.
-Mentoring and life - coaching.
- Modelling - where YP observes closely a trusted adult completing relevant and key tasks, discusses it, does in parrallel and then attempts it themselves.(The Model - Lead - Test Approach of Direct Instruction)
TALKING THERAPIES :
-Cognitive
Behavioural Therapy (CBT)
-Solution Focussed
Brief Therapy (SFBT)
-Reality Therapy (RT)
-Rational Emotive
Therapy (RET)
-Psychotherapy
-Person centred
counselling
-Non directive
counselling
-Coaching
-Play Therapy
-Art Therapy
-Music Therapy
OTHER THERAPIES.
Hydrotherapy,
Aromatherapy,
Hypnosis and 'Ego Strengthening',
Hypnosis and 'Ego Strengthening',
Positive
Visualisations / Affirmations,
The Emotional FreedomTechnique (EFT),
Neuro - linguistic Programming (NLP),
The Emotional FreedomTechnique (EFT),
Neuro - linguistic Programming (NLP),
'Retracking’,"Repunctuating
the day" with postive activities etc.
PHYSICAL OUTLETS FOR
CHANNELING FEELINGS:
-Outdoor pursuits
programmes
-Land based sports
e.g. the Zen of Golf
-Martial arts
training + discipline
-Walking and trekking
-Water based sports
-Sky diving and
bungee jumping
-Xtreme sports
-Gym fitness routines
-Circus skills
e.g.juggling
-Zumba
-Dancing / line
dancing
-Music
-Yoga
HEALTHY DIET
INTERVENTIONS
PROMOTING GOOD SLEEP PATTERNS
ANIMAL BASED
INTERVENTIONS:
-Equine Therapy
-Horse riding
-Rearing animals
-Stroking pets
-Animal welfare
WORKING FOR CHARITIES
WORK EXPERIENCE WITH
CARING EMPLOYERS
STRUCTURED PLAY
INCREASING SELF- EXPRESSION:
- Poetry
- Painting /
sketching
- Sculpture
- Pottery
- Playing an
instrument
- Joining a band
- Music
- Dance
- Creative writing
- Photography
- Digital photo labs
etc.
Building self-esteem
programmes
Stress management
programmes
Building self-control
programmes
Building Emotional
Intelligence (EI) programmes
Parent training
programmes
Alternative
curriculum programmes
Progressive
Relaxation Training (PRT)
Deep breathing
techniques e.g.'7-11'
Yoga
Massage
Meditation
Mindfulness training (focussing on the present - sensory experiences
e.g. breathing.)
MAPPING ANALOGY FOR PLANNING:
"Any journey is
therefore personally mapped discussing these options with a trusted
other and routed based on all the idiosyncratic
topograhical features( e.g. the 'hills','valleys' and 'sanctuaries.') that
might or might not assist them or hinder them on their travels." (Traxson
2011)
To overcome adversity and build resilience, children ideally require:
unconditional love and acceptance
some autonomy/
choice over decisions
trusting relationships with significant adults
feelings of independence / self-direction
trusting relationships with significant adults
feelings of independence / self-direction
making
relative progress with tasks
secure relationships in the community
secure relationships in the community
strong role
models foster friendships and commitment
a safe, stimulating and stable environment
a safe, stimulating and stable environment
create a sense
of 'belonging'
self-confidence and faith in themselves and their world
an intrisic sense of optimism and self-worth
self-confidence and faith in themselves and their world
an intrisic sense of optimism and self-worth
All these things help to build
resilience.
Ideas on Building Resilience by
the 'father of positive psychology' - Martin E.P. Seligman.
"Strangely, however, about a third of the animals and people who experience inescapable shocks or noise never become helpless. What is it about them that makes this so? Over 15 years of study, my colleagues and I discovered that the answer is optimism. We developed questionnaires and analyzed the content of verbatim speech and writing to assess “explanatory style” as optimistic or pessimistic. We discovered that people who don’t give up have a habit of interpreting setbacks as temporary, local, and changeable.
That suggested how we might immunize people against learned helplessness, against depression and anxiety, and against giving up after failure: by teaching them to think like optimists."
This
HPP Model we believe builds incrementally on the previous BPS - biopsychosocial
model proposed by Meyer et al from the 1970's onwards.( excerpts from an
article on the Critical Psychiatry website written by Professor David Pilgrim ,
Lancashire NHS) This model has sadly not significantly altered the power base
of the psycho-physical / bio-medical model which still predominantly pervades
the collective thinking in child mental health work and modern psychiatric
practice.
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