Peter Crascall, Director of Clinical Operations at Claimont, shares some thoughts about the Art of Basic Attendance.
As a reader you might question the title of my article, is there a paradox at play? Can there be artistry in something described as ‘basic’?
My response would be a resounding ‘yes’. I would invite the reader to continue and understand why.
The Basic Attendance Model of support for individuals affected by mental illness was something that I first encountered in the early 1990s as a (relatively) fresh faced, newly qualified nurse. It is derived from the book Recovering Sanity written by Edward M. Podvoll.
It is a style of treatment that is most effectively practised within a home treatment setting. It places importance on the healing component of an individual’s familiar surroundings and relationships as an essential part of the recovery process, whilst protecting the individual from other ‘confused minds’ that may be most likely encountered in an in-patient setting.
Basic Attendance may appear to be a relatively simple model from an observational perspective. However, there is a level of sophistication within the Model that may not be apparent at first glance.
The role of the practitioner and the wider therapeutic team within the Basic Attendance Model is to support and guide the client through a staged journey towards health. At all times, however, the fundamental principle is to offer a consistent presence to the client. Whilst this will invariably take on different forms, sometimes on an almost minute by minute basis (with the practitioner at times being at the forefront of the process, at others seeking to blend seamlessly into the background), the essential factor is that they are truly there.
This journey will almost certainly involve the shift from dependency to autonomy and the critical paradigm shift from being ‘inward facing’, as consistently occurs during the withdrawal phase of periods of mental ill health, to an ‘outward facing’ re-engagement with the world and the people within it. The pace and rhythm to this necessary voyage will be entirely unique to the individual and the power of the healing relationship established with the treating team.
In the early stages of contact this will almost certainly entail a requirement to meet with the client in the midst of their episode of mental ill health and to offer true availability at a time when an agenda for work may not be apparent. This may be an uncomfortable experience at times as, in essence, the practitioner is utilising their entire being to appreciate the client’s distress. Whilst a professional background is of value within this process, the practitioner is additionally drawing upon their full life experience.
Another key component of the approach is the appreciation that the client’s wider environment must also be attended to as part of the recovery process. For the treating team, this not only relates to the constellation of family and friends that may be affected by events, but extends to the physical environment. If helping with meal preparation is an intervention which has the outcome of reducing distress and tension within the household, it must be appreciated as offering overall value to the therapeutic process.
In summary, Basic Attendance is a style of treatment that requires true artistry. Whilst there can never be a substitute for specific therapeutic skills and a depth of professional experience (that, of course, all Claimont staff possess), the Model demands a requirement on the treating team to truly ‘be’ with the client in the moment, irrespective of what that moment demands.
Claimont is an independent healthcare service specialising in the treatment of mental ill health and addiction at home and offers a professional, convenient and discrete alternative to psychiatric hospital admission. Our private mental health services are delivered via home visits or live-in care. Find out more by contacting us today.