Using the Tree Of Life Approach With A Couple Going Through Cancer - - PowerPoint PPT Presentation

Using the Tree Of Life Approach With A Couple Going Through Cancer

Karin Jansen

Agenda

• Background
• Tree of life summary
• Helping process and cancer experience map
• Case discussion
• Reflection

Background

• SA Education and experience
• NZ experience
• SW practice approach
• History: Narrative therapy
• Motivation: Tree of Life in NZ

and in context of cancer

Te Whare Tapa Wha Mason Durie

Tree of Life development and metaphor

• Development of approach
• Metaphor
• Roots: Where come from, family

history, favourite place

• Ground: Present life, daily activities
• Trunk: skills, talents, abilities,

strengths

• Branches: Hopes, dreams, wishes
• Leaves: Important people (alive,

passed on)

• Fruits: Gifts received
• Storms and animals
• Letter

Cancer Experience Map

Helping Process

• Distress
• Referral
• Psycho social assessment
• Discuss Summary (Te whare tapa wha)
• Goal setting/work method
• Implementation
• Evaluation

Te Whare Tapa Wha Summary

Te taha Wairua Strengths: Faith, Hopes and dreams for future, Humour, Realistic. Needs: Connect with community of faith Spouse find “dark humour” challenging Communication about life/death challenging Action: How to connect with community of faith, How to have challenging conversations, Advanced Care Planning Te taha Whanau Strengths: Supportive spouse, active engagement to pursue financial support for unfunded treatment. Support from extended family, Cancer Society and Heart

• Foundation. No social safety concerns.

Needs: Spouse distress impact on patient distress. Patient and son attachment Social integration limited due to immunity challenges Action: Counselling; Family Start / attachment options to bond more with his son; Hospice involvement Te taha Tinana Strengths: Good self-management of health, physically

• independent. Home environment suitable, WINZ, CSC.

Selfcare - Play Station/mindfulness exercises. Skilled animation artist. Safety – medical alarm Needs: Palliative diagnosis, low energy, fatigue, sleeplessness, heart arrhythmias Action: Art as coping mechanism with Tree of Life Te taha Hinengaro Strengths: Positive mindset and attitude, motivated, patient open in communication Needs: Patient distress affected by spouse's ability to

• cope. Realist of diagnosis and communication

challenging Action: Suggest Tree of Life approach to assist with connection and communication

To my my bel elov

• ved

ed wife e S There e is so s so much to tell l you about

• ut us an

s and d our trees s of life. . How w I se see your r tree is s like e a my mythological hological creature ure called led a nymph, h, nymphs phs are known

• wn to live

e in trees s and d protect tect them as th s the tree itself self also so protects tects and d provides vides a h home me in return. rn. So going ing back k to my tree. . A t tree that t twist st and d turns ns that t has s been n broken

• ken and

d sc scared, d, with h a mighty ty trunk nk and d st strong

• ng roots
• ts it st

stands ds lost st in the center er of a field d that t has s bee een n ra ravaged aged and d tortured rtured by battles tles, , lea eaving ving only y the e tools

• ls of war

r behi ehind. nd. And d here e is s were we st stand d a t tree that t has s experienced ienced so some e of the worst st in life e being ng nour urished ished, , protec tecte ted d and d loved ved by you a beautiful tiful nymph ph that t grows ws her tree with h our love ve. Where re we are now nurtur turing ing our own n offspring fspring, , building lding a f future ure toge gether ther and d replenishing enishing the land d around und us to s to give e only y the best. st. It truly y amazes es me that t so someone

• ne with

h a t tree like ke mine has s so someone eone who can st still ll se see past st all that's t's wrong ng. Forever ver hoping ping to be the home e to your r heart t and d our love ve M

Evaluation

• Every session: Self-

assessment, SRS, ORS

• Exit: RBA principles:
• What changed
• Recommendations:
• Systemic involvement
• Utilization in context of

NZ culture and Cancer

Reflection on outcome

About the couple

• Discovery of each other

again

• Opportunity to identify and

express emotions

• Unfinished business –

catharsis

• Connection with each other

narrative, new narrative

• Motivation, energy and

impact on mood About cancer

• Using the tool removes

cancer as the centre of everything

• Other truths amplified and

changed perspectives

• Difficult conversations such

as impact of cancer on couple and the individual explored

Reflection on outcome

About the approach

• Non-threatening way to

address traumatic aspects with out re-traumatizing

• More sessions with themes:

therapeutic engagement and powerful impact

• Opportunity for patterns of

interaction to change

• Active engagement impact
• n energy, mind-set and

emotions

• Link: Spirituality and Te

Whare Tapa Wha About social work in health

• Justification of time
• Perceptions of social work

in physical health: counselling vs practical support and discharge planning

• Distress: emotional and

social impact on patient – is

• ne more important than

the other?

Innovation

• The face of social work is changing, and social work can

continue to change by:

• Social workers aligning with our professional identity as a

profession that contribute to the social and emotional well- being of people,

• Sharing the amazing work that we do,
• Justifying social work with a solid foundation based on research,

experience and the needs of our clients/patients.

Thank you

• Acknowledgement to

patient and spouse for giving their permission to share their story.

References

• Best, E. 1977. The Forest Lore of the Maori. EC Keating: Wellington.
• Denborough, D. 2008. Collective Narrative Practice. Dulwich Centre Publications: Adelaide.
• Hall LK, Kunz BF, Davis EV, Dawson RI, Powers RS. The Cancer Experience Map: An Approach to

Including the Patient Voice in Supportive Care Solutions . J Med Internet Res 2015;17(5):e132. DOI: 10.2196/jmir.3652 PMID: 26022846 PMCID: 4468569

• Kelley, P. 2009. Narrative Therapy. Social Worker’s Desk Reference. Oxford: New York.
• Ministry of Health website. Maori Health Models. www.health.govt.nz/our-work/populations/maori
• Ministry of Social Development website. Information about RBA and its use in New Zealand.

(https://www.familyservices.govt.nz/about -funding/results-based-accountability/rba-basics- guidelines.html)

• Ncube-Mlilo, N and Denborough, D. 2007. Tree of Life. Psychological Wellbeing Series. Repssi:
• Johannesburg. (www.pacificdisaster.net/pdnadmin/data/original/REPSSI_2007_Tree_life.pdf)
• Winslade, J. Storying professional identity. The International Journal of Narrative Therapy and

Community Work, 2002(4)

• Yalom, I.D. 2001.The gift of therapy: Reflections on being a therapist. Piatkus, London.