DREAM-A-WORLD CULTURAL THERAPY Frederick W. Hickling CD, DM, FRSM, FRCPsych, DLFAPA Caribbean Institute of Mental Health & Substance Abuse (CARIMENSA), University of the West Indies. Mona, Jamaica. Turning The World Upside Down, London , November 27, 2013
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DREAM-A-WORLD CULTURAL THERAPY
Frederick W. Hickling CD, DM, FRSM, FRCPsych, DLFAPA Caribbean Institute of Mental Health & Substance Abuse (CARIMENSA), University of the West Indies. Mona, Jamaica.
Turning The World Upside Down, London , November 27, 2013
DREAM-A-WORLD CULTURAL THERAPY
Frederick W. Hickling CD, DM, FRSM, FRCPsych, DLFAPA Caribbean Institute of Mental Health & Substance Abuse (CARIMENSA), University of the West Indies. Mona, Jamaica.
Turning The World Upside Down, London , November 27, 2013
Cultural therapy, was pioneered at Bellevue Hospital in 1978
“Madnificent Irations” A historical pageant of madness in Jamaica
Psychiatry in Jamaica has been assimilated into Primary & Secondary public health care
Jamaican society – Little Economic growth or development in 50 years
RESILIENT PRODUCTIVE 60% ADULTS
TRANSGRESSIVE UNPRODUCTIVE
40% ADULTS
HEALTHY PRODUCTIVE
ADOLESCENTS
Healthy resilient reading by age 8Disruptive, underperforming NOT
reading by age 8
MENTALLY UNHEALTHY DISRUPTIVE ADOLESCENTS
CHILDREN 0-3: - Economic & social inequality; high viability, high risk
DREAM-A-WORLD CULTURAL THERAPY
?
HOWEVER THE TRANSGRESSIVE
BEHAVIORAL UNDERBELLY OF THE SOCIETY HAS BEEN
EXPOSED:
The third highest murder rate in the world
Krause, K., et al (2011).
The third lowest suicide rate in the worldAbel, W., et al (2007)
Jamaican children are suffering
• High physical abuse and neglect• High rates of sexual molestation
Jamaican children are suffering
• 40% pregnancies under 16 years old • 50% school dropout rates & illiteracy
Jamaican children are suffering
• High rates of youth aggression & criminality
MENTAL HEALTH CHALLENGES FOR THE NEW MILLENNIUM
• A shift from curative to preventative mental health care
MENTAL HEALTH CHALLENGES FOR THE NEW MILLENNIUM
• Creation of antidotes for conduct and impulsivity disorders
MENTAL HEALTH CHALLENGES FOR THE NEW MILLENNIUM
• Creation of antidotes for anti social behavior
MENTAL HEALTH CHALLENGES FOR THE NEW MILLENNIUM
• Promotion of self-esteem and self-confidence
A bold new University of the West Indies
initiative in primary mental health
prevention
Caribbean Institute of Mental health & Substance Abuse
(CARIMENSA)
GOVERNMENTAL ORGANIZATIONS
(Health, Education,
Security etc)NGO’S TRANSITION TO
SCALE
SCALE UPSERVICES
EVIDENCED BASED OUTCOMES
CARIBBEAN INSTITUTE OF MENTAL HEALTH AND
SUBSTANCE ABUSE (CARIMENSA)
PROOF OF CONCEPT TRAINING
UNIVERSITY OF THE WEST INDIES
Recent international studies have demonstrated that children who cannot read by age 8 are most likely to become involved in high risk behaviors.
Huesmann LR, Eron LD, & Yarmel PW, 1987
ACHIEVEMENT GAP OF CHILDREN IN UK
Carimensa & Allman Town Primary Dream A World Cultural Therapy
‘Proof of Concept’ 2006
The Dream-A-World Process
• 30 who had failed Grade 3 Test, 30 controls
The Dream-A-World Process
• 40 hour 3-week workshops in summer vacation
The Dream-A-World Process
• 60 hours ‘top-up’ sessions during the term
The Dream-A-World Process
• 240 hours over 2½ years
The Dream-A-World Process
• Annual ‘Show and Tell’ performance
IDENTITY
Laminated photo-ID’s boosted self esteem
The Dream-A-World Workshop
• Breakfast and lunch• Daily literacy & numeracy
The Dream-A-World Workshop
• Psychotherapy ‘small groups’• Identify things they like in their world
The Dream-A-World Workshop
• Invent a new Planet comprising things they like - ‘Dream-A-World’
The Dream-A-World Show & Tell Pageant
• Created a play of their new World• Created songs about their new planet
The Dream-A-World Show & Tell Pageant
• Created costumes and masks• Performed to their community family
The Dream-A World Cultural Therapy process:
• Catalyzes the creative imagination
The Dream-A World Cultural Therapy process:
• Focuses on the drum and homemade instruments
The Dream-A World Cultural Therapy process:
•Creates music, songs, dances, skits and artwork
We took the children on field trips
We taught them to hug
PILOT PROJECT PROOF OF CONCEPT RESEARCH ARTICLE.
Promoting Resilience in High-risk Children in Jamaica: