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25.
RESIDENTIAL MANAGEMENT OF PERSONALITY DISORDER
I visited
several residential facilities in the community, but one was of
particular interest. This was Beit Inbalim ("Beit" = house,
"Inbal" = a girl's name) in Hadera. It is a new,
private-sector unit for up to 24 people living in three ordinary
houses in a residential area. The residents are young people (18-35)
who would otherwise be in hospital because of long-term mental health
problems such as schizophrenia, eating disorders or personality
disorders. Funding comes partly from the Ministry of Health (via the
saving on hospital costs), partly from housing benefit and partly
from residents' social security benefits and own wages.
26.The hostel
arose out of a Ministry of Health initiative to prevent newly
diagnosed clients from starting a long career as psychiatric
inpatients (as has previously been the case.) The aim is to raise
people's level of function towards the point where they can live and
work as independently as possible. Clients with diagnoses of
schizophrenia and borderline personality disorder are seen as
benefiting similarly from the regime, although the aetiology is very
different. Both groups tend to be hyper sensitive to the impact of
others on themselves, and under sensitive to their own impact on
others. Large group meetings twice weekly address any interpersonal
issues that arise, in the manner of a therapeutic community.
27. All
residents work, either in the open employment market, sheltered
workshops or within Beit Inbalim itself. The brought-in work tends to
be unskilled, repetitive tasks such as packing or light assembly. The
work is seen as important for structuring and giving a purpose to
people's day, maintaining and promoting work habits and skills, and
not least to provide a modest extra income for individuals.
28. I spent a
day with the manager of Beit Inbalim, a family therapist by
profession. We agreed that we both shared similar ideas, and will
keep in touch. They were keen to know more about our use of the 6PSM
in assessment, and my team is interested in therapeutic residential provision.
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29.
THE CHURCHILL FELLOWSHIP
My experience
of the Fellowship and the support from WCMT has been entirely
positive. The very name of Winston Churchill carries huge weight and
authority with people who may never have heard of the Fellowships or
the Trust, and opens doors that would otherwise have been shut. The
experience of the interview, with four such eminent figures, set the
tone that this was going to be an important experience for me. The
notion of a Fellowship for life was a sobering one and it was
important to be contacted by and meet Fellows from previous years via
the East Pennine Association.
30.The WCMT
presents an image that, although friendly and approachable, is also
businesslike and dignified. The importance with which the WCMT
regards its affairs and the name of Winston Churchill had a
rubbing-off effect on me, not to give myself airs and graces but to
say "Yes, my work is important and I can hold my head up with
anyone and say I am a Churchill Fellow."
31The funding
provided by WCMT was more than adequate, indeed it took me a few days
to realise that I did not have to scrimp and save and that I should
be using the money to make the very most of every day. The
administrative support, from business cards to thank you letters from
the Director General was also very much appreciated and extremely
fast. The only thing I remotely felt could be added was a name badge
in the WCMT format. I wore my badge from work when I was meeting
people, so that they could identify me and remind themselves of my
name - a badge identifying me as a Churchill Fellow might have been
more appropriate.
32.Many small
details occurred to me while away which might help future Fellows on
their journeys. I will collate these into a short document and
forward them to WCMT in case these would be helpful.
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FINAL
SUMMARY
The WCMT call
the Fellowships "The chance of a lifetime." This could be
an empty slogan but when I spoke to anyone in this country or Israel
about my Fellowship there was no other phrase to use. Being away from
my family for four weeks was hard, but having the time, the money and
the prestige of the Churchill Fellowship behind me was an
unrepeatable experience.
Winning the
Fellowship has given me the confidence to know I can take my interest
in the 6-Part Story further. I aim to start my PhD to research the
method in 2000, and the Fellowship has helped greatly towards this. I
will be passing on what I have learned both locally and, in the case
of the 6-Part Story, nationally. I have completed only the first four
weeks of my time as a Churchill Fellow. The WCMJ and my employers
have devoted considerable resources of money and time to this. Now I
have to make that investment pay throughout the future years of my Fellowship.
KIM DENT-BROWN
Dramatherapist,
1999 Churchill Fellow
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ACKNOWLEDGEMENTS
I would like
to thank the following:
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APPENDIX:DIARY
OF VISITS AND ACTIVITIES
Tuesday 2 Nov
Flew to Ben
Gurion airport, Tel Aviv, transferred to Jerusalem.
Wednesday
3-Thursday 4 Nov
USA-Israel
Joint Distribution Committee, Brookdale Institute, Jerusalem
Participated in bi-national (Israel-N.Carolina USA) conference
planning joint research proposals. Helped develop proposal for
testing the training of workers in post-disaster trauma. Made
contacts for visits during the rest of the trip.
Friday
5-Saturday 6 Nov
Jerusalem.Weekend
visiting Yad Vashem (Holocaust Memorial), Jerusalem Old City.
Sunday 7 Nov
Nes Tsiona
Hospital (15 miles SE of Tel Aviv)
Study day with
senior practitioners from health, social services, education and
representatives from each Ministry. Discussing implementation of a
case management approach to working with clients with complex needs
(eg children with severe mental health problems.) Also visited
psychiatric hospital with children's in-patient unit, autistic unit.
Monday 8 Nov
Jerusalem.
Admin day renting mobile phone, arranging car hire, accommodation for
the rest of the stay, following up contacts.
Tuesday 9 Nov
Beit Sahour,
Nr Bethlehem (5 miles S of Jerusalem). Visited rehabilitation centre
run by YMCA East Jerusalem (Palestinian branch of YMCA). Client
group: young people from throughout the Arab territories (West Bank)
with physical disabilities and post-traumatic stress disorder
following injury during the Intifada against Israeli occupation.
Jerusalem. Met
with people from 2 groups representing users of mental health
services in Jerusalem. Heard about their plans, described the role of
MIND in the UK. Arranged to make a presentation about Specialist
Therapies Team and ouruse of 6PSM to a larger group later in my stay.
Wednesday 10 Nov
Eitanim Mental
Health Centre (10 miles W of Jerusalem) Visited psychiatric hospital
with child, adolescent, adult services, occupational therapy
department, met OTs, art therapist, psychodramatist, psychiatrist.
Thursday 11 Nov
Jerusalem.
Visited Ministry of Health (mental health branch), learning about
overallstructure of mental health services in Israel.
Visited
Project Yesh - 80 place day centre (branch of Eitanim, visited
previous day). Client group: adults (17~0) with long term mental
health problems, typically schizophrenia. Saw rehabilitation
workshops, work activity programme, spoke to clients, managers and OT staff.
Visited hostel
run by Re'ut - non-profit organisation with links to Richmond
Fellowship. 14 bed long-term hostel for people previously housed in
long stay ward in large hospital. Spoke to residents and social worker.
Friday 12 Nov
Drove north up
West Bank and Jordan Valley to Sea of Galilee
Saturday 13 Nov
Drove north
from Sea of Galilee into Golan Heights, north-easternmost part of
Israeli-claimed territory. Then south to Rosh Pinna, home of host Dr
Mooli Lahad. Met Psychiatric Nurse and Dramatherapist Naomi Hadary
and discussed her MA thesis on the 6-Part Story Method and coping
mechanisms in nursing students.
Sunday 14 Nov
To Community
Stress Prevention Centre (CSPC), Kiryat Shmona. Met team and
presented STS model and our use of 6P SM. Spent time in library and
discussions with team.
Monday 15 Nov
Second day at
CSPC, using library, watching videotapes, photocopying..Visited Tel
Ha Day Centre for the Elderly.
Tuesday 16 Nov
Paediatric
Oncology Day Unit, Ha'Emek Hospital, Afula. Met Dramatherapist EIsa
Segev-Shoham using 6PSM with children undergoing treatment for cancer.
Tiv'on, nr
Haifa. Met Ofra Ayalon, author and co-developer of 6PSM. Rosh Pinna.
Discussion with Prof. Mooli Lahad, Dramatherapist and co-developer of bP3M.
Wednesday 17 Nov
Day recovering
from heavy cold.
Thursday
18 Nov
Visiting
Eshet, Kiryat Shmona, rehabilitation workshop for people with mental
health problems.
Visited
swimming pool at Rakefet, nr Karmi'eI, observing innovative
hydrotherapy method with children with physical and behavioural problems.
Friday 19 -
Saturday 20 November
Weekend
visiting Tsfat, Western Galilee, Akko, Mediterranean coast,
Sunday 21 November
Afula,
visiting Dr Alex Weissbuld, Consultant Psychiatrist.
Afula,
visiting day centre and accommodation run by Enosh. Met manager Mira
Farbstein and Enosh President Chanita Rodney.
Monday 22 November
Visiting Enosh
Day Centre, Givat Em, nr Tel Aviv.
Jaffa Mental
Health Centre
Tel Aviv Child
and Youth Clinic
Enosh hostel
accommodation, Tel Aviv.
Tuesday 23 November
Day off
visiting Masada, Dead Sea.
Wednesday 24 November
Day visiting
Beit Inbalim, Hadera. Privately run hostel for young clients,
including those with borderline personality disorder. Met manager and
family therapist Uzi Greenbaum.
Thursday 25 November
National
Insurance Institute, Jerusalem. Visited department responsible for
immediate aftercare and debriefing of victims of terrorist incidents.
Brookdale
Institute, Jerusalem. Made presentation of Specialist Therapies
Service to audience from health, social services and voluntary sector.
Friday 26 -
Saturday 27 November
Weekend
driving to Eilat on the Red Sea.
Sunday 28 November
Final admin
and beginning to write report
Monday 29 November
Driving from
Eilat to Tel Aviv
Tuesday 30 November
Flew out from
Ben Gurion airport.
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