The self evaluation assignment-managing change and promoting collaborative practice - Essay Example

The Self Evaluation Assignment-Managing Change and Promoting Collaborative Practice I am currently a mental health practitioner based in tier 3 of the outpatient unit for children and adolescent mental health services. We are specialists from different multidisciplinary teams that deal with problems too complex for tier 2. (Bicard & Davis 2012) state that such complex problems include development problems assessment, hypersensitivity, autism, early onset psychosis and depression. The team has needed me also to work as a systemic practitioner within our family therapy service. This involves working as part of a reflective team and as a lead therapist, where we strive to implement processes and techniques that assist in various systemic activities. Another activity I engage in, on occasion, is providing both external and internal consultation to my fellow colleagues and experts. Participative collaboration is a substantive aspect frequently discussed in health and social care services (Turpin, Rodger & hall 2012). The system at my workplace is very complex that allows the development of conflicts and chronic tension. It frequently undergoes considerable external stress in relation with concerns of high-risk in young adults, insufficient resources for families and children and funding issues. Nevertheless, the system remains to offer stable care relatively for a while even with its low staff and exhibits ability to adapt to new service demands. (Roose & John 2003). I think collaborative participation is a cornerstone of institutional conflict resolution. As a collaborative practitioner, I am required to facilitate conversations around children and families in order to promote the expression of different perspectives concerned with effective ways of defining and approaching problems. I believe in the strength of team performance. There are a range of differing perspectives held by different professionals in multi-disciplinary teams/consultation meetings. Therefore, how we the use theory to consult and communicate with different individuals in complex clinical situations can vary. Systems thinking remain a very strong influence in my work setting. Systemic Practitioners have challenged the medical-psychiatric model over the years due to diagnostic language and their view of pathology. (Strong & Bush 2013). My epistemology is based on social constructionist view of the world. I would aim to work in a collaborative manner in viewing clients as having a unique understanding of their conditions. When discussing clients within the consultation process, mindful of how I communicate my ideas, I aim to use language for others to engage in a systemic conversation, thereby, creating a context to help people think more systemically. (Campbell & Huffington 2008) propose six steps in the process of systemic consultation that allow you to develop tools and techniques in the consultation process. Refer to systemic consultations as a way to move people from different thinking to a systemic view. Consultation process creates a new context for other ways of understanding the situation and ways to respond (Campbell & Huffington 2008). Systemic Consultation is an area that I would envisage I will improve as I continue to build on my experience of systemic practice. My role as a mental health practitioner requires emergency mental health assessments to be completed. Hence, our work as practitioners is to make an analysis of how lethal the suicidal case is to determine the weight of the situation. The organization introduced a standard assessment procedure (FACE Risk Assessment) to measures the level of risk (Kondrat & Teater 2010). Our client groups are heterogeneous and complex. Our response to them needs to be sensitive to their needs. First encounters with clients’ needs to be shaped by what we see and hear and our skills adapt accordingly. Our response should not be predetermined by work principles that have to be followed all the times. My foremost fear is in relation to the introduction of these tools is the potential damaging influence they could have on the progress of the therapeutic relationship. The research tells us very clearly that therapeutic results are determined to a significant degree by the quality of the therapeutic relationship (Flaskas 1997). Moreover this is the case regardless of the therapeutic modality used. Therefore, our work in balancing organizational methods is in applying therapeutic methods of assessing the suicidal patient. The use of this tool is extremely challenging. Follow up work allows further opportunity to provide a context to work collaboratively to ensure the patient is recovering successfully. The program has encouraged the practice of a ‘Solution Focused Approach’ allowing clients to consider solutions to problems. This approach is empowering when you consider that hope and hopelessness do not have to be separate entities. (Flaskas 1997). A Solution Focused model fits well with my growing interest in narrative practices and how we work on the relationship with the problem rather than viewing the problem as stemming from the intra-psychic domain of the person (Eingarten 1998) On the other hand, working as a systemic practitioner within family therapy team has required me further to scrutinize my systemic knowledge base and experiment with other ways of working. The model used within my team is based on 5 part Milan model with the use of reflecting a team and reflecting conversations (Hoffman & Anderson, 2007) as part of this process. We ask the family questions and encourage their comments to offer a reflection of their view. This approach encourages transparency that is useful in expanding the family and the therapist’s lenses so that new ways of seeing are possible and increased options are available (Hoffman 1990). Families determine their relationship and reality with each other. ‘There is nothing so obvious that its look is not transformed when it is seen in a different light…Whatever existed can be reconstructed’ (Kelly 1969). Working as part of the reflective team is a comfortable place. The program has raised the issue of experimentation of clinical skills that are applied to different stages of the treatment process. These include the ability to maintain an alliance in treatment and the use of the ideas of hypothesizing, curiosity and strategizing (Tomm 1984). Change of setting in attending clinical placement moved me to a “not knowing” state that required a step back in time to build my knowledge and application of Milan approach in practice, prior to this sidestep of the use of the Milan techniques. Therefore, concepts of hypothesizing and circular questioning needed revisiting! Understanding that hypothesizing implies the creating of tentative solutions concerning interventions strategies and outcomes (Cecchin 1987), hypothesis formulation is a necessary step in the preparation of therapeutic intervention and has enabled me to change my stance as a therapist allowing further curiosity to arise. Curiosity can create a context for change in my practice, enhance my use of circular questioning, the challenge, and gentle reminder that the use of questioning is a way to gather and introduce information into the system. Information gathering is critical because it aids in gathering information and validating of hypotheses regarding the dynamic structure of the families (McDonald & Bubna-litic 2012). Bateson considers information as the difference that makes a difference. A new context has resulted in the learning and use of new information, created a different cycle of working that impacted on my style of interviewing, perturbed me as a therapist. Families are also dynamic and respond to their context, the capacity for change in families is essentially built into the family system. If the systemic therapist can present news of difference through the use of circular questions, it will help introduce differences in a variety of contexts. (Garven & white 2009). Therapist can also create a context for development through the use of collaborative language systems approach where language and discussion are seen as the core concepts. (Anderson 1997). The process of treatment is a very therapeutic conversation as it involves a dialogue between therapist and family where change in the cognitive or behavioral domain is a completely natural consequence. In conclusion, Systems’ thinking has a very strong influence within the company in spite of other programs and models that have been added over the past years. Funding by the company for the students to attend the Masters in Systemic Psychotherapy reflects the same. Moreover, my team creates an understanding of various systems that impact individuals and family life enabling them to work collaboratively with different clients. We develop and advance ability to perform a self-reflection, as well as reflect on and use personal experience as tools. My supervision helped apply this understanding in practices of treatment. Learning is a continuous process that keeps on happening throughout the service time. Supervision and training are crucial during the service period helping therapists to identify errors in their performance and institute proper mechanisms to counteract the adversities associated with delivery deficits. The course has also helped me in improving my work with children and families through increasing and consolidating my clinical and theoretical skills and understanding of using oneself in practice. Including a wide range of methods has been an important characteristic that has participated in encouraging my development of the theory that is approached critically and practice examining differences and inequalities such as race, gender, class, encouraging anti-discriminatory and ethical methods to clients. The training has enabled me to use self-reflexive practices as a core training aspect making a difference to my work as a collaborative practitioner and to how I view development process and work with challenges. References Anderson, H. (1997) Conversation, Language, and Possibilities: – A Post Modern Approach to Therapy. New York: Basic Books. Bicard, S., Bicard, D. F., Nicholas, K. F., & Plank, E. F. (2012). Technology for Multi-Tiered Interventions for Reading and Behavior in Early Childhood Education. Campbell, D & Huffington, C (2008) Organizations Connected: A Handbook of systemic Consultation: London, Karnac Cecchin, g. (1987) Hypothesising-circularity-Neutrality revisited: an invitation to curiosity. Family Process, 26, 405-413 Garven, R. and White, H. (2009) Key Systemic Ideas as Seen Through the Eyes of First year Trainees. The Australian and New Zealand Journal of Family Therapy, 30, 3,196-215 Flaskas, C (1997) Engagement and the therapeutic relationship in systemic therapy. Journal of Family Therapy, 19(3), 263-282 Flaskas, C. (2007). HOLDING Hope and hopelessness: therapeutic engagements with the balance of hope. Journal of Family Therapy, 29, 186-202. Hoffman, L. (1990) Constructing Realities: An Art of Lenses. Family Process, 29 1, 1-12 Hoffman, L (2007) the art of “witness”: A bright new edge. In H. Anderson & Gehart (eds.), collaborative therapy: Relationships and conversations that make a difference, 63-79 New York: Brunner/Routledge Kelly G. (1969) Clinical Psychology and personality: The selected papers of George Kelly. B Maher (ed.).New York: John Wiley & Sons KONDRAT, D.C, & TEATER, B. (2010) Solution-focused therapy in an Emergency Room setting: Increasing hope in persons presenting with suicidal ideation. Journal of Social Work 12 (1) 3-15 McDonald, M, & Bubna-Litic, D (2012), Applied Social Psychology: A Critical Theoretical Perspective, Social & Personality Psychology Compass, 6, 12, 853-864, Roose, G. A., & John, A. M. (2003). A focus group investigation into young children understands of mental health and their views on appropriate services for their age group. Child: Care, Health and Development. 29, 545-550. Strong, T. & Bush, R. (2013) ‘Family Therapy and the Spectre of DSM-‘5. Australian and New Zealand Journal of Family Therapy. 34, 87-89 Tomm, K (1984) one perspective on the Milan systemic approach: Part 11. Description of session format, interviewing style and intercventions. Journal of Martial and Family Therapy, 13, 2 139- 155 Turpin, M, Rodger, S, & Hall, A (2012), Occupational therapy students perceptions of occupational therapy, Australian Occupational Therapy Journal, 59, 5, 367-374. Weingarten, K (1998) The Small and the Ordinary: The Daily Practice of a Postmodern Narrative Therapy. Journal of Family Process 37, 3-15 Read More