Impasse In a Detention Impasse In a Detention UnitUnit

Joanna Kato M.Sc. Psychologist, Speech Therapist, Joanna Kato M.Sc. Psychologist, Speech Therapist, Gestalt Psychotherapist Gestalt Psychotherapist

Bianca Ellinger Psychologist, Gestalt Bianca Ellinger Psychologist, Gestalt Psychotherapist, Psychotherapist, Physiotherapist PhysiotherapistAthanasia Karantzia Psychologist, Psychotherapist,Athanasia Karantzia Psychologist, Psychotherapist,

Gestalt GraduateGestalt Graduate

Description of the FieldDescription of the Field

• Place and living Place and living conditionsconditions

CellsCellsLimited access to Limited access to

toilets and phonestoilets and phonesNo daily procedure No daily procedure

(routine)(routine)Limited access to Limited access to

information about information about rightsrights

Description of the FieldDescription of the Field

• Population of Population of detaineesdetainees

MulticulturalMulticulturalMultilingualMultilingualAge from 4 months till Age from 4 months till

72 years old72 years oldWide range of problemsWide range of problemsMigratingMigrating In crisis before detentionIn crisis before detention

Description of the FieldDescription of the Field

• Intervention TeamIntervention Team Program coordinator (nurse)Program coordinator (nurse)

General Practitioner (doctor)General Practitioner (doctor)

Psychologist (Gestalt therapist)Psychologist (Gestalt therapist)

Social worker (sociologist –criminologist)Social worker (sociologist –criminologist)

Volunteers (2 Gestalt therapists, 1 Volunteers (2 Gestalt therapists, 1 psychiatrist)psychiatrist)

Crisis DefinitionCrisis Definition

““Is a perception or experience of an Is a perception or experience of an event or situation as an intolerable event or situation as an intolerable difficulty that exceeds the person’s difficulty that exceeds the person’s current resources and coping current resources and coping mechanisms. Unless the person obtains mechanisms. Unless the person obtains relief, the crisis has the potential to relief, the crisis has the potential to cause severe affective, behavioural and cause severe affective, behavioural and cognitive malfunctioning”.cognitive malfunctioning”.

James R. K. Gilliand B. E. “Crisis Intervention James R. K. Gilliand B. E. “Crisis Intervention Strategies”Strategies”

Characteristics of CrisisCharacteristics of Crisis

Self-Destruction or Self-Destruction or Self-GrowthSelf-Growth

Complicated Complicated SymptomsSymptoms

No Temporary No Temporary SolutionsSolutions

A Generalized and A Generalized and Personalized Personalized Phenomenon Phenomenon

Types of CrisisTypes of Crisis

Developmental Developmental SituationalSituationalExistentialExistentialEnvironmentalEnvironmental

Possibilities at the Contact Possibilities at the Contact BoundaryBoundary

1.1. Equilibrium is easily establishedEquilibrium is easily established

2.2. Tension on both sides of the boundary is Tension on both sides of the boundary is difficult to equilibrate and is achievable difficult to equilibrate and is achievable

3.3. Situation of danger: Intolerably overworked Situation of danger: Intolerably overworked boundary by environmental forcesboundary by environmental forces

4.4. Frustration, starvation, illness: Intolerably Frustration, starvation, illness: Intolerably tensed boundary because of internal tensed boundary because of internal demandsdemands

Crisis in Gestalt Psychotherapy Crisis in Gestalt Psychotherapy TermsTerms

A person experiences crisis when a A person experiences crisis when a sudden change or situation cause sudden change or situation cause such a tension at the contact such a tension at the contact boundary, that the familiar self-boundary, that the familiar self-functions are unable to handle it in a functions are unable to handle it in a bearably comfort and safe waybearably comfort and safe way

Crisis in the Contact CycleCrisis in the Contact Cycle

EXITEMENT

AWARENESS

MOBILISATION

OF ENERGY

WITH-DRAWAL

CONTAT

ACTION

SENSATION

Crisis from a Gestalt Crisis from a Gestalt PerspectivePerspective

Self: Id – Ego – PersonalitySelf: Id – Ego – Personality Creative AdjustmentCreative Adjustment I-Thou relationshipI-Thou relationship ContactContact Here and NowHere and Now PhenomenologyPhenomenology

The Six Step Model Of Crisis The Six Step Model Of Crisis InterventionIntervention

ListeningListening

1.1. Define the problemDefine the problem

2.2. Ensure clients Ensure clients safetysafety

3.3. Provide supportProvide support

ActingActing

4.4. Examine Examine alternativesalternatives

5.5. Make plansMake plans

6.6. Obtain commitmentObtain commitment

Assessment

Step 1Step 1Define the ProblemDefine the Problem

Active listening – questions from Active listening – questions from intake formintake form

Words from clients language as Words from clients language as common ground of contact makingcommon ground of contact making

Translation – as tool to show interest Translation – as tool to show interest and a better understanding and a better understanding

Step 2 Step 2 Ensure Client SafetyEnsure Client Safety

• Minimize danger to self and others - assess Minimize danger to self and others - assess lethalitylethality

Have you been sleeping? Eating? Drinking? Have you been sleeping? Eating? Drinking? Since you have been here?Since you have been here?

Are you having bad dreams? Bad thoughts? Are you having bad dreams? Bad thoughts? about hurting yourself or anybody else?about hurting yourself or anybody else?

Is anything strange/scary happening to you?Is anything strange/scary happening to you?Is there anything you want to tell me which I Is there anything you want to tell me which I

didn’t ask and you think is important?didn’t ask and you think is important?

Step 3 Providing SupportStep 3 Providing Support

• Crisis worker: a valid person for supportCrisis worker: a valid person for support

• Giving something to grab onGiving something to grab on

I am here to help. If you need anything or want to I am here to help. If you need anything or want to talk we are here every day in the morning except talk we are here every day in the morning except weekends.weekends.

What is it that you need now? Here and now how can What is it that you need now? Here and now how can I help you? I help you?

Is there anyone you can talk to here in detention or in Is there anyone you can talk to here in detention or in Athens?Athens?

Is there anyone you can call and talk to?Is there anyone you can call and talk to?

Specific Support in Detention – Specific Support in Detention – Team WorkTeam Work

Informing about detention procedures and rightsInforming about detention procedures and rights Facilitating procedures (referring to hospital, to Facilitating procedures (referring to hospital, to

GCR lawyers, communicating with shelters, GCR lawyers, communicating with shelters, enabling meetings with other programs or enabling meetings with other programs or institutions)institutions)

Medical primary careMedical primary careSymptomatic treatment for drug abusers Symptomatic treatment for drug abusers Close cooperation with other organization – asking Close cooperation with other organization – asking

for help (modeling)for help (modeling)Tutoring of psychosomatic symptoms and aid in Tutoring of psychosomatic symptoms and aid in

finding relief finding relief

Step 4 Examining AlternativesStep 4 Examining Alternatives

• Looking for choicesLooking for choices

Let’s see what your options are…Let’s see what your options are…

Step 5 Making PlansStep 5 Making Plans

Client regains control and autonomyClient regains control and autonomy

and restores equilibriumand restores equilibrium

When you go out of here what are When you go out of here what are you going to do?you going to do?

If you go back to your country what If you go back to your country what do you need to take care of?do you need to take care of?

Step 6 Obtaining Step 6 Obtaining CommitmentCommitment

Verbally summarize the planVerbally summarize the plan

I want you to…….I want you to…….

And I will see you again on…. So you And I will see you again on…. So you can tell me how things are goingcan tell me how things are going

Team IssuesTeam Issues

Supervision (team and individual)Supervision (team and individual)

Transference and Transference and countertransference issuescountertransference issues

Ethical issuesEthical issues

ConflictsConflicts

Personal ProcessPersonal Process

Reason for working thereReason for working there

Inner Conflict - ImpasseInner Conflict - Impasse

Team workTeam work

Creative AdjustmentCreative Adjustment

ReferencesReferences

• F. Perls, R. F. Hefferline, P. Goodman,”Gestalt Therapy: Excitement and Growth in the F. Perls, R. F. Hefferline, P. Goodman,”Gestalt Therapy: Excitement and Growth in the Human Personality”,(260-261)Human Personality”,(260-261)

• James R. K. Gilliand B. E. “Crisis Intervention Strategies”James R. K. Gilliand B. E. “Crisis Intervention Strategies”

• Ann L Bauer and Sarah Toman“ A Gestalt Perspective of Crisis Debriefing: Working in Ann L Bauer and Sarah Toman“ A Gestalt Perspective of Crisis Debriefing: Working in the Here and Now When the Here and Now is Unbearable”. Gestalt Review, 7 (1):56-the Here and Now When the Here and Now is Unbearable”. Gestalt Review, 7 (1):56-71, 200371, 2003

• Glenys Parry, Glenys Parry, Ψυχολογικές κρίσεις και η αντιμετώπισή τους, Ελληνικά Γράμματα, Ψυχολογικές κρίσεις και η αντιμετώπισή τους, Ελληνικά Γράμματα, 19961996

• Iris Fodor “Reflections on September 11: “When therapist and Client Participate in the Iris Fodor “Reflections on September 11: “When therapist and Client Participate in the Same Trauma” British Gestalt Journal,2001,Vol.10,No2,(80-85)Same Trauma” British Gestalt Journal,2001,Vol.10,No2,(80-85)

• Juan Miguel Petit, Report of the Special Rapporteur on the sale of children, child Juan Miguel Petit, Report of the Special Rapporteur on the sale of children, child prostitution and child pornography, E/CN.4/2006/67Add.3prostitution and child pornography, E/CN.4/2006/67Add.3

• Maria Kichner Gestalt Therapy Theory: an Overview, Website: http://www.g-gej.org/4-Maria Kichner Gestalt Therapy Theory: an Overview, Website: http://www.g-gej.org/4-3/theoryoverview.html3/theoryoverview.html

• Lin Young, davi Lester, PhD “Gestal Therapy Approaches to Crisis Intervention With Lin Young, davi Lester, PhD “Gestal Therapy Approaches to Crisis Intervention With Suicidal clients – Brief treatment and Crisis Intervention /1:1 Summer 2001Suicidal clients – Brief treatment and Crisis Intervention /1:1 Summer 2001

• Gonzague Masquelier “Gestalt Therapy Living Creatively Today” GestaltPress,2006Gonzague Masquelier “Gestalt Therapy Living Creatively Today” GestaltPress,2006

• Tim Warneka, An Ohio Yankee in Queen Katrina's Court, Website:Tim Warneka, An Ohio Yankee in Queen Katrina's Court, Website: http://ohioyankee.blogspot.com/2006_03_01_archive.htmlhttp://ohioyankee.blogspot.com/2006_03_01_archive.html