KESHET Advancement, Sharing, and Communication

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• KESHETAdvancement, Sharing, and Communication
• A course for training parents and family members
  for a communication in a cognitive way
• Dr Noami Hadas-Lidor
• Mrs. Dorit Redlich
• Mr. David Moses
• Mrs. Penina Weiss

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• I would like first to thank the organizing
  committee, that invited me to speak here, and for
  you that came to hear this lecture

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• My name is Noami Hadas-Lidor
• I am the head of the Rehab. area in O.T
  department, in Tel Aviv University in Israel
• It is a pleasure for me, to share with you the
  innovative KESHET project, a unique experience
  with families in my country.
• I want to apologize for my lousy English,
• I hope you will understand and like my lecture

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Keshet

• In Hebrew, Keshet means rainbow
• The initials stand for
• Advancement
• Sharing
• and
• Communication.

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Keshet

• Keshet is a new program, to enhance coping skills
  of family members of patients with mental
  illnesses.
• Keshet is based on the Dynamic Cognitive
  Intervention (DCI) model

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What is Keshet?

• Keshet is an academic course, for teaching and
  training parents and family members, to use a
  unique dynamic cognitive tools for enhanced
  communication

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The leader staff of Keshet are

• Dr. Noami Hadas-Lidor
• Mrs. Dorit Redlich (O.T. specialist in DCI, a
  daughter to a mentally ill mother)
• Mr. David Moses (specialist in DCI and a father
  of a mentally ill son)
• Mrs. Penina Weiss (O.T., M.A., specialist in
  DCI)

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Rational

• The state of Israel has a population of 7
  millions citizens. Out of them, an estimated 80
  thousands people, coping with psychiatric
  diseases, whom usually have family members that
  share the struggle.
• 3.5 thousands are hospitalized, and over 14
  thousands receive community based rehabilitation
  services.

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Rational

• Many parents and family members, strive to
  improve the quality, of both their, and their
  children's lives, despite, and in light of the
  disability.
• They wish to be involved in, and to be a part of,
  the treatment and rehabilitation process.

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Rational

• They wish to take an active part in treatment
  responsibility, by transfer of intervention
  procedures and recommendations, outside of the
  hospitals and clinics, and in preference of
  natural surroundings

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Rational

• Many parents are frustrated from searching ways
  of coping with the situation, explaining to
  friends and neighbors, what their child is
  suffering from, why he never joined the army, why
  he hasnt yet found a job, why he didnt go to
  the university, why he hasn't gotten married.

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Rational

• The family, as a whole, wishes to live a
  fulfilling life, one that is connected to health
  related aspects of life, as opposed to illness
  related ones.

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Rational

• We too, the members of Keshet, share these
  aspirations.
• We believe in the need to "come out" of
  professional fortifications, and the mysterious
  atmosphere surrounding them.

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Rational

• Our goal, is to share with parents and
  caregivers, the knowledge, practical methods and
  instruments, for partaking responsibility in a
  more efficient manner, in order for them, and for
  their family, to change and develop.
• We are convinced, that an involved parent,
  represents an "insurance policy" for the
  efficiency of the intervention.

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The overall plan of Keshet

• The Keshet program is an academic course. It
  teaches family members and caregivers, to
  interact in a structured way, turning every
  family interaction into a learning and empowering
  situation.

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The overall plan of Keshet

• The Keshet program was initiated, founded and is
  currently directed by Dr. Noami Hadas-Lidor,
  along with a growing team of parents and expert
  health related professionals.

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The Mother of Keshet
(This picture was taken in famous San-Diego zoo)
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What do parents want?

• To improve communication between themselves and
  their disabled child.
• To assist the child with his/her personal and
  environmental hygiene.

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What do parents want?

• To encourage the child to take responsibility
  over his/her medical condition and treatment.
• To improve the child's awareness and
  consideration of his/her environment.
• To improve the child's independence in everyday
  activities and functions.

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What do parents want?

• To improve communication within the family.
• To improve communication with health care
  professional's.

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The objectives of the course

• To learn, how to efficiently deal with, and
  solve, everyday problems, stemming from the
  child's disability, within the family, the work
  place, and his/hers surroundings.

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The objectives of the course

• To learn, how to be an active, involved, and
  responsible parent, participating in the
  treatment of the child.
• To train parents as instructors, who will work
  alongside professional academic instructor's, in
  order to broaden and expand the program.

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The course's framework

• The course takes place at academic facilities in
  different sites throughout the country.
• The course includes 12 meetings, every second
  week, each meeting lasting 3 academic hours.

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The course's framework

• After finishing the course, there are three
  additional follow-up meetings, once a month.

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The course's framework

• Every course is coordinated by three instructors,
  two of whom are experts in the clinical field and
  theory of Dynamic Cognitive Intervention, the
  third one being a parent instructor, who had
  previously participated in a Keshet course.

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The course is constructed from

• Frontal lectures
• Workshops
• Group analysis of daily life events, presented
  as homework by course participants
• Group discussions

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The course is constructed from

• Viewing and analyzing films that deals with
  recovery issues and dynamic cognitive
  intervention.
• Reading articles.
• Writing and analyzing exercises (daily life
  events).

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Course content- central issues

• What is cognition how do we think?
• Cognition as a different way to understand
  behavior.
• The ability to change, as a chance for improving
  family life change of content, change of process
  and change of structure.

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Course content- central issues

• The built in ties, between cognition, emotion and
  behavior.
• Mediated Learning Experience, adapted to
  cognitive communication within the family.
• Acquiring cognitive milestones for enhancing
  sharing and reciprocity.

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R. Feuerstein-The Father of the Concept

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• Feursteins work is implemented on adults and
  children with special needs in more than 42
  countries world wild (including Arab countries)
• We adopted his concept and adjusted it to DCI
  model in KESHET project
• (Dr. Noami Hadas-Lidor and Penina Weiss,
  2004, 2006)

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The concept

• The belief in a human being's ability to learn
  and change, regardless of age, diagnosis, and
  state of health, yet depending upon suitable
  conditions, that promote the occurrence of
  change.
• These conditions being
• 1. Mediation (Mediated Learning Experience )
• 2. Suitable environments.

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Mediated learning Experience (MLE)

• MLE is a special interaction between a mediator
  (a guide/therapist/parent), learner
  (patient/child) and stimulus.
• The goal of the mediator is to adjust the
  stimulation, and to process it, so that it will
  be understood by the student.

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Model of learningthrough mediation
Stimulus , organism, response and the human
mediated between them
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The necessary criterions for the existence of
mediation

• Mediation of Intentionality and Reciprocity
• Mediation of Transcendence
• Mediation of Meaning
• Mediation of Feeling of Competence,
• and
• Mediation of Sharing Behavior

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Target population of Keshet

• Parents, family members or caregivers of children
  or people with special needs like Learning
  disabilities, development disorders, behavior
  disorders, psychiatric conditions gifted
  individuals, and acquired conditions such as
  traumatic injuries, and so on.

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Where are we today

• Over the last 5 years 12 courses were given and
  over 200 family members have graduated.
• Financial support for 60 of costs for 6 Keshet
  courses was given by the special projects fund of
  the Israeli National Insurance Foundation.

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Where are we today

• The Ministry of Health is funding 20 of the
  courses cost and the remaining 20 are paid by
  the families.
• Today, courses are taking place in Tel-Aviv,
  Jerusalem, Haifa and in the ultra orthodox
  religious sector.

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Where are we today

• During 2007 courses will take place in Tel-Aviv,
  Haifa, and the Arab sector.
• At the request of graduates from the first
  courses, a follow-up course will open in 2007,
  which will enhance learning and assimilation and
  will be headed by a graduate parent.

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The course is a journey of transcendency

• The course gives parents the opportunity to
  create changes first and foremost within
  themselves.

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What parents sayat the end of the course

• "I, as a parent, take charge of the acquisition
  of tools for understanding cognitive processes
  and how my intentions are understood and
  influence events in daily life."

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What parents say at the end of the course

• "In the past, when I didn't know what my son was
  going through, I could not truly mediate between
  him and the care-giving system. Today, I can
  truly say that we are an important factor,
  because we know our child."

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What parents sayat the end of the course

• "I've reached this course more than twenty years
  after my son was diagnosed with a mental
  illness. Today I encourage other parents to join
  the Keshet course as soon as possible.
• Why suffer so many years, without decent
  communication, when you have this course at your
  doorstep?"

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Parents speak

• The course introduced me to a new language. I
  learned that in order to be flexible in thought
  and behavior, I need to enrich my husband's and
  my tool box.
• The course gave me hope that there is another
  way

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Parents speak

• The course is like a bell which reminds me how
  it's possible
• I came to stop getting angry, I'm still getting
  angry, but sometimes I know and understand why,
  and sometimes I know how not to"

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Parents speak

• Now I know to organize events in my life, I
  learned how to arrange them, to deal with them
  one by one. (this mother is now one of our
  stuff)
• You make healthy parents for our sick children
  recovering parents.

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A few Outcome Examples from parents

• The son who started talking after six years of
  silence. (starting, during the course, with
  exchange of written notes with his mother, and
  gradually turning into a normal speaking)
• The son who loves books so much he finally went
  to the book store by himself. (many years after
  which he was afraid to do so, due to his fear
  maybe the salesman will talk to him)

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A few Outcome Examples from parents

• The couple who traveled for two weeks, alone,
  something they hadn't done since their son became
  ill, six years beforehand.

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A few Outcome Examples from parents

• The mother who felt that finally, after many
  years, she could identify with, and understand
  her son's suffering and pain.
• I earned my wife back.
• And more.

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Finally

• It is important to notice, that KESHET project,
  is accompanied by an EBP research from its
  beginning
• We have some English mother tongue speakers in
  our stuff, so dont hesitate to contact us for
  any question and reason,
• And now two pictures from our stuff meeting in
  my house

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A stuff meeting in my living room
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A stuff meeting in my living room