Narrative therapy that empowers patients finds way to NGO Umeed

Daisy Daruwalla Bhathena senior therapist at Ummeed and Jehnazeb Baldiwala head of the mental health team say Narrative Therapy encourages the patient to describe their circumstance and whatrsquos ailing them on their own terms PicSuresh KarkeraWhile earlier I would tell her what to do which school was good for her etc now I listen to her to understand what she wantsrdquo says 46yearold Sonali Jain a community worker with citybased Ra Foundation The NGO connects with children from less privileged backgrounds and funds their education at residential schools in order to help educate them in a protected environment The girl Jain is referring to is an orphan who was brought to the attention of the foundation when she was eight years old as she was being sexually assaulted by her maternal uncle with whom she livedA representational picture of an Ummeed counsellor interacting with a child Ummeed has been using Narrative Therapy developed in the 1980s by David Epston and Michael White for the last 10 yearsJain became her counsellor and is now her unofficial guardian Her more recent conversations with the young girl now in Std 10 revolve around the teenager wanting to find a parttime job But the way the conversations are patterned have shifted in the last 11 months This is after Jain took a course in Narrative Therapy at the Chinchpoklibased Ummeed Child Development Centre ldquoFrom telling her what is right for her I have changed focus to figure what she wants and why she wants it and how best she can achieve itrdquo says Jain The teenager is now discussing what measures she can take in order to ensure that she has time to spare for a parttime job that wonrsquot interfere with her education and whether itrsquos something that she is able to and willing toThis involvement of the patient in how the problem should be viewed and dealt with is central to the idea of Narrative therapy Developed in the 1980s by New Zealandbased David Epston and Australian social worker Michael White who passed away in 2008 itrsquos a form of mental and emotional healing in which the therapist is expected to play the role of the lsquoinfluencerrsquo through conversations A quote by Epston mdash ldquoevery time we ask a question wersquore generating a possible version of a life mdash exemplifies thisNext weekend a fourday event titled International Narrative Therapy Conference October 13 and 18 scheduled at the National Centre for the Performing Arts will host workshops and conferences to discuss the idea of Narrative therapyJaffer and SinghamNarrative therapy shies away from using labels that have become part of common mental health parlance such as depression bipolar bully etc This says Jehnazeb Baldiwala head of the mental health team at Ummeed encourages the patient to describe their circumstance and whatrsquos ailing them on their own terms while steering clear of internalising the problem As Daisy Daruwalla Bhathena senior therapist at Ummeed says ldquoThe problem is the problem not the personrdquoFor instance in an interaction with fiveyearold Jaffer Khan name changed an Ummeed community worker said the senior KG student would mostly be seen outside class Mischief and aggressive behaviour mdash troubling kids passing the corridor by teasing and hitting them slamming or kicking the doors mdash came to the social workerrsquos attentionIn a blog for the NGO she writes that her initial work with Jaffer was done by building a rapport A typical narrative therapy conversation goes like thisWhen anger comes what does Jaffer do at that timeHow does Jaffer feel when anger comes to himHow does it look What is its colour Can you draw it for meDo you want to name itJaffer writes the Ummeed team named his anger lsquoSinghamrsquo after the character in the Bollywood movie He drew pictures of a man bold and strong red in colour and called him lsquoSinghamrsquo Jaffer told the Ummeed team that when lsquoSinghamrsquo came to him he would hit run slam the door and not listen Due to this he said that his friends went away from him and said he was a bad boy Whenever Singham came to him Jaffer said his anger would increase and so he would trouble his teachers and the rest of the classThe solutions too had to come from Jaffer The questions then turned to ldquoDo you want to keep Singham as a part of your liferdquo ldquoHow should Singham go out of your liferdquo To reinforce a positive time questions also lean towards looking at times when the situation or the negative reaction to it are not present Therefore ldquoAre there any situations when Singham does not come to yourdquo Now a model child Jaffer is often used as an example for other kids who misbehavePediatrician Dr Vibha Krishnamurthy also the founder and medical director of Ummeed says that Narrative therapy became the predominant form of therapy at the centre as it was the training that Baldiwala had received ldquoHowever soon through anecdotal evidence we realised that the families that received this therapy said they felt empowered In traditional sessions they felt they were being given gyanrdquo she says adding that last year she too enrolled for a course With the children and their families being taught to identify problems and develop the skills they can use to counter them Dr Krishnamurthy believes that the therapy also ensures less dependence on the therapistSome drawbacksNarrative therapy has however some rough edges admits Baldiwala While there are some questions that a therapist can start with there is no threestep solution that will help the therapist reach a conclusion There are maps outlined over the years that act as guidesThe other issue is that while it encourages patients to identify why certain behaviours wonrsquot work in the long term they donrsquot try and identify why the patient responds to situations a certain way For instance traditional therapy would try and probe what about a classroom situation made Jaffer angry If for instance it was being told to do homework what about homework was upsettingCrossdisciplinary programmeYet feels Dr Krisnamurthy it is an approach that more and more health experts must adopt and move away from the ldquoexpert modelrdquo ldquoAs a pediatrician we believe we know all and we tell the patients what to do We do this because we are not taught any differently But I see a shift in that people want to participate in their healthcare and want to choose better When patients pick their goals they are more likely to stick to the therapyrdquo she addsPeggy Sax a Vermontbased psychologist who will be in Mumbai for a session at the conference titled A Room Full of Stories says this form should be seen as a crosstraining programme among various disciplines such as those involved in social work speech therapy and even parentingShona Russel a practitioner at Narrative Practices Adelaide who will also be talking at the conference says ldquoOften problems that are very serious and difficult push people apart but this approach enables people to work together to find solutions that are practical and fit for a particular family The approach helps children and families uncover novel and creative ways of managing the problems they facerdquo