Many refugee children and adults struggle with psychological problems. The childrens’ poor mental and social situations place great demands on the parents. Mothers especially describe a very exhausting daily life, and have their own psychological difficulties and stress. Cultural tradition may create patterns and behaviour which can be difficult to change. Parents want guidance in parenting skills. Most of all, they want time to be parents for their children. This is difficult combined when with participation in the introduction program.
Autonomiens betydning og vilkår ved ambulante akutteam – en teoretisk analyse
Med utgangspunkt i politiske beslutninger relatert til utviklingen av nye tjenester innen psykisk helsevern, er ambulante team etablert ved flere av de 78 distriktspsykiatriske sentrene i Norge. Å jobbe ambulant utfordrer tjenesteytere på flere områder, blant annet kunnskapsgrunnlaget de baserer seg på. Spørsmålet er om det er mulig å utøve en mer brukerinvolvert tjeneste uten for mye fokus på system og standardiserte rutiner, når et menneske får hjelp i sitt eget hjem i stedet for å bli lagt inn i en akuttpost. Forskning viser at mennesker med egenerfart psykisk krise opplever økt mestring og egenkontroll (autonomi) i møte med ambulante akutteam. I denne artikkelen vil vi drøfte hvordan autonomi, som et relasjonelt fenomen mellom bruker og tjenesteutøver, kan bli realisert i praksis. Dette drøftes også i relasjon til rammebetingelser som kan begrense klinisk autonomi, og dermed også hemme forutsetningene for utøvelse av en human og brukerfokusert tjeneste.
The significance and conditions of autonomy in relation to crisis resolution home treatment teams
The Norwegian Health Directorate targets the creation of ambulant home treatment teams in all 78 DPS units in Norway. This is seen not only as a new way of organizing services in the mental health field, but also as a new way of thinking which implicates an effort from the providers to involve users and next of kin in clinical decisions and the handling of crises. In this article we challenge the knowledge base for this kind of practice, and the necessary framework conditions. Research in this field shows that people who have received help at home for a mental health crisis, experiences increased feelings of coping and autonomy. It seems that a central premise for this is an experience of respected subjectivity and agency. We discuss how autonomy, as a relational phenomenon between user and provider, can be realized in practice. One problem can be framework conditions which foster standardization of practice and reduce the provider's clinical autonomy and, unintentionally, restrain the users’ autonomy.
Expressive arts therapy is a resource-oriented form of group psychotherapy where one views the art piece as it presents itself in a phenomenological context. The art product is accepted as it is; there is no interpretation, but it is viewed and shared. To be seen by others through the art piece, can increase self-confidence and self-acceptance. Expressive arts group therapy integrates and shapes experiences, recollections and emotions that cannot be verbalized directly. This article defines group-oriented expressive arts therapy, the group members, the specific structure of the group and its goal. The results are based on written evaluations and personal interviews of the group members, discussed through theory and recent research results in the field of the expressive arts. The article is based on two years of group therapy at Vinderen Psychiatric Heath Care, Diakonhjemmet Hospital.
The purpose of this article is to describe central aspects of the evidence movement, discuss the hierarchy of evidence and to relate the discussion on evidence based practice (EBP) by using a concrete example, namely co-operative research in the practical field conducted by the Institute of Mental Health and Society, Hedmark University College. We consider that this research milieu can be regarded as one of many examples of how the intentions of the Plan of Action can be pursued and developed further. In several ways the Plan of Action was a ground-breaking step towards achieving a more holistic and qualitative support for people with mental health disabilities. The EBP movement has proposed a working model which is supposed to lead to the best possible help that society can provide for vulnerable groups, including persons with mental health disabilities. This article argues that scientific knowledge, professional expertise and users' experiences, views and wishes should be valued equally – and should serve as a basis when making decisions about treatment and care of individual patients (situated evidence). Concerning the legitimacy hierarchy of evidence, we argue against the one-sided prioritization of RCT studies, and hold that a variety of data collection methods and modes of analyses could and should be used – and that they should be complementary to each other.
This article is based on experiences of a clinical social worker in a psychiatric outpatient clinic for adults. It is about a practice where the intention is not only to discover the client`s emotional and conditional experiences, but also their bodily experiences. Psychomotor physiotherapy and mindfulness are presented as two perspectives that give attention to the phenomenon of presence. In the article this will be illustrated in the encounters with two clients. Working with their own presence, both the client and the therapist become aware of and understand the connection between experiences of life, pain and feelings. The experiences of being present in the relationship, may in this way promote attention in itself and acceptance of what is, and extend the clients self-narratives.