Olivia’s Place

Experts Gather for Silk Road Child Health Forum

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Xian 1On 6-9 July, the Silk Road International Forum for Child Health 2017 was held in Xi’an by the Second Affiliated Hospital of Xi’an Jiaotong University and the Chinese Journal of Child Health Care. Nearly 500 experts in domestic and international pediatrics and health care participated in this meeting. A broad range of pediatric topics including early development, mental health, nutrition, growth and development, high risk infants, children with cerebral palsy, digestive health and allergic disorders, were discussed.

Dr. Susan Cadzow ( M.B.B.S., F.R.A.C.P., Australia, Chief of Behavioral and Developmental Pediatrics for LIH Oliva’s Place Clinics (a division of LIH Healthcare) and Kristi Troutman ((OTR/L, US), also with LIH Olivia’s Place, were invited and presented on “A Multidisciplinary Approach to Autism Diagnosis” and “What is Pediatric Occupational Therapy” respectively.
LIH Oliva’s Place Clinics, with rich resources in international healthcare, endeavors to build academic exchange with domestic medical institutes and is committed to the development of behavioral and developmental pediatrics and pediatric rehabilitation in China.

Congratulations on the success of the Silk Road International Forum for Child Health 2017!


GoBabyGo Speeds Into China!

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GoBabyGo is a US community-based non-profit research program that provides modified ride-on cars to children up to age 3 with limited mobility, such as children with cerebral palsy, Down syndrome, and spinal injury. Program teams design and retrofit toy ride-on cars based on a rehabilitative assessment of a child’s motor ability. Driving the ride-on cars can help children with disabilities to develop their sense of autonomy, judgement, and tactile response, and also facilitate physical development or recovery. The program was initiated by Dr. Cole Galloway at Delaware University in 2012. The program offers impaired children precious opportunities for movement, mobility, and socialization, integrating assistive techniques, families, physicians, and corporate partners.

Dr. Rogers, her team, and the LIH SkyCity Team

Dr. Rogers, her team, and the LIH SkyCity Team

 

The "assembly team" at Beijing LIH Olivia's Place

The “assembly team” at Beijing LIH Olivia’s Place

The initial launch of GoBabyGo in China brought 10 modified ride-on cars in total to Chinese children. Special donation ceremonies were held at LIH SkyCity Rehabilitation Hospital and LIH Olivia’s Place Beijing. Dr. Sandra Rogers, Professor at Pacific University (Oregon, US), and Dr. Fengyi Kuo, LIH Healthcare Occupational Therapy Corporate Lead, presented 4 retro-fitted ride-on cars to 2 Kunming families and 2 Beijing families. In Beijing, therapists from Shunyi Women and Children’s Hospital of Beijing Children’s Hospital also participated in the program.

Dr. Kuo and Dr. Rogers being interviewed by local media in Kunming

Dr. Kuo and Dr. Rogers being interviewed by local media in Kunming

GoBabyGo has been promoted in the US for 15 years and it is hoped that the modified ride-on cars can now be accessible to more Chinese children with disability, helping to improve their mobility. According to Dr. Sandra Rogers, GoBabyGo has been working in many nations and the reason for choosing Kunming and Beijing as the first cities in China to launch the program was that LIH Healthcare has international facilities with an advanced rehabilitation philosophy that matches well with the program’s philosophy and vision.According to Dr. Kuo, through the training conducted by Dr. Sandra Rogers and her team, physicans and therapists in Kunming and Beijing learned basic techinques to retrofit the motorized cars.

 

GBG General 2GBG General 1A child in Beijng, who has Type II Spinal Muscular Atrophy, sat in the car trying to make it move. When he was asked by a therapist which color car he liked best, he answered, “red,” without any hesitation, and gave a new name to the car- a little red bee! The child’s dad was asked to join the assembly team. He took out all the parts started work with the clinical team.

GBG General 3In Kunming, When Dr. Rogers and her team learned than an 8-year-old child would be presented with a car, they searched for a larger ride-on car to retrofit.  “We will tweak the car to fit each child’s condition, if the recipient is an older child, we will choose a proper sized car specific to the child’s situation, make the car more comfortable to maneuver for the child,” said Dr. Kuo.GBG KM 5GBG KM 3

 

Modifying the seat back panel to fit the child.

Modifying the seat back panel to fit the child.

When the assembly was finished, the program team and therapists let kids sit in the cars, adjusting the manual brake to make it easy to manipulate. At the same time, they tweaked the seats to make the child felt cozy behind the wheel, and enjoy the freedom of a little mobility when driving.GBG BJ 4

Replacing the controller based on the child's hand strength, from a selection of 3 controllers.

Replacing the controller based on the child’s hand strength, from a selection of 3 controllers.

That's it!

That’s it!

GBG KM 7
With the guidance of their therapy teams, the children learned to drive the modified cars, use the controller, and avoid the obstacles placed by therapists. They learned quickly while having fun.

In Beijing, a young driver can't get enough of his ride-on car, especially when crashing into targets.

In Beijing, a young driver can’t get enough of his ride-on car, especially when crashing into targets.

GBG BJ 7

Modified on-ride cars can improve children’s cognitive ability and independence, at the same time bringing happiness through play. The kids in Beijing were given group pictures as the event came to a close, some children exclaimed, “we are a family”, yeah! We are families, caring about each other, and fighting for love!”  Here, we’d like to extend our appreciation to Dr. Sandra Rogers, and her team, for this great program they brought to Chinese families and their dedication and contribution to pediatric rehabilitation.Together with LIH Healthcare, GoBabyGo is sure to continue its journey in China, creating more opportunities for the children we serve and their families.


LIH Healthcare Clinicians Attend NICU Training

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NICU 2A series of training on multidisciplinary practice in the neonatal intensive care unit (NICU) was held at LIH Olivia’s Place Beijing from 12-23 July. The training program was designed to integrate theoretical and practical components. Prof. Sandra Rogers, of Pacific University (Oregon, US) and Fellow of the American Occupational Therapy Association, and Prof. Fengyi Kuo, LIH Healthcare Occupational Therapy Corporate Lead, jointly provided a 2-day face-to-face training. Following that training, a 6-week online technical certification course was completed by physicians, therapists, and nurse teams from LIH Olivia’s Place Beijing, LIH SkyCity Rehabilitation Hospital Kunming, and LIH Olivia’s Place Shenzhen.

NICU 3Training content included babies’ development in utero, nursing models for newborns, stress signals, interpretation of APGAR, and positioning, evaluation and feeding of newborns.
In the class, learners were not only presented with theory but also video demonstration and manual manipulation for positioning and feeding babies, in order to smoothly transfer theoretical knowledge to clinical practice. Participants were required to pass an online test before finishing each day’s course content in order to reinforce theoretical foundations, fill in gaps, and foster discussion and exchange of ideas among peers.

Professor Roger’s passion for teaching was evident and many students commented that they learn a lot from the course, because the content was well structured and very practical.


Parents of Children with CP Receive Practical Training

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SZ CP 1A free lecture event for parents of children with cerebral palsy was recently hosted by LIH Olivia Place’s Shenzhen and Shenzhen Angelland Disabled Children Caring Center. Parents attended with great learning enthusiasm despite the summer heat. Lead physical therapy consultant Ilija Dmitrovosk presented a three-and-a-half hour feast of rehabilitation expertise.

Through demonstration, Ilija vividly introduced the principles and approaches of physical therapy for treating children with cerebral palsy. Bearing in mind that each child is unique, he patiently instructed parents one by one how to properly care for their children at home.

SZ CP 2Ilija elaborated on the concepts of physical therapy in simple language to increase parents’ understanding. Quite a number of parents had some knowledge of physical therapy, but through this event, they learned myriad approaches of physical therapy such as 24-hour postural therapy and water therapy, to name but a few. In addition, Ilija introduced how to use the various equipment and special considerations for them. Many parents discovered that they had been using their child’s assistive equipment improperly.
During practical training, Ilija patiently explained appropriate exercises. He noted repeatedly that parents need to help their children exercise to fulfill their potential. According to the situation of each child, parents can use common and simple equipment to help children do rehabilitation exercises properly. But these simple exercises have many points that need to be carefully considered, therefore parents need to closely pay attention to their child and actively interact with and encourage them while they exercise.

SZ CP 3
Encouraged by her mother, a little girl sitting in wheelchair began to respond actively, positions that she had been unable to do before. All the people present burst into cheers and her parents were greatly inspired.SZ CP 4

During a break, parents said that they planned on signing up for more courses and the vivid descriptions and practical training brought benefits to them. Despite a duration of more than 3 hours, many found the event too short. After the lecture concluded, parents gathered around Ilija, continuing to search for professional instruction.SZ CP 5

Ilija Dimitrovosk, Lead Physical Therapy Consultant at Shenzhen LIH Olivia’s Place, has 15 years of experience in physical therapy early intervention for newborns and premature infants, children’s growth and development, children’s physical therapy, and sports and rehabilitation medicine.


LIH Olivia’s Place Specialists Give Keynotes at 3rd China International Forum of Pediatric Development

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CIFPD 1

From 30 June to 2 July 2017, the 3rd China International Forum of Pediatric Development was grandly held in the Beijing Conference Center. About 5000 domestic and international pediatric experts and scholars gathered there to exchange and share new concepts, new explorations, new technologies and new achievements in pediatric diagnostic technology, preventive intervention, and healthcare management. LIH Olivia’s Place experts Dr. Susan Cadzow, Director of Developmental Behavioral Pediatrics, and Prof. Fengyi Kuo, Occupational Therapy Corporate Lead, were invited to present at the forum.

CIFPD 2

Dr. Susan Cadzow has abundant clinical and training experiences in the field of developmental behavioral pediatrics. In the conference’s pediatric development and nutrition sub-forum, Dr. Cadzow reviewed new research and advanced treatment concepts in the early diagnosis of autism in her presentation, “A Multidisciplinary Approach to Autism Diagnosis.” In the presentation, she introduced how western multi-disciplinary teams make autism diagnoses and provided intervention strategies to encourage family participation and follow-up treatment.

In the pediatric rehabilitation sub-forum, Prof. Fengyi Kuo, LIH Olivia’s Place Occupational Therapy Corporate Lead, spoke on “Early Intervention & Family-centered Care for Children with Autism: An Interdisciplinary Team Approach” to emphasize the importance of family involvement in early intervention. Children’s overall functions and daily living abilities can be improved by integrating family activities with an interdisciplinary team approach.
CIFPD 3
“Children’s Health, the Starting Point of the Chinese Dream” was the theme of this conference. With great government support government and collaborative efforts of pediatric experts, pediatrics in China is thriving. Increased professional interdisciplinary teams in China certainly will help more children to grow healthily.


MDT Care: Together, we achieve the best outcome

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Martin (Hai) Qiu, Speech and Language Therapist, HCPC Registered (Consultant), LIH Olivia's Place Shanghai

Martin (Hai) Qiu, Speech and Language Therapist, HCPC Registered (Consultant), LIH Olivia’s Place Shanghai

Last month, we were invited to participate in the Pediatric Innovation Forum at Shanghai Children’s Medical Center. The LIH Olivia’s Place Director of Developmental Behavioral Pediatrics Dr. Susan Cadzow, Shanghai Lead of Speech and Language Therapy Ms. Sophia Guarracino, and Speech and Language Therapist Mr. Martin Qiu attended the forum accompanied by LIH Healthcare public relations and translation staff members, Ms. Heidi Gao and Mr. Louis Liu.

In the forum, Dr. Michael Mintz, PsyD, from Children’s National Health System, gave a presentation on ‘Neurodevelopmental outcomes for children with congenital heart defects’ to share his experiences working with children with congenital heart defects in Washington D.C. Dr. Zhang Yiwen also presented about the ‘Cooperation of medicine and education for children with Down syndrome in Shanghai’ to discuss the recent reformation of pediatric care in local communities.

These two speakers shared their experiences from two different countries in different fields of pediatric care. However, they both emphasized the essence of the multi-disciplinary team (MDT) model of care for achieving the best outcome for the child. Dr. Mintz shined some light on the care pathway involving multiple health care professions, such as speech and language therapists and occupational therapists. Whereas, Dr. Zhang discussed cooperation on a larger scale, between the health care professions and education department.

These perspectives fit perfectly with our core vision at LIH Olivia’s Place, to enable all people of China to access high-quality, evidence-based, inter-disciplinary rehabilitation services. More recently, following the latest evidence, LIH Olivia’s Place has developed multi-disciplinary assessments which are financially accessible for more families. Many of the families who are now able to obtain assessment and subsequent treatment are families from local communities with a child with complex needs. The MDT model ensures better communication between disciplines so that clinicians can understand the child’s strengths and weaknesses clearly. Only then can the team make an accurate diagnosis and provide effective family-centered treatment plans.

LIH Olivia’s Place will continue to be devoted to enabling more families to access high-quality, evidence-based, inter-disciplinary pediatric services. We strongly believe that working closely with other disciplines and local communities can help us to achieve this mission.


Empowering Parents, Children’s, and Young People’s Psychological Journey

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RuChi Yang, PhD, Psychologist, LIH Olivia's Place Beijing

RuChi Yang, PhD, Psychologist, LIH Olivia’s Place Beijing

Many children and young people face social, emotional, or behavioral challenges that their parents find difficult to manage on their own, and help from a therapist through psychotherapy can often make a difference and assist the child or young person and their family to increase their communication, coping, or problem-solving skills; therefore, they are better able to handle future problems independently and successfully. The child or young person may also receive emotional support, resolve conflicts with people, understand feelings and problems, and try out new solutions to old problems.

Psychotherapy refers to a variety of techniques and methods used to help children and young people who are experiencing difficulties with their social interactions, emotions, or behavior. Although there are different types of psychotherapy, each relies on communication as the basic tool for bringing about change in a person’s feelings and behaviors. Psychotherapy may involve an individual child, a group of children, a family, or multiple families. For children and young people, playing, drawing, building, pretending, as well as talking, are important ways of sharing feelings and resolving problems.

The common signs and reasons that children and young people may benefit from seeking help include: developmental delay in speech, language, or toilet training; learning or attention problems; behavioral problems; a significant drop in grades; episodes of sadness, tearfulness, or depression; social withdrawal or isolation; being the victim of bullying or bullying other children; decreased interest in previously enjoyed activities; overly aggressive behavior ; sudden changes in appetite; insomnia or increased sleepiness; excessive school absenteeism or tardiness; mood swings; bereavement; custody evaluations; development of or an increase in physical complaints despite a normal physical exam by a doctor; management of a serious, acute, or chronic illness; signs of alcohol, drug, or other substance use; problems with transitions; and therapy following sexual, physical, or emotional abuse or other traumatic events.

Families play an important role in children’s and young people’s healing processes. Sometimes children and young people develop problems as a way of signaling that there is something wrong in the family. Other times the entire family becomes distressed because the child or young person’s problems are so disruptive. In all cases, children, young people, and families heal faster when they work together in treatment.

A psychological assessment may be indicated when there is a question about possible mental health diagnoses and/or when information is needed about the child or young person’s cognitive, academic, or adaptive skill levels. Assessment results lead to specific recommendations directly related to a child’s unique profile of strengths and weaknesses.

A comprehensive psychological assessment generally includes information from multiple sources, including parents and teachers, and an evaluation of a child’s social, behavioral, emotional, and/or cognitive and academic abilities or aptitudes. For children and young people, direct evaluation may include a series of tasks designed to assess different skill areas or psychological functioning; however, the format of a child’s assessment should be designed based on the best individual fit for a child.

A psychological assessment often includes a diagnostic interview, a cognitive test, a standardized test of academic abilities, neuropsychological batteries, assessments of developmental delays, and/or behavior or symptom rating scales, although many other measures may also be included. Behavioral observations are a critical part of the evaluation and may be conducted in the clinic and/or school setting. In addition, if a child has previously been evaluated or has any relevant medical or educational records, it is helpful to provide this documentation to the examiner conducting the assessment for review. Parents play a very essential role in their child’s life; therefore, they are very important to the work of the psychologist. The information they provide is crucial to how the psychologist moves forward with a psychological assessment.

Following assessment, a feedback meeting with the psychologist is good practice. This session is usually conducted with just the parent or caregivers without the presence of the child. During this appointment, the evaluator should review the results of the assessment, explain the implications of the findings, and provide a series of recommendations. Parents and caregivers should feel free to ask any questions or express any concerns during this session.

Following psychological assessment, parents or caregivers should also be provided with a written report that includes the results and the psychologist’s recommendations. This report will help parents and caregivers to understand the findings and work on the “next steps” to support their child. This report is also very useful for clear communication with the child’s school or medical providers.

In conclusion, children and young people are different from adults. Physical, emotional, and mental differences in maturity necessitate specialized expertise to achieve an optimal outcome. For this reason, it is essential for the parents or primary caregivers to choose providers who have both broad and in-depth clinical experience with children and young people and have professional knowledge in typical and atypical child development when seeking services during children’s and young people’s psychological journey.

 

Dr. Ruchi Yang earned a Ph. D. from Ganon University (Pennsylvania, US) and an M.S. in Counseling Psychology from State University of New York, Albany.  She  is a licensed psychologist and US registered play therapist-supervisor.  Dr. Yang has more than ten years of experience as a psychologist, primarily with children and adolescents  with learning difficulties, ADHD, ODD, disruptive behaviors, negative attention-seeking behaviors, low self-esteem, anxiety, depression, difficulty expressing thoughts/feelings, adjustment issues, grief, parental divorce/separation, low frustration tolerance, anger problems, parenting issues, parent-child relationship problems, trauma, poor decision-making skills, non-compliance behaviors, social skill deficits, relational issues, autism spectrum disorder, and limited coping skills. Dr. Yang provides individual, group, family, and vocational counseling; comprehensive psychological assessments (i.e. cognitive, academic, attention, executive function skills, social, emotional, personality, adaptive, developmental, & behavioral functioning); and crisis intervention/ risk assessment. She utilizes cognitive behavioral therapy (CBT) and behavioral therapy approaches. She also incorporates child-centered play therapy, cognitive behavioral play therapy, filial therapy, and child parent relationship therapy intervention in treatment. Dr. Yang is a member of the Association for Play Therapy (APT) and graduated from the APT Leadership Academy in 2012. She has served on several APT committees and task forces. She has also previously supervised graduate level clinicians. Languages: English, Mandarin


LIH Healthcare and CSH Take Next Steps Toward Greater Collaboration in Pediatric Services

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CEO of LIH Healthcare Nelson Chow presents at Children’s Specialized Hospital’s leadership council meeting

CEO of LIH Healthcare Nelson Chow presents at Children’s Specialized Hospital’s leadership council meeting

On 19th July 2017, LIH Healthcare CEO Nelson Chow, Executive Vice President Dr. Jie Zhang, and US Office Representative Anita Lin visited Children’s Specialized Hospital for new dialogue on continued collaboration opportunities. The focus of the discussion was to develop inpatient pediatric specialty service lines in China, including specialized pediatric rehabilitation programs such as post- NICU follow-up, post liver-transplant rehabilitation, post-surgical orthopedics, and traumatic brain injury (TBI)/non-TBI. In this full-day visit, the LIH Healthcare team conducted in-depth meetings with CSH clinical leaders and staff of the Infant Toddler Program, Brain Injury Program, Chronic Pain Program, Chronic Illness Management, and General Rehab Program. Open dialogue revealed opportunities to develop customized training programs for autism spectrum disorders and ADHD in China. In this full-day meeting, Mr. Chow also brought an exciting update to the executive team of Children’s Specialized Hospital to address 2016 – 2017 milestones, current progress, and forthcoming opportunities for collaboration between two organizations. CEO of Children’s Specialized Hospital, Warren Moore, and VP of Business Development, Michael Dribbon offered their congratulations personally for LIH Healthcare’s progress and shared their excitement about the opportunities in working with LIH Healthcare to create more quality pediatric service programs in China.


LIH Healthcare Visits Burke Rehabilitation Hospital for the Future of Adult Rehab in China

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Burke Rehabilitation Hospital

Burke Rehabilitation Hospital

From July 17th to 18th, LIH Healthcare CEO Nelson Chow, Executive Vice President Dr. Jie Zhang, and US Office Representative Anita Lin visited the hospital and met with the leadership team of Burke Rehabilitation Hospital to discover the great potential in a future partnership to improve adult rehabilitation in China.
As an organization that shares the same vision of providing high quality rehabilitation service, Burke Rehabilitation Hospital is a 102-year-old acute rehabilitation hospital with a long and prestigious history of providing high-standard, family-centered care in upstate New York. Joining highly-reputed medical center Montefiore in 2015, Burke Hospital also shares a strategic role in the alliance to expand the availability of advanced rehabilitation therapies as they work closely with Montefiore providers. Beautifully designed on a large, 61-acre campus, Burke Hospital currently owns 11 buildings that contain inpatient and outpatient services catering to various types of patient needs, ranging from neurological and musculoskeletal, to cardiac and pulmonary disabilities caused by disease or injury.

Left to right: Will Siegal (Operations, Burke Hospital), Nelson Chow (CEO, LIH Healthcare), Janet Herbold (Senior Administrator of Outcomes, Burke Hospital), Jeffrey Menkes (CEO, Burke Hospital), Jie Zhang (VP, LIH Healthcare), Barry Jordan (Sports Neurologist, Burke Hospital), Anita Lin (Representative, LIH US Office), Matthew Bartels (Chairman of PM&R Department, Montefiore), Stephen Rosenthal (Senior VP, Montefiore)

Left to right: Will Siegal (Operations, Burke Hospital), Nelson Chow (CEO, LIH Healthcare), Janet Herbold (Senior Administrator of Outcomes, Burke Hospital), Jeffrey Menkes (CEO, Burke Hospital), Jie Zhang (VP, LIH Healthcare), Barry Jordan (Sports Neurologist, Burke Hospital), Anita Lin (Representative, LIH US Office), Matthew Bartels (Chairman of PM&R Department, Montefiore), Stephen Rosenthal (Senior VP, Montefiore)

Through the visit, the leadership team at Burke Rehabilitation Hospital recognized LIH Healthcare’s achievements, potential, and determination in shaping the future of China’s adult rehabilitation services. Consensus was achieved around a desire to collaborate on high-end specialty service and professional development and education in southwest, China. Specialized in neurological, orthopedic and cardiopulmonary rehabilitation, Burke Hospital sees the opportunity to work with LIH Healthcare by bringing world-class education and training to future providers and building specialty services in China.

 


Book review: ‘Narrative Therapy in Wonderland: Connecting with Children’s Imaginative Know-How’ by David Marsten, David Epston, and Laurie Markham

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Dr. Sophie Westwood, Clinical Psychologist, LIH Olivia's Place Shanghai

Dr. Sophie Westwood, Clinical Psychologist, LIH Olivia’s Place Shanghai

Narrative therapy is an approach that I regularly consider and apply in my clinical work with children, young people, their families, others involved in their education and community, and adults. I was first introduced to this approach during my clinical training at the University of Surrey in the UK, and it was my experiences working in Shanghai that led me to want to get to know it a little better. Working as a British clinical psychologist in downtown Shanghai with clients from the international and local community was a new experience for me and a fresh way of thinking about culture. I too, had attempted to integrate into a different culture and apply my British ways of working (and living) which provided a melting pot of emotions with confusion, curiosity, amusement, wonder, disappointment, relief, sadness, stress, fatigue to name but a few. After nearly two years of working in Shanghai and a growing interest in a therapy approach that takes a long hard look at the influences of relationships and culture, I took the plunge and travelled ‘down under’ to Melbourne last November to complete the week-long Module 1 Narrative Therapy training course. I was surprised to be the only clinical psychologist present but delighted to be in the company of the other attendees who mostly worked with people experiencing all sorts of difficult situations rendering them vulnerable to mental health difficulties. Our shared aim was to try to help them to move forward in their lives in a meaningful way.

Narrative Therapy in WonderlandMy journey with narrative therapy is in its early stages and from my current perspective, the essence of it involves identifying the stories of our lives that we give the most attention to, and exploring what other stories may have been forgotten, dismissed, or are yet undiscovered. It’s the onion metaphor of first peeling back the delicate skin followed by the thick sticky outer layers to expose those that are perfectly snug and hidden that comes to mind. One of the central ideas of narrative therapy is that we are all make meaning of ourselves, others, our lives, and the landscapes we inhabit through the way that we share and create stories, or narratives. For example, a young child that startles easily and prefers to hide behind their Baba’s legs when they meet someone new might be described as ‘shy’ or ‘nervous’ and this becomes a story about them. From this story alone, we might assume that this child is prone to anxiety, has an ‘anxious temperament’ and might have difficulty making friends when they start school. However, when we introduce greater detail to that story and other stories become entwined too, such as startling easily but only when big dogs are around and hiding behind Baba’s legs when his male colleagues come over for dinner but then giving everyone big smiles after a few minutes or so, there is room for alternative or different meanings. This meaning-making process is heavily shaped by our social worlds and we learn much about ourselves through the ‘eyes’ of others (Bakhtin, 1986). During narrative therapy work, a watchful eye is kept on the influencers of stories and how powerful they can be. For example, it might be helpful to explore what it means to be ‘normal’ in any given family, culture, community, or society. Acknowledging this power dynamic and deciding whether the expectations related to certain narratives are something that we might need to live up to, can free up energy, thoughts, and ideas for different and valued directions in life.

The book, ‘Narrative Therapy in Wonderland,’ truly continued to inspire my interest and enthusiasm for the application of this approach in my work. A few years ago, I had called a young person to tell them more about a therapy group to which they had been invited. When I asked them* if they had any questions, the only pertinent question on the tip of their tongue was ‘will it be fun?’ I believe one of the aims of this book is to answer that question and help those working with younger people (and those fully grown too I wonder?!) to consider why fun is an essential ingredient of helpful therapy. Each chapter is littered with case examples of how ‘fun’ can show up in a variety of ways. For example, following a child into whichever ‘wonderland’ their imagination currently occupies is an adventure that can never be planned and is sure to surprise. It is a humbling experience to be invited into a world where fantasy writes the script and a playground of opportunity presents itself with see-saws and roundabouts rooted firmly in reality. My role is to support the young person and important others to navigate a route or generate a map, whereby together we can find a way to ‘shrink a problem down,’ or ‘stand up to’ it to prevent it from bothering the young person. I have witnessed the birth of incredible ideas to do just this from young people that no textbook or therapy manual could have ever directly prescribed. That is, of course, not to say that those textbooks or therapy manuals aren’t helpful too, and I am often grateful for their guidance in clinical work. The beauty of being trained to apply psychological theory is that alongside the person or people with whom I am working, we can decide collaboratively, which is the best fit for them. I am often drawn to a narrative therapy approach because it is very much led by the client and the knowledge, skills, abilities, talents, and qualities they have of what could work best for them, and not forgetting the valued involvement of those around them.

Something else that I hope to introduce into my clinical practice from Marston, Epston, and Larkham’s writing is the ‘wonderfulness interview.’ During our first meeting, it can be tempting for all of us in the therapy room to devote all of our attention to the problem and the story of how it might have developed, what is preventing it from going away, and the ways in which it is negatively influencing or affecting a person’s life. This is important information to hear but given that narrative therapy aims to find out what is not yet known, forgotten, or dismissed, it’s worthwhile listening to a different sort of story or stories too. By asking questions about what is ‘wonderful’ about the young person affected by a particular problem, we start to learn about other stories in their lives that speak to who they are, what they value, and wish, dream and hope for. Certain skills, abilities, qualities, or knowledge might be known and can be particularly handy in calling upon in service of freeing up the hold that the problem has on a person’s life. You’ll notice that problems in this article have been written about in a certain way: it is ‘the’ problem, as opposed to ‘the child’s’ problem.’ This is an important distinction in narrative therapy because it posits that ‘the person is not the problem, the problem is the problem’ (White, 1984; 2007. For younger people, this means that they receive the message ‘I am a good and worthwhile person who is currently doing my best to deal with a tough problem that’s causing lots of trouble for me and other people.’ This can be a big relief for some young people (and parents) to hear when they have not been particularly keen on coming along to the first session in the first place!

So, as I sat on the phone talking with this particular young person about their potential attendance at the therapy group I answered, ‘yes, it will be fun.’ As my experience has developed, and as I continue to engage in a career that will always be about learning, I now feel I could answer that young person with greater conviction. I keep wanting to learn more about this particular therapy approach because it provides a helpful set of ideas for working with families and helping them to ‘team up’ against a problem or difficulty in an empowering and respectful way. The book reviewed in this article is an excellent addition to any psychological practitioner’s library and a captivating read.

If you are a fully grown (but maybe not self-defined as ‘grown up’!) adult, a lovely introduction to the world of narrative therapy has been written by David Denborough and it is called ‘Re-telling the stories of our lives.’ I recommend this for anyone interested in making a change.

 

References:

Bakhtin, M. M. (1986). Speech Genres and Other Late Essays. Austin: University of Texas.

Denborough, D. (2014). Re-telling the stories of our lives. Everyday narrative therapy to draw inspiration and transform experience. New York: Norton.

Marsten, D., Epston D., & Markham, L. (2016). Narrative Therapy in Wonderland: Connecting with Children’s Imaginative Know-How. W. W. Norton & Company, Inc: New York

White, M. (1984). Pseudo-encopresis: From avalanche to victory, from vicious to virtuous cycles. Family Systems Medicine, 2(2), 150-160.

White, M. (2007). Maps of Narrative Practice. New York: Norton.

*’They’ is the author’s preferred pronoun to signify gender neutrality (as opposed to the use of ‘him/her’).


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