A novel way of Integrative Multimodal Practice
Fonagy, Target, Asen, Fuggle, Bevington
working
Wiki-
Wiki-
manualization...
“Only connect.”
Dr Dickon Bevington E.M. Forster
Dr Peter Fuggle From Multi-muddle... ... To Multi-modal
Beyond the manual…
MANUALIZATION - PROS:
• Standardisation - for research: “what are we testing?”
• Using ‘What Works for Whom’ – reduce the
“have my favourite intervention” factor…
• Quality Assurance – commissioners need to know what
they are buying.
• Practitioner confidence – Steven Scott research:
manualized Treatments work better. Evidence from MST.
• Look good on your shelf
Towards a solution
Beyond the manual…
• Integrative
Bring assessment, note-taking, outcomes-measurement
MANUALIZATION CONS: and manualized interventions into a single place.
• Outdated before you start – Evidence base shifts. • Interactive
• One-size-fits-all - no it doesn’t Link assessment material meaningfully via simple algorithms to
suggest specific interventions.
• Top-down disempowerment – “they don’t know
our clients, our geography, etc…” • Wiki-based
Allow/encourage teams to tweak, adjust, add links,
• Difficult or expensive to access - while retaining ownership of core content and capacity to ‘lock down’
for outcomes evaluations.
• Nobody reads them anyway…
• Encourage sharing of best practice
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Technical Must-haves
• Avoid expensive desktop software that • Jeremy Ruston
needs repeated updates.
• Avoid reliance on web connectivity, and • Jon Lister, Nick Webb
attendant risks re. confidentiality, • BT-Osmosoft
intrusions (hacking).
• Must run on the cheapest available • Open-source community
hardware - £200 laptops, or existing
desktop PC’s (or Apple Macs) • www.tiddlywiki.com
• Must work!
Wiki
• Iterative editing – “marriage”/conversation
between ‘top-down’ evidence-based material
and local expertise.
• ‘Work in progress’
• Iterative statement of Team identity
– Argue
– Agree (manualize~mentalize)
– Induction tool
• Social interactive Disciplines and Rituals
– Training
Main template
Show and tell
Team templates Team templates Team templates
Patient ‘workbooks’
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