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Updated: Nov 15

Brief report and highlights

NEW DEVELOPMENTS IN THE CARE MODEL TRAINING



On 4th and 5th of October 2022, The CARe Academy organized specialized follow up Model CARe training to support CARe trainers, CARe coaches and auditors in their professional practice, to embrace the strengths of The CARe Network and keep good quality of Model CARe practice.


The training took place in the beautiful city of Split, Croatia, which offer a lot of opportunities to be inspired by lovely atmosphere and rich history of the city. We are very delighted, that we could welcome 35 experienced CARe traines, CARe coaches and auditors from 6 countries across the Europe and Asia.


On day 1 we have focused mainly on sharing experiences with the CARe Model trainings, dived into new developments in model CARe and explored and experience using different creative tools to support recovery in several workshops.


Jean-Pierre Wilken and Dirk den Hollander introduced new developments in the CARe Model, highlighted the importance of CARe principles, relationship building, experiential knowledge and working with the community.


Juraj Marendiak, Radmila Stojanovic Babic, Aster Tooma, Triin Vana and Jana Pluhaříková Pomajzlová created in very nice and creative atmosphere a “training tips and tricks market”. So many wonderful training tools were shared and experienced and, in the end, we had a wall full of ideas and proved training tools for practice. We will continue with this idea and already started to create with the trainers a practice toolbox for CARe trainings😊


Marlie van de Berg introduced the Yucel method and together with Jana Pluhaříková Pomajzlová lead the online Yucel method workshop “building on recovery”. We were very happy that Marlie could participate and bring new inspiration to support recovery.


Dirk den Hollander and Michal Kašpar lead the workshop “Using the art of music and theatre for an expression of recovery journey”, empowering, personal deep experience guided by lyrics, personal recovery songs and creating lived sculptures.


Juraj Marendiak and Ludmila Horynová prepared in exterier of the venue wonderfull, sensitive and very personal workshop “Using the art and creativity for an expression of recovery journey”. The environment and used personal creative tools made the workshop very special. In the end of the workshop the artwork was introduced to all participants, very touching experience.


Aster Tooma introduced “Using dance and movement for an expression of recovery journey” and created together with the participants empowering, personal, expressive dance of CARe trainers, which we could not only see in the end of the workshop, but also dance and experience all together. Wonderfull closing of intensive first day.


Day 2 was dedicated mainly to the topic of The Model CARe implementation in different contexts and the importance of experiential knowledge, peer work and the support of family and loved ones.


Kadi Roosipu, Karin Hanga, Külli Mae and Triin Vana shared their experiences with the “Implementation CARe Model and ICF (International Classification of Functioning) in the Estonian Unemployment Insurance Fund's”. Such an extensive, systematic, and rich experience, very inspiring and many common topics for further elaboration were pointed out.


Ludmila Horynová, Juraj Marendiak and Jana Pluhaříková Pomajzlová introduced a painted river as a stream of the experiences with implementation of CARe model in The Czech Republic. Very special, personal and touching story about wonderfull joint cooperation and system change in the organization.


We have elaborated on the topic of implementation further in workshops and shared a lot of inspiration and practice. Many similarities and also important questions rised up.


In the afternoon Riina Järve-Tammiste brought very important topic in the workshop “Experiences from Recovery Learning Community Pool&looP, how to support families and friends”. She shared with us, how to use CARe to support recovery of families and we could touch a piece of her work in very personal deep exercise meeting our values and difficult times we are overcoming.


Zdeněk Císař and Jeannet Achterstraat prepared excellent workshop "Experiential knowledge and its importance in our practice and in our trainings – how we cooperate with peers in our trainings and implementation process". With personal, professional and peer expertise very special, important and touching workshop. It proved, that even though we are from different countries in recovery process we are closer than we might mean.


The CARe Academy will follow up the topics and highlited questions from all workshops in next year in the online workshops and webinars, thus it was so inspiring, that definitely we want to continue and to support CARe trainers, coaches and auditors as well as larger CARe Network community.


We would like to thank to Multimedijalni Kulturni Centar, Split, which kindly contributed to the realization of the training in its space. Many thanks also belong to the organizations Association for psychosocial assistance SUSRET and Association for promoting mental health PHOENIX SPLIT, which brought a lot of personal initiative and effort and helped with the organization and coordination of practical issues connected with the training. The training would not happen without the sponsorship of The CARe Network, so many thanks belong also to the whole organizational team and the CARe Academy trainers’ team, who did tremendous work to prepare and hold the training.


In CARe we have one principle: “never do the things alone!” We could experience the wisdom of this quote within the preparations and training itself and we are very grateful for such a great, enthusiastic, initiative team of trainers, without teamwork and participation from all the training would never happen. It was proved again; how much important it is to create joint space to meet and share experiences and to support continual professional growth and development.


Special thanks belong to all CARe trainers, coaches and auditors, who participated in the training and create beautiful, inspirational, supportive atmosphere. Many of our CARe trainers were also invited to take active part in the program and held a presentation or a workshop. We are persuaded, that this was one of important factor which made the event so special and rich. Other factor which made the trainings so special was the creativity, openness, diversity, and richness of the experiences from different countries, willingness to participate and be involved, friendships, professional mutuality and personal interest in all what we did.


We could experience deep mutual connection and understanding, empowering, and energizing for all. We are proud we could hold such an event to support our colleagues across different countries and enable to share experiences and expertise from different fields of practice.


A lot of new inspiration raised up during the event and the CARe Academy trainers’ team already prepare an itinerary of follow up webinars for CARe trainers and practitioners on the topics which were defined as important.


So be ready and follow us on the social media to keep updated😊


Looking forward meeting you soon,

Jana Pluhaříková Pomajzlová

Head trainer CARe Academy


Feedback: What did you experience in the training?


“I made social, professional, and personal connections, share experiences and heard stories. I got wider picture what is going on in other countries which opens up perspective. Safe environment and clear boundaries make me feel good and provide space for work and connection. I feel that after each event my CARe social network is stronger. I like meaningful activities together and this event totally met my expectations."


“I feel as a member of a broader team. Sharing experience gave me more courage not only for training.”


"Meeting people I haven't seen for years in a warm and human atmosphere. The training brought me lots of ideas for my trainings. This was the best part. I felt safe to speak, safe to share, safe to make mistake. Connected to ensuring part, feeling safe enabled me to participate with more ease. I was involved more than I ever imagined to be and it was a really empowering experience. Thank you for that."





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Updated: Oct 27



On 6th and 7th October 2022, the CARe Network brought people from many countries together for a conference themed RESILIENCE AND RECOVERY. The conference took place in the beautiful city of Split, Croatia, and was hosted by the NGO’s Susret and Feniks. It was a very lively and interactive meeting, sharing knowledge, experiences and feelings.



The first day we focused on how we can transform and enrich mental health care in general. The second day was dedicated to the challenges connected to the Ukraine crisis.


Anka Slonjšak, the Croatian Ombudsman for people with disabilities, expressed at the opening of the conference how important it is to work together on social inclusion and to ensure the rights of people with a disability.


Supporting recovery of people with mental health issues should go hand in hand with creating a society where everyone feels welcome and can contribute with his or her talents. In different sessions we shared the latest developments in mental health care and how we can make personal and social recovery support stronger.


Alie Weerman, professor of mental health & society at Windesheim University, deepened the concept of experiential knowledge, illustrating this with impressive examples from her own life. Developing experiential knowledge out of personal experiences contributes not only to personal recovery but also to peer support, advocacy and the enrichment of professional practices.


Zdenek Císař, Michal Kašpar (Czech Republic), Zsuzsa Kondor (Hungary) and Dirk den Hollander (Netherlands) conducted workshops demonstrating the principles and power of self-help and peer support.


Dagmar Narusson from Tartu University, Estonia, introduced the principles of Open Dialogue, which connect very well with working in a relational and experiential way, bringing a micro network of a person with a certain need, family members and professionals together on an equal basis. Sharing experiences, feelings, needs and creating mutual support is a powerful way towards recovery.


Recovery does not happen in mental health care institutions, but in communities in the real world.


Building community connections was introduced by Jean Pierre Wilken (Utrecht University Netherlands & Tartu University Estonia). Dagmar Narusson showed how participatory research can reveal on the one hand the views of clients, family members and care workers on community participation and on the other hand the views of facilities in the community, like libraries, museums and businesses. Bringing perspectives together and building bridges will increase the possibilities for people with mental health issues for social inclusion. Aster Tooma, representing the largest mental health care provider in Estonia, demonstrated how they have been working on deinstitutionalisation with impressive results over the past decade, reducing the number of institutions and creating a great variety of living and support arrangements. The next step however is to connect much more to local communities.


The first day was concluded by a GAGA dance session leaded by Nataša Novotná, Czech dancer, choreographer and lecturer. She showed that discovering and strengthening the body adds to flexibility, strength, stamina, and skills.

The whole day showed that contributions to recovery can be made in many different ways: by self-help, peer support, open dialogue, experiential knowledge, art-based and bodily forms of expression.



On the second day of the conference, we concentrated on the new challenges connected with the war in Ukraine, exploring how to find hope for people who experienced loss and trauma.


Keynote speaker Nino Makhashvili (from Global Initiative on Psychiatry in Georgia) gave a thorough overview of different aspects of trauma and how people may cope. She described the content of Trauma-informed Mental Health Care and Trauma-informed services & systems. In the second part of her presentation, she described the consequences of the annexation of the Crimea in 2014 by Russia and the recent invasion. Studies show a high burden of key mental disorders of PTSD, depression and anxiety among Internally Displaced Persons, particularly women. Mental disorders reduced strongly functioning. Almost 61 - 75% were not receiving the care they need. After the first war studies showed many unaddressed/untreated mental health problems and trauma related conditions. Ukraine has not a properly developed care infrastructure and care systems to meet treatment demand. There is a need for trauma informed public mental health policies & strategies. The current war worsened the situation considerably, with an on-going exposure to traumatic events, which may lead to cumulative trauma. The whole society is affected and vulnerable.

More than 7 million refugees have been recorded in Europe alone (UNHCR) and 7.1 million people have been internally displaced, representing one-third of the pre-war Ukrainian population. Despite the ongoing war, the generally unsafe situation and the increasing lack of resources, already 2.5 million persons returned to Ukraine. Towns and cities are systematically razed to the ground; schools and hospitals are bombed and destroyed, among them psychiatric hospitals and social care homes.

In the last part of her presentation, Makhashvili described the impressive efforts a number of organisations are making to support resilience One of the initiatives is the Ukrainian-language Samopomich program. It provides a multi-faceted platform to help Ukraine deal with the psychological consequences of the war. It includes a website with a wide variety of resources, that are further transmitted via social media helplines. Other activities involve consultation for first line respondents who are directly confronted with the traumatic experiences caused by the war.


Makhashvili’s keynote was followed by testimonies from different countries affected by the war, starting with two psychiatrists from Zaporizhzhia, Galyna Guk and Mykola Khomitskiy, being with us while their city was being bombed. They talked about the huge impact of the war, and the great needs for mental health care support. At the same time, they expressed the hope that better services could be build after the war, including the elements of recovery supportive care as discussed during the first day, like support groups and community reintegration activities.


Lilit Baghdasaryan and Narine Khachatryan (Head of the Recovery College in Armenia / director of the MA program in Personality and Counselling psychology).shared the developments in Armenia. Psychologists Gulzhan Amageldinova, Begaiym Borbieva and Aigul Alikanova talked about the situation in in Kazakhstan and Kyrgyzstan. It was impressive to notice that despite limited resources, in all countries responses have been found to deal with the mental distress of both refugees fleeing into the country as well the re-traumatization of the events among the population. Multidisciplinary teams were formed and training programmes were developed.

Dolores Britvić, head of Department for Social Psychiatry in Croatia told us about how in her country after the Balkan war, regional psychotrauma centers were established for war veterans and other persons seeking assistance suffering from PTSD. The programme consisted of three group modalities: socio-therapeutic, psycho-educative and trauma-focused groups. Research shows that the programme was successful, but also emphasized the importance of social support in the recovery process of severely traumatized persons.


The second keynote of the day was delivered by Leendert de Bell (professor at Utrecht University of Applied Sciences / Netherlands). He shared his knowledge about refugees, entrepreneurship and return migration. He described the struggle of many refugees to integrate in the host country, especially to get a meaningful job. This is often due to language and cultural barriers. He mentioned several examples of programmes that are developed to get a better access to the labour market, but also programmes that facilitate the preparation to return to the home country when the circumstances allow this.


The last part of the conference was dedicated to work in different sessions on how the CARe Network can add to the efforts already made in different countries. It was obvious that the recovery knowledge that is present in the network is valuable for strengthening mental health services in the near future. We will continue to work on this, in close collaboration with local, national and supraregional organisations.


This conference was a great occasion to share recent developments in recovery supportive care, to express our solidarity with the people of Ukraine, to strengthen connections, and to share knowledge that can help to deal with the immense trauma caused by war.





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Inspiration Model CARe journey July 2022

The CARe approach was developed in the Netherlands but now has spread all over the world. In English we call it CARe.

The CARe approach is alive in the Czech Republic. For example, trainers / coaches have been trained to teach and secure the Care approach. And every year a CARe Summer School is held: a multi-day event for the CARe trainers and practitioners to discuss the latest and desired developments together.

In addition, there have been several projects aimed to implement Model CARe into practice and improve quality of care. Within these projects employees of various facilities from the Czech Republic visited Nei Skoen from Helmond and other organizations and took inspiration for their own recovery sanctuary.

This year's Summer School was held in Ledce on July 14, 15 and 16. Dirk den Hollander (co-founder of SRH / CARe approach) and Luciano Mafficioli DelCastelletto, (CARe methodology Experience expert) were invited to attend the summer school.

Luciano and Dirk traveled to Prague on 11 July where they experienced a hospitable welcome at Jana’s place. The days preceding the CARe Summer School were used to visit initiatives that work with CARe and to exchange experiences and news from practice.


BONA o.p.s. July 12


On July 12, we visited several locations at BONA o.p.s. (https://www.bona-ops.cz/). BONA is an organization in Prague offering a wide range of services for people living with mental health issues, e.g. sheltered housing, supported living, community mental health teams, IPS, social entrepreneurship, and other recovery initiatives. BONA o.p.s. realized a 2 year comprehensive project to implement Model CARe systematically into practice across the whole organization.



- First we visited villa Alena. Spoken with an enthusiastic team. They already work with CARe Model.

In the morning there are participants in the context of vocational rehabilitation. For instance, by making beautiful articles by blowing glass. Besides that, there are regular working positions in social entrepreneurship.

In addition, a walk-in inspired by Nei Skoen is being worked on. The team is also working hard on contacts with the neighborhood/environment.

There is a garden that is maintained by several participants and creates a warm home atmosphere. Especially with Lucia´s dog, who welcomes everybody.

BONA (as a bigger umbrella) also organizes self-help groups and that's where Villa Alena participants also go.


- Then we visited Supported Housing.

Also here is a clear CARe environment. We spoke with employees and with clients. We got an insight into how the daily activities are organized and how participants play an important part in this. All this is housed in a large building that owned by the foundation and which looks institutional. But they are moving step by step towards recovery work: first you had 2 separate teams per location, now the employees follow the clients. All clients have a job outside the home. Some cook together and others just for themselves.

A development that is now being worked on: applying the CARe principles to the management team itself and in working with employees.


Finally, we visited so-called Social Community Mental Health Team. They work according to a FACT team format, including team support instead of individual support. There are 6 team members, mainly social workers and a psychologist (with addiction expertise) and a Peer Worker. Each worker cooperates with 10 clients.

There is a lot of collaboration with Sheltered Living and FACT teams and Psychiatric Hospital and other services. Due to this design, this is therefore not reimbursed by the insurance company: it is a BONA o.p.s. project currently supported financially by the Ministry of Social Affairs

http://www.bona-ops.cz/



Recovery College Prague:

In the afternoon we spoke with the team of the Recovery College in Prague at The Center for Mental Health Care Development. An entire afternoon sharing experiences.

For example, there are people present who are involved in preparing and realizing a Recovery college stage project, people who provide training in telling your recovery story and several trainings to support recovery, running self-help groups and a number of so-called Peer Lecturers, who teach at the universities and in different trainings. We have connected also with the colleagues from Jihlava, who recently started a project of Recovery college in this city in cooperation with RC Prague.

The whole afternoon was spent exchanging experiences and learning from each other. A rich meeting for all present.

https://www.cmhcd.cz/centrum/co-delame/skola-zotaveni/

https://skolazotaveni.com/


13 July visit Domov Na cestě, Předhradí - Domky

Morning:

We visited the organization Domov Na cestě, (2 hours by car:-). We visited in the morning a new built sheltered living facility, next to the castle Rychmburg (where the people lived previously), where we drank coffee and spoke with clients and employees of sheltered housing. This is a location that has recently moved. We were also here 2.5 years ago when people were still very hesitant about this and struggled with the question of how to use the CARe approach for this kind of service. It's great to see how far they have come. The CARe has been fully implemented. The clients are people with longer-lasting psychiatric disabilities and it is nice to see how they are physically (in the new space) and mentally attuned to this. A lovely quiet atmosphere in which residents get the opportunity to come out of their shell with these foreign guests. A very nice meeting.


The afternoon of the 13th in Domov Na cestě, Skuteč

We were surprised with an extensive homemade lunch with, among other things, 'moss cake'. Present more than 20 people mainly from various facilities of Domov Na cestě, but also other organizations. What immediately struck us: the warm atmosphere and the fact that there was a lot of laughter. Always a good sign.

There was no fixed agenda. In fact, here again: exchanging experiences.

It was very impressive to hear how a manager came out 'with his own experience' and can thus be an extra inspiration for his employees.

A very nice finding: an initiative for experiential expertise has been set up with the beautiful name: 'Space for souls'. Spontaneously also according to translation mistakes the name was shifted to “Space for beautiful souls”, how beautiful do you want it.

This meeting (just like the previous ones) was mainly about CARe and the use of experience expertise. The different methods and experiences. Great to be with. https://domovnaceste.cz/

Summer school CARe approach 14 and 15 July

The Summer School took place in Ledce in the home and recovery initiative of Martin Fojtíček. Martin and his wife have a large house where groups can also stay and with a large outdoor area. The meetings took place entirely outside.

The first part of the Summer School is primarily intended for the CARe trainers to discuss the most recent and desired developments and the second part is aimed to meet CARe practitioners and people interested in CARe to meet each other, share and discuss the topics from practice and encourage the workers to go on and keep CARe alive. Very nice that we could be here.


Meeting with CARe trainers

The CARe trainers currently developed a short training to support cooperation between community services and psychiatric hospitals based on CARe methodology. CARe model has become a part of the recommended methodology of the Ministry of Health for multidisciplinary cooperation and the demand to gain the knowledge and skills to work with CARe model is very current.

We have discussed this topic with CARe trainers and agree on the need to accent training on case studies and moving society from hospital to community.

Employees from psychiatric hospitals and community services can participate in the training together and there is very good experience with that.

We decided to discuss the set-up of a short training course based on the recent developments in CARe, because they make it possible to also make short training courses. See the Appendix at the bottom of this document.

We have discussed the situation in psychiatric hospitals in the Czech Republic and possible cooperation with smaller regional hospital. We made a suggestion to make it a 'best practice', because there is a great potential, so that large organizations can learn from it.


Basic CARe trainings are provided in many organizations, and we shortly discussed experiences from the trainings so far. We agreed on ongoing development of CARe basic training, and made a plan for next year to support a professional development of CARe trainers involved in the CARe team at The Center for Mental Health Care Development.

We have also discussed other trainings currently in preparations, for instance a training in de-escalation and safe wards, now only self-defense is trained.


CARe Summer School


Topics we have discussed:

Experiential knowledge and practice in acute care

• Peer Workers (how do we deploy them)

• Forensic psychiatry

• Recovery and acute admission wards

Dirk has written an article about recovery and acute care and was so great to share it with us. He has also found a few institutions in the Netherlands that work with peer workers in acute care (in case one wants to make working visits).

In addition, a question: deploy peer workers in all diagnosis categories or only with 'like-minded people'. In our view, all recovery processes have common characteristics and peer worker can use parts of his/her experiences in work with people in all diagnosis categories. There is contact with Norwegians (from Bergen), and they go a step further: peer workers always supervise fellows from a different diagnosis category.

We also were talking about ‘Housing First principles’ that are very important, such as first place then train. Honza from a Housing first project remarks that after 'first place' the 'then train' is no longer always necessary, many people have the skills to manage by themselves.



CARe approach and atmosphere

A question was to be discussed: how do you get such a nice atmosphere? Several suggestions are mentioned:

• Always start by creating a bubble (everything personal stays under this bubble) and: when a group comes together for the first time you make your own traditions. Traditions such as: The newcomer is the most important. And: expressing commitment. When the newcomer expresses his commitment, he is included in the group.

• Within the bubble we always start with a round to hear how everyone is doing and what wishes / needs there may be.

• Wearing silly hats helps.

• Assume a diversity of types of activities: just listening and looking at Power-Points does not work.


Our evening that day was related to joint making fire, music, singing, joy and connection:-)


Multiple topics on July 15:

• Much talked about working with Peers in psychiatric hospitals and especially admission wards

• Also talked about employees who share their experiences, struggles the worker might have in order to be in line with law and professional requirements, also in connection to culture and position in the team

• In the hospital: It is still 'she' and 'we', instead of 'us'. Recovery in the CARe approach is always about 'us'

• Many rituals are applied in the meetings of self-help groups: fixed components with an important character. Also apply this in training of CARe workers: create a bubble, hold personal rounds, make traditions for this group together, have participants read important passages, bring a round of 'sharing experiences in' etc.

• In your work, also start from your own passions: example of an accompanist who is interested in literature and has started a literature group, another works with cards, another takes his guitar, etc.

· Be aware of professional ground rules: these have been trained for so long and so internalized that we no longer realize them. Example: “professional distance”


In the afternoon we had a special opportunity to participate in a music therapy workshop led by Jana Fojtíčková, experienced music therapist focusing on recovery and music. Special experience, time with ourselves and with the group, healing for our souls.


There was also a place for moments of connection, quiet time, getting to know each other better, playing and small games (like withholding sticks together or finding something in common with everybody). Some had the opportunity to express the specialty in making the best coffee, others in cooking sweet apricot dumplings, some in singing and guitar playing, some in chatting or keeping balance while swinging on a tree branch.


We would like to thank all who participated in CARe Summer School and helped to create such a warm atmosphere full of commitment and shared experience. Special thanks belong to Dirk and Luciano for the inspiration, positive energy and enthusiasm they brought, to Martin and Jana for welcoming in their home, and CARe trainers for all preparations.




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