Presentazione di PowerPoint

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Training and therapy in a womans voice London,
may 2009
As a woman I have no country As a woman
I want no country As a woman my country is the
whole world Virginia Wolf
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Interpersonal and social processes involved in
helping contexts.

• Laura Fruggeri Umberta
  Telfener
• University of Parma University
  of Roma
• laura.fruggeri_at_unipr.it
  umberta.telfener_at_roma1.it

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Cybernetic epistemology

• Within a cybernetic epistemology nothing is good
  or harmful in itself. It can be defined either
  one or the other way only within a relationship
  and a context
• Successes or failures do not depend unilaterally
  on the clinician or on the client, but they are
  generated within the story of their relationship
  and of their reciprocal encounter.
• Successes and failures emerge from the
  coordination of actions and meanings

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Two levels of an intervention

• STRATEGIC
• RELATIONAL

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STRATEGIC level of the intervention from the
point of view of the PROFESSIONAL
Theoretical models
Institutional mission
Prejudices
PROFESSIONAL
CLIENT
Beliefs
Culture
Competence
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STRATEGIC level of the intervention from the
point of view of the CLIENT
Feelings
Personal aims
Prejudices
PROFESSIONAL
CLIENT
Beliefs
Culture
Previous experiencs
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RELATIONAL level of the intervention
Premises Prof Client
Prof Client Premises
JOINT ACTION
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RELATIONAL level of the interventionin a
triadic perspective
Premises Prof Client
Prof Client Premises
INTERACTION
Significant others
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Joint actions create contexts of meanings
unintended consequences
Premises Prof Client
Prof Client Premises
RELATIONAL INTERDEPENDENCE
Significant others
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Double description includes both

• strategic level of analysis
• technical competence

• relational level of analysis
• relational competence

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Different levels of responsibility

• Technical responsibility Professionals become
  competent in a model
• Relational responsibility Professionals reflect
  on the meaning that the expressions of their
  competence have within the relationship with
  client and his/her significant system
• Social responsibility Professionals reflect on
  how their actions contribute to maintain a
  certain structure of power

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RIFLEXIVITY professional knowledge as a second
order operation

• Professional
• theoretic Client
• model

• Theoretic Professional model
• Professional Client

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Different levels of knowledge

• Knowing/Not knowing (hypothesising , first level
  operations)
• Knowing that one knows (reflexivity and
  consciousness)
• Knowing that one doesnt know (curiosity)
• Not knowing that one knows (intuition)
• Not knowing that one doesnt know (collusion,
  resonance, blind spot)

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Operations necessary but not sufficient not to
become doctor homeostat

• The recognition that needs and models change over
  time
• The negotiation of the quest
• The usefulness of keeping in mind undesiderable
  outcomes
• The importance of unsaturated narratives
• Differenciating explanation and action domains
  (Lang-McAdam)
• .

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The importance of unsaturated narratives

• narratives co-constructed in therapy and in
  social settings should not saturate the curiosity
  of participants and leave instead space for new
  hypotheses and actions

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The negotiation of the quest

• We can never work without an explicit quest,
  since it allows the clinician to have clues about
  interactive aspects (the family pattern around
  symptoms, the referring person, expectations
  concerning the future clinical work, differences
  within the family)
• Even when people seem to have a clearly defined
  need, or when a context of intervention implies
  specific needs, we still have to be aware that
  the quest will emerge from the negotiation
  processes which leads to the construction of a
  shared frame

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The usefulness of keeping in mind undesiderable
outcomes

• Errors within the cybernetic framework are
  signals that can help clinicians to correct their
  strategizing (they are usually within a
  behavioral domain)
• Resonance is often inevitable and is overcomed by
  team work, co/super-vision, reflexion
• Collusion, Chronicity, Iatrogeny, orthopedic
  intervention are unintended consequences that
  emerge from interactive processes (even if the
  model is correctly applied)

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Invisible processes

• Cronicity occurs when map, story, narrative)
  becomes shared by all the components of the
  relational net (client, family, helpers, senders,
  colleagues, significant others). If everybody
  agrees there is no more curiosity and the
  situation is stuck
• Collusion when we participate to what goes on,
  we fall into the system instead of proposing an
  evolutionary stance, we have lost our
  strategizing ability or we think we utilize our
  strategizing instead we (non voluntarily) adhere
  to the core of the system
• Risk of iatrogenic risk it is the risk coming
  from the cure process (iatreia cure gignomai
  to emerge, to be born). It doesnt have to do
  with the severity of the symptoms or of the
  situation.The worsening of the symptoms emerges
  from the story of the relationship, of the
  encounter and from the coordination of
  coordination of premises and actions. It is a
  second order risk the mistake of the mistake,
  not knowing that you dont know, having confused
  the description of reality with reality itself.

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Systemic prejudicesaccording to Gianfranco
Cecchin

• A person has value since s/he exists
• It is impossible to controll others
• It is inevitable to delude oneself of the
  possibility of influencing and manipulating
  others
• It is good to bee usefull not to cure
• Typology is a myth
• Therapy will be prosperous despite outcome
  research
• We should have temporary certainties instead of
  permanent truths
• Before changing the world lets try to understand
  how it works

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Bibliography

• Fruggeri, L. (2002) Different levels of analysis
  in the supervisory process. In D. Campbell and
  B. Mason (eds) Perspectives on supervision.
  London, Karnac Books, PP. 3-20.
• Fruggeri, L. (1998) Famiglie. Roma, Carocci.
• Fruggeri, L. (2005) Diverse normalità. Roma,
  Carocci.
• Fruggeri, L., Telfener, U., Castellucci, A,
  Marzari,M., Matteini, M. (1991) New systemic
  ideas from the italian mental health mouvement.
  London, Karnac Books.
• Telfener U., Casadio L.,(a cura di)(2003),
  Sistemica, Voci e percorsi nella complessit?,
  Bollati Boringhieri, Torino.
• Telfener U. (2007),O Trabalho Com Imigrantes na
  Italia Da Psicoterapia ? clinica Intercultural,
  Pensando Familias, vol 11, n?2, pag.123-140.
• Telfener U.,(2008), La terapia individuale
  sistemica, alcune considerazioni, in Connessioni,
  N?20, marzo 2008, pag 28-52.