Integration or disintegration? Politics and practice

At the IFTA conference in Aberdeen I also took part in a panel presentation on service integration that brought together an international group of therapists. Preparing and taking part in this was in some ways nostalgic. I’ve been involved in discussions about service integration for years now and I’m not sure that things have improved. I fear that in some ways they may have even got worse. I had a role in the National Institute for Mental Health England around 2006 at a time that integration was a bit of a buzzword. We had a document on integration in teams and I’ve found references in my notes (yes, I keep notes for a very long time) to an integration helpsheet and toolkit. Goodness knows where all that work has gone now. And that reminds me of another startling realisation I had recently, that we easily lose our history and the learning that comes from it in our impermanent and ever changing digital society where fake news seems sometimes to be more powerful than fact. Remember the famous saying attributed to philosopher George Santayana:

“Those who cannot remember the past are condemned to repeat it.”

Finding ways to collaborate and integrate services is as important today as ever. 

Another workshop I went to focused on positioning change and I think I heard one presenter say “we are the agents of change“. That reminded me of one of my favourite quotes: Barack Obama said:

“Change will not come if we wait for some other person or some other time. We are the ones we’ve been waiting for. We are the change that we seek.” 

(see this youtube clip)

I also took away from the workshop the importance of being aware of my moments of discomfort (and this might not only apply to therapy) and that I might try to use them creatively rather than feel bad about them. Well, I can only hope and try …

Another speaker referred to a paper in Frontiers in Psychiatry entitled Why cognitive behavioural therapy is the current gold standard of psychotherapy (David et al, 2018). The paper itself refers to NICE guidelines and others. It’s useful to be aware of the AFT document from 2016 entitled NICE Clinical Guidelines recommending Family and Couple Therapy compiled by Dr Lucy Davis (read it here). It’s not all CBT! And in another session the speaker referred to “gold rust” which I found an intriguing thought in this context!

There were two plenary lectures by important figures during the conference and I love to go to these events (although sometimes I find that I’ve built up an unrealistic picture of what people are like). Neither of these big lectures disappointed, although in one, and in a number of the parallel sessions, we had technical issues. It always surprises me, though perhaps it shouldn’t, how often technical problems mar presentations. There’s an important message for me in this: always take your laptop connectors with you wherever you go! I don’t want to be negative about the venue though, the food was good and the rhubarb and custard muffins outstanding!

Whilst all the learning and sharing was going on, a parallel distraction was the ongoing political uncertainties about Brexit and we had some interesting cross border discussions about politics in a number of different countries. I found it strangely reassuring to discover that my colleagues around the globe have their own preoccupations about their politicians and governments. Perhaps that’s my inherent and maybe inappropriate optimism at work. Certainly in these uncertain times we need to nourish and strengthen our links around the world.

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