Collaboration & Accountability

Posted by on Jun 24, 2015 in Uncategorised | 42 comments

Narrative practices respect people as the experts of their own lives. As such, our expertise is not in how we deliver ‘interventions’, but in how we provide a context, through a scaffolding of questions, that makes it possible for people to become more aware of their own skills and knowledges and how to use these to address difficulties they may be facing.

We have included here a diverse collection of resources about the sorts of collaborations that are a key aspect of narrative practice.

 

 


Amanda Worrall is a mental health nurse in the Northern Territory (Australia). This presentation tells the story of how June and Amanda found ways to use externalising conversations to name and speak about social paranoia (SP). It also describes the ways in which these conversations enabled June to reclaim her life from the effects of paranoia. This presentation was filmed at Dulwich Centre at the International Spring Festival of Narrative Practice that took place from September 21-23, 2011.

 


Narrative therapy and community work practices engage what has come to be called a ‘Decentred and Influential’ position from which we can work with people. In this extract, Michael White describes this therapeutic posture.

Michael White Workshop Notes

The Four Quadrants

De-Centered Centered
Influential De-centered and influential (potentially invigorating of a therapist) Centered and influential (potentially burdening of therapist)
Non-influential De-centered and non-influential (potentially invalidating of therapist) Centered and non-influential (potentially exhausting of therapist)

It is the intention of the therapist to take up a “decentred and influential” posture in conversations had with the people who consult them – to develop therapeutic practices that make it possible for him/her to occupy the top-left quadrant. The notion “decentred” does not refer to the intensity of the therapist’s engagement (emotional or otherwise) with people seeking consultation, but to the therapist’s achievement in according priority to the personal stories and to the knowledges and skills of these people. In regard to the personal stories of people’s lives, in the context of this achievement, these people have a “primary authorship” status, and the knowledges and skills that have been generated in the history of their lives are the principal considerations.

The therapist is influential not in the sense of imposing an agenda or in the sense of delivering interventions, but in the sense of building a scaffold, through questions and reflections, that makes it possible for people to:

a) more richly describe the alternative stories of their lives,

b) step into and to explore some of the neglected territories of their lives, and to

c) become more significantly acquainted with the knowledges and skills of their lives that are relevant to addressing the concerns, predicaments and problems that are at hand.

 


 

In this paper by Sue Mann we examine ways of documenting that draw on collaborative practices, with particular reference to writing medical records.

‘Collaborative representation: Narrative ideas in practice’ | Sue Mann

 


The Just Therapy Team, from The Family Centre, Wellington, New Zealand, consists of Warihi Campbell, Kiwi Tamasese, Flora Tuhaka and Charles Waldegrave. Their highly respected work, which involves a strong commitment to addressing issues of culture, gender and socio-economic disadvantage, has come to be known as Just Therapy. These practitioners and their work significantly influenced narrative therapy and community work responses to accountability.

Extract from ‘Just Therapy’


This presentation by Tileah Drahm-Butler aims to bring forth conversation on the ways that narrative therapy can be used as a decolonising practice, where Aboriginal and Torres Strait Islander knowledge and skill in resistance is honoured and talked about in a therapy setting.Tileah is a Social Worker in a hospital setting, currently working in Emergency Department and Intensive Care Units. She completed the Masters in Narrative Therapy and Community Work in 2014 and is passionate about finding ways to describe Narrative Therapy practices in ways that are culturally resonant to Aboriginal and Torres Strait Islander people.  Furthermore, in the work that Tileah does, she continues to learn alongside the people who she meets to create and re-create narrative practices that are culturally resonate, and that are shaped by cultural and spiritual practices.

Decolonising Identity Stories | Tileah Drahm-Butler

Tileah-Drahm-Butler

 


 

 

For Reflection

 

In what ways have you entered into collaborations before? What made these collaborations possible?

 

What might make it hard to enter into these practices?

 

If these ways of working fit for you, what next steps could you take to build partnerships/collaborations in your work?

 


 

Please now join with others in reflecting on these questions and other wonderings below! Please include where you are writing from (City and Country). Thanks!


42 Comments

  1. Hello everyone, this is Lucia, from Spain. I found this one to be a beautiful and inspiring chapter. I deeply believe in collaboration, sharing, group work and accountability in order to grow (though it’s not easy!), learn and achieve better outcomes because if you close yourself to what you know, you are placing limits. I really likes what The Family Centre, beautiful work full of meaning and with a very clear base. And Tileah’s video was a wow, inclredibly insightful and with an very powerful concept for me, the Strong Line. I’ll try to (and will, whenever it’s possible for me) apply it from now on.

  2. My overriding observation and reflection on my past work is that “threat” acts as a huge barrier to truth within direct intervention with people. This threat seems to come from a fear of judgement, and consequently professional actions which might have significant consequences for people and take away control from their lives. A typical example in family work would be child protection issues and processes. The documents in this section reveal to me the differing ways in which practitioners have enabled the barrier of threat to be taken down. This seems to be a combination of taking time, building trust through genuine interest in the person and their agency being shown, and enabling the person to retain (or regain) a sense of control and agency enacted through their narrative. This has been really inspiring, and I feel hat focusing on this could really help me develop effective ways of working with people at a more truthful, and therefore resonant, level.

  3. I feel that my genuine interest in people and their stories fit naturally into the mould of collaborative practice. I am of CALD background, born in Greece – the listening of stories and telling of stories was embedded in my family and (in reflection) a way of keeping my parent’s dreams and hopes of their motherland, our roots – family survival of the Greek Genocide, culture, traditions and language alive (resonated with Tileah Drahm-Butler presentation).

    Every story we give or receive is a little like gift giving – each gift opened has a story that has lived within and a ‘story behind the story’. When we work alongside each other we awaken the untold stories and by doing so we honour the knowledge, skills and ‘survivance’ of the story-teller, whoever that may be in a ‘de-centred and influential’ way.

    Policies, confidentiality, funding, management/organisational position, our positions of experts holding power/authority problematise the stories we are told. I feel, these are some of the things that get in the way of Narrative work/Collaboration. Sue and Amanda’s pieces unlock creative thinking especially around the clever use of Amanda’s outsider witnesses. Making consented de-identified documents/letters available to outsider witnesses for their responses may be a way to overcome the confidentiality-policy hurdles. Perhaps wishful thinking on my part.

  4. The way I have found to enter collaborative practise is to prepare well to ease congruency, understanding and openness. Be patient, build rapport and understand that trust takes time. Be explicit about the goals by listening to what the clients need to help them choose the preferred direction for their lives. Entering these practices with clients that are not ready to talk openly or clients that challenge your ability to remain congruent would make this difficult.

    Campbell, Tamasese and Waldegrave’s idea of connecting with people is a terrific way to start ‘Just Therapy’. I also like the transparency of quantifying data to get policymakers to understand. As well as the movement to a value-based rather than medical model to capture issues based on social constructs. I also resonated with Sue Mann’s reflection on the issues of representing client’s lives. I thought the way she brought to life the concept of a collaborative practice working towards partnership is a respectful model which opens new possibilities. My next step is to work with my clients writing their case notes with based on the information they consider significant. Tileah Drahm-Butler notion of a ‘strong story’ is a powerful idea that influenced me. I love the way her narrative map unravels the causes of this suffering because of colonisation.

    Perth, Australia

  5. Working with women who are victims/survivors of domestic and family abuse I am constantly reminded of the stories women come with, of incredible courage, resourcefulness and imagination which can easily go unheard or acknowledged. (Thank you Sue Mann) They really are the experts.
    Using collaborative representation we ask women if there is anything in particular they would like recorded on their behalf. Women are also given the choice to compile their own ‘support plans’ or collaborate with worker to do so.

  6. In my career I have had a few roles where I have worked with clients from Aboriginal and Torres Strait Islander cultural backgrounds. I have always tried my best to work in ways that respect and empower my clients, but as a white person myself I’ve stumbled many times when making assumptions and value judgments that stem from my own culture and upbringing.

    It’s something that is really quite hidden, this concept of white privilege, when you grow up you get used to your own cultural norms, and I have accepted as normal all the opportunities that have come to me over my life.

    But now through my work I have been exposed to my own privilege, to know that my achievements have come with far less struggle. My education, my job opportunities, my family upbringing, my health, my skin colour, etc. have all been advantages for me.

    Learning of structural and institutionalised racism, the negative media and politics, the impacts of colonisation, the stolen generations, etc. have all taught me how lucky I have been to have been born white, male and middle class.

    To be accountable and to collaborate effectively with my Aboriginal and Torres Strait Islander colleagues and clients I feel like I must always reflect on the privilege I have experienced and the injustices that my clients have experienced, so that I can be fair in my thoughts and that my behaviour, attitude and actions can demonstrate respect and integrity.

    From a practice standpoint, I think this means to not be afraid to acknowledge the elephant in the room, i.e. my own cultural biases and privileged background, whilst sharing my desire to be of help .

  7. In what ways have you entered into collaborations before? What made these collaborations possible?

    From Melbourne, Australia.

    In my work with children who often don’t initiate sessions with a helping / allied health person, I have noted that there can be lots of resistance from the child to ‘the teaching of psychological strategies’ which is the dominant discourse for providing support via Medicare and Mental Health Care Plans. My understanding of a strengths perspective seems more aligned with narrative therapy in that we are helping the client identify their preferred ways / skills in addressing problems – and I find that children are more likely to experience improved functioning when they author (depict) and identify there own coping strategies rather than me ‘teaching’ them techniques.

    What might make it hard to enter into these practices?

    What makes it difficult are expectations from parents and other professionals that something will be taught (i.e., new skills that don’t necessarily resonate with the child) or some deficit discovered, rather than identifying or enhancing a child’s capacities, empowering the child or acknowledging how they are already coping – and also the problem of their wider context. I too often feel I am being asked to help children adjust to unhealthy or unsuitable contexts – which sits very uncomfortably. Also parental and teacher focus on ‘the child’s problem’ and schools wanting to label and diagnose children for funding / medicare requirements for a diagnosis of a disorder for session-funding, which requires assessment of symptoms / deficits. It seems so easy for organisations to place responsibility for problems with individuals.

    If these ways of working fit for you, what next steps could you take to build partnerships/collaborations in your work?

    I am beginning to incorporate children’s voices into email correspondence with parents and teachers, and in reporting letters to GPs. I also have parents check over and okay assessment reports before they become part of the record, to share ownership and control. I keep working to help adults understand how influential people and contexts are for children and their behaviour!

    I really appreciated Amanda Warrell’s work and telling of June’s story – thank you!

  8. Questions:
    In what ways have you entered into collaborations before? What made these collaborations possible?

    What might make it hard to enter into these practices?

    If these ways of working fit for you, what next steps could you take to build partnerships/collaborations in your work?

    Responses:
    I hold many views. One of which is- I cannot change another person. However, as a therapist, I can provide tools and assistance that have potential to enable persons seeking therapy, effect changes they desire for themselves to bring peace, harmony and balance in their life. This Chapter has been very clear on respecting individuals identities, empowering and respecting them as owners and tellers of their own life story/journey and the critical posture of being “DeCentred”. That the “problem is the problem” not the person. I have a passion for engaging in collaboration and consultation with others where they have sought it. All these elements I believe, are only some of the fundamental prerequisites for success in collaboration.

    As a professional, I have experiences in collaborative consultation (which is embedded through out Narrative Therapy Practices as I understand it). Unchecked Ego’s, ignorance, racism and all sorts of bias whether perceived or real, disrespect, acts of negation, pre-conceived ideas, minimisation, lack of Practitioner qualities, skills and abilities to effectively undertake work as a Therapist and such, are just some of the factors, that can substantially and negatively impact entering into Narrative Therapy Practices as a whole.

    The Narrative Therapy Practices discussed in this Chapter fits well with me and I embrace the wisdom and experiences shared in it by the various authors/presenters.I look forward to sharing with others the further evidence that NTP is a highly effective approach to supporting individuals and groups in working through their trauma’s that led them to seek therapy.

    NTP speaks my language and is ‘like music to my ears’. Thank you

  9. I have worked collaboratively with people in the field of personal development. I have facilitated workshops which offer people opportunities to tell their stories and explore possibilities in making change to those stories. Within the context of the workshop sometimes suggestions are offered but always on the understanding that they do not have to be accepted, or can be adapted by the participants to make them more relevant and useful for them, or simply used to spark ideas to explore with the participants alternative ideas they may already be contemplating. Collaboration was made possible by discussion prior to the workshops to talk about what they were seeking from the workshops and inviting them to join the workshops from the position of being the experts in their own lives and simply seeking new knowledge to develop a future of their own choosing.

    What makes it hard to enter into these practices is that I must always be aware of my own agendas – both those I can easily identify and acknowledge and more particularly those which are hidden because they are embedded on a deeper level and not yet identified or acknowledged.

    Working collaboratively does fit for me. A permanent step which I continue to take and retake is to develop increased awareness of my own issues so that I can deal with them in ways that support me, and allow me to set them aside when working with clients and participants so that I can focus wholly on their stories in ways that allow them to choose their own goals and ways forward.

  10. I have tried utilising Influential-Decentred approaches, however always find myself drawn back to Centred approaches. You can see the difference when it is Decentred, however I am usually working in a brief therapy setting where, because of funding pressures and care plan timelines, you feel more rushed to achieve where you need to go.

    I find it a lot easier to work on a decentred approach with children and teenagers than with adults, as they haven’t come in to see you with the knowledge that you are a “professional” and are looking for directed answers.

    It is something that I am continuing to work on, and with certain clients I can see it being more difficult but worthwhile.

  11. I think I often enter into collaborations with an end in mind and this is counter-productive to the collaboration process. Trying to give advice based on my own experience makes it hard to enter into collaborative practice. Steps I can take include setting up these discussions in safe, relaxed environments, using my own experience to act more in a peer support rather than an advisory role, and practicing active listening to ask more questions that make people aware of the skills and knowledge they have to solve their own problems.

  12. I felt a recognition in the article of Sue Mann. It was inspirational for me. After a session, I write a small report in the medical record, I copied it and talked about it with the client (after reading Sue Mann). I experienced that I was much more aware of what to write. I wrote in a more respectful way, much closer to the words the client used himself.
    At the same time, I felt towards doctors and colleageus a bit of shyness(?) because the language did seem not professional. I realise that I collaborated more with them than with the client. This makes it hard to explore it more but I am still going to develop it.

  13. Historically it has been difficult to engage in collaboration around mental health with the refugee communities we work with due to the stigma surrounding it.

    However the case study of ‘Just Therapy’ has inspired me to look at how we might address wellbeing more holistically, and begin conversations around traditional models of wellness and staying “strong” that are culturally resonant, while at the same time advocating for political, structural and social change that addresses the discrimination and disadvantage faced by refugees settling in a new country.

    While genuine collaboration may not be easy, without it, our efforts will be futile.

  14. I loved Amanda Worrell’s story about June and her experience of paranoia; especially, how she shifted away from isolation (and oppression by SP’s hold on her life), towards greater connection – with the gifts of externalizing and outside witnessing.

    I was also awed by Sue Mann’s honest reflections and learnings about the significance of collaborating in the composing of medical records: “… having the opportunity to take charge of the representation of her life in the medical record.” I felt like I was rooting for her, as she explained developing a conscious attitude of respect and openness rather than further propagating a culture of secrecy in institutional settings, where people in powerless circumstances are so often surrounded by those in positions of authority.

    In my personal life, I’ve recently been engaging with my parents in what I now see can be better (more beneficially) termed a collaboration; the asking of questions, active listening, pausing to invite further probing and reflection, practicing tolerance, and considering alternatives to the original, or widely (mis)understood stories and experiences of all our lives.

    Thank you for these insightful talks, stories and resources!

  15. In what ways have you entered into collaborations before? What made these collaborations possible?
    I have been privileged to work in prisons and on marae (Māori communal complexes, as one of many members of a theatre therapy collaboration. These collaborations were possible because they were in partnership with people who thought outside the square in wanting to find other ways of serving their community, and who were not afraid of upsetting the “powers that be”. One person who comes to mind is Celia Lashlie, a formidable woman (sadly now passed on) who was an advocate for women prison inmates in her home country (Aotearoa-NZ), and who supported our work. This section has brought her memory to my thoughts, and I am compelled to acknolwedge her: “No reira, e te whaea, te mihi nui nei ki a koe me to kaha; moe mai ra, moe mai ra.”

    What might make it hard to enter into these practices?
    At an organsational level, quite simply put: funding. At the coalface, it is the ability or inability of the therapist to make connections that are real, genuine, and to be very explicit that this is not about an expert coming into a community to save them from themselves or from the system – a deficits based assumption that trivialises a community’s autonomy and knowledges – yet is a standpoint from which a lot of public funding for community projects is distributed.

    If these ways of working fit for you, what next steps could you take to build partnerships/collaborations in your work?
    Build solid partnerships with communities and community members who are keen to work in this way – and who I could transfer knowledge and skills so that they and their community are centred and not me. Nevertheless ensure that their ways of being and doing – and of storytelling and memory keeping are privileged as “normal” and that my way is just one of many other ways – NOT “The Way”. At a 1:1 client-therapist relationship level, I am definitely intrigued by the notion of cowriting notes together and the therapy letters; and wonder how this might also work in the organisation I am contracted to, and their processes for client/clinical notes. This speaks to so many questions, e.g. of editorial power, intellectual property, and the authoritative power that one has over client notes. I hope that I will be able to integrate some of this learning into developing templates for my practice that speak to the collaborative relationship that I wish to engage with people in my practice, as well as the organisation’s best practice guidelines.

  16. I have entered collaborations with certain communities before, for example the communities of female artists, activists and other women who are interested in exploring and sharing their own stories complementing the dominant ones from mostly male perspectives. I have also entered collaborations with families whose relatives were taken during the Maoist insurgency in Nepal to tell their stories and attempt to create more empathy and understanding for their demands to get justice (whatever form of justice they choose in the end) amongst the audience.

    However, I realize that trust and direct access are really important and need to be built up gradually, so that those who lead traditionally are not offended, feel included even though they might not be directly included; and won’t bring our collaborations to a halt. Once I have built up direct links, I try to take steps gradually and carefully to bring leadership, agency and determination of the journey to those, who are directly involved.

    It is a very slow process that is never linear. It often frustrates me, as I struggle with issues of patriarchy, unquestioned privilege and dominance; and the desire to give all of the power to those I work with right away. While some of the leaders might be chosen and meaningful to the communities, others become corrupted so easily and it is hard for me to work with those. I also find it difficult to not pass judgment on those – what would be the alternative? How can I be compassionate towards someone I feel so alienated, even frustrated with? What are the needs and values behind their actions? I am anxious not to re-produce power-inequalities and really, I just want to work with the people directly.
    It’s also hard for me, as in most of the cases others determine to work with certain communities, rather than being invited by those communities themselves. I keep reminding myself that there is something we have to offer to those communities, something that they might not have heard about or would not be able to access otherwise – but the only thing we can do is to offer and the choice of taking us up on these offers, needs to stay with those we are working with directly. And that is also where most of our accountability has to be based with. Standing by and practicing this principle is not always easy, as I believe in what I do and am eager to share; but also when working with other colleagues, who might not have thought about this principle before, share it or give it as much importance as I do.

    What I will take up in the future is the idea of a ‘decentred and influential posture’. Facilitating workshops, collaborations and the sharing of stories gives me a special and powerful role – especially because I am not always a member of those communities, which tempts people to give me even more power and visibility due to local customs and concepts of being polite. I continue to question and examine my roles and practices in the different settings and feel that taking a decentred and influential posture will allow me to practice the value and meaning that can come with being something like an ‘outsider witness’ while also making sure that the principle agency stays with those, who chose to join me in this collaboration and journey.

  17. I have really tried to be respectful when writing client notes however reading how Sue Mann was able to achieve this with her clients really provided new possibilities and examples of professional growth for me in this area. I like how it is taking a de-centered approach to a new level by offering them (our clients) to be the expect on what and how their story is recorded.

    I also like how Tileah emphasised the point that identity is made up of the person, the family & the community and that there are collective experiences shared among people.

    i think what might make it hard to enter into these practices is when someone is really not interested in seeing you or when they are not ready to talk.

    My next step is to invite my clients to co-write their case notes with what they feel is important to be recorded.

  18. When Tileah Drahm-Butler spoke about how collaboration with indigenous people gave them their power back I was filled with inspiration. Her speech helped me to see how people are often made to feel weak through societies actions and how they can be strengthened again by telling their story back. It is the narratives, the puts down and prejudices, that keep people in bondage to others and therefore the narratives that can bring them out of bondage. That is an amazing and inspiring talk.

  19. My work as a freelance writer/editor/researcher/tutor my work is quite varied, and I enter into a lot of different kinds of collaborations. The most successful ones involve, among other things: a mutual respect for each other’s background and expertise; everyone having a strong drive towards honesty and openness and information sharing; a fearlessness to offer ideas that might not work, and to test out our own and other people’s ideas; a willingness to see when our ideas aren’t working and adjust our preconceived views – or let go of ideas that have been precious to us when they aren’t serving the project well; a sense of being united for a common cause that we believe in.

    The very best collaborations I’ve been involved in are those where I really *like* the people I’m working with, and am interested in how they see things, and also where, between us, we manage to generate a real feeling of excitement about what we’re working on. It can be hard to put my finger on exactly what brings that about. It’s when there’s a real sense of sparking off each others ideas and views and imaginations, of loving the new places that the other person (or people) takes ideas … and where conversations about the project are almost like playing a game of leapfrog, where one person builds on the last person’s ideas and pushes them forward, then the other person does the same with those ideas, and so on. I love it when this happens!

    It’s hard to get that going when egos are in the way; or where you have very different goals from each other; or where there is a destructive power imbalance; or where information, and access to information, is being wielded by at least one person as a tool of power. Those are some of the things that I’ve noticed getting in the way of good collaborations in my working life, but I’m sure there are others.

    I’m re-reading what I’ve just written and thinking about some of the ideas in this chapter, and seeing that I could do more to promote better collaborations – most especially in my teaching.

  20. I really appreciated these stories of collaboration. I was particularly challenged by the thought provoking examples of how Sue Mann endevoured to be transparent and represent the clients voice through collaboration. I have felt that my practice was collaborative and transparent as I inform the client that I have to write notes, why and who has access to them. In writing notes I am careful to write what the client has said not my position or opinion. However, I have not considered writing the notes with the client. This will require further pondering as to what alterations I may need to make to my practice to ensure collaboration and transparency are upheld.

  21. I love Sue Mann’s idea of working with the parents to create their case notes, many times I have thought what the staff in NICU wrote down about me – another junkie mother with a baby suffering from withdrawal? An overworked social worker called in to be lied to about my domestic violence situation, would that have been noted or left out as it would encompass too much work?
    At present where I volunteer there is a way to leave notes about clients. I am always aware of what I write if I do write anything. If I have an angry client, do I label them forever more for what may have been just a bad day? I also have to be aware of who will read these notes as any of the reception staff will have access to them, the majority are untrained volunteers and work for the dole participants.
    I think this once again illustrates the power of the written word, one sentence written hastily written has the power to change how that client is viewed and treated.

  22. Collaborative representation by Sue Mann struck a chord.When reading “I wonder if I didn’t feel some degree of self importance and certainty” (while writing in medical notes) I said “ouch!” out loud.I have written in many medical notes.The fact that the last person to see the records is the very person who is being written about, is really quite illogical.Why is there a reluctance to do so? Is it possibly because those of us who have written in them, included judgement and preconceptions in our ‘observations?’.Our opinions as to what WE feel would be the ‘best course of treatment?’ If we are all ‘experts in our own lives’,surely that includes people who may be experiencing difficulties in theirs. When we are working collaboratively,we are all (almost literally) on the same page.

  23. Amazing stories of honouring other’s stories, how “collaboration” can empower; how we need to be alive to dominant stories informed by constructs, and understand broader social issues:
    Amanda Worrall’s story of June and paranoia: how can I help, how can I invite “insider knowledge” and values rather than privileging expert knowledge?; in the words of Michael White what steps is June taking “to try to protect and preserve what she gives value to”; the use of the therapeutic letters sent after each session with the huge impact of seeing her words, sometimes forgotten by her after the session, but now captured on paper; how externalizing the problem can bring about freeing people to take a lighter, more effective and less stressed approach to serious problems; the notion of having “teams” like social paranoia and anxiety, externalised; of exploring alternative stories; June describing the outsider witness process as allowing herself to be visible and letting people in her life; and the value of experimentation that can take place such as using recordings for the outsider witness process, thereby being able to “delete drafts”; how the outsider witness process normalised June’s paranoia and her empowerment seeing how her stories may assist others; how the process assisted in opening up new possibilities.
    Sue Mann: the incredible empowerment given to a patient by their co-authorship of medical records and in so doing opening up new possibilities, new conversations.
    Just Therapy: being reminded how are many problems may have external origins, being symptoms of broader social issues such as unemployment, inadequate housing or being marginalised; finding a therapeutic framework that moves away from medical metaphors to being values based, in this case those of Belonging, Sacredness and Liberation, each one of these values bringing such richness and applicability to our lives.
    Decolonising Identity Stories by Tileah Drahm-Butler: the notion of being alert to continued colonisation, for example using the terms counselling or therapy in Indigenous communities, how this continues the story of there being something wrong with the individual and ignores the story of injustice; contrast “yarning for purpose”, reflecting Indigenous traditions of storytelling within the context of how the politics of experience may impact on problems; how this continued colonisation often privileges the “damaged centred story” which can also predominate in the person’s individual story, her identity; how Tileah Drahm-Butler uses the narrative framework in her practice.
    Brisbane, Australia

  24. I was truly intrigued by Sue Mann’s “collaboration representation: narrative ideas in practice”. As a new clinician working between a hospital and community setting I was able to relate to the article. Particularly her story of the man whose name she did not know. In my workplace I hear the “hospital story” and feel it is so easy to listen to this dominant story (neglecting the alternate story – the consumers own personal story). A challenge I am taking away from reading this article is to listen to the alternate story and seek it out.

    The article also really reinforced the power of documents and the records we keep. I am eager to implement narrative practices, and where possible to work alongside others to create their records. And like many pointed out, I too think this will take much practices and training.

    This article really reinforced the power of language, and how our choice and ways we use language can be so powerful. It also reinforced the need to work collaboratively and of the power imbalance that

  25. I have started to work collaboratively with colleagues when possible, and this material has shown how much further that can be taken working with families. Also less ‘weight of responsibility’ if taking the decentred influential position. This will require shift in expectations though.
    I really liked reading about how this can be done with medical records.
    Was inspiring to hear about the approach with June, and using outsider witness technique not in real time to allow for ‘retakes’.

  26. Thanks a lot for this wonderful study material.
    I like very much Michael White´s presentation of THE FOUR QUADRANT especially when he says that “ It is the intention of the therapist to take up a “decentred and influential” posture in conversations had with the people who consult them °
    In my opinion this is a paradigm shift that differs from conventional therapy and requires to rethink the therapy process as a whole.
    This process becomes more humane by the way therapist and patient meet.

  27. This has been a great chapter in the series and each of the presentations/readings have provided great learning and opportunity.
    Working in a hospital context in mental health I have the privilege of working in collaboration with people who are experiencing difficulties with mental illness and attempt to find opportunities to enter into externalising conversations and collaborations with clients. Thus Amanda Worrall’s presentation on exposing the workings of paranoia with June was particularly meaningful for me.
    I find the main challenges are working with people who are involuntary, ie. in hospital under legal Orders and also working within the dominant medical/psychiatric discourse. Although I do engage in this discourse, I remain aware of the language I bring to the table and the power the treating team brings to creating/changing/challenging existing stories for clients. Ensuring the principle that the client is the expert also consistently reminds me of how stories are shaped and influenced by episodes of illness and admissions to hospital. I try to remain one step behind the client, coming from a curious and loving place. Allowing the agenda of our work to be set by the client and remaining mindful that a hospital admission can add another layer to an existing devastating story of mental illness.
    The notion of accountability is something that this chapter has encouraged me to reflect on and explore new ways of being accountable to the people I work for and with. Sue Mann’s article in regards to medical records was particular encouraging and brings forth new ideas for my own work.
    Thank you.

  28. I have entered into a collaboration with a person who has ended his relationship with Heroin addiction 10 years ago, but feels trapped in the traditions of a well established and dominant program. He feels that the wording of the steps and principles keeps him and other persons who suffer under the effects of addiction, from fully appreciating and experiencing their own skills and knowledges that make them competent to live a rich life free from Addiction. He feels that the wording internalizes the problem and the regular repetition of the wording “I am an addict” in meetings makes him feel “chained to it, as if I will never feel completely free, as if it will always be part of who I am” We have embarked on an exciting journey of re-wording. He would read the traditional way and then make suggestions about what can be changed to make it more helpful for him personally, in his own context. He hopes to be able to still use the idea of the program, but with words that fit the narrative principal, as one of his many tools to stay free from the claws of addiction. My roll is merely to ask questions about the values he would prefer to have reflected back at him when making use of the program and what he would like to be reminded of about his alternative story, skills and knowledges when using the program.

    Our work together reminds me that stories are individual and that tradition, in this case, however well-intentioned, may not respect the person’s expertise in their own life and may even work against the story they are trying to tell about themselves.
    This, in turn, has made me conscious to take care to remain in a decentred influential position when working with persons, always acknowledging them as experts in their own lives with adequate skills and knowledges developed over time, making them the only ones qualified to author their alternative stories.

  29. What a thoughtful lesson! I am working to enact many of narrative practices into my training as a therapist. I appreciate your closing video in which you mention that this takes practice and the many comments that show that I am not alone in this endeavor. Thank you all for that reminder.

  30. I am intrigued by what I hear and looking forward to practicing in a new more effective way. However, in the place where I work as an addictions counsellor, I know the “outsider witnesses” would never be allowed. How can I incorporate this concept given such restrictions?

    • hi Eve,

      You might be interested in this paper:

      Reflections across time and space: Using voice recordings to facilitate ‘long-distance’ definitional ceremonies
      Hernandez, Ross
      2008
      The International Journal of Narrative Therapy and Community Work, (3), 35-40.

      Or this piece: http://dulwichcentre.com.au/linking-stories-and-initiatives.pdf

      There are lots of options for creative outsider-witnessing in which the witnessing does not have to happen in person or face-to-face.

      Hope this is helpful

  31. As someone who is new to the work of counselling I spend a lot of my time thinking about ways to be collaborative with my clients as I think it is essential to the therapeutic relationship. As someone else mentioned, this can sometimes prove difficult when clients are wanting me to give them answers to their issues as they feel I am somehow an expert. Often when I’ve had a conversation with clients around the importance of seeing themselves as the experts on their own lives and that I see my role as someone who will work with them and not for them, we’ve been able to build a more collaborative relationship.

  32. I do try to approach my meetings with people as a collaboration, but I sometimes find this hard because (as Amanda commented in that briiliant presentation) the people meeting me often have an expectation that I am the expert and will have an ‘answer’. This idea that I will have an ‘answer’ is even stronger when a situation is very stuck and I do have to work very hard at being de-centred and influential and not being the person to be sticking on the Mr Happy plasters as Jas mentioned above (which is a position I feel I do end up in).

    This chapter has really made me reflect how difficult it is to properly collaborate at times and has made me more mindful of ensuring that I do.

  33. It occurs to me that just as therapists are challenging themselves by finding collaborative ways of working with their clients, so too clients are being challenged. Sue Mann mentions that not everyone she has worked with has wanted to collaborate on the report she writes for their medical records. Perhaps the privileging of “professional” over “patient” remains strong in many people’s minds.

    The narrative therapy standpoint of respecting people as experts in their own lives may be an attitude that some people view with suspicion. They may not trust themselves, or believe they have the skills and attributes required to overcome certain difficulties. In seeking to de-centre him/herself, the therapist may often have to work first to overcome the client’s assumption that it is the therapist (professional/educated/expert) who is central to the conversation, before they can then move on towards assisting the client to recognise and tell their stories.

  34. I really enjoyed the video that offered a case study detailing the use of narrative therapy with a patient struggling with psychosis/paranoia. I also found the “Just Therapy” article very powerful. Much of what they said really resonated with me. In one of my professional roles, I am a Mental Health consultant for a Head Start program, which is a federally funded project for families who live in poverty. I am often directed to offer parent trainings in stress management, teach staff about attachment theory–but the bottom line is that people are struggling because they often face racism and a lack of opportunity. I often feel uncomfortable, as though I’m making the problem worse by pathologizing folks who are already struggling in an unjust system. I try to work against this as much as I can, refusing to incorporate CBT-oriented work, etc. but I already have in mind a training for next year on Storytelling for Wellbeing. Teaching staff not only about existing books that they can utilize in the classroom, but also how to listen for caregivers’ stories about their child, and also to recognize their own stories about the child/family.

    I have been trained as a psychodynamic therapist. Although I do have a more “professional” stance, I do see my work as very collaborative. I do not direct clients, rarely give homework, I allow the client to focus on what they want to. However, I do feel uncomfortable about note writing, and am really drawn to the collaborative style promoted through narrative therapy. As a therapist, I look for the “good” in people, find, nurture love for them, so that they can see the good in themselves, and ultimately love themselves. I do believe that it is this part of the work that is healing. I wonder how that can be when I’m writing notes that could be hurtful for the clients. It doesn’t match. I can definitely see myself incorporating this aspect into my work, but I really can only see that being done outside of a managed care situation, perhaps in a private practice. It seems unfortunate, because those seeking support through community behavioral health are likely to be those who are most in need of “regrading”.

  35. Wow, the story of June was very powerful. Hearing that her ex boy friend tell her that her checking in with him was not helpful. Hearing how when she goes on coffee dates she now knows from observing the person’s body language that they enjoy her company. I could identify her SP behaviour with my own behaviour, I would check in with my flatmate asking if we were friends or just flatmates now. Checking in was not helpful. If he is smiling, I need not check in with him. My intention was that I cared about him, but it did not serve our friendship. From listening to June’s story, I will no longer check in with people by questioning them, instead I will observe their body language. Thank you June, your story is inspirational.

  36. I am enjoying the idea of therapist intention as ‘decentred’ and ‘influential’. The first reminds me that stories belong to the storyteller, and the second uses the idea of ‘scaffolding’ to ask questions which help us to get to know our own stories better, that might build alternative stories or draw upon neglected stories in our past. Becoming – and remaining – decentred takes courage and humility and requires a high level of critical, reflective thinking.

  37. I do think that any mindfully conducted counselling relationship is collaborative but I think that in narrative therapeutic work, collaboration can be stretched out much further.

    My own experiences of working in a counselling environment in the UK were of the importance of the counselling ‘contract’ drawn up between the two people and the overall awareness of a path travelled together from beginning to end of therapy.

    However with the benefit of hindsight, I feel that there was an underlying feeling/culture that that the person coming for counselling was there to benefit from the interventions of the counsellor and due to it being ‘time limited’ short term work, these interventions were often strongly prescriptive in their nature. Whilst these sessions were deemed successful – my gnawing instinct is that they were Mr Happy sticking plasters covering up a much wider wound.

    I love the approach described in this section of allowing the person to develop their own truths and to find with them new ways of looking at their story. The hope being that they can take pride and happiness in being able to recount their stories and see how they can contribute and also heal problems at a personal, community and potentially up to a global scale – what a wonderful feeling…

  38. In the past we have undertaken counselling as the ’empowerer’ instead of recognising that it is the people who already have the power in their stories. It is going to take a great shift in organisational and individual thinking to incorporate this “new” knowledge into existing practice.

    I like to yarn with people, let them know a bit of my story then they feel safe to tell theirs. I enjoy looking for the strengths in each person and reminding them about them.

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