Sunday 25 March 2012

Trevor Hopkins and Trojan Mice

I am looking forward to attending a learning session on the practical application of asset based approaches later this week. The session is provided through the West Midlands Public Health Observatory Learning for Public Health programme and will be delivered by the engaging Trevor Hopkins from Asset Based Consulting and co-author of A Glass Half Full.

Trevor delivered an introductory afternoon seminar last month which I attended (the slides from the session are here). I Storified tweets from the session. The session included descriptions of 'deficit' and 'asset' approaches, applications of an assets approach in relation to health and wellbeing, case studies from Sandwell and Coventry and thoughts about community asset mapping and JSNAs (Joint Strategic Needs Analysis).

Trevor opened the session by saying that he would be challenging - that felt exciting to me. He asserted that a problem is a management issue - managers can deal with it, whereas a dilemma is something you can’t solve - it’s what leaders do. Trevor thinks we have a dilemma around public health and how we deal with it. He talked about recovery and resilience, using the example that personal networks and support are as effective as a flu jab ... if we can have both together then it’s even better. This reminded me of work that the RSA have been doing around whole person recovery and connected communities

Trevor explained that a deficit approach to health is a pathogenic approach which focuses on disease and death, and leads to disempowerment and dependency. (He challenged us to find more deficit ‘d’ words, which of course I tweeted. @lizzie_banks suggested depression, disorder, disengagement, debilitating and disaster!) 

The features of a deficit approach were described as including policymakers seeing systems or institutions as the principal tool for the work of society, a structure which is designed to permit a few people to control many other people and people being seen as clients or customers. This brings to my mind a description of neoliberalism in David Gauntlett’s excellent Making is Connecting:
“Neoliberalism...is the belief that markets are the only lens through which to run anything, or to assess the value of anything. It is manifested in many ways, and becomes apparent when individuals are seen as simply customers and consumers, and workers become faceless ‘service providers’. It means that the ‘voice’ of people is denied, because they can only express themselves through choices within the existing market, which is not genuine self-expression at all.”
Trevor highlighted that traditional approaches result in production a great deal of the same thing, whether goods or services. Then to overcome the issue that people are different and may have different needs or problems services are targeted at at those needs and problems, resulting in communities an individuals being ‘segmented’ and posts such as ‘obesity co-ordinator’, ‘smoking cessation co-ordinator’ being created. However people aren’t a condition, nor are obesity or smoking single problems, they are complex, wicked problems.

On organisational change, I liked what Trevor shared: that a lot of organisations see organisational change like a Trojan Horse. The organisational development team are hidden inside and come out at night! A better model is Trojan Mice - lots and lots of them nibbling away. What a fantastic vision, and imagine all the diverse challenges which could be made if there were lots of people making them. This makes me wonder whether the idea of trojan mice is similar to the idea of horizontalism:
“Horizontality or horizontalism is a social relationship that advocates the creation, development and maintenance of social structures for the equitable distribution of management power. These structures and relationships function as a result of dynamic self-management, involving continuous participation and exchange between individuals to achieve the larger desired outcomes of the collective whole” (from Wikipedia)
Trevor suggested that social sciences are going to save public health and referenced Ivan Illich and his publication ‘Medical Nemesis’. I’ve just come across Ivan Illich in Making is Connecting. I found this passage in chapter 7 useful to reflect on.
“Whilst big, uniform systems may have been developed with the intention of helping people on a broad and democratic scale, Illich argued that they always reach a point beyond which they cause more harm than good. Schools, for instance, are originally intended to provide an education - of course - but once they are established into an institutional system they become machines to deliver schooling - conformity to rules, and memorization of a set body of knowledge without necessarily learning or understanding - which is then measured as an end in itself. Therefore, Illich suggests, the institution of school makes people stupid, institutionalized medicine makes people sick, and the institution of of business ruins the planet. This sounds gloomy, then, but his solutions, based on more individual and community-based engagement, helpfulness and creativity, may be of interest."
During the seminar we heard from two officers involved in asset based projects in Sandwell and Coventry respectively. Marianne Munro, a Community Development Officer for Sandwell MBC shared the story of the Friends and Neighbours project and Kate O’Hara shared the Coventry Asset Based Approach which is linked to their 10 ways to wellbeing. Having heard both case studies I was left with a niggling frustration that both case studies seemed to be presented as a journey from initial stages of mapping, listening and networking, working towards goals of a structure, for example a formal partnership or Community Interest Company, with governance and sustainability plans. I can’t help feeling that this shouldn’t be the prescribed destination of asset based work, and it feels inherently unsustainable compared to other outcomes which asset based activity could result in. 

I return to the excellent Third Sector Research Council paper by Eileen Conn, as referred to in my last blog post. In Community engagement in the social eco-system dance Eileen’s description of vertical, hierarchical system of relationships fits with Trevor’s description of a deficit approach and Illich’s issues with institutions:
"... the nature of the relationships is primarily vertical and hierarchical: tightly regulated to ensure compliance with organisational policies and constraints including employment and contract laws, and financial and managerial governance. They are generally divided into segments, subjects and topics. The organisation structures, and management and governance systems, have co-evolved with the vertical hierarchical system of relationships."
I would have thought that an asset based approach would be concerned with creation and nurturing of the horizontal, peer system of relationships - Eileen suggests that to be healthy and strong 
"the roots for these social relationships need to be appropriately tended. The way grass roots grow… is an instructive image for this. Grass that grows strongly and healthily, and is difficult to uproot, has a strong and intertwining mat of roots. These are like the strong interconnections in a community, all giving strength and support to the whole. If the grass is separated from its mat of roots it loses its strength and its intrinsic nature. These social networks, and the need to nurture them, are fundamental to resilience."


Have the projects in Sandwell and Coventry been looking at communities through a lens which results in them looking for things like the institutions which initiated the projects? Eileen Conn helpfully describes issues with the lenses through which we see communities in this video clip

Trevor highlighted questions which arise if we agree that the solutions to health inequalities might be in the hands of individuals, their families and their friends: What does that feel like to health professionals? How can they do their jobs? He suggests that an infinite model of power is helpful. I think a very real focus on barriers people face and social justice is also helpful.

There was lots more covered in the first seminar, but I think this post is getting rather long. So .... was Trevor challenging, as he had promised? 

Perhaps some of the things that he said may have been challenging for participants who are working in vertical hierarchical systems of relationships, as I observe from the outside that such organisations squash creativity and assertive challenge of the status quo. However I didn't find anything challenging in what Trevor shared or suggested. It sounded to me like absolute common sense, and I really connected to the community development roots in what Trevor talked about, and welcomed his references to social justice as being fundamental to asset based approaches.

Two things I found challenging in the experience of attending the seminar were:
  • The style of the seminar not being asset based, given the content was about asset based approaches. I felt there were missed opportunities to share some of the assets in the room - particularly the knowledge and experiences of participants. I wonder if a better balance of time could have been achieved so that we became participants rather than an audience. Or perhaps different ways of sharing the case studies so that they were discussed rather than presented. Of course I say this with appreciation for the task that the organisers and presenters had, and there was an awful lot packed in to an afternoon session, which I greatly appreciated having the opportunity to attend.
  • Being the only person in the room who was visibly using a laptop/ipad for note taking and tweeting. I don’t think anyone else was tweeting (I expect some people aren't allowed due to organisational social media policies) and I felt a little self-conscious about it.
Finally here are some resources I recommend if you would like to find out more about asset approaches, and an online network (ABCD Europe) where the asset based practice and approaches are discussed.

Monday 12 March 2012

“Must you be so linear?”

I’ve just participated in the second Ageing Well Dudley stakeholder session, helpfully facilitated again by Carol Hayden (I shared reflections on the first session here).

Ageing Well Dudley activities have involved Appreciative Inquiry interviews and group sessions in two areas of the borough with contrasting demographics; Brockmoor and Pedmore. From the interview information some composite fictional profiles of older people in each area were put together and shared at the stakeholder event to get us thinking about:
  • What type of support would make a difference to this person’s quality of life?
  • What support could be found without relying on statutory services?
  • What is needed to extend this sort of support
  • How would you use £1000 to make this happen?

The group I was in were given a pen picture of the fictional Mrs Bates, a 73 year old retired dinner lady who is a council housing tenant in Brockmoor. Her husband died 8 yrs ago, she does a supermarket shop at the weekend with her daughter, shopping locally is not as easy as it was as she is less mobile. Her daughter and son-in-law are moving away, and she won't have to look after her grandchildren any more, she will miss them but is a bit relieved as it was becoming hard work. Getting things done in her home is difficult. She would like a grab rail but has been told that the council don't fit them. She waited 6 months for hole in ceiling to be fixed. She doesn't know who to ask for advice and help, she doesn't want to speak to social services.

Some of common features of discussions about the pen pictures of older people included a need for some listening, them having someone to talk to, seeing an older person as a whole (not a broken arm, in the case of one who had been in hospital) and older people knowing about services and activities when they need to. Then, in groups we were tasked with developing an idea to share with others in the room which could be done with £1000.

Dudley Social Media Surgery
I described to my group the model of Social Media Surgeries and that the beauty of them is that it is people offering their time and a bit of knowledge which creates connections in the room. Here are the ingredients for a Social Media Surgery, as compiled by Nick Booth in 2009.


I was wondering if a similar model of voluntary, peer support could be developed in a neighbourhood.

Nick stresses that social capital is the most important ingredient:
Think of social capital as the stock pot of your social media kitchen; you need to keep it constantly bubbling away. By the way, it has to be home made and hand made. In an emergency you can borrow some social capital from your neighbour, but please take care to return it as soon as you can. Some people are tempted to use shop bought social capital. It never works.
Nick recently updated his recipe as he thought it should be more simple and is mainly about being there - here's my version of the simple version for an older people's peer support meet-up:
  • A free room with some chairs and where you can buy or blag a drink (a cafe is perfect)
  • A host – the person who’s happy to choose a time and date and check with the people at the venue that it’s ok with them. On the day they welcome people, introduce them and just make sure people are ok
  • At least one volunteer helper from the neighbourhood and hopefully at least one older person from the neighbourhood looking to make new connections. 
  • Zero expectations – high hopes can kill enthusiasm. Expect nothing and be delighted by what does happen.
My difficulty today was that in starting to share this idea I was struggling to communicate, partly because  most people were service providers and immediately started think about giving advice, and what if the person volunteering gives the wrong advice … and so on. What I am thinking about isn’t really about advice at all, it’s about an impartial person giving their time freely to sit with someone else who lives in the same neighbourhood and is perhaps feeling a bit isolated. Admittedly the volunteer helpers might need to people who know a bit about what goes on in the area or have experience of accessing services and navigating through services, but there is no way that such an activity could be expected to match exactly a the needs or questions of an older person with a service provider who has an answer (see Nick's recipe: have zero expectations).

The Third Sector Research Council recently published a fantastic paper by Eileen Conn which helps me to understand why I’m struggling to communicate my idea. In Community engagement in the social eco-system dance Eileen describes two systems, as below.

The first is the system of relationships which we see in our public sector agencies and formal voluntary organisations:
... the nature of the relationships is primarily vertical and hierarchical: tightly regulated to ensure compliance with organisational policies and constraints including employment and contract laws, and financial and managerial governance. They are generally divided into segments, subjects and topics. The organisation structures, and management and governance systems, have co-evolved with the vertical hierarchical system of relationships.
Eileen calls this a vertical, hierarchical system of relationships. Eileen explains that this is very different to civil society - which is not like regulated organisations, where people are recruited to particular defined jobs. Instead, individuals, when they come together voluntarily through their shared interests, connect to give each other mutual ‘peer’ support in some way. These personal connections are the source of nourishment for the horizontal relationships between peers. Eileen explains that for the horizontal, peer system of relationships to be healthy and strong
the roots for these social relationships need to be appropriately tended. The way grass roots grow… is an instructive image for this. Grass that grows strongly and healthily, and is difficult to uproot, has a strong and intertwining mat of roots. These are like the strong interconnections in a community, all giving strength and support to the whole. If the grass is separated from its mat of roots it loses its strength and its intrinsic nature. These social networks, and the need to nurture them, are fundamental to resilience.
I guess what I was making a fumbled effort to convey in the meeting today was an idea for a very easy to manage way for some of those roots to give a bit of their time (an hour or two a month, or less) in a hosted space to connect and intertwine with neighbouring roots, perhaps with a look towards that whole other system of vertical, hierarchical relationships and tips on navigating it, but as much, if not more, with a view to people in similar situations sharing, connecting and learning from each other. It could be that the first time someone attends they end up sharing a recipe, or a story about living in the area 50 years ago… but they have had the opportunity to be listened to and to connect. No-one has put them in a box clearly marked with a service area.

My idea was about this, but I appreciate that it’s difficult to see that if you’re used to doing things for people, providing services to people and if you’re looking at the world from through the windows of your vertical structures. Eileen explains this really helpfully in this video clip:



So I’ve come away from the meeting feeling that I may have been less than helpful to my colleagues (in being inadequate in conveying my idea) and that I might have destroyed my idea by exposing it to a different way of thinking, which is very linear: a person is seen as having a problem, a service provides response. As the character Q in Star Trek: The Next Generation says to Captain Jean-Luc Picard: 
You humans are so linear… although you can occasionally break the patterns of thought that so limit you. While you know better from personal experience, you still engage in this linear thinking that so restricts your understanding …
I feel that I am frequently guilty of linear thought, and I think people who provide services often work in culture which encourages linear thought. In order for older people in Dudley to become empowered, connected and like the intertwined roots of grass needs us to stop worrying about linear solutions all of the time, and facilitate emergence. Rather than only providing the solution to what we see as a person's problems, can we do more to tend the whole lawn - allowing each blade of grass to lean towards the sunshine?