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The Work of the Women’s Therapy Centre A Dedicated Women’s Counselling and Psychotherapy Service in Ireland.

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Presentation on theme: "The Work of the Women’s Therapy Centre A Dedicated Women’s Counselling and Psychotherapy Service in Ireland."— Presentation transcript:

1 The Work of the Women’s Therapy Centre A Dedicated Women’s Counselling and Psychotherapy Service in Ireland

2 THE WOMEN’S THERAPY CENTRE BACKGROUND Other Women's Therapy Centres Mental Health is a Gender Issue so Gender Sensitive Responses Inequality / Poverty / Injustice Gender-based Abuse What Women Want 07/05/2015WTC / Felicity Kennedy2

3 THE WOMEN’S THERAPY CENTRE VISION A world where all women experience positive mental health and lead fulfilling self-determined lives. 07/05/2015WTC / Felicity Kennedy3

4 THE WOMEN’S THERAPY CENTRE PRINCIPLES AFFORDABLE: For women disadvantaged by poverty. ACCESSIBLE: For all with mental health distresses. SPECIALISED: Understanding of violence and coercive abuse. RELATIONAL: Valuing power with not power over therapeutic relationship. CULTURAL: Women live within social context within which there is a power differential. FEMINIST: Connection and mutuality gives us meaning. HUMBLE: In aspiration - listen and learn from clients. HOLISTIC: A continuity of care from 1 st contact with the WTC to last session. FLEXIBLE: Recognising the complexity of women’s lives. 07/05/2015WTC / Felicity Kennedy4

5 THE WOMEN’S THERAPY CENTRE OBJECTIVES 1.Counselling and Psychotherapy for Women 2.Specialist Counselling and Psychotherapy for Women Recovering from Abuse in Adult Relationships Domestic and Sexual Violence Psychological Coercion 3.Agency Services to Support Work of Others Responding to Abuse Clinical Supervision: Individual and Group Training and Policy Development 4. Dissemination of Knowledge and Practice Internship, Student Placement and Volunteer Programmes Research 07/05/2015WTC / Felicity Kennedy5

6 OVERVIEW SUMMARY ACHIEVEMENTS & LEARNING 2008 to 2014 TODAY’S SPEAKERS TINA – Learning from our clients - clinical outcomes MARIA – Learning from client’s experiences of helpful and un-helpful moments in therapy PATRICIA - Violence Against Women: European Perspective FELICITY – Summary achievements of WTC and Specialist learning 07/05/2015WTC / Felicity Kennedy6

7 SUMMARY ACHIEVEMENTS (2008 to 2014) 1.Counselling and Psychotherapy for Women 200 clients over 6 years 2013: 50 to 60 clients weekly Defined model of clinical service provision Introduction of quantitative (CORE) and qualitative evaluations (Questionnaires) Closing: 43 clients & 51 on waiting list 07/05/2015WTC / Felicity Kennedy7

8 WTC SUMMARY ACHIEVEMENTS (2008 to 2014) 2.Specialist Counselling and Psychotherapy for Women Recovering from Abuse in Adult Relationships Two thirds of clients recovering from controlling, coercive, violating relationships Referrals and collaboration with major domestic violence services: e.g. DVAS, Women’s Aid, Sonas and Refuges. Increasing recognised specialist service: Referrals from St. Patricks Hospital, Order of St. John of God, Social Workers and Therapists. 07/05/2015WTC / Felicity Kennedy8

9 WTC SUMMARY ACHIEVEMENTS (2008 to 2014) 3.Agency Services to Support Work of Others Responding to Abuse (a) Clinical Supervision: Individual and Group Agencies and Individual Helpers Responding to Domestic Violence DOMETIC VIOLENCE AGENCIES Directors, Managers, Project Leaders, Domestic Violence Practitioners PSYCHOTHERAPISTS : COUNSELLORS ; PSYCHOLOGISTS Many themselves working as clinical supervisors 07/05/2015WTC / Felicity Kennedy9

10 WTC SUMMARY ACHIEVEMENTS (2008 to 2014) (3) Agency Services to Support Work of Others Responding to Abuse (b) Training: Psychotherapy with Women / Clinical work with Domestic Abuse / Supervising Clinical Work with Complex Trauma / Vicarious Trauma AGENCIES INCLUDE: Fordham University, New York. Trinity College, Dublin. Psychological Society of Ireland National College of Ireland, Dublin. Clanwilliam Institute, Dublin. Crime Victims Helpline Parish of Travelling Community LGBT Helpline Mercy Law Resource Centre Longford Women’s Link 07/05/2015WTC / Felicity Kennedy10

11 WTC SUMMARY ACHIEVEMENTS (2008 to 2014) 4. Dissemination of Knowledge and Practice PROFESSIONAL INTERNSHIP PROGRAMME FOR COUNSELLORS & PSYCHOTHERAPISTS 9 people over 6 years PLACEMENTS FOR TRAINEE COUNSELLING AND CLINICAL PSYCHOLOGISTS Doctorate in Counselling Psychology (Trinity College Dublin) 3 people on 8-month placement Doctorate in Clinical Psychology (University College Dublin) I person on 4-month specialist placement VOLUNTEER PROGRAMME FOR COUNSELLORS 1 person for almost 4 years 07/05/2015WTC / Felicity Kennedy11

12 WTC SUMMARY ACHIEVEMENTS (2008 to 2014) 4. Dissemination of Knowledge and Practice PRACTICE TO RESEARCH / RESEARCH TO PRACTICE Formal Collaboration With Trinity College DUBLIN (PSYCHOLOGY DEPT.) Conference Presentations and Workshops Psychological Society of Ireland 1.Supervision of Practitioner’s work with Domestic Violence 2.Experiences and Protective Practices of Therapists working in Domestic Violence Counselling 3.Clinical Work with Trauma – Working at the Women’s Therapy Centre 4.Relationship-Building in Therapy: Helpful and Unhelpful Client Experiences as reported by Female Survivors of Domestic Abuse 07/05/2015WTC / Felicity Kennedy12

13 2. Specialist Counselling and Psychotherapy for Women Recovering from Abuse in Adult Relationships TRAUMA AND RECOVERY Working with the extremes of client experience which lies beyond the normal range of human experience (Page & Wosket 2009, p.239). Recovery from: Repetitive Sexual Assaults : Physical Assaults : Torture : Deprivation : Violation : Humiliation For example: Domestic Violence, Trafficking, Prostitution 07/05/2015WTC / Felicity Kennedy13

14 2. Specialist Counselling and Psychotherapy for Women Recovering from Abuse in Adult Relationships The prevalence of intimate partner abuse and relationship violence, combined with the severity of its impact at many levels, argues for the need for psychologists who are already engaged in their career, as well as those still in training, to be knowledgeable about a wide variety of issues related to partner violence. (American Psychological Association, 2002) 07/05/2015WTC / Felicity Kennedy14

15 NECESSARY KNOWLEDGE (1 to 8) 1. THE ABUSER'S AIM, METHOD and INTENT AIM Destruction of the authentic self of the victim SOUL MURDER METHOD Abuser gradually and deliberately deconstructs the victim’s external and internal reality and re-constructs that reality to mirror that of the abuser INTENT Dominate and control the victim in order to ensure own narcissistic needs constantly met. 07/05/2015WTC / Felicity Kennedy15

16 COERCIVE CONTROL THE PSYCHOLOGY OF ABUSE There are no bars to physically imprison the victim, therefore the abuser uses psychological tactics to progressively entice and entrap the victim Coercive control makes shadows of the most intelligent, independent women (Kacey Jai Smith, Observer Newspaper (p.8) 07/05/2015WTC / Felicity Kennedy16

17 COERCIVE CONTROL : TACTICS USED TO TAKE PSYCHOLOGICAL CONTROL TARGET: Identify victim, create specialness: - younger and kinder, meet needs of abuser - take responsibility for both in relationship -put own needs to background GROOM: - charm, protect, shower with gifts – similarly with others 07/05/2015WTC / Felicity Kennedy17

18 COERCIVE CONTROL : TACTICS USED TO TAKE PSYCHOLOGICAL CONTROL ENTICE AND ENTRAP Deliberately insert false interpretations & perceptions into the mind of the victim Abuser presents as the knowing protector in a special relationship ( Sanderson, 2010) Abuses initially mild – easy to explain away Abuser suggests victim over-reacting Victim’s confusion and distress increasing Fear of losing “love and protection” increasing No longer trusts own inner self or outer perceptions Significant others groomed to re-enforce abuser's interpretations 07/05/2015WTC / Felicity Kennedy18

19 SURRENDER Complete annihilation of the authentic self (Soul Murder) All perceptions of self and the world filtered through the perceptions of the abuser The self experienced as shameful, all bad, sexual object Dehumanisation – person feels an object Loss of self-agency, trust, relations with others Personhood of victim now inauthentic and silenced 07/05/2015WTC / Felicity Kennedy19

20 NECESSARY KNOWLEDGE 2. THE PSYCHOLOGICAL IMPACT OF REPETITIVE ABUSES Post Traumatic Stress Disorder (PTSD) The mental health impact of a single catastrophic event such as a death and / or assault. Complex Post Traumatic Stress Disorder (Complex PTSD) The mental health impacts of repetitive sexual and physical assaults as well as the psychologically coercive control associated with domestic abuse. Also experienced by hostages, political prisoners, child victims of abuse, war veterans, concentration camp survivors and victims of prostitution and / or trafficking 07/05/2015WTC / Felicity Kennedy20

21 COMPLEX TRAUMA A DEFINITION A type of trauma that occurs repeatedly and cumulatively, usually over a period of time and within specific relationships and contexts. The term came into being over the past decade as researchers found that some forms of trauma were much more pervasive and complicated than others... this expanded understanding now extends to all forms of domestic violence (Courtois, 2008). 07/05/2015WTC / Felicity Kennedy21

22 NECESSARY KNOWLEDGE 2. THE PSYCHOLOGICAL IMPACT OF REPETITIVE ABUSES & COERCIVE CONTROL An acute sense of potential danger: high anxiety Lack of trust in self or others Constant hypertension leading to poor ability to concentrate, reflect and make decisions A confused sense of authentic inner self and external reality Increasing sense of helplessness Loss of sense of freedom and hope An increasingly silenced self Imbued sense of shame, guilt and responsibility Possible view of the abuser as more powerful than actually is Possible dissociation at times of threat Likely somatic manifestations of silenced self 07/05/2015WTC / Felicity Kennedy22

23 3. NECESSARY KNOWLEDGE: CLINICAL GOALS RECOVERY Restoration of the authentic self of the client Restoration of the client's perspective of reality Trauma processed: understood and integrated Understanding: a personal narrative/journey Healing of somatic manifestations Restoration of confidence, agency and hope Integrated social connectedness 07/05/2015WTC / Felicity Kennedy23

24 4. NECESSARY KNOWLEDGE: CLINICAL STAGES SAFETY; REMEMBERANCE, MOURNING AND RECOVERY RECOVERY Shame Relieved Shame is one of the most profoundly enduring effects of chronic interpersonal trauma. Isolation Reduced To reduce the often overwhelming sense of being alone and disconnected from others. Personal Agency Achieved To counteract the feelings of helplessness and increase client’s sense of personal worth and choice. Healthy Relationships Developed The trusting therapeutic relationship serves as a model for re-developing personal and social relationships. Past and Present Experiences Integrated Counselling provides the safe context for disclosure and making connections between past and present. Mendelshoh, M., Herman, J., Schatzow, E., Coco, M., Kallivayalil, D., Levitan. J. (2011). The trauma recovery group: A guide for Practitioners. The Guilford Press, London. 07/05/2015WTC / Felicity Kennedy24

25 5. NECESSARY KNOWLEDGE: CLINICAL PROCESS THE POWER WITH NOT POWER OVER RELATIONSHIP Respect, Information, Connection, and Hope (The R.I.C.H Relationship; Pearlman & Courtois 2005) Relational-Cultural Theory 3 core relational processes that facilitate change and growth: 1. MUTUAL EMPATHY: The capacity to be moved by the experiences of the client and be willing to demonstrate this in the relationship with the client. 2. RELATIONAL AUTHENTICITY: The increasing capacity of the therapist to represent herself more fully in relationship. 3. MUTUAL EMPOWERMENT: A creative process in which the contributions of each person and openness to change allow something new to happen 07/05/2015WTC / Felicity Kennedy25

26 6. NECESSARY KNOWLEDGE: CLINICAL CAPACITIES THE HEALING CLINICAL RELATIONSHIP MUST BE THE OPPOSITE OF THE CONTROLING ABUSIVE RELATIONSHIP PRESENCE not ABSENCE Safety not fear Constantly check-in with client re safety Talk, Ask, Communicate – not silence Explore trauma with greatest of care Be consistent yet flexible not inconsistent and rigid Show exquisite empathy (Harrison & Woodward, 2009) Mutuality: Take a position of non-expertise Be consistently non-defensive – trust can take time Reach outside yourself to the client Adapt approach to individual experience of clients Accept ALL aspects of each person Stay steady in client's unsteadiness, horror and possible shame 07/05/2015WTC / Felicity Kennedy26

27 7. NECESSARY KNOWLEDGE: CLINICAL IMPACT ON THERAPIST: REFLECTIVE PRACTICE Attention To Transference And Countertransference Effects Possible signs: Overwhelmed by hopelessness and powerlessness Abandoned, isolated, frozen, silenced Leading to: - enmeshment; over involvement; uncertainty; need to rescue; inability to modulate feelings (Etherington, 2009) Exacerbated by: - multiple abuses; body violations; when abuse on-going; and when children involved 07/05/2015WTC / Felicity Kennedy27

28 8. NECESSARY KNOWLEDGE: CLINICAL IMPACT ON THERAPIST: REFLECTIVE PRACTICE Attention To Vicarious Trauma (the consequence of good empathic work): Personal and Professional: - cumulative - inevitable - individual 07/05/2015WTC / Felicity Kennedy28

29 NECESSARY KNOWLEDGE: CLINICAL IMPACT ON THERAPIST: REFLECTIVE PRACTICE Access to regular trauma-informed clinical supervision is vital Aim of clinical supervision is to ensure a high quality of care for clients (Courtois & Gold, 2009; Iliffe & Steed, 2000; O’Connor & Wilson, 2005; Prizeman, Donoghue & Harrington, 2001; Robinson, 2009; Ronayne, 2010; Slattery & Goodman, 2009). 07/05/2015WTC / Felicity Kennedy29

30 LAST WORD MAINTAIN HOPE MAINTAIN JOY THE WORK CAN BE WONDERFULLY REWARDING FOR YOU AND YOUR CLIENT 07/05/2015WTC / Felicity Kennedy30


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