Great! Let's spend our time and resources getting people to think better of their predicaments rather than trying to organize them to promote social and political change!
Hi Dennis:
With all due respect, the project is not about that, at all. I am not sure how you could come to conclude that the project is against promoting social change. It is about social change, and not just in terms of folks living in marginalized settings. It is about access to mental health services, period. A review of the literature shows that many of the same social factors that can act as determinants of health for diseases such as diabetes, also act to increase rates of depression and anxiety. Research shows that these illnesses have a greater impact on people living in marginalized settings, and yet people in these settings can have a more difficult time accessing treatment. Also, access to CBT, the gold standard for treating anxiety, for example, is poor in Canada period.
So yes, this work is about social change and not about socializing people to their predicaments. Cognitive Behavioural Therapy is about giving people a forum for building skills, not a form of social control.
I think that it is fabulous that CBT is being offered to low income persons living in social housing projects such as Regent Park, This is not about getting people to accept their lot in life, but is offering viable, tangible ways for them to cope with tremendous adversity. Providing low income persons with more coping strategies, it is a form of social change, as well as a fantastic way to cope with depression, anxiety and other life challenges. Kudso
quite obvious that you have NEVER lived in this community or any other that has pride in their existence.
Keep up the great work Jason and don't get bogged down by the occassional "crab in the bucket" who tries to pull you back. Whether or not your work involves direct or indirect socio-political advocacy, it is an important advance in an often overlooked direction. There are others who may wish to pick up on the structural injustices which these clients face , however I see no reason why such an approach cannot coexist with, and indeed compliment,your CBT approach.
Hi Jason.
Have you thought about taking training seminars to the schools that teach the children in Regent Park? Clearly a teacher cannot do the work you have trained in for years, but the benefits of augmenting the thinking of young children who are at-risk for academic failure through the use of positive/resilient reasoning is powerful. I think you are scratching the surface of a bigger movement. Good luck and I hope Walrus and you continue to track and inform on your project's impact.
I loved learning about this project and think it is a much-needed service in both urban and rural areas where access to mental health services is slim to none. As someone considering a future in this type of work I am inspired by your story and hope that the data bear out the positive effect CBT has on people's lives. Best regards.
D. Carlson's point about teaching some of these skills to kids is right on. Research evidence and clinical experience of those who work with kids both suggest that the earlier people learn skills such as confronting negative thought patterns, the better off they are. Put another way, the less time you spend being entrenched in thought patterns like "I'm a failure," the better.
hey Jason - I think the work that your doing is bang on. Love the thoughts of Dr. Carlson and D. Thomson. More research on this should be done with the thinking around helping people to move forward and not get bogged down. Sometimes we get so caught up in looking at the determinents of health that we do not focus on empowerment. As we know true empowerment is offering people the skills to move foward and be in charge of themselves. I invite us to focus on our youth - train them through teachers, CYW's, social workers, peer mentors... to be able to change their thought pattern's. Being self confident includes thinking that their is a future that does not have to reflect the environment they live within. I like that you are trying to help people have a sense of "I can" - with that people can be in a place of the anonymous writer and advocate with her/him the importance of change and feeling proud of where they come from. keep up the good work
As a journalist with a degree in sociology, I am curious about the "five" social determinants you see as pulling a person back against any progress he makes with CBT.
Akin to Lerner's "Dance of Anger," when someone tries to break a cycle — either a personally destructive one, or a socially unproductive one — the surrounding people respond by fighting the "defector," by trying to restore the status quo. These factors are real pressures against a person bettering himself against what appears to be a betrayal of his community and family.
What do you see comprising these factors?
It was disturbing to read Pearson’s article “Ghetto Affect”. Examining the use of cognitive behavioural therapy (CBT) - as one of many tools to support people - is a valuable undertaking. People living in poverty have equal right to access a range of services and supports that are meaningful to them. However, the tone of the article and the assumptions that were implicit in it are part of the very challenges people living in poverty and the communities in which they live are having to confront and overcome...and that’s what’s depressing.
The article paints a skewed portrait of Regent Park and her residents and offers no analysis regarding poverty, health or community capacity. Instead the article celebrates and perpetuates an individualized understanding of poverty and its impact. This approach only serves to reinforce the negative stereotypes, social isolation, and stigma associated with poverty and Regent Park. It reinforces the sense of people living in poverty and Regent Park as being ‘other’.
The Regent Park Community Health Centre has been working in this community for over 35 years. Yes there is pain, depression, struggle. But there is also pride, caring, resiliency, creativity, and hope. We know that an individual solution to social problems is of limited value. We also know that not understanding or contextualizing the individual experience within the larger social context leaves people isolated. Better to build on the resiliency, the hope, the creativity of this community. Better to find ways that create community – across economic and neighbourhood lines – than to promote isolation.
So, does CBT have a role? Yes, as one tool among many. Does good journalism have a role? Yes, as a vehicle to help contextualize the complexity of people lives and communities.
Sheila Braidek, Executive Director
Regent Park Community Health Centre
In response to Ms. Braidek's well thought-out comment:
It appears you have set a rather elaborate intellectual trap in which those empathizing with the plight of a person growing up in a poverty-stricken region are "contextualizing them and ignoring their individuality" while those focusing on the individual's capacity for change and betterment regardless of their surroundings is as you state "perpetuates an individualized understanding of poverty and its impact...It reinforces the sense of people living in poverty and Regent Park as being ‘other’."
There is no mention in this article of the people seeking CBT as "other", and to suggest there is beauty within the disenfranchisement of a region like Regent Park does nothing to actually address the issue of individual's who suffer from psychological difficulties regardless of their upbringing and environment. Instead it defers their troubles to the richness and "pride" of their locality, if anything such an approach does more to stigmatize individual's as the "other" when they seek help for what may be legitimate mental-health issues in the same context that anyone else would in our society. It is in effect treating them different than the affluent females noted to be most commonly referred to CBT because of where they are from.
I applaud the work your Health Centre does, it is critical in so many ways to both the region and to the city, but your broad-stroked dismissal of the CBT efforts directed to the community you serve only highlight the difficulties of health-care delivery in an ideologically oriented environment.
In response to J. Borsato- You have obviously not read the response of Sheila Braidek, ED of Regent Park Community Health Centre very carefully although you allude to her comments as 'thoughtful'. It is Regent Park Community Health Centre which has
given Jason Ramsey the space and referrals to provide CBT therapy for its patients.
Ms. Braidek has however provided and well articulated the larger community context within which the Health Centre operates, which the article "Ghetto Affect" has sadly not done at all.
