A Humanistic Approach to Critical Thinking and Higher Education Teaching.

Humanism is the approach taken in this paper as it recognises and allows for subjectivity, emotionality, the value, dignity and welfare of human beings-individually and collectively within Higher Education Teaching (HET). Rather than disguising or simply pretending they don't exist, the authors beliefs and experiences of HET and research will be evident throughout this paper. What is essential in creating containment (Bion, 1962) or a good-enough holding environment (Winnicott, 1965) within the context of HET will be also considered, with the main emphasis on the benefits of incorporating Psychodynamic theory into HET practice. In particular, the notion of therapeutic relationships will be considered as a process of communicating effectively with Higher Education Learners (HELs). Positive change is promoted in individuals within the context of a Therapeutic Relationship; this involves developing trust in order to embrace openness and honesty. This trust facilitates improved management of any difficulties that arise within the context of Higher Education Learning (HEL). It is dissimilar from other types of relationships because the focus is on assisting HEL's to experience positive change. Much early work on this subject was generated from a psychodynamic perspective. Previous works on attachment theory will be briefly mentioned including such theorists as Bowlby, Tronick, Stern, and Schore with a view to contemplating if attachment theory has any relevance or benefit in HET. Attachment theory develops from classifications of parent-child interactions which explain attachment formation and attachment concepts. Attachment theory makes connections between the detail of the daily care of children that can promote security and resilience. Being passionate about HET to the extent this author is, one feels obliged to discuss the work of Ecclestone and Hayes in order to convey the antithesis of this authors views.

The primary emphasis will be on considering the feasibility of using Attachment Theory, Psychodynamic Theory and the Therapeutic Relationship as effective tools to promote and enable HELs to become critical thinkers. This will be achieved

through considering literature that reflects the authors experience both as a HEL and a HET. Finally, included will be a brief analysis of answers from an impromptu questioning of students as we awaited the arrival of a replacement HET. With this paper in mind, the questions posed -what are your thoughts on the methods of teaching employed and what methods help you understand the lecture material, yielded 18 voluntary responses from a possible 47 (Appendix 2). Adams (2008) appreciated that stories were multifaceted, basic and significant phenomena that impart ethics and morals, presenting us with distinctive traditions of thinking and feeling, and facilitating individuals to understand themselves and others. The immeasurable ways individual experiences impacts on HET and Research must be recognised. Ellis & Bochner (2000) not only try to sensitise individuals to issues or experiences veiled in silence but also to forms of representation that intensify our aptitude to empathise with individuals who in some way differ from us. Psychodynamic approaches within educational contexts are not a new phenomena, theories of psychoanalysis based on the work of Sigmund Freud, particularly on his analysis of the unconscious mind, have emerged during the early 20th century. Psychodynamic theory may be regarded as a manner of encouraging closer engagement with feelings that may be obscured from the conscious mind, thus, this theory may be adapted or accommodated in HET. Therapeutic interventions work on uncovering unconscious systems that form personality, shape attitudes and generate emotional disorder. Fundamental to this analysis is an individuals current emotional and behavioural struggles arise from unresolved conflicts from an individual's early childhood. Psychodynamic

approaches highlight the significance of early childhood attachments and the importance of establishing an emphatic and trusting therapeutic relationship between HET and HEL's.

It may be a useful tool for HETs

to understand attachment and apply this to

understanding childrens (Learners) behaviours and their own parenting (teaching) styles, as well as to conceptualise ways of further developing Learners skills and capacities. Current university and clinical research stress that for individuals who developed an unhealthy attachment, the basic capacities for emotional health are severely compromised in later life (Cooper, G., Hoffman, K., Powell, B., & Marvin, R. (2005) Cited In L.J. Berlin, Y. Ziv, L.M. Amaya-Jackson, & M.T.Greenberg). Consequently, mental health professionals such as Stern (1998 & 2004), Tronnick (1989) and Schore (2003) are concentrating on evidence-based research concerning

attachment patterns. Once established, can damaging attachment patterns be altered? The author has found that they can and some approaches of achieving this is through Marte Meo Therapy (Aarts ,1996 &2000) and forming a Therapeutic relationship with the child/adult (See Appendix 1). Perhaps, HET can profit from these ideas by connecting to the fundamental interpersonal processes that support emotional and mental health throughout the life span. Attachment Theory affords a deep understanding of individuals social behaviour, leading to Attachment Theory being conceptualised in a various ways, for example, as a developmental personality theory and as a theory of affect regulation (Stern,1985 and Schore, 2003). The style of attachment the child has with the caregiver is mainly due to the interaction between the pair and mainly by the caregivers childhood experience of attachment which generally draws a parallel to their own attachment figures and experiences of a "secure base" 1980,1988). As the caregiver affects the child, the child equally affects the caregiver. Tronick (1989) terms this process "mutual regulation." Stern (1985) considers the ( Main & Goldwyn, 1984 and Bowlby, 1969, 1973,

"attunement" of the caregiver; where the caregiver is sensitive to the verbal and nonverbal signals of the child, and places himself/herself into the mind of the child. The

above mentioned theorists understand attachment as key to the capacity of emotion regulation. This author posits that a HEL in a state of high or low emotional arousal is not available or present to the learning process. If the HEL is unavailable to the learning process, critical thinking is unlikely to occur, leaving the HEL unfulfilled and disconnected from the learning opportunities provided by the HET. Bowlby (1969) maintained that close attachment to other human beings is the core around which a person's life revolves and it is from these close attachments a human beings draw their strength and enjoyment of life. When caregivers read the verbal and non-verbal cues of the child and reflects them back, the child sees him or herself through the eyes of the attachment figure. It is through this attunement and contingent communication process that the developing child realises their potential (Stern,1985). Can this not be replicated between HET and HEL and will this process inadvertently lead to critical thinking? One postulates that it can and will under certain conditions because it has been observed or modelled in the classroom. HEL's bringing their past emotional trauma into the

learning environment in a destructive manner (to themselves and other HEL's) being able to respond to the HET as she goes at their pace, always aware of their fragility and tethering on the edge of success or annihilation. This is achieved whilst also providing for the needs of other HEL's; whilst difficult with large groups not impossible. Adults assessed as having an insecure attachment generally struggle managing the uncertainties of life and predominantly interpersonal relationships, than those assessed as securely attached (Shaver and Mikulincer, 2002). This can be observed in the HEL's responses and actions to the uncertainties around assessment, what may be requested of them in the classroom and their reactions to group work. In previous work with Child Protection service users and currently with HEL's, a deep attunement to the HEL's/Service Users signals occurs, both their verbal and nonverbal signals, whilst simultaneously attending to ones own internal experiences and responses. This self-attuning may sometimes even occur during the personal reflection process. Resembling the mutual regulation that occurs between
4

caregivers and their child is a comparable to the process occurring in the unspoken therapeutic relationship with the HEL. In addition to verbal cues understated nonverbal cues are picked up and processed by the mind. Bion (1961,1962), Bowlby(1969, 1973, 1980, 1988) and Winnicott (1965) from their various perspectives on attachment theory stress that what occurs in these earliest relationships forms the core of future mental health. The framework of the mind and emotions are positioned during the early stages of life which impinges on all that follows. Winnicott (1964) believed the idea of "holding" progresses from the mother to the family as a whole, and to the wider world surrounding it. Winnicott understood core conditions for healthy development to be 'the continuation of reliable holding in terms of the ever-widening circle of family and school and social life'. The 1970s and 1980s saw key work undertaken on personality, perception and creativity. These works focused on particular groupings such as architects, students, children and young people, artists and HETs. They specify that the creative individual is capable of making diverse views of reality, has excellent communication between logic and imagination, has the bravery to challenge convention, believes in their own ideas and is emotionally connected to the work of creation (Smith &Carlsson, 1990, Schoon, 1992, Andersson & Rhyammer, 1998). At a basic level, offering space for HEL's to speak openly at the beginning of the academic year about their worries concerning a new learning experience, particularly when these individuals are entering HE for the first time, helping them sense the learning they will be engaging in. At this point, introducing a psychodynamic approach into the HELs learning through employing reflective journals to consider the role of self in the learning process. This approach can craft a varied HET

environment incorporating both formal lecture and less formal discussion, where HEL's can discover more about themselves and develop their reflexivity and critical thinking skills (Creme and Hunt, 2002). Bringing into our awareness different strands to learning; the cognitive, the emotional and social strands provide a framework within which the experiences of HEL can be consolidated into HET practice.

One can only request active participation when certain elements are present. These elements include providing a secure base (Bowlby,1969) from which HEL's feel comfortable to operate from, that as a HET there is attunement to the HEL's signals both verbal and non-verbal and that they are provided with the tools necessary to assist them self-regulate. This is achieved by naming what is happening in the moment and step by step guidance on how to move forward with the learning in a manner that is non-threatening to a HEL but at the pace of the HEL when possible. Learning cannot occur when a HEL is disconnected by fear of the unknown. They need to be introduced to a learning style that works for them. The learning has to make sense within the context of their reality. If the learning is pitched at too high a level for HEL's, they feel a sense of disconnect with the material. This may manifest itself through inappropriate behaviour as a result of the fear, insecurity and anxiety experienced by the HEL Chickering & Gramson (1987) list The Seven Principles f or Good Practice in Undergraduate Education. They state 1. Good practice encourages HEL -faculty contact. 2. Good practice encourages cooperation among HEL's. 3. Good practice encourages active learning. 4 Good practice gives prompt feedback. 5. Good practice emphasises time on task. 6. Good practice communicates high expectations. 7. Good practice respects diverse talents and ways of knowing. These Seven Principles for Good Practice in HET encompass, in the authors view, all that Attachment Theory, Psychodynamic Theory and Therapeutic Relationships have to offer in HET. Relating learning to HEL's needs is possible using a

psychodynamic approach. The attitudes the HET conveys to the HEL's is very important, it aids learning. In fact, in the seven principles for undergraduate teaching, the relationship with the HET is highly regarded as being conducive to meaningful learning. It is important to
6

convey respect for the HEL and demonstrate in very tangible ways interest in their learning but also their welfare and wellbeing. As HETs we can unconsciously

communicate positive attitudes that will affect the psycho-social atmosphere of the learning environment and the overall learning potential of our HEL's. Conversely, we can just as likely convey the opposite and the more damaged or traumatised our HEL is, the quicker they can pick up the negative signals in a self-fulfilling prophesy. It's expected that HELs augment HEL of fellow HEL's in the classroom by participating in HEL activities and being willing to support the active learning of their fellow HEL's. Often, if open to the experience, the HETs learning can also be

enriched in the moment (Loke & Chow 2007, Boud et al 2001). Frequently, the HEL's are surprised when they discover that an expectation of this HET includes learning from them. The power imbalance is also reduced at this point. Furthermore, if the HET obviously enjoys being part of what transpires in the classroom in both a planned and unplanned way, and is enthusiastic and excited about the subjects they teach, then that enthusiasm often could be infectious and with many of the HEL's embracing that enthusiasm too. Also, it would seem remarkable attuned HET's have a gift for knowing just how much information to offer and how much to ask the HEL's to discover for themselves. That gift is something one must continually strive to emulate. The key is to help HEL's get excited themselves about the subject, to want to acquire more information to push beyond what is covered in the classroom. Psychodynamic theory may be considered as a manner of supporting individuals to connect even more personally with thoughts and feelings that may be concealed from the conscious psyche, thus, this theory may be adapted or accommodated in numerous diverse and radical situations. HE currently does not essentially hold humanistic customs within their perception of HET. Humanistic customs all too often are considered the role of HEL counsellors or chaplains. Ecclestones and Hayes work, The dangerous rise of therapeutic education is considered due to it being the antithesis of all this author believes to be true in HET. Firstly, therapeutic education is not clearly defined, therapeutic education is defined as any activity that focuses on perceived emotional problems and which aims to
7

make

educational

content

and

learning

processes

more

emotionally

engaging(p.x). This is where this author believes that Ecclestone and Hayes imply there is a "dumbing down" of educational content in order to focus on "perceived emotional problems". The phrase "perceived emotional problems" leaves the reader wondering if the "perceived emotional problems" are perceived by the HET or the HEL. There appears to be a distaste that any one receiving an education would have emotional problems. However, Ecclestone and Hayes (2008) state Therapy was once regarded as a cure or treatment for people who were disturbed or troubled or mentally ill. now the term has changed its meaning and become a positive value. Regardless, they do not regard therapeutic education as enlightening and harmless. In their view, therapeutic education is profoundly anti-educational abandoning the liberating project of education. Ecclestone and Hayes (2008) maintain that educational facilities must restore the emphasis on "subject knowledge" and that the increase in anxious and depressed Learners is related to a therapeutic ethos forcing them to feel dependent and incapable of success, leading to anxiety and depression rather than exams and assessments pressures. Both authors firmly believe that it is vital for places of It's appears education to return to imparting disciplinary knowledge to learners.

narrow minded to suggest that teaching incorporating a therapeutic ethos fails to deliver disciplinary knowledge to Learners. Throughout their work, the underlying theme appears to be resistance to any form of emotional or therapeutic approaches to teaching and learning, in particular if ones aim is to educate/awaken the emotions. One wonders with such a resistant and superior approach to therapeutic education, is there an underlying fear of incorporating therapeutic approaches in their teaching? Are they unable to make a connection to learners? Do they consider providing the content as the only prerequisite to effective learning? Is there a fear of exposing their real self to their learners? Is there a belief that teaching using humanistic approaches diminishes critical thinking? This author believes the answer to the latter question is yes, most definitely.
8

This author is not suggesting a psychodynamic approach to HET and research is not risky. HET's are unable to provide the long-term ongoing support available in therapeutic settings to HEL's once unconscious emotions emerge. HETs most likely will not be skilled in managing aspects of transference and counter-transference or know what to do if HEL's experience challenging personal difficulties. Similar to Ecclestone and Hayes (2008) HETs may see their role solely as educators, that is to follow the syllabus, achieve learning outcomes and assess accordingly and do not have the capacity or the willingness to engage in a more humanistic approach to learning. Rogers (1969) and Biestek (1961) acknowledged definite interpersonal qualities as essential for effective teaching. The attitudinal conditions they identified perhaps foster an atmosphere of warmth, openness, trustworthiness, approachability and congruence which will hopefully preserve a group ambiance that is conducive to feelings of safety, allowing authentic discussions to unfold. Rogers (1969) implied HETs should be truthful with their HEL's about whom they are as multifaceted individuals and also acknowledge what they know and dont know. However, Rogers (1969) also proceeded to consider the type of relationships HET's have with their students. Rogers acknowledged this relationship as a way of being whereby HETs bring their emotions into awareness or are in the process of becoming more connected to their emotions, and act out of these emotions instead of pretending to be or feel a certain way during their teaching. Congruence with HEL's, predominantly means being honest with them about your feelings in the moment, thus engendering a level of trust. Bion (1961), Mann et al (1967), and Agazarian & Peters (1981) work all deliver important narratives with which to consider our own lived experiences. As tools for developing reflective practice, they provide key theoretical frameworks for our consideration (Knights, 1985). An underlying theme from the literature consulted for this paper is the value of a warm atmosphere and suitable environment conducive to reflection by providing clear step by step guidance around purpose, meanings and

expectations to support the HEL's experience and reflective ability (Boud and Knights, 1996). Mann (1967) identifies the different responses experienced by group leaders such as HET. Maybe, our HEL's reactions to us, are not solely as a result of the lecture content we deliver, but also to our interpersonal interactions with them. To clarify, Mann (1967) considers the reactions of HEL's towards HET whereby the HET is viewed as the helper/mediator if not replacement parent. In his work, he found HEL's as a group will react with displeasure when the HET neglects to provide the expected control, direction and mildly nurturant behaviour which many students anticipate on the part of a teacher (p.75). Mann (1967) postulates that these situations may evoke reaction experienced as dependent complaining in other words, discontentment that the HET isnt leading. Mann (1967) expands on Bions (1961) similar comments (p.29f). From a HET perspective, the containment process facilitates the HET to convey to the HEL's that they "are seen" in the moment and the HET can understand the HEL's point of view. In other words, the HET taking on the HEL's difficult emotions and returning them to the HEL in a more manageable form. These experiences are worth mentioning when considering transitioning from HETled to HEL-led teaching. Perhaps for this HEL led teaching to be wholly effective, there must be a return to small group HET. From the authors perspective, HEL's are expected and encouraged to play a role in the general learning of their HEL colleague by partaking in classroom activities and a willingness to work as a analytical colleague to their peers (Boud et al 2001, Loke & Chow 2007). Nicol (2010) believes research in HET illustrates that learning has more depth, can be more supported and gratifying as HEL's become equal collaborators in their acquisition of knowledge thus taking control of their learning. Assessment and feedback practices should be designed to enable students to become self-regulated learners, able to monitor and evaluate the quality and impact of their own work and that of others. (Nicol, 2010). The most influential technique to realise this is to actively engage HEL's in the assessment process, that is, allowing them regular opportunities to self assess judgements their work and the work of their HEL colleague This will increase their
10

skills in monitoring, evaluating and managing their own learning. The idea being that in due course, learners will most likely "become independent and self -regulated learners with the confidence, self-reliance and collaborative skills necessary for life" following HE (REAP). It is therefore necessary to disagree to some extent with Shuell (1986) when he states it is helpful to remember that what the learner does is actually more important in determining what is learned than what the teacher does. Probing the autobiographical dimensions of ones HET practice is achieved by explicitly incorporating psychodynamic ideologies in understanding features of ones own lived experiences. One believes in worth over magnitude and confirmation of critical thinking over total memorisation (Ennis 2004, Norris 1985). Among others, McKinney (2008), Prince (2004) and Felder (1992) recommend that maintaining HEL's in "active learning" as opposed to "passive listening" advances not only the pace but also the value of their learning. Consequently, the aim of HET must be to provide classes that promote active learning and are as participative as feasible and, as a HET, strive to establish a classroom environment that promotes active participation through discussion, role-play and HEL presentations. This author values the use of presentation props that aid HEL's to discover the key learning from subject matter and encourage them to reflect on significant questions whilst also ensuring vital information is available on-line. Whilst reflecting on our own HET practice, we might discover aspects of our own teaching behaviours that are habitually undesirable or ineffective in a HET situation. Moreover, we may notice that common HET methods are not flexible enough to consider the important role emotional and unconscious reactions have on the HEL's learning process, nor do they consider the power of group dynamics to impede the accomplishment or collapse of the learner group. Its notable how each HEL group differs dynamically. Lastly, this HET asked her HELs after her final class with them, What are your thoughts on the methods of teaching employed and what methods help you understand the lecture material? This yielded 18 varied responses. Responses were divided into 3 broad groups as surprisingly, HELs experienced the same teaching
11

methods differently. The first group (6) appears satisfied, the second group (6) were neither satisfied nor dissatisfied and the third group (6) were dissatisfied with the teaching style employed. Striking and a source of joy is the change of tone detectable in their written answers. When this group of HELs initially came to class, they presented with similar characteristics to what Mann (1967) describes as dependent complaining. This dependent complaining was often observed as adversarial and aggressive. One considered these inappropriate reactionary behaviours to be the bi-product of anxiety and fear. What is discernible from the handwritten notes is the ability to claim dissatisfaction in an entirely appropriate and respectful manner. This is gratifying to observe. There is a sense that these HELs are somewhat capable of transferring what was modeled in the classroom and utilising it in situations where such an approach is necessary. Furthermore, without the ability to be reflexive, the HELs may not have been capable of articulating what their thoughts on the methods of teaching employed and what methods helped them understand the subject material. Worthy of mention is that all 18 HELs received the same HET input yet their experienced reality varies to some degree from their fellow HELs. If we are serious about HEL participation, development of critical thinking skills and retention, we must continue a dialogue with HELs to ascertain the manner in which they would like to learn.

To conclude, one strongly advocates incorporating a Humanistic approach in HET, incorporating a psychodynamic approach, attachment theory and therapeutic relationships. Advocating a psychodynamic approach, managed with awareness

and sensitivity in appropriate situations, may assist differing HEL's to overcome some difficulties with learning and to progress towards a more reflexive self, more open to the fine-tuning and progress that considerable learning entails. There exists a consciousness of the importance of continually and vigorously examining ones own teaching practice to support further awareness of personal
12

experience and of what we are undertaking in our position as HETs and during this awareness to allow more of ourselves into our HET, provide a "secure base" for HEL's and increase our sense personal work fulfilment, including connectedness to both the HELs and the material we teach. This method of consciousness and teaching also encompasses a dual role, modelling behaviour suitable for the work place, in addition to modelling how to manage difficulties as they arise in daily living moments. Inadvertently, what may

be discovered is that this method of teaching evens out the power imbalance whilst remaining as the secure base for HELs to explore the learning styles best suited to them. It must also be stated that through this consideration of genuineness should come a recognition that even though advantageous to understand self, it is unacceptable as a HET to act on an emotion in a manner harmful to a HEL. It is true to say selfawareness should enable appropriate reactions regardless of the situations. Also, it may be determined that familiar HET techniques neglect to fully consider the power of emotional and unconscious processes during the learning process of a HEL, or that group dynamics can lead to the achievement or collapse of the HEL group itself. The Humanistic approach incorporating Psychodynamic Theory, Attachment Theory and the Therapeutic Relationship are invaluable in preparing the brain to absorb the theories, then providing the space for the HEL to connect with the material in a manner relevant to the HELs reality and lived experiences and then to build on this learning knowing that their HET and fellow HELs are available to support the learning in whatever form it takes. Durant, (1935, p605) says "I have never met a man so ignorant that I could not learn something from him. HELs from a previous place of HET were asked, "What are your thoughts on the methods of teaching employed and what methods help you understand the lecture material? Surprisingly, as stated earlier, their responses were divided into three broad categories. The first group appear satisfied (six responses), the second group (six responses) appear neither satisfied nor dissatisfied and the third group (six responses) appear dissatisfied with the teaching style employed. Yet, these HELs were present at the same lectures, were taught in the exact same manner as the other respondents. It would appear various answers are provided to the questions
13

and this provides the author with a clear picture illustrating that regardless of the HET style or methods HELs have an individual response to the material taught and construct their own reality from the material. This reality may be often unexpected. Some of the responses can be linked back to an earlier discussion where Mann (1967) established groups will react with displeasure when the HET neglects to offer the expected control, direction and mildly nurturant behaviour which many students anticipate on the part of a teacher (p.75). What is striking is that when HEL's are asked collectively during a lecture if everyone is clear, if everyone understands the information, there is yes nodding or often silence. Despite using a Humanistic approach to HET, it would seem what is important is to vary HET styles in order for as many learning styles to be catered for whilst simultaneously modeling for HELs, techniques they can employ to understand and make links with the learning material and their lived experiences. Providing a secure base from which HELs can explore these topics is paramount, whereby, their fears and anxieties are contained and managed. Winnicott was concerned with taking on the childs fears and anxieties and returning them to the child in a more manageable form. There is no reason why we as HETs cannot do this for our HELs. An unintended benefit of this authors HET approach was observing HELs advance from often displaying aggressive, adversarial and inappropriate responses to being somewhat capable of transferring what was modeled in the classroom and utilising it in situations where such an approach is necessary; in this instance, through their written responses to the questions posed. Finally, HELs may not have been capable of articulating their thoughts on the methods of HET employed or the methods they deemed necessary to help them understand the subject material had they not worked on developing reflexive skills. Today's HET's must increasingly go beyond presenting information or facts. For the HEL's future success, it is vital HET's ensure their HEL's have understood the delivered information and can now utilise and adapt it to various situations . The author feels the ability of HEL's to apply knowledge is as necessary for their success
14

as the quality of the information presented. Galileo Gallilei (cited in Camegie, (1935) states, "You cannot teach a man anything, you can only help him to find it within himself". The pedagogical approach we must encourage, is one whereby HET's do not provide answers, or even pretend to have answers, but help HEL's discover their own potential. Future writing on this topic will include the work of Kristjansson and his work on Aristotle, Emotions, and Education and Smeyers et al and their view on Philosophy, Happiness and Personal Growth within Therapeutic Education. As stated previously, the Humanistic approach to HET is not a recent phenomenon therefore the role of Phronesis in HET is worthy of exploration, as indeed is a more thorough study of the work of Rogers. Furedi. (word count 5,013) The work of other authors with a different view point to this author would also be considered, for instance, the writings of

15

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Appendix 1

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Marte Meo

Maria Aarts deliberately chose the name "MARTE MEO" to highlight the central focus of the programme, which is to identify, activate and develop skills to enable and enhance constructive interaction and development. "On one's own strength is the central MARTE MEO focus at all the various levels to encourage people to use their own strength to advance and stimulate developmental processes on the part of children, parents, professional caregivers and supervisors and thus learn to optimally utilise their capacities. Aarts asked herself: how could professional information be re-formulated so that it could be made accessible to caregivers in a practical way. The experts had often abstract and mainly problem oriented information and cryptic knowledge has to be rendered into practical, everyday language. In the process of attempting this, it was discovered that the professional focus was mainly problem oriented; focussing on explanations of pathology. What was often lacking were descriptions of what to do in order to try and solve the problem. The Marte Meo programmes contain concrete and detailed information packages about human interaction and development from different areas. These packages in turn contain practical knowledge about: how to identify opportunities for development; which natural supportive behaviours are required to assist development, and how this knowledge can be incorporated into the natural system of the individual so that they can learn the new skills in the most efficient way possible. The information packages were developed through observation and analysis of human interaction. Video is the most important tool used for interaction analysis. Within the Marte Meo programmes, the video becomes a behavioural microscope. The therapeutic process needs to incorporate opportunities to practice cooperation in ways that the child experiences as trust building. When the child sees that he can comply, and not only survives but feels a measure of joy and accomplishment, then he can begin to transfer that ability to trust adults both at school and at home. Developing therapeutic techniques that support the parent and childs relationship by incorporating trust and cooperation exercises are essential in promoting emotionally healthy and secure children.

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Appendix 2
6 HEL's seem satisfied with HET methods

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6 HEL's neither satisfied nor dissatisfied with HET methods

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6 HEL's appear dissatisfied with HET methods

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