Academic journal article The International Journal of Narrative Therapy and Community Work

Weaving Net-Works of Hope with Families, Practitioners and Communities: Inspiration from Systemic & Narrative Approaches

Academic journal article The International Journal of Narrative Therapy and Community Work

Weaving Net-Works of Hope with Families, Practitioners and Communities: Inspiration from Systemic & Narrative Approaches

Article excerpt

InTROdUCTIOn

In this paper, I describe some of the practices that I have evolved with colleagues over the past fifteen years for working with networks to create therapeutic oppor tunity. I draw from systemic (Cecchin, 1987, Cecchin, Lane & Ray, 1992, 1994; Boscolo et al, 1987), constructionist (Anderson & Goolishian, 1986, 1988 and 1992; Cronen & Lang, 1994) and narrative approaches (Freedman & Combs, 1996; Griffith & Griffith, 1994; White, 2007), in particular from Tom Andersen's work on reflecting processes (1991; 1992a, b; 1995; 1998) and Michael White's (2000a) outsider witnessing approach.

I began working with large networks within an adult mental health ser vice in the 1990s with parents who had been diagnosed with mental health problems (Fredman & Fuggle, 2000) and with younger adults (aged nineteen to twenty-six) who were admitted to an inpatient psychiatric ser vice with 'a first or second episode of psychosis'. Inspired by Tom Andersen's descriptions of Jaakko Seikkula's consultation work with large systems including family, community and services (Seikkula, 1995a; Seikkula, et al, 1995), I began inviting to meetings the referred persons, their families, ward staff involved in their care, including nurses, psychiatrists, social workers, occupational therapists and psychologists, community practitioners and significant and involved members of their local communities.

These 'network meetings' not only created oppor tunities for enhanced communication between the referred person, their families and practitioners, and facilitated coordinated and collaborative future planning among the different people involved; in most situations, they also offered therapeutic oppor tunities for all who par ticipated. Practitioners who were initially demoralised by lack of progress or overwhelmed by the enormity of their tasks, moved from attempts to withdraw or avoid contact with their clients towards motivation to stay involved and towards hope that inspired offers of creative contributions to the work. They repor ted that the meetings had given them 'more ideas about how to proceed' and clients were 'better engaged'. In most situations clients gave positive feedback to family or staff about these meetings, reporting that they felt 'listened to', 'understood', 'supported', 'taken seriously'. Family members reported feeling 'more hopeful'.

About ten years ago, I was introduced to Michael White's outsider witnessing approach (White, 2000a). Appreciating each model, technique or map as a different discursive option, I embraced the new perspectives, practices and orientations of outsider witnessing as an oppor tunity to enrich our network oriented approach. I have since joined with colleagues to work with these practices across a range of physical and mental health ser vices with older people (Anderson & Johnson, 2010) and people with intellectual disabilities in both inpatient and outpatient settings. My team and I have gone on to develop these practices within a child and adolescent health context (Christie & Fredman, 2001; Fredman, 2007).

The people using all these ser vices are usually connected in large networks of relationship with family, community and practitioners providing health, mental health, social care and education ser vices. The more isolated the individuals using these ser vices are from family or community, the more services seem to be involved.

Anderson and Johnson (2010) make a valuable contribution to network practices addressing: planning for network meetings; deciding whom and how to invite; contracting; ending with joint action planning and documenting the meeting.

In this paper I will focus on the activity and processes of 'weaving a network of relationships' and 'centring the client' that open space for collaborative dialogue and lay the foundation for those included to tell and witness preferred stories of each other and themselves. I will draw from examples of practice within a medical inpatient and outpatient service for children and young people who present with problems that affect their bodies, for example diabetes, rheumatoid ar thritis, cancer, chronic pain and fatigue, as well as some conditions that defy diagnosis. …

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