Tuesday, 17 June 2008

A window on to hope

Analogies from psychotherapy

The question of ‘hope’ and its essential position in conductive pedagogy has been raised more that once on Conductive Education World (see for example Sutton, 2008). Like everything else in Conductive Education this is not something unique to this field. I was therefore interested to see hope emerge as part-theme of an article in this month’s International Journal of Therapy and Rehabilitation, expressed there in relation to ‘mental heath’ problems (Bassett et al., 2008).

In fact there was only a little specifically on hope in this article but the references may be of use to others seeking to elaborate on this aspect of conductive-pedagogic practice.The article summarises hope as follows:

Hope. Clarke (2003) discusses the problem of demoralisation that occurs for people who are struggling with the impact of mental illness on their lives. He stated that it is characterised by a loss of hope. Hope is a factor that relates to an individual’s view of the future and, as such, is related to outcomes about one’s life (Nunn, 1196) … Clarke (2003) notes that hope is not just cognition or thought but is affective and volitional. It is a longing for something that may not be certain but is at least possible. People without hope have far poorer health outcomes than those who do (Clarke, 2993). Hope leads to a conviction that one’s future and meaning is [sic] inherently valuable (Spencer et al. 1997). This in turn encourages recovery (Nunn, 1996; Jacobson and Greenly, 2001). (p.256)

The article then tangles up further discussion of this important factor in terms of its possible relationship with ‘spirituality’, by which it means religious faith, as though there were no possibility of hope in other contexts, or even a non-religious concept of ‘spirit’, ‘soul’ or ‘psyche’.

The article then continues with a couple of to me vague approaches to ‘assessment’ of faith/spirituality and a couple of none-too-concrete ways of including spirituality/hope in intervention. At the level of general principle, however, it does seem reassuringly familia:

Developing hope. With regard to instilling hope, there are several practical steps, such as emphasising the importance of establishing a vision for the future, finding out what individuals want to become and highlighting the fact that development of hope is an evolving process. Practitioners can then equip people with specific problem-solving skills to get over the obstacles to achieving the vision… one of the most powerful tools available to practitioners is to help individuals find hope through the experience of engaging in meaningful activities and achieving small goals leading to more possibilities in the medium or longer term. This in turn creates a belief in possibilities, which were thought lost or were never imagined (Spencer et al., 1997). (p. 258)

This is a little more concrete and suggests that the academic study of hope in psychiatry, at least as reported in the article reported here, may have rather more to learn in practice from Conductive Education than vice versa.


Mental illness?

This article concerned ‘mental illness’ and by extension psychotherapy, mentioning specifically ‘spiritually-augmented cognitive behavioural therapy’. There as those who insist on calling Conductive Education 'a therapy' though, as I have insisted for more than twenty years, this is only really meaningful if it is thought of as a psycho-therapy (in which case the analogy can be highly heuristic). From this viewpoint the window opened on to a different literature by the review article of Bassett et al (2008) may prove useful to those looking furtherto broaden Conductive Education’s slowly spreading academic base.


References

Bassett, H., Lloyd, C. Tse S. (2008) Approaching in the right spirit: spirituality and hope in recovery from mental health problems, International Journal of Therapy and Rehabilitation, vol. 15, no 6, pp. 254-259

Clarke, D. (2003) Faith and hope. Australasian Psychiatry, vol. 11, no 2, pp. 164-168

Jacobson, N., Greenley, D. (2001) What is recovery? A conceptual model and explication. Psychiatric Services, vol. 52, April, pp. 482-485
http://psychservices.psychiatryonline.org/cgi/content/full/52/4/482

Nunn,K. (1996) Personal hopefulness: a conceptual review of the relevance of the perceived future in psychiatry, British Journal of Medical Psychology, vol. 69, pp. 227-245

Spencer, J. Davidson, H., White, V. (1997) Helping clients develop hopes for the future, American Journal of Occupational Therapy, vol. 51, no 3, pp. 91-198

Sutton, A. (2008) Know hope: hope for the future, Conductive Education World, 2 January
http://andrew-sutton.blogspot.com/search?q=%22know+hope%22


Postscript: commentaries


The article by Bassett et al. is followed immediately by three brief commentaries (pp. 260-1), written by three other academics/practitioners, only one of whom touches upon the issue of hope, all three of concentrating on the ‘spiritual’.

1 comment:

  1. Is it hope what humans really need, or is it faith… or is it a value system one can relate to from the heart and live by or is it a specific system or structure that facilitates/guides/empowers the individual to tap into the natural forces of health within to grow and develop?
    What all humans definitely need are… the sense of belonging, to be acknowledged, to be able to make their mark on the world in order to feel worthwhile. Beyond that possibly anything and everything one could ever wish for.

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