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全水果沙拉如何为农村和偏远地区的心理健康创造更美好的未来。

How the all fruits salad creates sweeter futures in rural and remote mental health.

作者信息

Lloyd Robbie

机构信息

Centre of Remote Health, Alice Springs, NT, Australia.

出版信息

Australas Psychiatry. 2009 Aug;17 Suppl 1:S142-5. doi: 10.1080/10398560902948464.

DOI:10.1080/10398560902948464
PMID:19579129
Abstract

OBJECTIVE

This paper outlines evidence of efficacious outcomes from mixing people living with diverse mental health challenges and/or intellectual disability. The intention was to show how mixing up people who are differently challenged can be efficacious in (re)habilitation terms. Two separate experiences of sharing personal narratives were involved, along with creative expressions in music, art and filming, combined with group gatherings providing discerning feedback for each other on members' day-to-day progress. After 12 months of 'open urban tribe' gatherings in Sydney, where participants formed a community of belonging, the model was adapted for use in Alice Springs. The original group developed a cycle of interactive ritual rhythms, and these became a special feature of their self-help, peer support approach. The Sydney project modelled community-based rehabilitation, and that process then informed the processes initiated in a rural, remote location.

METHODS

Regular whole tribe gatherings 'in the circle' combined with mentoring 'aunties and uncles'. By sharing stories and giving personal feedback on their progress, participants developed skills and confidence in self expression. Relating to each other and the group, and sharing creative expressions (group craft activities, dancing, small group performing) added depth to the experience of participants. Stories and celebrations were filmed, along with meetings to discuss progress and reflect on how to improve our process of sharing together. Ways for individuals to work on improving their life experiences were shared across the group, which generated a combination of forms of inquiry: supportive, collaborative and appreciative. These were combined with reflexive qualitative ethnographic recording by the researcher, to report and reflect on the whole process.

RESULTS

The original 12 month open urban tribe formation (May 2004-June 2005) in Sydney led to regular gatherings where participants sought to come together and celebrate their being with each other until 2007. From that model further work was undertaken in Alice Springs in early 2008, applying a smaller version of this approach to a new community group. The narrative testimony and witnessing in the first group formed one element of what participants called 'the magic', which they commented on throughout their time together. It was their way of just being together (what this author calls their 'metaphorical energetic presence' alongside each other) that carried the power of this tribe's interactions. Mirroring and feeding back messages to each other that they belonged, that they had an identity, role and purpose together, was a key influence on wellness. That they were seen and loved by all participants was a vital element in the dynamic. These combined to create an effect dubbed 'Working the Business of Life' (WTBOL), a group sharing process providing practical feedback on how to maintain balance in life. By giving everyone a sense of being nurtured in their day-to-day lives, WTBOL showed that people of mixed consciousness can assist each other's healing, growth and development. The value in mixing people of different challenges was that it created a rich field of exchange of their beingness, and mutual appreciation and support. Each had compassion for the other's challenge, and this helped their own process of growing beyond their own challenges. The process has now been successfully applied in Peer Support Training Workshops for Consumers and Carers (November 2008 in Alice Springs).

CONCLUSIONS

Arising from this work, the All Fruits Theory (AFT) argues that mixing people of diverse consciousness, in contexts of trust and safety with each other, can lead to enriching personal acknowledgement and a sense of belonging. By sharing stories, joining celebratory activities, it is possible to generate interactive rhythmical ritual cycles of companionship, celebration, communion and contemplation. The project thus stimulated purposeful motivation and intention to engage in new activities. Individual and group social and emotional wellbeing were enhanced by participating. The author argues that these results show that, just as biodiversity is essential for ecological sustainability, 'onto-diversity' (i.e. valuing diverse ways of being and knowing) is what is needed in rehabilitation settings. When applied across cultures, ethnicity, gender, class and capability differences, these wiser ways of knowing can lead to more sustainable ways of being (i.e. what this author calls 'onto-diversity for suss-tainability', playing on the modern slang term for 'sussing things out'--meaning gaining better understanding of what's really going on).

摘要

目的

本文概述了将患有各种心理健康挑战和/或智力残疾的人聚集在一起所产生有效成果的证据。目的是展示将面临不同挑战的人聚集在一起如何在康复方面产生效果。其中涉及两种分享个人故事的不同经历,以及音乐、艺术和电影制作方面的创意表达,同时还有小组聚会,成员们会就彼此的日常进展提供有洞察力的反馈。在悉尼进行了12个月的“开放城市部落”聚会后,参与者形成了一个有归属感的社区,该模式随后被改编用于爱丽丝泉。最初的小组形成了一个互动仪式节奏的循环,这些成为了他们自助、同伴支持方法的一个特色。悉尼项目为基于社区的康复树立了典范,随后这一过程为在偏远农村地区开展的工作提供了指导。

方法

定期举行全体部落成员围坐在一起的聚会,并由“阿姨和叔叔”进行指导。通过分享故事并对彼此的进展给予个人反馈,参与者在自我表达方面培养了技能和信心。与彼此及小组建立联系,并分享创意表达(小组手工活动、舞蹈、小组表演),加深了参与者的体验。故事和庆祝活动被拍摄下来,同时还举行会议讨论进展情况,并思考如何改进我们共同分享的过程。个人改善生活体验的方法在小组中分享,从而产生了多种探究形式:支持性的、协作性的和欣赏性的。这些与研究者进行反思性定性人种志记录相结合,以报告和反思整个过程。

结果

2004年5月至2005年6月在悉尼最初的12个月开放城市部落组建活动,促成了定期聚会,参与者们一直相聚并相互庆祝,这种情况持续到2007年。基于该模式,2008年初在爱丽丝泉开展了进一步工作,将这种方法的简化版应用于一个新社区团体。第一组中的叙述性见证构成了参与者所称的“魔力感”的一个要素,他们在相处过程中一直对此进行评论。正是他们彼此在一起的方式(作者称之为他们彼此之间“隐喻性的活力存在”)承载了这个部落互动的力量。相互映照并反馈他们属于彼此、他们有共同的身份、角色和目标的信息,对健康产生了关键影响。他们被所有参与者看到并被爱,这是这种动态关系中的一个重要因素。这些因素共同产生了一种被称为“经营生活事务”(WTBOL)的效果,这是一个小组分享过程,提供关于如何在生活中保持平衡的实际反馈。通过让每个人在日常生活中都有被滋养的感觉,WTBOL表明意识不同的人可以相互帮助治愈、成长和发展。将面临不同挑战的人聚集在一起的价值在于创造了一个丰富的关于他们存在状态的交流、相互欣赏和支持的领域。每个人都对对方的挑战抱有同情,这有助于他们自己超越自身挑战的成长过程。该过程现已成功应用于消费者和照顾者同伴支持培训工作坊(2008年11月在爱丽丝泉)。

结论

基于这项工作,全果理论(AFT)认为,在相互信任和安全的环境中,将意识不同的人聚集在一起,可以带来丰富的个人认知和归属感。通过分享故事、参加庆祝活动,有可能产生陪伴、庆祝、交流和沉思的互动节奏仪式循环。该项目因此激发了参与新活动的有目的的动机和意愿。参与增强了个人和群体的社会及情感幸福感。作者认为,这些结果表明,正如生物多样性对生态可持续性至关重要一样,“本体多样性”(即重视不同的存在方式和认知方式)是康复环境中所需要的。当应用于跨越文化、种族、性别、阶级和能力差异时,这些更明智地认知方式可以带来更可持续的存在方式(即作者所说的“为了可持续性的本体多样性”,利用现代俚语“弄清楚事情”——意思是更好地理解实际发生的事情)。

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