TRI-COUNTY — A series of articles on mental health published by The Big Bend Sentinel the past two months has highlighted both a variety and lack of resources in the tri-county area to address mental health. Most options involve individuals taking steps to address their mental health needs by working with licensed professional counselors.
However, one movement, relatively new to the United States but practiced worldwide, could provide benefits to the rural, isolated communities of the Big Bend through a different approach based on groups of people working together called integrative community therapy (ICT).
ICT can take many different forms, but it typically involves a group of 15 or more people who meet — often with a facilitator — at no cost to talk about challenges in their lives.
“It’s a beautiful and somewhat creative way of deliberately having discussion amongst a group of people that leads them through the ability to find these things that were going to be helpful to what we call the ‘daily pebbles,’” said Brigit Hassig, co-CEO of the Visible Hands Collaborative, a nonprofit seeking to grow the ICT movement. “Because you and I know if you get a pebble in your shoe and if it doesn’t get removed, it becomes constantly irritating, and so ICT is really meant to inspire the wisdom and power we have within ourselves to be able to find ways to manage the daily challenges of living.”
Hassig said the isolation of rural communities often creates situations that exacerbate a problem already prevalent in mental healthcare: our sense of individualism. “Most healthcare systems have been oriented around that sense that finding a solution is the burden for the individual, and even the field of psychology was set up on a one-on-one, confidential almost, type of setting.”
ICT, on the other hand, is not confidential and is oriented toward open communication in a group setting, she said.
Dr. Alan Tasman, an emeritus chair of the University of Louisville’s Department of Psychiatry and former president of the American Psychiatric Association, also is a proponent of ICT and serves on the board of Visible Hands Collective. “Mainly what they talk about are problems in daily living,” he said. “So, at the beginning of the meeting, they sort of go around, people say what they’d like to talk about. My husband won’t get a job, my kids are acting up, just the usual kinds of things that cause people problems in life.”
“One of the rules is you can’t give advice,” Tasman said, “You can’t say, ‘Well, you should do this about it.’ What people can do is say, ‘Well, I had that problem, and here’s what I did, and here’s what worked, and here’s what didn’t work.’ It’s to develop a cohesion that cuts down on social isolation.”
Hassig said isolation becomes an encumbrance for someone if they think they are facing it alone, even with help from a counselor. “With ICT, it becomes a community responsibility and a community issue,” Hassig said. “Traditional systems are very vertical, meaning I go to a counselor, I go to a community health worker, I go to a doctor, I go to a psychiatrist, and it can go up that existing healthcare chain. ICT is a return to a horizontal solution and system that is equitable, is accessible. It is culturally representative of the people participating. It’s even geographically [representative], depending upon where it’s happening.”
That geographic element is important for communities that are spread out over large areas, she said. Representatives from several mental healthcare organizations in the Big Bend The Sentinel spoke to had never heard of ICT, but all said they find it highly interesting and pledged to look into it. Hassig said unfamiliarity with ITC was typical, since even after a decade of use in the United States, it is still ramping up here.
The practice began in Brazil, where it is known as terapia comunitária integrativa. It was created by psychiatrist and anthropologist Dr. Adalberto Barreto in response to the need for “community-based mental health services in the extremely low-income neighborhoods.”
According to Visible Hands Collaborative, “Brazil now has over 42 training centers that have trained 37 thousand community therapists nation-wide, and TCI is offered across Latin America, Africa, Asia and Europe as a first-line treatment for patients who present to their primary care physician with mild to moderate mental health complaints as a supplement to medical management. Research examined surveys from 12,000 participants and found 88.5% reported that they had successfully resolved their primary mental health complaint.”
Visible Hands Collaborative, based in Pittsburgh, is the “hub” of ICT in the United States, Hassig said. The nonprofit is currently training ICT facilitators — including remotely — and working with community organizations to expand the movement. It also hosts a remote ICT session every Tuesday evening, and anyone can sign up at www.visiblehandscollaborative.org to participate.
Facilitators are being recruited, with no professional mental health experience needed, although many of the current facilitators do have a background or sincere interest in the field. Hassig stressed that people struggling with acute and more serious mental health issues will still need to seek assistance from professionals, but that they can still benefit from attending ICT meetings.
She encouraged any organizations interested in ICT to contact her. “If we can find partners that have the ability to work with us, either in finding a funding source or if there are community-based funds available, we can find a way to support and train them,” she said.
This is the final in a series of mental health articles — funded by the Presidio County Community Fund — the entirety of which can be found at: www.bigbendsentinel.com/mental-health-series/.