deviant. We chose this term for our group not because of this; rather, we privileged variance as a term representing a range or a variety of diff erences. In retrospect, perhaps we could have chosen other terms such as gender diversity.
Multi-family group beginnings While we worked closely with the
Tavistock service and there were existing local and pan-London supports such as Gendered Intelligence, we found there was a lack of cross-generation support, such as group support, for a mix of parents and children and adolescents together, specifi cally tailored to the needs with regard to gender identity and mental health issues. Two professional-interest-group
discussions were conducted in 2014 in response to the increase in clinical presentations identifi ed. The group also suggested conducting a focus-group discussion with service users in March 2015, as a needs assessment. Two families attended but a third family’s views were brought into the discussion as well from a separate discussion. Feedback from the participants included the following: • Monthly multi-family group meetings to be held within CAMHS will be very benefi cial, as it could be too far for families to travel to the Central-London-based support services like GIDS or Gendered Intelligence, and having support and a sense of not being alone within their locality.
• Having food as part of engagement process is important!
• Having split engagement-time with multi- families is important: the suggestion was to have 1.5 hours, 1 hour with everyone, and 0.5 hours, split groups into parents and children. The discussions also highlighted the
importance of engaging families as consultants for professionals, specifi cally CAMHS, schools, police, children’s services, foster carers. It was thus decided we co-facilitate
monthly gender-variant multi-family group meetings on a clinical site, which we commenced in April 2015. Over time, the membership increased from four young people and family members to 20. The group also served as a ‘step-down’ care for those discharged from CAMHS, similar to the concept of a mentoring service, to provide support for the families with gender-variant adolescents who might have
10 Picture 2: terms and issues commonly raised in the group
recovered from mental health struggles but need some level of mutual support from peers. Yang’s refl ection: That was a humbling experience for us. I still remember how worried we were in the initial months about whether anyone would attend, and how overjoyed we were when the membership swelled to a critical mass, which made the discussions and connections even more enriching and empowering for the group members.
Our multi-family way We drew ideas from both the multi-
family and narrative approaches. The multi-family approach (Asen & Scholz, 2010) has been widely applied eff ectively in various health, social care and school settings, especially for eating disorders (the Maudsley model), addiction, education (emotional and behavioural challenges of adolescents, the Marlborough model) and psychosis (the Somerset model). Over time, we structured the group sessions into wider group checking-in, separate parents’ and adolescents’ groups and feedback as a wider group. We used a group session rating scale (Duncan et al., 2003), and qualitative comments, as a form of structured feedback to improve and modify each subsequent session. We also invited guest speakers from our trust and the Tavistock GIDS service, to share specifi c topics. There was one session when we viewed and discussed a culture and gender identity related documentary: Taboo: the Third Sex (Lewman, 2008). Yang’s refl ection: I recently watched a BBC 2 documentary (Abelmoneim, 2017) and learnt
that, by the age of seven, children in the UK often develop strong and fi xed views that boys and girls are fundamentally diff erent. This not only aff ects their self-esteem but also limits their emotional expressions, academic achievements and future aspirations as adults. Another surprising fi nding is that such gender diff erences are often not because of biology –research evidence shows little diff erences in the brain structures and physical strengths of boys and girls prior to puberty; rather, they are perpetuated by gender-stereotypical narratives of social media, families and schools. The programme also found that, by creating a more gender-neutral home and classroom environment for a class of seven-year-olds for one school term, self-esteem diff erence improved from 8% to 0.2% between the boys and girls; the girls acquired more positive words to describe themselves; the boys’ pro- social behaviours improved by 10% and their emotional expressions improved. Although not featured in the programme, I wonder how such gender-neutral practices would benefi t trans children and youths as well? What role could we as systemic practitioners play to this gender-neutral movement? Although we did not specifi cally tailor
the group conversations with any particular systemic approach, on refl ection, we seemed to be drawing on many narrative ideas (White & Epston, 1990) that included the following: • Co-authoring lived experiences told as a group in the locality
• Thickening the plot – from thin to richer descriptions about the journey • Mutual-witnessing of growths and
Context 155, February 2018
Multi-family support for adolescents with gender variance
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44 |
Page 45 |
Page 46 |
Page 47 |
Page 48 |
Page 49 |
Page 50 |
Page 51 |
Page 52 |
Page 53 |
Page 54 |
Page 55 |
Page 56 |
Page 57 |
Page 58 |
Page 59 |
Page 60 |
Page 61 |
Page 62 |
Page 63 |
Page 64
