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Public Domain Notice
All material appearing in this volume is in the public domain and may be reproduced
or copied without permission from SAMHSA.
Citation of the source is appreciated.
Additional copies of this publication are available from:
SAMHSA
National Mental Health Information Center
P.O. Box 42557
Washington, DC 20015
Tel: 800-789-2647
TTY: 866-889-2647
E-mail: nmhic-info@samhsa.hhs.gov
Acknowledgments
I want to especially acknowledge Marilyn Carmi, my assistant, who helped with
all aspects of the production and design of the manual, also Ed Pazicky who
helped with the final formatting.
Many supporters read the document at different stages to give me feedback:
Fred and Sharon Newman, in Florida, Betty Weathers in Atlanta, Ann Marshall,
from Alabama, Laurie Weber, a co-coordinator of several Pioneer Dialogues, in
Florida, and Jacki McKinney, in Philadelphia.
Barbara Lee, from Tampa, Florida, helped with the research summary and bibliography;
Sally Clay, in Florida, edited and proofread. Barbara Jackson, in Florida, was
also a proofreader. Final proofreading and editing were done by Norma Wagner
and Rosemary Jones. Thanks to Natalie Reatig in Washington, D.C., and Irena
Rutenberg in New York City for their support.
Many thanks to Janet Foner, who assisted with the coordination of the Pittsburgh
Dialogue, wrote a summary report, and reviewed the draft for the manual, and
to Stephen Ferrante, in Florida, who wrote sections of the Facilitation guidelines.
Two articles were written by consumers who added a special dimension to the
manual Darby Penney wrote The Recovery Dialogues that describe
dialogues that were held in the State of New York. Sylvia Caras wrote Internet
Dialogues which describe how to communicate on the internet.
The assistance of all the folks involved in the two Pilot Dialogues
was invaluable, especially from coordinators Dr. Ken Thompson and Linda Morrison,
in Pittsburgh, and Renee Constantino and her staff at the Mental Health Association
in Palm Beach County. Thanks to J. Rock Johnson and others, in Nebraska, for
their efforts to plan a dialogue there.
Finally, I want to acknowledge and give special thanks to Paolo del Vecchio,
Risa Fox, and Iris Hyman at the Center for Mental Health Services whose assistance
was greatly appreciated.
Funding for this project was provided by the Center for Mental Health Services
(CMHS), the Substance Abuse and Mental Health Services Administration (SAMHSA),
Department of Health and Human Services (DHHS). The opinions expressed in this
document reflect the personal opinions of the authors and are not intended to
represent the views, positions or policies of CMHS, SAMHSA, DHHS or other agencies
or offices of the Federal Government.
Gayle Bluebird
Author
Table of Contents
Foreword
Introduction
What is a Dialogue?
Different Models of
Dialogues
Develop the Dialogue
Organize a Committee
Choose a Title and Theme
Develop the Budget
Set up the Meeting Logistics
Select a Location
Select Participants
The Invitation Letter
Plan Meals
Use Volunteers
Technical Considerations
Name Tags and Participant Packets
The Evaluation Form Dont
Forget
Time Limits and Time Frames
Ending Dialogues
Facilitation
Select the Facilitator
Use Co-Facilitators
The Role of the Facilitator(s)
Start the Roundtable Dialogue
Present Conduct Guidelines
Set Agenda
Maintain Flow of Conversation
Deal with Conflict
Stick to the Agenda
Future Plans and Strategies
Record the Dialogue
Conclude the Dialogue
Conference Dialogue
Selecting Participants
Planning
Send Letter and Brochure
Using Speakers
Preparing Small Group Dialogues
(Optional)
Choosing Facilitators
The Day of the Conference Dialogue
Registration
Welcoming Remarks
Keynote Speaker
First Panel
First Dialogue Session
Lunch
Second Panel and Dialogue Session
Open Mike
Ending the Conference
Attachments
Sample Brochure for Conference
Dialogue
Sample Evaluation for Conference
Dialogue
Sample Agenda for Conference Dialogue
Appendices
Appendix A: What Happens After
the Dialogue
Appendix B: Internet Dialogues
Appendix C: The Recovery Dialogues
Appendix D: Glossary of Terms
Appendix E: Literature Summary
Appendix F: Bibliography
Appendix G: Advisory Group
Appendix H: List of Resources
Foreword
The Center for Mental Health Services (CMHS), a part of the Substance Abuse
and Mental Health Services Administration (SAMHSA) was created in 1992 to meet
the need for an entity within the federal government that focuses on real-world
experiences, services and evaluation. CMHS works to promote mental health and
prevent the development or worsening of mental illnesses when possible. Changes
in the public mental health care system are affecting both mental health consumers
and practitioners. Mental health care is focusing less on stabilization or custodial
care, and more on rehabilitation and recovery; part of this new focus is to
involve consumers more than was customary in the past. The widespread adoption
of managed care programs and new technologies (particularly changes involved
in approaches to medication), along with the continuing problems of discrimination/stigma
associated with mental illness, offer tremendous ongoing challenges to the ability
to provide high quality mental health care. Current conditions make it important
more than ever to establish partnerships not just building one-to-one
relationships, but also creating lasting, productive alliances at both the system
and policy level.
Through dialogue people can come together for a mutual exchange of ideas, observations
and experiences. Dialogues go beyond the usual interactions between practitioners
and recipients of mental health services. They provide a safe environment in
which participants may speak freely to create better understanding and mutual
trust and respect.
For the first time ever, this participatory dialogue manual, developed by mental
health consumers, offers a blueprint for action. It describes the benefits of
dialogue meetings and provides easy-to-follow detailed specific action steps
on how states, local communities, providers, managed care organizations, advocates,
family members and consumers can organize meetings to develop working partnerships
to improve mental health service delivery. The goal is to bring all stakeholders
together on a level playing field and to develop the kinds of partnerships that
are needed to improve mental health services.
CMHS has successfully initiated a number of consumer/provider dialogues using
the methods outlined in the manual. After each dialogue, participants remark
about the value of the dialogue and the impetus the dialogue has provided to
instill changes, initiate additional programs, and examine the insights offered.
Dialoguing, communicating, and partnering are ongoing processes. These dialogues
offer hope for a foundation of sincerity and openness that will lead to significant
improvement of mental health services because both providers and mental health
consumers are effectively communicating and discovering the importance of such
a unique collaboration.
Introduction
Never doubt that a small group of thoughtful, committed
citizens can change the world. Indeed, its the only thing that ever has.
Margaret Mead
In July 1997, the Center for Mental Health Services convened a two-day meeting
in Arlington, Virginia, Consumers and Psychiatrists in Dialogue. The
meeting brought together twenty individuals who were equally divided between
current and former recipients of services (consumers), and psychiatrists from
all over the United States. This historic meeting provided opportunities for
people to explore uncharted territory through communication exchange. The meeting
was a success, measured by the reported feedback from those who participated.
It was recommended that dialogues be replicated among other constituencies
at state and local levels, and for a written report to be distributed to a wide
mental health community. Another recommendation was to create a manual for people
to learn how to create similar dialogues. This volume is in response to that
last recommendation.
Background
Dialogue is not a new concept. Participatory Action Research, twenty years
ago, created a new paradigm for the conduct of research using dialogues nationally
and internationally.
In the mental health arena, three roundtables were convened in 1989, by the
Community Support Program, under the National Institute of Mental Health, to
discuss the issue of involuntary treatment. These three meetings (held first
with consumers, then psychiatrists and consumers, lastly with consumers, psychiatrists
and family members) were the inspiration for a conference model, Pioneer
Dialogues, the first of which was held in Broward County, Florida, in 1992.
The two-day dialogue conference was held at South Florida State Hospital, bringing
consumers and professionals together to discuss basic consumer issues and strategies.
In other parts of the country, similar dialogues were being held. New York
State convened a series of Recovery Dialogues between psychiatrists and
consumers. Darby Penny, New Yorks Director of Recipient Affairs, describes
one of these dialogues in the manual. Dialogues were also organized between
state commissioners of mental health and mental health consumers under the direction
of Ann Loder, consumer advocate from Florida, while working with the National
Consumer Policy and Research Workgroup.
Why are Dialogues Important?
First, there is general agreement that the mental health system needs to change.
Consumers have been talking for years about what the problems are, expressing
anger about mistreatment in the name of treatment. Consumers have received support
for some of these viewpoints. Today, there are innovative programs, many of
which are directed by consumers, jobs that have been created, and new policy
development that has been influenced by consumer input. Yet, it just isnt
enough. The mental health system has had its equal share of failures and advances.
The climate of the general community is more volatile than ever; violence on
the rise is often attributed to mental patients. Approaches are being considered
that may further put consumers at risk for increased involuntary treatment.
Consumers need to talk about issues from their different perspectives in order
to develop workable solutions that will assure consumer survival.
To Talk About Differences, There Must Be a Partnership
Dialogue can be a first step toward establishing partnerships between people
who agree to listen to each other. They offer opportunities for people to exchange
their beliefs with others while simultaneously having a deep, private conversation
within themselves. A dialogue is a way of healing, opening the possibility for
gaining new trust and understanding. When people understand each other, they
are able to work together and create partnerships. Ultimately, however, the
success of a dialogue rests with the individual whose life has been changed.
Pilot Dialogues
In order to determine whether the steps outlined in this manual were adequate
or complete, two pilot dialogues were held in Pittsburgh, Pennsylvania, and
in Palm Beach County, Florida, both during the Spring of 1998. Each differed
in the dialogue model that was used. Pittsburgh used the roundtable model; Palm
Beach County used the conference model.
New approaches that worked in previous dialogues have been added to the how-to
steps in this manual. Approaches that did not work were considered just as valuable,
because they could be used as examples of what not to do. You will find many
references to the pilot dialogues throughout the text.
Other dialogues mentioned in the text are: the Pioneer Dialogues held in Broward
County, Florida (19921995), a dialogue between psychiatrists and consumers
held in Arlington, VA (1997), and Recovery Dialogues held in the state of New
York. Nebraska is used as an example, several times, to illustrate the difficulties
of organizing a dialogue in a rural state.
About the Manual
Although articles and reports have been written describing the benefits of
dialogues, writing about them is not the same as organizing them. The goal was
to create a practical manual with simple, concise, information that anyone could
use. Steps are included that talk about everything from location selection to
how to plan meals. Two models of dialogue are presented, the conference model,
and the roundtable model. Most of the steps in this manual are applicable to
both models, but specific steps for the conference dialogue have been added.
Examples in the form of vignettes have been added to most of the steps, as well
as tips that can be helpful.
Dialogues are also an art form, a variation on the art of conversation,
in which listening is as important as talking. A short narrative tells you how
to be a good listener. Another form of dialogue is communication on the Internet.
A chapter explains how to use it and also lists Web sites for discussion of
mental health issues.
The manual is for anyone to use. The main issue presented is mental health,
but most of the guidelines will also work for other groups. The population that
is the minority, or who has the least power, should take a lead in planning
a dialogue as much as possible. In a mental health dialogue, consumers should
take the lead. Consumers are the reason for the dialogues because consumers
are the subject of the dialogue. Creating a forum for equal exchange is a goal,
but it should not be forgotten that one of the primary reasons for dialogues
is for professionals to learn more about consumers from consumers.
The Art of Listening
A good dialogue requires you to be a good listener. Sadly, many people do more
talking than listening. Even while listening, we are thinking about what to
say, or we are listening to whats going on in our own head rather than
what is being said by the other person. Many of us want to talk, but few of
us really listen.
The first step in being a good listener is to be truly interested and concerned
about the other person. Start listening from the beginning. Clear your mind
from other distractions and focus on what the other person is saying.
Listen Objectively
If you listen with the intention of taking issue with what the other person
is saying, you will not be able to understand what the person is saying under
any circumstances. Good listening requires that you suspend judgment, cut through
emotional barriers, and keep an open mind.
Listen for the Main Idea
New information requires that you understand the point the other person is
making. However, sometimes the speaker may not be clear enough to be understood.
Ask questions for clarification. Make sure you can summarize the gist of the
message when the person is finished speaking.
Listen for Details
Specifics of a message are much more difficult when they involve names, dates,
places, facts, and figures. Try to remember which details are important, but
make sure that you dont pay so much attention to details that you lose
the overall concept of what is being said.
Listen to What is Not Being Said
Be aware of body language, tone of voice, eye contact, and gestures. It is
often what is not said that conveys the true message of what a person
is saying. Your own body posture and attentiveness will influence what and how
the person conveys information. Assume a posture of attention. Look at the person
while he is talking. It may not improve your ability to listen, but it may have
an effect on the other person.
Language Used
The generic term consumer has been used for persons who have or are currently
receiving mental health services. It is used only when necessary, because it
has been the most accepted term, not because it is the most popular. Other terms
such as consumer/survivor/ex-patient might have been used, but adding
words may be cumbersome. Most often, the words people or persons
are used for description.
Dialogues are being conducted all over the country, in many different ways.
They are being used as part of research and evaluation, to evaluate consumer
satisfaction, and to train staff in mental health agencies and hospitals. There
are many other possible purposes. Let this guide inspire you to create other
dialogues. How they take shape is up to you. Last word: Have fun creating
your dialogue! Have fun using the manual!
What is a Dialogue?
An ounce of dialogue is worth a pound of monologue.
Leonard Ray Frank
A dialogue is a forum in which two or more groups of people are brought together
as equals to explore their differing views, experiences, and belief systems,
in this case, about mental health topics and issues. A dialogue is structured
to allow for exploration of ones own perceptions and attitudes, as well
as to listen to other people explore their own.
All dialogues have the following common goals and objectives:
- Create better understanding and mutual respect among consumers, family members
and professionals.
- Allow participants to speak from their experiences and belief systems in
an atmosphere of safety.
- Create partnership ventures through compromise and consensus.
- Change attitudes and practices in the mental health system.
Dialogues Promote:
- Listening
- Serious inquiry
- Risk taking
- Curiosity
- Healthy conflict
- Openness
- Diversity inclusion
- Consensus building
- Empathy
- Understanding
But Discourage:
- Assumptions
- Being judgmental
- Argumentativeness
- Divisiveness
- Closed-mindedness
- Hidden agendas
- Uniformity
Different Models
of Dialogues
Roundtable Dialogue
A Roundtable Dialogue is an open discussion group with 2025 participants.
It brings people together who have different perspectives on mental health topics
and issues. The group may consist of two or more specific groups. The Roundtable
relies on a respectful facilitator or co-facilitators who treat people as equals
and are sensitive to individual needs.
Conference Dialogue
The Conference Dialogue combines speaker presentations with small group dialogues.
The audience may include up to 125 people who gather as a group and break up
into smaller groups (up to 25) where participants interact as equals. The Conference
Dialogue may be used as an annual event to honor our accomplishments, to educate,
and to involve a particular aspect of a mental health system.
Both styles of dialogues are intended to help people to understand each other
by talking over differences and sharing similarities in life experiences. The
results are improved relationships which can help to establish partnerships
within the mental health system.
Both Dialogue Models Include:
- Participant guidelines
- Facilitator guidelines
- Goals and objectives
- Participant selection guidelines
- Time for networking
- Conduct guidelines
- Plan for shared meals
- Timekeepers
- Time for strategies
- Evaluation forms
- Participant packets and name tags
Conference Dialogue Model Only:
- Requires more funding
- Planning takes longer
- Agenda more detailed
- Uses speakers/panelists
- Include arts and entertainment
- Small pre-set dialogues
- Uses more volunteers
- Requires brochure
- Location needs differ
- Open microphone
Develop the Dialogue
Organize a Committee
- A lead person from an agency will initiate the dialogue. This person may
later become the coordinator of the dialogue.
- Keep small, approximately five to six people. Too many people on the committee
will be confusing and make it harder to complete tasks on time.
- Include representatives of key constituency groups. Make sure consumers
are on the planning committee.
- Always include primary consumers (direct recipients of services), as the
dialogue is intentionally established to hear their views; however, a family
member may be included, if applicable.
- Select people who have organizing abilities, writing skills, and fund-raising
experience.
- The sponsoring agency should be represented whenever possible. The agency
should be able to provide secretarial support and other technical assistance,
including the ability to fax, send mailings, and print copies.
Other selection criteria to be considered:
- Enthusiasm about the dialogue.
- Familiarity of members, i.e., do committee members know each other?
- History of working together (because individual strengths and working styles
will already be known).
- Commitment to meet the demands of frequent meetings and tasks.
If planning a dialogue from long distance, committee members may meet by conference
calls and e-mail. Long-distance planning creates other considerations such as
whether a face-to-face meeting is indicated, how to delegate responsibilities,
participant selection, etc.
Organizing a dialogue can be a long, tedious process that requires committee
members to build trust. The planning process involves ongoing and open communication
between the committee members and is often a learning experience as significant
as the event itself.
The committee determines:
- The purpose of the dialogue
- Groups to be represented
- Length of dialogue (one or two-day meeting)
- Whom to invite
- Date, location, and time
- Type and model of dialogue (Roundtable or Conference)
- Selection and choice of coordinator and/or co-coordinators (It is helpful
to have two coordinators because they can share responsibilities and one can
take over for the other if necessary)
- Dialogue agenda
The coordinator(s):
- Demonstrate leadership
- Do the majority of the work
- Bring information to the committee for decisions
- Set agendas and time-lines for completion of tasks
- Keep the committees work on schedule
- Serve as primary spokespersons for the event
- Make on-the-spot decisions when necessary
The committee may want to add additional people for specific tasks, but the
nucleus group should remain intact for consistency, to make major decisions,
and to keep things running smoothly.
The committee should allow two to four months to plan a Roundtable Dialogue,
and at least four months for a Conference Dialogue.
Choose a Title and Theme
Choose a broad theme or concept for a first dialogue, such as recovery, mental
illness, partnerships, or stigma and name accordingly.
Subsequent dialogues are more specific and focus on defined issues such as
the criminal justice system, homelessness, state hospital closings, or out-patient
commitment.
Keep the title short, concise, and catchy in order to grab attention.
Examples
- The planning group in Pittsburgh, Pa. (March 1998) named their dialogue,
Talking with Each Other: For a Change. The sub-title was a double
entendre. Finally we are talking together instead of not communicating,
AND getting together to talk, pointing out the way to change.
- Pioneer Dialogue was the name given to the first Conference
Dialogue held in January, 1992, in Broward County, Florida. The word Pioneer
was chosen because, as defined in Websters Dictionary, pioneer is a
group originating a new idea, and because of a second Websters
Dictionary definition, of a plant capable of establishing itself in
barren soil. Pioneer Dialogues has become a common name
that other organizations are using in other parts of the country.
- Palm Beach County, Florida (June 1997) used the Pioneer Dialogue
trade name with the sub-title The Experience of Recovery. Their
second Pioneer Dialogue in 1998 dealt with more specific issues and was called,
The Health of the Mental Health System and How it Affects You.
Pittsburgh, March 1998
Talking with Each Other: For a Change
Broward County, Florida, 1992
Pioneer Discussions
Palm Beach County, Florida, 1997
Pioneer Dialogue
The Experience of Recovery
Focus Questions can be developed to yield information that is desired
from the dialogue. The committee should be careful to construct only broad questions,
since the specifics of topic discussion should come directly from the participants
in the dialogue.
Example
- Three roundtable discussions were convened in 19911993 by the National
Institute of Mental Healths Community Support Program.
The meetings focused on the subject of involuntary treatment and five basic
questions were developed prior to the meetings, as follows:
- What are the involuntary interventions used by the mental health system?
- How and why do people get treated against their will?
- How do involuntary interventions affect people who experience them?
- What are potential alternatives to involuntary intervention?
- What are the implications of answers to questions 13 for research,
training, and program development.
Develop the Budget
A budget must be created with estimated costs for the dialogue.
Find out first if all needed funds are available or if fund-raising will be
necessary.
Determine whether a written proposal with narrative and budget is required.
Sample Budget Items
- Site location
- Meals/refreshments
- Coordination
- Organizer of dialogue
- Facilitator fees
- Travel expenses
- Audiovisual equipment
- Documentation fees
- Printing
- Mailing and postage
- Hotel accommodations
- Recorder fees
Suggestions for Possible Funding
Government Funds
Government agencies are often interested in using funds for dialogues. In fact,
many of the dialogues that are discussed in this manual originated at the state
or federal government level. There may be discretionary funds at the end of
the fiscal year that agencies are eager to use.
Participating Agencies
Ask participating agencies to contribute funds or in-kind support. Collaboration
with participating agencies helps to insure the dialogues success.
Private Funds
Consider private funds or local foundations. Check the library for foundation
listings.
No Funds
It is possible to use an agency conference room requiring no funds at all. Have
everyone chip in for a pizza or similar lunch.
Two Dialogue Budgets:
(Note that the two different styles of dialogues vary in expenses.)
Funds for the above dialogue were raised through the Office of Educational
and Regional Programming in the amount of $1,000 and $500 each came from the
Pennsylvania Providers Association and the State Community Support Program.
Commentary from Pittsburgh organizer/consumer, Linda Morrison: We probably
could have done it cheaper, but we were in the belly of the bureaucracy and
we had a good marketer. There were no strings attached to the money.
Funds for Pioneer Dialogue on Crisis Alternatives included approximately $1,500
allocated by government adult mental health funds. Two local hospitals, the
State Protection and Advocacy Center, and a community mental health center provided
the balance of the funds. In addition, family member groups volunteered to serve
food and provide desserts for lunch.
We have provided you with only two sample budgets; however, there have been
many dialogues, each with their own variations.
Note
In Nebraska, a planning committee was formed to create a dialogue
which never got off the ground because the funding was not in place. In retrospect,
one of the planners concluded: Funding has to be in place . . . and
only when funding is in place can you operate as a planning committee.
Funding has to be in place . . . "
Set up the Meeting
Logistics
Day and Date
- Select a day that meets the needs of most participants.
- Consider providers, administrators, consumers preferences.
- Consult a calendar for already scheduled conferences.
- Note that air fares are cheaper when the weekend is included.
- Decide on a start and finish time (consider traffic patterns during business
hours and peoples family needs).
Set up:
- Day
- Date
- Hours
- Location
- Meals
- Breaks
- Smoking areas
Select a Location
A Conference Dialogue requires a large central meeting room plus break-out
rooms with circular seating for small group sessions. This site must be able
to support the total number of desired participants. For example, if the total
number is 100, at least five break-out rooms are needed. Frequently, locations
are considered ideal for the conference in every respect except for adequate
rooms for the dialogue sessions. At some conferences, outdoor space has been
used or rooms usually used for other purposes or a large meeting room broken
into sections.
A Roundtable Dialogue requires a large meeting room with people seated
at a table in a rectangle or square. It is important that all participants can
see each other.
An ideal site has:Adequate lighting (windows important)
- Adequate rest rooms
- Wheelchair accessibility
- Kitchen space (optional)
- Coffee makers available
- Electric outlets
- Parking
- Transportation to and from airports
- Good acoustics
- Comfortable chairs
- Public transportation accessibility
Hotel Settings
The selection of a site will be dependent on the budget. Select a hotel if
there is enough money in the budget. Hotels are desirable because they are convenient.
Arrangement of meeting rooms and other details are automatically taken care
of, and meals are prepared and served.
Note
Costs vary from city to city depending on the size. Meeting rooms vary greatly
in price depending on the facility. Time of year affects rates. (Areas that
attract tourists in the summer may lower rates in winter, and vice versa).
Check the Following Before Selecting a Hotel
- Parking space and fees Check to see whether the hotel offers
a discount or free parking for conference participants. Also make sure there
are adequate parking spaces.
- Hidden costs for extras It is important to ask whether there
are additional costs for microphones or other special equipment.
- Acoustics Make sure the rooms have adequate acoustics so that
people can hear each other.
- Accessibility for disabilities Check for accessibility for
wheelchairs, sign language, guides, etc.
- Food Be sure to check menus and costs. Most hotels will let
you sample food in advance. Some will even offer a free meal for this purpose
if you ask.
- Staff friendliness and helpfulness Does staff take time to
answer your questions? Do they return your phone calls in a timely manner?
Do they offer suggestions? Does your intuition tell you that they will be
friendly and helpful to the participants who attend the dialogue?
- Centralized location Is public transportation accessible,
close to participants homes, and near the airport?
- Surroundings and furnishings Are surroundings pleasing to
the eye? Are they comfortable and inviting?
- Directions to the hotel If you choose a hotel make sure you
ask for written directions and a map to include with the invitation. Most
hotels have these available including directions from the airport, and to
restaurants near the hotel. Nothing is more frustrating than to have participants
circling streets in a busy commercial area only to arrive at the meeting late,
totally exasperated.
Lower Cost Alternatives
- Agency boardrooms and conference rooms
- Colleges/educational centers
- Training rooms in banks, companies, hospitals
- Public libraries
- City Hall
- Schools (generally available only when school is not in session)
- Churches (not usually advised if religious icons are present)
- Community centers
- Homes are a possibility if nothing else seems workable.
Examples of site selections
- In Palm Beach County, Florida, the Mental Health Association held two successive
conference dialogues in 1997 and 1998. The first dialogue was held at a United
Way office. The second year dialogue was held in a hotel. The conference organizers
were all in agreement that the hotel setting was better although more expensive.
Tom Menard, one of the planners, stated: What we lost in money, we
gained in less stress.
- The Pittsburgh Pilot Roundtable Dialogue planners chose a hotel. Generally
speaking, everything was ideal. However, there were two problems. First, the
planning group forgot to give instructions on how the room should be set up.
As a result, the beginning of the dialogue was delayed. Second, this was one
of the meetings during which there was loud noise in the next room.
- The original Pioneer Dialogue in Broward County, Florida, would
not meet any of the standards for comfort as have been set forth in this manual.
The conference site was situated far from where most of the attendees lived.
The chairs were straight back and uncomfortable, the acoustics were terrible
(an old air conditioner went on and off making it almost impossible to hear)
and break out rooms for the dialogue sessions were far away from the general
meeting area. Despite these drawbacks, the conference dialogue was a major
success! Everyone loved it because it set precedents for involving an entire
community to make changes in the mental health system.
- A high school was selected for a Pioneer Dialogue, for which
there was no charge. All criteria were met with only one drawback. The size
of the auditorium was too large for the audience, which filled only one fifth
of the room. The problem did not become apparent until the day of the dialogue
when people spread to all areas of the auditorium, some at the entrance, and
some near the stage. The meeting was difficult to hold together, though in
many ways the site was ideal.
- One of the best site selections was for the 1996 Pioneer Dialogue, Broward
County, that was held at a Unitarian Church which offered pretty grounds with
flower gardens and trees and a large patio off the main meeting room. Break-out
rooms were adequate. Generally speaking, churches are not recommended they
may be offensive to some who are non-religious. Unitarians are a secular congregation,
consequently the meeting rooms were acceptable to all participants. The rental
cost was also reasonable. All in all, this may have been one of the nicer
settings for a conference.
Sometimes you try an alternative location, the next year a hotel, and compare
. . .
Sometimes the site appears perfect, but gaps in planning can disrupt . .
.
Sometimes a site appears marginal, and it works . . .
Sometimes a site that has no costs, has costs (if it is not working) . .
.
And sometimes it all comes together.
Select Participants
Invite people who will contribute to the dialogue and who will be affected
by the outcome. Selected individuals should have good communication
and listening skills, and have expressed an interest in participating in the
dialogue exchange.
A Roundtable Dialogue should be composed of no more than 25 (preferably
20) people. A 20-person dialogue should be equally divided among consumers,
providers and/or family members.
A Conference Dialogue may not have equal ratios. A 3040% consumer
representation may be adequate if the goal is to educate providers. Make sure
that consumers share lead roles.
Note
Consumer and provider definitions may be interchangeable. Some consumers are
providers and vice versa. The definition of a consumer used in this manual is
a person who has received direct services in the mental health system and who
openly defines himself/herself as an advocate for other consumers.
Key Factors in Selecting Participants
- Cultural backgrounds
- Geographic representations
- Background in leadership
- Political perspectives
- Employment-related diversity
- Gender
- Sexual orientation
- Age considerations
- Physical abilities
- Socio-economic backgrounds
Consider the Following
- Should only those consumers who can articulate an ideology be invited?
- Should non-verbal consumers be invited?
- Should consumers be invited if staff members from their agency are participating,
creating possible power imbalances?
These are issues to consider, but generally speaking, we recommend that participants
should be verbal and have some opinions on issues. Occasionally someone will
make a comment, The dialogue doesnt represent all consumers.
Usually, when one hears the stories of dialogue participants it becomes evident
that they were not as articulate as they are now.
In Nebraska, the planners were concerned about whether they had enough consumers
who were ready to participate in a Roundtable Dialogue. J. Rock Johnson, a consumer
advocate, made the following observation: It becomes obvious to me
that dialogues are not designed and may not be suitable for bootstrap
situations such as ours. The expectation is that there is an existing pool of
consumers who are self-assured, articulate, and can be at ease with authority
figures. My thinking was that we could use this vehicle to help find persons
with potential and help develop them. That is still our intention.
Diversity
It is important to reach out and include as many people as possible from different
racial and cultural backgrounds. Perspectives on mental health differ greatly,
and people of color have been discriminated against, not only in society, but
in the mental health system as well. Sometimes they are added as an afterthought.
Jacki McKinney, consumer advocate (PA) states: Most of the time, no matter
how large or small the meeting, theres only one or two people of color
present. I am excited, as I see that dialogues can be used as a positive tool
to correct this.
In Arlington, Virginia, a dialogue between psychiatrists and consumers, in
1997, included a diverse group of people who were Asian, Polynesian, African
American, as well as people with differing sexual orientations, religious and
age backgrounds. Janet Foner, consumer advocate from Pennsylvania, stated: The
inclusion of persons with so many different backgrounds made it a truly rich
experience.
. . . dialogues are not designed and may not be suitable for bootstrap
situations such as ours.
. . . no matter how large or small the meeting, theres only
one or two people of color present . . .I see that dialogues can . . . correct
this.
. . . different backgrounds made it a truly rich experience.
Other Considerations
Consider whether to invite an individual who has a history of grandstanding
or being hostile or disruptive at meetings. While it is important to be inclusive
of all viewpoints, it is also important to ensure as much as possible that participants
are not going to be disruptive. Talk to an individual before inviting him/her,
define the problem, ask for cooperation, and ask for an agreement to follow
guidelines. If the person agrees, fine; if not, reconsider the invitation.
Example
- The planning group from Pittsburgh was worried that a potential invitee
might not be able to be objective at the meeting and decided to discuss it
with the individual ahead of time to express their concerns. The person agreed
to follow the guidelines, was invited, and only had to be reminded once that
a dialogue is not a debate, and every persons opinion is valid.
Pittsburgh
. . . a dialogue is not a debate, and every persons opinion is
valid.
Finally, the Pittsburgh dialogue raised the question regarding the presence
of observers. It was clarified that all participants should be full participants,
not observers.
The Invitation Letter
An invitation should be sent well in advance of the dialogue.
For a Roundtable Dialogue, the letter is sent to individuals who have
been pre-selected by the committee. The letter should specify pertinent information.
- Who The name of the sponsoring organization
- What The event (title of the dialogue)
- Where Location of the event, including, address, phone number,
fax, and e-mail, if possible
- When Day, date, and time
- Why Objectives, specific goals for the meeting
Make sure to mention if there are any costs involved and whether meals are
included. Request that casual clothes be worn. Also, ask if there are any special
needs requiring accommodation. After all the pertinent details of the event
are given, an RSVP should be requested with an expected date of return.
For a Conference Dialogue, an initial notice should be sent to mental
health agencies, selected individuals, and other facilities to alert them about
the upcoming dialogue. Later correspondence will include a brochure that provides
more detailed information (See illustration of a brochure in the conference
section).
Plan Meals
Meals are an important part of the dialogue. Plan meals that keep the group
together so that people can socialize with each other and network to exchange
information. Participants should be told in advance that meals are part of the
dialogue.
Selecting Foods
Continental Breakfast
Coffee, juice, muffins or sweet rolls. Make sure there are selections with
little or no sugar such as fresh fruit. Set a cutoff time for coffee in order
to minimize distractions during the dialogue.
Buffet Style Lunch
Simple foods such as sandwich ingredients, cut-up vegetables, finger foods,
and salads are good choices. Make sure that vegetarians and people with special
diets are accommodated, including persons with religious restrictions. A choice
of beverages may include iced tea or lemonade.
Food Preparation
Food can be prepared at the dialogue if the site includes kitchen facilities.
However, make sure that participation in the dialogue is not compromised by
persons who are involved in food preparation, and that the kitchen is far enough
away from the dialogue to avoid distractions. A special committee may be appointed
to take care of the food and all of the tasks involved. Another option is to
have food prepared in advance and delivered.
Use Volunteers
Recruit volunteers from the invited participants to perform a variety of tasks.
This maximizes participation and helps to make participants feel like they are
an important part of the planning process. Volunteers can help prepare food,
design a brochure, set-up rooms, greet, video or audiotape the conference, keep
time, etc.
Note
Use consumers as volunteers whenever possible. Try to pay stipends for performing
a variety of tasks. Be creative . . . use volunteers as photographers, taxi
drivers, ushers, etc. We call stipend volunteers paid volunteers.
Technical Considerations
Flip Charts
- Write in bold capital letters
- Use dark colored ink
- Number each page for reference
- Use colors for highlighting
- Keep one idea heading per page
- Post on walls for easy reference
- Pre-cut masking tape and put tape on sides, not top, to remove it easily
Video/Audiotape: To Tape Or Not To Tape
Roundtable Dialogue
Videotaping and audio-taping is discouraged in a Roundtable Dialogue because
participants may not be as open or honest in their discussions. However, a Roundtable
Dialogue may be audio-taped only for the purpose of documenting minutes for
a summary report.
Conference Dialogue
Videotapes or audio-tapes may be made of speakers and panelists at a Conference
Dialogue, but the small group dialogues should never be taped. Assign
someone to keep track of when to change the tape and to make sure the tape player
is near the microphone. Give the task to someone who has experience with the
audiovisual equipment.
Note
Be sure to have signed consent forms for anyone video or audio-taped.
Example
- Dialogues were videotaped in the state of New York between psychiatrists
and consumers and they were used as effective training tools. However, a key
organizer, Darby Penney, New York State Director of Recipient Affairs, stated:
. . . the discussion may have been freer and deeper had they not
been taped. There was one of our six sessions that was not taped, and my sense
is that conversation was much more intense and dealt with more difficult topics
than the others.
. . . the discussion may have been freer and deeper had they not
been taped.
Name Tags and
Participant Packets
Hand out name tags at the beginning of the dialogue. Name tags can be purchased
or made by hand with an artistic design. Cardboard place cards
are also important at a Roundtable Dialogue. Place cards can be labeled with
names and placed ahead of time in order to diversify seating arrangements. Participant
packets can provide all participants with information pertinent to the dialogue,
such as dialogue guidelines, agenda and a list of participants.
Participant Packets May Include:
- Dialogue guidelines
- Agenda
- Blank paper
- Pen
- Acknowledgments
- Resource articles
- Brochures of local programs
- Names and addresses of all participants
The Evaluation
Form
. . . Dont Forget!
Reasons for evaluating the dialogue:
- To determine whether the dialogue was helpful
- To identify areas of improvement'
- To assess the effectiveness and whether to continue
Design a one-page form that is user-friendly and simple with carefully
constructed questions for the information needed. (See samples in Attachments)
Establish a rating system, with five choices (15) that designates
excellent to poor.
Include open-ended questions with adequate space for comments and suggestions.
Ask questions like: What did you like best about the dialogue? What
did you like least? What suggestions do you have for improvement?
Rate the Following:
- Overall presentation
- Facility/location
- Food and service
- Facilitators and speakers
- Topic relevance
- Pacing
- Start and finish time
Give attendees the option of not revealing their names and addresses.
This option encourages candid responses since people write comments more freely
if they do so anonymously.
Collect forms at the end of the day.
Note
Do not give people the option of sending forms back since they rarely do. In
order to ensure that evaluation forms are completed, announce their importance
at opportune times during the day and request that people return them before
leaving.
Time Limits and Time
Frame
In a Roundtable Dialogue, set specific time limits for the introduction
and for the closing session.
A Conference Dialogue must have carefully planned time frames for each
section of the day and for speakers and panelists.
Designate someone to be the timekeeper who will use a stop watch or timer.
The timekeeper will need to present information such as, We have about
two minutes for each person. When you hear the bell or see the signal that your
time is up, please try to finish your thought quickly, so that everyone has
a chance to speak. If presented correctly, even those people who dislike
time limits may like the challenge. Individuals may get a chance to laugh at
themselves if they start to go over the time. The group can laugh with them.
Ending Dialogues
Both dialogues should end with spontaneous comments from participants.
In a Roundtable Dialogue it is called Round Robin, for which
an hour is allowed for final comments.
A Conference Dialogue ends with Open Mike (microphone).
Both of these methods are explained in more detail in their respective sections.
Facilitation
Select the Facilitator
Dialogues are interactive and participatory events. They rely on effective
facilitation to promote participation, stimulate interaction, and summarize
information. A skillful facilitator, therefore, is a major player in the success
of a dialogue.
Choose a facilitator with the following qualities
- Energetic, enthusiastic
- Good active listening skills
- Able to be neutral on sensitive issues
- Previous experience
- Preferably a consumer
Consider the Following
- Whether to use a person on the planning committee or someone outside of
the planning process.
- Whether to choose a person not associated with your mental health system
to ensure total neutrality.
- Whether or not to select a consumer or professional. One possibility would
be to utilize a facilitator and a co-facilitator one a professional,
and the other one a consumer.
Use Co-Facilitators
Two facilitators can share roles and responsibilities. However, one person
should take the lead. A co-facilitator can take over if the lead facilitator
gets stuck, or if the group becomes stagnant. A co-facilitator can also add
information or clarify points being made. Another role may be to record suggestions
on a flip chart, serve as timekeeper, and be available for any unanticipated
situations that may arise.
The Role of the Facilitator(s)
The facilitator(s) role involves each of the following tasks:
- To create a safe, open, trusting and supportive environment for all group
members.
- To guide the group activity and discussion.
- To keep the channels of communication open.
- To sense moods and feelings within the group.
- To keep the group focused.
Directive, Participatory or Non-directive Facilitator(s):
A Directive Facilitator — Asks prepared questions and keeps the discussion
focused on those questions.
A Participatory Facilitator Starts the discussion by reminding
the group of the goals and objectives of the dialogue, then invites suggestions
on how to proceed as a group, as well as on the specifics of what will be discussed.
A Non-Directive Facilitator Declares the discussion open, sometimes
acting as a gatekeeper like the participatory facilitator. He/she
will only be involved directly in the discussion when it gets too heated or
if there is more than one person talking at the same time.
A good facilitator uses all three styles at different times, and will know
when to apply each one. The group that is tightly reined will be less creative,
and if too unstructured may lose focus and will not be cohesive. The facilitator
who is most effective is eclectic and intuitive to group needs.
A factor in facilitation style may be determined by the particular group and
the goals of the dialogue. It may be appropriate for the facilitator to interact
as a group member if it is decided the group will benefit.
The facilitators primary role, however, is to manage process and time.
While doing so, the facilitator should allow the group to direct itself as much
as possible, and only introduce new topics to keep the discussion flowing in
a positive direction.
Facilitator Top 10 Tips:
- Greet participants when they enter the room.
- Acknowledge suggestions.
- Use names of participants as often as possible.
- Watch out for your own biases.
- Avoid interrupting.
- Allow the group to solve problems.
- Maintain eye contact.
- Give positive reinforcement.
- Recognize sponsors.
- Remember, this is their show, not yours!
Facilitator Pitfalls:
- Not managing monopolizers.
- Talking down to the group.
- Not finishing on time.
- Telling a flat joke!
- Using sexist language.
Start the Roundtable
Dialogue
Welcome Everyone
- Tell a joke or anecdotal story.
- Brief group members on the purpose and objectives of the dialogue.
- Acknowledge individuals who planned the dialogue.
- Give recognition to sponsors and underwriters.
- Review housekeeping information, including location of rest rooms smoking
areas, time for lunch, and ending time of dialogue.
Introductions
The facilitator should start the introductions so that participants will feel
comfortable with him/her and serve as a model for others when it is their turn
to introduce themselves.
Information requested may include whether the person is a consumer, family
member or provider, job title or employment, advocacy affiliation, whether they
are a parent, or grandparent, and where they live, or other pertinent information.
Set time limits for participant introductions (three minutes each for a 20-person
dialogue).
Present Conduct Guidelines
The following guidelines should be observed:
- Be considerate.
- Be able to consider new ideas.
- Avoid professional jargon.
- Feel free to ask any questions.
- Have fun!
Ask the group if they have any other guidelines to add.
Set Agenda
Pre-selected topics or focus questions should be presented to dialogue participants
for their approval or modification. The group should approve the focus questions,
make minor changes, but not alter them entirely.
- Allow a limited amount of time for modifications.
- Usually the initial topic is first-person stories and narratives.
- Set approximate time frames for all topics.
- Make sure to allow time for future planning and closing.
- Set times for breaks and lunch, and ending time.
Maintain Flow of
Conversation
While the dialogue group session is taking place, it is the job of the facilitator
to maintain the flow of communication within the group. In order to do this,
the facilitator should use the following techniques:
- Building/Crediting Add to others ideas or suggestions.
It can include picking out from what everyone says and adding additional clarification.
- Encouraging The facilitator should be friendly and responsive
to members and their contributions and make positive, genuine, reinforcing
statements about participants input.
- Harmonizing Encourage people to explore their differences
and appreciate each others point of view.
- Clarifying Clarify vague statements, as well as offer facts
or relevant information about issues being discussed. This technique can include
answering questions, interpreting or reflecting ideas and suggestions, or
giving and seeking information to clear up confusion. At the same time, the
facilitator should avoid interrupting or speaking too long. Interruptions
may be necessary only when a person has talked too long or has strayed from
the subject.
- Summarizing Summarize statements made by members of the group.
These summaries generally recap what has been said or covered; pull together
ideas that are related, and identify areas of agreement. A summary can also
restate suggestions after the group has discussed them.
- Motivating The facilitator is expected to keep the discussion
process flowing. If the group becomes stagnant, he/she can change the direction
of the dialogue, suggest a break, or ask the group where it wants to go next.
The facilitator can also introduce a new topic. It may be necessary to restate
the goal or purpose of the discussion session. If the group reaches a consensus,
acknowledge it, and move forward.
Deal with Conflict
As group members interact, it is likely that their perspectives will clash
or contradict. This contradiction can create conflict within the group session.
It is the job of the facilitator to evaluate this conflict and determine if
any intervention is necessary.
When assessing conflict, the facilitator should consider these key points:
- Allow a reasonable amount of subject-related conflict. Such conflict is
healthy for the group.
- Encourage the group to thoroughly weigh, explore and examine topics and
issues, including conflict.
- Do not retreat from tension-filled situations.
- Minimize conflict among members on unrelated topics.
- Keep the group focused on ideas, not personalities.
- Remain neutral during disagreements. Avoid taking sides.
- Avoid being heavy-handed or too controlling.
Note
Recognize that controversy can spark creativity, promote growth, and build
allies. Do not feel compelled to discourage or stop conflict immediately. Remember
that feelings, emotions and conflict are legitimate factors in the dialogue
process. It is important for the facilitator to recognize this from the start.
Stick to the Agenda
Stick to the planned agenda as much as possible. When you see that participants
are ready to move on, go to the next agenda item. Sometimes the dialogue will
take on a life of its own, but the facilitator should remind the group that
there are topics still to be discussed.
Future Plans and Strategies
The last portion of the dialogue should be used for creating strategies and
initiatives and making future plans:
- Take all suggestions and place on the flip charts.
- Allocate at least one hour for strategizing.
- End with a challenge.
- Ask everyone to commit to a task.
- Prioritize suggestions.
- Write participants suggestions on the flip chart.
- Make plans for reconvening if the group decides to do so.
Record the Dialogue
Designate a person to record minutes of the dialogue which later become the
summary report and/or documentation of the meeting. It is important that the
draft of the report be read and approved by all of the participants before being
put into final form. When recording:
- Respect confidentiality when taking notes.
- Do not tag responses with participants names.
- Do not feel compelled to note everything.
- Be concise, brief, and summarize.
- If a consensus is reached on a topic or suggestion, record the item.
Conclude the Dialogue
The Round Robin is the final portion of the Roundtable Dialogue. Allow
an hour at the end of the dialogue for last-minute comments, suggestions and
expressions. Instruct each person to take a turn around the group to provide
input, but make sure to state that people can pass.
Timekeeping is particularly important during Round Robin. First determine the
total amount of time remaining in the dialogue. Then divide that time by the
number of participants so that each person receives an equal amount of time.
A timekeeper will keep close tabs on each person.
After the Round Robin, show appreciation for everyones participation.
The closing remarks are sometimes very personal and reinforce connections between
people, making the day a memorable one.
Conference Dialogue
This section describes the particular steps that need to be added to organize
a Conference Dialogue.
Selecting Participants
- Approximately 50150 people.
- Use the same criteria as for a Roundtable to select participants.
- Ask mental health agencies to select participants after receiving a letter
and brochure that includes the number of slots allotted.
- Send individual family members, consumers, and advocates separate invitations.
- Invite public officials and dignitaries.
Note
VIP guests should be full participants but may not be able to stay for the
entire conference.
Planning
- Planning takes at least four months.
- The core planning group may add special subcommittees for tasks.
- Early in the planning stages inform mental health constituents about the
conference for their information and involvement in planning.
Dialogue as Training Day (Inservice):
Make sure to inform mental health agencies well in advance of the dialogue
to ensure their cooperation and participation in giving employees a day for
inservice training.
Send Letter and Brochure
Two months before the Conference, send the first letter of invitation to mental
health agencies, organizations, and individuals. The letter should be written
on agency stationery and signed by the executive director.
The letter assigns a specific number of registration openings for each agency
proportionate to its size. Request that mental health consumers be included,
as well as persons with different cultural backgrounds and other diversities.
The Brochure
A brochure should be enclosed in a second letter to be sent to all invitees
one month before the Conference. The brochure should include all of the factual
material. It may include art work and illustrations that are appropriate to
the theme of the conference.
Include a registration form in the brochure that will be returned in order
to pre-register all participants. For expediency, agencies may fax or e-mail
back the names and titles of the participants. Individuals can mail their registration
forms or could also fax or e-mail them. When all names are in, compile in categories
in order to prepare the dialogue sessions in advance. (Please note that advance
preparation of the dialogue sessions is optional).
For an example brochure, see Attachments.
Brochure Should Include:
- Title and theme
- Date, time and location
- Purpose/philosophy
- Information about the conference
- Goals and objectives
- Cost, if any
- Conference coordinators and guest speakers
- Conference agenda
- Who will attend
- Registration form
- Sponsors and funding agents
- Names of planning committee
- Phone contact for additional information
Using Speakers
A Conference Dialogue includes a keynote speaker and two sets of panelists
(for a one-day conference). A keynote speaker talks for no more than 30 minutes,
panelists are given 15 minutes each for a panel of four.
Steer away from long introductions and formal recognitions that distinguish
speakers from other participants in the audience Treat all participants as equals.
Preparing
the Small Group Dialogues (Optional)
Allow two hours to organize the small group dialogues. This can be accomplished
by a small sub-committee. The committee members must be familiar with the local
mental health community professionals and consumers in order to pre-set the
small groups.
Assign approximately 2025 (preferably 20) participants to each
group. More than 20 individuals is difficult to manage, however you need to
allow for people who leave or do not appear. It is essential to know, in advance,
how many breakout rooms are available in order to determine the size of the
groups.
Gather all of the names of pre-registered participants. Although there
will be people who do not register in advance, it is essential to know most
of the attendees names and affiliations in order to create a balanced
group of participants for the dialogue sessions.
Sort participants names and arrange them according to status,
providers, administrators, family members, therapists, psychiatrists, etc. Be
sure to include people at all levels of work experience, i.e., front line staff,
volunteers, etc. Ideal groups include diverse participants who have different
perspectives on mental health issues.
Designate a different color or symbol for each group. A designated symbol
or color is attached to the participants name tag the day of the dialogue.
Participants will be given instructions on the location of their group session
corresponding to the symbol or color.
Make a plan for the break-out groups. It is recommended that people
stay with the same group for each dialogue session.
Choosing Facilitators
A facilitator and co-facilitator should be selected for each small group dialogue.
Ask the panelists to serve as facilitators of the small group dialogues in
order to provide continuity and expansion of ideas that were presented. Panelists
generally have the necessary skills, but be sure to offer them the facilitator
guidelines.
Persons chosen to be co-facilitators should include a mixture of consumers,
professionals, and family members.
Guidelines for facilitators should be developed and enclosed in their packets.
It is desirable to offer facilitator training prior to the Conference Dialogue.
Skills should include active listening, dealing with conflict, redirecting,
and leading the group toward consensus. Role playing situations can be helpful.
The Day of the
Conference Dialogue
Documentation
Be sure to make a plan to document the conference with a report, photographs,
and/or videotape. When designating the writer, videographer or photographer,
it is preferable to use professionals or persons who have skills and experience.
Documentations can be circulated to participants and other parties who wish
to replicate the effort. Note that release forms are necessary for persons photographed
or videotaped. Finally, if you use a professional documenter, he/she will charge
a fee, which will need to be included in your budget.
Registration
Registration materials, cash drawer (if applicable), name tags, participant
packets, etc. should be assembled, and ready for distribution at the earliest
registration time. Allow at least one half hour for registration prior to opening
ceremonies.
Registrars should be well informed in order to answer questions.
Assign one registrar for persons who come to the conference without pre-registering.
Serve refreshments during time of registration in an area that will not interfere
with the conference. Make sure to establish a cut off time.
Welcoming Remarks
The conference coordinator should welcome all participants, state the theme
of the dialogue, review participant guidelines, and set the agenda for the day.
The coordinator usually introduces the keynote speaker.
Keynote Speaker
It is desirable that a consumer be the keynote speaker whenever possible, either
an out-of-town guest, or a recognized individual from the local community.
First Panel
The first panel takes place after the keynote speaker.
Typically the first panel includes first person narratives and stories from
the perspective of consumers, family members, and providers. All panelists must
be given careful time limits (10 to15 minutes each for a panel of four). It
is essential that the panel not exceed an hour in order for the dialogue sessions
to have enough time.
First Dialogue Session
All participants go to their assigned room. The facilitators start the group
with first name introductions and present the subject matter which relates to
what was discussed by the first panel. The small group dialogue is conducted
in the same manner as a Roundtable Dialogue. However, discussion will be limited
by time constraints, therefore limiting the scope of discussion.
Flip charts should be used to place suggestions and other feedback. At the
end of the session, one of the facilitators will be responsible for transcribing
flip chart information to a report sheet which is given to the conference coordinator.
Lunch
Time allotted for lunch should be long enough to allow time for networking.
An art exhibit and/or book display table would add another dimension to
the conference. It may even be desirable to have entertainment presented by
local consumers.
Second Panel
and Dialogue Session
Timing is important. The conference coordinator should pull everyone together
for the second panel discussion. The second panel usually focuses on problems,
barriers, and solutions to current mental health issues.
Open Mike
The Open Mike session for a Conference Dialogue is a final feedback session
conducted with the entire group.
A pre-appointed emcee moves about the audience with a microphone and encourages
people to get involved. A good emcee will know how to encourage people to come
up and speak in front of an audience.
Participants should be told they only have one-to-two minutes to speak. The
emcee will inspire the audience to express themselves spontaneously with comments
ranging from serious to humorous. Subject matter could include thoughts about
the conference, suggestions, personal anecdotes, jokes, poetry, songs, etc.
It is always nice to end Open Mike with an inspirational thought or song.
Ending the Conference
End the Conference Dialogue with an expression of appreciation and final acknowledgments.
Collect evaluation forms. In Palm Beach County, Pioneer Dialogue, 1999, the
coordinator announced at different times during the day, We have certificates
of attendance for everyone to receive, but you will only receive one if you
fill out the evaluation form. Everyone did.
Certificates of attendance are a nice reward and can be given out as participants
leave the conference.
Attachments
Sample
Brochure for Conference Dialogue
This sample is of a tri-fold brochure printed on two sides.
front side
back side
Sample
Evaluation for Conference Dialogue
This sample is of a one-page evaluation, printed on one side.
Sample Agenda
for Conference Dialogue
This sample is of a one-page agenda, printed on one side.
Appendix A
What Happens
After the Dialogue?
One way to measure the success of dialogues is to note what happens afterward.
A good dialogue is one that results in concrete plans for the future, incorporating
the suggestions received from the dialogue participants. All of the suggestions
should be reviewed and prioritized in order to develop action plans. Each communitys
needs are different. Recommendations may include requests for more dialogues
on special issues or with different groups, or plans for new program development.
Some Results from Pilot Dialogues
In Pittsburgh, participants suggestions included plans to hold all-day
dialogues in ten other counties in Western Pennsylvania, as well as follow-up
dialogues on topics such as managed care. Participants at the 1998 Dialogue
requested that family members be invited to future dialogues, as well as a broader
group of consumers. Other goals focused on the need for consumer sensitivity
training in professional educational programs, particularly for medical residents.
It was suggested that consumer-run drop-in centers be used for visitation and
on-the-job training. It was also recommended that a set of best practices,
describing quality programs and consumer groups be catalogued for professional
use. A written report of their first dialogue was sent to major stakeholders
in their county system. Proposed plans will be implemented in the next year.
In the meantime, people still talk about the dialogue they attended.
Palm Beach County made plans for dialogues and trainings (some of them related
to legislative issues) as a result of their conference dialogue. Letter writing
campaigns were underway during an election year and a training session was held
for consumers to inform them about candidates issues and ways to respond.
It was decided that Pioneer Dialogue would become an annual conference
each year to focus on a different aspect of their mental health system. Other
recommendations included the need for increased consumer involvement in district
planning and enhancement of their drop-in center, Peer Place. Participants
who attended Pioneer Dialogue from nearby districts took an interest in the
conference, and are making plans to organize their own.
At the national level, dialogues are being held between consumers and different
professional groups, i.e., psychologists and nurses. A dialogue with children
is being considered, with special regard for confidentiality issues. This Manual
is one of the outcomes from a recommendation made at the 1997 dialogue between
psychiatrists and consumers. Other recommendations were to establish possibilities
for more communication and shared endeavors between psychiatrists and consumers,
to replicate dialogues at the state and federal level, and to improve access
for consumers in different parts of government and managed care. Some of these
issues are being worked on and are at various stages of readiness. As one participant
at the national dialogue said: Success is a journey, not a destination.
What About Partnerships?
One of the goals for dialogues is for partnerships to be created between diverse
groups to develop and conduct dialogues. The question is whether partnerships
after the dialogue are sustaining.
Depending on what is meant by partnerships, too high expectations may not be
realistic. Differences that existed prior to the dialogue do not automatically
disappear. Peoples attitudes will hopefully shift to some degree, but
it must be considered that persons with different perspectives usually have
different work and life experiences. Consumers who are developing new self-run
programs rely more on life experience than professional degrees. Providers,
on the other hand, are required to hold licenses that dictate mode of treatment
which limits flexibility. Both groups have certain vulnerabilities. While professional
providers are concerned with risk factors and liabilities, consumers worry about
being co-opted into adapting to medical model practices.
Positive partnerships then, might be defined as learning partnerships in which
both groups agree to continue the dialogue and plan activities that are mutually
beneficial. This may include working on strategies to follow up on recommendations
or training on subjects that are helpful to both groups. Informal gatherings
that bring people together socially will also help to break down barriers. Full
partnerships will occur because people want them to and when they are ready.
Full partnerships are like any other relationship. They are chosen. They are
trusting. They treat each other as equals. In the mental health arena, this
will take time and work. Dialogues are a good way to start the process.
Appendix B
Other Dialogues
Internet Dialogues
Computer-mediated communication is a new dialogue technology. Electronic mail
e-mail is less formal than usual written exchanges and less textured
than in-person dialogue. E-mail is forgiving of punctuation and spelling errors
and typos. E-mail is intolerant of affectation and tends to ignore pedigree.
E-mail substitutes for nonverbal communication, not usually with literary expression
of mood and affect, but more often with icons: for instance :) for smile, or
<grin>. Those who like to use voice and presence and non-verbals to communicate
are not always comfortable.
Computer-mediated communication generally takes place on a neutral and level
field. Feedback is quick; gratification is frequent. People Who have-not
can use free e-mail from their public library on equal footing with e-mail from
a mental health program director. Rural areas without even cheap local phone
service can
use wireless, satellite links and Web TV. Third world countries, newly wired,
are installing state-of-the-art infrastructures.
People Who experience mood swings, fear, voices and visions (People
Who) have found each other on the Internet through news groups, Web pages,
and mailing lists. They have found support, mutuality, and advocacy for system
change. They have found relief from the loneliness associated with seeming different,
cutting edge medical information, and quick error correction of bad data. They
have found a range of views about psychiatric disabilities, from iatrogenic
to disease.
People Who have also found the mental health professionals online. There
are a large number of professionally oriented mailing lists for instance
about forensics, psychopharmacology, managed care, outcomes; some welcome People
Who as a valued resource, some open the lists only to professionals.
Exchange with a mental health professional by e-mail has a different tone from
in-person exchange. The territory is neutral one's own computer screen
rather than a therapist's private office or a mental health director's conference
room. The Person Who can take whatever space and time is needed to express a
point of view, can set the context of the response by excerpting from a previous
message, can readily provide supporting ideas and evidence that the professional
might not have considered. Those in conversation are not limited by having to
share a fixed amount of time, are not limited by having to stay focused on the
topic, are not limited by the inherent power imbalance between professional
and Person Who.
People Who dialogue with peers about work opportunities, and advocacy
and rights issues, and about managing the situations that earned them a psychiatric
label. People Who dialogue with professionals about advocacy and rights issues,
especially forced treatment; and about DSM diagnoses, prognoses, and psychotropic
medications, and especially new treatments.
People Who read news groups like alt.society.mental-health, sci.med.psychobiology,
alt.support.depression, alt.support.anxiety-panic, alt.support.loneliness, and
soc.support.depression.family. Moderated news group discussions stay focused.
Many unmoderated people like to post to unmoderated news groups, and opinions
are apt to be polarized.
People Who visit the many mental health information Web sites. Generally
this is a one way exchange the visitor reads what is provided, perhaps
makes a comment to the Web master. Some Web sites provide chats and have some
interaction. Some Web sites are actually run on bulletin board software and
have more interactivity.
People Who use Internet Relay Chat and other chat software and situations
to join in synchronous exchanges with each other and with professionals.
Managed care companies and public health providers are beginning to use modem
technology to provide patient management and support.
And then there are lists. There are lists for moods Walkers (melancholy),
Pendulum (mood swings); for voices and visions Schizoph; for advocacy
Act-Mad; for safe support ClubMad; for spirituality MadSpirit;
for working as a consumer mental health professional TwoHats; for state-specific
issues MHCONSUMERS-OR. The exchanges are international, asynchronous,
and vigorous. Some lists generate upwards of 100 e-mail messages a day. Content
varies from humor, to dismay about psychiatric labels and public images, to
reviews of newly released DSM's, to newspaper articles. Some participants post
a reply to almost every message they read; some only read. Internet lists help
to realize the slogan of the South African anti-Apartheid movement: "Nothing
about me without me."
The MADNESS list states, "We bear witness each to our own experience with
madness, to how we have been treated, and to the social consequences we have
felt. We bear witness to the common vision and aspirations of People Who
experience mood swings, fear, voices and visions.
Lists are effective organizing tools. SAMHSA/Center for Mental Health Service
organized a Walk the Walk: With Lives Touched by Mental Illness in May 1998.
A hundred Internet users planned ways to participate on a list devoted to the
Walk. Australia and Canada planned parallel events, as did some other United
States cities. Posters and symbols were devised and posted on the Web, the message
People Who desired to communicate was hotly debated and finally agreed,
and press releases were drafted and distributed. Now it seems there is new momentum
among those consumer/survivors wanting to make improvements especially in public
mental health systems.
People Who are politically active have found support for resistance
to involuntary treatment and resistance to unconsented electro-shock, as well
as encouragement for Advance Directives, support for including independent grievance
procedures in managed care contracts.
Appendix C
The Recovery Dialogues A Personal Reflection and a Cautionary Note
In 1992, the New York State Office of Mental Health (OMH) began an innovative
project which brought together nine consumers/survivors/ex-patients (c/s/x)
with seven psychiatrists for a series of structured dialogues about the concept
of recovery. During a two-year period, this group met on five different occasions,
four of which were videotaped. Two training video-tapes were produced using
footage from the first two dialogue meetings.
The goal of the project was to create shared understandings between the two
groups about the process of recovery from a diagnosis of "mental illness,"
resulting in recommendations for the public mental health system on how these
understandings could be used to promote recovery. There was a sense that the
consumer/survivor/ex-patient movement had valuable experiential knowledge on
this issue that wasn't being adequately heard by clinicians and administrators,
and the dialogues were seen as a tool to build consensus on the importance of
system reform.
On the face of it, the dialogue process seems like an ideal way to bring together
two groups of people with disparate positions in order to converse on difficult
topics. As envisioned by the project organizers, dialogues bring "groups
together as equals and provide a structured opportunity for people to explore
and reflect on their own experience and their own belief systems.. . . They
allow the integration of diverse perspectives, resulting in a more complex understanding
. . . [and] result in a shared vision rather than a vision imposed from the
outside."
The dialogue process was painstakingly planned to reduce barriers to communication
due to power imbalances between psychiatrists and c/s/x. For example, the c/s/x
outnumbered the psychiatrists, and the particular c/s/x participants were selected
because they were seen as strong, articulate individuals who would not be easily
intimidated. Skilled, neutral facilitators used a carefully sequenced series
of focus questions to guide the discussion. People used first names, not titles;
we were seated in the round and the two groups were interspersed; informal time
for socializing was built into the schedule.
Over the course of the five meetings, we covered a wide variety of sometimes
controversial topics in a fairly collegial manner. After an initial period of
polite tenseness, we were able to speak frankly and freely among ourselves.
As we got to know the psychiatrists as individuals, some of the distance created
by our very different statuses were narrowed. While much of what the c/s/x had
to say about our treatment in the system was difficult for the psychiatrists
to hear and acknowledge, many of them clearly struggled to understand views
that were foreign to them. There was a shared sense that what we were doing
was important and valuable. And, yet.
And yet something really didn't feel quite right. While the experience of speaking
truth to power was liberating at first, I felt a surprising undercurrent of
unease and even resentment associated with the process. Naturally, as a good
ex-patient, I blamed myself: somehow, I wasn't feeling the "right"
emotions in this process. Here I was with a group of my peers, having the opportunity
to explain our views to people who could have an impact, and instead of feeling
pleased and excited, I felt very uncomfortable.
During a break, I learned that I wasn't the only c/s/x in the group feeling
ill at ease. As we talked among ourselves, several themes emerged that seemed
connected to our ambivalent reactions. First, there was a sense that we were
putting out a tremendous amount of emotional energy, talking about difficult
personal experiences in the hope of making important points about what was wrong
with the mental health system and what would be preferable. Our emotional efforts
(and the resulting vulnerability we felt) were not being reciprocated by the
psychiatrists. Despite all the steps taken to reduce the power imbalances and
to create a level playing field, the process did not feel "equal."
There was a feeling that, while we were finally being listened to, it wasn't
really in the spirit of mutuality. Rather, we were being used as teaching tools
for the professionals, and in the end, they got much more benefit from the experience
than we did. While we spoke from the heart about experiences that had defined
our lives and our sense of ourselves, they were still able to listen from their
"doctor" roles. They learned some new ideas, rejected others that
made them uneasy, and went away with their professional roles intact. We, on
the other hand, felt emotionally spent, slightly patronized, and decidedly unfulfilled
by the experience.
For me, the emotional strain of the process reached a crescendo at what turned
out to the last structured dialogue between the two groups. During the discussions,
it came out that all eight of the c/s/xs around the table that day were
trauma survivors. This was a startling revelation to the c/s/x, as we had never
discussed this among ourselves, and we were eager to pursue the subject in the
context of discussing recovery. The psychiatrists, to a person, almost immediately
shut down, and the discussion was quickly steered to a less threatening topic.
At that moment, it finally became crystal clear to me that this was not a process
of exploring beliefs and experiences in search of a shared vision. Even in this
structured process which worked so hard to be egalitarian, the psychiatrists
continued to define reality for us. It brought back all those old feelings of
being subordinated, of having one's life discounted, of being seen as "less
than." It didn't feel equal, it didn't feel like progress, and it sure
as hell didn't feel safe.
In February 1998, more than four years after our last meeting with the psychiatrists,
eight of the original nine c/s/x came together again to talk about trauma issues.
This time, we did not invite the psychiatrists. We came together to have a dialogue
among ourselves, to learn from each other, and to share our experiential knowledge
in a safe place. It felt remarkably productive, and we came away with consensus
on a number of steps that could be taken to make the mental health system less
re-traumatizing for people, as well as hours of videotape with which to make
training tapes from our perspectives. If I learned one important thing during
this long, multistage process called the Recovery Dialogues, it is this: Communication
is only possible between equals.
Appendix D
Glossary of Terms
Collaborate To work with others. In area of mental health, collaboration
may refer to interaction between mental health consumers, families and professionals
in order to effect change.
Dialogue A dialogue is a forum in which two or more groups are
brought together as equals to explore their differing views, experiences, and
belief systems. A dialogue is structured to allow for self exploration of one's
own behavior and attitudes as well as to listen to other people explore their
own.
Empowerment "Becoming connected and integrated into a community
that is mutually respectful and being able to fully participate in the decisions
affecting your life (Fisher). "When people are transformed from their
roles as passive objects to historical self-reflective subjects capable of acting
to transform their own conditions (Rose and Black).
Facilitator Conductor of a meeting who remains neutral and respectful
of all participants. Maintains power balance in the group, ensures that all
participants have an equal opportunity to speak
and keeps the group focused and within established time frames. Sets guidelines
for all participants to follow. Recognizes when the group reaches consensus
on issues.
Focus Group An interview style of collecting data designed for
small groups. Researchers strive to learn through discussion about conscious,
semiconscious, and unconscious psychological and sociological characteristics
and processes among various groups. It is an attempt to learn about the biographies
and life structures of group participants. To be more specific, focus group
interviews are either guided or unguided discussions addressing a particular
topic of interest or relevance to the group and the researchers.
Moderator A person who presides over a discussion or meeting
differentiated from a facilitator who remains neutral. A moderator may be much
more directive and involved in a meeting.
Paradigm A word used often in current research to define a shift
in values, thinking, or ways of conducting treatment. Treatment of mental illness
used to be thought of as long-term and non-reversible. People would never get
better. Today thinking has changed to include the possibility that full recovery
may take place. This is one example of a paradigm shift.
Participatory Means that all who wish to can make a difference
through their participation. The difference can be positive or neutral but not
negative. No one need fear that their participation will harm others. Each person's
contribution will either contribute to the group's potential for increased learning
or it will result in not much difference in whether the group moves forward
or stays at the same place.
Participatory Action Research Defined as a study in which people
being studied participate actively with the professional researcher throughout
the research process, from the initial design to the final presentation of the
results and discussion of their action implications. (E. Sally Rogers)
Recovery Is best understood as a process, not an outcome. A key
element in recovery is the presence of people who offer hope, understanding,
and support; who encourage self-determination; and who promote self-actualization.
(Frese and Davis)
Self-help Self-help groups include people who have a common bond,
and who voluntarily come together to share experiences, reach out and learn
from each other in a trusting, supportive and open environment. The common bond
is defined as both a) the collective experience related to being diagnosed as
having a mental illness and receiving services from the mental health system
and b) the individual experience(s) associated with having survived the process.
Self help is based on the principle of helping both one's self and others at
the same time.
Transformation A complete change as of appearance or personality.
Working Group Similar to focus group in regardsto size and makeup
of group, however, a working group has an action agenda and may include formulation
of policies and development of tasks to accomplish.
Appendix E
Literature Summary
At first glance there appeared to be very little literature on the subject
of dialogues. Manuals and books are written about focus groups and how to do
them. Articles on Participatory Action Research talk about the need for dialogue.
There are many articles written about self-help and empowerment, including research
studies using focus groups as the means to collect data.
What began as a frustrating task became enjoyable as people around the nation
responded to my request on the Internet. Many people shared information with
me by e-mail as well as sending me names of individuals to contact. The library
also became a great resource when the words "Communication Building,"
"Community Dialogues," "Participatory Action," and other
terms were used to find related materials. Suddenly, a picture began to emerge
of what should be read in order to develop and create a dialogue. There were
many examples of dialogues. I suspected I only began to scratch the surface.
Particularly exciting were examples of dialogues, town meetings, study circles,
etc., held not only in this country, but in other countries as well. In many
cases, these dialogues served to create better communication between disadvantaged
groups and under-served populations.
The Experience of Stigma and Dis-empowerment It became clear
that it is necessary to understand underlying principles and values guiding
the consumer/survivor movement. Many articles on self-help, empowerment, and
partnerships were reviewed. The ones chosen for this research summary are ones
I enjoyed the most, because they are interesting and easy to read. Other articles
are cited in a supplementary bibliography for additional insight and reference.
A good place to start is Priscilla Ridgway's, "The Voice of Consumers
in Mental Health Systems: A Call for Change" (1988). Esso Leete's quote
begins the narrative: "I can talk, but I may not be heard. I can make
suggestions, but they may not be taken seriously. I can voice my thoughts, but
they may be seen as delusions. I can recite experiences, but they may be interpreted
as fantasies. To be a patient or even an ex-client is to be discounted."
Ridgway believes that the most important reason for professionals discounting
the consumer voice is the idea, "that providers know best."
She explores client self-determination in its raw beginnings, and reports that
one of the responses of the consumer movement to this entrenched idea was to
develop self-help alternatives, and to focus on the importance of empowerment.
Reidy (1993) did a study on stigma in which 46 people gave personal testimony
about their own experiences with stigma, including ones involving employment,
including employment in the mental health system.
Empowerment and Self-help Alternatives Chamberlin (1997) defines
empowerment in a research project in which 12 consumers, who are also service
providers, agreed on 15 statements, in which they attempted to describe the
qualities of empowerment. The statements show that empowerment is a complex
process, not an event, in which the power to make decisions, and to have choices
from a range of options, are the most important elements. Self-help alternatives
and consumer-provided mental health services provide the most favorable situation
for these elements to exist. Zinman, Harp, and Budd (1997) describe these in
self-help efforts among consumers. Knight and Carpinello (1991) also found these
same important elements in a qualitative study of the perceptions of self-help
group processes and outcomes.
The Need for Consumer Involvement in Research Anyone interested
in knowing more about consumer mental health research will want to read the
works of Jean Campbell. She has written extensively on the subject and was largely
responsible for a Quality of Life Study by The Well Being Project, California
(1989). The study was conducted by consumers for consumers and asked questions
previously not asked. It was the feeling of 56% of mental health consumers that
mental health professionals do not really listen to them, and 47% of the participants
stated they avoided mental health services for fear of involuntary commitment.
Jonikas and Bamberger (1998) also found important differences in women's perceptions
of their own needs, compared to professionals.
Campbell, Ralph, and Glover (1993) presented the subject of consumer/survivor
involvement in research at the Fourth Annual National Conference on State Mental
Health Agency Services Research and Program Evaluation. Campbell reviewed the
history of consumer/survivor involvement in research, and Glover reported that
36 of 50 states fund consumer-operated services, suggesting there is enough
consumer leadership to support full integration into research projects. Ralph
provides an interesting summary of research models in which consumers are either
lab rats (passive objects) at one extreme, or independent researchers at the
other end, planning and writing grants, collecting data, and analyzing and interpreting
results.
In an article "Behavioral Healthcare Tomorrow" (May/June 1995)
Campbell and Johnson talk about beliefs and attitudes viewed differently by
consumers and professionals. Discussed is the need for research partnerships.
The original Pioneer Dialogues is mentioned as having brought consumers and
state mental health administrators together to discuss system reform (1994).They
state in the conclusion of the article, "Now is a rare moment, a clearing
horizon of historic opportunity for individuals and communities to enter into
dialogue about values and goals and to proceed thoughtfully into all areas where
health quality and consumer choice are assured and policy decisions are made.
Dialogues: Developing the Potential for Partnership between consumers and
Professionals Since about 1990, there has been growing interest in
the use of dialogues as a way to bridge the differences between consumers and
professionals, or consumers and providers. Also, many writers, including Deegan
(1991), Johnson (1996), Frese (1997), and others have published important work
recommending training of professionals to increase sensitivity to, and partnership
with, consumers.
Caras (1995) states the potential of the information superhighway in the Internet
Report at HSRI. She discusses the Internet as a means for dialogue between people
and groups who "experience mood swings, fear, voices, and visions."
Caras summarizes the value of Internet discussion groups and dialogues in just
26 words: "Someone listens. Usually someone replies. I hear. When I'm
heard, I feel appreciated. I feel worthy. I feel understood. I feel respected.
I feel affirmed."
Dialogues: the Practice and the Results The early Roundtable
discussions and dialogues were often on the issue of involuntary treatment.
The participants were able to come to surprising levels of consensus, given
the initial differences in perspective. Dialogues documented between consumers
and providers, state commissioners, and psychiatrists, all seemed to have been
quite successful in raising consciousness, influencing some changes in policies,
and establishing the value of true collaboration among the participants.
Much of the literature on conducting focus groups is useful to help teach people
how to do dialogues. Also, Knight (1998) provides some guidelines for developing
dialogues which stress the importance of participant selection, and other specifics
of organizing a quality dialogue. Bluebird (1992) outlines steps for replication
in the Pioneer Dialogue Recipe.
Bassman (1989) writes an article describing dialogues in which he makes the
plea to psychologists and other professionals "to come forward, to blast
open the doors to legitimate inquiry, to separate control and management from
treatment services, to question all the so-called truths about mental illness,
and to stand up for people's rights."
In summary, the published literature is a rich source of materials to enrich
planners' understanding of power dynamics and how to overcome them in the conduct
of dialogues. Those briefly mentioned above, and others, suggested that all
meetings for planning and conducting dialogues must operate in a way that is
sensitive to the stigma and dis-empowerment that may be felt by the consumer
participants. Care must be taken to ensure an atmosphere of safety to express
conflicting perspectives.
Appendix F
Bibliography
Bassman, R. (1989). The Mental Health System: Experiences from Both Sides
of the Locked Doors. Professional Psychology-Research and Practice,
Vol. 5 Foc 28, No.3. New York State Office of Mental Health.
Blanch, A., Fisher, D., Tucker, W., and Chassman, J. (1993). Consumer
Practitioners and Psychiatrists Share Insights About Recovery and Coping.
Disability Studies Quarterly, 13 (2), 1720.
Bluebird, G. (1992). The Story of Pioneer Dialogue. (a report).
Brown, Cherie R., and Mazza, George J. (1997). Healing Into Action: A
Leadership Guide for Creating Diverse Communities. Washington, D.C., National
Coalition Building Institute, (a manual).
Campbell, J. (1992). The Well-Being Project Mental Health Clients Speak
for Themselves. In Third Annual Conference Proceedings in State Mental
Health Agency Research, Alexandria, VA: National Association for State Mental
Health Program Directors Research Institute.
Campbell, J. (Fall,1996). Toward Collaborative Mental Health Outcomes
Systems. New Directions for Mental Health Services, No. 71, Jossey-Bass
Publishers, 6976.
Campbell, J., and Johnson, J. (1995). Struggling to Reach Common Ground.
Behavioral Healthcare Tomorrow, 4 (3), 40, 4546.
Carr, W., and Kemmis, S. (1983). Becoming Critical: Knowledge Through Action
Research. Victoria, Australia: Deakin University Press.
Chamberlin, J. (1978). On Our Own: Patient-Controlled Alternatives to the
Mental Health System. Hawthorne Books, NY.
Curtis, Laurie C., and Shore, Samuel E. (1997). Managing Workplace Conflict:
A skills training workbook for mental health consumers and supervisors.
National Research and Training Center on Psychiatric Disability, University
of Illinois at Chicago, IL.
Chester, M. (1991). Participatory Action Research with Self-help Groups:
An Alternative Paradigm for Inquiry and Action. American Journal of
Community Psychology, 19 (5), 757768.
Doyle, M.,and Strauss, D. (1976). How to Make Meetings Work. Jove Books,
NY.
Fals-Borda, O. (1984). Participatory Action Research. Development:
Seeds of Change, 2, 1820.
Fisher, R., Ury, W., and Bruce Patton of the Harvard Negotiation Project (1991).
Getting to Yes: Negotiating Agreement Without Giving In. Second Edition,
Penguin Books, NY.
Fisher, B. Tucker & Chasman (1993). Consumer Practitioners and Psychiatrists
Share Insights about Recovery and Coping. Disability Studies Quarterly,
13:2.
Foner, J. Leadership Exchange Listening. A brochure and leadership
materials.
Jonikas, J.A., Bamberger, E. (1997). Needs Assessment Survey Project:
Women Speaking for Themselves. (A report.) The National Research and Training
Center on Psychiatric Disability, Chicago, IL.
Jonikas, J A.., Solomon, M L., Cook, J A., and Kerouac, J. (1998). Positive
Partnerships: How Consumers and Non-Consumers Can Work Together as Service Providers.
National Research and Training Center on Psychiatric Disability, Chicago, IL.
Knight, E. (1992). A Dialogue on Recovery: Tips for Structuring a Recipients
Dialogue. Report done for the office of Mental Health, New York State.
Knight, E., and Carpinello, S. (1991). A Report of the Qualitative Study
of the Perceptions of the Meaning of Self-help. Self-help Group Processes
and Outcomes, Presentation at Consumer Advocacy Training Program, Batavia, NY,
November 21.
Loder, A., and Glover, R. (1992). New Frontiers: Pioneer Dialogue Between Consumers/Survivors
and Commissioners. MHSIP Updates, Nov. pp.1314.
Park, P., Brydon-Miller, M., Hall, B., and Jackson, T. (1988). Voices of
Change: Participatory Research in the United States and Canada. Bergin &
Garvey, Westport, CN. London: UK.
Penny, Darby. A Dialogue on Recovery: Tips for Structuring a Recipient
Dialogue. Albany, NY: New York State Office of Mental Health, undated
brochure.
Reidy, D. (1993). Stigma is Social Death, Mental Health Consumers/Survivors
Talk About Stigma in Their Lives. Education for Community Initiation,
February.
Ridgway, P. (1988). The Voice of Consumers in Mental Health Systems:
A Call for Change. South Burlington, VT.: Center for Community Change Through
Housing and Support.
Rogers, E. S., and Palmer, V. (1994). Participatory Action Research:
Implications for Research and Evaluation in Psychiatric Rehabilitation.
Psychosocial Rehabilitation Journal, October, Vol.18, No.2
Shea, S., and Herold, N.H. (1995). Evaluating Internet Mental Health
Applications: A Roundtable Report. The Evaluation Center @ HSRI.
Susko, M. (Ed.), (1991). Cry of the Invisible: Writings from the Homeless
and Survivors of Psychiatric Hospitals. Baltimore Conservatory Press.
Tyman, A.C. & Dryton (1984) Conducting Focus Groups: A Guide for
First Time Users. In T.J.Hayes and C.B. Tatum Focus Group Interviews
A Reader.
Zinman, S., Harp, H., and Budd, S. (1987). Reaching Across: Mental Health
Clients Helping Each Other. Riverside: California Network of Mental Health
Clients, (a manual).
Appendix G
Advisory Group
Advisors to the project participated in a teleconference to review the outline
of the dialogue in order to make suggestions and recommendations. In addition,
there were numerous phone calls, e-mails, and meetings with individuals in the
group.
Gayle Bluebird
Sally Clay
Fred Frese
Janet Foner
Larry Fricks
Hikmah Gardiner
John Gates, Ph.D.
Ed Knight, Ph.D.
Barbara Lee, Ph.D.
Warren Liang, M.D.
Ann Marshall
Jacki McKinney
Frederick L Newman, Ph.D.
Kenneth Thompson, M.D.
Bazelon Center for Mental Health Law
1101 15th Street, NW, Ste. 1212
Washington, D.C. 20005
phone: (202) 467-5730
fax: (202) 223-0409
www.bazelon.org
Carter Center Mental Health Program
One Copenhill
Atlanta, GA 30307
phone: (404) 420-5165
fax: (404) 420-5158
Consumer Organization and Networking Technical Assistance Center (CONTAC)
910 Quarrier Street, Suite 414
Charleston, WV 25301
phone: (888) 825-TECH (8324)
fax: (304) 345-7303
www.contac.org
SAMHSAs
Center for Mental Health Services
National Mental Health Information Center
P.O. Box 42557
Washington, D.C. 20015
phone: 1-800-789-CMHS (2647)
fax: (301) 984-8796
tdd: (866) 889-2647
e-mail: nmhic-info@samhsa.hhs.gov
http://mentalhealth.samhsa.gov/
The Evaluation Center@HSRI
2269 Massachusetts Avenue
Cambridge, MA 02140
phone: (617) 876-0426 ext. 4
fax: (617) 497-1762
e-mail: tecenter@hsri.org
www.tecathsri.org
National Alliance for the Mentally Ill
2107 Wilson Boulevard, Ste. 300
Arlington, VA 22201-3042
phone: (703) 524-7600 or 1-800-950-NAMI
fax: (703) 524-9094
www.nami.org
National DisabilityRights Network
900 2nd Street NE, Ste. 211
Washington, D.C. 20002
phone: (202) 408-9514
fax: (202) 408-9520
www.ndrn.org
Appendix H
List of Resources
Depression and Bipolar Support Alliance
730 N Franklin, Ste. 501
Chicago, IL 60610
phone: (312) 642-0049 or 1-800-826-3632
fax: (312) 642-7243
www.dballiance.org
National Empowerment Center
599 Canal Street
Lawrence, MA 01840
phone: 1-800-POWER2U
tty: (800) TTY-POWER
fax: (978) 681-6426
www.power2u.org
National Mental Health Association
2001 N. Beauregard Street, 12th Floor
Alexandria, VA 22314-2971
phone: (703) 684-7722 or 1-800-969-NMHA
fax: (703) 684-5968
www.nmha.org
National Mental Health Consumers Self-help Clearinghouse
1211 Chestnut Street, Ste. 1107
Philadelphia, PA 19107
phone: 1-800-553-4539
fax: (215) 636-6312
tdd: (215) 751-9655
www.mhselfhelp.org
National Research and Training Center on Psychiatric Disability
104 S Michigan Avenue
Chicago, IL 60603
phone: (312) 422-8180
fax: (312) 422-0706
www.psych.uic.edu/uicnrtc
National Technical Assistance Center for State Mental Health Planning
66 Canal Center Plaza, Ste. 302
Alexandria, VA 22314
phone: (730) 739-9333
fax: (703) 548-9517
www.nasmhpd.org/ntac.cfm
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