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intervention is needed, which may not fi t with the stated needs of the child. He cited evidence that matching diagnosis to a specifi c technique or model has a small impact on outcome whereas contextual factors such as poverty, housing, wider- family relationships alongside the quality of the therapeutic relationship have the greatest impact on outcome. Sami described the OOOCAMHS model he has developed within his CAMHS service in Lincolnshire in which the identifi ed patient completes a questionnaire on an iPad aſt er each session. He talked about the diff erence between evidence- based treatments and common factors, emphasising the importance of ensuring clients are engaged and that dropout rates are low. His framework was as follows:


• CONSULTATION: Extra-therapeutic factors: professionals meetings to address external factors before starting therapy.


• OUTCOME: Monitor outcome session- by-session to alert early to poor response.


• RELATIONSHIP: Monitor the alliance session-by-session.


• ETHICS OF CARE: Whole team ethos. Support for clinicians in feeling listened to, respected and supported. Sami showed a fi lm in which his


colleagues described their growing enthusiasm for this feedback method. If there is no improvement aſt er fi ve sessions, the work is reviewed and diff erent approaches considered. Sami suggested professionals can create complex cases that at ract diff erent styles of interventions and an increasing number of voices without making any demonstrable diff erence. T e workshop focused on the feedback in relation to the therapy. It would have been helpful to know how the practitioners engaged with the clients’ wider system such as school and family environment during the process. Perhaps the review aſt er fi ve sessions may lead to a decision to work within a broader framework. T is was an interesting workshop


packed with information about a particular approach. I went away with many thoughts about how I could work more eff ectively within my own practice.


Sara Barratt, consultant systemic psychotherapist and team leader, fostering, adoption and kinship care team, Tavistock and Portman NHS trust.


Context February 2012 Caitlin Blythin (head left body right) and Natalie Alleyne (vice versa) Presenters: Caitlin Blythin and


Natalie Alleyne In the introduction to their


experiential workshop, Natalie and Caitlin acknowledged the possibility that some of the participants might feel nervousness and other “uncomfortable feelings” about the expectation of dancing together. Natalie and Caitlin’s personal experience as dancers, commercial/street dance and Latin/ ballroom respectively, informed their decision to work with young women on issues of body image and female friendships, using dance as a medium for communication and creation. This resulted in them establishing a “therapeutic dance company” working with children, young people and adults who were referred by schools and police and youth-offending services. However, despite their professional experience as an educational psychologist and key worker in the intensive family service,


they found it hard to explain why this method seemed “to work so well”, until they started training in systemic practice. Connecting with Michael White’s ideas,


they found that, for themselves and others, “dance holds narrated meaning”. Natalie and Caitlin developed structured-dance experiences that connected a series of expressive “poses”, generated by young dancers, into embodied narratives. The young dancers’ dominant narratives, and then their alternative narratives were explored by using their own bodies as a “physiological system” for “working on problems, and developing solutions”. These two narratives were then choreographed by Natalie and Caitlin into a complete dance. The young dancers’ narratives were


danced by all other group members, including Natalie and Caitlin. This “synchrony” of movement and witnessing proved a powerful experience. They said, “When we struggle (or are stuck), sometimes others are struggling (or are stuck) with the same issue”. Conversely,


45


Mindstep: A whole new mindset for systemic practice


AFT National Conference workshop reports


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