The Soteria Network presents

Alternatives Within and Beyond Psychiatry

A one-day conference exploring different approaches to thought
and practice in the mental health arena to be held in:

Derby on Friday 11th November 2011

at the Riverside Conference Centre

9am - 5pm

 
Click here to see the powerpoint presentations from the conference

Click on the 'Info' icon for details of the workshops/presentations and biographies
Keynote Speakers
Robert Whitaker (US)
Pulitzer-prize nominated journalist and author of ‘Mad in America’ and ‘Anatomy of an Epidemic’
Jaakko Seikkula (Finland)
Psychologist and psychotherapist – developed the ‘Open Dialogue’ approach to treating psychosis
Richard Bentall
Professor of Psychology, University of Liverpool and author of ‘Madness Explained’ and ‘Doctoring the Mind’
Sonia Johnson
Professor of Social and Community Psychiatry
University College London
Workshops
1. Alistair Morgan & Bob Diamond
Recovery: help or hindrance?
3. Jen Kilyon & Theresa Smith
The Soteria Bradford Project - The story so far and our plans to open a Soteria house
2. Dave Nunn, Michelle Cree & Mark Chapman
Innovation in Derbyshire: Community football, compassion-focused therapy, Root & Branch Project
4. Philip Thomas & Pete Sanders
Phenomenological and humanistic approaches to psychosis
6. Jan van Blarikom, Han Deibert & Mario Domen
Using Soteria philosophy inside and outside psychiatric services in the Netherlands
5. Carina Håkansson
“Healing Homes”, a film documenting the work of the Family Care Foundation in Sweden
Robert Whitaker
Presentation Title

Antipsychotics in the Soteria Model of Care: The Importance of Limiting the Use of the Medications

Abstract

Loren Mosher established the first Soteria House in the 1970s, and today there are a number of Soteria programs that are being run in Europe (and one in Alaska). The emphasis in these programs is usually on establishing a therapeutic community, and use of antipsychotics varies from program to program. However, the limited use of antipsychotics was an essential aspect of the original Soteria Project, and a review of the outcomes literature for antipsychotics reveals why this policy is vital to successful long-term outcomes.

Biography

Robert Whitaker is the author of four books, two of which tell of the history of psychiatry. His first, "Mad in America: Bad Science, Bad Medicine and the Enduring Mistreatment of the Mentally Ill", was named by Discover magazine as one of the best science books of 2002, while the American Library Association named it one of the best history books of that year. His newest book on this topic, "Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America", won the Investigative Reporters and Editors book award for best investigative journalism in 2010.

Prior to writing books, Robert Whitaker worked as the science and medical reporter at the Albany Times Union newspaper in New York for a number of years. His journalism articles won several national awards, including a George Polk award for medical writing, and a National Association of Science Writers’ award for best magazine article. A series he co-wrote for The Boston Globe was named a finalist for the Pulitzer Prize in 1998.

Jaakko Seikkula Richard Bentall Sonia Johnson
Jaakko Seikkula
Presentation Title

Open dialogues in severe crises: Mobilizing own resources and decreasing medication and hospitalization

Abstract

The open dialogue approach, used with people in severe crises, has been in use in Finnish Western Lapland since the late 1980s, for about 25 years in all. The principles are simple. Those working in the service meet clients in crisis immediately and often daily until the crises are resolved. They avoid hospitalization, preferring to meet in the homes of those seeking their services. And they avoid the use of anti-psychotic medication wherever possible. They also work in groups, because they view psychosis as a problem involving relationships. They include in the treatment process the families and social networks of those seeking their help. Additionally, their approach values the voice of everyone in the process, most especially the person directly in crisis. And finally, they provide their services, which operate within the context of Finnish socialized medicine, for free. In new fresh studies it has been shown that the extraordinary outcomes – 81% returned to full employment or studies, 81% without any remaining psychotic symptoms – has remained stable, and surprisingly the incidence of schizophrenia has declined to one tenth since the mid 1980s. In the presentation the basic principles will be described with some examples of the application of the open dialogue approach in other countries.

Biography

Jaakko Seikkula, Ph.D., Professor of psychotherapy, Department of Psychology, University of Jyväskylä. I have been mostly involved in developing new family and social network orientated practices for the most severe psychiatric problems, such as psychosis and severe depression. The practice has been analysed and further developed by naturalistic studies, which show the effectiveness of open dialogues and other dialogical practices.

Robert Whitaker Richard Bentall Sonia Johnson
Richard Bentall
Presentation Title

The social origins of psychosis

Abstract

Conventional approaches to understanding and treating psychosis have emphasized genetic and neurobiological determinants and hence biological interventions. However, the outcomes of people with psychosis today are no better than those of patients treated in the Victorian era. This should not be surprising when it is realised that the conventional approach is based on bad science. For example, although there is almost certainly a genetic contribution to psychosis, there are no genes that are specific for 'schizophrenia' or 'bipolar disorder'; instead a very large number of genes have tiny effects, making it very unlikely that genetic research will lead to useful diagnostic tools or treatments. Conversely, there is very compelling and consistent evidence that a variety of adversities, especially in childhood, can increase the risk of psychosis, and the way that these adversities affect the development of key cognitive and emotional mechanisms is becoming known. One implication of these findings is that services should pay attention to patients' life stories; sadly this is something that conventional services often neglect.

Biography

Richard Bentall was a non-stellar performer at school and was required to repeat his final school examinations, before being given a second chance by being admitted to the psychology undergraduate course at the University College of North Wales (now Bangor University). After discovering a fascination with psychology that has proved life-long, he went on to do a PhD in experimental psychology before moving to Liverpool University, where he completed his training in clinical psychology in 1984. He worked in the British National Health Service for two years, at a time when to be a psychologist interested in psychosis was considered to be eccentric. In 1986 he took up a lectureship at Liverpool and began a research programme into psychosis that continues today, and which has encompassed studies of psychological mechanisms using both psychological and biological (e.g. fMRI) methods, and also randomized controlled trials of novel psychological interventions. His work has been supported by a succession of brilliant and hard-working PhD students who have generously allowed him to share credit for their work, many of whom have gone on to pursue their own research careers. Geographically, his career path has involved a slow orbit of the north west of the UK, with chairs at Liverpool (1994-199), Manchester (1999-2008) and Bangor (2008-2011). In 2011 he returned to Liverpool University but remains a visiting professor at Bangor University. At the time of writing this bio he feels not as young as he used to feel and very knackered.

Robert Whitaker Jaakko Seikkula Sonia Johnson
Sonia Johnson
Presentation Title

Alternatives to standard inpatient care in England

Abstract

The main aim of the presentation is to summarise the findings of The Alternatives Study, a national study funded by the NIHR SDO programme and run between 2005 and 2009. It wasa collaboration between King’s College London and the Institute of Psychiatry. It explored the potential of residential and community-based settings as alternatives to acute inpatient care, which can experience bed pressures, high costs, and user dissatisfaction.

The study identified a widespread variety of alternative residential and community-based settings, including clinical community houses; short-stay crisis response team linked beds; non-clinical alternatives; and specialist crisis houses. These serve a mixture of purposes from acute admissions through to respite care. A number of methods were used to compare alternatives to local acute wards, such as the characteristics of service users, short and medium term health outcomes, and costs and cost-effectiveness.

Whilst the purpose and population are similar for both sets of services, those clients who use alternatives tend to seek care themselves and are already known to the services. Admissions were shorter and cheaper at alternatives than standard wards. Patients improve less during admission at alternatives on ratings of symptoms and social functioning, but they are no more likely to be readmitted over the subsequent year. Satisfaction was greater at alternatives than standard services. The models of care were in many ways not strikingly different at alternatives and standard services. However, alternatives were seen to offer choice and reduce the pressure on standard acute wards through acute admission diversion, early discharge from wards, and pre-empting imminent crises.

A strength of alternatives is their close links with other services across their local systems. In particular, synergies with crisis teams were important in providing clinical expertise which helped residential alternatives to manage a greater range of crisis than either service alone, as well as allowing the admissions to be brief. However, a limitation of this integration into the mainstream local system was that few seemed to provide a really radically different approach to the management of crises from standard services.

Biography

Sonia Johnson is Professor of Social and Community Psychiatry at UCL. As well as training in medicine, she obtained a BA in Social and Political Sciences and an MSc in Social Psychology. Most of her research is on innovative models of mental health service delivery and on the needs of people with severe mental health problems.

Robert Whitaker Jaakko Seikkula Richard Bentall
Alistair Morgan & Bob Diamond
Workshop Title

Recovery: help or hindrance?

Abstract

The concept of recovery in mental health is now firmly embedded at the heart of psychiatric care. It is being used as a brand to give mental health services the aura of providing more person-centred care, but at the same time the use of coercion in mental health care is increasing. This workshop will explore whether there is still a critical concept of recovery that survives its embrace by mainstream psychiatric care. We will also explore how the practice of the Soteria approach can offer a truly alternative space for recovery in mental health care. The workshop will be participative, and we encourage people to contribute their stories and opinions.

Biographies

Alastair Morgan is a Lecturer in Mental Health at the University of Nottingham. He is the editor of the book “Being Human: reflections on mental distress in society” ( PCCS Books, 2008).

Bob Diamond is a Clinical Psychologist who has particular interests in writing about and applying in practice the ideas of critical community psychology to mental health services.

Innovation in Derbyshire
Three mini-workshops exploring innovative projects and approaches to mental health in the Derbyshire area
Dave Nunn
Workshop Title

The Winning Mentality: Using Football to Help Men with Mental Health Problems

Abstract

This workshop will look at the use of football sessions to help men’s’ mental health. Over the last 8 years in Derbyshire we have developed footballing opportunities for men with mental health problems and now have a partnership with the local professional football club, Derby County FC, which supports people to play socially, competitively or just to be involved in training, according to their preference. We have undertaken research to look at the effectiveness of what we do in terms of helping the men’s mental health and the workshop will look at some of these results. The project has moved on to include mental health promotion, which we have started to do in local workplaces, delivered through a football themed approach.

Biography

I have worked as a Mental Health Nurse in Derbyshire for 25 years and am currently employed in the Pathfinder Assessment Team. I previously worked in dementia care for several years where I helped develop programmes of care which centred around people’s social and recreational needs, leading to huge reductions in levels of violence, falls and use of sedation. Having been employed as a CPN in Community Mental Health Teams since 2000, I have helped set up a number of football groups for men with mental health problems. Alongside the local professional football club, Derby County, a network of local teams have been established, along with regular training sessions, mental health promotion work and I have led a research project to evaluate all of this. Significant funding has been acquired through several sources. The feedback from the football work has been phenomenal, with it being cited by several individuals as the most important part of their recovery from their mental health problems. In June 2011 I was awarded an MBE for services to healthcare.

Michelle Cree
Workshop Title

An introduction to Compassion Focused Therapy

Abstract

Compassionate Focused Therapy has been developed by Derby’s Professor Paul Gilbert for treatment of people struggling with high shame and self-criticism. With its focus on the development of our innate soothing/calming system which can then be brought on line to calm our threat system when we feel attacked, angry or scared; it’s potential for use with people hearing malevolent voices or suffering from psychotic experiences was quickly noticed. It has proven to be a successful and powerful way of reducing malevolent voices, and building compassion and soothing in people who may feel ashamed and stigmatised through their experiences of, and societal responses to, psychosis.

Biography

Michelle Cree is a Consultant Clinical Psychologist working at Derby Perinatal Mental Health Service and a Compassionate Mind Foundation Board Member. She is a Compassionate Mind Foundation trainer and provides group and individual Compassion Focused Therapy (CFT). She also provides supervision and local and national training in CFT. These include Compassionate Mind masterclasses for the Department of Health Family-Nurse Partnership initiative.

Mark Chapman & Deb Rose
Workshop Title

The Root And Branch Project: Our roots, hopes and aims to support all aspects of Bi-polar and related conditions

Abstract

My partner Deb Rose and myself are both diagnosed 'Bi-polar'. We will explain the inspiration, hopes and aims of The Root and Branch Project, giving support along the lines of Soteria but in a different more outdoor environment, and accepting a wider range of 'clients'. The retreat, part woodland, will include a small secluded 'crisis' dwelling area for 4/5 clients experiencing mania/ psychosis, centred on the fundamentals of humanity (fetching, preparing and cooking on a fire, 'being with' and talking/storytelling) together with other therapeutic activities. There will be a much larger 'health and well-being' area, with 'green gym' activities, as well as art/craft therapies, for a wider range of enduring mental health issues.

Our project will be a place for meaningful activities and an opportunity to make a contribution, including those facing life on long-term benefits due to their diagnosis, helping people stay well, as well as giving peer-support to those in need.

Biography

Mark Chapman is an ex-teacher who has worked in a wide range of areas with young people, including those with severe learning/behaviour difficulties as well as one-to-one with the disaffected and emotionally vulnerable. After a long period of depression, he had his first hypo-manic episode in 2001, and there have been 5 more since, and he was diagnosed in 2005 (he feels lucky to have avoided hospital). Since 2003 he has done a range of voluntary work, most recently as a rep for Derbyshire Voice, as well as a lot of time researching into mania and psychosis, its treatment and attitudes towards it in our own and other cultures.

When Mark observed the 'treatment' Deb received in hospital he just knew there had to be a better way, as the environment made her trauma worse, a horrendous experience for both of them and her family. He felt they would have been better off camping in quiet woodland with a couple of friends for support and that seed of thought has grown and developed into The Root and Branch Project.

Mark is a musician and poet. He has gigged extensivelly at festivals since 1991. His recently formed band are The Cactus Room and sales of their CD have helped with fund-raising as well as awareness-raising for mental health issues.

Jen Kilyon & Theresa Smith
Presentation Title

The Soteria Bradford Project - The story so far and our plans to open a Soteria house and related services in the Bradford area

Biographies
Jen Kilyon

Jen taught for 20 years then worked as an education adviser for 10 years. She began campaigning for changes in the mental health service after her son became entangled in this system ten years ago. She is involved in many statutory and voluntary working groups, projects and networks locally, regionally, nationally and internationally and acts as a trainer, consultant, speaker and facilitator.

She trained as a carer interviewer for PICAP (Partners in Carers Assessment Project) an SDO funded piece of research led by the University of Sheffield. Jen is a committee member of ISPSUK (International Society for the Psychological Treatment of Schizophrenia and Other Psychosis) and has written articles and contributed to their publications as well as helping in the planning of conferences and running workshops including one at their international conference in Madrid in 2006 and presented at their international conferences in Copenhagen in 2009 and Dubrovnic in 2011. She has worked as a Peer Reviewer for RCPsych AIMS (Accreditation for Acute In-patient Mental Health Services) and is involved in the development and teaching of the University of Bradford MA in Mental Health and was Coordinator of the SHA funded Community Liaison Group of the Doctorate in Clinical Psychology at the University of Manchester.

She was Carer Involvement Lead for New Ways of Working in Mental Health with the NIMHE National Workforce Programme until 2009 and worked together with the User Involvement Lead to seek and represent the views of users and carers nationally at a range of forums at a senior level as well as developing networks to engage and support users and carers in implementing New Ways of Working. She was also a member of the Mental Health Act National Implementation Team with CSIP’s programme to introduce the changes to the Mental Health Act.

Jen is a member of the Care Quality Commission’s Carer Advisory Board and National Stakeholder Group for mental Health and the National Workforce Reference Group of the Mental Health Network at the NHS Confederation. She co-edited a book “A Straight Talking Introduction to Caring For Someone With Mental Health Problems” which is part of a major new series published by PCCS Books. She is a trustee of the Soteria Network and is very active in helping to set up the first Soteria House in the UK.

Contact details: jen@jenkilyon.net

Theresa Smith

Theresa graduated with a B’Ed in Theatre Arts from Bangor University St Mary’s in 1979. During the early 80’s she worked for the NHS in North Wales as a dance teacher as part of a pioneering integrated treatment programme for children with cerebral palsy.

She gained a Masters in Health Education at the University of Leeds in 1991 where she carried out research in Mexico looking at the use of Theatre Arts in hygiene education.

She worked as Head of Drama in Leeds before and after gaining her Masters.

In 1999 her daughter developed a psychosis. Dismayed at the treatment her daughter received she went on in 2002 to co found Shoestring Theatre Company creating original touring theatre pieces illustrating the reality of psychiatric treatment for those in serious distress. Shoestring has worked closely with a number of Primary Care Trusts nationally in training and awareness raising programmes. Currently they work with service users delivering a weekly community drama facility.

Theresa has worked on research projects looking at the experience of families with mental health services in both regional and national research programmes and co-edited a carers self help book for PCCS books as part of their Straight Talking Introduction series.

She has worked for 9yrs as a support worker with MIND in Bradford.

In 2009 she helped organise the Soteria Saltaire conference from which the Bradford Soteria group was born.

Dr Philip Thomas & Pete Sanders
Presentation Title

The Interface between humanistic and phenomenological approaches to psychosis/severe mental health problems

Abstract

The workshop will introduce two approaches to distress; interpersonal phenomenology and a person-centred humanistic approach. After a brief history, each will be contrasted with ‘scientific’ psychiatry, and the overlaps with the Soteria ‘model’ as developed by Loren Mosher will also be considered. The time will be roughly divided into four sections:

  • A 20 minute presentation by Phil Thomas on an interpersonal phenomenological approach and its implications
  • A 20 minute presentation by Pete Sanders on a person-centred approach and its implications
  • A time for discussion and reflection in groups
  • A time for feedback, questions and discussion of the whole workshop

Biographies
Pete Sanders

Since working as a nursing assistant in a large mental hospital as a teenager, Pete Sanders has always believed that understanding, respect, authenticity and consistency are the essentially helpful ways of being human, regardless of the bells and whistles which modern psychotechnology requires. He has written over a dozen books on this and similar subjects, but thinks the establishment of Soteria houses will do more than all his writing and qualifications.

Dr Philip Thomas

Philip Thomas graduated from Manchester University with a degree in medicine in 1972, and trained as a psychiatrist in Edinburgh. He worked as a full-time consultant psychiatrist in the NHS for over twenty years, but left clinical practice in 2004 to focus on writing. He is well known internationally for his scholarly work in philosophy and its relevance to madness, diversity and identity in psychiatry and society. He has worked closely with survivors of psychiatry, service users and community groups, nationally and internationally. Until recently he was chair of Sharing Voices Bradford, a community development project working with Black and Minority Ethnic communities. He is a founder member and co-chair of the Critical Psychiatry Network, and has published over 100 scholarly papers mostly in peer reviewed journals. His first book, Dialectics of Schizophrenia was published by Free Association books, and he has co-authored two other books, most recently Postpsychiatry, with Pat Bracken, published by Oxford University Press in 2005. Until recently he was professor of philosophy, diversity and mental health in the University of Central Lancashire, and is now an honorary visiting professor in the Department of Social Sciences and Humanities in the University of Bradford. He is now a full-time writer, working on a collection of short stories, on doctors, medicine and madness.

Carina Håkansson
Presentation Title

Healing Homes

Abstract

I will be screening the movie "Healing Homes" which is a documentary by Daniel Mackler about our practice and philosophy at the Family Care Foundation in Sweden. Our work originates from a vision to try together with others to create a place built upon both a so called ordinary life and a professional, therapeutic knowledge. It is nearly 25 years since we started, lots of things have happened during the years. The group is much bigger, we are part of a huge network, and we meet people having different kinds of difficulties. Experience has grown, but the vision is still alive. Every day has to do with how to do right now, how to go on from here, how to keep a hope alive even when it feels hopeless, how to make use of oneself and others? Several years ago we decided not to use psychiatric diagnosis or psychological wordings in work. It was a radical decision, and has been important both for us working and for those coming to our organisation.

After the movie there will be time for some discussions and questions.

Biography

Carina Håkansson founded the Family Care Foundation in 1987 and has been working there ever since as manager and psychotherapist. She has written several articles and two books based upon her experiences in this work.

Jan van Blarikom, Han Deibert & Mario Domen
Presentation Title

The challenges of using Soteria philosophy inside and outside psychiatric services in the Netherlands

Abstract

Jan van Blarikom will speak of his work within psychiatric services to promote Soteria philosophy, and then Han Deibert and Mario Domen will speak about their work to establish a Soteria house in the Netherlands outside of mainstream services. There will then be an opportunity for discussion about these different methods of using the Soteria model.

Biographies
Jan van Blarikom

Jan van Blarikom is director of Zeeuwse Gronden, a mental health institution in the Netherlands founded together with family members of patients with serious mental illnesses. He also works as a psychologist at an institution of mental health in Zeeland (the Netherlands) Emergis. He is responsible for the (long term) care of persons diagnosed with schizophrenia. Since January 2011 he has founded a ‘Soteria house’ in the psychiatric institution of Emergis itself, for people who are suffering a psychotic episode. He has written an article: A Person-Centered Approach to Schizophrenia, in Person-Centered & Experiential Psychotherapies, Autumn 2006.

Han Deibert

Han Deibert has worked for more than 25 years in the adult psychiatric care in different positions. For 11 years he has been teaching and training in the recovery and rehabilitation method for workers in psychiatry. For the last 3 years he has been chairman of the Soteria Foundation in the Netherlands. For Han Deibert the Soteria project is really a challenge to step outside the boxes of the psychiatric history, to create an environment of healing, respect and trust in each other, in an organisation which is really supporting the clients and her or his system. Soteria is “doing together” and “being with each other”, that is the strength.