A blinding light

An early use of flash photography, I learned from artist Anthony Luvera on World Homelessness Day in Birmingham, was by Jacob Riis who used flash photograph at the end of the 19th century to photograph homeless people flop houses and other previously unseen recesses of poverty. Riis was also one  of the first to use photography to raise awareness and change minds about a social issue. Images of bleary-eyed, disorientated people, dehumanised as much by the sudden flash of light as by the effects of poverty, set the tone for a century of representations of people going through tough times as objects of pity and fascination.

Luvera was speaking at the launch of Construct, his participative photography project, which began with him spending time with people at homelessness support services, getting to know people, and then helping them to take their own ‘assisted self-portraits’. Here is a little of (roughly) what I said for my bit at the launch:

I’m struck by the way that Anthony challenges the traditional idea of the artist as lone genius, taking his subjects, and creating his art from them.

Charities leaders are often uncomfortably close to that traditional model of the artist: inspired by the people we work with, but ultimately creating our unique vision for our organisation, for our ‘beneficiaries’, ‘service users’ or in the most up-to-date jargon, ‘customers’. Around the time that Jacob Riis was both bringing a social problem into public consciousness, and dehumanising the people he wanted to help, charities and early public services were still very much working in the tradition of the Poor Laws, which sought to help, control and punish in equal measure. We like to believe we’ve escaped those roots, but the image of the camera flash momentarily engulfing the scene of someone’s suffering in its glare brought to mind the way that every ‘support journey’ in our modern community services, starts with the brutal glare of the Needs Assessment: a slice through everything that is going wrong in someone’s life, in which the goal, if you want any help, is to display every possible need, risk and problem.

Anthony and some of the work of Construct

The art we are launching today starts with a relationship, and it’s clear that how it’s made is as important as what is created. We heard from Mauvette earlier that her participation in the project was more than a snapshot, it was an ongoing relationship, and the fulfilment of her long-held dream of being a photographer, not just Anthony’s. The potential for social change was all the greater. The co-created portraits do not fetishise suffering, vulnerability, or heroic battles. People present themselves as they are: human.

Eschewing the easy snapshot of a ‘subject’, in place of a painstaking processing of getting to know each other: there is a lot that we in charities and support services could learn about how to start real conversations and see whole people.

Birmingham’s Choir with No Name, including some of the Construct artists, perform at the event

How do national networks create system change?

Do national networks create change? I’m involved with three networks which are coming together as part of HumanLearningSystems Week to share their core change ideas:

This session will explore how alliances and movements are trying to achieve system change within public services, co-led by three prominent networks:

  • Human Learning Systems is an alternative approach to public management which embraces the complexity of the real world, and enables us to work effectively in that complexity. HLS will present on learning organisations (Gary Smith, Plymouth City Council)
  • New System Alliance is a UK wide alliance of people and organisations working to change the systems people come up against when they experience tough times will present on strengths-based working. I’ll be joined by our coach and learning lead Jhoana Serna.
  • Think Local Act Personal is a national partnership of more than 50 organisations committed to transforming health and care through personalisation and community-based support. The partnership spans central and local government, social care providers, the NHS, and the voluntary and community sector as well as people with lived experience. TLAP’s experts by experience will present on co-production

 A panel discussion will follow looking at questions such as:

  • What works and doesn’t work in pressing for radical change in public service systems?
  • Should change makers be disruptive or collaborative? Radical or incremental?
  • To what extent do/ should national partnerships like ours collaborate and compete?

The event is free online 10-11am 10th Oct. Register here

Does your area or organisation want to become strengths-based?

Have you ever wondered if your organisation could be more person-led and strength based in the way you work?

We are match-funding the costs of our strategic advice and consultancy offer for up to three organisations or areas! We must hear from you ahead of Sept 9th to be in the mix for this one-off opportunity.

Mayday offer strategic advice which draws on our experiences of radical organisational transformation and of developing the #PTSResponse: a strengths-based, person-led coaching alternative to traditional support work. We offer:

– System Reflect sessions for frontline & leadership teams who want to challenge themselves to think outside of current systems

Wisdoms people-led inquiries, to generate insights and ideas for action from a more diverse group of people who use – and don’t currently use – your services

– Organisational change support to look at every aspect of your strategy and operations through a strengths-based lens.

Our work ranges from working with a small grassroots soup kitchen and food bank which wants to remain person-led in its journey as it becomes an established local charity, to working with health and council partners in a London borough to introduce multi-level change to tackle inequalities through a combination of new support approaches and system redesign.

We have secured funding to enable us to offer a 50% discount to a small number of places or organisations. Contact robert.white@maydaytrust.org.uk or download our services brochure to gather more info.

Can you help lead and grow Mayday Trust?

In his rather touching farewell blog, my colleague Robert White, who is leaving on a jet plane in the direction of Australia in November, gives a sense of the adventure it’s been over the last two years, moving from a local authority commissioning role to work in one of the sector’s most radical, change-hungry charities at Mayday Trust. It’s worth a read, particularly if you are interested in applying for the role of Director of Development, Income and Impact (closes 20th July) which is essentially the role Rob is leaving at the end of October this year. Rob has been driving our income-generating and partnership building work with councils and provider organisations who want to do public services differently, whether that’s through employing their own strengths-based, person-led coaches, or pursuing whole-organisation or whole-system change. It’s an exciting role, at the heart of our ambitions and part of a small senior team that’s a lot of fun to work with.

Rob captures something about the work of the coaches, whether our colleagues in Mayday, or the 20 odd coaches working in other charities we’ve supported to adopt the model, which I think is central to what makes them special. He says he is constantly amazed by how coaches “are able to hold a relationship that can be so fragile and support people to see the best in themselves, whilst vehemently challenging the injustices they see around them.” That combination of delicacy in building support relationships that feel much more human than so many traditional support relationships, coupled with the tenacity and passion to see and challenge injustice, exclusion and inequality, makes the coaching role uniquely valuable and needed by people who often say they feel listened to and human for the first time in ages. It also makes it uniquely challenging to learn and deliver. As Rob says in his blog, it’s a huge privilege to witness and support coaches doing that work. I’m hugely grateful for the work that Rob has done to bring Mayday and that work to more people and new areas, including our new beacon area of Haringey in London. He will be a tough act to follow. If you want to give it a go, and think you can help us to build our ambitions, income and impact, do please get in touch!

Do strengths-based approaches work?

A 2021 literature review (Caiels, J, Milne, A and Beadle-Brown, J. 2021. Strengths-Based Approaches in Social Work and Social Care: Reviewing the Evidence. Journal of Long-Term Care, (2021), pp. 401–422.) (shared on twitter recently by former King’s Fund policy lead and author, Richard Humphries), came to the familiar conclusion that it’s promising, but hard to pin down as a concept and the evidence is still not there.

The authors helpfully note the difficulties in producing traditional kinds of evidence (eg RCTs) for complex cultural and system changes like the shift to strengths-based working. If a system change is hard to define and imperfectly implemented, who would the control group be in a traditional research model? How can you confidently attribute a positive outcome to a strengths-based service intervention, when many factors can be affecting someone’s wellbeing?

They note briefly at the end that the “review may be limited by the lack of evidence in a relatively under-researched area of practice.” This is in fact the key fact here, and is worth setting in context.

Vast sums are spent on evaluating mainstream public service responses and they often produce robust evidence due the large sample sizes available. Tiny sums in comparison are spent on emerging models. They often find promising results, as the recent new economics foundation evaluation of our work did, showing that the PTS Response enabled people to take control of their support and reported huge improvements in their wellbeing including an increase in self-esteem, sense of purpose, and optimism, as well as better mental health including feeling happier, and a reduction in anxiety (report here). But their small scale limits their impact in the context of large scale established services and associated research programme.

This evidence trap is not incidental: it is a fundamental driver against innovation in public services, which set extremely high evidence bars to introducing new approaches (in comparison to the private sector which often tries something, and switches to the new approach rapidly if it appears to work better) while spending tiny amounts researching emerging approaches. This is ironic, because there is vast evidence of the ways that current service models do not work. Mainstream homeless support services for instance typically have little evidence of consistent effectiveness in helping people achieve long-term housing security. But that context is rarely considered or presented by studies such as this one, leading us to think about the evidence for new approaches as if it exists in a vacuum, leading us to ask, Is this new approach proven to be highly effective? Whereas a more realistic question is nearly always, Does this new approach appear to be less problematic than the current one?

Academics invariably unconsciously present themselves as impartial and apolitical, whereas researchers, like the rest of us, are deeply embedded in and influenced by the current public service and its system. An enquiry into strengths-based approaches is inevitably done by someone who has been conditioned to see deficit-based service models as normal and neutral, rather than as, say, institutionally ableist, sexist and racist.

In my book, I argued that public service researchers are unwittingly part of an “academic-public service complex” and to see that and have some chance of escaping it, need to abandon the fantasy of themselves as neutral. Like everyone with power in public services, they – we – are privileged. We either acknowledge that or don’t, but we can’t make that fact disappear. I argued that the impact of this can be lessened by co-designing research funding, programmes and projects with people affected by public services (at present only commissioners, politicians and people leading organisations with large budgets get to do this – again, not a neutral group), by working with peer-researchers and by engaging with the political nature of all public service related activity rather than pretending it doesn’t exist.

So it is indeed unarguable that the evidence for strengths-based approaches is currently patchy and incomplete at best. And also unarguable that deficit-based approaches are harmful and unwittingly or sometimes consciously abusive. Presenting only one of those facts is unconsciously political.

How can social prescribing be strengths-based?

I’m grateful to Prof Becky Malby who leads the Health Systems Innovation Lab at London South Bank University for hosting a guest blog on our work to bring strengths-based person-led working into social prescribing with Bridges Outcomes Partnership. The blog draws on learning from our PTS coaches Lilly Broujerdi and Shauna Hemphill who offer coaching to people with long term conditions. They say, “A diagnosis becomes an identity. People will introduce themselves as their long-term health condition and their deficits, thinking that’s what we are there to talk about. They are used to clinical and formal environments which focuses on things they cannot do, or things that ‘other’ them such as groups for people with certain long-term health conditions”. A common comment heard by coaches is that they are first person who “actually listens to me,” and “makes me feel like a ‘normal’ person”. 

The blog is here: https://beckymalby.wordpress.com/2022/06/22/shameless-sharing/ and you’ll also find there Becky’s fascinating thinking on reforming primary care.

International shared living gathering

The New York Alliance for Inclusion and Innovation is hosting a virtual gathering on shared living initiatives around the globe: Home is the Heart of Shared Living: An International Gathering on November 3 & 4, 2022 via Zoom. I’m looking forward to joining the opening panel and hearing from shared living initiatives from other countries.

The organisers are keen to hear from people and organisations which want to present, especially people with their own experience of shared living. You can submit proposals to speak here.

Language barriers

Can changing the way we talk change the way we think?

At Mayday, we’ve always seen language as an expression of power and beliefs. It’s a window into how people and organisations think, and it’s a way of passing on their belief systems to new people as they join the organisation. So challenging and changing language can be a way into a conversation which isn’t just about the way we talk but the way we act. I was reminded of this after a conversation with Jane Devine of Foursquare, a progressive Edinburgh charity supporting people who are homeless or at risk of becoming homeless, who wrote this piece on jargon for the Scotsman. I am a fan of Bryony Shannon’s Words that Make Me Go Hmmm… blog on language in social care.

There are dangers in language wars though. Challenging words only gets you so far, particularly if you do the easy bit of changing the words without the hard part of changing how we act. I wrote about the language of ‘customers’ and ‘customer service’ in public services, in my book, to argue that changing the language used within organisations and systems can often be a substitute for changing behaviour and beliefs, with the new softer-sounding language adding a coating of irony to unyielding bureaucracies:

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Moving on?

When is the right time for someone to move on from support?

Much traditional support work works to a tightly-defined timescale and has targets about ‘moving people on’.

Some services offer people a Catch 22 situation: on the one hand, we will become what may be the only supportive relationship in your life, in which you may be required to organise your life around that support, or even move into our building, but on the other hand you mustn’t feel dependent on us, and we will end that support and leave your life as dramatically as we entered it, on our terms and at a time of our choosing.

Mayday’s PTS strengths-based coaching, which we offer ourselves and support a growing network of other charities to offer, has some core principles, and one is that people begin, pause and end their coaching as much as possible on their terms. So, coaching cannot be imposed, and it focuses on what feels most important to them at the time. It can be paused -if someone doesn’t want to see their coach for a while, we don’t regard that as ‘non-compliance’ or ‘close the case’; we are patient. And our aim is for the individual to reduce and end their coaching, having filled their life with more confidence, more meaningful relationships and activities, and a bigger support network outside of services.

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More freedom to practice, tighter grip on data

At Mayday Trust, we recruit PTS Coaches using a highly values-based approach so that the organisation can trust coaches to take on unusually autonomous roles, with a lot of freedom to act for the coach and the individual they are working with. We recruit people who love to reflect, share their work and communicate with their peers, and provide opportunities to do that regularly, which reduces the need for the expensive and time-consuming processes which many organisations use to check and monitor their staff. People can come to coaching on their own terms, with more choice about what information they share with us, and we enable them to set and change their goals, rather than doing that for them.

All that freedom could lead to us having an unclear picture of what the impact and outcomes of the work is. So that freedom for people to choose and control support relationships at the practice end, has to be matched with an unusually strong focus on tracking outcomes and learning which sits behind that practice. Many organisations which collect a lot of data, are also rigid in the services they offer and how they manage staff, but if data collection is done effectively, and it is showing that support is working, it should allow for more rather than less autonomy. One of the ways we collect data on outcomes is using WEMWBS scales. Ashraf Hamzah, Head of Social Impact at Mayday Trust, describes our journey to introduce WEMWBS and reflects on its value in this blog for the What Works Centre for Wellbeing. Lilly Broujerdi and Shauna Hemphill, who are coaches with Mayday Trust in East Northamptonshire, reflect on what it’s been like to use the outcome measuring approach in real life, its limitations and what we’ve learned here.