Aim Consider the role of the Social Worker as a bringer/agent of change Objectives Familiarise ourselves with an anatomy of the change process Review likely responses to invitations/requests for change Consider the impact of loss Identify factors that promote engaging with change Introduce some models to help with decision making about change Engage in some case study work using some of these models Reflect on what sort of intervention will you offer? 4pm-anatomy of change.ppt

Change is: To make or become different Exchange for another Move from one to another (place) It involves:- Unfamiliarity and Uncertainty; Places, in which, people do not tend to dwell.

Bringer/Agent of Change Perceptions By statuteCriminal Justice Care Proceedings Mental Health By CoercionChild Protection Investigations Mental health, > Debility, Dependency By InvitationAdvocacy Provision of Support Services By Structural Intervention Community Development Projects

Changing behaviour is hard because:- Behaviour isnt at random but serves to meet certain needs – even if these needs are considered by others to be dysfunctional needs or have dysfunctional outcomes, this does not invalidate the need. It should come of no surprise therefore, that so long as the need remains the behaviour to satisfy it will also remain.

The Seven Steps of Contemplation Morrison (1998) I accept there is a problem I accept I have some responsibility for the problem I have some discomfort about the problem I believe that things must change I can see that I can be part of the solution I can make a choice I can see the next step toward change

Response to Change HIGHLOW Genuine Commitment Tokenism Compliance Imitation Approval Seeking Dissent Avoidance EFFORT

PHASEFEELINGS NumbnessShock – disbelief Wishing forRemembering Looking for Imagining Anger Guilt Disorganisation and despairAnxiety Loneliness Disengaged Disinterest ReorganisationEmotional regrouping around acceptance Relief Calm Loss

Learning Theories Experiential Learning tells us that: 1.Significant learning takes place when the subject matter is relevant to the personal interests of the individual concerned. 2.Learning which is threatening to the self (eg new attitudes or perspectives) are more easily assimilated when external threats are at a minimum. 3.Self-initiated learning is the most lasting and pervasive.

Social Learning Theory Tells us that: Individuals are more likely to adopt a modelled behaviour if it results in outcomes they value. (Bandura 1993)

Factors Promoting Engagement with Change Changer has: Some acknowledgement of need and relevance Some degree of say, power and control Some degree of responsibility and ownership Can overcome losses involved Can see some benefits Access to support Time and tolerance of relapse

Why is Partnership Important? It is a practice requirement for Social Care Workers in respect of: Legislative Frameworks Policy and Procedures Moral and Ethical considerations (GSCC CofP) Improved Outcomes

What is Partnership?.... A shared endeavour rather than a one- sided process in which the powerful expert diagnoses the problems and prescribes the solution, with little or no reference to the relatively powerless person – In short a partnership model is to be preferred to a medical model.... Thompson, N (1998) Social Work with adults in Adams, A Dominelli. L & Payne, M Social Work: Themes, Issues and Critical Debates, Basingstoke, Macmillan.

Successful Partnership With Parents: Shared commitment to promotion of childs welfare mutual respect and trust Recognition of: The unequal nature of power Parents own needs Service restraints Good communication skills Shared decision making

Agreements CAN Increase motivation to change Remind people of arrangements Offer the potential for shared work Provide clear expectations Create opportunities for review

But.... Obliging reluctant parents to sign an agreement which, in reality is a list of stipulations will do nothing to establish that vital ingredient, co-operation between the adults Turnard (1988)

Agreements: Turnards 9 Conditions Pro-Client Motivation Negotiated – not imposed Everyone can seek advice Respect for family views Clarity re tasks for workers Review The final version is agreed by all Unambiguous language Right of Appeal

The role and power of workers The expectations you have of the person/people How you (the worker) will respond to non-compliance Options and choices Identify specific goals How you are going to support/recognise early success (Ivanoff et al, 1994) They should also include:-

Force Field Analysis of Proposed Change DRIVING FORCES RESTRAINING FORCES CHANGE OBJECTIVES

Cost/Benefit Analysis of Proposed Change COSTS BENEFITS

Promoting Cause and Effect Thinking on Proposed Change ACTIONS LIKELY CONSEQUENCES

SWOT Analysis of Proposed Change STRENGTHS WEAKNESSES OPPORTUNITIES THREATS

Cognitive Dissonance Theory Tells us that: 1.There is a tendency for individuals to seek consistency and congruence between their cognitions (ie beliefs) and their behaviours. 2.Where there is inconsistency and incongruence between beliefs and behaviours Dissonance is created. 3.An individual will usually seek to minimise dissonance often by reducing the importance of the belief.

Motivational Interviewing What is it?: A therapeutic counselling technique that seeks to motivate change through negotiation rather than conflict. Although originating from within Psychiatry and Psychology regarding addictive behaviours its principles can be applied to any change related intervention.

The Four Central Principles of Motivational Interviewing 1.Express empathy by using reflective listening to convey understanding of the patients point of view and underlying drives 2.Develop the discrepancy between the patients most deeply held values and their current behaviour (ie tease out ways in which current unhealthy behaviours conflict with the wish to be good – or to be viewed to be good) 3.Sidestep resistance by responding with empathy and understanding rather than confrontation 4.Support self-efficacy by building the patients confidence that change is possible

Models of Intervention The Deficit model The Questioning model The Procedural model The Exchange model