Intense final day of FGC training in Tokyo

Today, Monday 20 July 2015, was the final day of the training on Family Group Conferencing (FGC) in Tokyo. I decided to go to the referrers-training for professionals, given by Rob, because there appeared to be a lot of discussion in this group, and a lot of people had come to me to ask for clarification. At the start of the session, a participant immediately started by saying he would like to have more information on the practice of FGC in other countries, and Rob referred him to the break-time. Then Rob asked the participants for feedback about yesterday. A comment was made on the role of professionals who have a long term relationship with a client, is their role a referrer or can they be a friend, and be part of the private family time. Rob answered that professionals are not trained in FGC, but rather the opposite (taking over control), and it’s a lot of work to change the mindset of caregivers. Also it was asked whether professionals could take a role closer to the coordinator, to ensure the process and the solution, - but within FGC it is the network that has to create the plan, and that this format is solid.

Then parts of a training film for FGC-coordinators was displayed. I had not seen this film before, because it hadn’t been shared with me, although I had wanted that. (what I saw was very disturbing). It was about a Dutch case of a mother with alcohol abuse and domestic violence towards her daughters. Then an FGC was started, and in the film the process was staged with actors. Parts of the film were selected to illustrate the role of professionals. The film showed the following: In the preparation process of the FGC, the coordinator talked with the guardian from child protection, who set demands on the family: the mother had to get help for her alcohol-addiction to be allowed to keep her children with her. And the child-protection-guardian was willing to come and explain this condition at the information part of the FGC. Then the coordinator talked to a person from mental health care services, who was unknown to the family, to ask what options there are for alcohol-addiction-treatment, which were hospitalization or day-care, and this person was also willing to come and explain this at the information part of the FGC.
Immediately a smart question was raised on how these professionals were selected by FGC, because there is a lot of variety in different services and opinions. Rob explained that there were 3 organizations on alcohol-addiction in Amsterdam, and they had just called one of them (sounded quite random). Another response came from the participants, saying that in Japan most services are not public but private, and it will be hard to ensure that professionals give the right info. Rob suggested to make a database of good informers.
Then about the date and time of the FGC-conference, which is often outside office-hours and can be problematic considering the rules of the professional system, a remark was made by a care-worker that this would disturb his private life and could be unhealthy for him. But this can be solved by lobbying to the director to change the rules and enable to give such support. Also in the Netherlands some professionals do want to come, and some don’t.

Then the first part of the conference was shown: the information sharing part. The child-protection-guardian explained that the was mother obliged to follow the condition set by the guardian to get help for alcohol-addiction, and the person of mental health care services for alcohol addiction explained their options of hospitalization and day care, and emphasized that they wanted the mother to be able to live a normal, good and healthy life. It was also added that sometimes there is no other option than to intervene in the case of acute danger, and then a crisis-hospitalization can be arranged.
The fact that this film literally mentioned that the mother was “obliged to get care” from mental health care services on the basis of the opinion of the child’s guardian came as a shocking surprise to me. In this example, there seemed to be no other option given to the mother and the family group (no information on any alternative or other service). So in a way, the FGC-conference appeared to be used to pressure the mother into mental health care. I was shocked and quite furious to see this being displayed in this conference. Rob and Hedda know who I am, and they know that there are a lot of peer activists at this conference. I didn’t understand why they had chosen to display this. It was very painful, and it destroyed even my faith in FGC, and I started doubting whether I had made a mistake to work with FGC. (there are also other family-group-plan organizations, mostly splinters of the FGC). I didn’t understand why this happened.

It was quite ironic, that Rob mentioned on FGC that there should be “no surprises in conferences”, and all information that will be shared in the conference by professionals, should be shared in advance with the main person.

The next fragment of the film was the presentation of the plan to the professional (the child-protection-guardian), who “accepted” the plan, because the mother had promised to contact the mental health care service on alcohol addiction the next day, and the grandma would supervise that. It was clear that the main condition was “to accept treatment”, while I had always thought that FGC was really about a wider flexibility on solutions. But this construction almost resembled Community Treatment Orders, where a person has to be submissive to treatment to NOT be institutionalized. This was really really shocking and painful.
Rob closed the film by saying “FGC is only an inbetween between professionals and family”. I couldn’t make sense of it anymore. I though FGC was a tool to empower families, not to make them submissive to the care system. It was very confusing and disturbing. I don’t know if I like FGC anymore.

I was really glad that at least the coordinators-training was good and inspiring, so that allows me to keep some hope in FGC. With a good coordinator, and real flexibility towards solutions, the idea of a family group making their own plan could work. So not all is lost.
And in Japan, the network has the freedom to make their own practice of family group plan-making, and I noticed a high level of awareness amongst the participants, and many active pioneers pushing for the needed change in Japan. I do have faith in that, and I am really curious to see how the developments will proceed in Japan. There is certainly hope.

After the film there was some time for questions. I was still too much in shock to say anything, and so were many. One person even left the room out of protest. So also today there was a lot of tension in the referrers-training, where also a lot of users/survivors of psychiatry were in. We shared the feelings of shock. That was good, to be not alone.

Then it was lunchtime. We went to the 26th floor of the building, where sandwiches were awaiting us, and we had a nice view over Tokyo. In this room we had our closing session. All participants were asked to give their reflection on the past 4 days of FGC training, and each of them took the time to state what they had experienced, learned or realized. That was very interesting. All people were inspired by the FGC-model, some took it as hints to develop something, and others embraced the model. That was a very positive result of course. The atmosphere was positive.
Many remarks were made about the vulnerability of persons with psychosocial and intellectual disabilities, and the risk of their voice being overruled by family or professionals, because stigma and discrimination are very big in Japan. Repeatedly it was said that attention needs to be paid to the conflict of interest (dominant family interest), conflict in information (dominant medical model), and the need for a support person to empower the voice of the person with psychosocial or intellectual disabilities in an FGC. I personally was very happy to hear these points, because I have been saying that as well to the FGC organization in the Netherlands. I now felt recognized and not alone. I felt more connected to the Japanese participants, than to the Dutch persons. And the recognition of perspective was empowering to me. That made me feel okay, and I avoided the Dutch persons further on.
It was also an extreme compliment to hear that several participants had come especially to see me, and when the microphone passed me, I apologized that the programme hadn’t left me much room to make a contribution. But on 25 July I will have a lecture in Tokyo in the evening, and everyone is welcome of course.

After the round of statements, Rob, Hedda and I were thanked for our contributions, and we got a present of appreciation. I got a very nice stamp of my name Jolijn spelled in Kanji characters, with the meanings: Sunshine Orchid, very nice!
Rob and Hedda also had a present for all participants, and they symbolically gave them flower-seeds. That was also nice of course.

After the conference I stayed with the Japanese users/survivors and we went to a place across the street, where we had drinks and again delicious food. At some point also the Dutch persons came in, but I kept my distance. When they came to say goodbye, I did make a remark that I wasn’t so happy about the process, and afterwards I have emailed them with some feedback. I spent all evening with the Japanese users/survivors and organizers. And I had a great time, exchanging experiences and views, and fun and laughter. It was really good. I feel great now, even though it was a very intense day. I will have some free time in Tokyo now (but I also need to do a lot of work that is piled up). And I am really looking forward to the meetings with the Japanese organization of Mentally Disabled Persons. I feel blessed again :)