Category Archives: Person-centred working

Podcast Episode 047: Anne Clilverd Interview ~ Narrative Therapy

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

Podcast Episode 046: Valuing Narrative

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].

Values-Based Practice

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 Episode 035: Care & Support Planning

TheStrengthsRevolution_albumart_2-2Why develop care or support plans in health and social care services? Isn’t it just another one of those bureaucratic requirements from the world of box-ticking, form-filling, audit-pleasing managerial culture? Well no it shouldn’t be; we need a thoughtful person-centred approach to the complex physical and psychological needs experienced by many people across all age groups and disabilities.

The strengths approach focuses specifically on the priorities expressed by the person through the vehicle of a strengths assessment, and these priority wishes will only become achievable goals if we put some kind of plan in place. The planning element is essentially about actions and responsibilities for actions. Within a strengths approach care or support planning is not limited to strengths-based wishes, we also need to plan for the difficulties and concerns that need to be managed. But the paperwork, paper-based or electronic, will have a role to play if we can keep it to the essential minimum amount.

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/035-care-support-planning/id867043694?i=326563007&mt=2

https://soundcloud.com/stevemorgan57/035-care-support-planning

“Spontaneity is one of the joys of existence, especially if you prepare for it in advance.” [Alan Dean Foster].

Podcast Episode 032: Why plan?

TheStrengthsRevolution_albumart_2-2This episode raises the philosophical question of ‘why plan?’, and what role does planning play in our day-to-day lives? We all have needs and wants, and it is the conscious or subconscious plans that help us to exert some control in our aim of achieving them.

We engage in relationship plans, financial goals, career planning, and chosen uses of leisure time. It is a natural human activity that can become quickly mired in the bureaucratic jargon of goal-setting, care planning, support planning, where we talk of being person-centred when our systems are imposing service-centred solutions on people.

It can be a conflict between a requirement for order and a way of managing chaos, even though some people claim to prefer chaos. Plans can’t guarantee success but they can help to build confidence, apply order and structure, focus our energy, provide a road map. In the event of a crisis we have means of responding with our own personal crisis plans; and in anticipation of something desired going wrong we should have some kind of contingency plans.

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/032-why-plan/id867043694?i=322813027&mt=2

“Failing to plan is planning to fail.” [Alan Lakein].

Podcast Episode 031: Say hi to Dave

TheStrengthsRevolution_albumart_2-2Dave is a reported case example (not interview) of someone advancing in age and who is not only coming to terms with complex health problems, but is also adamant about exerting his own views of what a plan for his life should look like when in contact with health care professionals.

Dave has recently lost his wife in a road traffic accident, and his children are concerned about his care needs as he is now diagnosed with Alzheimers disease. Dave puts his strengths to work, using skills he has developed over many years as a financial advisor, as well as his passion for reading up about his condition and the way services should work for him, not making him fit into a standard bureaucratic process. He challenges his local services to be genuinely person-centred and flexible in the way they meet with him, listen to him, and document his wishes. He also makes it very clear that he will not become a token gesture to service user involvement by refusing an invitation to join a local strategic committee.

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/031-say-hi-to-dave/id867043694?i=321218937&mt=2

“It is not true that people stop pursuing dreams because they grow old, they grow old because they stop pursuing dreams.” [Gabriel Garcia Marquez].

Podcast Episode 030: Age of experience

TheStrengthsRevolution_albumart_2-2One of the main challenges of the widely recognised ageing population is how we tap into the deep well of resources in older people, as well as identifying more resources in order to support older people with specific needs.

This episode will explore the idea of ‘care capital’ from the perspective of contributing through voluntary work. An emphais is placed on the baby boomer generation, with a wealth of skills and talents alongside a desire to contribute something back into society.

What do others gain from our charitable contributions? The flip side of that coin is that we also gain enormously from making contributions of time and effort; not least the protective factors that come from structured physical and psychological activity. There are a multitude of opportunities in local communities, but our more flexible way of thinking about work should also be reflected in more flexible ways in which we may be able to shape our voluntary contributions, so that we tap into the strengths of the many. A good neighbour befriending scheme is identified as one personal example.

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/030-age-of-experience/id867043694?i=320358977&mt=2

“Age is an issue of mind over matter. If you don’t mind, it doesn’t matter.” [Mark Twain].

Podcast Episode 029: Toby Williamson Interview Part 2

TheStrengthsRevolution_albumart_2-2In conversation with Toby Williamson regarding his role in the Mental Health Foundation focused on Later Life. Services for older people are traditionally looked on negatively, particularly dementia.

In this episode Toby reflects on the positives of how we are living longer, and the majority of people, even those ‘living with dementia’, are experiencing a good quality of life. Mental health problems are not a necessary companion of growing older, and even the comparative cognitive decline can be adapted to. We can develop more of our own protective factors by planning more for an active retirement.

Two-thirds of people living with dementia do so in their own homes, and the Dementia Friendly Communities and Age Friendly Cities initiatives are two of the many positive developments contributing to the better wellbeing of older people. The challenge for service providers is to attract more excellent practitioners to see the exciting challenges and opportunities offered by working in these services. The lack of cure or effective medical treatments opens the door to a range of other exciting therapeutic opportunities for supporting people and their informal carers. Finally, we should also do more to tap into the ‘care capital’ potential of baby boomers retiring with experience and a commitment to contribute back to society.

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/029-toby-williamson-interview/id867043694?i=320199331&mt=2

Podcast Episode 028: Toby Williamson Interview Part 1

TheStrengthsRevolution_albumart_2-2Toby Williamson works for the UK Mental Health Foundation in the role of Head of Development & Later Life, and is extensively published particularly around the subjects of Values and Mental Capacity. Here he talks about what we mean by ‘values’ in mental health practice, borrowing a phrase from Professor Bill Fulford who describes them as ‘action guiding words’.

He explores the importance of values diversity, reflected particularly in the expectations of how we set up multidisciplinary teams. Toby draws on examples from his previous role managing Impact, an assertive outreach team developed in the voluntary sector services run by Mind in Hammersmith & Fulham (west London).

Toby and Steve also reflect on the conflict between person-centred values upheld by the majority of public service practitioners, and the commercial values slowly creeping into UK public services in recent years.

To access the full content of this episode click on the links to 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/028-toby-williamson-interview/id867043694?i=319964730&mt=2

Podcast Episode 027: Identifying values

TheStrengthsRevolution_albumart_2-2What are values?

This episode highlights the importance of reflecting on these largely unseen influences on everything we think, we do, we decide, they inform our core beliefs, they are the sum of who we are. Nothing more than that! So, if they have such a significant influence we would be well advised to be more aware of what they are.

They come dressed up in almost endless lists of good words, but this episode argues for spending more time examining the impact they have on the ways we behave and act in particular situations. Steve Morgan poses a series of questions to help us explore our underlying values, offering examples from his own experiences by way of illustration.

Core personal and corporate values are contrasted, and examples are identified of where conflicting values can contribute to better decisions, or even disasters. As a strengths approach, the examination of values is one way of demonstrating how we are putting genuine person-centred practice into action.

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/027-identifying-values/id867043694?i=319716735&mt=2

“Living in a way that reflects one’s values is not just about what you do, it is also about how you do things.” [Deborah Day].