DOMAINS and LEVELS of dis-integration

28th December 2013

Introduction

Mapping the complexity of human interactions is helped by considering different Domains, and the different Levels within these at which dis-integrative processes tend to occur.

The Domains we highlight in this respect are analogous to the Domains and Levels of dysfunction that help us to map our patients' problems and plan interventions.

These simple ideas underpin the Dis-integration grid that offers a way to structure interventions to reduce the negative impact of dis-integration.

DOMAINS OF DIS-INTEGRATION

Any of the following domains may clash on a number of different levels:

Young personFamily membersPeers/Social EcologyIndividual ClinicianMultidisciplinary teamOther Multi-Agency teams

Within the Multi-Agency network for any particular young person, you might highlight particular agencies:

Social ServicesEducationYouth OffendingGeneral PractitionerCAMHSPoliceetc...etc...

The Dis-integration of treatments may occur in any of these domains (often simultaneously), and occurs at any one of three different Levels:

LEVELS OF DIS-INTEGRATION


1.CONCEPTUAL/EXPLANATIONWhat's the problem?
2.PRAGMATIC/INTERVENTION SKILLSWhat to do?
3.SYSTEMIC/ NETWORKRESPONSIBILITIESWho does what?

A range of different Dis-integrativeProcesses can be identified as driving the unwanted outcome of dis-integration.

Dis-integrative processes are most easily mapped onto these different Domains, and Levels using the simple Grid, found at Dis-integratedInterventions (and repeated below). An important practical technique for keyworkerrs to master is the use of this grid as a tool in case discussions, sketching out the details of a particular case helps the Keyworker and Team to identify sources of dis-integration and to develop strategies to counter these.

  1. Individual Clinician - see Dis-integrative processes in an Individual Clinician
  2. Multi Disciplinary Team - see Dis-integrative processes in a Multi Disciplinary Team
  3. Multi-Agency context - see Dis-integrative processes in a Multi-Agency context
  4. Family/Systemic context - see Dis-integrative processes in a Family/Systemic context