Jerry Tew - Family Potential

advertisement
Rediscovering family assets
utilising models of co-production,
personalisation and recovery
Jerry Tew
Tentative new paradigm for
‘welfare’


Shift from a paternalistic deficit-based model of
‘doing to’ service provision to more of a
‘shared ownership’ model which focuses on
what people can (potentially) do, and the
resources they may be able to access, in
conjunction with others
Emerging in wider policy discourse in public
services, and particularly in relation to adult
social care and health and wellbeing
- but not always very clearly articulated
Drivers:
a)
Pressure from user and carer groups
to be able to do what works best for
them
b)
Current system for providing social
care is unaffordable
c)
Local Authorities taking on
responsibilities for public health and
wellbeing
Inhibitors:


Statutory focus on ‘risk’ and ‘need’
Short-sighted approach to resource
rationing: eligibility based on current
level of deficit / risk, not on potential
outcomes

Marketisation of services

Top-down managerialism
Theorising ‘positives’: some
overlapping terms
Assets
Capabilities
Capitals
Assets approach – looking for ‘can
do’ rather than ‘can’t do’






Knowledge and abilities
Resources (including time)
Access to opportunities
Relationships, trust and reciprocity
Enthusiasm, motivation and positive
thinking
Potential
Seen as key to promoting wellbeing (Foot, 2012).
Links to strengths approach in social work
Assets approach
Internalised
assets
Relational
assets
Access to
resources /
opportunities
Assets approach
Has tended to be applied at individual or
community levels (Morgan and Ziglio, 2007)
Little explicit engagement with ‘family’
– but ‘family’ may represent an
intermediate level of context where an
assets approach may be particularly
effective in mobilising potential and
bringing about different outcomes.
Some current asset-based
models for policy and practice
Co-production
Personalisation
Recovery
Co-production
Situates people not as passive
consumers of (marketised) services, but
as active asset-holders in the
collaborative development of resources
and solutions (Needham and Carr, 2009)

utilising assets such as local / personal
knowledge, time, access to resources and
social connectivity in order to produce some
combination of private value for individuals
and / or public value for groups and
communities
Co-production




Emphasis on ‘relational’ rather than
‘transactional’ approaches to service delivery
Frontline staff as catalysts / enablers rather
than as gatekeepers for over-stretched
services
Relocation of power and control from
organisational hierarchies to citizens and
frontline staff
Focus on outcomes – enhanced capitals and
capabilities, not just problems solved or risks
managed
Co-production and families



Families as neglected ‘layer’ in much of
the literature which tends to focus on
either individuals or communities
Families may have greater potential to
be co-productive than individuals
(more assets, especially relational
assets)
Families may also be the site of
oppressive processes that limit
deployment of specific forms of capital.
Personalisation
(Putting People First)
Broad capability-based vision for adult
social care:
1. access to mainstream (education,
employment, leisure)
2. prevention / early intervention :
provision of more intensive resource when
most productive
3. choice and control – personal budgets
4. social capital.
Service user as co-producer / asset-holder
Personalisation in practice
With notable exceptions...
 Focus on personal budgets rather than
broader asset-building agenda
 Individualised rather than collective
solutions
 Resource Allocation System (restriction to
‘critical’) diverting resources to reactive
purchase of ‘dependence-inducing’ care
services rather than strategic building of
longer term capability
Confused approach to role of family
However...

Some localities have managed to use
personal budgets as a mechanism to shift
resources into asset-building approaches
(e.g. working with user-led organisations)
– but hard to use current resource allocation systems
to support asset-building at family level

Community Budget initiatives may open up
mechanisms for more effective family-based
approach – but how do we join this up with
personal health and social care budgets?
Recovery (mental health)
Idea rooted in user/survivor movement

people taking back power for
themselves in order to ‘get a life’ –
irrespective of any ongoing mental
health difficulties.
Recovery can involve
1.
(Re)discovering a positive sense of self and
hope for the future
2.
Finding a way of understanding that gives
meaning to (or control over) one’s experiences
3.
Dealing with personal, social or relationship
issues that may contribute to one’s difficulties
4.
Taking on satisfying and meaningful social roles
within mainstream society
5.
Having strategies for managing particular
situations, experiences or behaviours that cause
difficulty or distress
6.
Being able to call upon formal and / or informal
systems of support as needed (Tew, 2011)
What makes a difference in
enabling recovery?




Having opportunities to reclaim power
and control over one’s life
Supportive relationships that allow for
reciprocity
Social inclusion and acceptance (places
and activities)
Opportunities to rebuild positive
personal and social identities
(Tew et al, 2012)
What gets in the way of recovery?





‘Them and us’ thinking and practices
Disproportionate focus on risk and
dangerousness
Services that construct people as
passive ‘patients’ that require
treatment by ‘experts’
Stigmatisation within services and
wider community
Implicit messages of hopelessness
Wider implications


Much of idea and practice of recovery
is applicable outside mental health
It is potentially applicable to ‘troubled’
families as well as ‘troubled’ individuals
To conclude: an assets approach
to engaging with families
Requires:
 A fundamental shift of perception, analysis and
practice




Looking for capabilities and capitals – actual and
potential
Adopting a relational (doing with / facilitating /
catalysing) rather than a transactional (doing
to) approach
Building on and adapting models so that they
can work at the scale of the family (e.g.
personalisation, recovery)
Organisational culture change
Key questions for discussion
1.
What might assets thinking have to offer in different areas
of policy and practice with families?


How transferable are ideas such as co-production, personalisation
and recovery?
How well might these work at the level of ‘whole family’ contexts
and practices?
2.
What may be dangers or limitations of going down this
route?
3.
Where it may be a good idea, what could be the barriers
to implementing assets-based approaches?



4.
Cultural
Organisational
Other
How might we overcome these?
References
Bourdieu, P (1986) The forms of capital. In J.Richardson (ed)
Handbook of theory and research for the sociology of education.
New York: Greenwood Press.
Department of Health (2007) Putting people first: a shared vision
and commitment to the transformation of adult social care.
London: Department of Health
Foot, J (2012) What makes us healthy? The asset approach in
practice
http://www.janefoot.co.uk/downloads/files/healthy%20FINAL%
20FINAL.pdf
Morgan A and Ziglio E (2007) Revitalising the evidence base for
public health: an assets model, Promotion and Education
Supplement 2 pp17-22
Needham, C and Carr, S (2009) Co-production: an emerging
evidence base for adult social care transformation. SCIE
Research briefing 31.
Sen, A. (1993). Capability and Well-Being. In M. Nussbaum and A.
Sen, eds. The Quality of Life, pp. 30–53. New York: Oxford
Clarendon Press.
Schuller, T, Bynner, J and Feinstein, L (2004) Capitals and
capabilities. London: Centre for Research on the Wider Benefits
of Learning.
Tew, J (2011) Social approaches to mental distress. Basingstoke:
Palgrave Macmillan
Tew, J (2012) Recovery capital: what enables a sustainable recovery
from mental health difficulties? European Journal of Social Work
DOI:10.1080/13691457.2012.687713
Tew, J et al, (2012) Social factors and recovery from mental health
difficulties: a review of the evidence. British Journal of Social
Work 42(3): 443-460
White, W and Cloud, W (2008) Recovery capital: a primer for
addictions professionals. Counsellor 9(5):22-27
Download