Distress needs to be spoken. And it needs to be heard. By our loved ones and peers. And by the people with the social power, training and responsibility, and our taxes, to provide the resources that could alleviate our distress.
Supportive dialogue between peers
is the basis and strength of the ‘Safely Held’ sessions that we have been
holding in Cambridge over the past months. The compassionate listening and
validation that can be offered by other group members who have lived through
similar experiences feeds the inner strength and self-esteem of the
participants. It also helps them to see ‘personal’ problems as not their fault
but as part of a wider social context in which social justice can be lacking.
And it gives the confidence and the opportunity to take action together to
challenge those with social power and campaign for social justice.
For some members of the group, the
‘Safely Held’ sessions are the fruit of decades of working with dialogue to
these ends.
A BACKGROUND TALE
One of the roots of the ‘Safely Held’ sessions is the
ground-breaking work carried out within an initiative called the ‘Patient
Voice’.
The ‘Patient Voice’ was a project
initiated here in Cambridge at Addenbrooke’s Hospital Clinical School in the
late 1980s into the 90s, bringing in colleagues from the work we began in 1978
in Manchester with the University Department of General Practice. We have continued to develop the practice to the
present day, at Leeds University and with postgraduate medical education in
London.
The work focuses on helping doctors and the
medical team to really listen and share understanding, so that patient needs
are met with compassion, understanding, and the best possible appropriate
medical response – whether the patient’s distress is physical, mental or
both. The work has now become a standard component of GP and other
specialty training and undergraduate medical education, nationwide.
The aim is to remake the professional-patient
relationship as a discussion between equals, recognising that there is
expertise in both parties. The patient is an expert in
their own condition. True to its roots in the community (specifically the
community theatre of North West Spanner in the 70s), the work involves lay
people acting as ‘patient teachers’ to do role play with professionals and give
feedback. Later work in the 90s, with the community organisation Westside
Health Authority in Chicago, encouraging a group of patient teachers from the
bottom up, helped keep our community roots solid.
From the beginning, these ‘simulated’ patients have created their own roles, based in their own lived
experience and responding to professionals’ learning needs, independently
developing and leading methods of reflection and feedback. They are not audio-visual aids but embody an independent performance
practice which gently challenges, and then enables authentic change for individuals. In recent years,
the practice has deepened to include patients and professionals learning
together to develop their situations, including ward-based work in secure
mental health units. Learning from this
work fed into the core support of London’s psychiatry trainees needing help to
improve their communication with patients and teams.
From our photo album…
In the 1970s the
community theatre group, North West Spanner, based in
Salford, created plays in response to local events and concerns, performed in
and outside workplaces, clubs and community centres, including:
 |
‘The Sinking of HMS NHS’, in
support of the nurses’ strike. Trafford Park, 1973
 |
‘Safety First or Last?’ performed
at British Leyland works canteen, Birmingham, October 1976
This photo of the play in the work’s canteen is taken from
‘The Spanner Experiment’.
http://www.justpress.co.uk/SpannerExperiment.html
 |
Andrea McGoverin, Senior Teaching
Fellow in Communication, Patient Perspective,
University of Leeds Medical School and London Professional Support Unit
facilitator,
working from lived experience, with Darren Hart, expert patient teacher,
supporting
psychiatric team members at a secure unit.
The
flyer (below) shows courses in London for doctors mentioning the role of expert
patient teachers
FURTHER INFO
For ongoing developments of this practice,
see also Delia Muir:
https://deliamuir.wordpress.com/author/deliamuir/
For more background information, see:
Whitehouse C, Morris P, Marks B. (1984).
The role of actors in teaching communication.
https://onlinelibrary.wiley.com/doi/full/10.1111/j.1365-2923.1984.tb01021.x
Morris P, O’Neill F. (2006). Preparing for patient-centred practice:
developing the patient voice in health professional learning.
Whiteman J, Morris P, Halpern H (2013). Professional Support, London: the professional development unit supporting professional well-being, refreshment, remediation and revalidation.
