All posts by Steve Morgan

Occupational Therapist since 1986, Case Manager since 1990, Author since 1993, Consultancy since 2001. Launched a blog from 2013, a podcast in 2014, and YouTube videos from 2017.
Podcast Episodes, Teams

Podcast Episode 048: Team Strengths Assessment

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TheStrengthsRevolution_albumart_2-2We all work in teams from time-to-time but how much do we really focus on identifying and developing the individual talents of the workers, and the overall strengths of good team-working?

A team is a group of people coming together for a common purpose or goal, and often it is the challenges and difficulties that define the work of the team that will most influence its outlook in terms of development. All too often teams and services look on training and developing the areas of weakness, to the detriment of boosting and exploiting areas of success into areas of excellence.

In this episode I outline my categorisation of teams in relation to the degree in which they relate to, identify, and work with strengths, and the Team Strengths Assessment tool that I developed in the early 2000’s to support this area of practice development. Examples of three types of mental health teams are referred to as examples where these tools have been used.

To access the full content of this episode click on the links to iTunes and Sound Cloud (or go to Stitcher Radio):

https://itunes.apple.com/gb/podcast/strengths-revolution-steve/id867043694

https://itunes.apple.com/gb/podcast/048-team-strengths-assessment/id867043694?i=336480841&mt=2

“Never doubt that a small group of thoughtful, committed people can change the world. Indeed, it is the only thing that ever has.” [Margaret Mead].

 

Person-centred working, Podcast Episodes, Podcast Interviews

Podcast Episode 047: Anne Clilverd Interview ~ Narrative Therapy

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TheStrengthsRevolution_albumart_2-2This episode is the first part of an interview with Anne Clilverd, formerly Team Manager of the Kings Cross Community Mental Health Team in London. In this discussion Anne reflects on where she first became aware of Narrative Therapy, how she followed through the specific training faciltated by Michael White, and some of the challenges of embedding it into her primary work role in a community service.

The concept of the ‘outsider witness’ as a distinct function within Narrative Therapy is explored in relation to the therapeutic role offered with clients. Specific reference is made to use of the therapeutic approach in locally designed ‘Mental Health Matters’ workshops, where a client, carer and practitioner are able to work together in supporting people to tell and analyse their own story. The role of family and cultural values are able to be honoured as an element that can emerge through a workshop style of approach to embedding the ideas of Narrative Therapy.

The approach can also be shared and adapted through staff supervision with practitioners open and interested in developing the ideas into their practice, and for exploring how they are functioning in the practitioner role.

For the full content of this episode click on the links to iTunes and Sound Cloud (or go to Stitcher Radio):

https://itunes.apple.com/gb/podcast/strengths-revolution-steve/id867043694

https://itunes.apple.com/gb/podcast/047-anne-clilverd-interview/id867043694?i=335937142&mt=2

A Strengths Approach, Person-centred working, Podcast Episodes

Podcast Episode 046: Valuing Narrative

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TheStrengthsRevolution_albumart_2-2The term narrative is important for many reasons; it is the means by which we recount our lives, the events, emotions and experiences that make up the patchwork of our existence. It is the core of each interpersonal relationship, and it has become a continual theme throughout my working career. The fundamental basis of mental health care is the trust and confidence built through the power of working relationships, enabling people to tell their stories.

Documenting our work also presents a conflict between the dominance of bureaucratic tick-box approaches and the need to represent someone through a narrative of their lives. Then there is narrative therapy as a psychotherapeutic approach to talking treatments. This episode concludes by outlining two of the core components of narrative therapy, before the next episode which will take the form of an interview with a friend and colleague who has trained in narrative therapy.

For the full content of this episode click on the links to iTunes and Sound Cloud (or go to Stitcher Radio):

https://itunes.apple.com/gb/podcast/strengths-revolution-steve/id867043694

https://itunes.apple.com/gb/podcast/046-valuing-narrative/id867043694?i=335428751&mt=2

“We construct a narrative for ourselves, and that’s the thread we follow from one day to the next. People who disintegrate as personalities are the ones who lose that thread.” [Paul Benjamin].

Positive Risk-Taking

Do what you say on your tin

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Canadian Falls 3Are you taking the risk? It is something we all do, but why do we confuse and complicate it by our lackadaisical use of language? We take risks in order to gain something for ourselves, and occasionally others. We weigh up the options available to us, and make a decision based on what we compute to be the most beneficial course of action. It is called positive risk-taking not because we are trying to find a ‘positive risk’ (whatever that is), but because we are taking the risk in order to achieve a positive outcome (the gain or benefit). So, the word positive is about the outcome not about the risk! I am also not talking about ‘positive risk management’, which sounds too general and like unnecessary window-dressing of a process more often seen as negative or risk-averse. The word positive is being added to risk-taking, in my context, in order to bring some clarity and specific detail to your thinking.

We revere risk-takers in the worlds of sport, entertainment and business, tending to attribute degrees of awe to their decision-making and achievements. Do you think Ayrton Senna planned his route, speed and overtaking manoeuvres around the race-track because he thought the risk would be nice? Does Warren Buffett make his financial decisions based on a spin of his favourite coin? It is more than likely that both of these people employed complex ways of weighing up the pros and cons of choices facing them, sometimes with careful thought and consideration, and sometimes distilling a lifetime of experience into a split second. So do we, in our own personal circumstances.

Risk Decision-MakingSo, next time you are leaning on a bar deciding whether to have that extra Babycham, remember that positive risk-taking is weighing up the pros and cons of your particular set of circumstances at that time. Whereas the positive risk is simply the chance that they might taste better the more you have; and the positive risk management is the hope that those around you will help you home instead of tying you to a lamp-post at the end of the night. These concepts mean different things, so be clear when you use language, only positive risk-taking is thoughtful and considered. But… what do you think?

http://www.pavpub.com/risk-decision-making/

“Words are how people think. When you misuse words, you diminish your ability to think clearly and truthfully.” [Margaret Heffernan].

A Strengths Approach, Podcast Episodes

Podcast Episode 045: A Place for Carers

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TheStrengthsRevolution_albumart_2-2In this episode the focus is on informal unpaid carers in the health and social care system. Who carers are, and the roles they perform, are honoured as amazing strengths that can be relied upon. However, the role comes with burdens and pressures, and services have not been so quick to see carers as a priority for the vital support they need.

The focus for this episode was triggered through reading an article by Nicci Gerrard in the Observer newspaper (UK Sunday broadsheet). She was reflecting on her father’s experiences of dementia, and more specifically on the damaging effect of a hospital admission on his ability to function independently. It is not a way of blaming staff or the service, but more a reality check on how the demands of an ageing population are overloading the existing service.

John’s Campaign has been established to promote greater access for carers on to hospital wards, particularly to continue supporting their loved ones who have succumbed to dementia. The costs are very minimal and the benefits for patients, carers and staff are very significant. Good practice in this issue exists in small pockets, but the challenge of the campaign is for best practice to become standard practice everywhere.

To access the full content of this episode click on the links to iTunes and Sound Cloud (or go to Stitcher Radio):

https://itunes.apple.com/gb/podcast/strengths-revolution-steve/id867043694

https://itunes.apple.com/gb/podcast/045-a-place-for-carers/id867043694?i=334927346&mt=2

“To care for those who once cared for us is one of the highest honors.” [Tia Walker].

“I am sickened that the government thinks my value is so low when actually carers save the government billions.” [Anonymous carer survey response].

Podcast Episodes, Working with Risk

Podcast Episode 044: Suicide Risk Factors

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TheStrengthsRevolution_albumart_2-2In this episode I maintain a focus on suicide risk by reviewing risk factors and the importance of counter-balancing these with a focus on protective factors and strengths.

A specific program in Detroit has generated debate and pilot sites in the UK to develop a zero tolerance to suicide risk, and while aiming for zero suicides is an excellent ideal, it raises several important questions. Firstly, some people have made a clear and final decision to take their own lives for their own complex and personal reasons, so how will choice be respected within a zero tolerance approach? Will services be recognised for reductions in suicide rates or will the blame culture still focus on the diminishing few completed cases? Should any practitioners or advocates seriously question the ethos and intentions behind a zero tolerance approach?

Suicide risk factors from the known research are outlined, and the more personalised reflection of protective factors are highlighted. The emphasis on assessing and working with suicide risk is placed on the quality information through narrative approaches, not the more frequent bureaucratic requirement for ticking boxes.

For the full content of this episode click on the links for iTunes and Sound Cloud (or go to Stitcher Radio):

https://itunes.apple.com/gb/podcast/strengths-revolution-steve/id867043694

https://itunes.apple.com/gb/podcast/044-suicide-risk-factors/id867043694?i=334338377&mt=2

“Suicide is a permanent solution to a temporary problem.” [Phil Donahue].

Person-centred working

Values-Based Practice

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TheStrengthsRevolution_albumart_1In 2013 Oxleas NHS Foundation Trust, in south-east London, commissioned a piece of work from Practice Based Evidence and the Mental Health Foundation to explore ways in which ‘values-based practice’ can be practiced and evidenced more in the day-to-day work with service users and carers within the Adult Mental Health Directorate. So far, the programme has engaged with six pilot teams and produced a set of draft guidelines. In 2014 the programme explore innovative ways of implementing the ideas, and spreading ideas to staff in other directorates.

Now in 2015 the programme draws to a close with a focus on a specific group of people, explored elsewhere in a few podcast episodes, the team and ward managers. These are seen by the programme developers as the key people for embodying and promoting the culture change needed within teams in order to implement refined approaches to the day-to-day challenges of working with peoples strengths and focusing on person-centred values in practice rather than just words in policies and mission statements.

WHY FOCUS ON VALUES-BASED PRACTICE?

They influence everything we think, decide and do in day-to-day practice, though often in a more sub-conscious way rather than overt statements and discussions. Good practice is not about adhering to one set of right values, we should respect and embrace values diversity. Values can be very personal, professional or organisational statements, but the focus here is on the values that underpin the day-to-day language of focusing on the needs and priorities of the individual service user. Practitioners need to be supported to be able to work where values of the service user, organisation, or professional may differ or conflict.  A recent high profile report in the UK highlights the need to put this approach to values-based practice into context:

Francis Report into Stafford Hospital “People must always come before numbers. Individual patients and their treatment are what really matters. Statistics, benchmarks and action plans are tools not ends in themselves. They should not come before patients and their experiences. This is what must be remembered by all those who design and implement policy for the NHS.” Excerpt from press release statement by Robert Francis QC in Stafford (5/2/13).

One product of the overall programme has been the development of brief practical guidelines linking together values and principles, working with strengths, positive risk-taking, and the role of person-centred care planning. A modified version of these can be accessed on request through The Strengths Revolution blog.

Podcast Episodes, Positive Risk-Taking, Working with Risk

Podcast Episode 043: Suicide Risk [2]

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IMAG1511What role does positive risk-taking have to play when someone is experiencing and expressing serious suicidal thoughts? Firstly, we have a duty to take such expressions very seriously, but the language of suicide risk can often appear overwhelming to others, and generate great fears of what might be.

Do we respond in a way that manages the other person, manages the situation, and ultimately takes over through assuming control over and for the person? Do we really take that step backwards, and give ourselves whatever time is available to listen to the person and help them explore their options in a supported relationship? We cannot eliminate risk, but do we become overwhelmed by a fear of engaging in the real conversation?

There is no such thing as a risk-free option, and in this episode I outline a case example from my own practice that illustrates how positive risk-taking was put in place through listening and acting on what the individual has to say, identifying alternatives, and exploring strengths and potential protective factors alongside the serious expression of risk.

For the full content of this episode click on the links for iTunes and Sound Cloud (or go to Stitcher Radio):

https://itunes.apple.com/gb/podcast/strengths-revolution-steve/id867043694

https://itunes.apple.com/gb/podcast/043-suicide-risk-2/id867043694?i=333467695&mt=2

“If it wasn’t for the possibility of suicide I would have killed myself a long time ago.” [Unknown source].

Podcast Episodes, Podcast Interviews, Positive Risk-Taking, Working with Risk

Podcast Episode 042: Suicide Risk (Interview case example)

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TheStrengthsRevolution_albumart_2-2This episode is an interview with Satsanga (Lawrence Borish) reflecting on a case example of Alice, who he worked with whilst on a family counselling placement in his Masters Degree Social Work training in the US back in 1968. The placement was focused on cultural awareness, and the specific referral emerged through neighbourly concern for a woman whose behaviour and appearance was deteriorating. However, on engaging Alice, Satsanga discusses how, as a young inexperienced social worker, he is suddenly presented with an expression of suicidal ideas.

How we respond to these immediate circumstances can have a heavy bearing on the future life of another person. The interview explores issues of engagement of trusting working relationships, working with instinct, exploration of genuine alternatives to suicide, genuine collaboration between a person and a worker… all of which are important components of the process of ‘positive risk-taking’. The discussion raises thoughts about how we are supported, or not, to make difficult decisions; and could a decision-making process from a bygone era remain relevant today?

For the full content of this episode click on iTunes or Sound Cloud (or go to Stitcher Radio):

https://itunes.apple.com/gb/podcast/strengths-revolution-steve/id867043694

https://itunes.apple.com/gb/podcast/042-suicide-risk/id867043694?i=331833222&mt=2