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Tejo de Bruijn tejo.debruijn@vantaa.fi

This presentation was held on a conference of the project „STEP“. The project „STEP“ has been funded with support from the European Commission.

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Tejo de Bruijn tejo.debruijn@vantaa.fi

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  1. This presentation was held on a conference of the project „STEP“. The project „STEP“ has been funded with support from the European Commission. This publication [communication] reflects the views only of the author, and the Commission cannot be held responsible for any use which may be made of the information contained therein. From Gällivare to Vantaa:a model for working dialogically with reluctant families and their referring agencies Tejo de Bruijn tejo.debruijn@vantaa.fi

  2. Background of the Gällivare-model • The Gällivare-model was originally developed by the child-psychiatric policlinic of Gällivare, in Northern Sweden in order to chart the situation of so-called ”reluctant client-families” • Those families often came to the clinic – not so much of their own free will, but – referred (almost forced) by child protective services. Therefore, these families were usually not very well able to define goals for their involvement with the policlinic, or if they were, these goals were often less relevant to the reasons they had been referred for. • Whenever the policlinic started to work with them based on these goals, this often led to frustrating, apparent working processes for both parties. • These kind of situations are also very familiar to family-guidance clinics, family-revalidation centres, A-clinics (for substance abuse) and other similar institutions. CIMO, Systemic Social Work throughout Europe STEP, Helsinki1st Congress on Dialogical Practices, Helsinki, 22.-24.09.2011 1st Congress on Dialogical Practices, Helsinki, 22.-24.09.2011 2 7.8.2014

  3. Basic idea of the original Gällivare- model 1 • The working-model developed in Gällivare was based on the idea, that the actual ”orderer” of the services of the policlinic, (the”receiving agency”), was the child-protective service and not the family. • Therefore the child-welfare workers were invited to the first session along with the family and even interviewed first, while the family was listening. Only after this the family was interviewed, while the social workers were listening to how the family defined their own situation. After that an attempt was made to find common enough objectives for the possible involvement of the receiving agency with the family. CIMO, Systemic Social Work throughout Europe STEP, Helsinki1st Congress on Dialogical Practices, Helsinki, 22.-24.09.2011 3 7.8.2014

  4. Basic idea of the original Gällivare- model 2 • The decision to start the involvement of the ”receiving agency” (the policlinic) with the family was made only after sufficient agreement had been reached about the objectives of the involvement with the receiving agency and these were also the kind of objectives the receiving agency was able to answerto. • During this initial interview there was also discussion about what would happen in case the family interrupted their involvement or decided not to be involved with the receiving agency in the first place. CIMO, Systemic Social Work throughout Europe STEP, Helsinki1st Congress on Dialogical Practices, Helsinki, 22.-24.09.2011 4 7.8.2014

  5. Vantaa’s application of the Gällivare- model 1 • The application developed in Vantaa starts from the point of view that a ”receiving agency” can be whatever institution. The ”client-system” in this case is formed by the “orderer” of the service and the family together. The model may be used at any interface, where the need for the service of the receiving agency is defined in the first place by the referring agency and is not or only partly shared by the family. In that case the ”orderer” is usually also the most ”worried” party about the situation. • One of the main objectives of the model is for the ”most worried party” to be heard by both the receiving agency and the family. CIMO, Systemic Social Work throughout Europe STEP, Helsinki1st Congress on Dialogical Practices, Helsinki, 22.-24.09.2011 5 7.8.2014

  6. Vantaa’s application of the Gällivare- model 2 • The model is mostly used whenever a certain ”orderer-” agency is trying to refer the family to another agency and the family does not feel it needs the services of that ”receiving agency”. • If e.g. Child-welfare thinks that the family (also) needs the services of the A-clinic, this clinic is the ”receiving” and child-welfare the ”referring agency”. • If, however, the A-clinic, which is working with the family feels that the need for child-welfare involvement should be evaluated, this clinic is the ”referring-” and child-welfare the ”receiving agency”. • The ”orderer” of Child-welfare services may also be a ”worried” private person, who has made a child-welfare referral. • Nobody (no agency) owns the model exclusively as their tool. CIMO, Systemic Social Work throughout Europe STEP, Helsinki1st Congress on Dialogical Practices, Helsinki, 22.-24.09.2011 6 7.8.2014

  7. The Gällivare-model as a system • CLIENT- • Referring • institution • Receiving • institution • Family • SYSTEM CIMO, Systemic Social Work throughout Europe STEP, Helsinki1st Congress on Dialogical Practices, Helsinki, 22.-24.09.2011 1st Congress on Dialogical Practices, Helsinki, 22.-24.09.2011 7 7.8.2014

  8. The Gällivare model’s place in the process of early interventions when worries about a child arise Parents get worried Someone else gets worried Ask for Don’t ask for “Taking up your worry” help help attempt to share the worry with the parents Cooperational Worry is well- Worry is ill- process founded founded process ends Get help Don’t get help The parents The parents process ends agree don’t agree Referred elsewhere The ”worrier” deliberates/ asks for consultation Gällivare-modelReferral toChild-welfare CIMO, Systemic Social Work throughout Europe STEP, Helsinki1st Congress on Dialogical Practices, Helsinki, 22.-24.09.2011 1st Congress on Dialogical Practices, Helsinki, 22.-24.09.2011 8 7.8.2014

  9. Principles of using the Gällivare model • Clear structure - creates security for all parties involved • Openness - all information is heard by everyone involved - no secret meetings • Reflective approach - Alternately speaking and listening • Dialogical approach - Attempting to create an atmosphere of reciprocal respect and equality • Polyphony - Nobody owns the ”truth”. Everyone’s view is relevant CIMO, Systemic Social Work throughout Europe STEP, Helsinki1st Congress on Dialogical Practices, Helsinki, 22.-24.09.2011 1st Congress on Dialogical Practices, Helsinki, 22.-24.09.2011 9 7.8.2014

  10. The 3 stages of the Gällivare model • A well-structured initial meeting • The ”receiving agency” works with the family • A well-structured final meeting CIMO, Systemic Social Work throughout Europe STEP, Helsinki1st Congress on Dialogical Practices, Helsinki, 22.-24.09.2011 1st Congress on Dialogical Practices, Helsinki, 22.-24.09.2011 10 7.8.2014

  11. Stage 1 : The well-structured initial meeting(1) • The Gällivare model’s initial meeting is very well-structured and proceeds in stages. • The meeting is clearly conducted by the ”receiving agency”, which is represented by at least two workers. The ”receiving agency” also calls the meeting together. • Both the referred family and the referring agency, which often is the party which has ”ordered” the involvement of the ”receiving agency” and is usually also the most worried about the situation. • The receiving agency may use a so called ”reflective team” if possible. • The main topics of the every stage of this initial meeting are written on flap boards (or some other visual device) for everybody to see. CIMO, Systemic Social Work throughout Europe STEP, Helsinki1st Congress on Dialogical Practices, Helsinki, 22.-24.09.2011 1st Congress on Dialogical Practices, Helsinki, 22.-24.09.2011 11 7.8.2014

  12. 1. The well-structured initial meeting: Stages 1 and 2 • 1. A short introduction • - The chairman welcomes everyone and a short introduction round is made. (during which the main subject is not yet touched upon). • - The working procedure for this meeting is presented. • 2. The actual meeting is started with a dialogically open-ended question like: Which of you could tell us why we are gathered here today? • - This usually brings forwards the party, which is most worried about the situation. CIMO, Systemic Social Work throughout Europe STEP, Helsinki1st Congress on Dialogical Practices, Helsinki, 22.-24.09.2011 1st Congress on Dialogical Practices, Helsinki, 22.-24.09.2011 12 7.8.2014

  13. 1. The well-structured initial meeting: Stage 3 • 3. Interviewing the referring agency • - Charting previous and current working • involvements and used methods. • - What do they want from the ”receiving agency”? • - Worries and questions as specific as possible and • specified to any family member individually. • - What kind of information the referring agency needs for • their own work with this family? • - Any other questions? • - Which specific persons / family members should be • involved with the receiving agency? • (During this stage the family listens and does not comment) CIMO, Systemic Social Work throughout Europe STEP, Helsinki1st Congress on Dialogical Practices, Helsinki, 22.-24.09.2011 1st Congress on Dialogical Practices, Helsinki, 22.-24.09.2011 13 7.8.2014

  14. 1. The well-structured initial meeting: Stage 4 • 4. Interviewing the family: • - The family’s composition and life situation • (A family-diagram is drawn) • - What are the family’s worries or questions. As specified • by each family-member • - The family’s possible wishes or expectation in relation to • the ”receiving agency”. • (During this phase the referring agency’s workers listen and do not comment) • (In case other workers/agencies are present they are interviewed after the family, using the stage 3 issues.) CIMO, Systemic Social Work throughout Europe STEP, Helsinki1st Congress on Dialogical Practices, Helsinki, 22.-24.09.2011 1st Congress on Dialogical Practices, Helsinki, 22.-24.09.2011 14 7.8.2014

  15. 1. The well-structured initial meeting: Stage 5 • 5. Discussion: • Both parties are reciprocally given the chance to • comment on each other’s visions and if possible to • specify their own positions. • Reflection by the receiving agency possibly using a • reflective team. • - Looking for shared objectives • If a sufficiently shared objectives are not found, and/or the family refuses to be involved with the ”receiving agency” the referring agency is invited to tell what this means on their behalf, so that the family will be aware of possible consequences. • If this does not change the situation the meeting and the whole process will be ended here. CIMO, Systemic Social Work throughout Europe STEP, Helsinki1st Congress on Dialogical Practices, Helsinki, 22.-24.09.2011 1st Congress on Dialogical Practices, Helsinki, 22.-24.09.2011 15 7.8.2014

  16. 1. The well-structured initial meeting: Stage 6 • 6. Working context and background conditions: • When sufficiently shared objectives are found: • - The receiving agency tells whether and which of the expectations they will be able to meet. • - Timetables are presented and agreed upon. • - Discussion about what will be expected of the • family as their client, and what will be the consequences if the family Would choose not to live up to these expectations. • - The need for possible interim report to the referring agency is discussed. • - A tangible working-plan is agreed upon. CIMO, Systemic Social Work throughout Europe STEP, Helsinki1st Congress on Dialogical Practices, Helsinki, 22.-24.09.2011 1st Congress on Dialogical Practices, Helsinki, 22.-24.09.2011 16 7.8.2014

  17. 1. The well-structured initial meeting: Stage 7 • 7. Drawing up the working-contract: • The questions to be answered, the objectives of the • different parties and the actual working-contract are • written down in such a form that they can be accepted by • everyone involved. • The working-process is described so that it is clear to both • the family and the referring agency. • A final meeting with the same parties, evaluating the • results of the working-process by all the parties involved is • planned on basis of which a shared report will be written, • in which the visions of all parties involved will be • reflected. • The need for possible interim report to the referring • agency will be agreed upon. CIMO, Systemic Social Work throughout Europe STEP, Helsinki1st Congress on Dialogical Practices, Helsinki, 22.-24.09.2011 1st Congress on Dialogical Practices, Helsinki, 22.-24.09.2011 17 7.8.2014

  18. Phase 2: The ”receiving agency” works with the family • During this phase the receiving agency works with the family using its own methods according to the shared objectives and plans agreed upon during the initial meeting. • In case clear divergences are made from the working-plans, it will be discussed with the family on whether and how this must be reported to the referring agency, or an additional interim meeting will be proposed. CIMO, Systemic Social Work throughout Europe STEP, Helsinki1st Congress on Dialogical Practices, Helsinki, 22.-24.09.2011 18 7.8.2014

  19. Phase 3 Structured final meeting • If possible the same workers from the receiving agency call also this final meeting together and function as chairman/secretary. It is advisable that also the ”flaps” or other documents from the initial meeting are available. • After mentioning the objectives that were agreed upon during the initial meeting, first the family is asked to estimate what has happened in relation to these objectives. After that the referring agency is given the chance to bring forwards their own estimations/visions and if needed to ask additional questions. It is attempted to make a final report with all parties involved, about the working-process and its results from the point of view of all the parties involved, which can be signed by everyone. If needed a contract for continued involvement may be made, for which new objectives must be formulated. • The receiving agency takes responsibility for finalizing the final report. This will be the official document of the whole process. CIMO, Systemic Social Work throughout Europe STEP, Helsinki1st Congress on Dialogical Practices, Helsinki, 22.-24.09.2011 1st Congress on Dialogical Practices, Helsinki, 22.-24.09.2011 19 7.8.2014

  20. Literature/material about the Gällivare model • de Bruijn, Tejo Jällivaaran malli, koulutus- materiaali,Vantaa, 2007 • http://intra.vantaa.fi/dokumentti.asp?path=1;1286;1288;5979;5981;26367;51863;57184 • - Edwardsson, M.;Johansson Sesam öppna dig!! • Niemelä, B.; Kjellberg, E.; Utredningsarbete inom • Löveborn, G.; Nordvall, A.; barnpsykiatrisk öppenvard • Olsson, A.; Wessel, A.; 1994, Fokus på familien, vol. • Öberg, T. 22 s. 181 – 191, Oslo, ISSN • 0332-5415 • Kjellberg, E. Man kan ju inte så nog veta. Bockum • Maahi, Katri; Paasivirta, Annukka & Tilannearviotyöskentely lasten- • Vuori, Annasuojelun ja A-klinikan yhteistyönä. • Sosiaaliportti, Hyvä käytäntö kuvaus • http://www.sosiaaliportti.fi/File/febfebce-e77a-445b-bc12-96155a3ae986/Tilannearviomalli%20A-klinikan%20kanssa.doc CIMO, Systemic Social Work throughout Europe STEP, Helsinki1st Congress on Dialogical Practices, Helsinki, 22.-24.09.2011 20 7.8.2014

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