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.

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'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.

Entries in risk assessment (4)


Paris Conference Presentation 2018

The following was the abstract I submitted for the keynote presentation at the recent Mental Health Congress in Paris (9-11/7/18):

Positive Risk-Taking: From Rhetoric to Reality

Do we pay enough attention to the impact that the language we use has on the people we serve, and the ways in which we serve them? Our adherence to professional jargon more often serves to exclude and/or confuse other people. This is most notable in the language of risk, particularly where the negative connotations can often drive a blame culture and promote an unnecessary risk averse approach. Where is the person within such a picture?

Assessing and manging risk is an essential skill; but, so to is calculated and reasoned risk-taking. My concept of ‘Positive Risk-Taking’, initiated in 1994, brings the language of risk, strengths and person-centred outcomes together in a clear and sharp focus. As a concept, it is underpinned by the principles and practice of good risk assessment and management, applicable to all facets of mental health, wider health, and social care considerations.

The concept is focused on the outcomes, rather than solely being led by the risks. Taking risks for positive outcomesrequires a clear definition and description; but, it is also underpinned by the fully recognized components of mental health good practice… focused and contextualized risk assessment is counter-balanced by a full strengths assessment; supervision and support is complemented by teamwork and team-focused training. Collective decision-making enables balanced and reasoned risk-taking decisions to be made with confidence, and the identification of individual responsibilities for action to be outlined within a thoughtful plan.

Welcoming the audience to the presentation:

A partial link to what you missed!

Fielding a question or two:

And sharing in the post presentation accolades (holiday snapshots time !!):


Risk Decision-Making

How many times have you been asked 'where is the risk assessment?' knowing that the quality of the work is of secondary value at best. A new manual has been produced in 2013 to focus the attention of people at all levels of organisations involved in health and social care services. We all make risk decisions, but we occasionally need guidance to support our confidence in doing so. This manual is focused on reducing bureaucracy, promoting quality, and responding to what we should really mean when we talk of being person-centred in our work.

Risk Decision-Making is available from Pavilion Publishing.


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'.


Risk Definitions


is the likelihood of an event happening with potentially harmful or beneficial outcomes for self and others. (Possible behaviours include suicide, self-harm, neglect, aggression and violence; with an additional range of other positive or negative service user experiences).

Risk Assessment:

is the gathering of information through processes of communication, investigation, observation and persistence; and analysis of the potential outcomes of identified behaviours. Identifying specific risk factors of relevance to an individual, and the circumstances in which they may occur. This process requires linking the context of historical information to current circumstances, to anticipate possible future change.

Risk Management:

is the statement of plans and the allocation of responsibilities for translating collective decisions into real actions. It is the activity of exercising a duty of care where risks (positive and negative) are identified. It entails a broad range of responses linked closely to the wider process of care planning. The activities may involve preventative, responsive and supportive measures to diminish the potential negative consequences of risk and to promote potential benefits of taking appropriate risks. These will occasionally involve more restrictive measures and crisis responses where the identified risks have an increased potential for harmful outcomes. It should also clearly identify the dates for reviewing the assessment and the management plans.

Positive Risk-Taking:

[From: Morgan, 2004]: is weighing up the potential benefits and harms of exercising one choice of action over another. Identifying the potential risks involved, and developing plans and actions that reflect the positive potentials and stated priorities of the service user. It involves using available resources and support to achieve the desired outcomes, and to minimise the potential harmful outcomes. It requires an agreement of the goals to be achieved, or a clear explanation of any differences of opinion regarding the goals or courses of action.

Morgan, S. (2004) Positive risk-taking: an idea whose time has come. Health Care Risk Report 10 (10) 18-19.

Morgan, S. (2007) Working with Risk Practitioner’s Manual. Brighton: Pavilion Publishing.