Michael Smull on One Page Profiles

Michael Smull speaking in Texas

Michael Smull sent out the following message to people on the Learning Community for Person Centred Practices general mailing list today, he's given permission for us to share it.

"In our efforts to support people in have lives of their own choosing within their communities we have developed an array of practices, skills, and tools. Notable among them are 1 page profiles.  They are both powerful and remarkably useful.  They have made significant differences in the lives of people and have been a critical part of making positive changes in practices.  One page profiles are not meant to be a complete picture of a person, rather they are a snapshot that introduces the reader to the person, outlines what matters most to that person and gives the top tips for support.  Part of their power is in their brevity and that, done well, they are visually attractive.  They are a powerful “tool” in changing how people are perceived and supported.  But they are not powerful simply because they exist but because of their impact.  People who use services, their families, and those who support them have given us story after story about how they have helped in their efforts.  For some people part of what was powerful was the learning that that takes place in development.  For many others it is how effective they are in introducing someone and advocating for them. 

 

A test for something being person centered is that it works for humans.  If it just works for disability it is clinical.  When we apply this test for 1 page profiles we see that can be helpful in a variety of human circumstances.  My 1 page profile as a trainer (on the learning community’s website) is very helpful for those asking me to do training.  With teams, I have facilitated a process for them to develop 1 page profiles on each other and team members find that they are then more effective in working together.

 

There are so many stories about the efficacy of 1 page profiles from so many places that I find it difficult that anyone paying attention can criticize them as ineffective. This is not to say that they cannot be poorly done or badly used.  They are a means not an end. They are not a “magic bullet”, they are not the only thing that needs to be done to change practices, but they are key part of what I teach and coach.   Criticism of those done badly or done just to be “trendy” is justified and useful.  Broad criticism flies in the face of the reality of their impact.  But that criticism has occurred. The criticism I have seen suggests that we are promoting  one page profiles as an end.  Yet if you read the stories associated with the profiles you see that it is how it was used not just that it exists.

 

Because 1 page profiles are being criticized we need more stories.  If you could take a few moments and share your learning it would be very helpful.  Clearly we want stories that illustrate the breadth and power of their use.  But, because we are learning community, we also want stories that illustrate your learning in what was required to make them useful.

 

Thank you.

 

Michael"

One Page Profiles: Just Garnish?

One page profiles are a simple person centred thinking tool that sum up what people like and admire about a person, what's important to that person, and the best ways to support that person on a single sheet of paper. Their simplicity and practicality means that they are becoming very popular, they are an easy first step in the person-centred journey. The growing uptake of these tools however  has inevitably meant that they have also invited criticism, criticism which gives us an opportunity to think more deeply about the best ways to use one page profiles, their benefits and their limits.

Last week Simon Duffy tweeted what looks like a quote from Peter Kinsella at a big everyday living conference "One Page Profiles are just garnish, they make no difference".

This is a 'black swan' statement. Find one black swan and you prove that the statement 'there is no such thing as a black swan' is pretty unfounded.

As a black swan statement, all that's required to prove that particular tweet wrong is one example of a One Page Profile that has made a difference for somebody. And of course there are many more than just one example, all kinds of examples and stories of one page profiles that made a difference are posted on the '100 One Page Profiles' blog. Stories are statistics with souls, and the list of stories on that blog is only growing longer and richer.

Sweeping statements that dismiss One Page Profiles and other pieces of person centred thinking as 'just garnish' are therefore pretty unhelpful and easily disproved, though to be fair to Simon and Peter, maybe the statement would have been phrased better if it was not constrained by the 140 character limit set by twitter.

 A more helpful statement would have been 'some one page profiles are just garnish and make no difference'. We could then investigate what makes the difference between one page profiles that achieve change in people's lives, and those that don't, so that we can work to create the conditions where more of the first kind are produced. This is the purpose of the Learning Community for Person Centred Practices, which develops person centred thinking tools, shares them and then gathers learning about the best ways to use them to ensure that people win more choice and control in their lives. You can also find TLCPCP on facebook and twitter.

There are however some more thoughtful criticisms of One Page Profiles out there that we need to consider seriously because they will help us work better at increasing choice and control in people's lives. Below I'm listing some of these criticisms, and giving what I hope are some  equally thoughtful and constructive responses, the beginning of a respectful learning conversation:

1.    "One Page Profiles are only for disabled people, so having one labels you as disabled"

We would argue that one page profiles have many many uses, with applications for many diverse people, including non-disabled people and situations that are nothing to do with health or social care.

 

On the 100 One Page Profiles website, there are examples of one page profiles used in mainstream schools, in a couple's birthing plan, to find a nursery, to help people know how to speak to a recently bereaved woman, as a way of applying for a job, as a method that an employer can support their staff. People are inventing new ways to use one page profiles in almost every aspect of their lives.

 

We also use one page profiles in our own work as trainers and planners, we share our own profiles with the people we serve, and their families before we ask them to share anything with us. We see one page profiles as being useful in many different people's lives and work, and not as something exclusively for disabled people.

 

Because they increase the amount of choice and control in people's lives however, we're do find one page profiles particularly useful in the lives of people who have less choice and control in their lives as a consequence of society's attitude to the presence of ill health or disability.

2.    We shouldn't use any predetermined tools or scripts. If we properly listen to people we can improvise and adapt our approaches in a way that suits that person.

 

There are a few, absolutely brilliant and charismatic facilitators out there who have the ability to facilitate person centred thinking and practice 'on the hoof'.

The rest of us however don't share this level of confidence in our abilities, many of us may be new, inexperienced and nervous, and therefore find tools that prompt and structure our discussions in a direction that inquires into a person's gifts and skills and that seeks out what really matters to them very useful.

 Having such simple tools means many more people can practice and experience person centred thinking. They democratise the practice rather than leaving it in the hands of a small and gifted elite, and mean that many more people get to benefit from more person-centred support in their lives.

 We also hope One Page Profiles will replace those much more complex and negative tools that services traditionally (and many still currently) use. Assessments and approaches that focus on what a person can't do, that inquire into people's incapacities rather than their capacities, that consider health and safety without also considering what really matters to a person and which implicitly regard the person as a problem to be solved are doing great damage to people, saddle them with negative reputations, and lead us to support them in paternalistic and overprotective ways.

 

Replacing such segregating deficit model tools with simple tools that focus on gifts and capacities and on connecting a person into the community is part of shifting the whole culture of health and social care toward a different way of regarding people.

 Of course we must endeavour when we use one page profiles, to do so in a way that respects the person's preferred methods of communication to be sensitive to what really matters to that person. We need to keep learning about what helps this work best.

 

3.    Sometimes One Page Profiles are just superficial lists of likes and dislikes.

 

Like any tool, there are useful ways of using them and ways that are less useful. I don't prove that my screwdriver is useless just because my shelves fall down, I prove that I need some help and advice to use my tools better.

 Using a one page profile well, to structure a meaningful conversation and to delvier change, requires a real intention to discover what's strong and valuable about the person, and a determination to find ways to support that person that make sense for the person, as well as a genuine will to act on whatever is learned.

 

To be able to write one page profiles with others, we therefore require that people have first written and used one page profiles themselves in their own lives, to gain an appreciation of their potential to make a difference when used well, and to ensure that we don't ask people questions that we have not been prepared to answer ourselves.

 

4.    Introducing One Page Profiles En Masse would lead to tickbox planning.

This is a real risk if one page profiles are implemented by people or systems that don’t care about one page profiles or the people they are supposed to be supporting, and don’t endeavour to train people well in how to use them. Such people implement changes to 'meet targets' without thinking more deeply about the purpose of such changes.

 

In such a scenario, we’d be likely to see plans that are just superficial lists of likes and dislikes. This would be far less harmful than continuing the implementation of tools that focus on deficits, but would not lead to the change we wish to see. Just like any other approach, one page profiles rely on genuine intent to listen well and to act on what is learned, and if change is to happen this intent must be reflected at every level.

 

Where people really are stuck in structures and systems so deeply imbued with this target-driven cynicism, then measures like personal budgets that enable people to seek support from outside such systems are going to be helpful. Good person centred thinking helps with good support planning and helps people use their personal budgets most effectively.

 

We'd also advocate other methods of cultural change within these structures, that shift the conversation away from targets toward the meaning and purpose of the work, and toward practical ways of bringing about system change.

 

5.    There are some things we don't wish to share about ourselves

Don’t share those things then!

 

It’s up to the person what they choose to share in their one page profile. It helps to think about what the purpose of the one page profile is, and therefore who needs to see it, as well as what they need to know and do to support you well. These questions help focus us on what needs to be included in a one page profile, and which people it would be shown to.

 

6.    One Page Profiles are not a panacea

One page profiles will not solve all the problems inherent in health and social care or in our disablist society. If you’re looking for something that does, keep working hard! We’re right with you! In the meantime people still need better lives that mean something to them, and better supports delivered in a way that makes sense to them. In an imperfect and confusing system and a society rife with unjust power and resource distribution, every tiny bit of choice and control we can win back in our lives is precious.

 

7.    One Page Profiles could become a substitute for doing more detailed person centred planning.

 

There’s definitely a risk that someone could write a one page profile and say “And now my work here is done”. However as we explain in this paper, the one page profile is just a first step in the person centred journey. There are many other tools that do equally useful jobs: communication charts, staff matching tools, tools that help us explain to staff their different roles and responsibilities, learning tools, community connecting tools, tools that help us move toward our dreams and avoid our nightmares. These tools are there to try out and experiment with. Find ways to use them that make sense to you. Share what you're learning while you do!

 

Please don’t stop thinking together just because you’ve completed a one page profile! There is so much more to discover, and it could be great fun discovering it!

 

More info on One Page Profiles here: http://www.helensandersonassociates.co.uk/reading-room/how/person-centred-thinking/one-page-profiles.aspx 

 

Person Centered Approaches to Conflict with Max Neill

Rhizomatic Leadership and Meadian Networking

I'm interested in the way movements and their leaders have effectively delivered transformational change. It's quite different from the straightforward almost mechanical model that we usually begin to use when considering how to lead and how to deliver change.

The way we tend to construct organisations, and the way change actually happens can be quite different. We tend to build organisations with a 'pyramid' shape. A small group at the top, a larger number at the bottom. The group at the top sets standards and rules that determine how the whole organisation works. Every organisation has it's flowchart showing the lines of power and responsibility stretching down from the top toward the bottom.

When we apply this model to reality however, we find it doesn't match how human beings actually think and organise. It doesn't reflect the complex knots of different circles and coalitions we participate in, particularly when working to deliver change in a highly complex society. It gives a very false picture of who the leaders of change actually are.

The rigidity and inflexibility of pyramid shaped organisations means they can become obstacles to change and to the kind of coalitions that work. I was privileged to hear John McKnight talking in Preston a couple of years ago about how voluntary community organisations tend to be more 'circular', while companies and statutory organisations tend to be 'pyramid shaped', and that the interaction of such circles and such pyramids can be very problematic.

In thinking about this blogpost, I googled 'Rhizomatic Leadership' and found this PInterest board by Renee Charney. http://www.pinterest.com/rcharney1208/rhizomes-and-rhizomatic-leadership/  I haven't had a chance to speak to her or read her work, but in may ways the pictures of different kinds of rhizomes she has collected together in themselves show the 'knotty' way humans organise ourselves naturally.

In my experience of work for change in my own local area, people with affiliations to different local, national and international organisations, with very different cultures, belief systems, backgrounds, still often managed to network with each other in their every day work for change and to create productive results. These people were showing true leadership, prepared to take on each others ideas, be eclectic, experiment, and work together to see how things come out. Being doctrinaire, being 'pure'; insisting that your path is the only true path are all obstacles to such networking (Though the energy behind such single-minded commitment can be very useful to networks if ways of working together can be found)

Rhizomes are really really interesting. The biggest 'single' living organism in the world is a rhizomatic forest. To the eye it looks like thousands of separate trees, but under the ground, they have a single multiply intertwined and interconnected root system. If a piece of that rhizome root were detached and planted elsewhere, in the right conditions,  it would be capable of forming it's own rhizomatic forest. Rhizomatic root systems are strong because they go in all available directions, what nourishes one, nourishes all. Often they're hidden beneath the surface - people's unofficial, social and virtual networks being at least as significant as their 'official' position in a formal organisational structure. Chop down a tree, the rhizome that grew it is still there, nourishing more saplings!

Margaret Mead wrote a lot about forming networks of very diverse people around common goals, and a rhizomatic approach strikes me as being very similar - understanding that we gain when we're prepared to join with others, let the root systems that nourish us, also nourish them, and vice versa, what is a resource for one, is a resource for all.

David Towell blogs about this 'Meadian Networking' in his blog 'Networking for a purpose' with examples from the work done by very many different people and organisations with many differing interests and visions, to shift the culture of social and health care toward personalisation in the UK.

He uses a graphic developed by Margaret Wheatley and Deborah Frieze to argue that in any major cultural change process, there are 3 stages of emergence for radical new ideas and practices:
1.  A stage where small separate groups of individual pioneers develop groundbreaking countercultural ideas and new ways of doing things

2. A stage where these radical and experimental ideas are being applied in small areas, learning from this is happening and communities of practice are developing and sharing them, and then finally

3. A stage where these communities of practice themselves develop and network further into whole systems of influence that are much more widely accepted. It's easier when you see the picture he uses, so here it is:

 

From a network, to a network of networks, to a whole movement for social change"

 

So what implications does this have for people who wish to be part of leading person centred change today?

First of all I'd suggest that in terms of person centred practices, we're at a point in the transition between stage 2 and stage 3. The word 'person centred' is now widely used, the need for person centred practices and values is widely recognised, even if there are still many people unaware of the practical ways such change can be delivered. The practicalities need to occupy the space opened up by the aspirations before those aspirations become diluted buzzwords.

The experience of the UK suggests the deep value of being willing to network and connect with people with similar and values and aims, even where their way of doing things may seem very different - in complex multifaceted environments many different tactics may be necessary to achieve a single overall strategic aim: Any movement for diversity and inclusion, must by definition be diverse and inclusive. Sometimes this may lead to unfamiliar, uncomfortable and difficult compromises, but the most creative work happens when people with very different ways of doing things get together, and use the conflicts that happen between them as sources of productive energy rather than allowing them to become destructive rivalries.

To become part of  a 'system of influence' we need to work on what helps us influence: Our personal relationships, our work relationships, our online networks, all the multiple circles we inhabit where we can use influence. In areas close to us the chromatography of our influence will be clear, further away it may be fainter, and tinted with shades of the influence of others. This leads to the other role of influencers - finding ways to protect the integrity of the original values that motivated the change, without preventing the change. A subtle and difficult balance, but not an impossible one.

Keeping Fidelity To Person Centred Values

This is a question we need to keep thinking about: "How do we keep fidelity to person centred values?"

Because it's so clear that person centred thinking and practices are a neccessity, because of the heroic work of the pioneers of community living, of inclusion, co-production and self-direction, of rights and citizenship, the words 'person centred' appear on every health and social-care organisations' website. It's a phrase that gets bandied about at every management meeting, but we also know that these aspirations are not always backed by action.

It's particularly painful when some terrible institutional abuse is described in a news article. Then, almost inevitably. in their reply, the leaders of that organisation describe how 'person centred' their approach to care is. Every time this happens, it devalues the concept in the eyes of readers and encourages a cynicism that justifies inaction, some people already feel the phrase "person centred" is just part of a new social care jargon - though it's also very clear to many the difference between what truly person centred practice can be like, and some of the service centred practices they've experienced.

It becomes difficult for anyone who is new to Health and Social Care to discriminate between those organisations who think all they have to do to make their organisation personcentred is to stick the words into their mission statement, and maybe some colourful paper on their walls, and those organisations (and there are quite a few out there) who are seriously striving to bring about person centred change with the people they support in a variety of imaginative and innovative ways.

We need ways of ensuring people find the right trainers, with the right values, and ways that help trainers keep hold of those values, and maintain their hope.

We need ways of making sure that the organisations that do strive for person centred change are recognised for the efforts they're making.

We need stories that show what real person centred practice is like and the difference it makes.

We need ways that can help some organisations can break out of those self-deluding and complacent phrases "We're already person centred", "we do all that already" so that they can begin the journey that is the striving for person centred change.

The UK learning community for person centred practices (and the international community it forms part of) is one of the major ways that the above needs can be addressed - because it contains different people, with different backgrounds, experiences and perspectives and people who hold person centred practice dear to their hearts, making it a repository of the values that matter,

Our community must be a place where rich learning is shared, a place where we can celebrate and share the serious work that is being done for change. We must support each other to maintain good values and share the best tools and practices, tell those powerful stories of change and then find ways to share them with the world.

The way to respond to those who misuse the words 'person centred', who use it without reference to the deeply rooted values behind it and treat it as a mere buzzword or a passing fashion is to demonstrate practically in people's real lives the best of what being person centred actually means.

The word "Moron": It's dark and bloody history.

I got involved in one of those pointless twitter debates yesterday. I was trying to point out to a fellow anti-fascist who uses twitter, that if he understood the history of the word 'moron', he wouldn't use it against the assorted fascist and thug organisations we both oppose.

It's difficult to call someone out on the language they use. They very rarely see any problem with their language. Their view is that the problem is obviously with the person who is pointing it out. They're being too sensitive, a bit prickly, pedantic and trying to police our language is exactly what fascists do, isn't it? And fascism is such dark, evil and dangerous force that any language or tactic used against it is justified, surely?

My point is that the same antifascists who use the word 'moron' so freely as an insult, would never use words relating to race or gender as insulting epithets, and that if they were to spend the time to investigate the history of this word, the concepts it supported and the consequences of these concepts for hundreds of thousands of people, they would understand why they should stop using this word in this way.

So where did the word 'moron' come from, and what does it mean?

Like many of these words, it was invented by a member of the medical profession: Henry H. Goddard, a psychologist and eugenicist. It was used freely in his seminal work 'The Kallikak Family'

A moron in Goddard's definition was precisely defined (If you can call anything related to IQ measurements precise or useful) as someone whose IQ fell between 51 and 70, higher up the IQ scale than an 'imbecile' or an 'idiot'. As can be seen from the illustration, this "scientific" theory also got mixed up with moralising and class and race prejudices. This brutal classification of human beings was used to justify compulsory sterilisation in the USA.

Between 1907 and 1963 64000 sterilisations were carried out in the United States, with eugenic sterilisation programs being enacted in 27 American states. As well as people with intellectual impairments, many of these sterilisations were carried out against poor people and ethnic minorities. The sterilisation program in California was particularly inspiring to the Nazi party in Germany, and funding for eugenics research flowed from the USA, from wealthy foundations like the Rockefeller institute to German eugenicists such as Joseph Mengele. Eugenics was also popular in Britain; as much an ideology of the left as of the right.

People are not aware in general, that the first victims of the Nazi holocaust were the disabled. Nor are they aware that it was not jackbooted Nazi stormtroopers that carried out the killings of disabled people in the Aktion T4 programme, but ordinary doctors, nurses and medical staff. Some of these people were card carrying Nazis, others were apolitical people, convinced by the prevailing medical opinion of the time (held all round the world) that eugenics was an ethical, moral, economic and even 'kind' way of dealing with disabled people. The concepts enshrined in the word 'moron' and the classification and segregation of human beings by IQ, popularised by eugenicists in the USA and Britain, helped convince these ordinary people that what they were doing, the sterilisation and 'euthanasia' was OK, even "in the person's best interests", because someone who was so disabled could obviously have no "quality of life".

Nor is eugenics something confined to the distant past. Sterilisations of people with intellectual disabilities continued in North Carolina up to 1974. The state just a couple of weeks ago set aside a $10m compensation fund to attempt to assuage it's guilt to the 7600 men women and children whose reproductive rights were stolen by this brutal policy.

In this facebook thread members of The Learning Community for Person Centred Practices recount some of their experiences of what happened in North Carolina: Bill Allen said "It still gives me shivers! At one time, Sonoma Developmental Center (not far from my home) was a "leader" in the sterilization of people with developmental disabilities. Years after there were restrictions placed on this practice, I found myself at a People First Conference in San Francisco. It must have been 1982. I didn't have a schedule, so I just decided on a session and walked in. As it turned out, it was a panel discussion on sterilization. What made this particular panel different from any others was that everyone on it (men and women) had been sterilized at Sonoma Developmental Center. Even more surreal was that there was a pro and con side of panel participants. I have never forgotten that day. If there is a video or audio record of it, I can't seem to locate it. Whether they agreed with it or not, it obviously impacted the lives of these individuals forever more. When the discussion was over, everyone on the panel chatted with each other and just moved on. It may have affected me more than any other event in my life working with people with developmental disabilities. California needs to follow North Carolina and soon!"
Val Carmine said "A former director of Caswell Center (NC) told me that he would get calls and letters from people who had once lived at the Center as children. They were wanting to start a family and were asking if anything had been done to them at the facility. Unfortunately 100 per cent of those people had indeed been sterilized."

The word "moron" is still heard in the mouths of bullies and those perpetrating vile hate crimes against people with learning disabilities. It's a word that among other insults and demeaning language forms the background noise of many peoples daily lives.

In conclusion, the word "moron" was deliberately invented by eugenicists to prop up their theory of eugenics. The word "moron" was used to justify categorisation, segregation, discrimination, sterilisation, euthanisation and  attempted eradication of a whole segment of humanity. It is a word that people who know the history of eugenics and the consequences of this theory to countless thousands of disabled people know is dripping in blood. To object to people who should know better using it is not being 'over sensitive'. It is simply to ask that people with intellectual impairments be treated with the same respect as other victims  and survivors of eugenics theories and the Nazi holocaust.

Thinking Bomb

I found this nice app called 'Tagxedo' and put the URL of this blog into it.

This is what it came up with: