dxsummit.org - The Commentary for the Holistic Politico-Psychological Model of Mental Health and Wellbeing

 

We are collectively at a new dawn of understanding our Mental Health

HYPERLINK TO HOLISTIC POLITICO-PSYCHOLOGICAL MODEL OF MENTAL HEALTH AND WELLBEING

http://dxsummit.org/archives/1664

A Commentary for the Holistic Politico - Psychological Model(2013) - for the Solution Focussed Discussion of a Child’s Mental Health Needs and their Wellbeing within the Context of a Multi-professional Planning or Child in Need Meeting.

(HPP MODEL : Traxson, Parker, Rowland and Matthews 2013 – article pending in the Division of Educational and Child Psychology Debate Journal  By Dr Kevin Rowland and Dave Traxson –December 2013)

“What we require as professionals is a naturalistic narrative about a client’s needs and opportunities for change rather than  a dysfunctional discussion of dubiously diagnosed disorders.”(Traxson 2013)

FEATURES OF THE MODEL –

- A multi-dimensional discursive approach that challenges the dominant 'within   child' biomedical model of mental illness that currently drives the majority of practice with Mental Health and Psychiatry professionals.

- An optimistic and Solution Focussed approach to the understanding and resolving mental health needs that uses a primarily Humanistic Psychological perspective to generate thinking and solutions that benefits 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 help resolve their current difficulties.

- Colleagues using it have reported that it promotes a Holistic reflection on the young persons’ needs and helps to ‘unstick’ bio-medical ‘log jams’  that can often result from only looking at the presenting situational pattern from a rational scientific viewpoint.

 - A Key Isssue is the use of terminology.The difference between 'client' and 'patient'is a fundamental one.

'Patient' often represents a totally different 'mind set' for those involved and has so often the meaning 'of doing to' someone rather than the 'co-constructed' view of 'discussing with' and the notion of 'shared responsibility' for the agreed way ahead.

- A blank  proforma  allows summary notes to be taken of the discussion that can then be formulated into a Hypothesis and Action Plan to help avoid the need for psychotropic medication to be used with the child. The hope is that it will encourage creative thinking in the ‘team around the child’ to develop proactive strategies that resolve issues without recourse to ‘quick fixes.’

THE FORMULA :

OPTIMAL PERFORMANCE  = (POTENTIAL + PERSONALITY) - INTERFERENCE + SUPPORT

So, a human being's   Optimal  performance is about maximising the  positive interaction of their inner potentials   and their unique   personality taking away the   interference   from many listed factors  then adding the ‘magic element’ which is the    support  that we can creatively offer  as professionals and a society.

TRY THE PROFORMA  and make notes under each category, during a multi-professional meeting, to help you formulate your professional  working hypothesis and action plan for positive change.

INSTRUCTIONS FOR USE OF THE PROFORMA:

1)Place the detailed table of the HPP Model within easy sight.

  2)Use the prompts under each heading to elicit discussion with  all professionals of the child’s holistic circumstances and needs. Obviously this is not all done in  one sitting but is a cumulative process over a series of discussions / supervision sessions.

    3)Make brief notes of the key points of the discussion.

4)Formulate a hypothesis 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 of them as mentally ill or as patients  that the health system acts upon in either a hopefully beneficial or sadly all too often in a harmful way.”                ( 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.

“Giving a child a label of mental illness is stigmatisation not diagnosis.”

“ The two most precious things in life are children and freedom.” - medicalisation harms both of these  (Thomas Szasz from his speech on “The Myth of Mental Illness.” – on Youtube .)

"Psychiatry is still so subjective that it would be more honest to use Social Science Methodologies for assessment and review rather than Medical Model Systems. This would better Safeguard our children.” (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)

                                                                                                       

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.  disadvantage, poverty, exercise, locality, air quality including crop spraying and sound or infra- red pollution.

EDUCATION e.g.  positive expectations of children, quality of personalised programme, relevance, and the influence of inspirational  teachers.

TOXICITY e.g.  relationships, abusive households, medications, subcultures, environmental pollution and dietary additives etc.

BIOLOGICAL e.g.  physical and mental health, genes and family traits, diet, toxins, metabolic rate and 'recovery rate.'

INTERPERSONAL e.g. 'interpersonal transactions'(T.A.), ‘family dances,’(Family Therapy) friends, social groupings , social dynamics and ‘personal power’(Family Links) e.g. bullying or being bullied.

SPIRITUAL e.g.  beliefs, dogma, ‘inner peace of mind,’ spiritual ideation, meditation, ‘special place’ or sanctuary and personal relevance.

POLITICAL e.g.  oppression, ideology, ‘mind set,’ class,  elites, status, power relationships, personal relevance and prejudice.

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 along with their successes.

PATTERNING e.g. routines, established patterns of behaviour,  ‘family dances,' sleep and eating patterns and biorhythms.

EMOTIONAL e.g. loves - hates, hopes - fears, ‘emotional articulacy’ or  E.Q., ablity to maintain relationships and cope emotionally with them.

INTELLECTUAL e.g. interests, hobbies, reading preferences, self-expression, response to challenge and stimulation.

AESTHETIC e.g. music, colours, arts and crafts, architecture, drama, environmental stimuli e.g. light , smells and response to paintings etc.

All of these dimensions have Positive and Negative elements that interact to produce the 'big picture.'

The aim of mental health work is simply to ameliorate where-ever possible some of the Negative aspects and to promote the psychological benefits of increasing the person’s development of their own 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, social circles and colleagues.

POLITICO  -  that all individuals live in and their 'mind set' is fundamentally 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, cults or evangelising groups of any faith,  political persuasion, or belief subgroup.

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 the new proposed categories of mental illness using theDSM5 in 2013 is increasingly unacceptable to more and more members of society.e.g. “Sub-clinical normal variation social anxiety” that until now we have called 'shyness' and subclinical normal variation depression which is usually called 'sadness.'

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 positive and negative factors of the world around them.     Mental health teams should be working towards achieving and        maximising these shared outcomes with individualised approaches that suit a person’s current wants, their mutually determined needs and their  situation, starting with where they are at and not where society or professionals think they are or 'should' be.                                                                                                               We need to reduce the stress in their internal ‘stress bucket.’ (Traxson 1993)

Basically if we reduce the 'teaspoons', 'cupfuls' and 'kettlefuls' that helps people develop more self-control, enhancing their personal self-efficacy and their feelings of self-worth and wellbeing - 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.(See post on my blog:cope-yp@blogspot.com and use search engine on blog)

- 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)

                                                                                                        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

- Drama Therapy

-Music Therapy

OTHER THERAPIES.

Hydrotherapy, Aromatherapy, Hypnosis and 'Ego Strengthening',

Positive Visualisations, Affirmations, The Emotional Freedom

Technique (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, orienteering, cycling etc.

-Martial arts training and the associated self- discipline

-Walking and trekking

-Water based sports e.g.canoing,sailing,water skiing.etc

-Sky diving and bungee jumping

-Xtreme sports 

-Gym fitness routines

-Circus skills e.g.juggling

-Zumba and exercise classes

-Dancing / line dancing

-Music – playing individually or in a band

-Yoga

ECOTHERAPY

HEALTHY DIET INTERVENTIONS e.g. ‘5 a day,’ or mindful eating

PROMOTING GOOD SLEEP PATTERNS e.g. avoiding stimulants

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

RELAXATION TRAINING:

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 uniquely routed  based on all the idiosyncratic topograhical features that might or might not assist them or hinder them on their travels." (Traxson 2011)

We should aim to build resiliency in vulnerable others in all of these following areas.

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

    making relative progress with tasks   

    secure relationships in the community

    strong role models foster friendships and commitment   

    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

   

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 or potential for negative influence of the psycho-physical / bio-medical model which still predominantly pervades the collective thinking in child mental health work and modern psychiatric practice.

CONTACT DETAILS:

Home telephone: 01902 741193

Mobile: )7809 460521

Home e-mail: traxsondave@gmail.com

Blog: cope-yp@blogspot.com

Twitter: @davetraxson