Growing Well

Ways of noticing our emotional and mental wellbeing

We spend so much time monitoring and enhancing our physical health. Now let's take the time to actively engage with our mental wellbeing.

The Growing Well kit is for mental health professionals, clients, students, and anyone interested in monitoring their own mental wellbeing. It is made up of 50 cards with a booklet and 5 scaling pads. This practical and highly innovative resource is built around 50 key statements that research has shown are important indicators of mental health and balance. Accompanying each statement is a 'scale' using simple illustrations of a seed growing into a tree. A user checks the box that is relevant to them-every day or every week, perhaps. In this way the scale can be used to notice change and describe growth, even when words seem inadequate.

The creative spark for Growing Well came from the mental health team from St Luke's Anglicare who developed the tool together with staff from the Department of Social Work at La Trobe University, Bendigo, Australia. Pivotal to the development were consultations with people using mental health services. The result is a tool that can:

'Attaining and maintaining mental and emotional wellbeing is becoming one of the greatest challenges worldwide. Growing Well is more than a tool; it offers the potential for artistry to be brought to bear as we strive to find depth and meaning in our lives.'

From the foreword by Jennifer Lehmann PhD

Senior lecturer in Social Work, La Trobe University, Australia

'Mental Health Kit Will Assist Wellbeing,' The Bendigo Advertiser, October 10, 2006, p.2

A new tool for monitoring mental health was showcased by St Luke's Anglicare yesterday during its launch at the White Hills Botanic Gardens.

Dubbed the Growing Well kit, the tool allows people to track changes and growth in their own mental and emotional health.

It has been developed by the St Luke's mental health team, in conjunction with staff from the School of Social Work at La Trobe University Bendigo, and was built around 50 key statements that research has shown are important indicators of mental health and balance.

Russell Deal, the director of St Luke's publishing company Innovative Resources, said included with each of the 50 statements was a scale that used simple illustrations of a seed growing into a tree.

"The user checks the box that is relevant to them on a regular basis," he said. "In this way the scale can be used to notice change and describe growth, even when words seem inadequate."

The kit was developed from consultations with people using mental health services, Mr Deal said - although it was designed to engage and support anyone interested in monitoring and enhancing their own mental wellbeing.

The result is a tool that can map pathways through depression and stress, encourage a focus on strengths rather than deficits, and build emotional balance.

La Trobe University 's Social Work senior lecturer, Dr Jennifer Lehmann, said attaining and maintaining mental and emotional wellbeing was becoming one of the greatest challenges worldwide.

"For rich and poor alike, the chances of being touched by the problems generated by less than optimum mental health are unacceptably high," she said.

Dr Lehmann said the resource would be useful for mental health professionals and students.

USING THE GROWING WELL CARDS

The Growing Well card set consists of 50 laminated, write-on/wipe-off cards with key statements that are indicators of mental wellbeing. As well as the statement, each card features a scale made up of six small boxes with an illustration inside each box. The illustrations show six stages of a seed growing into a seedling and finally, a tree. Anyone can select a card, read the statement on the card and, if they wish, mark a box (with non-permanent whiteboard pens) that shows where they feel they are at in relation to the statement. The cards can then be wiped and re-used many times over.

Clearly, not all statements will be relevant to everyone. A therapeutic conversation may be built around a single card or the cards can be sorted according to their perceived relevance. To assist with this, the cards are colour-coded (10 cards in each of the five suits). By selecting specific cards, users can opt to focus on a particular theme (for example, all the orange cards in the 'Being Healthy' set).

The Growing Well cards can be used in many different settings and ways. They are designed to be used by individuals alone or as conversation-building tools between a professional and a client, or between colleagues, friends or groups members. Apart from the cautions mentioned earlier, there are no rules that dictate how they are to be used. This will vary with the creativity and discretion of the people introducing them. Here are some suggestions that might spark your imagination:

Scanning and Grouping

Spread the Growing Well cards out on a flat surface like a kitchen table so that they can all be scanned quite quickly. The cards can then be categorised or grouped according to a range of possible considerations.

Limiting the Range

At times it will be important to reduce the number of cards to be scanned. This might be because of an individual's attention span, the amount of time available, the lack of relevance of some cards or because some of the issues have been dealt with in previous conversations. For example, it may be apparent that one of the five dimensions should take priority over the other four. This gives 10 pertinent cards to scan, sort and discuss. Of course, a powerful conversation can be built around a single card if the issue it raises is relevant.

Random Choice

Shuffling the cards into a deck, turning them face down and then turning them over one at a time provides an interesting means of introduction. This can add an element of surprise and serendipity to the conversation. The cards can still be sorted into categories as above, but the sequence of the cards might provide another element to consider.

Many people use journal writing as an important way of recording both their journey through life and as a means of staying healthy.

Do any of the cards suggest something you would like to write about?

Are there any words on the cards that spark your imagination or interest you for any reason? Place a word in the centre of a page and circle it. Create a mind-map by placing other circled words that come to mind around it. Draw lines between words to create chains of linked words. Let your imagination run free with the words and then stand back and see if any significant information has been captured on the page.

Are some of the statements on the cards very significant for you? Write the statement in your journal and use it as a prompt for writing.

Take a statement from one of the cards that you think is important for you (e.g. 'I stay healthy by eating well') and create a collage of images from magazines and newspapers.

Use the same statement as a theme for a poem or short story, or use it as a theme for writing a paragraph each day for a week.

Which cards describe an important part of your journey at present?

Which parts of your journey are worth recording so that you can look back on them to note how you have grown?

Write a letter to yourself as if you are 100 years old and have now have a great deal of wisdom. Speak very kindly to yourself in this letter telling yourself what you now know.

In Group Work

Sharing stories of struggles and successes is an essential element of many groups. As well as being suitable for personal reflection and one-on-one conversations, Growing Well has many applications within small groups. Each member of the group can be asked to pick one or more cards that say something about them.

An alternative for groups is to use a random selection activity by inviting participants to each discuss how they can go about achieving success with each card as it is turned over.

Or the cards might be shuffled and dealt out around the group with each participant invited to talk about the 'hand' of cards they have been dealt, or an individual card from that hand that they would most like to talk about. Each 'hand' can be passed to the next person to continue the discussion or the deck can be reshuffled and re-dealt to start again.

Card of the Day/Card of the Week

With 50 cards in the set, the Growing Well cards can provide a daily or weekly reminder of skills we might practice or areas in our lives where we can make improvements. A card of the day or the week can be put in a prominent place-on a desk, a notice board, a fridge or in a diary-to remind us of some of the significant components of a healthy life. Even if the cards describe activities that come easily to us they can remind us that there is always room for improvement.

USING THE GROWING WELL SCALES PADS

The five suits and 50 statements (10 for each suit) that make up Growing Well are available as five gummed, tear-off, A4-sized pads, each with 25 tear-off sheets. Each of the statements is accompanied by the same visual rating scale that appears on the cards. These scaling pads are simple, practical, highly accessible paperwork tools that can be dated, written on, used over time and included in a case file or service folder, if desired.

People using the pads can do their own recording on each sheet or they can do this in conjunction with a carer, support worker, therapist, clinician or case manager. While originally designed as a self-assessment tool for people accessing mental health services, they can be used by anyone who wishes to actively engage with their own wellbeing. Scaling sheets can also be used by professionals and carers. The scaling pads can thus provide a rich record of a person's self-perceptions as well as a record of the perceptions of significant others over time.

Each of the five suits or dimensions of 'wellness' (Being Connected, Being Healthy, Being Active, Being Satisfied and Being Organised) has a checklist of 10 statements that accompany it. These have been made into five gummed, tear-off pads with a simple illustration of a seed growing into a tree on each sheet.

Each statement on the checklist (for example, 'I stay healthy by thinking clearly') is written in plain, simple English giving opportunities for people to maintain their own record of their growth and change.

Sometimes, these pads will be used by individuals in conversations with a professional. The pads can help story a person's journey through their own eyes and through the eyes of the worker, as required.

Completing the checklists can provide a 'snapshot' of how an individual is travelling at a particular time. This can be tested against the perceptions of others. It can also be compared to other snapshots taken at other times to note the changes that have taken place over time. As a record purely of an individual's own perceptions, the key question is how to make the pads most useful to a particular individual. What is useful to one person may be the opposite for others.

There are no rules laid down for how the pads should be used. All of the suggestions made for using the cards can be adapted for use with the pads. As stated earlier, privacy and confidentiality should be negotiated beforehand with a clear statement that there are no hidden meanings and no claims of statistical significance.

Some questions to consider in introducing the Growing Well pads are:

The style of the Growing Well pads is designed to integrate with client-directed, client-owned case recording systems such as the 'service folders' designed by St Luke's Anglicare. (Please see Wayne McCashen's book called The Strengths Approach, published in 2005 by St Luke's Innovative Resources, Bendigo, Australia for a description of service folders as they are used in strengths-based social work practice.)

Client-owned recording systems are based on the understanding that the ownership of any records of service delivery rests with the person accessing the services. They are the ones who should have maximum input into, and control over, any record keeping that is required by a human service professional or organisation. If such a system is adopted it is suggested that clients keep the originals of their completed checklists and workers keep a photocopy.