Professor Charlie Rapp and colleagues at the University of Kansas offered a beacon of light to anyone finding themselves ground down by the negativity and demoralisation that can creep into areas of mental health work, particularly where progress and change are not easily seen. They established the ‘Personal Strengths Model of Case Management’ in the early 1980’s in order to re-balance attention from a preoccupation with pathology and disability to one of potential and ability. Indeed it was Professor Charlie Rapp and Walter Kisthardt who introduced the model to a group of practitioners in the UK in 1991. From then a few people have continued to promote its way of thinking and working as ‘A Strengths Approach’.
As an ‘approach’ it recognises the fundamental influence of personal values and guiding principles on everything we do. It should be a way of thinking and being, not a set of tasks that there isn’t time for because of everything else demanded of you. It offers the possibility for service users to say and achieve the things that are important to them. It is also a way for practitioners to feel energised by a more rewarding way of working.
We invite you, whoever you are and wherever you are, to contribute your thoughts, ideas, experiences and questions relating to working in a strengths way. We don’t pretend to have all the answers but do hope this can become a place for sharing and developing positive practice.
To start, we would like to hear about your experiences or concerns regarding Strengths focused practice, and invite you to leave comments in responce to the following questions:
- What role does strengths play in your own approach to your work?
- What difficulties do you encounter in trying to practice the concept of a 'strengths approach' in your work?
- What place do you think 'strengths' has in the current fashion for calling everything 'recovery'?
Please see 'The Rules' above before submitting comments.
9 comments:
What a welcome idea. My practice and publications have been deeply rooted in this approach and I have a special interest in how they translate at systems level using Appreciative Inquiry and solutions focussed approaches. Both directly address the issue of cynicism among staff and the sense of alienation that so many people seem to feel when at work. I spent just yesterday with an excellent team manager who seemed at the edge of tears for want of a little bit of praise from the powers that be above him. So in short I am very very interested in how a strenghts approach gets embedded within organisations and systems starting with the relationship between staff and users and their supports and then radiating outwards. "Work is love made visible" as Gibran said.
Steve's comments raise a very important dilemma faced in mental health (and other) organisations. The dominant culture is to focus in detail on flaws, to either find a quick fix to the problem, or blame a perpetrator, whichever is easier. Many of the motivated and driven people I have had the pleasure to encounter are those with some appreciation of their abilities and achievements, however large or small they may be. Service users, practitioners and managers share an equal need to feel valued for who they are and what they can do. This shift in the culture of thinking is one of the greatest challenges we all need to take on. The role models do exist in the wider world of business, if we are genuinely looking for examples of how it can be done. However, focusing on the strengths, interests and talents of service users and staff alike can be a more difficult challenge than finding a quick fix, or identifying failings.
Its great that people have started to post their comments. Please feel free to contribute to this debate. We are particularly interested in hearing your experiences of either working positively with strengths as a practitioner, or experiencing this approach from workers (as a service user). Please tell us what impact this approach may have had on you, your life, or your practice.
Responding to Steve's comment, it is my opinion that in the current climate 'The Strengths Approach' (and positive, user-led, ethical practice in general) is not on many organisational agendas right now, despite rhetoric and government policy on 'Expert Patients' and 'Independence, Wellbeing, and Choice'.
Therefore, The Strengths Approach can most effectively be imbedded within organisations by the individual commitment of service users, practitioners, and managers in exploring these issues, and persisting in debating, demanding, modelling, leading, and promoting this approach within health and social care.
It is my hope that this blogsite will be of some aid and support in this task, and can offer you hope that you are not isolated and alone in your beliefs and commitment.
Please add your own post if you agree or disagree, wish to expand on this view, or tell me I am off the track.
Chris R
Can we really genuinely work with peoples strengths in such a target-oriented culture of service provision? You dont get any additional funding attached to achieving ways of identifying and using peoples strengths. Get the waiting lists down... get the caseload numbers up... get more people discharged... get the new quotas met... reduce the existing service to cover the shortfall establishing the newly wanted service. Forget assertive outreach, its been done, so confine it to the bin for old hats (where you will find a number of community mental health teams)... lets get the crisis team rolling, and what about setting a target for people with first onset psychosis? Perhaps we need to advocate for making strengths assessment a target... but then again please dont! A strengths approach is a fundamental way of thinking, being and working, that can help achieve all those other ill-conceived and poorly resourced targets. It is as much about how you are doing things, as it is about what things you are doing. Targeting it will only serve to diminish its potential.
So how do individual practitioners work with Strengths dispite the picture Steve M illistrates above?
Adopt an optimistic attitude;
Focus on assets;
Collaborate with the service user;
Work towards empowerment; And.
Work towards social inclusion.
Adapted from Healy (2005) Social Work Theories in Context; Palgrave Macmillan, New York.
Also:
User-led Practice!
Develop a broad definition of recovery, not limited to the mere absence of symptoms;
Tolerate ‘positive risk taking’ to enable service users to develop their skills and test their resources;
Respect the individual service user's view, and acknowledge their right to make choices (and make mistakes) about their life; And.
Be willing to learn from service users.
Working ‘Alongside’ Service Users!
Provide accessible & meaningful information;
Avoid using jargon, and adopt the service user's frame of reference;
Listen & respond to the wants, views and goals of the service user.
Maintain positive regard towards the service user & demonstrate your belief in them.
Anti-discriminatory Practice!
Recognise and reduce the inherent imbalance of power that exists between service user and practitioner.
Respect the power of language, and its effects on how workers view service users, and how they in turn view themselves.
Strengths Based Goal Setting
Goals should be important to, and owned by the service user, and expressed in there own terms, & language.
Goals should be small, concrete, & specific;
Goals should focus on adding positives to the service users life, rather then eliminating negatives.
Goal setting is a process, so the first steps towards a desired end should be conceptualised, rather then the whole aim; And.
First steps should be realistic within the context of the service user’s life, but the overall goal should not be limited, nor forgotten.
Adapted from De Jong, P. Millar, S. D. (1995) How To Interview For Client Strengths, Social Work/Vol. 40, No. 6,/Nov ‘95.
The above ideas set out a context for working in a strengths way with individual service users, and I hope it may encourage others to share in this conversation by possibly offering their own examples of how it feels and works for real.
Colleagues I have contact with in Julian Housing in Norwich drew my attention a few years ago to the power of musical talent for helping people achieve a sense of their own personal worth. Service users enabled to explore their own abilities and interests resulted in a few people achieving the creation of their own rock CD.
However, I am also interested in the ways practitioners can productively identify and apply their own strengths in their work.
Language is key. Just think of the words we use. Illness, engagement (we also engage in warfare), compliance, care plan (very passive suggesting the recipient is a receiver rather then a participant or a partner).
Are terms like difficulty, distress, need, support, and concordance really any less negative?
Imagine what it is like to be continually reminded that you have support needs, without any reference to the things you can do.
In assessments I often start with ‘what’s happening for you today’ or similar, rather then ‘what’s the problem?
I still often hear Service Users being referred to as Schizophrenic, bi-polar, PD rather then referred to as individuals with a specific diagnosis. Terms that describe mental health service users should always affirm their individuality, and suggest there is more to this person then just a diagnosis; for example:
A person diagnosed with schizophrenia; or even
A person living with schizophrenia. Here are some useful trigger questions adapted from Pegg, M. & Moore; S. (2005) Strengths coaching in 90 Minutes, Management Books 2000 Ltd, Gloustershire:
What Are Your Strengths or Talents?
What Do You Enjoy?
What Are You Good at?
What Do People Ask Your Advice About?
When Do You Feel You Are in Your Element?
What would Be Your Perfect Day?
When Do You Feel Safe?
When Do You Feel Confident?
What Does Being ‘Well’ Mean to You?
Describe Something You Did That You Were Proud of.
Describe a Time When Something Went Particularly Well.
Chris,
Just reading through these questions puts me into an entirely different frame of mind for contemplating what I want to do next, and what I can do to achieve things that are important to me.
Whenever someone starts a conversation with me by asking what the problem is I immediately feel placed in a more negative space.
Why is it that when we intend to help someone climb a ladder we start by placing the ladder in a hole? The power of language can never be under-estimated.
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