Engage Aotearoa

Category Archives: Engage Updates

Creative connections in the Community Resources Directory

The Creative Connections section of The Community Resources Directory has now been updated and moved online. This section lists national and local Auckland groups that provide support for creatives and opportunities to engage with the arts, explore your creative side, and get involved in the creative community.  While we are in level 3 lockdown in Auckland at the moment and we can’t physically go out to participate in these groups, many offer online resources and networks that might help to fill the gap.

That’s 13 sections you can easily browse online now and only 4 left to go.

Screenshot of Community Resources Directory contents page showing sections on Funding Mental Health Treatment in New Zealand, Acute / Crisis / Urgent Teams, Community Mental Health Centres (DHB), Community Support Services, Counsellors and Therapists in Private Practice, Creative Connections, Cultural, Refugee and Migrant Services, Disability Services, Help Lines, Psychiatrists in Private Practice, Rainbow Community Resources, Respite Services, and Service User Initiatives

The return to zoom: resources for lockdown

We woke up on Sunday morning to the start of another 7-day level 3 rahui in Auckland. I will be working through this time but have now returned to seeing people on Zoom. I’ll resume seeing people in person when we move back down to level 1.

The team at Changing Minds continues to deliver the Whakatau Mai Wellbeing Sessions. If you are 18+ and need a bit of extra support or me-time over the next week you can check them out here: www.wellbeingsessions.nz. If you are under 18, TheLowdown.co.nz and ThrivingAdolescent.com have a bunch of useful online resources you might like to explore. There are several websites and apps full of helpful ways of coping with stressful times such as these in the Engage Online Resources Pack too.

You can find the latest government announcements about alert levels here: https://covid19.govt.nz/ They’ve put together a host of wellbeing resources that are worth a browse.

New study highlights stories of successful withdrawal

My latest paper has just been published in the open access journal, Therapeutic Advances in Psychopharmacology, as part of their special collection on discontinuing psychotropic medication.

You can read the full text free here: Service-user efforts to maintain their wellbeing during and after successful withdrawal from antipsychotic medication (Larsen-Barr and Seymour, 2021).

Abstract

Background: It is well-known that attempting antipsychotic withdrawal can be a fraught process, with a high risk of relapse that often leads people to resume the medication. Nonetheless, there is a group of people who appear to be able to discontinue successfully. Relatively little is known about how people do this.

Methods: A convenience sample of adults who had stopped taking antipsychotic medication for more than a year were recruited to participate in semi-structured interviews through an anonymous online survey that investigated antipsychotic medication experiences in New Zealand. Thematic analysis explored participant descriptions of their efforts to maintain their wellbeing during and after the withdrawal process.

Results: Of the seven women who volunteered to participate, six reported bipolar disorder diagnoses and one reported diagnoses of obsessive compulsive disorder and depression. The women reported successfully discontinuing antipsychotics for 1.25–25 years; six followed a gradual withdrawal method and had support to prepare for and manage this. Participants defined wellbeing in terms of their ability to manage the impact of any difficulties faced rather than their ability to prevent them entirely, and saw this as something that evolved over time. They described managing the process and maintaining their wellbeing afterwards by ‘understanding myself and my needs’, ‘finding what works for me’ and ‘connecting with support’. Sub-themes expand on the way in which they did this. For example, ‘finding what works for me’ included using a tool-box of strategies to flexibly meet their needs, practicing acceptance, drawing on persistence and curiosity and creating positive life experiences.

Conclusion: This is a small, qualitative study and results should be interpreted with caution. This sample shows it is possible for people who experience mania and psychosis to successfully discontinue antipsychotics and safely manage the impact of any symptoms that emerge as a result of the withdrawal process or other life stressors that arise afterwards. Findings suggest internal resources and systemic factors play a role in the outcomes observed among people who attempt to stop taking antipsychotics and a preoccupation with avoiding relapse may be counterproductive to these efforts. Professionals can play a valuable role in facilitating change.

Referrals open for Mondays in Henderson

I am all set to move into full-time private practice and will be available to see people for private therapy at WEST Community Hub in Henderson on Mondays from March, with a view to shift to Tuesdays when office space becomes available.

I will continue to see people online and from Changing Minds in Mount Eden, but will move to Wednesdays and Thursdays so Fridays can become a day for groups. I have found a most excellent peer support worker with a background in poetry and performance like me, and we are getting ready to co-design and run some groups together later this year. More info soon.

I am now accepting referrals for my first four time-slots at my new Henderson office on Monday March 1st and March 8th. Find out more about my availability and making a referral here.

I have truly loved my first six months of part-time private practice at Changing Minds. There is something different about working from a service-user led space with such a long history of systemic advocacy in New Zealand. As someone who once participated in Changing Minds’ monthly Consumer Forums, and later served as a trustee on the board, for me it feels rather a lot like coming home each time I walk through the door. I like the way we have a lounge room instead of a waiting room, and the way the walls are covered in framed stories of recovery from real people who have been there before.

Back in my days as a full-time activist, when I was working with Taimi Allan on the Like Minds Like Mine team at Mind and Body Consultants, we often used to weave fantasies about a fictional ‘service-user led clinical service’ and when I left that job for my clinical training, we promised ourselves ‘one day…’ Our little partnership at Changing Minds feels rather a lot like the first step in our own tiny little revolution in that way.

I have searched long and hard for a similar service-user led space to partner with in West Auckland, but it turns out there is nowhere else quite like Changing Minds. I was very excited to discover the peer-led space Te Ata in Henderson (if you haven’t been yet, do go check it out, it’s pretty awesome). Unfortunately, they didn’t yet have a room that was suitable for therapy and it was a bit far from public transport options. So I have opted to use the therapy rooms at WEST Community Hub for the time-being. It’s not a service-user led space or quite as homey, even though it’s also in a repurposed house. But it is a community-led space, so it’s similar enough to my kaupapa to fit. Plus it is super close to bus-stops, the train station and lots of parking – and just down the road from Te Ata.

Here’s to the next chapter.

Take care out there everyone,

Miriam

Out of hiatus and open for private practice!

Engage Aotearoa is finally ready to come out of hibernation and you’ll notice a few changes have taken place over the past few months.

The big news is that after five years working full time as a psychologist within our DHB services, I have now freed myself up to add one day of private practice to the Engage Aotearoa web-resources. I have teamed up with the good folks at Changing Minds for a space to see people and am looking forward to working from a service-user led setting once again. You can find out more about my private psychology services here.

I’ve simplified things a fair bit and Engage Aotearoa has returned to its original form as a self-funded, non-profit initiative, now with a small private practice on the side to help sustain it. Over the last few years, Daniel has taught me everything I need to know to keep the website updated by myself and more than a decade after setting out on the Engage Aotearoa journey it’s an exciting step to be able move forward on my own two feet.

I am in progress with reviewing and updating all of the resources on the website. You will notice that the links to some resources have been disabled while I do this. A number of the info packs have already been reviewed and you can read them online here. The Butterfly Diaries Volume 1 has now been made available as a PDF e-book you can download and share around at will. And the Community Resources Directory has been moved onto its own series of webpages so you no longer have to download a long pdf document to read it – you can still download it to share around in the real world if you’d like though. Updating the directory after a five year hiatus is a pretty big task and a lot has changed in that time. If there is something you would like to suggest I add, do get in touch.

Please note, that I have updated my contact details.

Viva la revolution!

Miriam

Dr Miriam Larsen-Barr
DClinPsych, MNZCCPTLE



Highlights from Engage on Facebook

We Can’t Keep Treating Anxiety From Complex Trauma the Same Way We Treat Generalized Anxiety: Vicki Peterson writes “I’ve been living with the effects of complex trauma for a long time, but for many years, I didn’t know what it was. […] For those who have experienced trauma, anxiety comes from an automatic physiological response to what has actuallyalready happened. The brain and body have already lived through “worst case scenario” situations, know what it feels like and are hell-bent on never going back there again. The fight/flight/ freeze response goes into overdrive. It’s like living with a fire alarm that goes off at random intervals 24 hours a day. It is extremely difficult for the rational brain to be convinced “that won’t happen,” because it already knows that it has happened, and it was horrific.” Read more here.

Man Lessons – How to make a documentary about transitioning: “Over six years, Ben Sarten filmed Adam Rohe (who was assigned female at birth) on his journey into manhood, forming a friendship that to them has become as important as the documentary itself.” Read more here.

I was diagnosed with acute psychosis at 19. Here’s what came next:Kris Herbert reflects on her tumultuous mental health journey to share what she’s learnt along the way. She writes,”Our mental wellbeing is not fixed. It’s a shifting continuum and at the edges, we each have our limits. We all also have access to tools like exercise and meditation, good food and, hopefully, someone to talk to.” Read more here.

Researchers Find Lack of Evidence, Call for Halt to ECT: “A new review, published in Ethical Human Psychology and Psychiatry, re-assesses studies that compare electroconvulsive therapy (ECT) with placebo treatment for depression. The analysis also assesses the only five available meta-analyses that claim that ECT is effective.” In a press release, John Read, the lead author says “This body of research is of the lowest quality of any I have seen in my 40-year career.” Read more here. In related news, dozens of people have sued the NHS after experiencing a slew of serious adverse effects that they were not informed of before they consented to ECT procedures.

Inside Internal Family Systems Therapy: In this article, Ben Blum gives a detailed description of Internal Family Systems Therapy (IFS), including both clinician and service-user perspectives. Blum writes,”IFS therapy is upending the thinking around schizophrenia, depression, OCD, and more. […] In IFS, mental health symptoms like anxiety, depression, paranoia, and even psychosis were regarded not as impassive biochemical phenomena but as emotional events under the control of unconscious “parts” of the patient — which they could learn to interact with directly.” Read more here.

Find more on the Engage Facebook page.
www.facebook.com/engageaotearoa/

Engage Update: Slowly coming out of hibernation

It’s been two years since our last update, and though the Engage Facebook page remains active, we are still in the process of slowly coming out of hibernation. Please note that The Butterfly Diaries is now officially out of print for the time-being and we are unable to accept new orders. An e-book is on the horizon. We’ll update you when we have a timeline in mind. Our co-editor Michelle Bolton unfortunately passed away in June of 2016 and we are only just now beginning to think our way back into the project.

We’ve gone through a few transformations of our own since we last updated the Engage Aotearoa website. We couldn’t keep up with the demands of maintaining charitable status and a volunteer base when Miriam entered her doctoral studies and then began working full-time as a psychologist. We were so busy having governance meetings, we couldn’t get the actual work done. So we’ve abandoned the charitable structure and reverted back to our original independent, self-funded structure.

The website and many of the resources are well over-due for an update and that’s the first thing on our to-do list as we try to figure out what’s next for the Engage Aotearoa website. Now that we’ve got a doctor of clinical psychology in the house we might be able to see a little private practice tab in the menu options one of these days in the not-too-very-distant future. For the moment, we’re just going to keep the website alive and gradually update it.

The efficacy of a text messaging intervention for anxiety and depression among young people

One of Engage Aotearoa’s recovery resources, the Small Victories challenge, was included in the pilot of a text-messaging programme for young people with depression and anxiety at Youthline. The results of the evaluation were published last year in the Children and Youth Services Review.

Abstract
Background: Depression and anxiety are among the most commonly experienced mental health issues faced by young people in Aotearoa, New Zealand. Considerable barriers exist that prevent young people from engaging with face-to-face mental health services. Young people’s preference for technology-based counselling mediums such as text messaging opens up new pathways for intervention. Objective: A pilot text message-based intervention package was trialed for use by young people to evaluate the potential efficacy of the text package as an intervention for depression and anxiety symptoms.
Method: The text package was piloted using a 10-week longitudinal cohort pilot with 21 young participants (12– 24 years) who demonstrated mild to moderate anxiety and/or depression symptoms.
Results: Participants’ post-package scores were significantly lower than their pre-package scores for both anxiety (Z = −2.83, p = .005, r = −0.65) and depression (Z = −2.49, p = .013, r = −.056). ‘Feeling encouraged and supported’ increased as a result of receiving support from a trained supporter (Z = −2.06, p = .039, r = −0.45), but not from friends/family (Z = −1.72, p = .130, r = −0.37). Anxiety and depression scores did not change as a result of support from either trained supporters or friends/family.
Conclusions: Findings support the potential efficacy of the text package, justify wider trials of the text package, and support the use of text message-based interventions as potentially effective therapies for young people.

Read the full-text article by David Anstiss and Amber Davies here.

Engage Consideration: “Crazy”

Hello from Engage.

I often notice, not only in the media but around family, friends and strangers, the pejorative use of the terms of mental illness – people use ‘crazy’ to mean ‘bad’ all the time. “You drove drunk? You must be insane!” “She stole all the money even though she knew she’d be caught – crazy!” “The only reason you would kill a person is if you were mad.”

Bad things are often crazy. Crazy things are rarely bad. I have read some fine pieces encouraging the use of phrases such as “crazy good” and “mad fun”, and I love these phrases and want to hear them more. The comparison I want to make briefly here though is to the use of the word ‘gay’ to mean ‘bad’, which is appropriately frowned upon. People seem to understand now that using the denomination of a group of people as a catchword for the negative is just not on. So I hope it may go for ‘crazy’ some day.

If somebody uses crazy to mean bad, call them out on it. Say to them, “Being bad may be crazy, but being crazy isn’t bad.”

Daniel Larsen-Barr

Engage Facebook Updates

Here are a half a dozen recent highlights from our Facebook page. Please LIKE US!

Mr David Rutherford, Chief Human Rights Commissioner, releases the updated 2015 Bullying Prevention Guidelines on Pink Shirt Day at Silverstream School.
They call it waking up alive – that moment you’re aware your suicide attempt was not fatal.
Devastating news for vulnerable Kiwis
Relationships Aotearoa struggling to stay afloat.
New Zealand’s social welfare system “dehumanises” people in need.
Laughter yoga is the practice of deliberate, voluntary laughter. The idea is that forced laughter soon turns into real laughter.