Aim

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• 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
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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.

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Bringer/Agent of ChangePerceptions
By statute Criminal Justice Care Proceedings Mental Health
By Coercion Child Protection Investigations Mental health, gt Debility, Dependency
By Invitation Advocacy Provision of Support Services
By Structural Intervention Community Development Projects
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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.
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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

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Response to Change
EFFORT
HIGH LOW
Genuine Commitment Tokenism
Compliance Imitation Approval Seeking Dissent Avoidance
HIGH
COMMITMENT TO CHANGE
LOW
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Loss

• PHASE FEELINGS
• Numbness Shock disbelief
• Wishing for Remembering
• Looking for
• Imagining
• Anger
• Guilt
• Disorganisation and despair Anxiety
• Loneliness
• Disengaged
• Disinterest
• Reorganisation Emotional regrouping
• around acceptance
• Relief
• Calm

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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.

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Social Learning Theory

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

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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

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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

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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.

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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

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Agreements

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

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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)

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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

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They should also include-

• 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)

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Force Field Analysis of Proposed Change

• DRIVING
• FORCES
• RESTRAINING
• FORCES

CHANGE OBJECTIVES
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Cost/Benefit Analysis of Proposed Change
COSTS
BENEFITS
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Promoting Cause and Effect Thinking on Proposed
Change
LIKELY CONSEQUENCES
ACTIONS
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SWOT Analysis of Proposed Change
WEAKNESSES
STRENGTHS
THREATS
OPPORTUNITIES
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Cognitive Dissonance Theory

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

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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.

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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

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Models of Intervention

• The Deficit model
• The Questioning model
• The Procedural model
• The Exchange model