Tag Archives: therapeutic optimism

The picture on the box

Making sense of mental health

Mental health work needn’t drive you up the wall!

Mental health work can seem so complicated… and not just for beginners. Many seasoned practitioners go on for years without a clear idea of how the different diagnoses, conditions and coping strategies fit together. It’s like trying to make sense of a 1,000 piece jigsaw without any real idea of what the overall picture is supposed to look like.

The confusion that arises can lead to workplace stress, unclear aims and difficulties in following care plans with different workers pulling in different directions whilst the service-user or client gets stuck in the middle of a whirlpool of confusion.

It’s always better when you can see the whole picture

This course is intended to provide the ‘picture on the box’. It shows clearly and simply exactly how the different types of diagnosis and conditions fit together and even maintain and exacerbate each other. Delivered either online or face to face (with appropriate distancing, of course) it’s available to staff teams anywhere in the world, just so long as they speak English and have a working internet connection.

The course involves…

Session 1

Anxiety (the gateway to mental disorder)

Freeze, flight and fight

Session 2

Depression (when you’re tired of trying)The opposite of the FIVE ‘F’S             

Psychosis (The Devil makes work for idle hands)

Session 3

Personality disorder (9 statements of vulnerability)

The symptom groups – are the same as the 3 clusters… are the same as the vulnerabilities    

3 models – All roads lead to the same destination   

Session 4

Dependence and self-reliance        

Therapeutic optimism Expressed emotion

Get in touch to book this training for your own staff. Go on, you know you want to!

Labelling, recovery and therapeutic optimism

 Back in 1963, researcher David L. Rosenhan masterminded an elaborate hoax. It was a scam designed to study the effects of labelling upon clinical practice and to determine whether psychiatric diagnosis is based upon professional skill or simple expectation and prejudice. It was a bold experiment with profound implications for clinical practice even now almost half a century later.

The idea was simple enough. Rosenhan persuaded a group of confederates to approach state hospitals in America and request a consultation. Each told the psychiatrist who assessed them that they had begun to hear a voice which said “Empty”, “Hollow” or “Thud”. That was enough to secure them a bed in the local psychiatric hospital. But that wasn’t all, bad though that low threshold for admission might be, in itself.

Once admitted on to the ward Rosenhan’s confederates ceased any pretence of voice-hearing. They behaved perfectly normally and showed no symptoms of mental disorder at all. At this point we might expect the staff running the ward to smell a rat but that’s not what happened. Whilst the fellow patients could tell very quickly that their fellow patients weren’t actually ill, the staff apparently could not.

Even perfectly ordinary activities such as writing was seen as pathological. Pacing up and down through boredom in this secure, low-stimulus environment was interpreted as a sign of illness. It seems that once the label of ‘mentally ill patient’ was applied everything the confederate did was interpreted by those lights.

The staff saw precisely what they expected to see.

This mirrors an earlier study by Rosenhan and his colleague, Jacobson who examined teachers’ attitudes to students who had arbitrarily been tagged either as ‘bright’ or ‘not bright’ by the researchers. The school, known as ‘Oak school’ to protect the identities of all concerned, also lived up to expectations of labelling theory. Not only did teachers interact with children in accordance with the labels they had been assigned, but the children also began to live up or down to the expectations of the teachers – even though their actual test scores had been ignored when they were randomly assigned ‘bright’ or ‘not bright’ status. Each child took on the behaviours and traits of the label, regardless of their actual abilities and achievements.

This is why it is so important that we understand labelling in our work with people who have mental disorders. Whatever we believe and expect is likely to come true.

If you want the people you work with to recover you need to start believing that they can, and you need to act upon that belief. Remember that recovery is built upon lots of little steps in the right direction and we can encourage that simply and effectively by doing relatively simple things, things like offering praise, acknowledgement, recognition and practical help, repeatedly and well.

That’s hardly rocket science, is it?

Complete the contact form below to arrange training for your staff.

Don’t blame people with mental disorders…

“Don’t blame people with mental disorders for behaving like people with mental disorders”

Too often mental health workers expect far more from their service-users than they are currently able to give. Then they blame them for having the very problems that brought them into mental health services in the first place. This is a fundamental misunderstanding of mental illness, of the process of recovery and of the role of mental health workers themselves.

It’s true that people are just people and there really is no ‘us and them’. But when people are struggling it’s not fair to expect them to perform at their best. Instead we should practice ‘therapeutic optimism’… Accept the person’s current difficulties but continue to expect them to overcome those difficulties with a succession of little steps.

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To arrange training for your staff please complete the contact form below…