The Strengths Revolution’ weekly podcast show was launched on 22nd April 2014. Just go into iTunes Store, click the ‘Podcast’ link on the top menu, then put ‘The Strengths Revolution’ into the search box.

Listen, subscribe, and add a review if you feel able to. Remember… listening, downloading or subscribing to the show is FREE!

'Working with Strengths' was published in May 2014 as a comprehensive resource for reviewing the literature and reflecting on strengths-based practice as applied to people in contact with services, as well as the strengths-focused development of practitioners, teams and organisations. It draws on the wider business literature as well as health and social care references to broaden the applicability of the ideas.

'Risk Decision-Making' was published in 2013 to help shift the focus from a tick-box culture to the realities of what good practice should be about. The manual and cd-rom provide the resources that should engage senior management in organisations, as well as the practitioners and multidisciplinary teams.

June 2007 saw the publication of the Working With Risk Trainers Manual and Practitioner Manual through Pavilion Publishing. The Trainers Manual provides a flexible two-day training programme, with the option of using any of the individual sessions as stand-alone training resources. The Practitioner Manual provides a set of practice-based risk tools with supporting guidance on how and when to use each. These materials also aim to discuss some of the wider risk issues and identify a key part of current research and literature. The practice-based tools are also supported by completed case examples.

To make contact either send me a message via the 'Contact Me' form or (if it's urgent) you can call me on 07733 105264.

Practice Based Evidence commenced business in October 2001. Promoting the value of the messages from service users, carers and practitioners experiences. These are often marginalised by the emphasis placed on research.


 

Twitter
  • The Art of Co-ordinating Care: A Handbook of Best Practice for Everyone Involved in Care and Support
    The Art of Co-ordinating Care: A Handbook of Best Practice for Everyone Involved in Care and Support

    Jointly written by Practice Based Evidence & ARW, this resource is of importance to everyone in mental health, social care and learning disability services, including primary care.

  • Assertive Outreach: A Strengths Approach to Policy and Practice
    Assertive Outreach: A Strengths Approach to Policy and Practice

    Primarily aimed at developing assertive outreach, but its focus on a strengths approach is applicable to all parts of the mental health system.

Thursday
Nov042010

Bureaucracy Busting

The PDF below is for viewing purposes only and is not to be used without the explicit permission of Steve Morgan

PDF: Framework for Review (15kb)

Thursday
Nov042010

CPA: a process or an event?

First published in Openmind February 2007 and printed here with kind permission

In the article below, available as a PDF, Steve Morgan argues that we need a radical shift in thinking to support the CPA to deliver in the way originally intended.

PDF: CPA - process or event? - OpenMind article

To read the report above you will need free software called Adobe Reader. This software can be downloaded here.

Thursday
Nov042010

Finding a place for Practice Based Evidence

The domain of numbers and science

The randomised controlled trial has taken its place as the gold standard for providing evidence that a treatment or intervention works. It helps to describe the important features and characteristics that influence its working, which must be replicated in order to achieve the desired results in other settings. It has been compared to a control group that lacked the desired features, and the differences have been carefully enumerated. The systematic reviews and meta-analyses help to establish the cross-research validity of the findings to further boost the value of the message. It comes dressed up in science and numbers to give it greater gravitas, but equally making it less accessible to many of the people who should be more aware of the messages and how to implement them.

The power of numbers is very clear in the scientific world of precise measurement, but as Goldacre (2009) points out, unless it is undertaken in a transparent way it has tremendous potential to be used in ways that deceive people into believing what the procurer of the evidence wants people to believe. The report of a Practice Based Evidence initiative with the National Audit Office (Morgan and Hunte, 2008) also illustrates how the power of numbers channeled through the slavish pursuit of targets can completely distort priorities on the ground away from recognised best practice.

If so much attention is placed on demonstrating the evidence for what we do, just how much of what we do in healthcare is evidence-based? Goldacre (2009) draws a distinction between true evidence-based medicine and the wider activity that happens in delivering a healthcare service: “From the state of current knowledge, around 13% of all treatments have good evidence, and a further 21% are likely to be beneficial… These real world studies give a more meaningful figure: lots were done in the 1990’s, and it turns out, depending on speciality, that between 50% and 80% of all medical activity is ‘evidence-based’. (p199)” The power of the medical lobby is still evident in these broader findings… he is still talking about ‘medical activity’, so is this the most desirable approach to adopt for developing the wider health and social care sector that is not medical based?

Venturing into touchy-feely territory

The academics, researchers, policy-makers and medical establishment are very quick to put down areas of interest that do not conveniently fall into their evidence-based domain; it must be the touchy-feely stuff of casual distraction but of little scientific value! Models of team-working have received great attention from the research community, but it is arguable whether they are really concerned to get involved in the questions of micro-detail, preferring again to restrict their evaluations of whether a particular type of team works depending on the numerical impacts it has, particularly on hospital bed use and medical symptomatology. Only casual significance is accorded to the narrative messages of case study and service user statements of experience.

Practice Based Evidence is not about undermining good quality research, but it does place a fundamentally different emphasis on the priorities of active practice development and geography (Morgan, 2008). Evidence-based practice is often concerned with examining controlled variables from the distance of apparent scientific impartiality, then reporting the findings for practitioners through papers and workshops to take away into their practice to interpret for themselves. Practice-based evidence should be more about working alongside people in the workplace, to help develop their interpretations of recognised good practice, and to subsequently evaluate the outcomes of changes they are able to put into place.

Finding the common ground

The focus and approach of evidence-based practice provides vitally important messages for the development of defined and controlled specific types of intervention or treatment. However, it has a weaker role to play when addressing the challenges of wider questions, such as:

  • What does good practice in team-working look like?
  • How can we promote a more integrated configuration of teams across a local service?
  • How and why should we develop a strengths approach to individual practice and team-working?
  • How and why should we be taking risks?

These questions require an entirely different approach to developing and examining evidence, but also the narrative and collaborative approaches to evaluating practice development should not be interpreted through the same prism owned by the evidence-based practice lobby, as it is collected differently to address different but equally necessary questions.

Goldacre, B. (2009) Bad Science. London: Harper Collins.
Morgan, S. and Hunte, K. (2008) One foot in the door. Mental Health Today, March pp32-35.

Thursday
Sep232010

Risk-taking and the 'Risk Business'

We are in 'the risk business', but what is so wrong about that? Just as risk applies to the lives of everyone every day, so risk has always been an integral part of daily working practice in mental health services. We have choices:

  • To take a narrow and restrictive approach in our expectations of risk avoidance, with the more likely consequences of frustrating the potential of those who deliver services, and risk the disengagement and disenchantment of those who need and use the services.
  • To be more proactive and constructive in our appreciation that calculated risk-taking motivates and benefits everyone.

The article below (unpublished) sets out a definition of what Positive Risk-Taking is and how we go about doing it in a constructive way

PDF: Risk Taking and the Risk Business

To read the report above you will need free software called Adobe Reader. This software can be downloaded here.



Thursday
Sep232010

A Strengths Approach - Principles and Frequent Reactions

A Strength Approach has been adapted from the original ‘Personal Strengths Model of Case Management’ developed by Professor Charlie Rapp and colleagues at Kansas University in the early 1980’s. I was part of the original UK case management initiative that Professor Charlie Rapp and Wally Kisthardt presented their ideas to in 1991.

This approach has underpinned all of my work as a practitioner, supervisor, writer, trainer, and developer of other teams from 1991 onwards, and is the core philosophy of Practice Based Evidence.

PDF: Principles and Frequent Reactions