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.
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.
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.
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
I believe that one page profiles can be a powerful tool but how successful they are depends entirely on how they are used. I would say exactly the same about my charts (www.carechartsuk.co.uk). Different scenarios call for different approaches, and most environments can benefit from a variety of tools, but if people do not use them as intended they're not going to deliver the potential benefits. Perhaps the biggest risk is one you mention, that one tool is adopted as a blanket solution and the thinking stops there. Good management is required to avoid that trap.
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