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Course One

The Caregiver-Client Relationship and Self-Care

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The History of PET

PET originally was developed in The Netherlands in response to the needs of volunteers with asylum seekers who were good people with big hearts but who had little if any education in these areas or in psychological supervision. These people were being asked to deal with cultures that were not their own and with people who had very high levels of psychological traumatization from what had happened to them in their regions of origin and along their journeys, as well as through the administrative processes of seeking asylum. Later, doctors, nurses, social workers, and other professionals also asked us for assistance.

Aims of PET

In the September 2007 edition of the medical journal, The Lancet, it was reported that more than 90% of the people needing psychological assistance weren’t getting it. Unfortunately, in the years since then, the situation hasn’t improved.

Thus, the main goal of PET is to increase capacity to deal with psychological traumatization.

Some Advantages of PET

Another point is that the so-called experts tend to be elite and not closely related to the people whom they’re trying to serve. People accept things much better from members of their own communities than they do from experts. They feel better understood and feel that the person working with them is more on their wavelength.

Also, getting psychological therapy is highly stigmatized in many cultures. Other people think that the person is crazy, out of his or her mind. Having a talk with a friend or with someone from your own community is much less stigmatized than going to a psychologist or a psychiatrist. Then, you are not sick or crazy, but you are getting help.

Terminology of People Trained in PET

We call the people trained in PET “barefoot therapists” or “peer supporters” and sometimes “helper therapists”. You might want to give such people a name more appropriate to your own culture. You need to be careful in that you don’t violate the laws or conventions of the place where you’re living. For example, in many places, the term therapist is reserved for people who have undergone a specific sort of training and/or who have been tested by a governmental or professional body. The same may be true of the word counselor. Please be careful of that.

Methodology of PET

The methodology of PET is as important or even more important than its content.

First, it’s important to keep the size of the educational or self-help group small so that everyone can participate fully. Our guideline on this is between three and twelve people. If the group gets larger, we split it into two or more groups.

Next, it’s important to limit the amount of time that each session lasts. Our experience is that people can concentrate for a maximum of about an hour and a half to two hours, usually with a break at about the half-way point. That may differ, depending on the group.

An important aspect of PET is that every group is specific. Thus, even two groups in the same town with people of the same age and the same background will be different.

The curriculum of PET is the one that you’ll be getting in this series of courses. However, there may be specific things that you want to add to the curriculum. You might even want to take certain things out, depending on the needs and desires of the people in the group, although we don’t recommend that.

The order of what is covered is not important as long as it all is covered in the long run. One of the roles of the facilitator of the group is to keep track of that. We’ll talk about facilitation in the next section of this course and in the course on communication.

In general, a session starts with each person telling what has happened in his or her life since the last session. The group then picks a topic to discuss.

The topic is important. It can be something that happened in the community, in the life of one or more members of the group, or it can be something that people want to know. The point is that there is discussion and that people gain trust with one another so that they can discuss virtually everything that they want to discuss. The psychologist Carl Rogers said that we’re the best experts about ourselves. Therefore, we also know the best order in which to discuss topics of concern to us.

In this sense, PET can be very much like therapy. We talk about ourselves and our own issues in a safe place, which is what therapy really is. Of course, in a PET group, that kind of discussion is much less stigmatized.

Also, practice becomes an important part of PET groups. Thus, in the course in communication, we practice how to have a conversation between two people and how to have a good group conversation. Also, it’s possible to practice dealing with specific situations.

Psychological Supervision

Psychological supervision frequently takes place in PET groups. Psychological supervision has a number of parts to it. In the first instance, it involves looking at what you’re doing with a client or with other people. The role of the supervisor or the supervisory group, which also may be called an intervision group or a Balint group, is not to criticize someone but to give new insights and angles that perhaps he or she hasn’t thought of. Two or more heads usually are better than one.

The other point of supervision is for a person to get out into the open how work is affecting his or her private life and vice versa. Work with highly traumatized clients is difficult and has emotional effects on everyone. People think that they have to be strong and don’t want to look at these difficulties, which are natural. It’s very important to get balance into life. Talking to another person about what’s going on helps.

As we’ve already said, we think that supervision is essential for anyone working with other people at any level. That applies not only to psychologists and psychiatrists but to everyone, including social workers, teachers, police, fire fighters and volunteers, however long-term or short-term their involvement is. We go so far as to say that people who don’t have supervision are not acting responsibly professionally. Supervision helps to prevent and cure burnout. We’ll talk about burnout in detail later in this course.

The Content of PET

First, PET involves people learning how to work with other people. There are some general principles of this that we’ll get into a little later in this course. Not the least of these is how to gain trust. Ethics in dealing with other people also is essential, and we’ll talk about that in detail.

As we mentioned, it’s also very important that you learn to care for yourself.

It’s also very important to learn how to communicate with other people individually and in groups. That will be different in various cultures, and so what we’ll talk about is a foundation that you can adapt to your own specific situation.

Psychology, trauma, and how to deal with it is a very wide field. We think that people need to know as much as possible. Thus, we’ll talk about various approaches to psychology, about various concepts in psychology, about what trauma is from various points of view, about specific situations that can cause trauma, and about how to deal with people in those situations to assist them to live with what they’ve been through.

Next, we’ll talk about how to transform conflict from violent and negative situations into something positive so that people can live with one another without resorting to violence. Psychological work is very important in this.

After that, we’ll talk about civil society, that is, non-governmental and non-commercial work. There is a long tradition of this kind of work in many places. In other places, it is relatively new. Certainly, it is changing very quickly.

Also, we feel that that it is important to talk about how people can integrate into societies and how societies can change to include people. We see this as a two-way street.

Finally, we’ll talk about human rights. There are some basics that we feel that everyone should know.

Some Final Comments

Thus, PET includes a lot of material. Our advice is to take it slowly and to deal with the issues that affect you most.

One final point. If you’re seriously going to take this series of courses, we think that it would be a good idea for you to form a small group to discuss things among yourselves. We’ll talk about that in the next section.

As always, tell us what you think of all of this. We very much want to hear from you.

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Pragmatic Empowerment Training (PET)