Collaboration & Accountability
Narrative practices respect people as the experts of their own lives. As such, our expertise is not in how we deliver ‘interventions’, but in how we provide a context, through a scaffolding of questions, that makes it possible for people to become more aware of their own skills and knowledges and how to use these to address difficulties they may be facing.
We have included here a diverse collection of resources about the sorts of collaborations that are a key aspect of narrative practice.
Amanda Worrall is a mental health nurse in the Northern Territory (Australia). This presentation tells the story of how June and Amanda found ways to use externalising conversations to name and speak about social paranoia (SP). It also describes the ways in which these conversations enabled June to reclaim her life from the effects of paranoia. This presentation was filmed at Dulwich Centre at the International Spring Festival of Narrative Practice that took place from September 21-23, 2011.
Narrative therapy and community work practices engage what has come to be called a ‘Decentred and Influential’ position from which we can work with people. In this extract, Michael White describes this therapeutic posture.
Michael White Workshop Notes
The Four Quadrants
| De-Centered | Centered | |
|---|---|---|
| Influential | De-centered and influential (potentially invigorating of a therapist) | Centered and influential (potentially burdening of therapist) |
| Non-influential | De-centered and non-influential (potentially invalidating of therapist) | Centered and non-influential (potentially exhausting of therapist) |
It is the intention of the therapist to take up a “decentred and influential” posture in conversations had with the people who consult them – to develop therapeutic practices that make it possible for him/her to occupy the top-left quadrant. The notion “decentred” does not refer to the intensity of the therapist’s engagement (emotional or otherwise) with people seeking consultation, but to the therapist’s achievement in according priority to the personal stories and to the knowledges and skills of these people. In regard to the personal stories of people’s lives, in the context of this achievement, these people have a “primary authorship” status, and the knowledges and skills that have been generated in the history of their lives are the principal considerations.
The therapist is influential not in the sense of imposing an agenda or in the sense of delivering interventions, but in the sense of building a scaffold, through questions and reflections, that makes it possible for people to:
a) more richly describe the alternative stories of their lives,
b) step into and to explore some of the neglected territories of their lives, and to
c) become more significantly acquainted with the knowledges and skills of their lives that are relevant to addressing the concerns, predicaments and problems that are at hand.
In this paper by Sue Mann we examine ways of documenting that draw on collaborative practices, with particular reference to writing medical records.
‘Collaborative representation: Narrative ideas in practice’ | Sue Mann
The Just Therapy Team, from The Family Centre, Wellington, New Zealand, consists of Warihi Campbell, Kiwi Tamasese, Flora Tuhaka and Charles Waldegrave. Their highly respected work, which involves a strong commitment to addressing issues of culture, gender and socio-economic disadvantage, has come to be known as Just Therapy. These practitioners and their work significantly influenced narrative therapy and community work responses to accountability.
This presentation by Tileah Drahm-Butler aims to bring forth conversation on the ways that narrative therapy can be used as a decolonising practice, where Aboriginal and Torres Strait Islander knowledge and skill in resistance is honoured and talked about in a therapy setting.Tileah is a Social Worker in a hospital setting, currently working in Emergency Department and Intensive Care Units. She completed the Masters in Narrative Therapy and Community Work in 2014 and is passionate about finding ways to describe Narrative Therapy practices in ways that are culturally resonant to Aboriginal and Torres Strait Islander people. Furthermore, in the work that Tileah does, she continues to learn alongside the people who she meets to create and re-create narrative practices that are culturally resonate, and that are shaped by cultural and spiritual practices.
To view video, please click link below
Decolonising Identity Stories | Tileah Drahm-Butler
For Reflection
In what ways have you entered into collaborations before? What made these collaborations possible?
What might make it hard to enter into these practices?
If these ways of working fit for you, what next steps could you take to build partnerships/collaborations in your work?
Please now join with others in reflecting on these questions and other wonderings below! Please include where you are writing from (City and Country). Thanks!
mcosta_01
April 14, 2023Meg, Philadelphia, PA – USA
In what ways have you entered into collaborations before? What made these collaborations possible?
In my work on an inpatient psychiatric unit, I engage in collaboration quite often, whether that be a group collaboration between the patients and I or a 1:1 collaboration. I also collaborate frequently with my coworkers, and I think this is an important collaboration to recognize because without teamwork we would all be at a huge disadvantage. Open-mindedness and a passion for learning are essential for collaborating, but I believe humility is the most important trait one should keep in mind when collaborating with others. Especially cultural humility, because assuming someone’s cultural practices rather than asking can have lasting, harmful consequences on the relationship you have with that person.
What might make it hard to enter into these practices?
It is harder to collaborate with someone who has no interest in working with you, but is stuck with you anyway. This type of tension comes up where I work because many of the patients are involuntarily committed for a 7-10 day stay with us. When someone is unwilling, but has no other choice to see you for therapeutic services, collaboration quickly turns into compromise. As you build rapport with this person, collaboration usually becomes more possible.
If these ways of working fit for you, what next steps could you take to build partnerships/collaborations in your work?
I am starting a year-long internship this May, which is required for me to graduate with a master’s in mental health counseling. At this internship I will have a supervisor, as well as a peer supervision group and a graduate course associated with my internship. I will have many opportunities to collaborate with others on how to help the clients I am seeing and how they can help the clients they are seeing. A major source of collaboration will be between me and my supervisor. Again, humility, open-mindedness, and a willingness to learn will be essential here, as well as critical thinking skills. Just because someone is my supervisor does not mean they have all the answers, so I think it is important to maintain a healthy level of skepticism.
Olena
April 3, 2023For me the collaboration starts with talking with a client, first following them and then guiding, showing that there is another path to explore. At the same time, being not the one who just gives directions, but exploring together.
There are several hardships as I see them: the psychologist might sometimes think that he/she knows better and sometimes also the clients doesn’t want collaboration, the expectation might be that someone will just solve all the problems for them. Also for the therapist it requires practice, lots of practice to implement ideas into life.
I think for me it’s very important to listen carefully to the client and ask questions, and to show how important their inputs are, as they are the experts of their lives.
Olena from Dubai, UAE
Lynn
March 30, 2023I agree with the trainee psychiatrist that the power dynamic between doctor and patient may be a barrier to collaborate, I also noticed the power difference and hierarchy in workplace made it hard for team members to collaborate. I believe it takes many efforts to collaborate with clients, families, team members, especially in an interdisciplinary team. Although there are challenges, it is essential to make collaboration happen for the best care of clients. In therapy room, I feel that if the counsellor acts as an open collaborator in the therapy process, it would be easier to allow clients to take an active role in their own healing. However, it may also work in the opposite way for certain clients as a collaborative counsellor may appear to be less powered and realize that in certain culture, clients tend to work better with an-expert-like counsellor, such as in masculine authoritarian cultures. Therefore, I believe the counsellor should adapt their style to better serving the need of clients.
julianne.gordon
March 24, 2023Hello from Saskatoon, Canada in Treaty 6 Territory.
This was an important chapter for me and I realize now it was what drew me to narrative practice in the first place. In the past I have struggled with trying to “fix” a person enough so they can survive in broken systems within our society. I appreciate how Tileah Drahm-Butler explores acts of resistance to injustice no matter how small they may seem. I think it can be very valuable to highlight where someone might have learned this from as it can connect them to family, community, or other important people in their life at a time when they might feel very alone. Even if the person they learned it from is no longer around, it can explore how the relationship with that person continues as they carry that value and resistance with them in their life.
This also has me reflecting on acts of resistance to injustice in my own work. At times, it can be so disheartening to see the lack of change in the broader systems in our society. Exploring my own small acts of resistance gives me motivation to carry on.
susan fagerland
March 13, 2023Hello from Yarra Junction, Victoria, Australia.
In what ways have you entered into collaborations before? What made these collaborations possible?
I feel I have always been a collaborative person, always asking people where they would like to meet up, as a parent this collaboration grew, as I would check with the children what they wanted to wear, what food they wanted to eat within reason, and what they wanted o do. This allowed them to become independent thinkers while also understanding they had to share and take responsibility for actions. These collaborations were made possible due to flexibilty from me, but also having boundaries in place.
What might make it hard to enter into these practices?
If the collaboration is outside your scope, or outside your personal or professional boundaries.
If these ways of working fit for you, what next steps could you take to build partnerships/collaborations in your work?
I guess I have always known that I dislike being told what to do, therefore, I think other people do not like this either, generally if I am told what to do, I do the opposite sometimes to my detriment. Hence, I like to ask, or invite opinions and collaboration when I can. Making sure the person I am talking to is playing the lead role in their own life.
jennyheraghty
February 23, 2023hi this is Jenny, Mareeba Queensland
In what ways have you entered into collaborations before? What made these collaborations possible?
I would often work collaboratively with people when I was doing face-to-face counselling, seating the person beside me while viewing genograms or creating a case plan. my work now is on line or via telephone.
What might make it hard to enter into these practices? Not having the person in the room makes collaboration more of a challenge, but it can be done by sharing notes and asking if my notes are they want recorded.
If these ways of working fit for you, what next steps could you take to build partnerships/collaborations in your work?
I plan to share notes with people when possible and one of my team leaders have agrees that this is empowering and fits the trauma informed scope of the service.
tlcoope
February 3, 2023I am a trainee psychiatrist working in the UK. The power dynamic between doctor and patient can act as a barrier to collaborative ways of working, particularly if legal frameworks are being imposed. A more relational way of working can help to address this, adopting the decentred and influential position described by Michael White. In my current work, the main opportunity for collaboration arises when completing formulations, which are always more powerful if written and shared with the patient or service user. When writing clinical letters, I ensure that the patient has opportunities to question the information described and make modifications or revisions that better fit with their evolving personal narrative of events and ongoing difficulties. This module has been useful in further developing a collaborative approach.
Greetings from Perth where it is cooler today 🙂 I haven’t collaborated much in a therapeutic setting (yet) but I have learnt the power of sharing in a group setting through my own recovery journey. I can see how frustrating it might be to work in an organisation that is set in its ways and where its employees don’t have a knowledge of the concepts that we are learning about in Narrative Therapy. We will need to be trailblazers if we want to change things for the better!
I loved Sue Mann’s paper on keeping records collaboratively. Just the simple action of sitting next to her client in compiling the records acts as a powerful metaphor for us all. I had goose bumps when I read about the lady who signed her records with a big signature. That says it all, doesn’t it! Through Narrative Therapy we are giving people a voice, the opportunity to come out into the light and to be seen and respected. Thanks for this inspiring chapter.