Transforming community psychiatry1 through transformational research I have been working in an institution in community psychiatry in Denmark, where there was a great demand for transformation. The political parties wanted change, the citizens wanted change, half of the users in the institution was change from old people with dementia to user with psychiatric diagnoses, which the institution never worked with before and they were rebuilding the institution. And all these changes were wanted at the same time. I wrote this article to show anyone with an interest in transforming large and small systems, how you can work with a simple approach applied to the different parts of the system. I call this approach transformational research. New demands for community psychiatry – the political context In 1998 the parliament of Denmark passed a new bill, which changed the foundation for community psychiatry. The most important changes are: 1. The users of community psychiatry have the right to know which service they can get from the system 2. The users have the right to decide for themselves 3. All users live in their own home even if they are in an institution 4. Everything you get is service not treatment 5. In order to achieve the above all users have the right to have a written actionplan that states which service they can expect and makes sure the professionals know what has been decided. An actionplan must specify what the user has been promised and how these promises will be handled The institution – the local context The institution is facing a large change. New groups of users are one of the challenges they are facing. Some of the users are leaving and new groups of users are replacing them. These new users have diagnoses, which the institution has no experience with. As a part of this change the institution is being rebuild. Transformational research – a short description of my methods In my work as a consultant I want to use simple methods that can be applied in many different contexts, so that you by knowing one simple method can deal with a large number of different issues. My method consist of three parts The process Visualising the system you are exploring The main questions 1 The term community psychiatry refers to services to users outside of the psychiatric hospitals. 1 These parts are highly integrated but I will explain the one at a time. The process The process uses three phases Creating visions – starting with personal visions for all participants and sharing these visions in order to create shared visions for the system. A vision consists of an understanding of the best of the present and the best ideas we have to make things even better. Future search – telling the story of how the future looks like when the visions have come through and how we managed to get there. Training to live in the future – to become a master of living in the future you have to practise Visualising the system you work in In a systemic perspective a system consists of a lot of elements and the relationships between them. I have develop a very simple way to visualise the system you work in: I start by putting the person you want to work with at the centre and then find the relationships that makes it possible (or impossible) for this person to do what is needed. Then I draw the system like this: External partners Management Job/tasks Users Other departments Users family Other proffessions Colleagues This drawing shows the system of an employee in community psychiatry, which means that I focus on The relationship between this person and the job or the tasks The relationship between this person and the users The relationship between this person and the users family The relationship between this person and the colleagues The relationship between this person and the other professions 2 The relationship between this person and the departments The relationship between this person and the management (from the closest manager to the top) The relationship between this person and external partners of co-operation This is the system that usually creates the successes and failures of an employee in an institution in community psychiatry. Basically there are three things that are necessary to do a good job. You have to be able to do the tasks the job demands including interactions with the people you do it for/with. You have to be able to create the internal co-operation that makes it possible to do the tasks. And you have to be able to create the external cooperation that makes it possible to do the tasks. In all systems this guide needs interpretation. As a consultant representatives from the system and I decide on the relationships that are put explicitly in the interview-guide, but I leave the interpretation to each person being interviewed. If you’re a manger in the system you have to divide your colleagues into employees and managers at your own level. If you’re a secretary your users could be both the real users and the staff in the system and even central departments in the organisation. So this way of visualising the system is more a way to make people think systematically about how the system they are working in looks like – the actual interpretation is done in the interviews. The questions I use a very small number of questions: For creating visions the questions are What are the best experiences you’ve had in relation to .....? (..... refers to a relationship) What made it possible for you to have these experiences? What do you dream of was possible as well in relation to your .....? For future search the instructions are Leap 5 years into the future – here the visions have become reality Tell the story about how it is to live in the vision and the stories about what you did to make it happen – tell all the details For training in living in the future the instructions are Start living the way you live in the vision OBS Transformational research in the institution” In the institution we worked like this. 3 The process of building personal and shared visions and the future search was done as a two-day seminar. Training to live in the future is done as part of the normal work in this institution. I conducted the two-day seminar and I am supervisor for a group of “learning guides” who supports the process of creating, evaluating and adjusting actionplans. Building personal visions In order to participate in a transformation of your work you need to have a personal vision for your work life. In order to establish that I make people interview each other for about an hour: Instructions Personal vision Find the person you know the least – if it’s possible find someone from another profession or department. Now you’re going to interview each other for about an hour per interview. The purpose of the interview is to make it possible for the person who is being interviewed to get as clear a picture of his or hers personal vision. The interviewer must help by asking questions to the answers the interviewed person gives. Here are the questions you must look into: 1. What are the best experiences you’ve had in relation to your job? 2. What made it possible for you to have these experiences? 3. What would you dream of was possible as well in relation to your job? 4. What are the best experiences you’ve had in relation to your users? 5. What made it possible for you to have these experiences? 6. What would you dream of was possible as well in relation to your users? 7. What are the best experiences you’ve had in relation to the families of the users? 8. What made it possible for you to have these experiences? 9. What would you dream of was possible as well in relation to the families of the users? 10. What are the best experiences you’ve had in relation to your colleagues? 11. What made it possible for you to have these experiences? 12. What would you dream of was possible as well in relation to your colleagues? 4 13. What are the best experiences you’ve had in relation to other professions? 14. What made it possible for you to have these experiences? 15. What would you dream of was possible as well in relation to other professions? 16. What are the best experiences you’ve had in relation to other departments? 17. What made it possible for you to have these experiences? 18. What would you dream of was possible as well in relation to your other departments? 19. What are the best experiences you’ve had in relation to your managers? 20. What made it possible for you to have these experiences? 21. What would you dream of was possible as well in relation to your managers? 22. What are the best experiences you’ve had in relation to your external partners of co-operation? 23. What made it possible for you to have these experiences? 24. What would you dream of was possible as well in relation to your external partners of co-operation? The interviewer must take notes during the interview. You have two hour to do the interviews. Creating shared visions After the personal interviews people are put into new groups which are put together of people from different departments and professions. The group consists of 5 to 6 people. In these groups each person tells what his or her personal vision are. And the others ask questions if there is something they want to know more about. There is no discussion of the visions of the others – they’re allowed to have their vision. Here a shared vision consists of the best from all the personal visions, so everything is brought forth to the next phases in the process. There is no discussion about which things are to be done and which are to be left out. The group choose 3 to 5 issues they would like to go into depth with in the next process. This process takes between two and four hours. My experience is that the more time people get here the better. This is where people really get to know the detail of their organisation and get a detailed knowledge about other members of the organisation. 5 Future search In a plenary session all groups tell which issues they would like to go on with. The purpose of the plenary is to get a first impression of the work the members of the institution has done up until now and to make sure each group work with different issues in the future search. After this each group have an issue to work with. Instructions Future search Assigning tasks First you have to assign one person to be a language guardian. The language guardian must make sure the conversation follows the rules in the instruction. In case somebody slips into different rules the language guardian lovingly must help them to get back in the rules. Secondly you need someone to take notes from the conversation you are going to have. The headline Before you start you conversation. You need to make a headline for your work. This is necessary to make sure you can use the instructions below and to make it easy to bring back to the rest of the organisation. The headline you come up with must follow these rules: It must be positive It must incorporate all participant It must be future oriented The conversation Now you are ready to have a conversation about the future. First you take a leap five years into the future – here your vision has come through. Everything in you vision is now a reality. Then you start telling how it is to live in the vision (in the present tense) and after a while you start telling the story about how you got here (in the past tense). A visualisation of the future The last task the group must do is to make a drawing of the vision for their issue. The future search takes an hour in each group. 6 Dissemination of the results from the future search In the plenary each group makes a replay of their future search and shows their drawing of the future. After this the others allowed to ask questions and make connections to the future search. This part takes about 30 minutes per group. Training to live in the future In the day-to-day life in this institution the transformation takes place through two main activities: Each person has a “learning partner” – if one person wants to try something new, then you can talk it through with his or hers “learning partner" The work related to the creation, evaluation and adjustment of the actionplan “Learning partners” The idea behind a structure of learning partners is, that in a transformation you need to experiment with different approaches to many of the activities in the institution. This is the smallest room for reflection for each person. Instruction “Learning partners” Find your “learning partner” in another department and from another profession. Feed forward If you want to try something new – find your “learning partner”. Partner A: I’ve got an idea – will you help me to reflect on this idea? Can we do it now or can we find another time? All right, now listen here the idea. Partner B: What are your best experiences with this? Which competencies do you use to create these experiences? I see these competencies in your handling of this situation! What are your dreams for the co-operation with the users? What are your dreams for the co-operation with your colleagues? My dreams would be to ….! Partner A: Thanks a lot – what was most useful to me was ......! 7 Partner B: I thought this ........ was very interesting to me! Feed back When you have tried something and experienced what happened – find your “learning partner” Person A: Do you have a moment – I would like to tell you what happened when I tried ..... Can we do it now or take it some other time? All right. I did like this: ......... And the best things that happened was ....... And I showed the competencies of ….. Now my dreams are like this ….. Person B: That’s very interesting. I think the way you changed your idea made this happen .... And I see you have developed these new competencies …..! How could you use these competencies to develop this idea even further? Both: What should we tell the others at the next department meeting? Thanks a lot – I learned this from our reflection on these experiences. The department meeting At all department meetings there are time on the agenda for news from the “learning partners”. Working with actionplans To create, evaluate and adjust the actionplan for each user, there are a number of different activities: A personal interview with the user (if possible) A staff-evaluation of the users situation A actionplan meeting where things are decided for the next year A meeting in the department where the new actionplan is presented, discussed and where necessary decisions about how to implement the actionplan takes place A series of evaluations of the work with the user 8 The personal interview with the user. This interview follows the same procedure as the personal vision interview described earlier but with a different system. The user system looks like this: Professionals Interests Friends Every-day life Other users Family The interviewer takes notes along the way and the answers are divided into two categories: Competencies – which are the thing the user can do Potentials – which are the things that the user would like to become better at The interview is conducted by the contact-person, who is responsible for taking care of the different contacts between the user and the surrounding system. The staff evaluation of the users situation. This evaluation follows the same procedure as the personal interview with the user but the questions are asked in a group evaluation of the users situation done by the staff. The contact-person for this user takes notes along the way and again the answers are divided into two categories: Competencies – which are the thing the user can do Potentials – which are the things that the user are likely to become better at The actionplan meeting At the actionplan meeting the users own ideas about competencies and potentials are presented along with the staff-evaluation and other professionals evaluations. All conversations are based on talking about competencies and potentials. The meeting ends with the formulation of the actionplan. It consists of the actions that are agreed upon to work with in the next year. These agreements are written down. 9 The department meeting At the department meeting the contact-person tells the rest of the staff in the department about the content in the actionplan and the reasoning behind these decisions. Then the staff breaks into pairs who for five minutes talk about: What was said and what was not said in the presentation of the actionplan? Which comments and questions do we have in relation to the action plan? What are the strengths of this action plan? All comments and questions are collected and the contact-person answers as well as possible. Things that cannot be answered at the meeting will be communicated at a later meeting. In the end all members of the staff are asked: “Does any of you think, that you won't be able to do some of the things in the action plan?" If someone can’t do some of the agreed upon actions, then there has to be created some sort of support system or the organising of the work must include these considerations. Continuous evaluation of the work with the user Between the actionplan meetings there are a series of evaluations of the work done and if it’s necessary because of changes in the users competencies and potentials or new ideas in the staff about how to make the users life better then there will be made changes in the way the action plan is implemented. 10 Ørbæklund i udvikling Emner: Videreudvikling af Teamfunktionen Lederudvikling i retning af læringsguide Skiftet fra enerådende leder til at inddrage medarbejderne Har vi fod på konsekvenserne af det vi tager fat på? Sneboldeffekten – en lille beslutning skaber meget arbejde Hvordan rummer vi den store omstilling i hele socialpsykiatrien i Ringkjøbing amt samtidig med at vi har mange interne omstillingsprocesser i gang? Hvor er vi? Hvordan går det i forhold til den vision vi havde? Hvor går vi ind i den nye lederrolle og hvordan sikrer vi så overblikket? Hvordan sikrer vi en fornuftig balance mellem arbejdsliv og privatliv? Hvordan sikrer vi at have en fornemmelse af hvordan driften går samtidig med at vi går til mange møder? Hvad er det der forstyrrer jer udefra? Implementeringen af lokalpsykiatrien Opgavefordelingen mellem de forskellige dele af lokalpsykiatrien Udvikling af de nødvendige kompetencer til at få lokalpsykiatrien til at fungere Projekter Finde nye måder at arbejde i psykiatrien Implementering af serviceloven Magtanvendelsescirkulæret Hvor skal man lægge sin loyalitet? Implementeringens Challenger syndrom Historien om Challengers ulykke er, at faststofraketterne på siden af den store tank består af en række sektioner, der er sammenføjet. I sammenføjning er der nogle gummiringe, der sikrer at sammenføjningerne er tætte. Når det er koldt trækker gummiet sig sammen. Den morgen Challenger blev sendt op var det meget koldt, så rent statistisk var der 95% sandsynlighed for at sammenføjningerne var utætte. Det var de og Challenger eksploderede. I forbindelse med implementering af større forandringer i det offentlige (og i det private) ser man til en parallel til dette uheld. I forbindelse med den nye servicelov er der forskellige instanser der skal fastlægge rammerne for andre instansers arbejde. I Ørbæklunds situation kunne instanserne tegnes sådan. Folketinget og regeringen Ministeriet Amtsrådsforeningen og Kommunernes Landsforening Amtet og kommuneren i amtet 11 Amtsrådet Institution Logikken i dette hierarki er at de enkelte instanser fastlægger rammerne for de underliggende instanser. Implementeringens Challenger syndrom optræder, når en eller flere af disse instanser ikke har fastlagt de nødvendige rammer. Pilene viser, hvor sammenføjninger er. I serviceloven er den enkelte borgers rettigheder og nogle af de redskaber der skal bruges fastlagt. Men det nødvendige samarbejde omkring den enkelte bruger skal aftales mellem en række forskellige parter med forskellige interesser. For at få hverdagen til at fungere er man nødt til at få etableret det nye eksterne samarbejde for at kunne få institutionen til at køre. Samtidig skal man deltage i at få fastlagt rammerne i de overliggende instanser. Så der skal arbejdes med de samme problemstillinger i flere forskellige sammenhænge. Og det foregår tit ved at man laver arbejdsgrupper som beskæftiger sig med forskellige aspekter af den nødvendige udvikling. Og de arbejder ofte uden den helt store koordination. Så det de beslutter i en arbejdsgruppe forstyrrer ofte det der foregår i en anden. Udvikling og arbejdsdeling er en farlig cocktail Implementeringens Challenger syndrom kan kun løses ved at samle det system, der tilsammen kan definere opgave og som tilsammen kan skabe gode løsninger. Udvikling er en sammenhængende proces, der kun kan skabes sammenhæng i, hvis man arbejder med det hele og det foregår bedst hvis der ikke er skjulte eller faste dagsordener. Open Space Teknologi er et af svarene på, hvordan man kan arbejde med denne slags udviklingsopgaver. Internt på Ørbæklund er udviklingen også lagt ud i arbejdsgrupper. Mit forslag til jer er at samle det jeres fællesmøder og bruge ideerne fra Appreciative Inquiry og Open Space. I forhold til den eksterne udviklingsproces, kan man vælge at lade være med at deltage alt for aktivt og så have følgende reaktion på beslutninger taget højere oppe i systemet: ”Det var da rart med en beslutning, hvordan støtter denne beslutning det gode arbejde vi allerede er i gang med?” Ind i denne sammenhæng skal man nok kalde grupper, der får til opgave at lave et stykke arbejde for Studiekredse, hvor man forsøger at belyse et emne ved at bruge egne og andres erfaringer Erfaringsudvekslingsgrupper, hvor man kun benytter sig af egne erfaringer Egentlig er det lidt den samme ide som i SU-systemet. En sag skal belyses så godt som muligt ved at inddrage så mange synsvinkler som muligt, før man træffer en beslutning. Fællesmøderne kan bruges til det, men I har allerede sat det i system i forhold til tjenestetidsplaner. Erfaringsindsamling via Appreciative Inquiry suppleret med en lille gruppe medarbejdere, der selv lægger planerne inden for de rammer I har udstukket som 12 ledelse. Hvis jeres erfaringer ikke havde været tilstrækkelige kunne I have søgt information udenfor Ørbæklund. Jeg tror ikke udvikling trives i bureaukratier, hvor alt skal være styret og udvikling trives heller ikke i hierarkier, som ikke taler sammen, fordi den viden der er nødvendig for at træffe gode beslutninger er spredt ud over lagene i hierarkiet. Synlig ledelse Ideen om synlig ledelse fortolkes ofte på den måde, at lederen skal være synlig ved at træffe beslutninger og fortælle medarbejderne hvad der er rigtigt og forkert. Når man går folk, der beder om synlig ledelse på klingen, så får man normalt en anden historie: ”Det ville være rart hvis min leder interesserede sig for mig og det jeg laver:” Så synlig ledelse er ofte en invitation til at interessere sig for medarbejderne som mennesker og for det de laver. Hvis man oven i købet kan være med til at styrke deres selvværd og selvtillid, mens man er synlig, så er det helt i top. Kan I huske historien, jeg fortalte om en amerikansk direktør: ”What happened to Rick?” I gamle dage ankom han til møderne og sagde: ”Frem med problemerne, så vi kan få gjort noget ved dem!” Nu ankommer han til møderne og sætter sig ned og bruger de første 10-20 minutter med at lytte til deres svar på følgende spørgsmål: ”Hvilke succeser har I haft siden jeg var her sidst?” Og så går han til det næste spørgsmål: Er der nogle ting I har brug for at jeg tager mig af?” Hvad skal ledergruppen beskæftige sig med? Ledergrupper er et sted, hvor der er mulighed for at få etableret kontakter og få snakket om ting. Hvis mange af tingene der behandles i ledergruppen egentlig kun vedkommer to eller tre. Så er der mange der spilder deres tid. Så det er tit en god ide at få sorteret, hvad der skal arbejdes med i ledergruppen, så andre ting kan løses mellem de relevante dele af ledergruppen. Hvad er det vi har besluttet? En af de ting, der ofte giver anledning til misforståelser i en gruppe er, at vi går ud fra at vi mener det samme med ordene. Det gør vi aldrig! Derfor er der brug for at synliggøre en beslutning ret detaljeret i en del tilfælde. Et spørgsmål, som ledergrupper kan have gavn af at stille sig selv, når de beslutter noget er: ”Hvad skal det bruges til og hvordan ser det videre forløb ud?” Et andet vigtigt spørgsmål er: ”Hvordan sikrer vi, at vi kan følge med i hvordan det går?” MEN pas på! Vi har en ide om, at man helst skal have overblik over alt, hvad der foregår. I Peter Senge’s bog ”Den femte disciplin” har han et afsnit med overskriften ”Illusionen om at have kontrol med tingene”. Det er en illusion, men den sidder godt fast i os alle. Jeres eksempel med tidsregistrering viser, hvordan det kan gå. Og det sker altid – det kan simpelthen ikke undgås fuldstændigt. Jeg tror det bedste man kan gøre er at acceptere at tingene lever deres eget liv, når man uddelegerer noget til andre og når man bliver overrasket, så skal man bliver rigtig dygtig til at sige: Det lyder interessant, det vil jeg gerne 13 høre mere om!” Vores normale reaktioner, når vi bliver overraskede er ofte forvirrende eller sårende for dem, der hører på eller senere får fortalt historien af andre. Hvad er der sket efter personaleseminarerne? Vi holder fællesmøder en gang om måneden Vi ser på vores egne strukturer Det at være leder Det at være en del af et lederteam Det at være en repræsentant fra Ørbæklund Det at arbejde med tingene samtidig med at det gamle system virker oppefra Vi er begyndt at lave handleplaner på alle afdelinger Processen er i gang hele tiden Det er godt, men det er også svært især hos beboere uden sprog Loven skaber forventninger om at beboerne indgår aktivt Andre siger: ”Vi giver dem et tilbud, som de selv må sige ja til.” Vi vil give alle en handleplan Personaleevalueringen sætter ting i gang som ellers ikke ville komme frem Produktet er godt pga. de mange subjektive billeder, fornemmelser og tolkninger Det ser ud til at det er de rigtige mål der kommer frem Det ser ud som om beboerne får det bedre Tingene kan tages op senere Den etiske forpligtelse Det bliver helt konkret og helt nede på jorden Det laves realistiske mål Det er formen, der sikrer det gode resultat Det at følge en opskrift Det at samle gruppens mangfoldighed Det er den eksterne styring, der holder dem på sporet (sprog og opskrift) Vi har udvidet opskriften med en checkliste på hvad et godt hverdagsliv er Vi savner feedback udefra Dem vi inviterer til Handleplansmødet kommer ikke Vi bruger vores psykiater-tid beregnet til supervision af personalet til beboerne Beboerne vil gerne tale med psykiateren – formelt skal de have en aftale gennem deres praktiserende læge, som har behandlingsansvaret De praktiserende læger holder månedlige møder med psykiateren Kommunerne interesserer sig ikke meget for beboerne, selv om de egentlig har ansvaret for handleplanen og for en del af betalingen Ansvaret i forhold til den enkelte beboer er blevet tydeligere Der er kommet et nyt indhold i kontaktpersonordningen 14 Kontaktpersonordningen er blevet organiseret anderledes – en kontaktperson – resten af teamet støtter op Der kan handles når der er brug for det, fordi alle kender personen og derfor kan tage over Det giver hurtigere reaktioner Når man kan se at det er en god ide, så gør man det Der er kommet mere tryghed og tillid Personalet er mere medbestemmende og tager mere ansvar De har f.eks. taget ansvaret for tjenestetidsplanen Samarbejdet med psykiatrisk afdeling har ændret sig Vi laver bedre indflytninger med overlap af personale ved indflytning fra psykiatrisk afdeling Vi forventer at det vil gå godt frem for at se problemer Vi ser på mulighederne og inddrager familierne, hvis det er muligt Vi har hjulpet en person til et bedre tilbud end vi kunne give, fordi vi vidste hvilken form for tilbud vedkommende havde brug for Vi spørger om, hvad NN har brug for og tager det op på lederniveau, hvis vi ikke kan levere det, der er brug for Det kan give bedre løsninger for den enkelte og skaber et bedre samarbejde Vi har brugt metoden i forhold til psykiatrisk afdeling (de undrede sig og grinede, men de har taget det til sig). Vi har brugt metoden til at lave tjenestetidsplaner Det var en forudsætning at hverdagen skulle fungere på et fagligt forsvarligt niveau Vi undersøgte hvad der virkede i forhold til de enkelte elementer i tjenestetidsplanen Det har givet nogle bedre principper for planlægningen Det har skabt et meget positivt engagement De er gode til at finde ud af det selv – de får deres ønsker opfyldt og må så tage lidt for at få det Hvis fagligheden ikke er i den enkelte gruppe, så undersøger de om den findes i en af de andre grupper – det har skabt samarbejde på tværs De aftaler selv tingene i god tid De undersøger om der er hjælp at hente hos andre grupper før de begynder at lede efter vikarer (det sparer 3 timers arbejde, hver gang man ikke skal have fat i en vikar) Og så en stor tak til Mette for den sidste bemærkning: ”Måske skulle vi have startet med det her!” Selvfølgelig skulle vi det, men jeg glemte at undersøge, hvilken aftale I havde med hinanden om dagen. Jeg havde forestillet mig at jeg skulle snakke med Lise og Mette om, hvad der var sket efter personaleseminarerne og at vi så skulle finde ud af, hvad vi kunne gøre for ledergruppen og lægge en plan. 15 Da jeg kom opdagede jeg jo hurtigt at det var hele ledergruppen der kom. Jeg undlod at spørge om dagens plan, så jeg gik ud fra at vi skulle afdække behovet for supervision til ledergruppen og når vi var færdige med det, så ville jeg interviewe Lise og Mette til min artikel. Jeg havde nemlig talt med Aase og hun havde ikke fået artiklen, så jeg gik bare ud fra at jeg skulle tale med en mindre kreds om artiklen og om jeres erfaringer. Så jeg har lært at man nok altid skal starte med Appreciative Inquiry og blive ved med at bruge det. Tak for jeres fantastiske historier. Jeg håber nogle af mine historier var interessante for jer, så I har kunne komme ud af nogle af de frustrationer, vi startede med. Husk så at et problem er en frustreret drøm. I er godt i gang med at realisere jeres drømme og jeres vision, men det gemte sig vist bag nogle af frustrationerne. Min drøm er at finde ud af, hvor langt man kan komme med Appreciative Inquiry og læring i ledelse, samarbejde og organisering og hvad der skal til for at både ledere og medarbejdere kan komme godt gennem denne omstilling. Og I har bevist at det kan lade sig gøre. Og I har brugt nogle af mine ideer helt anderledes end jeg havde tænkt mig, at man kunne. Så jeg blev glædeligt overrasket over jeres erfaringer. Og jeg har ellers stor tiltro til metoderne, jeg har lært jer. Og alligevel har I brugt dem mere kreativt end jeg umiddelbart kunne forestille mig!!!!! 16