“The penny dropped”

ACT’s Reflective Practice project is seeking to bring about transformation to the area of mental health treatment by offering practical skills trainings. Working with our partner CDIS Médenine in the south of Tunisia, ACT is aiming to empower mental and social health care workers – some of which are already seeing their thinking transformed.

This project arose in response to the way in which mental health treatment tends to be taught – often through the learning of outdated theory and no real practical skills training.

“There are many Tunisians who have psychological or social problems who are not being optimally helped in an empowering and sustainable way,” says Project manager Dieke. “[ACT is] working to build-up and equip well-trained and professional […] workers in order to empower them to do their work and to reach the goals of their organisation better.”

This starts with the Centre for Defence and Social Integration (CDIS – Centre de Défense et d’Intégration Sociale) – a national network of workers, centres and resources offering a wide variety of support to the communities they serve.

The project

A group of participants are currently being trained together weekly. They are made up of psychologists, social workers and specialist educators.

The training is being delivered by Dieke, who uses a model developed for professional reflection and her experience in mental health education.

One person really understood the training after starting out a little unsure of it’s worth – “The penny dropped: they have now understood how to take the problem and look at it in perspective,” says Dieke.

“[The training] helps me to analyse the situation”, reflects one participant. “I have now understood how this will help me in my work and in my relationships,” says another.

“People tend to jump from the problem to the solution – no proper analyses of the problem, no explicit goal setting/defining before defining and then doing interventions” explains Dieke. “This project promotes the start of more systemic and methodical way of working.”

One participant used the model for a case at her work. “She mentioned that this has helped her to takes it out of her head,” says Dieke, “and onto paper, looking at it carefully. After that she said she slept better, as her mind was less preoccupied with work.”

Another participant even mentioned that, just two sessions into the training, they already knew that “next time I’ll do this or that slightly differently.” The training will help people be able to be better at their work.

Being trained to treat each case exactly the same is unhelpful. There is often no space for tailored approaches; a one size fits all approach is not effective. “I hope that, by them learning to undertake a proper analysis, it will open their eyes that not everyone is the same,” says Dieke. “One family will need this; one will need that.” This is one of the project’s goals.

The training is covering a model of reflection and analysis that is new to everyone at CDIS. The hope is that, once participants have mastered this, it will be of great benefit to their work.

The Model: think of a big knot you’re trying to unravel

Participants are told to look back at a situation they’ve been in with a task – for example, a complaint someone has raised on a house visits – and describe…

  • what did I do?
  • what did I think?
  • what did I feel?
  • what did I want?

Then, gather the answers to get a bigger picture of the reality faced.

This process helps to get all the things out of your head, and loaded into the model. It helps things be seen more clearly. It then allows you to explore the next level of questions raised (“Why was I so upset about a situation? Why was she so fearful? Why was he not able to be honest with me?”)

Whilst it is still early days, there has been a lot of interaction from the participants which is great. “We’ve never learnt anything like this in our studies,” says one. “We are only taught this is the way you have to do things.”

ACT is grateful to CDIS Medenine, our partners in this project, and to ACT project staff Massika who’s help has been invaluable.

We look forward to seeing how the rest of the project unfolds!