This paper describes the journey and process of conducting Illness Management and Recovery (IMR) programs in Brunei Darussalam to the current date. In the last decade, Occupational Therapy has focused on activities of daily living as a non-standardised form of assessment and treatment approach for clients with mental illness in Brunei Darussalam. Most of the treatment models used are conservative and are effective in reducing the symptoms but they do not prevent relapses and assist in empowerment of clients. This awareness led to the search for evidence-based practices to improve outcomes. IMR program was initially implemented in RIPAS Hospital, Brunei by Occupational Therapist for clients from Psychiatric Day Hospital.
The original modules were translated into Malay Language and Islamic spiritual aspects were included to provide for congruence with local cultural beliefs. The modules contents were not standardised and not audited by any assessors. After the completion of IMR, no follow-up was done on clients’ chosen goals. Towards the end of 2014, we were involved with the Community Psychiatric Rehabilitation Centre who piloted this recovery program for a selected group of clients with Schizophrenia for 3 months. Two weeks training and practical exposure were delivered to the Rehabilitation Centre staffs. Conclusion Involvement of other staff from the Mental Health setting has facilitated the evaluation of the effectiveness of the program.
However, assessment of the pilot showed lack of communication, insufficient training, usage of “too technical” and non standardised modules, poor follow-up on consumers’ goals and lack of relapse prevention plans. Our program scored reasonably well in the IMR fidelity scale (41/65) although it scored poorly on the General Organisational Index (15/60). Implementation of Illness Management and Recovery in Brunei can be further improved through strong leadership, effective training and committed staff to ensure sustainability of an effective evidence-based recovery program.
Informed by hermeneutic philosophical traditions, this will be a presentation of a brief art psychotherapy intervention from a phenomenological perspective. The idea of “meaning-making” is constructed from a phenomenological interpretation of art making, revealing psychological life as defined by Jung to be “the totality of all psychic processes, conscious as well as unconscious”.
Exploring into local collectivist Malays culture led the researchers to construct the Family Therapeutic Alliance (FTA) which is an invaluable therapeutic source of authority applicable as the underlying element in multicultural psychotherapy. FTA was used in a longitudinal study of relapse prevention among the Malay collectivist recovering addicts and their family that has produced a positive outcome. Four recovering addicts and their families were invited to form four study groups with an initial goal of establishing FTA, and later on, to maintain their alliances. Eight sessions of Collective Family Therapy using a multicultural approach that adopt the basic element of psychotherapy and critical values of the clients was used as the treatment approach.
Attention Deficit/Hyperactive Disorder (ADD/ADHD) is a neurodevelopmental psychological disorder. People with ADHD commonly display significant problems in executive functions. It has been suggested that underlying abnormalities in the brain contribute to ADHD (Amen, 2001). Seven types of ADD/ADHD were classified based on the symptoms and brain spectroscopy (SPECT) scans; different types of ADD/ADHD were attributed to different areas of brain atrophy and over-activation/inactivation. Several mechanisms and theories will be discussed: Neurotransmitters, Hormones, and Stress.
Embryo Donation (ED) is the donation by a couple who have surplus embryos following in vitro fertilisation to another infertile couple or person. This presentation, on counsellors’ experience in providing compulsory ED counselling, was part of a larger research investigation designed to explore how ED is understood and experienced by donors and recipients in Aotearoa New Zealand, a country with unique legislative and policy donation guidelines. The practice of ED counselling in Aotearoa New Zealand differs from other jurisdictions in that counsellors enact and facilitate the policy of ‘open’ donation in which donors and recipients meet and select each other for ED.
The literature is rich with studies addressing stress effects on In Vitro Fertilisation (IVF) outcomes. Debate continues regarding whether there is a cause-and-effect relationship, or merely a correlation, between stress and IVF failure. While several studies have addressed coping mechanisms used by couples undergoing IVF, and some even investigated the effects of coping mechanisms used at three points within an IVF cycle, the author found no study that presented a programme for women to deal with stress before, during and after IVF cycles.
Psychoanalysis passed its heyday in the seventies and has been usurped by short term cognitive-behavioural therapies. Despite this trend, recently there has been a small growth of psychoanalytic psychotherapy in Aotearoa New Zealand. This presentation describes my experience of employing a psychoanalytic sensibility in teaching and supervising intern counselling psychologists in a cognitive-behaviourally dominated university system. Vignettes are used to illustrate where differences between the psychoanalytic and cognitive-behavioural worldviews arose in supervision and how I attempted to deal with them.
Most couple therapy models do not produce therapy that worked for couples. Their techniques, including visualisation, positive dialogues and homework as utilised for example by Emotion Focused Couple Therapy (EFCT) (Greenberg & Johnson 1988, Gottman based couple therapy (Declare & Gottman 2001), and Imago therapy by Hendrix and Hunt (Hendrix and Hunt, 2003; Hendrix and Hunt, 2005), have led to little successful outcome. These techniques are not able to address the multisensory amygdala based ruptures in relationships. The techniques employed by most couple therapy models are prefrontal lobe based i.e. they engage couples' prefrontal lobe only. The activations patterns of each other's amygdala by each party of the couple who seek therapy remain unchanged despite going through most of these therapies.