New and bestselling titles on spiritual care and chaplaincy

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Incorporating creativity in supervision

Chesner-Zografo_Creative-Superv_978-1-84905-316-7_colourjpg-print Anna Chesner, co-author of Creative Supervision Across Modalities, explains why using creativity in supervision sessions can benefit both the supervisor and supervisee, and gives her top tips for any therapist or helping professional new to using this approach.

Why is the use of creativity so effective in supervision sessions?
Creativity helps to link right brain and left brain understanding of practice. Often as practitioners we may have a feeling of stuckness, or going round in circles. Using creative methods helps us to facilitate new perspectives and fresh energy.

How can creative supervision ensure that a fresh perspective is maintained in supervision sessions, and how does this benefit the supervisor and supervisee?
Creative supervision can bring a new perspective and fresh energy to reflecting on our clinical or other professional practice. This in term can bring fresh energy and clarity to our sessions with clients. If supervision itself lacks vitality it may become part of the problem, rather than facilitating possible solutions.

In chapters 2 and 3 of your new book you write about the importance of roles in creative supervision – why is this? Which of the roles you mention do you think it is most difficult for a new supervisor to take on? Is there one that they tend to slip into more easily?
Not so much roles as an understanding of role (singular). The concept of role helps us to think about our “way of being” and our clients’ way of being. It is a practical tool for looking at patterns of behaviour and relating. Supervisor’s need an awareness of the multiple roles they may inhabit as a supervisor, and in the best case some role flexibility. Similarly, practitioners from all fields can benefit from thinking about their own roles in their practice, and indeed the roles of their clients within their various systems.

What is the most challenging thing you have to cover with trainee supervisors? What is it that they usually struggle most with in terms of incorporating creativity into sessions?
Supervision trainees have firstly to meet the challenge of getting to grips with the role of supervisor, which is distinct from their more familiar roles as clinician. There is an added challenge in learning how to use creative techniques in a way that is a spontaneous response to the supervisory question or focus and remains firmly within the frame of supervision.

Why is it that ‘irrational’ thinking can be such a crucial part of the creative process?
Not so much irrational as out of awareness, or known only implicitly. Face to face clinical work involves the practitioner in complex, multi-layered interactions, where physical or felt sense, and imagination are as important as the actual words spoken. Our right brain awareness can be brought to light particularly well through creative approaches to supervision.

You mention several times the importance of establishing a clear focus in the supervisory session – why is this?
A clear focus or supervisory question is helpful for a number of reasons. It ensures transparency about what kind of help or reflection opportunity is being sought. It supports a collaborative approach between supervisor and supervisee. It reveals the level at which a supervisee is able to reflect on and articulate their process.

What are the top tips you would give to a supervisor who is new to using creativity in their sessions?
– Reflect on your own interventions in the light of supervision theory
– Bring your creative supervision practice to your own supervision space
– Remain open to new learning
– Undertake training in the use of creative supervision methods


An evening at the ‘Humanizing Healthcare Reforms’ book launch

Martin Laverty – CEO Catholic Health Australia & Gerald A. Arbuckle, PhD.

The trustees of Mary Aikenhead Ministries in Sydney, Australia, were proud to host the launch of Humanizing Healthcare Reforms by Gerald A. Arbuckle, PhD on 13th December 2012.

Here are a few words that were said at the launch on behalf of Jessica Kingsley, MD of Jessica Kingsley Publishers:

“The sample pages [Gerry] sent were immediately fascinating – full of rich examples, and an approach that enlarged one’s thinking. Rather than management jargon, condemnation, or cheery good advice, here was a multi-levelled analysis of how the structure of health care operates to affect the people within in it. It quickly became clear that the perspective of an anthropologist – objective, rational, deeply perceptive about relationship, but above all compassionate – was work from a very different perspective.

This book is being published at a time when further dreadful stories are emerging from the UK health service – the book, with its very positive message and call to action, is very much needed, and needed now… Thank you, Gerry, very much, for choosing to publish your important book with us.”

The book was also featured in The Australian newspaper today in a piece entitled ‘A major hole in health reform’, which you can read about here. Gerald Arbuckle also recently contributed to the JKP blog discussing the threats that are currently facing our healthcare systems.

Here are some more photos from the event:

Gerald A. Arbuckle, PhD.



From left: Martin Laverty – CEO Catholic Health Australia (who launched the book), Sr Helen Clarke (Mary Aikenhead Ministries Trustee), Emeritus Professor Gabrielle McMullen (MAM Trustee), Gerald A. Arbuckle, PhD., Leanne King (Performed Acknowledgement to Country), Robert Cusack CEO St Vincent’s Private and Mater Hospitals, Dr Tessa Ho (MAM Trustee) and David Robinson (Chair-MAM Trustees)

Humanizing Healthcare Reforms is available to purchase directly from Jessica Kingsley Publishers.

Humanizing Healthcare Reforms

Gerald A. Arbuckle, PhD, author of the new book Humanizing Healthcare Reforms, talks about the threats currently facing our healthcare systems.

Healthcare  systems throughout the Western world, including the much loved National Health Service (NHS) in England, are under ever-increasing threats. This means that the welfare and safety of patients are endangered. The threats come from two interconnected external and internal sources.

Externally, the threats are caused by governments’ financial and administrative decisions. The original founding  of healthcare focused on the physical, mental, and social needs of patients; hence, the emphasis on the values of compassion, solidarity, justice and holistic care.  Now the emphasis in places like Britain and Australia is increasingly on market economics, such as we see in the United States. Healthcare becomes more and more a competitive business. The poor especially suffer. Two words summarise what is happening:  privatization and corporatization.

Paradoxically, at the same time this is happening, concerned reformers in the United States led by President Obama are struggling to modify their long-established, highly expensive model of healthcare built on the competitive values of market economics to the detriment of millions of people who cannot afford private insurance. They are not calling for the end of autonomy, diversity, individuality or self-determination in healthcare, but the return to the founding values of solidarity and a greater concern for the common good.

Internally healthcare systems are also under growing pressures.  Governments are administratively imposing more and more structural changes on hospitals and aged care facilities. In Britain, for example, significant organizational disruptions have occurred annually since the mid-1980s, but the administrative decisions of 2012 are the most radical since 1948.

Structural changes, especially when rapidly imposed from above, impact negatively on the cultures and consequently on the morale of key staff members such as clinicians and managers. The result – patients again suffer. Governments think that organization cultures – the symbolic landscapes of people – can be destroyed overnight by an administrative decision. They then expect new cultures to emerge with similar speed.

Cultures are not machines. The fact is that the uprooting of the inner framework of an institutional culture, such as a hospital, destroys a people’s stable sense of belonging and self-esteem. Most staff members are bound to experience periods of intense loss, which can lead to all kinds of dysfunctional behaviours, including outbursts of anger, authoritarian leadership, professional tribalism, bullying, the concealment of mistakes, absenteeism, and cynicism.  These dysfunctional behaviours are clearly evident in our healthcare systems.

Michael Sandel of Harvard University is correct. Market triumphalism has failed; we need a public and informed debate based on moral and spiritual values.  When applied to healthcare this means a return to the foundational values of healthcare such as solidarity, equity, respect and compassion.  People have a right to choose their healthcare services, but it must not be pursued at the expense of solidarity, that is, the needs of people of the margins of society. Healthcare reforms cannot succeed until we seriously challenge some of the core values of the marketplace: autonomy, individuality, self-determination and diversity.

Spiritual reminiscence work with people with dementia – The Role of the Group Facilitator

Finding Meaning in the Experience of Dementia by Elizabeth Mackinlay and Corinne Trevitt is based on the findings of the first major study on spiritual reminiscence work with people with dementia. This extract explains the role of the facilitator in spiritual reminiscence groups.

The communication strategies demonstrated by the facilitator could ‘make or break’ a group. When listening to the recordings of spiritual reminiscence groups it was interesting to note how much the difference between responses depended on the group facilitator’s style. Prior to the commencement of the project in each facility, the group facilitators had training in techniques to enhance their communication and group facilitation skills. The research assistant present at all the group sessions was of considerable assistance in assisting with challenging communication issues and in debriefing the facilitator at the completion of each session. It was good if the facilitator had had the experience of being a participant in a spiritual reminiscence session, prior to facilitating a group themselves.

The facilitator had to be very comfortable with the notion of personhood and be able to identify the behaviours that led to ‘malignant social psychology’ (Kitwood 1997). In addition, s/he needed to have a good understanding of the elements of behaviour that encourage person-centred care and also the guidelines for managing reminiscence activities. In the following example the facilitator gave as much time as needed to help Jessica find what she wanted to say. By just affirming that she was still listening, the participant was encouraged to keep going – to try to find the right words. The interaction also identifies how frustrating it can be for people with dementia to join in and contribute when words are difficult to find.

Facilitator: Mmm.
Jessica: I want to do it, but I am slow. And that is the main problem I think, that I am slow at doing these things. I know how to do it, but it doesn’t come.
Facilitator: Mmm hmm.
Jessica: I am slow to get that done, and I keep thinking about it, but it is not coming as quickly as I wanted to, and I am slowly exasperated.
Facilitator: Mmm.

The facilitator also needs to be aware of his/her own spirituality, to be comfortable with the types of questions asked in spiritual reminiscence.

Questions such as:
• What gives you most meaning in your life?
• What does spirituality mean for you?
• What makes you feel happy or sad?
• What has brought you joy?
• What do you look forward to as you come near the end of your life?

Questions of God and religion were also asked in the groups, and facilitators had to be comfortable with their own spirituality so they could facilitate these topics in discussion. One facilitator in the study decided not to continue facilitating a group as, although she felt this was important work and she attended church regularly, she did not feel comfortable speaking about religion with others.

An essential beginning for group work is respect by the group facilitator for the group members and a willingness to meet them where they are in their life journeys. The skills used in small groups are those used by the helping professions – first, active listening and being really present with the participants.

Effective facilitation of group participation includes using appropriate and open-ended questions and then allowing space and silence while the individual reflects. It includes the use of paraphrasing, unconditional acceptance and the skills of focusing and summarising.
In spiritual reminiscence, it is best to focus on the meaning of events and experiences in the lives of the participants rather than simply on the description of the events remembered. This moves the conversation to a deeper level and enables a review of life meaning. Spiritual reminiscence is one of the spiritual tasks of ageing, and as such an important component of the life journey; it is so much more than simply an activity.

*This article is adapted from Chapter Twelve: Maximising Effective Communication.

Bereavement support groups and creative writing – a conversation between Dodie Graves and Jane Moss

In this conversation, bereavement service co-ordinator Dodie Graves and creative writing tutor/bereavement group leader Jane Moss talk about their experiences of facilitating bereavement groups and some of the creative techniques that can help people express themselves.

Dodie Graves (left) and Jane Moss (right)

Dodie: My experience of groups goes way back to being a participant during my seminary days, when we had to work collaboratively to get projects completed. It always seemed to me to be a most unhelpful and unfair way of doing things, as there were a few of us that would do the work and a few who would be “carried”. I suppose after that I wanted to make sure that groups I was in were more structured and constructive and I guess I took that into my counselling training when it came to doing a module on groups. In my own “group work” I was looking for clear and safe leadership and a place to be myself in secure hands. This, I think, is what I have wanted to create for bereaved people in groups, where they already feel vulnerable and want to find a safe place to share some deep things.

Jane: This rings lots of bells with me. As a writer working in bereavement support (through Cruse Bereavement Care and in partnership with hospice counselling teams), I find that the people who come to my writing groups are looking for something more structured than a talking group. They want to try writing as a means of self-expression, but attending a group also seems to offer them a safe place in which to compare their experiences and stories with others. They often take their writing into one to one sessions too, which can be helpful.

Dodie: It’s so good for them if they can get a benefit in that way. Being in a group can be quite scary for the participants as they will have to contend with others’ opinions of them and others’ needs. There are some real advantages to attending a group though, once the initial apprehension has passed and the group starts to feel cohesive. Bereaved people who join a group are coming into a “community” of suffering and they can start to be there for each other, they can share together, cry together and encourage one another. They can also get advice from each other that they wouldn’t get from being in a one-to-one counselling session.

Jane: That’s so true. People are always nervous at the first meeting. I hear worries such as ‘I can’t spell’, or ‘I was rubbish at writing essays at school’! It’s part of my role to reassure people that spelling and grammar don’t matter; you can always go and tidy it up later. It’s much more about finding the confidence to express yourself in your own voice and share with others who empathise with you. I believe the arts are a great way for people to open up about things they might find hard to talk about or even give a name to. The great thing about writing is that it is so accessible. All you need is a pen and paper, and the page is available any time of day or night.

Dodie: As a facilitator, I think you also have to have an added dimension – a real appreciation for the power of the written word. I have found getting people to write and also to work creatively with their emotions and their thoughts can be powerful. Having tried some group work with creative exercises, I would love to try the approach that you, Jane, have taken with bereaved people coming together to write creatively about their grief.

Jane: When I first started thinking about ways to bring writing and bereavement support together, you, Dodie were one of the people who inspired me. I think we’re both quite practical people, and writing is such a practical activity. I have found that some people want to write directly about their grief, whereas others prefer not to. At first this worried me because I thought some people might feel forced into writing about sad experiences; but in practice I find that people write about whatever they need to. I use themes and structured exercises a lot – for example, journeys, family stories, anniversaries – and I often offer a published poem or extract from a story to provide people with a starting point, so they can respond in any way they want to. People often express pleasant surprise at the results, saying that they hadn’t expected to write about a happy memory or a positive emotion such as hope.

But going back to your first point, Dodie, about the value of providing structure, I often find that some people in a group will participate fully while others stay quiet. These are the ones I work hard to engage with. Offering short writing forms like lists, acrostics or haikus (short poems of three lines of five, seven and five syllables) can work well. If someone is feeling shy or tongue-tied in the face of big difficult emotions, a word limit or a specific focus seems to help them contain what they want to express.

Dodie: I guess in a “talking” support group, we might feel more at ease with people who are quieter, as long as they are engaged in the process. It’s the dominating ones that can cause us concern. These people need to be encouraged to find their place but not take over. Facilitating groups with a number of unknown people is a real adventure!

Copyright © Jessica Kingsley Publishers 2012.

VIDEO: An insider’s perspective on what you can do to help a person with dementia – with JKP author Christine Bryden

In this video, Christine Bryden – author of Who will I be when I die? and Dancing with Dementia – gives family members, carers and professionals an insider’s perspective on what it feels like to have dementia, and what they can do to help.

Stay tuned for more videos from Christine Bryden and her husband, Paul, on the JKP Blog!

Christine Bryden has worked in the pharmaceutical industry and as a senior executive in the Australian Prime Minister’s Department. Following her diagnosis with Alzheimer’s Disease in 1995, she has been instrumental in setting up local support groups for people with dementia and has addressed national and international conferences. In 2003 she was the first person with dementia to be elected to the Board of Alzheimer’s Disease International. Her first book Who will I be when I die? was published in 1998 and has been translated into several languages. She lives in Brisbane, Australia.

Living with Dementia: A journey to the inner self – An Interview with Christine Bryden

Since Christine Bryden was diagnosed with Alzheimer’s Disease in 1995, she has been instrumental in garnering local, national and international support for people with dementia. In 2003 she was the first person with dementia to be elected to the Board of Alzheimer’s Disease International.

Who will I be when I die? is the “prequel” to her first JKP book, Dancing with Dementia. In it she recounts the emotional and spiritual rollercoaster she found herself on immediately after her diagnosis and provides unique first-hand insights into how it feels to gradually lose the ability to undertake tasks most of us take for granted.

In this interview, Christine reflects on the source of her unwavering positivity and sense of purpose, and the work still to be done to achieve greater empowerment and respect for people with dementia as individuals.

This is a profoundly moving and personal book – what made you write it Christine?

It was 1995 when I was diagnosed, at the age of only 46, and views were very different back then. People with dementia were thought to be mindless empty shells and to lack insight from the moment of diagnosis. There was no support for us, only for our families. I was amazed that this should be the case, but felt the task of changing these attitudes was too daunting for me, as I had enough problems coming to terms with my diagnosis.

But by what I call in my book a “God-incidence”, at the time that I was going through the awful time of testing and final diagnosis, I was part of a team preparing to run a weekend Christian retreat called Cursillo. This not only provided me with all the support I needed, but also put me in touch with Professor Elizabeth MacKinlay, who was also on this team. She is a gerontological specialist nurse, as well as an Anglican Minister. By the end of our time on Cursillo, I had plucked up courage to ask her to be my spiritual adviser, to help me through these dark and depressing times in my life.

We met monthly for prayer and encouragement, and Liz suggested that I think about writing my thoughts and feelings down. Soon a book began to emerge, reflecting on what it feels like to go through the trauma of diagnosis, the isolation of the stigma of dementia, and the fear of the future with this disease that is meant to take away your identity, your sense of self.

How did it feel to reflect back, and how are you now?

It was like looking into a window, peering into someone who was fearful of what the future held, who did not know she was about to embark on an exciting and challenging journey to change attitudes around the world!

It was also quite confronting to see the depth and breadth of my vocabulary, and the amount of research I had been able to do on the science of dementia. That was another window onto the past, opening out to someone I could no longer recognise as being me.

Once I realised how much had changed – even since 1996-1998 when I wrote this book – I then asked a former work colleague of mine if she could write a few words reflecting on what I was like in the mid 80’s to early 90’s, well before my diagnosis in 1995. She is one of a very few colleagues who has kept in touch with me over the years. Her words describe someone who has long ago been lost to the ravages of dementia:

“One of Christine’s defining characteristics was the speed at which she worked and the number of projects she juggled at once. … What do I see as being different now between the ‘then’ Christine and the ’now’ Christine? The main difference is speed – she certainly doesn’t juggle projects and ideas like she used to.

She is … much more passive – someone else does the organising. The ‘now’ Christine is slower, sometimes forgets the names of things, takes longer to understand new information, and may not remember what I have told her. … While the doctors may tell her she has lost a lot of brain function, they don’t realize how much she had to start with, so losing some brain cells has brought her back to average from stratospherically high.”

– Dr. Lyndal Thorburn, Viria Pty Ltd.

After 15 years, much has changed in my functioning. I am far more reliant on others, and far less capable than I was back then. I am increasingly frustrated and angry at my difficulties with finding words when speaking, and my equally increasing difficulty in writing words down. I am not as much in control of my emotions, so find it hard to control anxiety and depression, as well as anger and frustration.

When I wrote the book, I lived alone with my youngest daughter, who was then aged nine. Now I would no longer be able to live alone, and feel really blessed to have met and married my second husband Paul. With his patient support and encouragement, I am still doing far more than would be expected by looking at my latest scans, but still very much less than 15 years ago.

What gives you the strength to remain positive?

My Christian faith gives me deep meaning in life, giving me hope for the future and a perspective of my life being eternal, not simply limited to what we see on this temporal plane.

Now I have met so many people with dementia around the world, all at various stages of ability due to their declining function with these diseases that cause brain damage. Each person still remains an individual, with their true inner being shining through without words. The eyes remain a window into someone’s soul, and reflect our humanity.

Each person with dementia is making an important journey away from outer masks of cognition and function in our superficial world of what we do. They are travelling within, to a world of emotions, even if these become increasingly scrambled with the dementia. Emotions connect us to each other, allowing us to form relationships, which are a mark of truly being human. Then, deep within, their journey is to the inner self, their reflection in the divine. This is what gives me an abiding sense of meaning as I travel on this journey from diagnosis to death.

For me, I remain positive, feeling that I am gaining along this journey a far better sense of what it means to be truly human, and that much can be achieved to help others as I travel this path.

How much do you think our understanding of people with dementia changed since you were diagnosed?

When I first started, there was no support for people with dementia, as it was assumed we lacked insight. Indeed the words of an Annual Report in 2000 of an Alzheimer’s Association spoke of us as being “mindless empty shells”. At first when I spoke up, people did not believe I had dementia because I could still speak. They said that even if I was showing the early signs, I was not a credible representative of people with dementia because of my level of function.

Yet since then I have met so many others who have this diagnosis who are speaking out, and being included in the activities of Alzheimer’s Associations. We are receiving so much support and encouragement, and we are being listened to and respected. No longer are we being dismissed. By treating us as experts in what it feels like to have a diagnosis of dementia, services and support are being much improved.

More remains to be done, as there still is so little understanding of dementia in the community. Even people who come into my home to help me when Paul is not here don’t realise that dementia is a terminal illness, leading to death, nor do they understand that it is caused by brain damage as a result of more than around 100 different diseases. Still the mindset is of an elderly person in a nursing home who is unable to communicate, and who can be treated somewhat as a child.

Yet the diseases that cause dementia are diseases like any other, and can strike at any age, although they are more likely to occur as you get older. And after diagnosis people are usually still functioning reasonably well, with support and encouragement. It is inclusion and being valued that we need, not exclusion and isolation.

What do you hope readers will take away from your book?

An understanding of what it feels like to be diagnosed with dementia: the shock and horror of diagnosis, the overwhelming fear of the future, and the isolation as a result of the stigma surrounding dementia in society.

We can provide hope and encouragement to help overcome the fear, and we can do much more to change public perception of dementia that isolates us in a spider’s web of stigma.

Christine Bryden
December 2011

Copyright © Jessica Kingsley Publishers 2012.

VIDEO: Writing for Therapy or Personal Development – A Conversation with Dr Gillie Bolton

Dr Gillie Bolton is a renowned therapeutic writing practitioner and author of many JKP books, including Write Yourself: Creative Writing and Personal Development.

In this video, Dr Bolton discusses the new book – the latest in the Writing for Therapy or Personal Development series, of which she is also the series Editor – and shares some of the experiences that brought her to the growing field of therapeutic writing. She also shares some of the types of writing exercises that she returns to again and again for her own personal development, and talks about the importance of hearing your own internal mentor.


Copyright © Jessica Kingsley Publishers 2011.

VIDEO: An Interview with Anthony Peake, co-editor of Making Sense of Near-Death Experiences: A Handbook for Clinicians

Anthony Peake is a renowned writer and researcher whose work focuses on the nature of consciousness and reality, and mysterious phenomena such as déjà vu.

He is the co-editor, with Mahendra Perera and Karuppiah Jagadheesan, of the forthcoming book, Making Sense of Near-Death Experiences: A Handbook for Clinicians‘ – available from Jessica Kingsley Publishers in November 2011.

In this video, he discusses the phenomenon of the Near Death Experience (NDE); why it is essential that nurses, doctors, palliative care workers, psychologists, psychiatrists and other helping professionals learn how to talk seriously about these experiences in a non-judgemental way; and offers some advice about what clinicians should do when encountering a patient or client who has had an NDE.


Copyright © Jessica Kingsley Publishers 2011.