Using the Tree Of Life Approach With A Couple Going Through Cancer - PowerPoint PPT Presentation

Using the Tree Of Life Approach With A Couple Going Through Cancer Karin Jansen

Agenda • Background • Tree of life summary • Helping process and cancer experience map • Case discussion • Reflection

Background • SA Education and experience • NZ experience • SW practice approach • History: Narrative therapy • Motivation: Tree of Life in NZ and in context of cancer

Te Whare Tapa Wha Mason Durie

Tree of Life development and metaphor • Development of approach • Metaphor • Roots: Where come from, family history, favourite place • Ground: Present life, daily activities • Trunk: skills, talents, abilities, strengths • Branches: Hopes, dreams, wishes • Leaves: Important people (alive, passed on) • Fruits: Gifts received • Storms and animals • Letter

Cancer Experience Map

Helping Process • Distress • Referral • Psycho social assessment • Discuss Summary (Te whare tapa wha) • Goal setting/work method • Implementation • Evaluation

Te Whare Tapa Wha Summary Te taha Wairua Te taha Whanau Strengths: Faith, Hopes and dreams for future, Humour, Strengths: Supportive spouse, active engagement to Realistic. pursue financial support for unfunded treatment. Support from extended family, Cancer Society and Heart Needs: Connect with community of faith Spouse find Foundation. No social safety concerns. “dark humour” challenging Communication about life/death challenging Needs: Spouse distress impact on patient distress. Patient and son attachment Social integration limited due to Action: How to connect with community of faith, How immunity challenges to have challenging conversations, Advanced Care Planning Action: Counselling; Family Start / attachment options to bond more with his son; Hospice involvement Te taha Tinana Te taha Hinengaro Strengths: Good self-management of health, physically Strengths: Positive mindset and attitude, motivated, independent. Home environment suitable, WINZ, CSC. patient open in communication Selfcare - Play Station/mindfulness exercises. Skilled Needs: Patient distress affected by spouse's ability to animation artist. Safety – medical alarm cope. Realist of diagnosis and communication Needs: Palliative diagnosis, low energy, fatigue, challenging sleeplessness, heart arrhythmias Action: Suggest Tree of Life approach to assist with Action: Art as coping mechanism with Tree of Life connection and communication

To my my bel elov oved ed wife e S There e is so s so much to tell l you about out us an s and d our trees s of life. . How w I se see your r tree is s like e a my mythological hological creature ure called led a nymph, h, nymphs phs are known own to live e in trees s and d protect tect them as th s the tree itself self also so protects tects and d provides vides a h home me in return. rn. So going ing back k to my tree. . A t tree that t twist st and d turns ns that t has s been n broken oken and d sc scared, d, with h a mighty ty trunk nk and d st strong ong roots ots it st stands ds lost st in the center er of a field d that t has s bee een n ra ravaged aged and d tortured rtured by battles tles, , lea eaving ving only y the e tools ols of war r behi ehind. nd. And d here e is s were we st stand d a t tree that t has s experienced ienced so some e of the worst st in life e being ng nour urished ished, , protec tecte ted d and d loved ved by you a beautiful tiful nymph ph that t grows ws her tree with h our love ve. Where re we are now nurtur turing ing our own n offspring fspring, , building lding a f future ure toge gether ther and d replenishing enishing the land d around und us to s to give e only y the best. st. It truly y amazes es me that t so someone one with h a t tree like ke mine has s so someone eone who can st still ll se see past st all that's t's wrong ng. Forever ver hoping ping to be the home e to your r heart t and d our love ve M

Evaluation • Every session: Self- assessment, SRS, ORS • Exit: RBA principles: - What changed • Recommendations: - Systemic involvement - Utilization in context of NZ culture and Cancer

Reflection on outcome About the couple About cancer • Discovery of each other • Using the tool removes again cancer as the centre of everything • Opportunity to identify and express emotions • Other truths amplified and changed perspectives • Unfinished business – catharsis • Difficult conversations such as impact of cancer on • Connection with each other couple and the individual narrative, new narrative explored • Motivation, energy and impact on mood

Reflection on outcome About the approach About social work in health • Non-threatening way to • Justification of time address traumatic aspects with out re-traumatizing • Perceptions of social work in physical health: • More sessions with themes: counselling vs practical therapeutic engagement support and discharge and powerful impact planning • Opportunity for patterns of • Distress: emotional and interaction to change social impact on patient – is • Active engagement impact one more important than on energy, mind-set and the other? emotions • Link: Spirituality and Te Whare Tapa Wha

Innovation • The face of social work is changing, and social work can continue to change by: • Social workers aligning with our professional identity as a profession that contribute to the social and emotional well- being of people, • Sharing the amazing work that we do, • Justifying social work with a solid foundation based on research, experience and the needs of our clients/patients.

Thank you • Acknowledgement to patient and spouse for giving their permission to share their story.

References • Best, E. 1977. The Forest Lore of the Maori. EC Keating: Wellington. • Denborough, D. 2008. Collective Narrative Practice. Dulwich Centre Publications: Adelaide. • Hall LK, Kunz BF, Davis EV, Dawson RI, Powers RS. The Cancer Experience Map: An Approach to Including the Patient Voice in Supportive Care Solutions . J Med Internet Res 2015;17(5):e132. DOI: 10.2196/jmir.3652 PMID: 26022846 PMCID: 4468569 • Kelley, P. 2009. Narrative Therapy. Social Worker’s Desk Reference. Oxford: New York. • Ministry of Health website. Maori Health Models. www.health.govt.nz/our-work/populations/maori • Ministry of Social Development website. Information about RBA and its use in New Zealand. (https://www.familyservices.govt.nz/about -funding/results-based-accountability/rba-basics- guidelines.html) • Ncube-Mlilo, N and Denborough, D. 2007. Tree of Life. Psychological Wellbeing Series. Repssi: Johannesburg. (www.pacificdisaster.net/pdnadmin/data/original/REPSSI_2007_Tree_life.pdf) • Winslade, J. Storying professional identity. The International Journal of Narrative Therapy and Community Work, 2002(4) • Yalom, I.D. 2001.The gift of therapy: Reflections on being a therapist. Piatkus, London.