Interculturalidad: encuentro de la comunidad y otros contextos

This first theme looks at how practitioners became involved with ODA and how they acquired the skills to become ODA practitioners. Some practitioners were provided with ODA information/ learning whilst others had been immersed into sessions without such information.

Rachel’s manner during the interview was very measured in that she would usually have long pauses before answering questions during which periods she appeared to be thinking carefully about her responses. This appeared to mirror one of her responses to a question on experiential learning where Rachel felt it was important to maintain professionalism during the network meeting:

… And the experiential learning, what about that?

Well experiential learning or working with a real person, means you have to think on your feet, you can’t just burst into fits of giggles and kind of start messing about because you’re in a real situation and it’s somebody’s life, their dignity and so on. And the other thing that I think about experiential learning is that you do, it forces you to think more about what you’re doing because you are with a real person. If you are in an artificial situation you can afford to make mistakes and I’m not saying in experiential learning you don’t make mistakes, you do but you learn somehow more from them than you do if you make a mistake in role play because of that, because the bar is in a different place.

So if you say something wrong it really sticks with you because you are attuned you have to get this right as much as possible

Yeah, if somebody suddenly starts to cry or gets angry.

Real emotions

Yes, they are not somebody acting it. And it’s that person’s life that you are interfering with really so you’ve got to sort of... and if you’ve made a mistake you have to be upfront about it,

88

there’s a kind of honesty with it, so I think those are some of the really good things about doing the experiential stuff.

Rachel Pg. 7

Rachel used the requirement and expectation that she would be professional at all times with the service user as the mechanism for her to maintain control within the session. In this way Rachel was in control of her own behaviours and thereby able to maintain a sense of safety within the encounter.

Despite this Rachel felt that this experience of attending network meetings as a clinician left her quite exposed (undertaking ODA and having only some initial information about it); she states that some role play may have been beneficial:

I think that I would have liked to have done some kind of role play type, training.

Beforehand?

Before actually going into the kind of invitro situation, but that might just be because I’m used to doing that, I’m used to that

Through the family work?

And through other things like motivational interview training, you do a lot of role play before you actually you know, do it with real people.

Rachel Pg. 7

Although, as previously stated Rachel goes on to say that experiential learning can be a positive experience as it pushed her out of her comfort zone and enabled her to ‘think on her feet’. Rachel feels it is an important learning experience to learn in real life situations, where mistakes will happen but you have to think on your feet to undo those mistakes. In a way it could be argued that this is a more honest approach and one that can be made to be successful when undertaking such an intervention with an experienced ODA clinician.

But Rachel also describes herself as being very confident that being exposed to real life ODA meetings was a positive thing:

The first time it happened, what was your experience of that?

I actually found it fine, I didn’t have... aside from just that kind of awareness of you know not being over disclosing and talking about generalities, but I don’t mind talking about personal things as long as I can see a point to it and as long as it doesn’t kind of trespass into what I

89

would regard as intimacy and I think that’s really important, but I think I’ve got enough

experience in a professional sense to be quite sort of careful about that, but also to be able to say I’ve actually experienced whatever. You could be talking about anger, you could be talking about all kinds of things that people bring up and so yeah, I think it is, it’s not something, I didn’t feel uncomfortable with that at all and that came quite naturally again.

Rachel Pg.3

However, the above shows some hesitancy (‘found it fine’) about the approach. I also felt that Rachel cut herself off when beginning ‘I didn’t have...’ by veering into a professional debate about how she represented herself. The excerpt below by Rachel highlights how uncomfortable it could be for staff who are not trained in the ODA approach; this could in fact be Rachel’s true initial experience of ODA itself, that is an uncomfortable experience:

Partnership working. I suppose the bit that is different is having that open dialogue in front of the person and everybody else about a particular aspect of what has been said. So that might be things like discussing your own life experiences, I mean not in a kind of an unboundaried and you know, kind of mawkish way, but doing so – you know at one point we were talking about what happens because there were some abuse issues for the person. What happens in the relationship sometimes between men and women and so it was useful to have a man and a woman having that dialogue I think. The perception of both can be different but equally helpful. I did feel once or twice that there were some uncomfortable moments, I think that’s probably something that you have to get used to.

What’s an uncomfortable moment? Not to break confidentiality but you tell me?

I think it was mainly on my part to do with the presence of staff because I felt that it wasn’t ODA anymore.

So going back to that first meeting where for want of a better word, the staff had gate crashed the network meeting and you felt that they were uninvited in a way so you found that uncomfortable

Yes and also I think the person that the meeting was focussed on said a couple of things and they contradicted her and I felt that was wrong. When I say wrong, it’s a difficult thing to describe but I felt that those staff had been in the meeting and been given enough information perhaps to realise it wasn’t your usual meeting, if I can put it like that. And you know, I still, having done the unite family work and other work I’ve done with clients in the past plus this, I do get very uncomfortable when people talk about people or talk disrespectfully. I’m by no means saying that I always manage to achieve that myself, but I’ve become increasingly aware, sensitive to the way we talk to people.

90

And talk about people

Yes

So going back to that first meeting then – it was uncomfortable to see that. What was the client’s reaction to being contradicted?

I think she feels quite sort of irate about it really. I think that you know, she’s not here, I’m talking about her and you’re not supposed to really in many ways.

I suppose it’s your perception really

Yes, she I think wanted to give a different image of herself and I think that’s her, the image she wants to project is the one we should be going with. It’s not to say you ignore what people have to say because they might have something important to say, but there are other fora in which you could do that. That wasn’t really what it was intended to be. So that was

uncomfortable.

Rachel Pg. 1

Here Rachel struggles with a meeting that has evidently not adhered to the principles that should govern it and potentially highlights her own novice failings and ability to adequately and successfully chair ODA meetings. Rachel highlights the importance of chairing the meeting effectively so that all voices are heard; ODA requires a certain level of skill to deal with invited clinicians/ staff that may not be trained in ODA and may therefore attempt to alter the tone of the meeting and take control or become too confrontational. However, another way of looking at this is that this is real life and the service user needs to start learning how to equip themselves socially with confrontations – hopefully this is done in a controlled and measured manner. It reminded me of my experience of observing ODA when I was in Finland and observed many meetings, but one stood out from the rest because one of the clinicians took on a more confrontational approach with the service user which closed the service user down and appeared to stunt the previous open flow of dialogue; apparently the nurse was new to the service and had only just started ODA training.

Rachel goes on to state how difficult it can be to talk about yourself:

The other thing that I found uncomfortable at first really was I suppose and still feel unsure about, is how much to disclose about yourself. It can be, I think it can be a very normalising thing for other people, people who have experienced such serious difficulties whether it’s through life experience, things like being abused or through psychotic experiences. I would have thought it must be something of a relief sometimes to have that normalised. Provided of course, you know, that there are sufficient boundaries in place to protect both them and you.

91

Rachel Pg. 2

The above concerns raised by Rachel about how much of a personal disclosure is revealed when service uses disclose their own personal and painful recollections/ uncomfortable moments, it is therefore important that staff are equipped and supported to deal with such revelations.

Therefore Rachel’s initial experience of ODA revolved around her believing that learning beforehand through role play would be a positive thing, but simultaneously being immersed into ODA was also a positive experience. Although she felt that previous experience of psychosocial interventions helped this. However Rachel did express how staff utilising ODA for the first time could find it uncomfortable which probably represents how she felt about her initial network meeting with a service user.