In Gothenburg, Ordinary Homes Serve as Havens for Healing

Family Care Foundation came into being in a café somewhere in Gothenburg one day in 1987. Ideas about value, about what is important, and why we humans do as we do, had been with me for a long time, as long as I remember. However, I did not really know what to do. For a few years I had worked in a municipal project involving adults with huge troubles, placed in so-called ordinary families (family homes) who in turn had professional support from social workers. I was one of those social workers and I warmed to the thought that the people we call clients would live in an ordinary neighborhood instead of an institution, a prison or a hospital. However as time went by I noticed that something was missing, something that would be there for the patient besides the family home. And what about the patient’s own family, what happened to them and with their relationship?

The organization I worked for did not make it possible to explore and develop these and many other thoughts and questions. Maybe it would be possible to establish a foundation and in that structure realize these ideas?

 

FROM THOUGHT TO ACTION

An extraordinary chain of events, where my at-that-time complete ignorance of economy, organization and bureaucracy, together with something you might call conviction, luck and immense stubbornness, led to the creation of the Family Care Foundation in 1987. We received some help from the National Board of Health and Welfare in Sweden as well. Some of the family homes I had collaborated with in the project joined in, and we are still working together.

In the first years, we were two trained social workers and five family homes who worked together with the clients. One of the social workers would be talking to the family home (what we now call supervision) and the other would talk with the client (what we now call therapy). In between, we would sit together in the kitchen of the family home and talk about how they were getting along together.

This is what it looked like, and even though the organization is much larger nowadays, many of the ideas are still the same. That is to say, that it is good to be talking to both the family home and to the client, since it makes you less likely to be caught into one single way to “understand and look at the world”. The family home and their “ordinary” life remain the base of our work, but we have extended our professional rooms and work and encourage others to take part. Nowadays, we meet not “just” in the family home, but also at our office where we have team meetings including the client, her/ his family, the therapist, the family home and their supervisor. Regularly the team is expanded to include other important people who might be useful, as for example other professionals and friends.

Summer party and Christmas party are events taking place every year where all of us gather for a day to celebrate and share impressions and experiences. At this time we also invite former clients and their families. Twice a year all family homes and the staff meet for a weekend to talk about and evaluate the collaborative work.

Nowadays we work not just with adults, but also with children and youngsters. Most of the children come to us with at least one parent, many youngsters come alone, but we always engage their own family in the work. Our clients come to us since they are having such huge difficulties in life that they do not have the strength to cope on their own. Battering, confusion, drug addiction, powerlessness, feelings of unreality and terror is what they use to act or talk about at their first visit with us. Many people come to us in a crisis that has lasted for a long time and they describe how they are running out of strength, but also running out of hope for something better.

 

THE THERAPEUTIC CONTEXT

Family Care Foundation grows from the idea of combining a so-called ordinary life with a therapeutic knowledge. The client is both a family member in the family home and a client in the therapeutic room. Both in how she relates to herself and to how we around her relate to her. She is not the one or the other, she is both and.

The same is true for the family home. They are both a so-called ordinary family and participants in a therapeutic context. They participate in teams, big meetings and their own supervision, sometimes as colleagues of the professionals and sometimes as supervisees.

The professionals are both supervisors and therapists. In one piece of work we are the one, in another we are the other. However, we are also ordinary people with our very own experiences. This creates both possibilities and difficulties. Sometimes the one overshadows and sometimes the other. There are days and moments when just about everything seems possible and there are days and moments when you are ready to shut up shop.

Being in the world and in the therapeutic work means at any given moment asking your self: What am I doing here and what is my task? The human being unfolds in interplay with others, but also in a room of her own. She is created in relation to the other, as well as approaching her own “I”.

For nearly 25 years I have been working together with several people at Family Care Foundation in Gothenburg. Our shared vision is to try to create a good space for people to be in, to combine a so called ordinary life with a therapeutic thinking and being. Through the years the practical work has generated new knowledge and a new understanding, which we, in different ways, try to apply in our different rooms.

 

THE FAMILY HOME

The word family home means a kind of foster home, a family who is part of our organization and who opens their home and life for one of our clients, or sometimes for a parent and her or his children. We prefer the word family home, since it is what we in a way “offer” to the client, to take part in an ordinary family life for a while, instead of being at an institution or a hospital. Most of the people we work with do not go back to an institution or a hospital, but of course it sometimes happens. The clients used to stay for a few years, sometimes a bit shorter and sometimes a bit longer. We work with people whom have been in many institutions before coming to us. Many of them are described as “nearly hopeless” , but I am happy to say that they are not.

Tom Andersen ( Jensen, 2008) says: “Sometimes …both therapists and researchers try to create a common dominating back-ground, a consensus background. This is meant to contribute to firm and objective evidence-based knowledge, in that the therapist and researchers try to remove all of their personal issues from the background they are using as a basis for understanding. I do not only think it is a misunderstanding to believe that this is possible, but also that it is an unfortunate misunderstanding.”

This I have experienced over and over again, especially in the psychiatric world with its concepts, diagnosis and wordings about people´s ways of behaving. As if there was one objective truth. And as if the professionals didn’t influence and get influenced by the other. It is of outmost importance to be clear about that what I say is my understanding that I base upon my perception of the world and about my own experiences in life. At times my understanding corresponds with the other, but not always. It may be that the other person and me see, hear and experience things in different ways. Then – that is the way it is. Then each of us has our own understanding without the one or the other being the owner of the truth.

Language has a fundamental importance for our coming into being and our way of understanding the world. One part of my professional responsibility is to try to create a culture where we are given the opportunity to talk to each other and use language in a way which is possible to understand and make useful. In the context where I work it means to facilitate communication between the family home and the client and those around them, a language which is including instead of excluding, where people have an opportunity to recognize and participate.

When we refrain in our work from using manuals, tables and other “technical stuff,” I and the others around together create a shared work place with its different stories. What goes into that space? What knowledge and experience is conveyed? How does this happen? Not to use psychiatric diagnosis, technical models and concepts in the therapeutic work has consequences, not only for those called clients but also for me as a therapist. Together with the other, instead of watching and observing, I need to create a space for feelings, thoughts, reflections and shared creativity, a context that influences and touches both of us.

Participation and sharing are important issues in our organization, and a structure to lean on. It is not done in a second and it takes a lot from each of us, but it is worth it. When talking to people involved in our shared work, no matter if it is family homes, therapists or clients, they tell me about the importance of not being alone, to know there are others beside and to know we have a common base, a shared vision.

 

 

References

Andersen T (1996) Words are not innocent. In Kaslow, F W. Ed. The handbook of relational diagnosis and dysfunctional family patterns. New York: John Wiley & Sons Inc.

Håkansson C (2009) Ordinary Life Therapy. Taos Institute Publications, USA

Jensen P (2008) The Narratives Which Connect. Tavistock Clinic, UK

2 COMMENTS

  1. This is the one program in the world that I personally want to see replicated everywhere. But equally I also understand and respect that the primary success of this program is based on having very carefully chosen family homes and a community type atmosphere, something that cannot be replicated on a large scale. I have watched the documentary made by Daniel Mackler and am currently reading the only book about the program I can find in English – ordinary life therapy. I’m in Australia and while there are many programs that intrigue me and that I would love to see, Open Dialogue being one of them, the only one I have ever wanted to run away to is this one. It is something that I have thought at the back of my mind for years would have been and in all respects still would be the most therapeutic thing for me. I guess what I have loved the most is to see that someone somewhere has actually put into practice what I have longed for and proven that it can work. Something so simple, but equally so therapeutic. I am equally impressed with what I would regard as the real therapy being offered, as I personally cannot come across anyone who does anything except for Cognitive Behavioural Therapy in its strictest form in Australia and it is in many ways quite insulting for me. I am told that my past is not important and all I need to do is to think differently. I cannot think differently until and unless I have some other experiences that are different to create new thoughts with. For that to happen I need to be able to live a real life and to have real life experiences, something that is denied to me by ALL other programs and services. Thank you for having common sense to see what people really need. I only wish I could find one person on your wave length in my own country!!!

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  2. Hi Belinda, thank you for your post!!! I agree, it is not “just” to copy, but to start with some people involved, as we did many years ago. The main thing is to have an idea, to hold the vision and to go for it. Find some other people who you trust and will be able to cooperate with. The sad thing, as I think, is that professionals are taught so many things which indeed are not the most important when meeting people who struggle with life and death, as for example different methods, manuals to follow and the idea to find “the truth”, to be “perfect”. Sometimes it seems as if professionals “forget” important principals of life when entering a professional room, as for example the need of time, trust, ambivalence, struggling, doubts, love, recognition and to be included and counted on. I hope you find someone to share your visions and ideas with, please let me know how it works out.

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