Using the Rock & Water method in the treatment of forensic psychiatric patients

 

This is linked to a previous blog entitled “Holland and Belgium Are Getting It Right: The 2017 ATSA-NL conference”. Kieran.

 

We are honored to write a blog about our work at the Van der Hoeven Kliniek, a forensic psychiatric hospital in Utrecht the Netherlands.

 On the 26^th of January 2017 Kieran and Bill had a guided tour in our hospital. At the Sports department they were very interested in the Rock & Water method which Lonneke v/d Pol, Ernst Janzen and Erik Timmerman provide besides other sport lessons. After their visit they asked to write this blog and so we did.

The Rock & Water method has been implemented within this hospital in 2008. The workshops for patients focus on aggression regulation, learning how to set boundaries, and how to improve social skills. The focus is on becoming aware of their own behaviour and the impact of their behaviour on others in daily life.

 

The Rock & Water method

 

The Rock & Water method provides participants with skills for physical-social teaching with a focus on body awareness, emotional awareness and self-awareness. The concepts 'rock' and 'water' are being used as a metaphor to explicit different forms of communication.

By experiencing practice-focused physical exercises, it is easier to transfer these skills to situations in daily work or life. By creating moments of choice, the participants can learn to consciously make decisions and regain control over their behaviour in complicated situations, for instance, when it is needed to set boundaries without getting in an escalating conflict. Participants will learn to become aware of personal possibilities, qualities and responsibilities. The workshop focuses on social competence and inner strength. In daily life, individuals will have to be able to function as a rock (strong, immovable and with self-confidence) and as water (remaining in contact, flexible and connecting). The basics of the program include grounding and centring exercises, standing strong and rock and water attitude in physical and verbal communication. The power of this method is that by practicing and experiencing the different physical exercises, one can learn to regain control in their daily life at work, school or society.

Golden triangle:

 The golden triangle comprises of

                 -              Self-awareness
                 -              Body awareness                              
                 -              Emotional awareness

Applicability in daily clinical forensic psychiatric practice:

Since 2008, the Rock & Water program is being used with the Sports department. Just like the other sport activities, the program is part of the treatment program of the patient. When the method was implemented, it was immediately successful. All patients easily recognized the terms Rock and Water and the active part was appealing to them. These lessons are provided for individual patients or to small groups of maximum 6 patients.

For the TBS (disposal to be treated on behalf of the state implying mandatory treatment) patients with severe and complex psychopathology, we offer individualized programs in close collaboration with their psychotherapists or their supervisors. For patients with other judicial titles who are usually admitted for shorter-term , we provide series of 10 lessons supervised by a sports teacher together with a therapist. The workshop has multiple aims. Generally, the workshops focus on reduction of tension and emotion regulation, learning how to set boundaries and improving social skills.

After the implementation in 2008, the use of the method has expanded enormously. For the TBS patients the method is oftentimes mentioned as one of the indicated treatment activities and there is constructive deliberation between the trainers and psychotherapists in improving treatment of patients. For the patients with other juridical titles, the Rock & Water program is standardly adopted in the treatment plan. Both patients and staff members are very enthusiastic about the method. Patients indicate that “not just talking” works well for them and that they like to be able to put in their own perspective.

More and more, the program is being incorporated by patients in their early signal plans and relapse prevention plans. Multiple patients state that months or years later they still make use of the techniques and benefit from it. For us, this is a strong indication that the Rock & Water program is effective and suitable for forensic psychiatric patients.

Erik Timmerman (etimmerman@hoevenkliniek.nl) is sports teacher, staff trainer and coordinator of the Sports department in the Van der Hoevenkliniek. As advanced Rock & Water trainer he provides individual workshops and group workshop for patients, as well as for staff members.  He is owner of EighT – Opleidingen, Trainingen & Coaching in which he also predominantly works with the Rock & Water method.

References

-          Ykema, F., Het Rots & Water Perspectief – basisboek (2002)
www.rockandwaterprogram.com

 

-          Ykema, F., Hartman, D. and Imms, W. (2012) Bringing it Together, - Includes 22 case studies of Rock & Water in practice in various settings

 

-          Timmerman, E. (2012) WESOCO training, EighT – Opleidingen, Trainingen & Coaching. www.eight-trainingen.nl

 

-          Graaf I. de, Haas S. de, Zaagsma M. and Wijsen C. (2015) Trimbos-institute Utrecht, The Netherlands. Effects of Rock and Water: an intervention to prevent sexual Aggression. Journal of Sexual Aggression.