Narrative social work with families of people with mental health problems

V magistrskem delu se posvečam temi narativnega socialnega dela z družinami oseb s težavami v duševnem zdravju. Najprej predstavim značilnosti družin oseb s težavami v duševnem zdravju, njihove stiske, potrebe in obstoječe oblike pomoči, ki so jim na voljo. Osebam se ob nastanku težav v duševnem zdravju spremeni vsakdanje življenje, na njihove predstave o zdravju, okrevanju, identiteti in svobodi vplivajo prevladujoči diskurzi družbe, znotraj katere bivajo. Sočasno spremembe občutijo tudi družinski člani oseb, kar preoblikuje njihove medsebojne odnose, komunikacijo in seveda življenja vsakega posameznika. Da bi družinski člani lažje premagovali stres in stisko, ki jo čutijo, vzpostavijo nova družinska pravila in vloge. V delu opisujem oblike podpore in pomoči, ki so družinam oseb s psihiatrično diagnozo na voljo. Družine lahko veliko prispevajo, kadar se oblikuje pomoč z(a) osebo s težavami v duševnem zdravju, vendar so v ta proces še vedno premalo vključene. Prav tako je pomanjkljivo konkretno sodelovanje z njimi. Opišem tudi socialno delo z družino. V socialnem delu stalno prihajamo v stik z družinami s številnimi izzivi in mnoge pričajo tudi o prisotnosti težav v duševnem zdravju. Imamo dobro razvite koncepte dela z družino ter znanje in kompetence, ki nas zavezujejo k delu, ki temelji na soustvarjanju in sodelovanju. V magistrskem delu se osredotočim na narativne pristope, s katerimi si v sodobnem socialnem delu delimo epistemološko držo socialnega konstrukcionizma. Ta drža nas med drugim usmerja k prevpraševanju dominantnih diskurzov na področju duševnega zdravja ter oblik pomoči, ki temeljijo na medicinskem modelu obravnave. Mnogi načini ravnanja, značilni za narativne prakse, so že v rabi na področju duševnega zdravja in pri sodelovanju z družinami. V delu opišem načine ravnanja značilne za narativne pristope in analiziram, kako se lahko v socialnem delu z družinami oseb s psihiatrično diagnozo bolj opremo nanje. Narativni pristopi lahko obogatijo prakso socialnega dela in nas podprejo pri inovativnem soustvarjanju rešitev s sogovorniki. Vodijo nas pri raziskovanju osebnih naracij sogovornikov in spreminjanju odnosa, ki ga imajo s problemom. Z njihovo pomočjo odkrivamo izjemne trenutke, vire moči in sogovornike podpremo pri pisanju ljubše zgodbe.The focus of this master’s thesis is the subject of narrative social work with families of people experiencing mental health problems. Firstly, characteristics of such families are highlighted, including the issues they face, their needs and avenues of support already available to them. The emergence of mental health problems impacts the daily lives of people experiencing them. Their conceptions of mental wellbeing, recovery, identity, and freedom are influenced by discourses prevalent in their society. The family dynamic is also affected by the change, namely the interpersonal relationships and communication within the family, as well as the daily lives of each family member. To combat stress and hardships, new family rules and roles are developed among the family members. Forms of help and support open to the families of individuals with a mental health diagnosis are also described. Families can contribute a great deal to the process of co-creating help with and for people with mental health problems, but they remain insufficiently included. Cooperation with families is also infrequent. Additionally, social work with families is presented. In social work we constantly meet multi-stressed families, and many cite challenges related to mental health as parts of their experience. We have well-developed models of social work with families, as well as expertise and competences binding us to collaborative practice. In this thesis, narrative approaches, with which social work shares an epistemological stance, are presented. The stance, social constructivism, compels us to challenge dominant discourses regarding mental health and forms of support based on the medicalizing treatment model. Many techniques typical for narrative practices have already been utilized in the mental health field, as well as in collaborative practices with families. I analyze and detail how narrative ideas may be used in social work with families of people with mental health problems. Accordingly, techniques introduced by narrative authors are presented. These have the potential to strengthen social work practice and assist the development of innovative outcomes with our collaborative partners. Narrative offers guidance to exploration of stories and presents methods of encouraging change in one’s relationship with their problem. Narrative practices remind us to uncover unique outcomes and strengths together with our interlocutors and help them to re-write preferred stories