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TRANSMURAL FAMILY GUIDANCE what is the difference with open dialogue?. 2nd International Conference on Dialogical Practices Margreet de Pater Truus van den Brink Leuven, 8-3-2013.
2nd International Conference on Dialogical Practices
Margreet de Pater
Truus van den Brink
Throughout the mental health system
Need-adapted treatment given by the same team
Working with families from the very first start in open dialogue, every voice is heard
An outreaching team
The possibility to add intensive home treatment by the IHT-team, visits twice a day were possible
Care conferences (not within 24 hours)
We had to work in the shadow of a large university facility
Which was biologically oriented
Had a high status
Nearly all patients with a first psychosis started there
Theory: there is a circular relationship between psychosis, development of the person and family reactions
Labeled as possibly adolescent development crisis
Organization: starts from the very first crisis
Content: starts as family psycho-education.
Setting limits to overwhelming psychotic behavior
Then problem solving and promoting autonomy of the psychotic person
No intensive family story taking
Family talks about their problems during this process
Please don’t act crazy, it does confuse me, you may only act crazy in your own bedroom
Trans mural family guidance
Assist family to set limits
More on family structure
Promoting clear communication
Open conflicts without good or bad
When family hierarchy is restored we expect better prognosis
Staying with the family
Patient is not allowed to terrorize
Family is open about family life during process
In context of continuity of care of MFE
46 patients and family members (37 TMG).
What is the process was only one of the questions
Moroccan guy: thinks he is possessed by Jesus and Maria
Family was strict Islamic, but school was Christian, father tried to convince schoolleader about praying but didn’t succeed
After family intervention he can tell his father that he missed his influence very much in school
Young guy was psychoticaftercaraccident
Butbefore that the light in hiseyesdisappeared
Tellshisparentshe was sexualabusedbyolderwomen
a thick layer of managers
Everywhere in the country
are mobile first psychosis teams
there is work to do!
Why is familywork, which is evidencebased, notusedeverywhere?
How toimplementfamilyworkwith open/transmuraldialoguein more teams?
Whatshould we do in Amersfoort?