Core Unit 2: Relationships, recovery and care and treatment planning

7/27/2019 Core Unit 2: Relationships, recovery and care and treatment planning

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Uned Graidd 2: Adeiladu perthynas,

gwellhada chynllunio gofal a thriniaeth

Core Unit 2: Relationships, recovery

and care and treatment planning


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Uned Graidd 2: Adeiladu perthynas, gwellhad a chynllunio gofal a thriniaeth

Uned Graidd 2: Adeiladu perthynas, gwellhad a chynllunio goal

a thriniaeth

Oriau hyorddi yn gysylltiedig r Uned hon: 3 Awr

Nod yr uned

Helpu cyranogwyr i ddeall yn well sut maer berthynas y maent yn ei urfo el cydlynwyr goal

yn gallu helpu i genogi gwellhad denyddwyr gwasanaeth.

Pri negeseuon i hwyluswyr

Yn yr uned hon, dylair hwylusydd bwysleisior canlynol:

ermwyngweithreduMesurIechydMeddwl(Cymru)2010yneffeithiolrhaidrhoisylw

goalus a pharhaus ir berthynas rhwng y cydlynydd goal ar denyddiwr gwasanaeth

boddulliaurtmogynlluniogofalathriniaethynseiliedigarhwylusoperthynasfuddiolrhwng y bobl dan sylw.

Cywyniad

MaeLlywodraethCymruwediymrwymoisicrhaubodgwellhadwrthgaloneibolisiiechyd

meddwl.MaeMesurIechydMeddwl(Cymru)2010;RheoliadauIechydMeddwl(Cydlynu

gofalachynlluniogofalathriniaeth)(Cymru)2011arCodYmarferargyferRhannau2a3

oFesurIechydMeddwl(Cymru)2010ynpwysleisiogwerthgwellhadachynlluniogofaldrwy

ganolbwyntio ar ganlyniadau i ddenyddwyr y gwasanaeth iechyd meddwl o ewn goal iechyd

meddwl eilaidd.

Maerdullgwellhadyngalwamfathhollolwahanoloberthynasgydardefnyddiwrgwasanaeth.

Bydd angen i gydlynwyr goal arbenigo mewn:

rhoillaisiddefnyddwyrgwasanaetha;

manteisioargyeoeddirymuso,ahybucyfrifoldebpersonolacymrwymiadatgynnydd.

Byddyrunedhonynrhoicyeigyfranogwyrystyriedsutigreuperthynassynhybugwellhad

unigolion yn rhan ou rl el cydlynydd goal. Rhoddir sylw ir elennau craidd yn y berthynas

syn hybu gwellhad ac yn benodol, sut mae dull cyathrebu cydweithredol yn gallu cynnig

strategaethau syn hybu gwellhad.


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Core Unit 2: Relationships, recovery and care and treatment planning


Training hours associated with this Unit: 3 hours

Aims o the unit

To enhance participants understanding o how the relationships they orm as care coordinators

can help to support the recovery o service users.

Key messages or acilitators

Inthisunit,thefacilitatorshouldemphasisethefollowing:

effectivedeliveryoftheMentalHealth(Wales)Measure2010requirescarefulandon-going

attention to the relationship between the care coordinator and the service user.

theteamapproachtocareandtreatmentplanningisbasedonfacilitationofhelpful

relationships between those involved.

Introduction

TheWelshGovernmenthasplacedacommitmenttorecoveryattheheartofitsmentalhealth

policy.TheMentalHealth(Wales)Measure2010;theMentalHealth(CareCoordinationandCare

andTreatmentPlanning)(Wales)Regulations2011andtheCodeofPracticetoParts2and3of

theMentalHealth(Wales)Measure2010emphasisethevalueofrecoveryandoutcomesfocused

care planning or mental health service users within secondary mental health care.

Recoveryrequiresattentionbepaidtotherelationshipwiththeserviceuser.Carecoordinators

willrequireexpertisein:

givingavoicetoserviceusersand;

exploitingopportunitiestosupportempowermentandenhancepersonalresponsibilitywitha

commitment to progress.

This unit will enable participants to consider how they may build relationships or recovery as

part o their role as a care coordinator. Attention will be paid to the core components o recovery

relationships and particularly to how a collaborative communication style can provide a strategy to

promote recovery.


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Canlyniadau dysgu

Adnoddau dysgu angenrheidiol:

Siartfipneufwrddgwynaphinnaulliw

CyfriadurathaunyddPowerPoint

Digonogopauortaennigwaithaphapuriwneudnodiadau

Cynllun y wers

Ar l cwblhaur uned hon bydd y cyranogwyr yn:

1 nodir pri elennau mewn perthynas syn hybu gwellhad

2 cydnabod pwysigrwydd cyathrebu cydweithredol wrth gydlynu goal

3 dangos sut mae dull cydweithredol o gydlynu goal yn gallu helpu gydag ymddygiad gwellhad

Amser

(munudau)Focws

Canlyniadau

dysgu

cysylltiedig

Dull dysgu/

adnoddauCynnwys

5 munudGweithiotrwyr

unedauCywyniadau Sleid1

10munudRhan 1:Cywynorunedacadolygu gwybodaeth

Sleidiau 2 5

30munudCyfathrebumewncyd-destundwyieithog

Ymarer 1Cyfathrebumewncyd-destundwyiethog

Thaen1

ClipDVD

35 munud

Rhan 2:Perthynasbaternalistig apherthynas i helpu

gwellhad

1 Traodaeth grwpSleid 6

ClipDVD

45 munudCyfathrebuCydweithredol

2Ymarer 2Traodaeth grwp

Sleidiau 7 8

Taen2

40munudRhan 3:Trosglwyddo

3Ymarer 3Traodaeth grwp

Taen3

ClipDVD

15munud Crynhoi

Cwestiynau

negeseuon addysgwyd


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Learning outcomes

Required teaching resources:

ipchartorwhiteboardandcolouredpens

computer and PowerPoint projector

sufcientcopiesofthereectionworksheetsandpaperfornotes

Lesson plan

On completion o this unit the participants will be able to:

1identifythekeyelementsofarelationshipthatpromotesrecoverywhichareconsistent

withtheaimsoftheMentalHealth(Wales)Measure2010

2 recognise the importance o collaborative communication to support care coordination

3demonstrate how a collaborative approach to care coordination can support recovery

behaviours

Time

(minutes)Focus

Related

learning

outcomes

Teaching method/

resourcesContent

5 mins Orientation Introductions Slide1

10mins

Section 1:Introduceunit& review oinormation

Slides 2 5

30minsCommunicationinabilingualcontext

Exercise 1Communicationinabilingualcontext

Handout1

DVDclip

35 mins

Section 2:Paternalisticrelationships

and recoveryrelationships

1 GroupdiscussionSlide 6

DVDclip

45 minsCollaborativecommunication

2Exercise 2Groupdiscussion

Slides 7 8

Handout 2

40minsSection 3:Transitions

3Exercise 3Groupdiscussion

Handout 3

DVDclip

15mins ConclusionQuestions &takehomemessages


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Cynllun gwers manwl

Gweithio trwyr uned

Sleid 1:GallechddangosysleidPowerPointcyntafwrthibawbgyrraedd.

Yndibynnuarysefyllfa,gallechfanteisioarycyeigywynoeichhunarcyfranogwyriwgilydd.

Peidiwch threulio gormod o amser yn gwneud hyn.

Rhan 1: (40 munud)

Cywyniad ir uned

Sleidiau 2 a 3:Cywynwchnodauachanlyniadauruned.Dyliddangosyrhainautrafod

yn yr.

Cyathrebu mewn cyd-destun dwyieithog

Ymarer 1:

Taen 1:

Maerfforddyrydymyndefnyddioiaithyngalludibynnunfawrarysefyllfayrydymynddiac

maengalluamrywioornaillsefyllfairllall.Mewnsefyllfaoeddanghyfarwyddefallaiybyddem

yn awyddus i greur argra iawn a theimlo gorodaeth i gydymurfo norm y lleoliad yr ydym

ynddo.MeddyliwchamddefnyddwyrgwasanaethsyddynwellganddyntsiaradynGymraeg

(oherwyddeubodyngallumynegieuhunainynwellynddi)synderbyngwasanaethneunmynd

i gyarod i adolygur cynllun goal. Sut maen nhw yn teimlo, ydyn nhwn teimlo dan orodaeth i

ddenyddio iaith benodol?

Pwrpas yr ymarer hwn yw annog cyranogwyr i eddwl am eu hymarer el gweithwyr iechyd

meddwlosafbwyntdefnyddwyrgwasanaethsyddangendefnyddiorGymraeg.

Denyddiwch Daen 1 i draod y materion hyn os ydych yn meddwl nad oes denyddwyr

gwasanaethafyddaindewissiaradCymraegyneichgwasanaeth,gofynnwchichhunair

rheswm am hyn yw ein bod ni heb oyn iddyn nhw pa iaith yddain well ganddyn nhw neu ba iaith

syddeihangenarnynnhw?Maetystiolaethsynawgrymubodpoblynderbyngwasanaethau

Saesneg oherwydd eu bod yn meddwl mai dim ond hynny sydd ar gael1.

Mewngrwpiaubachtrafodwchysenarioyn Nhaen 1 a cheisiwch gael adborth gan y grwp gan

ysgrifennueuhymatebionarsiartfip.

1MaerymaferhwnarwybodaethwedieihaddasuoTheyallspeakEnglishanywayAdnoddHyfforddi

YmwybyddiaethorGymraeg.CyngorGofalCymru.


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Detailed lesson plan

Orientation

Slide 1:YoumightliketohavetherstPowerPointslideshowingwhenparticipantsarrive.

Dependingonthesituation,youmightliketointroduceyourselfandparticipantstoeachother.

Thisshouldbekeptfairlybrief.

Section 1: (40 mins)

Introduction to the unit

Slides 2 & 3: Introducetheaimsandoutcomesfortheunit.Theseshouldbeshownand

brieydiscussed.

Communication in a bilingual context

Exercise 1:

Handout 1:

How we use language can be heavily dependent on the situation we fnd ourselves in and can

varyfromsituationtosituation.Inunfamiliarsettingswemaybeverykeentocreatetheright

impressionandfeelcompelledtoconformtothenormsofthesettingwearein.Thinkabout

serviceuserswhoprefertospeakinWelsh(becausethisisthelanguagetheyfeelmostable

toexpressthemselves)enteringacareplanreviewmeeting.Howmighttheybefeeling,what

compulsionmighttheybeexperiencingwhenitcomestotheuseoflanguage?

ThisexerciseisintendedtoencourageparticipantstothinkabouttheirpracticeasworkersformentalhealthandtheexperienceofserviceuserswhoselanguageofneedisWelsh.

Use Handout 1todiscusstheseissuesifyouthinktherearenoserviceuserswhoprefer

tospeakWelshinyourservice,askyourselfisthisbecausewehavenotaskedthemwhich

languagetheypreferorneed?ThereisevidencetosuggestthatpeopleacceptEnglishonly

servicesbecausetheythinkthatisallthatisonoffer1.

InsmallgroupsdiscussthescenarioinHandout 1andgainfeedbackfromparticipantswhile

writingtheirresponsesonaipchart.

1ThisexerciseandinformationisadaptedfromTheyallspeakEnglishanywayAWelshLanguageAwareness

TrainingResource.CareCouncilforWales.


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Nodiadau ir hwylusydd: Efallaiycewchadborthsyncyeupryderamygorbwyslaisary

Gymraegardraulgrwpiaudiwylliannoleraill.MaeCodYmarferyMesurIechydMeddwlyn

cyfeirionarbennigatanghenionsiaradwyrCymraeg.Hefyd,maeMesuryrIaithGymraeg2011

ynnodinglirydylidtrinyGymraegyngyfartalrSaesneg.FellymaellearbennigirGymraegyn

y ddeddwriaeth, a dylai pawb yn y grwp od yn ymwybodol o hynny.

Clip DVD:

Chwaraewchglipoddefnyddiwrgwasanaeth/gweithiwriechydmeddwlyntrafodeu

proadogaelmynediadatwasanaethauCymraeg.DVD


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DVD

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Notes or acilitator: Youmayexperiencesomefeedbackwhichreectsaconcernonanover

emphasisontheWelshlanguageattheexpenseofotherculturalgroups.TheCodeofPractice

fortheMentalHealthMeasuremakesspecialreferencetomeetingtheneedsofWelsh

speakers.Additionally,theWelshLanguageMeasure2011,clearlyidentiesthatWelshshould

betreatednolessfavourablythanEnglish.ThereforetheWelshlanguagehasaspecialplace

within the law and this should be noted by participants.

Clip DVD:

Playaclipofaserviceuser/mentalhealthworkertalkingabouttheirexperienceof

gainingaccesstoWelshlanguageservices.


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Rhan 2: (80 munud)

Sleidiau 4 a 5: Trosolwg o egwyddorion gwellhad

Gellirdefnyddiorrhainosbyddangenatgoffargr wpamydulloymdrinagelfennaugwellhadmewn gwasanaethau iechyd meddwl. Fel gyda phob traodaeth ar wellhad, bydd angen rhoi sylw i

sicrhaugwellhadyngnghyd-destungofalpoblhwnacirrhaisyddyngngwasanaethCAMHS.

Perthynas baternalistig a pherthynas i helpu gwellhad

Sleid 6: Perthnasau paternalistaidd a pherthnasau gwellhad

Maersleidhonyncyfeiriosutiddefnyddioperthynasihelpugwellhad.Maegwrandogweithredol

a rhoi sylw i bersbecti gwahanol yn hanodol er mwyn creu perthynas a gweithio tuag at

benderyniadau ar y cyd.

Nodiadau ir hwylusydd: Maenbwysignodibodmwynagundifniadowellhadabodydifniada

ddenyddir yma yn cyeirio at y themu cyredin syn dod yn amlwg drwy nier o ddifniadau.

MaerrhainynseiliedigarHafal 3, nodwch y bydd angen i bawb syn gweithio ym maes goal i bobl

hynneuCAMHSaddasurmodelsyddyma.Treuliwchamsergydagrwpiauneglurormaterionhyn

cyn symud ymlaen.

Clip DVD:

Gwrandewcha/neugwyliwchydefnyddwyrgwasanaethyntrafodsutmaeeuperthynas

gydau cydlynydd goal wedi helpu eu gwellhad.

Sleidiau 7 a 8:Cyfathrebucydweithredol

Maerrhainyncyfeirioatgyfathrebucydweithredol.Ynamlcyfeiriratofeldullsyndefnyddio

deialog yn hytrach na chyathrebu hierarchaidd neu ddull monolog. Y gwahaniaeth yw hyn nid od

rhywunynsiaradnhweuhunain(monolog)ondeubodynsiaradgydaphersonarallmewnffordd

synatalypersonarallrhagcyfrannunllawnatybroses.Maecyfathrebutrwyfonologyncaeleigrynhoi gan Richard Johannesen4.

Apersonemployingmonologueseekstocommand,coerce,manipulate,conquer,dazzle,

deceive,orexploit.Otherpersonsareviewedasthingstobeexploitedsolelyforthe

communicatorsself-servingpurpose:theyarenottakenseriouslyaspersons.Choicesare

narrowedandconsequencesareobscured.Focusisonthecommunicatorsmessage,not

ontheaudiencesrealneeds.()Monologicalcommunicatorspersistentlystrivetoimpose

theirtruthorprogramonothers;theyhavethesuperiorattitudethattheymustcoerce

peopletoyieldtowhattheybelieveothersoughttoknow(page69).

DVD

3Hafal(2009)Fyadferiad:cynllungamwrthgamargyferpoblagaechydmeddwldifrifol.

4Johannesen,R.L.(1996).EthicsinHumanCommunication,ProspectHeights,WavelandPress.


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Section 2: (80 minutes)

Slides 4 & 5: An overview o recovery principles

Thesemaybeusedifparticipantsrequireareminderofanapproachtothecomponentsofrecovery in mental health services. As with all these discussions on recovery, attention will be

neededinarticulatingrecoveryinthecontextofcareofolderpeopleandforthosewithinthe

CAMHservice.

Paternalistic relationships and recovery relationships

Slide 6: Paternalistic relationships and recovery relationships

This slide provides an overview o how relationships can be used to support recovery.Activelisteningandattentiontodifferentperspectivesareessentialrequirementsinbuilding

relationshipsandworkingtowardsshareddecisionmaking.

Notes or acilitator: Itisimportanttoacknowledgethatthereisnotonlyonedenitionofrecovery

andthatthedenitionusedherepicksuponcommonthemesfromanumberofdenitions.

These are based on Haal5, please note that the approach presented here will need adaption by

participantswhoworkincareofolderpeopleorCAMHS.Spendtimewithgroupsonclarifying

these issues beore proceeding.

DVD clip/audio clip:

Listenand/orwatchserviceuserstalkingabouthowtheirrelationshipwiththeircare

coordinator has promoted their recovery.

Slides 7 & 8: Collaborativecommunication

These outline collaborative communication. This style is oten reerred to as engaging in dialogue

and is contrasted to hierarchical communication. The dierence here is not between someone

talkingtothemselves(monologue)buttalkingtoothersinwaysthattheothersareexcludedfromfullparticipationintheinteraction.Communicationwhichdoesnotencouragefullparticipation

has been summarised by Richard Johannesen6.

Apersonemployingmonologueseekstocommand,coerce,manipulate,conquer,dazzle,

deceive,orexploit.Otherpersonsareviewedasthingstobeexploitedsolelyforthe

communicatorsself-servingpurpose:theyarenottakenseriouslyaspersons.Choicesare

narrowedandconsequencesareobscured.Focusisonthecommunicatorsmessage,not

ontheaudiencesrealneeds.()Monologicalcommunicatorspersistentlystrivetoimpose

theirtruthorprogramonothers;theyhavethesuperiorattitudethattheymustcoerce

peopletoyieldtowhattheybelieveothersoughttoknow(page69).

DVD

5Hafal(2009)Myrecovery:astepbystepplanforpeoplewithseriousmentalillness.

6Johannesen,R.L.(1996).EthicsinHumanCommunication,ProspectHeights,WavelandPress.


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Maecyfathrebucydweithredolynddullsyndefnyddiodeialogermwyngwahoddpobligymryd

rhanynllawn.Gydardullhwnmaercyfathrebwryngwerthfawrogibarnasafbwyntiaupobleraill

yn hytrach na chadwn gaeth at y cwestiynau neu orodi eu syniadau neu eu hiaith eu hunain er

yn gwneud hynny weithiau trwy roir argra od cyranogi go iawn yn digwydd.

Mae sleid 7 yn dangos sut maer dulliaun wahanol:

Mewnmonologmaeunfarnynbwysigtraboddeialogyncydnabodbodsawlfforddoedrych

ar bethau.

Oi gymharu deialog, mae monolog yn tueddu i gynnwys llawer llai o negydu neu draod, mae

llawermwyobwyslaisargaelypersonaralliweldeinsafbwynt(cyfarwyddoadweud).Mae

deialog yn gwahodd negydu a gwahanol sabwyntiau.

Nodiadau ir hwylusydd:MaerCodYmarferynrhoipwyslaisarbennigarsgiliaucyfathrebuwrth

sicrhaugofynionMesurIechydMeddwl(Cymru)2010.

Heyd, gall od yn bwysig ystyried materion pwer a chyathrebu mewn cynlluniau goal athriniaeth.Gellirrhoisylwarbennigiblantaphoblifancaphoblhyn.Maergrwpiauhynyngallu

bodynagorediniwedagorfodaethoherwyddeubodyncaeleuhystyriedynanaeddfeda/neu

ynllaigalluog.Mewnymarferclinigolgalldullcyfathrebunadywnannogyrunigolynigyfrannu

gynnwys peth ymdrech i wrando ar y denyddiwr gwasanaeth cyn mynd ati wedyn i ysgriennur

cynllun goal ar sail sylwadau a barn y clinigwr yn unig gan beidio chynnwys yn y cynllun goal

a thriniaeth y gwahaniaethau gwirioneddol rhwng sabwyntiaur naill ar llall.

Ymarer 2:SenariosDavidaNeal/Lloyd,DilysaFon

Yn yr ymarer hwn, rhaid ir grwp ddarllen un or trawsgrifadau ar Daen 2 neu 2a. Ar l darllen

y deunyddiau, goynnir iddynt ysgriennu eu sylwadau yn y llyr gwaith a thraod mewn grwpiau

bachcyneucywynoirprifgrwp.

Taen 2 a 2a: cyathrebu cydweithredol

Gofynnirirgrwpystyriedpamorberthnasolywrhanesyniwhymarfernhwfelcydlynwyrgofal.

Gofynniriddyntaallantfeddwlamffyrddiwellalefelycyfathrebucydweithredolwrthr yngweithio

defnyddwyrgwasanaeth.MaerCodYmarferyngofynigydlynwyrgofalgefnogicyfathrebucydweithredol, eeithiol gyda denyddwyr gwasanaeth a goalwyr. Rhaid i unrhyw beth syn atal

cyathrebu eeithiol gael ei gydnabod ai oresgyn, os yn bosibl.

Maecopauortrawsgriadauargaelar Daen 2 neu 2a. Dylair cyranogwyr nodi enghreitiau o

gyathrebu cydweithredol a chyathrebu syn atal deialog.

Dylid rhoi sylw arbennig i:

ymddygiadcadarnhaolwrthymarferdodchopiorcynllungofaliwdrafod

ymddygiadcyfathrebuatalgwrthdaro

ymddygiadprosesmeddwlamddullcamwrthgamigreucynllungofal.


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Collaborativespeechisarealdialogueinthatitopenlyinvitesfullparticipation.Itisabouthowthe

communicator values other peoples opinions and worldviews rather than cutting to the chase

or imposing their own ideas or their own language, sometimes whilst maintaining an image o

participation.

Slide 7 shows these contrasts:

Non-participativecommunicationseesoneviewashavingimportancewhereasdialogue

acknowledgesthattherecanbemanyequallycompellingwaysofseeingthings.

Monologuetendstoinvolvefarlessnegotiationthandialogue;thereismuchmoreemphasis

ongettingtheotherpersontoseeourpointofview(instructionandtelling).Dialogueinvites

negotiation and attempts to bring opposing positions into play.

Notes or acilitator:TheCodeofPracticeplacesparticularemphasisoncommunicationskillsin

deliveryoftherequirementsoftheMentalHealth(Wales)Measure2010.TheCodestatesthat

carecoordinatorswillneedtorecordandseekresolutionsofanydisagreementsaboutcareand

treatment planning.

Additionally,itmaybeimportanttothinkaboutissuesofpowerandcommunicationincareand

treatmentplanshere.Ifthisisrelevanttotheaudience,particularattentioncanbeplacedon

children & young people and older people. These groups can be vulnerable and open to coercion

assuchpeoplemaybeseenasimmatureand/orlesscapable.Inmentalhealthpractice,an

approachtocommunicationwhichdoesnotencourageparticipationmightincludemakingsome

efforttolistentotheserviceuserbutthentowritethecareandtreatmentplanusingtheworkers

views and opinions any real dierences in position are eectively written out o the care and

treatment plan.

Exercise 2:ScenariosDavidandNeal/Lloyd,DilysandFon

Inthisexercise,participantsarerequiredtoreadthroughoneofthetranscriptsavailableas

Handout 2 or 2a.Afterreadingthroughthematerials,theyareaskedtowritetheirreectionsin

theworkbookanddiscussinsmallgroups.Therecanthenbefeedbacktothemaingroup.

Handout 2 & 2a: collaborative communication

Participantsareaskedtothinkoftherelevanceofthenarrativefortheirpracticeascare

coordinators.Theywillbeaskedwhethertheycanthinkofwaysinwhichtheycanactivelyincrease

collaborativecommunicationintheirinteractionswithserviceusers.TheCodeofPracticecalls

on care coordinators to pay attention to supporting eective, collaborative communication with

service users and carers. Any barriers to eective communication must be recognised and

wherever possible, overcome.

CopiesofthetranscriptsareavailableasHandout 2 & 2a.Participantsshouldworktoidentify

examplesofcollaborativecommunicationandthecommunicationwhichclosesdialogue.

Pay particular attention to:

positivepracticebehaviourbringingcopyofcareplanfordiscussion

communicationbehaviourclosingdownconict

processbehaviourthinkingintermsofstepbystepapproachestocareplanconstruction.


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Rhan 3: (55 munud)

Sgiliau cyathrebu a Mesur Iechyd Meddwl (Cymru) 2010:

Trosglwyddo

MaeunelfenallweddolamgyfathrebuynyMesurynymwneudphwnctrosglwyddodefnyddwyrgwasanaeth o ewn y gwasanaeth a rhwng un gwasanaeth ar llall. Un enghrait o drosglwyddo

fyddaisymudunigolynorgwasanaethCAMHSirgwasanaethoedolion.Enghraifftarallfyddai

symudunigolynigarcharacorcarchar.Maerllwybrrhwnggwasanaethaunelfenhollbwysigi

sicrhaubodanghenionpoblyncaeleubodloniacnadydyntynmyndargollynysystem.Felgyda

nier o bethau mewn bywyd, mae llwyddiant y prosesau y cytunwyd arnynt yn dibynnu ar gyathrebu

eeithiol rhwng pobl i gilydd.

MaerCodYmarferynawgrymuydylidsefydluperthynaswaithsyddwedieidifnionglirermwyn

cefnogiarheolidefnyddwyrgwasanaethsyddhanesodroseddu.Maerperthnasoeddhynny

yn canolbwyntio ar gynllunio a chydlynu symudiadau rhwng un gwasanaeth ar llall a sicrhau bod

anghenion denyddwyr gwasanaeth yn cael eu nodi au bodloni.

Taen 3: Trosglwyddo

Ymarer 3: Senarios grwpiau bach

Ydasgywgweithiomewngrwpiauodriichwaraerl.Maeununigolynynarsylwi.Ymmhobgolygfa

maetrosglwyddocorfforolneubersonolyndigwydd.

Dywedwch wrth y grwp dreulio 5 munud ar dair senario cyn treulio 5 munud yn cael adborth gan yr

arsyllwr. Dylair ocws yn yr adborth ganolbwyntio ar natur gydweithredol y cyathrebu ac elennau

oegwyddorioncanologMesurIechydMeddwl(Cymru)2010.Efallaiybyddwchynawyddusi

ddangos y sleidiau PowerPoint i atgoa pobl am yr elennau hynny.


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Section 3: (55 minutes)

Communication skills and the Mental Health (Wales) Measure 2010:

Transitions

AkeycomponentofcommunicationwithintheMeasureisonthesubjectofserviceusertransitionwithinandbetweenservices.Anexampleofsuchatransitionwouldbewhenapersonmoves

fromaCAMHservicetoadultservices.Anotherexamplewouldbewhenapersonmovestoand

rom prison. The pathway between services is a critical component in ensuring that peoples

needsaremetandthattheydonotbecomelostwithinthesystem.Aswithmanythingsinlife,it

is eective communication between people that determines the success o agreed processes.

TheCodeofPracticesuggeststhatclearlydenedworkingrelationshipsshouldbeinplaceto

support and manage service users who have a history o oending. These relationships centre

on planning and coordinating movement between services and ensuring service user needs are

recorded in the care and treatment plan.

Handout 3: Transitions

Exercise 3: Small group scenarios

Thetaskistoworkingroupsofthreeandrole-playthescenes.Onepersonalwaysactsasan

observer.Ineachscenethereisatransitioneitherphysicalorpersonal.

Instructparticipantstospend5minutesonthescenariosandthenspend5minutesreceivingfeedbackfromtheobserver.Thefocusonthefeedbackshouldfocusonthecollaborative

natureofthecommunicationandthecomponentsoftheguidingprinciplesoftheMentalHealth

(Wales)Measure2010.YoumaywishtodisplaythePowerPointslidestoremindpeopleofthese

elements.


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Crynhoi

Rhowchgyeigodicwestiynaunaofynnwydeisoes(dylidcadwrsesiwnynfyrachanolbwyntioar

gynnwysyruned).

Dylair uned hon alluogi cyranogwyr i ddeall sut gallan nhw greu perthynas syn hybu gwellhad yneu rl el cydlynwyr goal. Dylai cyranogwyr ddeall bod y math yma o berthynas yn gallu bod yn

wahanol iawn ir berthynas draddodiadol. Dylair cyranogwyr allu deall ac ystyried sut gallan nhw

ddefnyddiodullcyfathrebucydweithredol(deialog)adullymgynghoryddirdefnyddiwrgwasanaethi

genogi gwellhad y denyddwyr gwasanaeth hynny y maent yn gydlynwyr goal iddynt.

Cwestiynau a Beth ydych chi am ei wneud yn wahanol nawr?

Maerrhanhonynrhoicyeirgrwpgaeleglurhadamunrhywbwyntiauagodwydynysesiwn.

Maehefydyngyepwysigiofynigyfranogwyrystyriedcamauymarferolygallannhweucymrydi

helpuiweithredurMesuragofaliechydmeddwlsynrhoipwyslaisarwellhad.

Gofynnwchircyfranogwyrnodiyneullyfraugwaitholeiafuncamybyddennhwngallueigymrydi

wellar broses o gynllunio goal a thriniaeth syn rhoi pwyslais ar wellhad.

Negeseuon a ddysgwyd

Maecynlluniogofalathriniaethynddullsynrhoillecanologiofal.

Nidywperthnasoeddtraddodiadolsynseiliedigarbwerbobamseryncyd-fyndyndda

pherthnasoedd syn hybu gwellhad.

Maecyfathrebucydweithredoldeialogagoredynhanfodolargyfercydlynugofalsynhybu

gwellhad.

MaeegwyddorioncanologyCodYmarferyncyfeirionbenodolatycamaucyfathrebusyn

ofynnoliweithwyriechydmeddwlermwyngweithreduMesurIechydMeddwl(Cymru)2010.

Darllen pellach

Borg,M.&Kristiansen,K.(2004)Recoveryorientedprofessionals:Helpingrelationshipsin

mentalhealthservices.JournalofMentalHealth,13,493505.

Hafal(2009)Fyadferiad:cynllungamwrthgamargyferpoblagaechydmeddwldifrifol.

Rethink(2009)Gettingbackintotheworld.Reectionsonlivedexperiencesofrecovery.Rethink.Llundain

ShepherdG,BoardmanJ&SladeM(2008)MakingRecoveryaReality.SainsburyCentrefor

MentalHealth.Llundain

SladeM(2009)100WaystoSupportRecovery:AGuideforMentalHealthProfessionals.

Llundain.Rethink.


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Conclusion

Offeropportunityforclaricationbyeldinganyquestionsthathavenotalreadybeenasked(keep

briefandfocusedonunitcontent).

This unit should enable participants to identiy how they can build relationships or recovery in

their role as care coordinators. Participants should recognise that these relationships may be very

dierent rom traditional ones. The participants should be able to identiy and consider how they

can use a collaborative communication style to support the recovery o service users.

Questions and What are you going to do dierently now?

This section oers participants and opportunity to clariy any points raised in the session.

Itisalsoanimportantjuncturetoaskparticipantstoexplorepracticalactionstheycantaketo

supportimplementationoftheMeasureandrecoveryorientatedmentalhealthcare.

Askparticipantsintheirworkbookstonoteatleastoneactiontheyfeeltheycantaketoimprove

recovery orientated care and treatment planning.

Take home messages

Careandtreatmentplanningisanapproachwithcareatitsfoundation.

Traditionalpowerbasedrelationshipsdonotalwaystwellwithpartnershipsforrecovery.

Collaborativecommunicationwithopendialogueisavitalfactorforcarecoordinationthat

promotes recovery.

TheguidingprinciplesoftheCodeofPractice2012makeexplicitreferencetothe

communicationactionsrequiredbymentalhealthworkerstodelivertheMentalHealth(Wales)

Measure2010.

Further reading

Borg,M.&Kristiansen,K.(2004)Recoveryorientedprofessionals:Helpingrelationshipsin

mentalhealthservices.JournalofMentalHealth,13,493505.

Hafal(2009)Myrecovery:astepbystepplanforpeoplewithseriousIllness

Rethink(2009)Gettingbackintotheworld.Reectionsonlivedexperiencesofrecovery.Rethink.

London

ShepherdG,BoardmanJ&SladeM(2008)MakingRecoveryaReality.SainsburyCentrefor

MentalHealth.London

SladeM(2009)100WaystoSupportRecovery:AGuideforMentalHealthProfessionals.London.

Rethink.


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Taen 1: Cyfathrebumewncyd-destundwyieithog

Maerdefnyddiwrgwasanaethynamlwgynnerfusacyndweudwrthychchi,eichydlynyddgofal,

ybyddainwellganddisiaradynGymraegacybyddainhofcynnaleichyfarfodadolygunesaftrwygyfrwngyGymraeg.MaenesbonioeibodyngallumeddwlyngliriachynGymraegacyngallu

myneginwellsutmaenteimloabethmaeneifeddwlsyddeiangenarni.Maerdefnyddiwr

gwasanaethynawyddusibeidiochreutrafferthnachaeleihystyriedfelunsynachositrwbwl.

Cynhelirycyfarfodymhenpythefnosacmaertmclinigolyncyfarfodidrafodycais.Maentyn

penderfynunadywradnoddauargael,fellybyddynrhaidirdefnyddiwrsiaradSaesneg.Cytuniry

byddmoddcyeithurcynllungifalirGymraeg.

Cwestiwn 1:

BethmaerCodYmarfersyncefnogiMesurIechydMeddwl(Cymru)2010yneiddweudamy

seylla hon?

Cwestiwn 2:

Yn eich barn chi, sut mae datblygu ymarer cadarnhaol yn y seylla hon?


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Handout 1: Communicationinabilingualcontext

A clearly nervous service user confdes in you, as her care coordinator, that she would preer

tospeakinWelshandthatshewouldliketohavehernextreviewmeetingconductedinthismedium.SheexplainsthatshecanthinkmoreclearlyinWelshandisbetterabletoexpresshow

shefeelsandwhatshefeelssheneeds.Theserviceuseriskeennottocauseafussorbeseen

tobeatroublemaker.

Themeetingisscheduledfortwoweekstimeandtheclinicalteammeettodiscusstherequest.

Theydecidethatresourcesareunavailable,sotheserviceuserwillhavetospeakEnglish.Itis

agreedthatthecareandtreatmentplancanbetranslatedintoWelsh.

Question 1:

WhatdoestheCodeofPractice2012whichsupportstheMentalHealth(Wales)Measure2010,

say about this situation?

Question 2:

Whatdoyouthinkdevelopingpositivepracticewouldbeinthissituation?


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Taen 2:

Ymarer 2: SenariosachosDavidaNeal(1)

Cendir: Gwr34oedywNeal.Maeganddohaneshirogysyllturgwasanaethauiechydmeddwlachaeleidderbynirysbyty,ynamlyndilyncyfnodauostraencynyddolyneifywyd(problemau

ariannol,eiberthynasgydaideuluaiffrindiauagosynchwalu).MaeNealyntuedduiddefnyddio

cyffuriauseico-symbyluacmaencynyddurddospanmaenteimlonadywngalluymdopi.

Roedd Neal wedi torri enestr yng nghartre ei rieni cyn yr achos diwetha pan caodd ei dderbyn ir

ysbyty.Cynhynnyroeddweditorriffenestrisiopau,weditausbwrielatgeiroeddynmyndheibio

ac wedi rhedeg at bobl nad oedd yn eu hadnabod gan chwifo ei reichiau, gweiddi a rhegi mewn

mannau cyhoeddus.

Nidywncredufodganddosalwchmeddwl.Maenmeddwlydylaigaelhawlifyweifywydfely maen dymuno. Ond ar hyn o bryd maen cymryd meddyginiaeth ac maen gorod cadw at

OrchymynTriniaethGymunedol.

Heddiw mae David yn ymweld Neal, se ei gydlynydd goal syn nyrs iechyd meddwl cymunedol.

MaeDavidwedibodyngweithiogydaNealersiddogaeleiryddhauorysbyty9wythnosynl.

MaeNealhefydmewncysylltiadrclinigwrsyngyfrifolamdano,DrGrahameEvans.Maewedi

caeleiatgyfeiriohefydatnyrsarbenigol,SarahHughes.MaeSarahynasesulefelrisgNealac

mae heyd yn gobeithio gwneud ychydig o waith ar reoli tymer.

Trawsgrifad:

David: Trafymodiyma,Neal,dwiamsiaradamdygynllungofalcyninigyfarfodDrEvans,dyweithiwr cenogi a Sarah iw adolygu wythnos nesa.

Neal:Iabethamdanofo?

David: Dw i wedi dod chopi gyda mi i edrych arno i weld beth syn digwydd rhag on bod angen i

ni ystyried newid unrhyw beth.

Neal: Welmiddywedaiunpethsyddangeneinewid,yfeddyginiaeth.Maeneffeithioarnaia

does moi angen o arna i.

David: Dw in gwrando arnat ti ac maen bwysig ei ystyried. Beth am draod hynna mewn munud

gan od triniaeth eddygol yn is i lawr ar y cynllun goal ac mae angen i ni od yn holistaidd acedrych ar bopeth?

Neal: Ondmaenfyngwneudinhollolddiamynedd;ddylaineborfoddioddefrwyndweud

wrthych chi, dw in cael y arteithio. Dw in cael y arteithion llythrennol gennych chi i gyd. Beth

arall ydych chi eisiau ei draod elly?

David: Iawn,ypethcyntafarycynllunywarian,sutmaepethauoranarianydirLwfansBywir

Anabl wedi ei ddatrys bellach?

Neal: Ydi diolch, rhyw bythenos yn l, maen ddrwg gen i ond roeddwn in meddwl y mod wedi sn

wrthychchi!MiddefnyddiaisoifyndiffwrddefoKatepenwythnosdiwethafmiaethpethaunr

rhyngomniynydiweddoherwyddmodingwrthodcymrydfymeddyginiaeth.Miaethhiadrefyngynnar... bitsh, dw i ddim wedi ei gweld ers hynny.


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Handout 2:

Exercise 2: CasescenariosDavid&Neal(1)

Background: Neal is a 34 year old man. He has a long history o contact with mental healthservicesincludingfrequentinpatientadmissions,theseareoftenprecededbyperiodsof

increasinglifestress(nancialproblems,fracturedrelationshipswithfamilyandclosefriends).

Nealtendstouseavarietyofpsycho-stimulantsandincreaseshisintakewhenhefeelsunable

tocope.Admissionisusuallytriggeredbyanexacerbationofcrisisinvolvingthepolice.

Neal had smashed a window at his parents house prior to his last admission. Previously he has

smashed shop windows, thrown rubble at passing cars and ran up to strangers waving his arms,

shouting and swearing in public places.

He does not believe that he is mentally ill and that he should be allowed to live his lie as he

pleases.HoweverheiscurrentlytakingmedicationandissubjecttoaCommunity

Treatment Order.

Today Neal is being visited by his care coordinator who is a community mental health nurse called

David.DavidhasbeenworkingwithNealsincehislastdischargefromhospital9weeksago.

Nealalsohascontactwithhisresponsibleclinician,DrGrahameEvans.Hehasalsobeen

referredtoanursespecialist,SarahHughes.SarahisassessingNealslevelofriskandisalso

hopingtoprovidesomeangermanagementwork.

Transcript:

David:WhilstImhereNealIjustneedtotalktoyouaboutyourcareplanbeforewemeetwith

DrEvans,yoursupportworkerandSarahtoreviewitnextweek.

Neal: Yeah what about it?

David:Ivebroughtacopywithmeforustolookatandseewhatshappeningandwhetherwe

needtothinkaboutchanginganything.

Neal:WellIlltellyouonethingthatneedschangingthatsthemedication.ItsdoingmeinandI

dont need it.

David:Ihearwhatyouaresayinganditsimportanttothinkaboutit.Shallwecometothatin

abitasmedicaltreatmentisfurtherdownthecareplanandweneedtobeholisticandlookat

everything?

Neal:Butitshackingmerightoff;nohumanbeingshouldbemadetosufferImtellingyouIm

beingtortured.Literallytorturedbyyoulot.Whatelseisitthatyouwanttotalkabout?

David:OknowtherstthingonhereisnanceshowarethingsinthatregardistheDLA

sorted now?

Neal:YeahthanksIgotthatthroughacoupleofweeksback,sorryIthoughtIhadtoldyou?Iused

ittogoawaywithKatelastweekendweendeduphavingarightdingdongasIdidntwantmymeds.ShecamehomeearlybitchIhaventseenhersince.


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David:Maenddrwggeni,wyddwnimohynny.Efallaiygallwnniedrycharhynnapanddownniat

bethau cymdeithasol, diwylliannol ac ysbrydol?

Neal: ambethydychchinsn?Doesnaddimiwddweudamypethmaehinbitshadynafo.

David:FellymiwyttincaelyLwfansBywirAnabl?Maehynnandda,bethamdyfudd-daliadau

eraill di?

Neal:Wel,maennhwniawn.

David: Ac mae dy seylla ariannol din iawn?

Neal:Nacydisiwrdwin34oeddwiddimynwirion.

David: Nac wyt siwr, ond roedd y rheolwraig yman dweud dy od ti wedi bod yn trio benthyg arian

gan breswylwyr eraill.

Neal: Beth sy a wnelo hynny hi, yr hen beth usneslyd iddi, a chi o ran hynny? Oes oes raid i

chigaelgwybod,roeddangenarianarnaiargyfercyffuriauacmiddefnyddiaisirarianarwhizz.

Roedd yn rhaid i mi gael peth oherwydd yr holl gyuriau yma yr ydych chin eu rhoi i mi. Rhaid i mi

ei gael o at y sgil eeithiau.

David: Felly mae gen ti rai problemau trin arian o hyd? el maen ddweud ar dy gynllun goal.

Ydirstaffyncynnigunrhywhelpitigydahynna?Maendweudydylennhwdygefnogidrwygynnig

sgiliau trin arian.

Neal: Dw i ddim angen help a dw i ddim eisiau iddyn nhw usnesa. Fel dw i wedi dweud or blaen

miallaiymdopifyhun.MidalaisirarianynliRoddyddyddIau.

David: Felly beth ddywedwn ni yn yr adroddiad? Nad wyt ti eisiau unrhyw help?

Neal:Dywedwchbethydychchieisiau,wniddimefallaigallwchchiddweudbodynwellgeni

ddatrys y mhroblemau ariannol y hun.

David:Miallaiddweudhynnyondypryderywdyfodwedigwarioarianyngyymynygorffennolac

wedi gorod benthyca. Ydw in iawn yn meddwl bod hynny wedi achosi problemau yn y gorennol?

Neal:Efallaibrydhynny,ondddimbellach.Dwinhynrwanacmiallaiwneudifyarianbara.

Ycyfanmaerstaffwedieiwneudywbusnesa.Miallaireolifyarianfyhunfellypeidiwchdweud

yn groes i hynny.

David:Oc,fellymaeniawndweuddyfodyncreduygellididrindyarianadyfodwedirheolidy

arian yn ystod y 6 mis diwetha heb unrhyw broblem a heb gymorth gan sta.

Neal:Maehynnynswnionagosati,fellyia,dywedwchhynna.

David:Iawnondmaenamlwgybyddynrhaidimiwiriogydarstaffigaeleubarnhwyonddwinhapusinodihynny.Ypethnesafyndygynllunywllety.MaendweudybyddidinbywymaynThe

Hollowoesynaunrhywbroblemauwedicodiefodyfat?

Neal: Beth ydych chin eddwl?

David:Wel,felcaelcymorthganstaffymacyd-dynnuphreswylwyreraill

Neal:Maewedibodyniawn-maennhwnbusnesuweithiaueisiaugwybodbledwinmynda

phryd y bydda in l. Dw i ddim yn hof pobl yn cadw llygaid arna i.

David:Maensiwreubodnhwncadwgolwgarnatfelmaendweudarycynlluniddarparu

cymorth dyddiol a monitro.

Neal: Ond dw i wedi dweud wrthych chi dydw i ddim yn ho o hynny a does dim angen y

feddyginiaethymaarnaillonyddsyddeiangenarnai.Maepawbeisiaubodynberchenarran

ohona i.


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David:Iawn,fellymaenswniofelbodpethaunmyndardynerfauymaacybyddainwellgentipe

baennhwnrhoimwyolonydditi.Wrthfeddwlamypethmaensiwrbodcaeldyfonitroyngallu

bod yn deimlad rhwystredig. Ydi hyn yn rhywbeth y gallwn ni edrych arno gydar sta yma, er mwyn

gweld a oes modd ei wneud mewn ordd wahanol?

Neal: Ydi, pe baen nhwn gadael i mi ynd ir swydda i ddweud wrthyn nhw yn hytrach nau bod nhw

bobamseryncnociofynrwsyngofynbethydwiwedibodynwneud.Maenwellgenifyndatynnhw.

David:Iawn,dwiwedinodibodangenedrycharhynynystodyradolygiad,ybyddainwellgentigael

llonyddabodynwellgentifyndirswyddfa.Nesaf,maegennymdriniaethaumeddygolaceraill

mi wyt ti wedi gweld Sarah ychydig o weithiau, sut maen mynd?

Neal:Iawn,felmaendigwydd.Maehinmalioamdanaifelpersonadydihiddimyngofyny

cwestiynau gwirion yma nac yn y llenwi chyuriau.

David:Dwinfalchoglywedhynnyachbodchincyd-dynnuniawn.Maehindodiradolygiad

wythnos nesa elly mi alla i oyn iddi sut mae hin meddwl dy od yn datblygu. Ydi hi wedi dechrau

unrhyw sesiynau rheoli tymer?

Neal:Rheolitymermaehintriodangosffyrddimibwylloapheidiogwylltioondfuaswniddimyn gwylltio pe na bawn in gorod cymryd y eddyginiaeth neu orod ateb eich cwestiynau chi. Hynny

syn y ngwylltio i.

David: Felly mi wyt tin hapus i weld Sarah?

Neal:Dimhapusddywedaisi,ondoc.

David:Iawn,maenddrwggeni,efallaibodfforddwelloedrycharno.Sutfuasettinhofimieieirio

o?

Neal: Beth am ddweud y byddain well gen i pe na bawn in ei gweld ond nad oes gen i ddewis ai

bod hi o leia yn gwrando arna i yn hytrach na gwthio cyuriau arna i el chi i gyd.

David:Iawn,fellydwiwedidweuddyfodynmeddwleibodogymorthacybyddidinparhauiw

gweld.Dwingwyboddyfodeisiautrafoddyfeddyginiaeth.Maenamlwgnadwyttinhapuserei

od yn gwneud lles i ti.

Neal:Gwneudllesimi,ymmhafforddmaerstwffynangwneudllesimi?

David:Welabodyndeg,dwyttiddimwedibodynwaelnacynlynyrysbyty.Onddwingallugweld

nadwyttinhapus.Miwnainodyndyfodeisiaueidrafodynycyfarfod.

Neal:Bethamroirgorauiddo.Nidyfeddyginiaethywrbroblem.Maenfyngwneudinwaeth.

David: Ond maer ymchwil yn dweud yn glir ei od yn helpu i atal pobl rhag cael pyliau eraill. Dwyt ti

ddim wedi bod yn seicotig ers i ti ei gymryd.

Neal: Seicotig? Fues i erioed yn seicotig. Rydych chin swnion union yr un ath r meddyg gwirion

yna.Ydwdwiwedibodyninacynddryslydefallaiondmaehynnynwirambawb,dydwiddimyn

seicotig.

David:Weldynamaenddweudyndygynllungofal y nod yw atal pyliau eraill o afechyd seicotig.

Neal:Ersprydmaebodyninynaechyd.Ylwch,fuesierioedynslfelyna.Dydwiddimfelybobl

eraill yma. Pryd wnewch chi i gyd ddeall hynny?

David:Welosnadwyttinslpamwyttinmeddwlfodgentinyrs,seicolegyddameddygyn

dy weld?

Neal:Maehynynwirion,maenfynghynddeiriogi.Ylwch,rhowchygorauiddi,dwiddimynsl.Yrunig reswm dwineichgweldchiywoherwyddfymodyngorfodgwneudhynny.Iawn?

David:Iawn.


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David:Rightsoitsoundslikethingsaregettingtoyouhereandyoudlikethemtobeabitmore

handsoff.ThinkingaboutitIexpectitcanbefrustratingfeelingyouarebeingmonitored.Isthis

somethingwecanexplorewiththestaffhere,toseeifitcanbedonedifferently?

Neal: Yes just i they allowed me to go to the ofce to tell them rather than always banging on my

dooraskingwhatIvebeendoing.Iprefertogotothem.

David:RightIvemadeanotetosaythatthisneedstobelookedatduringthereviewasyoudlike

themtoleaveyoualoneandthatyouprefertogototheofce.Nextwehavemedicalandother

treatmentsyouveseenSarahafewtimeshowsitgoing?

Neal:Alrightasithappens.Shesactuallybotheredaboutmeasapersonanddoesntjustkeep

askingmethesestupidquestionsorpumpingmefullofdrugs.

David:Thatsgoodtohear,Impleasedyouaregettingonok.Shescomingtothereviewnextweek

soIcanaskhowshethinksyouaregettingon.Hasshestartedanyangermanagement?

Neal: AngermanagementsheistryingtoshowmewaystostopmegettingwoundupbutI

wouldntbewoundupifIdidnthavemedicationoryougoingonatme.Thatswhatdrivesmemad.

David: So you are happy seeing Sarah then?

Neal:HappysnotwhatIsaidbutitsok.

David:OkImsorry,perhapstheresabetterwayofseeingit.Howwouldyoulikemetowordit?

Neal:HowaboutsayingthatIdratherIwasntseeingherbutfeelIvegotnochoiceandthatat

leastshelistenstomeandisntapillpusherlikeyoulot.

David:RightsoIvesaidyouarendingherhelpfulandwillcontinuetoseeher.Iknowyouwant

totalkaboutyourmedication.Itsobviousyouarenthappywithiteventhoughitsbeendoingyougood.

Neal: Doing me good, in what way is that stu doing me good?

David:Wellinfairnessyouvenotbeenunwellorendedupbackinhospital.HoweverIcanseeyou

arenothappywithit.Illmakeanotethatyouwanttodiscussitinthemeeting.

Neal:Letslookatgettingmeoffit.Itsnotthemedication.Imtellingyouitmakesmeworse.

David: But the research around this is clear it helps to prevent relapse. You have not been psychotic

sincetakingit.

Neal:Psychotic?Ineverwaspsychotic.Yousoundjustlikethatdaftdoctor.YesIhavebeenangry

andperhapsconfusedbutsohaseveryoneImnotpsychotic.

David:Wellitswhatitsaysinyourcareplanthegoalistopreventrelapseofpsychoticillness.

Neal:SincewhenhasbeingangrybeenillnesslookIveneverbeenilllikethat.Imnothinglike

thoseotherpeoplehere.Whenwillyoulotunderstandthat?

David:Wellifyouarenotillwhydoyouthinkyouvegotanurse,psychologistanddoctor

seeing you?

Neal:Thisisdaftitswindingmeup.LookletsdropthisImnotill.IonlyseeyoubecauseIhaveto.Enoughsaid?

David:Okenoughsaid.


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Pwynt Traod:

Ym mha yrdd y gallai David od wedi talu mwy o sylw yn y ddeialog gyda Neal yn y senario uchod?

Pwynt Myyrio

Ystyriwch sut y gallai cyathrebu cydweithredol od yn berthnasol ich ymarer chi elcydlynydd goal.

Nodwch unrhyw yrdd y gallech hybu cyathrebu cydweithredol wrth weithio gyda denyddwyr

gwasanaeth.


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Discussion Point:

InwhatwayscouldDavidhavepaidgreaterattentiontothedialoguewithNealintheabove

scenario?

Reection pointThinkaboutwhatrelevancecollaborativecommunicationmayhaveforyourpracticeasa

care coordinator.

Note down any ways in which you might increase collaborative communication in your interactions

with service users.


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Taen 2a:

Ymarer 2: SenariosachosLloydaDilysHughesaFon(2)

Cendir: Gwr78oedywLloydHughessynbywgydaiwraig,Dilysmewnbyngalogwarchod.Nidoesganddyntunrhywberthnasauagos.GofalwrysgolwediymddeolywLloydacarferaiDilys

weithiofelcogyddesmewngwestylleol.MaeganLloydraiproblemaugydarcof,maengallumynd

yn ddryslyd ac yn gynhyrus ac maen cael traerth gyda thasgau bob dydd. Ar l cael ei atgyeirio

at y gwasanaethau iechyd meddwl pobl hyn, mae wedi cael diagnosis yn ddiweddar ei od wy na

thebygyndioddefoglefydAlzheimer.

BellachmaeLloydynderbyngofalgartrefacmaenmyndiganolfandyddleolddwywaithyr

wythnosermwyniDilysgaelseibiant.HefydmaeFon,NyrsIechydMeddwlGymunedolynymweld

rddaubobpythefnos.Pwrpasymweliadheddiwywadolygurcynllungofal.Maerhanor ddeialog isod.

Trawsgrifad:

Ffon: Felly, sut maer cynllun goal yn mynd i chich dau?

Dilys:WelmaenllawergwellarycyfanbodygofalwyryndodigodiLloydairoiynygwelyyny

nos.Maenhelpmawr,tydi?(maentroiatLloyd)

Lloyd:Wel,wniddimYrhollboblddieithr(chwerthin)

Dilys:Miwyttinhofrmerchedsyndod,ondwytmiwyttincaelhwylgydanhw

Lloyd:(chwerthin).

Ffon:YdionwirLloydeichbodynhofrmerched?AcmaenhelpiDilyshefyd,tydi?

Lloyd:Maendebyg,(chwerthin)ondmaennhwnwahanol.

Ffon:Gwahanol?

Lloyd:Maeynawahanolrainmyndadod.

Dilys:Bethwyttinfeddwlydibodynalawerowahanolferched-oherwyddeubodnhwngweithio

arrota,bethbynnagmaenbrafcaelnewid;dylettigyfridyfendithion.Byddairrhanfwyafo

ddynion wrth eu boddaun cael sylw el ti.

Lloyd: Rwyn hofr un ach yna syn dod.

Dilys:Maureenywhonnomaendlwsacyngln.Maebobamseryngwneudichiwenu.

Miwnaethdywalltdihefyd,yndo?

Ffon:Fellymiallaidrefnubodhynnynparhau?Mifyddangenimiroigwybodiddynnhw.

Dilys: Ydi, maen iawn uaswn i ddim yn gallu ymdopi hebddyn nhw.

Ffon:BethamdanochchiLloyd?Wnawnnibarhauiofynirgofalwyrddodichhelpuynyborea

gydar nos?

Lloyd:Ia,debyg(chwerthin).


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Handout 2a:

Exercise 2: CasescenariosLloyd,DilysHughes&Fon(2)

Background: LloydHughesisan78yearoldmanwholiveswithhiswife,Dilysinashelteredbungalow.Theyhavenocloserelatives.LloydisaretiredschoolcaretakerandDilysworkedas

acookatalocalhotel.Lloydhassomeproblemswithmemory,hecanbecomeconfusedand

agitated and has struggled with his daily unctioning. Following reerral to older peoples mental

healthserviceshehasrecentlybeendiagnosedwithprobableAlzheimersdisease.

Lloydisnowprovidedwithpersonalcareathomeandattendsalocaldaycentretwotimesaweek

inordertoprovidesomerespiteforDilys.ThecouplearealsovisitedeverytwoweeksbyFon,a

CommunityMentalHealthNurse.Todaysvisitistoreviewthecareandtreatmentplan.

Anexcerptoftheinteractionisbelow.

Transcript:

Ffon: So then, the care plan hows it been or you both?

Dilys:Wellalotbetteroverall,havingthecarerscomeandgetLloydupandputtinghimbackto

bedatnightisabighelpisntit?(turnstoLloyd)

Lloyd:WellIdontknowlikeAllthemstrangers(chuckles)

Dilys:Youlikethegirlscomingdontyouyouhavealaughwiththem

Lloyd:(chuckles).

Ffon:isthatrightLloydyoulikethegirls?AnditshelpingDilystooisntit?

Lloyd:Iexpectso(chuckles)buttheyredifferent

Ffon: Dierent?

Lloyd: Theres all sorts coming in and out.

Dilys:Youmeanthatthereslotsofdifferentgirls-thatsbecauseoftheirrotasanyhowitsnice

tohaveachange;youshouldcountyourselfluckyhavingthem.Mostmenwouldlovetogetwhat

youre having.

Lloyd:Ilikethatlittleonethatcomes.

Dilys:Maureen,thatsMaureenshesaprettylittlethingandlovelywithit.Shealwaysgetsyou

to smile. She did your hair or you as well didnt she?

Ffon:SoIcancarrythatonthen?Illneedtoletthemknow.

Dilys:YesthatsneIcouldntmanagewithoutthem.

Ffon:HowaboutyouLloydwellcarryonwiththecarerscomingtohelpyouinthemorningsand

evenings?Lloyd:Isupposewecan(chuckles).


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Ffon:Iawn,maehynnandda,bethamyGanolfanDyddmiglywaisinadoeddechchineihof.

Lloyd:(Chwerthin).

Ffon:Eichbodyngofynohydamgaelmyndadref,ydihynnyniawn?

Lloyd:(Chwerthin)Maenswnllyd,dydynnhwmonheipi.

Dilys:Ddimeichteipchi?(chwerthin)Miwyttinmyndbraiddynsnoblydwyttiddim?Er,dydwi

ddimynmeddwldyfodynhofynowytti?Maenanoddimieigaelifyndorty acmaebobamser

yncaeltrafferthsetloarldodynl.Maeychydigynanniddigadoesganddofawroawyddbwydy

nosweithiau hynny. Rwyn meddwl tybed a ywn wy o broblem yn hynny o beth.

Ffon:Ondypwrpasywrhoiseibiantichi.MaenanoddgofaluamLloyd,maeangenychydigo

seibiant arnoch chi.

Dilys:Weldydioddimynseibiantmewngwirioneddpebawninonestmifyddaingodioymaar

y mhen y hun sut bydd o pan ddaw on l.

Ffon: Dyna bechod beth yddem nin gallu ei wneud i helpu: yddech chin gallu mynd ir grwpcymdeithasolynyneuaddmaenedrychynhwyl?

Dilys:dydioddimatfynantipebawninonest,rwyfelLloydoranhynny,rydymniwedicadweu

hunain i ni ein hunain.

Ffon: Ond mae angen seibiant arnoch chi. Ydych chin meddwl y byddem nin gallu adolygur

feddyginiaetharydiwrnodauhynnyfelnadywLloydmoranniddig?

Lloyd:(chwerthin)ywhwnnw.

Ffon:BethfuasechchinhofLloyd?Dydychchiddimswnionhofforganolfan,bethfuasechchin

ei hof?

Lloyd:Welwyddochchi

Dilys: Fyddai meddyginiaeth yn eich helpu i setlo?

Dilys: Na nid dynar ateb, dydi o ddim i ni, nac ydi cariad?

Lloyd:Naddimini.Myndibartonaballu.

Ffon:(chwerthin)Dwiddimsiwrybuaswniwedieialwonbarti.

Lloyd:Wel,wyddochchi,chwaraegemaugemauplant.Maenwellgenifyndirardd.

Ffon: Roeddwn i wedi clywed eich bod yn mwynhau hynny ond does gennych chi ddim gardd yma,

nac oes? Ond ydi hynnyn rhywbeth yr hoech chi ei wneud?

Lloyd: Plannu y nhatws a y nionod.

Dilys:Dydwiddimynmeddwlcariad,maensGorffennafmiwyttibraiddynhwyrrwan.

Pwynt Traod:

YmmhaffyrddygallairsgwrsrhwngFon,DilysaLloydfodwedibodynwellynysenariouchod?

Pwynt Myyrio

Ystyriwch sut y gallai cyathrebu cydweithredol od yn berthnasol ich ymarer chi el cydlynydd goal.

Nodwch unrhyw yrdd y gallech hybu cyathrebu cydweithredol wrth weithio gyda denyddwyr

gwasanaeth.


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Ffon:OkthatsgoodwhatabouttheDayCentreIhadheardyoudidntlikeit.

Lloyd:(Laughs).

Ffon:Thatyoukeptaskingtogohome,isthatright?

Lloyd:(Chuckles)Itsnoisytheyarentmytype.

Dilys:Notyourtype?(laughs)Youaregettingabitsnobbyarentyou?MindyouIdontthinkyou

likeittheredoyou?Itshardformetogethimoutofthedoorandhesalwayshardtosettlewhen

hegetsback.Hesabitcrankyandoffhisfoodthosenights.Idowonderwhetheritsmoreofa

problem in that way.

Ffon:Butitismeanttogiveyouabreak.ItshardcaringforLloyd,youneedabitofabreak.

Dilys:WellitsnotreallyabreakifImhonest-Ijustmopeabouthereonmyownandworrywhat

hellbelikewhenhegetsback.

Ffon: Thats a shame what could we do to help: could you go to the social group in the hall that

lookslikefun?

Dilys:ItsnotmycupofteaifImreallyhonest.ImabitlikeLloydinthatregard,wealwayskept

ourselves to ourselves.

Ffon:Butyouneedabreak.DoyouthinkwecouldreviewthemedicationonthosedayssoLloyd

wasnt so agitated?

Lloyd:(laughs)thatsme.

Ffon:WhatwouldyoulikeLloyd?Youdontsoundkeenonthecentre,whatwouldyoulike?

Lloyd:Wellyouknow

Ffon: So medication would that help to settle you down?

Dilys: No its not that its just not us, is it love?

Lloyd: No its not us. Partying and that.

Ffon:(laughs)ImnotsureIdhavecalleditaparty.

Lloyd:Wellyouknowplayinggames.kidsgames.Iprefertogetoutinthegarden.

Ffon:YesIheardyouenjoyedthatbutyouhaventgotagardenherehaveyou?Butisthat

somethingyoudliketodo?

Lloyd:Getmypotatoesandonionsin.

Dilys:IdontthinksoloveitsJuly...youreabitlatenow.

Discussion Point:

InwhatwayscouldtheconversationbetweenFon,DilysandLloydhavebeenbetterintheabove

scenario?

Reection point

Thinkaboutwhatrelevanceparticipativecommunicationmayhaveforyourpracticeasacare

coordinator.

Note down any ways in which you might increase collaborative communication in your interactions

with service users.


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Taen 3: Trosglwyddo a pherthnasoedd

Maercanlynolynenghreifftiauodrosglwyddosyddnaillaindigwyddoherwyddsymudcorfforol

rhwng un gwasanaeth ar llall neu oherwydd newidiadau personol o ran cred ac ymddygiad.

Mewngrwpiauo3ewchatiichwaraerl(dylaiunpersonarsylwi).Yneichtro,symudwchornaill

senario ir llall.

Golyga 1:

Maedefnyddiwrgwasanaeth(Rhian)yneisteddgydachi(eichydlynyddgofal)acyndweud

nadywnhapusgydaigofal.MaewediclywedamofynionyMesuracwedisylweddolibod

cyarodydd adolygur cynllun goal yn cael eu dylanwadun benna gan y seiciatrydd ymgynghorol.

Bwriedir cynnal adolygiad yn uan ac mae Rhian yn awyddus i chi ei chenogi i herior seiciatrydd

ymgynghorol a chynllunio rhai ymatebion ymlaen llaw cyn y cyarod.

Golyga 2:

MaeAnwenynsiaradCymraegachynhelireihadolygiadynfuan.Mewncyfarfodtm,maeJon,

aelodortmyndweudeifodwedicaelgairrtmgofalaifodynbryderusbodAnwenyndymuno

cynnaleihadolygiadynGymraeg.DimondununigolynynytmsynsiaradCymraeg(acnidyn

rhugl).Maertmweditrafodygoblygiadauoranyradnoddaufyddaieuhangenermwyncyawni

dyheadau Anwen ac awgrymwyd eich bod chi, el ei chydlynydd goal, yn cael gair gyda hi i ddweud

wrthi y bydd yn rhaid cynnal ei chyarod yn Saesneg.

Golyga 3:MaePhilynddefnyddiwrgwasanaethyneichtmcymunedolacynfuanbyddynymddangos

gerbronyllysacyndebygologaeldedfrydogarchar.MaePhilyndroseddwrmynychondmae

ganddoanghenioniechydmeddwlsylweddol.MaePhilwedidweudwrthychchi,eigydlynyddgofal,

nad ywn dymuno i unrhyw wybodaeth am ei anghenion gael ei throsglwyddo ir uned iechyd yn y

carchar oherwydd ei od yn poeni sut bydd yn cael ei drin dan glo.

Golyga 4:

DywedKathysynddefnyddiwrgwasanaethnadywnawyddusiwneuddimichynllungofal,

nidyweisiaugwybodbethmaeneiddweud,acnidywameiarwyddo.DywedKathyeibodwedi

bodynceisioymdopiersblynyddoeddaibodbellachwedicaeldigon.Maehieisiauichi(ei

chydlynyddgofal)ddweudwrthibethiwwneudamnadywngalluymdopimwyach.


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Handout 3: Transitions and relationships

Thefollowingareexamplesoftransitionstheymaybeeitherphysicalmovementsbetween

services or personal changes in belie and behaviour.

Ingroupsof3role-playtheparts(onepersonactsasobserver).Taketurnsinmovingfrom

scenario to scenario.

Scene 1:

Aserviceuser(Rhian)sitsdownwithyou(astheircarecoordinator)andstatesthattheyarenot

happywiththeircare.TheyhaveheardabouttherequirementsoftheMeasureandhavecometo

realise that care plan review meetings are dominated by the consultant psychiatrist. A review is

planned shortly and Rhian says she wants your support to challenge the consultant psychiatrist

and to plan some responses in advance o the meeting.

Scene 2:

AnwenisaWelshspeakerandisdueforareviewshortly.Inateammeeting,Jon,ateammember

statesthathehastalkedwiththecareteamandisconcernedthatAnwenwantsthereviewto

beheldinWelsh.ThereisonlyonepersonintheteamwhocanspeakWelsh(andnotuently).

TheteamhasdiscussedtheresourceimplicationsrequiredtomeetAnwenswishesandhas

suggestedthatyou,ashercarecoordinator,speakwithherandinformher,themeetingwillhave

tobeheldinEnglish.

Scene 3:

Philisaserviceuserinyourcommunityteamandisdueincourtsoonwithalikelihoodof

receiving a custodial sentence. Phil is a repeat oender but has some signifcant mental health

needs. Phil inorms you, as his care coordinator, that he does not wish any inormation to be

passed to the health unit in the prison about his needs as he is concerned how he will be treated

inside.

Scene 4:

Kathy,aserviceusersaysthatshedoesnotwantanythingtodowithhercareplan,shedoes

notwanttoknowwhatitsaysandisnotgoingtosignit.Kathysaysshehasbeentryingto

keepmyheadabovewaterforyearsandnowIvehadenough.Shejustwantsyou(ashercarecoordinator)totellherwhattodoasshecantcopeanymore.

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Core Unit 2: Relationships, recovery and care and treatment planning

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