Posted by: ayrshirehealth | September 10, 2014

Let’s talk about…thinking differently by @Amy13simp

Thinking differently

Fit into boxI’m sure most of us would agree we came in to the jobs to “make a difference”, to “empower people” and to “support people to achieve the things that are important to them” but somewhere along the line systems and processes, risk aversion and “fitting people into boxes” got in the way.

Sound familiar? Thought so!

So if we could get back to when we were all brand new, just out the wrapper, a newly qualified Nurse, Social Worker, AHP or GP, would you be up for “Thinking Differently”? You bet but how do we do such a massive 360?

It’s quite simple really…. let’s start with the question “What makes a good life for you?”

What makes a life good for you?

Over the last 18 months in East Ayrshire we have had many conversations with people who use services (families, carers, practitioners and care providers) about “What makes a good life for you?”, “The little things that matter” and “The bottom line”. All of this is about how we as practitioners and providers of care Think Differently. The people we support get it, they know what makes a difference for them – they’ve been ready to think differently for a long time and they’ve just been waiting for us to catch up.

EACLogoSDSSo what do we mean by Thinking Differently? Well, in East Ayrshire it covers a range of strategic drivers including Self Directed Support (SDS), Smart Supports and Anticipatory Care Planning (ACPs) as they have shared core principles in ensuring that individuals have choice and control, people are seen as the experts in their own lives and services and supports are truly person-centred and focus on meeting each person’s outcomes.

Which brings us back to the question of “What makes a good life for you?”. When we asked a range of people from across the East Ayrshire Health and Social Care Partnership, people talked about spending time with family and friends, laughing, having fun, being outside, music , shopping and sport. This lead us to ask: is this any different for the people we support? Absolutely not – but does the way we have been traditionally supporting people support them to do the things that give them a good life?

Small differencesEven if we had understood what made a good life for the person, did we know how they did it? Or have we made assumptions about how people recover from ill health, keep well and improve their independence? Did we truly understand the outcome? Is it about feeling safe, healthy, valued, confident, being a mum or dad or just feeling good about yourself?Cafe

So if you’ve read this and think, I want to know more, I am ready to think differently, then please join us at one of our forthcoming conversation cafes across East Ayrshire.

To find your nearest conversation cafe please visit www.my-east-ayrshire.co.uk or call 01563 503302.

This week’s blog was by @amy13simp (Amy Simpson), Team Manager, Smart Supports and Anticipatory Care Planning, East Ayrshire Council

On Twitter follow us at: @eacThinkDiff

 

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Responses

  1. Hi there,

    I most interesting post and I just have to comment that we have been using an intervention called Solution focus practice for years which formalises the type of thinking you are describing. It can be used in practically any environment and has a good evidence base and track record.

    I have posted below a brief outline for you consideration.

    We use and train people in SFP throughout our work with people suffering psychological distress as well as in the workplace, industrial, commercial and health care.

    Solution Focus Practice and philosophy.

    What are the benefits of “solution talk” as opposed to “problem talk”?

    Solution talk opens up the conversation, creates space for possibilities and exploration whereas problem talk closes things down and limits creativity
    Solution talk highlights that there may be many routes to what you want without needing to tackle the problem directly
    Solution Focused Assumptions

    Enabling and underpinning the shift away from focusing on problems to focusing on solutions are a number of key assumptions:
    Clients often have the resources to deal with their difficulties;

    The client’s view of the change that is wanted for the future is paramount;
    Clinicians (or coaches, supervisors, consultants, etc) don’t solve problems but ask questions that enable clients to build their own solutions;
    • Problems never happen always and they vary in their intensity
    • Small steps can lead to big changes
    • There may be many routes to a solution that do not necessarily involve directly “fixing” the problem

    Solution Focused Practice is more than a set of techniques

    Origins
    SFBT developed by Insoo Kim Berg, Steve de Shazer & colleagues at the Milwaukee Brief Family Centre; 1980s

    Pragmatic not theoretical in development (but also shares roots with philosophy of Wittgenstein & Buddhist thinking)

    Observation of many hours of therapy: identified the questions that led to clients conceptualising & achieving viable, real-life solutions?

    ‘Brief’…the more time was spent on talking about what was wanted rather than about problems, the shorter the therapy tended to be!
    “Several techniques were found to operate like skeleton keys (deShazer, 1985), able to unlock a process of problem resolution without having to be tailored to the problem in question.
    Gradually, deShazer and colleagues articulated a set of assumptions and techniques named as SFBT. In practice these two aspects, assumptions and techniques, link to each other in a recursive manner. The techniques without the assumptions often fail to be of benefit, while the assumptions can be seen as propositions which can be tested out by using the techniques.”

    Wheeler, J. (2001) A Helping Hand: Solution-Focused Brief Therapy and Child and Adolescent Mental Health. Clinical Child Psychology and Psychiatry, 1359-1045

    Solution Focused Philosophy

    Future-focused
    About what is wanted not what is unwanted
    Solutions are not always directly related to problems
    Problems never happen always
    ‘Exceptions’ used to explore small successes
    Small steps can lead to big changes

    Solution Focused Approaches
    Central Pillars:
    • Establishing the preferred future – how would the person really like things to be in future?
    • Exploring exceptions to the problem – what are the times when what is wanted is already happening?
    • Identifying strengths and resources – how has the person managed, coped or achieved in the past?
    • Leads to consideration of signs of progress (and next steps)
    • Preferred Future – whose targets/goals?
    • Preferred Future is….
    • …about ends rather than means
    • …broader and more ‘aspirational’ than goals
    • …not necessarily “realistic”!!
    • …the key to finding out what the person really values and wants, not what they don’t want

    There are people at Edinburgh University who use and train SFP too: Steve Smith for example.

    It has been widely used in the last 20 years in various public sectors in Scotland.

    Go on – dip your toes in!!

    Steve Flatt
    The psychological Therapies Unit
    54 St James Street
    Liverpool
    L1 0AB

    0151 706 8163

  2. I have been an AHP in mental health for 30….31years this month!
    I can honestly say that 1 week of training in SFBT some 18(ish) years ago was the most useful of my career. I use some part of the philosophy almost everyday.

  3. As a Self Help Worker in South Ayrshire, I agree wholeheartedly with the idea of Thinking Differently. We all know ourselves what will make a difference in our lives. Knowing that someone is really listening to us and with a little help to recognise our inner resources and those around us, we can work together to achieve the healthiest life possible for everyone ………….

  4. I am also a self help worker in South Ayrshire and ‘thinking differently’ is a major part of my role.
    Not what “Can I do for you?” but “What can YOU do for you ?.”


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