ARAFMI Tasmania

An Association of Friends and Relatives of the Mentally Ill (Tasmania) Incorporated

ARAFMI has two libraries located in the Northern & Southern Offices - all are welcome to explore and borrow resources.

 

Please call 6228 7448 in the South or 6331 4486 in the North

to confirm before you come!

We have an extensive book and video library on many aspects of mental health and illness suitable for people with disorders, carers and friends. You can visit, browse, read or watch your choice here or borrow to take home FREE! Please provide ID for borrowing privileges. A 3 week borrowing period applies. Extensions by approval depending reservations.

Book Review              “ I am not sick. I don’t need help”          By Xavier Amador

 

This is such a helpful reminder to all of us who encounter this aspect of mental illness from time to time. Firstly Xavier explains the biological nature of insight and how it varies within an individual depending upon treatment response and the severity of the illness. A lack of insight is due to the illness itself, that is, the brain is not functioning as it should. Insight however can improve with treatment and be fostered by an enlightened way of our discussing such issues with the person. So there is a message of hope here. He shows that it is not necessarily stubbornness or defensiveness that leads to denial of illness and of help seeking.

             Then he shows how to talk with someone experiencing less than optimal insight into their condition and need for treatment.  He uses a simple acronym, LEAP in creating an agreement.

 

Listen: with attention to hear what it’s really like from their point of view. This enables us: to help us respond in a way that will increase their insight gently, step by step.

Set aside suitable time / place to discuss

Agree on the items you want to talk about

Listen for beliefs about themselves and the illness

Don’t react emotionally. (real hard)

Let the chaos be (even if it’s ‘crazy’ talk)

Echo what you’ve heard

Maybe write it down, stick it on the frig…

 

2     Empathise: if you want someone to understand your point of view, we must first understand theirs. So reflect back what the person says to check that you have really understood it. Feed back their emotions also. Listen for:
- Frustration about being pressured to take medication,

- or that personal goals remain unfulfilled, or being stigmatised and feeling like a failure..
- Fears about the medication, side effects: feeling stiff / discomfort, loss of creativity,

- Awful memories about the compulsory admission, a sense of unfairness even
- Their desires, ambitions and wants.

       & tentatively reflect back what you’ve heard.

3     Agree: Find an area to agree with, find facts you both agree with, goals you both want.
Use a window of opportunity:
-Normalize their experience, eg I’m sure I’d feel the same way if it happened to me”
-Discuss the problems using the person’s words or description of them.
-Discuss the perceived advantages and disadvantages of  the issue (eg treatment) even if irrational.
-Correct any misconceptions about medication (they’re not addictive etc).
-Reflect the perceived benefits you both mentioned before, about taking it
-Sometimes we may just have to agree to disagree about something: it is their choice.

4     Partnership: a collaboration on working towards the goals you both want.
-Try to find achievable goals (this can be difficult.) 

- Allow yourself to say that you’re worried about the person getting sick again and ending up in hospital or whatever…)
- Use empathy when you think you’re losing rapport with the person
-Summarise any agreement, maybe make a compromise.

- Would you like to offer to be a part of the agreement activity?
- Refrain from confronting them or making demands.

 

All in all, this is a very timely but easy read with lots of detail on how to actually phrase up those difficult topics. Please read this book.

Anne.

Book Review  - “Social Work Practice in Mental Health” - An Introduction, Robert Bland, Noel Renouf & Ann Tullgren, 2009.

 

Social Work Practice in Mental Health emphasises the importance of appreciating the lived experience of mental illness, and of establishing partnerships based on and incorporating a consumer perspective into mental health work. It also emphasises the healing potential in relationships between consumer, carers, and service providers.

 

It provides a knowledge base for practice with people with the most commonly encountered mental health problems.