Future Oriented Group Training

							Future Oriented Group Training
Wessel van Beek, October 2007




We developed a treatment program for people with suicidal ideations. Our aim is to
offer a method that can be easily implemented and that is based upon scientifically
proven elements. With this treatment we want to help patients to regain their trust
that they can influence their own lives and futures. We called it ‘Future Oriented
Group Training’ because we hope that we can help participants to construct a
meaningful personal future.
There are a few treatment programs for suicidal patients, but we are not aware of
any programs meant for people with thoughts about suicide.


4 Cognitive therapy
A major part of the treatment is based upon the findings from research on cognitive
therapy. The ideas and research done by Aaron Beck, Gregory Brown and by David
Rudd and Thomas Joiner, motivated us to insert a cognitive therapy section in our
treatment. In the training we particularly discuss the role of negative thinking in
amplifying hopelessness. The counterpart, construing thoughts about possibilities
and positive outcomes, is another main topic.


4 Motivation reinforcement
People who come into our therapy are afraid to change, because they need their
protection to (sometimes literally) survive. They are scared to fantasize about a
positive future, because they feel that they cannot cope with more pain and setback.
On the other hand people know something needs to change and their lives need to
get better. During our training we stimulate people to deal with this internal struggle
and strengthen their inner motivation. We use several techniques for this, most of
them lend from Motivational Interviewing, developed by Miller & Rollnick.


4 Positive Psychology
Another part of the treatment program is stimulating participants to find back their
own qualities and strength. We know from Positive Psychology, people like Martin
Seligman and Mihaly Csikszentmihalyi, how important it is to help people to use their
positive characteristics in becoming happier persons. Some depressed people lose
the connection with their strength and virtues, lose their Reasons for Living and
become suicidal. We try to teach people to use their capabilities once again.


4 Problem solving
Suicidality is correlated with decreased problem solving, according to most experts
in this field, like Marsha Linehan, Keith Hawton and Mark Williams. Suicidal patients
lose their abilities to solve even minor problems, they ruminate on problems and
tend to avoid instead of solve problems. During our training we use ideas from
problem-solving therapy to help people reach their personal meaningful goals. We
do not focus on problems, but on possibilities. Stop worrying about what can not be
done and start focusing on what is possible. And which techniques and tricks can
you use in order to reach your own goals?


4 Coaching
Another aspect of our training is to break the isolation most suicidal people are in.
We encourage them to talk about this therapy with others and to ask someone to be
their coach during this training. The role of this coach is to help the participant
understand the theory and to support him practicing. Someone’s coach can attend a
group meeting when it’s helpful.


4 Workbook & audio recordings
We provide a workbook with texts which participants are supposed to read, and with
exercises participants are supposed to do. So we do have homework assignments,
meant to bridge the gap between theory and everyday life. We put some of these
exercises on an audio cd, on which we read out the text accompanied by relaxing
music or sound. We hope to stimulate different sensory inputs (reading, listening,
watching the trainer) in order to get the best possible effect.


4 Group meetings
People who participate in the training visit the 10 group sessions of 1½ hours each.
In a group of about 8 people they discuss the workbook and the exercises with their
fellow group members and the therapist/trainer. Attending the group meetings is a
requirement. Focus of the group training is the encouragement of mutual future
oriented health promoting behavior and understanding suicidality. We actively
discourage talking about problems or causes of the current suicidality and misery.
We want to be a work-group instead of a talking-about-problems therapy group.


4 Website
We use an internet website in order to provide information on the project
(www.toekomstgerichtetraining.nl/english for an English summary). On the site
people can download text files and find links to other useful websites and phone
numbers of institutions and facilities.


4 Research project
The treatment is also part of a scientific research. We do a Randomized Clinical Trial
in which we compare suicidal people who partake in this training, with both suicidal
people who get treatment as usual and non suicidal patients (N=210). One of the
underlying research questions is how suicidality is related to the concepts of future
thinking and time orientation. Hopelessness in suicidal people has to do with a lack
of positive future thinking, according to researchers like Andrew MacLeod, Rory
O’Conner and Mark Williams. We want to find out if suicidal people are less able to
think about a positive future and whether this has to do with a predominant focus on
the negative past. And is this lack of positive future thinking related to a more stable
individual cognitive emphasize on certain time frames (past, present, future), the
concept of time orientation as has been researched by Philip Zimbardo and John
Boyd?




The training is currently being researched in a Dutch psychiatric population. When
the results are hopeful, we intend to make it available for other Dutch speaking
patients.


Please feel free to respond: ) w.van.beek.hil@symfora.nl