I am pleased with how things are going.
AMBIT manuals
The multiple versions of the Core content of the AMBIT manual are starting bit by bit (and it was always meant to be bit by bit!) to inch towards differentiated, customised forms, that begin to address local specifics - "how we do this stuff here, with these kids, in these streets". Far be it from me to introduce comptetition into this collaborative exercise, but Kids company and the MAC team are giving the CASUS team a run for their money in starting to introduce regular slots to MANUALIZE their own practice in their own local versions, inter-digitating their contributions alongside the pre-formed manualization content about AMBIT that is curated from the Anna Freud Centre.
MBT-F manual(s)
At last, I have managed to put the MBT-F manual into the new AMBIT-theme, so that it has the same (we think greatly improved, though FEEDBACK is still something we crave) user interface as the AMBIT manual.
This user interface is thanks to the generous support of COMIC RELIEF, which is funding improvements to the manual, as well as training for non-statutory teams (there are still a few slots for FREE TRAINING in AMBIT for non-statutory teams in the UK if you rush to the Anna Freud Centre)
Fellowship at the CLARHC
I am thrilled to have been given a one year Fellowship at the Cambridge-based CLARHC (Collaboration for Leadership and Applied Research for Health and Care), starting in September. As a CLARHC Fellow, I get to spend a day a week working with Cambridge University academics, the Judge Business School, and other experienced clinicians to look specifically at the implementation of a TiddlyManual in a clinical, "real world" setting.
We are currently looking at different ways to do this, and some of the opportunities are more than exciting, involving the possibility of formal cluster analysis of outcomes for multiple teams engaging in AMBIT and using tiddlymanuals to support themselves in this - watch this space.
Blog describing work by a child and adolescent psychiatrist on a project using Wiki technology (TiddlyWiki) to develop a radically new type of treatment manualization (TiddlyManuals).
Wednesday, 3 August 2011
Tuesday, 3 May 2011
New user interface goes live
It is not yet finished, and the content probably still requires a lot more shaping.. but the new user interface is now set as the default, and you can see it at:
ambit core content manual
the list of teams starting to edit ther own local versions of the manual is held at
Tiddlymanuals.com
Please have a look, and feedback if you can.
ambit core content manual
the list of teams starting to edit ther own local versions of the manual is held at
Tiddlymanuals.com
Please have a look, and feedback if you can.
Monday, 28 March 2011
2nd Version of New Look - & how do we get more feedback?
As described in my last post, we are working hard on the user interface.
There is a working version of where we have got to here, but we are now working towards a second version, which is not yet working, though you can see a mock-up here - simpler still, I think, and loses the 'floating' sidebar, which I think will be easier.
Of course designing an interface is a little like trying to mentalize another person - making sense of their actions (clicking that link there, rather than this one here - NOW WHY WOULD THEY DO THAT?!) in terms of their intentional mental state at the time: their beliefs, their wishes, their worries - which collectively drive their actions. It is hard! As a user of the site, some of my intentional state in a particular moment is, of course, pre-conscious - not in my own awareness, let alone that of the guy struggling to predict how to make a website so self-evidently obvious as to make the 'interface' practically invisible to me... Interesting how it takes expertise (Jon Lister and Joshua Bradley, and our frineds at Osmosoft supplying this) and experience/feedback (me, and the others who I can squeeze feedback out of) to get this anything like 'right'...
Feedback is the gold-dust we require, and it is very hard to get others quite as fired up as those close to the project so as to increase our data from 'ordinary users... It takes a certain head of steam to go to the bother of letting a web-designer know what annoyed me about the website, where I got lost...
I guess what I am saying is that sometimes this whole tiddlymanuals project seems a very lonely task. People will look once, but if they don't like it they'll go away. However, what we are trying to do with the AMBIT intervention (for multi-problem, complex, and "hard to reach" young people) as a whole is what Weisz and Simpson-Gray (2008) describe as a "deployment-focussed" development of a new intervention, and I guess this is very similar to the methods of open source development on the web. I love the saying of open-source programmers "Release Early, and Release Often" - as this seems to capture something of the AMBIT developmental method, too - keep showing people your ideas, keep trying them out, keep tweaking, tinkering, improving, bit by bit. Build on what we know works for whom, and keep pruning out what doesn't work...
That pruning bit is the painful one - will we really manage to persuade enough teams to actually begin actively 'manualizing' their own practice in the kind of co-constructed wiki-manual that the TiddlySpace AMBIT manual promises? If we don't, then the basic premise of the Tiddlymanuals project is challenged, but it is hard for teams to do this before the technology easily and "invisibly" supports this. How long do we give it before we have to prune that idea?!
I take heart from parallels in neurodevelopment... neural development follows a line of early (pre-birth to young childhood) massive "efflorescence" of nerve connections, generating billions of synapses (links between branches of nerves). In mid-childhood, and accelerating in adolescence, this process then goes into reverse with what is called "synaptic pruning"... Structures, or more importantly functional pathways, that have adaptive value to the individual are preserved, and strengthened, whereas unused pathways (poor adaptive value) are gradually shed. BUT... certain areas of the brain - most notably, the highest executive bits such as the pre-frontal cortex (where mentalizing occurs) tend to lag behind in their development relative to more archaic structures that deal with, say, threat and attachment. This is not because the prefrontal cortex is less useful; on the contrary, it is just that it is doing such a compex job (working out why people are behaving the way they are on the basis of empathic and imaginative intuition of their intentional mental states) that it takes a while to come on-line... let's be hoping that tiddlymanuals are a bit like that, and not just another part of the massive pluripotentiality of the developing world of effective interventions that yet fails to show adaptive value. My hope is in the fact that it is the very qualities of flexibility and adaptability that tiddlymanuals are directed towards, my fear is that the technology will be too alien to facilitate easy adoption, or that teams struggling under the burden of surviving in the current harsh economic climate will baulk at "adding" the task of manualizing their practice (though I maintain that this can more or less be done in real time, or at least in "bite-sized chunks", so that the time burden should be minimal, and a reasonable investment.) We shall see.
There is a working version of where we have got to here, but we are now working towards a second version, which is not yet working, though you can see a mock-up here - simpler still, I think, and loses the 'floating' sidebar, which I think will be easier.
Of course designing an interface is a little like trying to mentalize another person - making sense of their actions (clicking that link there, rather than this one here - NOW WHY WOULD THEY DO THAT?!) in terms of their intentional mental state at the time: their beliefs, their wishes, their worries - which collectively drive their actions. It is hard! As a user of the site, some of my intentional state in a particular moment is, of course, pre-conscious - not in my own awareness, let alone that of the guy struggling to predict how to make a website so self-evidently obvious as to make the 'interface' practically invisible to me... Interesting how it takes expertise (Jon Lister and Joshua Bradley, and our frineds at Osmosoft supplying this) and experience/feedback (me, and the others who I can squeeze feedback out of) to get this anything like 'right'...
Feedback is the gold-dust we require, and it is very hard to get others quite as fired up as those close to the project so as to increase our data from 'ordinary users... It takes a certain head of steam to go to the bother of letting a web-designer know what annoyed me about the website, where I got lost...
I guess what I am saying is that sometimes this whole tiddlymanuals project seems a very lonely task. People will look once, but if they don't like it they'll go away. However, what we are trying to do with the AMBIT intervention (for multi-problem, complex, and "hard to reach" young people) as a whole is what Weisz and Simpson-Gray (2008) describe as a "deployment-focussed" development of a new intervention, and I guess this is very similar to the methods of open source development on the web. I love the saying of open-source programmers "Release Early, and Release Often" - as this seems to capture something of the AMBIT developmental method, too - keep showing people your ideas, keep trying them out, keep tweaking, tinkering, improving, bit by bit. Build on what we know works for whom, and keep pruning out what doesn't work...
That pruning bit is the painful one - will we really manage to persuade enough teams to actually begin actively 'manualizing' their own practice in the kind of co-constructed wiki-manual that the TiddlySpace AMBIT manual promises? If we don't, then the basic premise of the Tiddlymanuals project is challenged, but it is hard for teams to do this before the technology easily and "invisibly" supports this. How long do we give it before we have to prune that idea?!
I take heart from parallels in neurodevelopment... neural development follows a line of early (pre-birth to young childhood) massive "efflorescence" of nerve connections, generating billions of synapses (links between branches of nerves). In mid-childhood, and accelerating in adolescence, this process then goes into reverse with what is called "synaptic pruning"... Structures, or more importantly functional pathways, that have adaptive value to the individual are preserved, and strengthened, whereas unused pathways (poor adaptive value) are gradually shed. BUT... certain areas of the brain - most notably, the highest executive bits such as the pre-frontal cortex (where mentalizing occurs) tend to lag behind in their development relative to more archaic structures that deal with, say, threat and attachment. This is not because the prefrontal cortex is less useful; on the contrary, it is just that it is doing such a compex job (working out why people are behaving the way they are on the basis of empathic and imaginative intuition of their intentional mental states) that it takes a while to come on-line... let's be hoping that tiddlymanuals are a bit like that, and not just another part of the massive pluripotentiality of the developing world of effective interventions that yet fails to show adaptive value. My hope is in the fact that it is the very qualities of flexibility and adaptability that tiddlymanuals are directed towards, my fear is that the technology will be too alien to facilitate easy adoption, or that teams struggling under the burden of surviving in the current harsh economic climate will baulk at "adding" the task of manualizing their practice (though I maintain that this can more or less be done in real time, or at least in "bite-sized chunks", so that the time burden should be minimal, and a reasonable investment.) We shall see.
Wednesday, 9 March 2011
New hosting site and new Theme for the AMBIT TiddlyManual
Some of the money from our Comic Relief grant is directed towards improving the user experience of the AMBIT manual.
We have moved it to TiddlySpace now (you can still access it and all tiddlymanuals through the central 'signposting site' www.tiddlymanuals.com). This makes it much easier for new adopters to set up their own space (wiki) at TiddlySpace and then to opt to "include" all the ambit.tiddlyspace within their own. When they add their material (local expertise, implementation protocols) this is saved in their space, but links directly to the Anna Freud Centre's curated content, so that from a user's point of view the whole wiki is seamless.
It also makes the major renovation of the theme easier to try out. You can see where we have got to here - as ever feedback is very welcome and there is a link to this in the manual.
The idea of the new theme, that is being developed by Jonathan Lister & Joshua Bradley at J&J, is to make the manual a much easier experience for the user. The original manual was very "busy" - far too many links, not enough of what I call "centripetal" force in the writing (that is, the intrinsic interst and relevance of what I am reading that holds my attention, as opposed to centrifugal forces that are sparked by relevant or interesting links.
Ideally a wiki has the perfect balance: allowing exploration in depth, that is nonetheless contextualised through links to relevant details that draw me on into material that is just 'meta' to what I originally came for.
By 'calming the typeface down' and setting links to new tiddlers (in tiddlywiki, 'tiddlers' are small chunks of content - not quite pages, more like hyper-linked and taggable notelets) to open down below, out of sight, this makes for a much more fluid reading experience. As a reader clicks and opens tiddlers, it is as though that reader is setting up their tailor-made 'chapter' up ahead of them. A menu ("you are currently reading") on the right lists all the tiddlers open at any one time, and you can flick back and forth between these, or close them from there. Best to try this out rather than have me attempt to explain it. It seems different but highly intuitive... Interested to get feedback though.
We have moved it to TiddlySpace now (you can still access it and all tiddlymanuals through the central 'signposting site' www.tiddlymanuals.com). This makes it much easier for new adopters to set up their own space (wiki) at TiddlySpace and then to opt to "include" all the ambit.tiddlyspace within their own. When they add their material (local expertise, implementation protocols) this is saved in their space, but links directly to the Anna Freud Centre's curated content, so that from a user's point of view the whole wiki is seamless.
It also makes the major renovation of the theme easier to try out. You can see where we have got to here - as ever feedback is very welcome and there is a link to this in the manual.
The idea of the new theme, that is being developed by Jonathan Lister & Joshua Bradley at J&J, is to make the manual a much easier experience for the user. The original manual was very "busy" - far too many links, not enough of what I call "centripetal" force in the writing (that is, the intrinsic interst and relevance of what I am reading that holds my attention, as opposed to centrifugal forces that are sparked by relevant or interesting links.
Ideally a wiki has the perfect balance: allowing exploration in depth, that is nonetheless contextualised through links to relevant details that draw me on into material that is just 'meta' to what I originally came for.
By 'calming the typeface down' and setting links to new tiddlers (in tiddlywiki, 'tiddlers' are small chunks of content - not quite pages, more like hyper-linked and taggable notelets) to open down below, out of sight, this makes for a much more fluid reading experience. As a reader clicks and opens tiddlers, it is as though that reader is setting up their tailor-made 'chapter' up ahead of them. A menu ("you are currently reading") on the right lists all the tiddlers open at any one time, and you can flick back and forth between these, or close them from there. Best to try this out rather than have me attempt to explain it. It seems different but highly intuitive... Interested to get feedback though.
Saturday, 29 January 2011
Moving into TiddlySpace
These are exciting days as the AMBIT tiddlymanual is moved from it's second home, TiddlyWeb, into it's third one - which is it's ultimate destination, really. You can have a look at http://ambit.tiddlyspace.com, or you can see some of the local versions via the same 'signposting' site - www.tiddlymanuals.com
TiddlySpace works - albeit a bit clunkily in places so far - but with a bit of imagination you can see what this might start to look like.
TiddlySpace is a web service that allows you to open a 'Space' which is in effect a simple, self-editable wiki - a tiddlywiki, of course. But there is more. Your wiki, comprising a collection of 'notelets' (tiddlers) offers a place to curate your own content, and even to hold draft contact back from publication (every tiddler has two possible states - public or private - the latter being visible only to you when you are logged in as a member of that space), and you can invite close trusted colleagues to share any space you open (you can open as many as you want). So far so good. Being tiddlywiki, at a click you can of course download the whole wiki and run it from a USB stick, etc, without being on the web at all.
The really wonderful bit comes when another person, or small trusted group, decides to open their own space, to curate their own material... They can choose to "include" all of the public content from my Space inside their own. Any content thus included is still clearly marked as mine, and I still manage its content. However, by including my public content in her Space, a collaborator of mine can add her own details, local additions, or overwrite sections of my wiki where she has local material that fits her situation better, etc. She doesn't erase my own curated content, just replaces it within her own in her Space, in such a way that it is explicit that this is her over-written material, and so that the reader can toggle back and forth between the two versions - hers and mine.
As many people as want to can include someone elses' Space in their own, and they can include as many Spaces as they want to in their own Spaces... This is an extraordinarily fecund way of sharing, digesting, reworking and re-sharing ideas and expertise. Where Facebook is all surface - Face - TiddlySpace is all depth, meaning, accuracy, understanding - MindBook, if you like.
In terms of my biopsychosocial treatment manuals, you can see how this technical capacity supports the notion of a balance between a centrally-curated 'Core Template' and multiple local iterations of this methodology, with their own super-added attunements - a co-construction or collaborative authoring of content becomes simple to achieve; principles and variants of local praxis, recorded in a way that other workers can easily browse different variants and choose the most suitable local attunement for their specific needs. We are only making explicit what every team adopting a manualized treatment protocol does - and come formal (randomized controlled) trials of a method of working it is easy enough to 'switch off' the editing function...
It's is easier to see and play than to explain. AMBIT
Thanks to our Comic Relief Grant, and the support of the James Wentworth Stanley fund, we are also able to invest in programming time to iron our glitches and make huge improvements to the user interface, and navigation, which has, to date, been pretty chronic. Please check in over the coming months as things should be improving in quantum leaps before May 2011.
TiddlySpace works - albeit a bit clunkily in places so far - but with a bit of imagination you can see what this might start to look like.
TiddlySpace is a web service that allows you to open a 'Space' which is in effect a simple, self-editable wiki - a tiddlywiki, of course. But there is more. Your wiki, comprising a collection of 'notelets' (tiddlers) offers a place to curate your own content, and even to hold draft contact back from publication (every tiddler has two possible states - public or private - the latter being visible only to you when you are logged in as a member of that space), and you can invite close trusted colleagues to share any space you open (you can open as many as you want). So far so good. Being tiddlywiki, at a click you can of course download the whole wiki and run it from a USB stick, etc, without being on the web at all.
The really wonderful bit comes when another person, or small trusted group, decides to open their own space, to curate their own material... They can choose to "include" all of the public content from my Space inside their own. Any content thus included is still clearly marked as mine, and I still manage its content. However, by including my public content in her Space, a collaborator of mine can add her own details, local additions, or overwrite sections of my wiki where she has local material that fits her situation better, etc. She doesn't erase my own curated content, just replaces it within her own in her Space, in such a way that it is explicit that this is her over-written material, and so that the reader can toggle back and forth between the two versions - hers and mine.
As many people as want to can include someone elses' Space in their own, and they can include as many Spaces as they want to in their own Spaces... This is an extraordinarily fecund way of sharing, digesting, reworking and re-sharing ideas and expertise. Where Facebook is all surface - Face - TiddlySpace is all depth, meaning, accuracy, understanding - MindBook, if you like.
In terms of my biopsychosocial treatment manuals, you can see how this technical capacity supports the notion of a balance between a centrally-curated 'Core Template' and multiple local iterations of this methodology, with their own super-added attunements - a co-construction or collaborative authoring of content becomes simple to achieve; principles and variants of local praxis, recorded in a way that other workers can easily browse different variants and choose the most suitable local attunement for their specific needs. We are only making explicit what every team adopting a manualized treatment protocol does - and come formal (randomized controlled) trials of a method of working it is easy enough to 'switch off' the editing function...
It's is easier to see and play than to explain. AMBIT
Thanks to our Comic Relief Grant, and the support of the James Wentworth Stanley fund, we are also able to invest in programming time to iron our glitches and make huge improvements to the user interface, and navigation, which has, to date, been pretty chronic. Please check in over the coming months as things should be improving in quantum leaps before May 2011.
Sunday, 24 October 2010
Yale and New York, thoughts on Mentalization...
Honoured, excited and not a litle over-awed to be in a golden-leafed Yale this week, for a conference on mentalization based treatments for children and families, in which I am speaking about AMBIT and running a training with Efrain Bleiberg on MBT-F. Next week I go down to New York, where I am talking at the American Academy of Child and Adolescent Psychiatrists annual conference about Mentalization - as part of Efrain's symposium; how it arises and why it is particularly challenged in Adolescence.
Thanks to our grants (see earlier post)the AMBIT project is gearing up for a growth spurt. As a coda, I realise that the preceding sentence contains an appalling bit of metaphor-mixing; images of heavy machinery (gears) alongside biological processes (growth) - hmmm, a metaphor within a metaphor, perhaps. I increasingly see one of the bonuses of Mentalization as being a concept that can help lubricate the existing 'heavy machinery' of evidence-based therapies (CBT, Psychodynamic approaches, Family work, etc) by helping them to rub alongside each other, encouraging what Peter Fuggle has called 'cross -border trade'. One of the interesting phenomena that we have seen is that the concept of mentalization, or M-B therapies themselves have been claimed as 'coherent with' or indeed 'plagiarised from' (!) a range of older and distinguished therapeutic and theoretical models, ones that, between themselves have often offered a rather unedifying spectacle of internecine strife ('last man standing wins'). Mentalizing, perhaps by being at least inoffensive to most, offers soemthing approaching a common language that neurosciences, cognitive-behaviourist, systems and psychoanalytic practitioners can sign up to. If I am right, that is real progress.
I hope to see progress for AMBIT in the coming months, with migration of the AMBIT and MBT-F manuals from Tiddlyspot and Tiddlyweb to the TiddlySpace site (I will put automatic forwarding and/or links into the orginal sites) - when this occurs it will become much easier for local services to incorporate this 'core' material in their own manual variants... allow for glitches and please support the brave few services that try this to start with...!
Thanks to our grants (see earlier post)the AMBIT project is gearing up for a growth spurt. As a coda, I realise that the preceding sentence contains an appalling bit of metaphor-mixing; images of heavy machinery (gears) alongside biological processes (growth) - hmmm, a metaphor within a metaphor, perhaps. I increasingly see one of the bonuses of Mentalization as being a concept that can help lubricate the existing 'heavy machinery' of evidence-based therapies (CBT, Psychodynamic approaches, Family work, etc) by helping them to rub alongside each other, encouraging what Peter Fuggle has called 'cross -border trade'. One of the interesting phenomena that we have seen is that the concept of mentalization, or M-B therapies themselves have been claimed as 'coherent with' or indeed 'plagiarised from' (!) a range of older and distinguished therapeutic and theoretical models, ones that, between themselves have often offered a rather unedifying spectacle of internecine strife ('last man standing wins'). Mentalizing, perhaps by being at least inoffensive to most, offers soemthing approaching a common language that neurosciences, cognitive-behaviourist, systems and psychoanalytic practitioners can sign up to. If I am right, that is real progress.
I hope to see progress for AMBIT in the coming months, with migration of the AMBIT and MBT-F manuals from Tiddlyspot and Tiddlyweb to the TiddlySpace site (I will put automatic forwarding and/or links into the orginal sites) - when this occurs it will become much easier for local services to incorporate this 'core' material in their own manual variants... allow for glitches and please support the brave few services that try this to start with...!
Wednesday, 15 September 2010
TiddlySpace
Ultimately, the new and increasingly wonderful TiddlySpace version of TiddlyWiki, that builds on TiddlyWeb (described below), will be the place that hosts the treatment manual, and we hope to move the manuals there fairly soon.
Tiddlyspace is very exciting (no, really...!) Think of a group (us at the Anna Freud Centre) who offer up our core template of the AMBIT treatment manual. Our TiddlySpace will consist of Private space (where we, as a closed group, argue about the precise content and layout of the manual as it continues to mature) and Public space - all the bits of the manual that we have agreed we are happy to 'stand by' and to release as our best current effort.
Now, imagine another team - from, say, Tiddletown.
They train up in AMBIT, and start up their own TiddletownSpace . Because they are basically into AMBIT, or at least adapting it to their local needs, they opt to "include" the core AMBIT Space within their own Tiddletown Space - which means that all the public content within our original AMBIT Space is automatically included within their own space. They can then add any local implementation details, or indeed specific protocols that they believe better suit their population, but they interweave this material into the existing matrix of theory and practice that the original AMBIT core consists of, via links, tags, etc.
Of course the "inclusion" method that TiddlySpace adopts to help different groups/teams/"Spaces" to interact means that the AMBIT manual itself could conceivably be subdivided into more manageable chunks, that could separately be included within (or left out of) a local Space.
The most obvious example of this would be the part of the manual that, in a sense, is the most exciting, but which is also the hardest to implement, and that is the use of downloaded versions of the manual as integrated recording systems for separate young people. It is exciting because in our experience no complex treatment manual to date (except small ones that can be presented as physical "workbooks") has managed to get the worker to refer to it, or at least "be exposed to it" on a daily basis. If we are honest, most treatment manuals are tedious beyond belief, and are rarely read, and their capacity to truly influence practice is limited. If you are integrating your daily working notes within the manual, then (we argue) there is a much higher chance that you will "brush up" alongside manualized material and that your practice will be influenced by this contact. Especially if the material is not only dense text, but also comes in the form of quick film clip vignettes and role plays, demonstrating how to use specific techniques, etc.
To date none of the AMBIT teams around the UK (see TiddlyManuals) have yet really begun to use this in earnest, partly (I hope mainly) because of the continuing 'clunkiness' of the software, but partly because the concept is very alien. Anyway, to get back to TiddlySpace, all of these more explicitly 'interactive' aspects of the AMBIT manual could be in a separate "Space" that local teams could take, or leave, as they wish...
Tiddlyspace is very exciting (no, really...!) Think of a group (us at the Anna Freud Centre) who offer up our core template of the AMBIT treatment manual. Our TiddlySpace will consist of Private space (where we, as a closed group, argue about the precise content and layout of the manual as it continues to mature) and Public space - all the bits of the manual that we have agreed we are happy to 'stand by' and to release as our best current effort.
Now, imagine another team - from, say, Tiddletown.
They train up in AMBIT, and start up their own TiddletownSpace . Because they are basically into AMBIT, or at least adapting it to their local needs, they opt to "include" the core AMBIT Space within their own Tiddletown Space - which means that all the public content within our original AMBIT Space is automatically included within their own space. They can then add any local implementation details, or indeed specific protocols that they believe better suit their population, but they interweave this material into the existing matrix of theory and practice that the original AMBIT core consists of, via links, tags, etc.
Of course the "inclusion" method that TiddlySpace adopts to help different groups/teams/"Spaces" to interact means that the AMBIT manual itself could conceivably be subdivided into more manageable chunks, that could separately be included within (or left out of) a local Space.
The most obvious example of this would be the part of the manual that, in a sense, is the most exciting, but which is also the hardest to implement, and that is the use of downloaded versions of the manual as integrated recording systems for separate young people. It is exciting because in our experience no complex treatment manual to date (except small ones that can be presented as physical "workbooks") has managed to get the worker to refer to it, or at least "be exposed to it" on a daily basis. If we are honest, most treatment manuals are tedious beyond belief, and are rarely read, and their capacity to truly influence practice is limited. If you are integrating your daily working notes within the manual, then (we argue) there is a much higher chance that you will "brush up" alongside manualized material and that your practice will be influenced by this contact. Especially if the material is not only dense text, but also comes in the form of quick film clip vignettes and role plays, demonstrating how to use specific techniques, etc.
To date none of the AMBIT teams around the UK (see TiddlyManuals) have yet really begun to use this in earnest, partly (I hope mainly) because of the continuing 'clunkiness' of the software, but partly because the concept is very alien. Anyway, to get back to TiddlySpace, all of these more explicitly 'interactive' aspects of the AMBIT manual could be in a separate "Space" that local teams could take, or leave, as they wish...
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