Monday 18th February

The cockerel unleashed its cry at 6.50am and it didn’t stop. Not that I was complaining. I managed to grab 8 hours of sleep. It was a warm evening but the silk sleeping bag liner that we had been advised to bring on the trip did a great job of keeping me cool. In conjunction with the net that hung around me it also prevented me from becoming too much of a meal for the mosquitoes. The group met up at 7.45am and we made our way to the venue where the workshop was due to take place – Caritas’s offices which sit beside the National Football stadium in Freetown. Workshops in SL are always preceded by a communal breakfast. Facilitators and attendees literally and figuratively breaking bread together at the start of the day. It was great to catch up with familiar faces who had attended the Introductory workshop that we did last year. If there is one thing that is better than visiting Sierra Leone, it is returning to Sierra Leone. And this was never more apparent than seeing familiar, smiling faces this morning. There were some new faces too – people who had attended Beate’s first workshop in Sierra Leone 2 years ago. The day didn’t get off to quite the start we had intended. There was a mix up with the breakfast arrangements. It was not ready for the scheduled 8.30 sit-down. The training we deliver focuses a lot on psychological flexibility – accepting non-judgementally situations that might arise and being able to respond effectively in a way that fits with what is important in life. We were flexibility personified. The schedule was amended, and we gathered the 35 attendees together to have a welcome celebration. Florence and Hannah took it in turns to lead us in traditional SL songs. The attendees sang along too and clapped the rhythm. There were then prayers led by Christian and Muslim attendees. We took time to introduce ourselves as facilitators to the attendees and vice versa. We agreed some ground-rules for the group before outlining some aims for the day. At that point breakfast was ready to be served. After breakfast attendees were invited to participate in the evaluation of the workshops. The majority of attendees consented to this process. 30 minutes were allocated to the completion of baseline measures. Corinna Stewart did a great job of organising this part of the day. We then got down to the business of the day. Beate got things going with a mindfulness exercise that helped orient attendees of the workshops to important themes for the day including acceptance and values. Following the exercise the attendees shared their reflections on how they experienced it. I then outlined the principal focus of the morning – highlighting the importance of good assessment and formulation for psychosocial interventions. I instructed the attendees on how The Matrix approach (developed by Kevin Polk and colleagues) could be used to guide the assessment and formulation of clients’ difficulties. Attendees were invited to share their thoughts on what exactly assessment and formulation are. Together we explored the way in which these represent the foundations on which a treatment plan can be developed. The rationale of the Matrix was explored in an interactive way. The Matrix was sketched out on the floor using two lines of masking tape (not exactly sophisticated but effective!). I asked an attendee to come forward an represent a particular client that an attendee had worked with recently. I asked the attendee (Thomas) some assessment questions and we invited other attendees to come up and represent aspects of the matrix including: Sources of suffering Attempts to move away from suffering Values Committed Action It seemed to be a fairly engaging way to help folk understand the principles and they seemed to understand the approach well. After lunch we progressed on to thinking about how assessment and formulation can be used to inform treatment. This allowed us to focus on strategies that people can use to help their clients get unstuck from getting caught up struggling with suffering. There were plenty of opportunities for role play and giving attendees a chance to play about with the approaches. The afternoon concluded with some Q&A and a summary of the day. It was a productive day and Beate and myself are really pleased with how engaged the attendees were, how they synthesised the material we were discussing and how willing they were ask questions. We also learnt a lit from the attendees about how distress is experienced and described in SL. I stayed behind after the workshop to write today’s blog entry and wait for Iain. He had arranged an interview with an attendee as part of his MSc project that explores people’s experience of ACT training. Tonight we are off to Alex’s restaurant to meet up with Heather Weaver from Enabling Access to Mental Health Sierra Leone. An EU sponsored project that she has been working with for over 12 months. We met with Heather last year when she was relatively new to SL. It will be great to catch up with her.

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