PTA - PORTUGAL COLLABORATIONS - THERAPEUTIC MODELS, ARTICLES, & OTHER WORK

Date added: 23/07/24

I have created this page to share aspects of my work in Portugal, which began in 2015. Also to share some of my articles which have been translated into Portuguese by Maria João Braga da Cruz. These can be downloaded as PDFs at the bottom of the page. We plan to keep adding translated articles.

My first connection with Portugal was a conference talk and training in Reguengos de Monsaraz. Since then my work in Portugal has included,

- training & conference events

- co-creation of two organizational therapeutic models & soon to begin on the third

- publication of 5 book chapters & several translated articles

- a project to develop the relationships between young people & their families to better support young people leaving Livramento

- developmental mentoring with several professionals and organizations

In particular, I would like to thank Ivone Soares de Almeida, Liliana Resende, Carla Cabral, Maria João Braga da Cruz, and Bruna Ferreira the senior team at Lar de Nossa Sr.ª do Livramento, in Porto. I would also like to thank Rui Lopes, Dr. Adriana Bastos Dias, Ricardo Saraiva, Eva Gondamar, Tatiana Cosme, Madalena Sofia Oliveira, Carlos Peixoto, Diogo António, and Alexandra Macedo Lima, among others for connections, collaborations, and opportunities.

Therapeutic Model of Care with Lar de Nossa Sr.ª do Livramento

Having attended some of my training, in 2018 Lar de Nossa Sr.ª do Livramento asked me to be the lead consultant in creating a therapeutic model. This was funded by the Government's Social Innovation 2020 initiative.

Livramanto has existed as a care service since 1810 and on the present site in Porto for 100 years. Livramnento provides a therapeutic residential service for up to 40 girls and young women. This is Livramento with its timeline since 1810.

We planned the model work on a typical basis - one year for creating the model, another year for implementation, and the 3rd for consolidation and establishment.

Livramento was supported in putting together an application for funding from the Portugal 2020 European Funds by Dr. Maria da Saúde Nicolau Inácio and Dr. Manuel António Miranda Ribeiro, qualified professionals from the consulting company Ksocial. They accompanied the entire process, from the application to monitoring its full implementation. Livramento's work was recognized as an Entrepreneurship and Social Innovation Initiative.

A Social Impact Assessment System was also developed to measure outcomes in the model development and implementation phases. This part of the project was led by Dr. Margarida Azevedo through the consultancy TESE - Non-Governmental Organization for Development.

(Left to right Dr. Manuel António Miranda Ribeiro, Maria João Braga da Cruz, Ivone Soares de Almeida, Patrick Tomlinson, Dr. Margarida Azevedo, Carla Cabral, Liliana Resende, Dr. Jorge Morais Cordeiro Dias)

The picture is from one of our first model project meetings. I would like to acknowledge Dr. Jorge Morais Cordeiro Dias who sadly passed in 2023. He was President of the Livramanto Board and attended several meetings I also attended. He was a great advocate for the therapeutic model and always welcoming, kind, and humourous. I remember one occasion, with Jorge talking passionately about the value of collaboration across international boundaries.

One of the unique and innovative aspects of this model development process was its inclusiveness. As well as the partners mentioned above, representatives of all levels in the organization and young people were included. I am delighted to say that 6 years after we began, great progress has been made, and many young people and adults continue to benefit from their life at Livramanto.

The senior team is a model of commitment, CARE, and professionalism. It is a rare thing to say that 4 of the 5 have worked together as a team now for over 10 years. And the 5th, Bruna Ferreira joined the team this year after being an intern for a year.

As well as creating and implementing their model, which is a major change process. The senior team has managed the transition from the time when Livramento was run by nuns to the present professional-based organization. This change began in 2012 and the nuns had been running the service for children and young people in need of affection and support for over 200 years. Some people may assume that a religious-based institution might not have been a great environment to grow up in. In recent years we have heard of various scandals around the world. I was interested in discussing with one of the young women who grew up in Livramanto (now studying at University) to hear about her positive memories of when the nuns lived with and looked after her.

(The Technical Director Ivone Soares de Almeida at Livramento's 214th Birthday celebration)

Following the model creation we had 4 chapters related to it published in -

Residential Reception of Children and Youth in Danger - Concepts, Practice and Intervention (Acolhimento Residencial de Criancas e Jovens em Perigo) (2021) Editors - Carlos Silva Peixoto and Madalena Sofia Oliveira.

This book is the first major publication on therapeutic residential care for children and young people in Portugal,

“It is intended to provide an understanding of childhood traumas, how they affect child development, and how we can work with traumatized children and youth to facilitate their recovery. The daily work in Homes for Residential Reception is presented with children and young people who have been traumatized by abuse and neglect, showing that any context, situation, and action in daily life is an opportunity to encourage therapeutic changes.

For the conception of this work, national and foreign professionals and researchers were invited, from different scientific areas, to create a multidisciplinary team. The themes dealt with here are based, in addition to research produced in academia, on the practices, challenges, dilemmas, and success of professionals who daily work in a residential care context. It also systematizes important and significant information for an articulated, concerted, and networked intervention in the field of Promotion and Protection.

This book is, therefore, essential reading for students and researchers, as well as an important tool for professionals in the social, human, educational, and health areas involved in the System for the Promotion and Protection of Children and Youth in Danger, specifically in the measure of placement in residential care.” (Vania Reis, 2021)

The book chapters are written in Portuguese, and Spanish, mine are in English and it can be purchased here.

The chapters we contributed are,

Process of Building a Therapeutic Intervention Model in a Residential Care Home - (Carla Cabral, Ivone Soares de Almeida, Liliana Resende, Maria João Braga da Cruz, and Patrick Tomlinson)
Bridges with the Community - (Carla Cabral, Ivone Soares de Almeida, Liliana Resende, Maria João Braga da Cruz, and Patrick Tomlinson)
Assessment Of Needs – (Patrick Tomlinson)
Transition Planning - Leaving a Residential Care Home – (Patrick Tomlinson)

For more details on the chapters see here.

Book Launch Video
In this video, there is an interesting short speech by Richard Rollinson (@1 hr. 22 mins, 50 secs). I am sure the whole video is interesting, unfortunately, my Portuguese needs much improvement! Richard has been a consultant in Portugal and was previously Director at the Mulberry Bush Therapeutic School in England. He summarizes why therapeutic residential care can be so vital to young people who have suffered so much trauma and adversity. He refers to the work of Dr. Donald Winnicott the English Paediatrician and Psychoanalyst. Richard concludes with typical humour which provides a nice balance to the seriousness of the task,

"The third word I want to share with you is care. An understandable translation of that word, Acolhemento. But it’s something more easy to recognize than a simple hoteling function. And it’s not exactly love. Dr. Winnicott called it a kind of loving. It was a loving care. It is a loving care. And it requires us to invest ourselves in that caring. The early eighteenth-century Doctor and Philosopher Wilhelm Leibniz said that, if we care and we try to care wisely, we shall not go too far wrong. Now that’s very comforting because we don’t have to hold ourselves to a council of perfection. As Dr. Winnicott said, good enough is more than good enough. And finally, for this occasion, there’s something about presence and being present in that work of residential care that we commit ourselves to. And let's bear that in mind when we are reading the contents of this publication.

Of course, your own, Antonio Damasio made it very clear. It’s about being consciously aware and being consciously engaged, in touch, and in tune with those for whom we try to care. And that’s something quite crucial. We call it involvement in English, but I think evolvement is an even better word because it means we are really part of this commitment rather than a simple servicing of it. And just to really up the ante let me refer to that very famous practitioner and philosopher, Kung Fu Panda, who said memorably,

‘’The Past is history. Tomorrow is a mystery but Today is a gift. That is why we call it the Present.” Master Oogway (Kung Fu Panda)’’
So enjoy this present today and the future, of this gift of this book, in your work. And I close by saying, be well, work and live well. And read well, read this book well. To inform, inspire, and grow in life and in our work.”

I have continued working with Livramento to assist with the model implementation, establishment, and continuous development. I do this by regular consultation/ mentoring sessions for the senior team of five. I meet them individually and together as a team.

The articles that Maria João Braga da Cruz from Livramento has kindly and expertly translated are,

Acting out Behaviour of Traumatized Children, Through the Lens of Polyvagal Theory
Punishments & Rewards – Consequences & Discipline (In Work with Children and Young People who have Suffered Trauma and Other Adversities)
Reasons a Traumatized Child Runs Away?

Another article I have included below as it refers to Livramanto is,

What is Institutionalising for 'Looked After' Children and Young People? (2022) Emma Blakemore, Sir Martin Narey, Patrick Tomlinson & John Whitwell, in, Journal of Social Work Practice

They can also be downloaded as PDFs at the bottom of the page. We plan to publish further translated articles.

Project "ReViraVolta"

In 2023, we received funding for a new project - "ReViraVolta". In English ReViraVota means ReTurnAround. The project was financed by the Prémio BPI Fundação"La Caixa" Infância. It was led by Dr. Adriana Bastos Dias, with her team of two psychologists, Bruna Ferreira and Ricardo Saraiva. I was supervisor to the team and we met every week for a year.

The project was designed to address concerns related to the possibility of offering the families of the children and young people staying at Livramento so that they could make the necessary changes to fulfil the conditions needed for a reunification process or, if not possible, an increase in healthy relationships between the various elements of the family system. Ultimately, this healthier relationship pattern would serve as a very important protective factor for the better development of children and young people. (In the picture, left to right, Bruna Ferreira, Ricardo Saraiva, and Dr. Adriana Bastos Dias)

(A PDF explaining the project design and process in full can be downloaded at the bottom of this page.)

Adriana captured a little bit of our journey, reflecting her creative nature and the work of the team with a short piece (Which can also be downloaded as a PDF at the bottom of the page).

What we call the beginning is often the end. And to make an end is to make a beginning. The end is where we start from. (T.S. Eliot, 1943 - Little Gidding).

Rui Lopes and Boa Vista, Santa Casa - Lisbon

In 2020 I began mentoring/consultation work with Rui Lopez in Lisbon. During the next few years, we co-created a therapeutic model, for the therapeutic residential service care he was Director of at Boa Vista, Santa Casa. Rui now works as an independent consultant and we continue working on projects and publishing. In 2023, we co-authored a book chapter,

Management and Leadership in Trauma Services: A Reflection on Individual and Organizational Factors.

It is published in the Portuguese book, Children at Risk and Danger – Vol. 6: Contexts, Research and Intervention, Editors: Eunice Magalhães, Ligia Monteiro, Maria Manuela Calheiros. (PDF can be downloaded below),

“This book seeks to fill an important gap in the dissemination of research work in the area of protection of children and young people in various sectors of social intervention in Portugal. In this sense, the texts presented intend to identify and problematize both the state of the art and present technical solutions at the family, social and organizational levels."

An interesting bit of history to finish with :) The Anglo-Portuguese Alliance is the world’s oldest alliance in known history, established by the Treaty of Windsor in 1386. These two countries have always had a strong friendship throughout the centuries, dating back to 1147 when English crusaders helped King Alfonso I, capture Lisbon from the Moors.

With some humour and seriousness at the same time, I have learned that Portugal claims to have invented the British drink of Tea, and the British have claimed to have invented the Portuguese drink, Port Wine.

I guess that when collaboration is as strong as that between Portugal and Great Britain it becomes difficult to know what came from where. But when the result is so good, as it is in a good cup of tea or glass of port, it does not matter.

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