A Commentary for the Holistic Politico-Psychological Model
What we require as professionals is a naturalistic narrative about a client’s needs and opportunities for change rather than a dysfunctional discussion of dubiously diagnosed disorders.
-Dave Traxson, 2013
Features of the model
- A multi-dimensional discursive approach that challenges the dominant ‘within child’ biomedical model of mental illness that currently drives the majority of practice with Mental Health and Psychiatry professionals.
- An optimistic and solution-focused approach to the understanding and resolving mental health needs that uses a primarily humanistic psychological perspective to generate thinking and solutions that benefits a client.
- It provides an Aide Memoire to professionals in a multi-agency meetings to stimulate discussion about areas that might be impacting a young person’s world and also stimulates creative solutions involving them to help resolve their current difficulties.
- Colleagues using it have reported that it promotes a holistic reflection on the young persons’ needs and helps to ‘unstick’ bio-medical ‘log jams’ that can often result from only looking at the presenting situational pattern from a rational scientific viewpoint.
- A key issue is the use of terminology. The difference between ‘client’ and ‘patient ‘is a fundamental one.
- ‘Patient’ often represents a totally different ‘mind set’ for those involved and has so often the meaning ‘of doing to’ someone rather than the ‘co-constructed’ view of ‘discussing with’ and the notion of ‘shared responsibility’ for the agreed way ahead.
- A blank proforma allows summary notes to be taken of the discussion that can then be formulated into a hypothesis and action plan to help avoid the need for psychotropic medication to be used with the child. The hope is that it will encourage creative thinking in the ‘team around the child’ to develop proactive strategies that resolve issues without recourse to ‘quick fixes.’
OPTIMAL PERFORMANCE = (POTENTIAL + PERSONALITY) – INTERFERENCE + SUPPORT
So, a human being’s optimal performance is about maximising the positive interaction of their inner potentials and their unique personality taking away the interference from many listed factors then adding the ‘magic element,’ which is the support that we can creatively offer as professionals and a society.
Try the proforma and make notes under each category, during a multi-professional meeting, to help you formulate your professional working hypothesis and action plan for positive change.
Instructions for use of the proforma:
- Place the detailed table of the HPP Model within easy sight.
- Use the prompts under each heading to elicit discussion with all professionals of the child’s holistic circumstances and needs. Obviously this is not all done in one sitting but is a cumulative process over a series of discussions/supervision sessions.
- Make brief notes of the key points of the discussion.
- Formulate a hypothesis based on the collated information.
- Then use it to help select appropriate strategies to meet the child’s specific and unique needs.
- Monitor the success of the Action Plan and Review the hoped for improvements in the child’s Mental Health and Wellbeing.
Some quotes related to the model:
The promotion of holistic assessments and self-directed behaviour in young people is more effective than treating of them as mentally ill or as patients that the health system acts upon in either a hopefully beneficial or sadly all too often in a harmful way.
The Paramount responsibility of any childcare worker is safeguarding the welfare and the emotional well being of the children with whom they work.
-Directors of Childrens’ Services in the U.K.
Giving a child a label of mental illness is stigmatisation not diagnosis. The two most precious things in life are children and freedom -medicalisation harms both of these.
-Thomas Szasz from his “The Myth of Mental Illness” speech
Psychiatry is still so subjective that it would be more honest to use Social Science Methodologies for assessment and review rather than Medical Model Systems. This would better Safeguard our children. -Dave TraxsonAn individual child’s mental health can not be separated from the health of all the many interacting strata that constitute a rich and diverse society in our modern world. It starts with the family and wider community in which they are nurtured or not as the case may be.
It’s not what’s wrong with you that matters, but what has happened to you.
There are a multitude of interactive factors or variables that impinge on individual children and can either support their healthy growth or interfere with the positive development of their ‘identity’ and their ‘integration of self.’
Just a few are:
ENVIRONMENTAL (e.g. disadvantage, poverty, exercise, locality, air quality including crop spraying and sound or infra- red pollution)
EDUCATION (e.g. positive expectations of children, quality of personalised programme, relevance, and the influence of inspirational teachers)
TOXICITY (e.g. relationships, abusive households, medications, subcultures, environmental pollution and dietary additives etc.)
BIOLOGICAL (e.g. physical and mental health, genes and family traits, diet, toxins, metabolic rate and ‘recovery rate’)
INTERPERSONAL (e.g. ‘interpersonal transactions’ (T.A.), ‘family dances,’(Family Therapy) friends, social groupings, social dynamics and ‘personal power’ (Family Links) e.g. bullying or being bullied)
SPIRITUAL (e.g. beliefs, dogma, ‘inner peace of mind,’ spiritual ideation, meditation, ‘special place’ or sanctuary and personal relevance)
POLITICAL e.g. oppression, ideology, ‘mind set,’ class, elites, status, power relationships, personal relevance and prejudice.
BEHAVIOURAL (e.g. learnt responses, traits, behavioural patterns and reinforcers (external and intrinsic))
HISTORICAL (e.g. family norms, parenting, support for education and the individual along with their successes)
PATTERNING (e.g. routines, established patterns of behaviour, ‘family dances,’ sleep and eating patterns and biorhythms)
EMOTIONAL (e.g. loves – hates, hopes – fears, ‘emotional articulacy’ or E.Q., ability to maintain relationships and cope emotionally with them)
INTELLECTUAL (e.g. interests, hobbies, reading preferences, self-expression, response to challenge and stimulation)
AESTHETIC (e.g. music, colours, arts and crafts, architecture, drama, environmental stimuli e.g. light , smells and response to paintings etc.)
All of these dimensions have Positive and Negative elements that interact to produce the ‘big picture.’
The aim of mental health work is simply to ameliorate wherever possible some of the negative aspects and to promote the psychological benefits of increasing the person’s development of their own chosen positive ones in many and varied ways.
Mental well-being will then automatically improve within the individual child and also within their circle of influence (i.e.their family, friends, social circles and colleagues).
That all individuals live in and their ‘mind set’ is fundamentally affected by a ‘social world’ within which they either succeed/thrive or struggle/decline. It is an essentially political ecosystem where it is often normal for power to be unequally distributed with the powerful always striving to maintain their dominance. They consequently further diminish the influence of the ‘dis-empowered’ and ‘underclasses’ in order to ‘profit’ from them or ‘abuse’ their power over those individuals.
Subcultures within the greater society that the individual chooses to join or is coerced to belong to can also impact greatly at this level (e.g. gangs, secret societies, cults or evangelising groups of any faith, political persuasion, or belief subgroup).
That an individual’s mind and will are the strongest determinant of their ’empowerment’ or success in life and should not be impeded by the “toxic labeling” of unnecessary categorisations and scientifically dubious judgements made by professionals. This would the help to reduce unnecessary “toxic prescribing” of drugs that may not be in the person’s short or longer term best interests.
Labeling with the new proposed categories of mental illness using the DSM-5 in 2013 is increasingly unacceptable to more and more members of society (e.g. “sub-clinical normal variation social anxiety” that until now we have called ‘shyness’ and subclinical normal variation depression, which is usually called ‘sadness.’
The good it does is temporary. The harm it does can be permanent.
We therefore need to maximise appropriate support and reduce areas of interference to help people achieve their ‘potential’ and use their unique personality to succeed with their total performance mentally, socially, and physically.
So simply put as a society we must find nurturing, relevant, empathic, creative, and motivational ways of supporting people who are struggling to succeed or experiencing temporary states of alienation, fear, and disempowerment in their current state of being.
Performance is the total response of a human being both mentally and physically to the demands placed on them and to the positive and negative factors of the world around them.
Mental health teams should be working towards achieving and maximising these shared outcomes with individualised approaches that suit a person’s current wants, their mutually determined needs, and their situation, starting with where they are at and not where society or professionals think they are or ‘should’ be.
We need to reduce the stress in their internal ‘stress bucket.’
Basically if we reduce the ‘teaspoons,’ ‘cupfuls,’ and ‘kettlefuls’ that help people develop more self-control, enhancing their personal self-efficacy and their feelings of self-worth and well-being
– Dave Traxson, 1993
The support offered could include:
“Human Bridge” activities:
- Social Pedagogy – an intensive Northern European approach using regular psychologically based life-coaching by highly qualified professionals for vulnerable and ‘Looked After’ YP (e.g. of positive outcomes of the model is that 6 out of 10 get into University that have had this approach compared to 6 out of 1,000 in the U.K.) See post on my blog and use search engine on blog.
- Trusting relationships with key adults – who act as a ‘social interpreter’ and ‘learning coach’ to support YP through the school day, etc.
- “Positive Targeting” – key adults arrange regular appointments with YP to motivate them and discuss concerns, helping to problem solve situations. They have ‘meaningful conversations’ with the YP about the ‘relative progress’ they are achieving.
- Mentoring and life – coaching.
- Modeling – where YP observes closely a trusted adult completing relevant and key tasks, discusses it, does in parallel and then attempts it themselves (The Model – Lead – Test Approach).
- Cognitive Behavioural Therapy (CBT)
- Solution Focused Brief Therapy (SFBT)
- Reality Therapy (RT)
- Rational Emotive Therapy (RET)
- Person-centered counseling
- Non-directive counseling
- Play Therapy
- Art Therapy
- Drama Therapy
- Music Therapy
Hydrotherapy, Aromatherapy, Hypnosis and ‘Ego Strengthening,’
Positive Visualisations, Affirmations, The Emotional Freedom
Technique (EFT), Neuro-linguistic Programming (NLP),
‘Re-tracking’, “Re-punctuating the day” with positive activities, etc.
Physical outlets for channeling feelings
- Outdoor pursuits programmes
- Land-based sports( e.g. the Zen of Golf, orienteering, cycling, etc.)
- Martial arts training and the associated self-discipline
- Walking and trekking
- Water based sports (e.g. canoeing, sailing,water skiing, etc)
- Sky diving and bungee jumping
- Extreme sports
- Gym fitness routines
- Circus skills (e.g. juggling)
- Zumba and exercise classes
- Music – playing individually or in a band
Healthy Diet Interventions
- ‘5 a day’ or mindful eating
Promoting Good Sleep Patterns
- Avoiding stimulants
Animal Based Interventions
- Equine Therapy
- Horse riding
- Rearing animals
- Stroking pets
- Animal welfare
Working for charities
Work experience with caring employers
- Playing an instrument
- Joining a band
- Creative writing
- Digital photo labs, etc.
Building self-esteem programmes
Stress management programmes
Building self-control programmes
Building emotional intelligence (EI) programmes
Parent training programmes
Alternative curriculum programmes
- Progressive Relaxation Training (PRT)
- Deep breathing techniques e.g.’7-11′
- Mindfulness training (focusing on the present – sensory experiences e.g. breathing.)
Mapping analogy for planning:
Any journey is therefore personally mapped discussing these options with a trusted other and uniquely routed based on all the idiosyncratic topographical features that might or might not assist them or hinder them on their travels.
-Dave Traxson, 2011
We should aim to build resiliency in vulnerable others in all of these following areas.
To overcome adversity and build resilience, children ideally require:
- unconditional love and acceptance
- some autonomy/choice over decisions
- trusting relationships with significant adults
- feelings of independence/self-direction
- making relative progress with tasks
- secure relationships in the community
- strong role models foster friendships and commitment
- a safe, stimulating, and stable environment
- create a sense of ‘belonging’
- self-confidence and faith in themselves and their world
- an intrinsic sense of optimism and self-worth
All these things help to build resilience.
Ideas on Building Resilience by the ‘father of positive psychology’ – Martin E.P. Seligman
“Strangely, however, about a third of the animals and people who experience inescapable shocks or noise never become helpless. What is it about them that makes this so? Over 15 years of study, my colleagues and I discovered that the answer is optimism. We developed questionnaires and analyzed the content of verbatim speech and writing to assess “explanatory style” as optimistic or pessimistic. We discovered that people who don’t give up have a habit of interpreting setbacks as temporary, local, and changeable.
That suggested how we might immunize people against learned helplessness, against depression and anxiety, and against giving up after failure: by teaching them to think like optimists.”
This HPP Model we believe builds incrementally on the previous BPS – biopsychosocial model proposed by Meyer et al from the 1970’s onwards (excerpts from an article on the Critical Psychiatry website written by Professor David Pilgrim, Lancashire NHS)
This model has sadly not significantly altered the power base or potential for negative influence of the psycho-physical/bio-medical model which still predominantly pervades the collective thinking in child mental health work and modern psychiatric practice.
The Holistic Politico-Psychological Model of Mental Health (HPP)
PERFORMANCE = ( Potential + Personality ) – Interference + Support
|Personal SkillsInterpersonal SkillsPhysical SkillsCognitive SkillsEmotional SkillsPsychological SkillsResilienceHappinessConfidence StabilityIndependenceCreative skillsSelf-Esteem/ Self-EfficacyRelationshipsSelf-Management of StressMental HealthEnjoyment / joyAltruism
Mood / Humour
|Human / PersonalPhysical/CoordinationIntellectual Political / Spiritual Emotional ArticulacyLiteracy abilityNumeracy abilityLogical abilityThinking abilitiesReceptivity to ideasMemoryCreativityArtistic abilitySporting abilityLeisure/ Reading Humour /MoodCoping strategiesHelping others
Contribution to Society
Work related skills
|OpennessCuriosityCreativityConscientiousnessOrganisational abilityEfficiencyOutgoingEnergy / FocusFriendlinessKind / CaringSelf – awarenessAssertiveAltruisticCompassionateSensitivitySecurity / StabilityVision for futureOptimism / Hope
Motivation / Drive
|Environment / EcologyEducation quality / TeachersToxicity /Pollution: Air/WaterBiological (genetic, health, diet, sleep, physique etc)Interpersonal /Social Spiritual/Political beliefsLoss/Migration/BereavementBehaviour/Thoughts/ FeelingsSignificant life eventsHistorical (norms in family)Patterns (habits, routines, biorythms, ‘family dances’)Cultural / Ethnic / GenderSexualised behaviourSexuality Poor/ Broken attachmentsPhysical – including abuse Emotional – including abuse Screen time / Sensory load Aesthetic/ Media/Sub-culture
Bullying / Intimidation
Oppression / Prejudice
Level of urban/rural deprivation
Addiction / substance abuse
Class, Race, Gender, Age
|‘Human Bridge’ relationshipsPlay Therapy / PlayingArt Therapy / PaintingMusic Therapy / PlayingDrama Therapy /Performing Alternative CurriculumSocial Pedagogy (N.European)‘Life Coaching’ / MentoringTalking Therapies/CounsellingEmployment/financial security Sport / Physical outletsFind ‘Exceptions to Rules’ /’Rays of Sunshine’‘Reframing’ possibilitiesSolution Focussed ideasDeveloping self-controlRelaxation training
Breathing exercisesYoga / MindfulnessDiet / Food -MoodHealth strategies including
Using Creative Strategies + Whatever works for the child and family
PERFORMANCE = ( Potential + Personality ) – Interference + Support
To obtain a copy of the HPP Model word document e-mail Dave Traxson using the contact information listed below.
“Human Bridge” Metaphor
from the H.P.P. model of mental health
- An unconditional human support structure
- An accepting + validating other human being
- Co-constructs a hopeful path to a better future
- Facilitator of a child’s self-efficacy and belief
- The helping hand of a nurturing other person
- A guide to accessing the child’s inner strength
The secret of support is to provide a human bridge over the ‘river of stress’ that a young person is experiencing at that moment.
Dave Traxson 2012
Home telephone: 01902 741193
Mobile: 7809 460521
Home e-mail: firstname.lastname@example.org
Acknowledgements: HPP MODEL : Traxson, Parker, Rowland and Matthews 2013 – article pending in the Division of Educational and Child Psychology Debate Journal By Dr Kevin Rowland and Dave Traxson –December 2013
Dr Kevin Rowland – Chartered Educational Psychologist
Charles Matthews – Chartered Educational Psychologist
Howard Parker – Sociologist and Life Coach