November 19th 2015 Service, treatment and collaboration, viewed from a milieu-therapeutic perspektive Erik Larsen Professor emeritus Specialist in clinical psychology Oslo, Norway
INTRODUCTION In the introduction of this presentation I will describe how I understand the concepts service, treatment and collaboration Then I will give a more extensive presentation of how I understand milieu-therapeutic perspectives and why this perspective is a contradiction to what is understood by service Furthermore the necessity of collaboration will be discussed and some ethical implications of offering service instead of milieu-therapeutic interventions will be focused Conclusively service, treatment, collaboration and the milieu-therapeutic perspective will shortly be focused once again and some concusions will be drawn
THE CONCEPTS SERVICE MILIEU-THERAPY ORGANIZING DEVELPOMENT/CHANGE
THE MILIEU THERAPEUTIC HOUSE Basic models, theories and concepts Room for investigations and reflections Conference and meetings Supervision Dialogues amongst colleagues Everyday milieu-therapeutic life The milieu therapeutic field of power
THE MUTUAL RELATION BETWEEN THE TASK, THE WAY OF ORGANIZING AND PROFESSIONAL KNOWLEDGE THE PRIMARY MILIEU THERAPEUTIC TASK THE MILIEU-THERAPEUTIC ORGANIZATION PROFESSIONAL KNOWLEDGE THAT MAKES IT POSSIBLE TO SOLVE THE TASK
The primary milieu therapeutic task RESOURCES IN WORKING WITH THE PRIMARY MILIEU THERAPEUTIC TASK The milieu- therapeutic territory The milieu- therapeutic time The availability in the role as milieu -therapist
THE MILIEU-THERAPEUTIC ORGANIZATION The formal organization The dynamic organization
MILIEU-THERAPY IN A SYSTEM ORIENTATED PERSPECTIVE The milieu therapeutic organization The clientsystem The system of children or youth The personelsystem Milieu-therapists Milieu therapeutic leadership
THE ROLES IN MILIEU THERAPEUTIC WORK The formal roles The dynamic roles
THE INTEGRATED MILIEU THERAPIST ROLE Formal qualifications Formal education Developmental psychology Organizational understanding Family comprehension Knowledge about activities The integrated milieu therapist role Informal gualifications Life`s school One`s basic family One`s actual family Professional experiences Interests and hobbies Formal experiences One`s own therapy Supervision Reflections with colleagues Being personally suitable The value as model, the ability for empathy Good communication Can handle critics Not easily insulted
INTEGRATED, DESINTEGRATED AND POORLY INTEGRATED YOUTHS INTEGRATED YOUTHS They can understand the connections between feelings, thoughts and behavior DESINTEGRATED YOUTHS They have temporarily lost their ability to see these connections POORLY INTEGRATED YOUTHS These youngsters do not understand the connections between feelings, thoughts and behavior There youngsters commute between their longings for attachment and contact and their anxiety for attachment and contact They lack concepts for their inner life They have an unclear picture of their self-esteem They have an unclear boundary between fantasy and reality They have fixed pictures of reality and these fixed Pictures are not investigated They basically strive with the theme of survival
FIGHT FLIGHT FREEZE
SERVICE AND TREATMENT Type of relation Time perspective Assignment (task) What does one do in the face of resistance? SERVICE One sided I do something for you Which will ease your situation Transient satisfaction Our relationship ends When your wish is realized Please the user The customer is always right Attempt to minimize I apologize... TREATMENT Mutually binding I enter into a relationship with you that enables you to develop yourself Long term binding I commit myself to working for a long time Arrange for the client`s own development I can help you but you must do the work yourself Mobilize and deal with reststance This is our structure and here you must learn to deal with it. It is obvious that you can`t get it completely right from day one
SERVICE AND TREATMENT Work assignment Complexity SERVICE Do things for the user What would you like for dinner Attempt to minimize complexity TREATMENT Help the clients to do things for themselves Do you need help in preparing dinner? Acknowledge complexity We can do the impossible it just takes bit longer You must work with many task and on many levels in reach a goal Who is responsible The service provider Client and therapist or treatment agent
THANK YOU