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.


  • 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.


Missing the real target

Nothing drains passion more effectively than constant demands for information to meet apparent targets, asked without consultation or explanation, and with no meaningful returns in the form of useful feedback. Auditing everything has become an industry – but to satisfy what? The function of co-ordinating care, specifically CPA, has become a focus for quantitative returns that seemingly have little to do with the quality of the working relationships and everything to do with numbers and signatures. As many service users, carers and practitioners will testify, presence at a meeting and signing a form does not necessarily reflect influence, involvement or even truthful agreement with the documented outcomes. Yet, the bureaucratic process keeps requiring the numbers with no apparent reciprocal benefits for practitioners and teams.
I wouldn’t argue against the need for auditing practice; but it does appear from conversations with many practitioners that there are widely differing perceptions about priorities between the management of services and the deliverers of services. Anecdotal sources suggest that most practitioners feel they only receive feedback from audit sources when things go wrong, and that good practice is not confirmed or highlighted when it happens. If practitioners, service users and carers were asked to define the parameters of what needs to be audited, there would be some disagreements between them but the priorities would probably look a lot different from what currently occurs. Most people in the real world are concerned about relationship-building in order to support people to be more self-reliant through identifying and working with their own strengths. Audit needs to be of practice and for practice, with a focus on sustaining current good practice. But that would only put an awful lot of middle management and auditors out of a job, for their focus is 'change' for its own sake; as long as the merry-go-round keeps moving they will have a purpose.

See 'The Art of Coordinating Care' publication for a detailed framework on delivering a service user-focused, strengths-based, bureaucracy-busting approach to real practice. It has been developed as a reflection of what good practice looks like, but will challenge all practitioners to step up to the mark to deliver values-based personalised services based on working with people's strengths. Failure to do this leads to the alternative... the more usual current situation of an over-regulated system driven by the need to satisfy the politicians and public that if anything goes wrong 'it will never happen again'. What the current system can ensure will never happen again is the enjoyment and creativity fuelled by the passion of people who want to make a positive contribution to service users lives.


Coordinating Care: Art or Science?

Being a care coordinator and managing the care programme approach has become a challenging function of our care and support services, attracting more than its fair share of negative connotations. A genuine tension exists between the passion and artfulness of human relationships on the one hand, and the pursuit of a scientific basis for interventions on the other. The science of research seeks to impose a sense of reassurance by means of consistent results when defined sets of circumstances are observed or applied. By contrast, the quality of an artful endeavour may be measured more by its emotional characteristics and the feelings it engenders in those involved or observing. In reality, the experience and practice of mental health and learning disability services is primarily a study of people’s emotional experiences, feelings and behaviour patterns. So we should be wary of any attempts to understate the elements of artfulness and passion; and we should recognise the potential impact this may have on our enjoyment of the work, as well as our motivation for doing it.
Arguably, one of the most crucial effects of the evidence-based practice focus of research is that it undermines the art of relationship-building. The pursuit of a rigorous scientific rationale places a clear priority on the cult of numbers. ‘How many?’ and ‘How frequently?’ and ‘How quickly?’ become the valued quantitative outcomes of an efficient service. But what is the cost of this, in terms of an effective, good quality experience for the individual service user within this wider research picture? Or, indeed, what is the cost of its impact on the qualitative experience of the work that, for many practitioners, is their motivation? Ideally, we need to strike a careful balance between art and science in the delivery of good quality care and support.

Find out more on these views from the published manual The Art of Coordinating Care


Inadequate risk assessment

A Foundation Trust (along with a care home provider) has recently received a heavy fine for inadequate risk assessment when placing a man at the care home; he subsequently killed one and seriously injured another care home worker. The degree of tragedy should not be underestimated, but you can instantly feel the bureaucratic knees jerking across the managerial universe. Larger tick-box forms will be required in greater frequencies so we can all rest assured 'this will never happen again', or so the political rhetoric goes!

I don't know the full details of the case, but I do know these are extremely rare incidents that should not be allowed to cloud over the vast majority of good decisions and good practice that does happen across our stretched public bodies. However, there is a wider case to be answered in the quality of information being communicated when a person with complex issues is required to be placed out of the health care system into the social care system. There is a 'tip of an iceberg' effect happening here, but it is not one that is going to trigger a rash of homicides. What I observe in my travels around the care and support landscape is a wholly inadequate approach to referrals, mostly driven by fear of the commissioning and managerial stick that drives the pursuit of numbers and throughput.

The result is often one of referral being a process of withholding relevant information (particularly risk information) for fear that it will be used to refuse the placement. Practitioners are under pressure to get people moved on, not to find the most suitable place for their continuing progress and support. Even when risk information is passed on, it is more frequently in the format of the dreaded tick-box exercise that communicates little of any use or relevance for planning appropriate support.

For me this case does raise the issue of poor examples of practice, but I would like the starting point for addressing the issue to be one that investigates the crazy 'system' we have evolved, whereby staff are under constant pressures from the bureaucracy that completely undermine any chance of delivering good and safe practice. If you want to develop a system that thrives on good practice it has to be a bottom-up approach; if you want a system that demonstrates what schizophrenia actually is then use the top-down managerial approach of 'talking the talk while actively disabling the walk'.


Reflective Practice

The following article is published with the kind permission of Jayasree Kalathil (Editor of Open Mind). It is with mixed feelings that I post the following article. It hopefully helps to raise the profile of the vitally important role of 'reflective practice', but it is also a sad reflection on the passing of Open Mind, as the final edition sees the end of what has been a terrific source of reflection, knowledge and a welcome haven for independent thinkers... it will be greatly missed and cannot be replaced.



Do what you say on your tin

Are 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...

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