There Are Two Sides to Every Story Differing Perspectives of WWII Battles.
Every Generation Must Fight the Same Battles Again &...
Transcript of Every Generation Must Fight the Same Battles Again &...
“EveryGenerationMustFighttheSameBattlesAgain&Again”:RememberingAllTheVariables?WhySubjectiveShouldBeTheNewObjective
TonyOsgood
Abriefpersonalviewpointtoaccompanyakeynote
KeyPoints:
• PositiveBehaviourSupport(PBS)isablendofpersoncentredand
behaviouralapproaches
• Theconstellationoflegitimatedatashouldincludestoriesandsubjective
accounts:‘subjectivedata’canbegivenasmuchauthorityas‘objective
data’[ExplicitlyfavouringoneortheotherwilldamagethePBSproject]
• Technologicalsolutionstohumanproblemsgivesrisetotechnocratswho
holdmorepowerandstatusthanothers:thisisevidentinlanguageused
todescribepeople.Including,asaninherentcomponentofPBS,thevoices
ofstakeholdersmaymoderatetechnocratpowerandimprovedeliveryof
individualsolutionsandstakeholdersatisfaction
• PBSpractitionerscanprovidepracticeleadershipnotonlyinPBSbut
humansystemdesigns
• PBSpractitionerscancontributetotheknowledgeofthoseresponsiblefor
purchasingservices:PBSpractitionersmightthereforeengageinclinical
andpoliticalandsocialjusticework
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RememberingWhereWe’veBeen…Somewillrememberhowbehaviouraltechnologyhasbeenmisusedtosubjugate
individuals(Repp&Singh,1990):“Earlyeffortstoreducechallengingbehaviour
typicallyinvolvedarrangingreinforcersfornotengaginginthetargetbehaviour
andpunishersforengaginginthebehaviour.Thesepunisherswereoftenused
indiscriminately.Thatis,theywerenotreservedforthemostseverebehaviour,”
(Wagner,2002,p.284).AppliedBehaviourAnalysis(ABA)isnotunique:ifthere’sa
hammertobehad,someonesomewherewillwielditasifeveryoneisanail,no
mattertheobviousbenefitsofthetechnology-andmakenomistake,thebenefits
ofskilledapplicationofABAareremarkable.
Leavingasidethenotinsignificantalignmentfallacy(LaVigna&Willis,2016)
implicitinWagner’squote,itisusefultoconsiderhowthebehaviourof
interventionistsarose,wascondoned,andcontinued.PractitionersofPBSare
skilledatexpandingthemodeloffour-termcontingenciesbeyondchallenging
behaviourandtostaffororganisations,sometimeseventhemselves,toexplore
whythediscrepancybetweendescriptionofmoreconstructiveorstatus-
enhancingbehaviouralsupport,andtheavailabilityofitinsystemstookeento
adoptaversives,exists.Wemightsuggestnegativereinforcementofdefault
technologiessuchaspunishing.Wemightsuggestthatsurelythebehaviourof
thoseusingdehumanisingtechniquesislesstodowithpractitionerspersonally
failingtoadheretobestpracticebutthatbestpracticesthemselvesarealwaysset
withinaculturalcontext:itwas‘ok’touseaversivesanddehumanisingtechniques
because“theyworked”withpeopleno-oneelsewaskeentoworkwithatatime
whenpunishmentgenerallywascondoned.(PBSpractitionerswouldraiseaweary
pointhere:“worked”inwhatmanner,andforhowlong–foraslongasthestudy
lasted?Foraslongastheinterventionistwasbeingpaidtobepresent?Andif
otherswereabletoadoptconstructive,non-dehumanisingmethodstoenable
learning,whynoteveryone?)
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Manypeoplefoughtagainsttheuseofdehumanisingtechniquesbydeveloping
alternatives;notaninsignificantnumberofothersadvocatedforthecontinued
useofaversives(seeLucyshynetal.,2015forabriefhistory–butremember
historyhasahabitofrepeatingitselfforreasonsRobertPirsigpointsout;never
thinktheseargumentswonforever).Fromthesedebatesarosewhatwasto
becomePBSanditsplethoraofminimallyaversive,constructiveandfunctionally-
basedinterventionsthataimedforsociallyvalidity(Meyer&Park,1999).
FortheeditedbookBehaviouralIntervention:principles,modelsandpractices,
ScottiandMeyerchosetodedicatetheworkasfollows:“ToKevinCloughand
Danny,whosebehaviour,asthesystemfailedthem,ledtotheiruntimelydeaths,
aloneandwithoutfamilyorsupports”.TheythenciteDante:“Nakedtheywere
blownthroughthecirclesofHell”(1999).Whenitcomestotheirpersonal
dedications,botheditorschosethepeoplewholovethem,andthattheylove.
HowmanyinterventiongoalsindaytodayUKPBSpracticeconsiderfriendships,
loveandbelongingasdidtheseeditors?InthesamevolumeEvans,Scottiand
Hawkinsnoted,“Ithasbeenourexperienceindiscussionwithcolleaguesand
conductingworkshopsthat‘traditionalbehaviourmodification’isstillthe
predominantapproachtotreatingbehaviouralexcessesanddeficits”(1999,p.3).
IntheUKtherearemanyKevinsandDannystwentyyearson.Peoplebuyservices
thatinhibitandconstrainlives.Despiteourknowingmoreandmoreeachyear
abouthowbesttosupportpeoplewhosebehaviourchallengesthesystem,in
practiceweencounterlessandlessunderstandingoftheimportanceofvalues.(It
seemsaninverserelationshipexists:themoreverbiage,thelesstheaction.)
ValuesentwinethetechnologywithintheapproachwecallPBS.(Justbecausewe
coulddoesn’tmeanweshoulddosomethingtosomeone.)Andsoweencountera
‘PBSUnit’thatillegallyholdssomeonewithautism.Weencountera‘socialstory’
thattellssomeonetocomplywithstaff.Organisations‘adopt’PBSlikeafadyet
relationshipsandpracticesremainunchanged.TheUKisnotuniqueinespousing
onething,doinganother.TheUKislikethemusclebuilderonthebeach,often
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glisteninglyshowyandimpressivetocasualexamination:butwhenoneknows
thatmuscle-buildersachievetheirphysiquesbyensuringmusclesworkagainst
oneanother,andaren’tasstrongastheywouldhaveusbelieve,themetaphor
hintsatotheragendas.
Skinnersuggestedbehaviouralprinciplesinthemselvesarevalueless–likegravity,
lawsofbehaviourjustare:theycanbeappliedinmannersthatresultin
subjectivelyharmfulorbeneficialoutcomes–butsocananytechnology.
Therefore‘use’and‘misuse’areeasilyconfused–standpointmattershere.Here’s
themoralcrux:whodecides?Whoholdsthereinforcers?Dotheendsjustifythe
means?Andareallvoicestreatedequallywhenweseektoanswerthese
questions?PBSshouldconsidertheeffectofpowerandstatus.Ifan
interventionistisknowntohold‘thekeystogoodthings’isitthatorthereinforcer
thatmodifiesbehaviour?
ItiseasytoassumesuchthingsasoutlinedbyEvans,ScottiandHawkinsare
consignedtodarkcornersandancienthistory,thatsucheventsillustratehowfara
givensocietyhaschanged.Butabusescontinue,andpeoplewithintellectual
disabilities,childrenwithautism,likemanyminoritygroups,continuetobe
excludedandoppressed,andexperiencecontrollingtechnologies.“Whenthereis
abroadsocialacceptanceofagrouphavinglessaccesstotheirrightsandhaving
difficultyinhavingthoserightsupheld,systemsareseeminglyallowedtodevelop
which,mostlyunintentionally,allowabusetothrive”(RobinsonandChenoweth,
2011,p.65).WhatPBScontributesisachallengetocurrentpracticenormsand
valuesorassumptions.(Itseemseachgenerationmustfightthesamebattles
againandagain.)AsJimMansellwaskeentocommunicatetohisstudents,the
priceofsuccessisconstantvigilance.
Intervention(anyintervention–forcommunication,foractivities,fornewskills)
withoutcontextismerelystickyplastertherapy.Learningnewskillsand
competingbehavioursisrelativelystraightforwardbutiftheindividualstilllives
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withouthopeorloveorpeoplewhoarebotheredaboutthem,thenperhapswe’re
focussingonanimportantbutincompletework,aresponse,notan
accomplishment.“[A]ppliedsciencecannotaffordtoretreatbehindthemaskof
disinterestempiricism”(Evans,Scotti,Hawkins,1999,p.3).
Whobettertocontinuethefightfordecentoptionsforpeoplethanthoseoften
erroneouslyidentifiedascontributingtotheproblem?Isnotus,thenwho?Andif
nowisnotthetimetorememberhowPBScameabout,thenwhen?
…InformsWhereWe’reGoingABAisonlyonefoundingcomponentofPBS:apersoncentred,sociallyvalidand
constructivevalues-derivedparadigmwasequallycentral.Indeed,the
rapprochementbetweenvaluesandtechnologyisattheheartofPBS.Atendency
torelyondata(aswecharacterise‘objective’measurementsasproviding)atthe
costofstories(aswethinkofthevoicesofexperienceasbeing)mightprove
counter-productivefortheacceptabilityofPBS.Theinclusionofsubjective
perspectiveswithinPBSisoneofits‘uniquesellingpoints’.(Canweimaginea
scenariowhereaPBSpractitionermightfaceopprobriumfromcolleaguesifshe
forgetstogatherinter-observeragreement(IOA)databutfewerraisedeyebrows
ifshefailedtoconfirmthegoodnessoffitofheradvice?Manyofushave
encounteredplentyofdataminusIOA,plentyofinterventionslackingtheviewsof
thepersonattheheartofwork.Smallhabitsaccrue.)
PBSinpartgrewfromaprofessionaluneasewiththedominationofa
methodologicalbehaviouralparadigm:manyoftheoriginatorsofPBSdiscovered
whatmatteredtofamiliesandpeopleusingserviceswasnotsomuchreliabledata
andreplicabletechnologies,asbeinglistenedtoandinvolved.Theywantedgood
technologyappliedininclusiveways.Itseemsthesamedimensionsand
definitionsofgoodsupportusedbyfamiliesandpeoplewithdisabilitiesremain
unchangedovertheyears(Danforth,2000;Evans&Gore,2016).AsPBSgrows
adherents,practitionersneedtorememberthelessonsofthepastandbalance
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clinicalwithsocialvalidity,valueswithtechnology.PBSisnotanexercisein
rebrandingABA.
PBSisatacusp.Thereisanunderstandabledrivetosetstandardsanddefinitionsof
whatPBSis,howitisdone,andcertificationofcompetencies.Itisnaturaltohave
ourbehaviourandknowledgeaccreditedinordertohelppeoplerecognisetheskills
weclaim.Havingcertificationmeanswe’reconsideredcompetenttopractice.Tobe
certifiedmeanswe’vetakenaparticularprogrammeofstudiesorpassedatest
administeredbyabodyrepresentingtheinterestsofaprofessionalidentity.
Fundamentallycertificationisaboutqualityassurance.Butitisalsoabouta
professionalbodyacquiringcontrolofaskillorprofession.
Thereareconstructivebenefitstothisbutinherentlimitations.AsPBSgrowsin
significanceitwillbecomemoreformalisedandstandardised.Toremainrelevantto
people,PBSmustnotloseitsflexibility,itssystemicapproachtoworkingwith
environmentsandindividuals:asitstrengthensitsbodyitmustnotloseitsheart.To
focusoncollectingreliableandvaliddimensionsofbehaviouratthecostof
measuringsometimesmorenebulousbutneverthelessprizedoutcomes(suchas
qualityoflifeorpersonalgoalsofhumans),PBSrunstheriskofreplicatingtheerrors
ofthepast.Measuringwhatcountstoustoensureaccreditationmustalsoreflect
whatcountstopeopleusingtheknowledge.
TheSubjectiveNatureofObjectivity
StandPointTheory(SPT)seemsthepolaroppositeofpositivism(aguiding
principleofbehaviouralscience).SPTiswhollypost-modernandsuggestsour
individualperspectivesareshapedbyourexperiencesandmostvoiceshavea
relativepositiontoothervoices.Itsoriginscanbetracedtostudiesofslavesand
mastersinthe1800s.Ourbelongingtocertaingroupsorcultures,ourtraining,
accruetomakeusconceiveofwhatweencounterincertainbiasedways.Wesee
throughwhowethinkweare.Someonewhoisnotautisticmightmakea
judgementaboutthevalueofabehaviourshownbyanautisticwoman,for
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example-whois‘right’?Whilstmanyofusmayworkinthefieldofautismor
intellectualdisabilities,wecannotknowautismorintellectualdisabilitiesthrough
anylensotherthantheonewehavelearned.Myunderstandingofautismis
merelyonestandpoint.ThisaccountisbasedonotherstandpointsIcallresearch
orfirsthandaccounts,butalsomyexperienceasafather.Post-modernism*is
perplexingtomanyofusnotschooledinitinpartbecausewehavebeen
indoctrinatedinotherwaysofknowing.
SPTsuggeststheauthorityofpeople’svoicesrestsintheirdirectknowledgeof
dailyexperienceratherthanotherqualifications.Yourpositionimpactsyour
knowledgeandabilitytobeheard.Standpointsarenotfixedbutfluid:aperson
canbeamotherofanautisticchild,aBCBA,andanassociateprofessor.Sucha
personmightholdagreaterwarrantthansomeonewhoisnotofthoseidentities.
Historyhasshownusthatonepointofviewtendstodominate–ascientific
accountofanautisticlife,forexample.Notbecausethescientificstandpointis
right,butbecauseweadherecurrentlytotheideathatscienceholdsmore
warrantthanindividualexperiences.SPTcanbeexpandedtoconcludeone
methodtocounterthedominanceofoneviewistoincludetheexperiencesof
others.Soindescribingautism,anyaccountthatincludestheexperiencesof
autisticindividualsandresearchfindingsmaycarrymorewarrantforaclaimtobe
acomprehensiveaccountofautism.SPTnotesauthorityisoftenvestedinone
groupofviews(say,maleprofessionals)thatdominateanother(say,mothersof
autisticchildren).Subordinategroupsareheardlessthandominantgroups.Tatum
(1997)suggestspeoplemaymaintainbiasesagainstothersinordertostrengthen
theirowngrouporstatus.
*post-modernismisbroadlyskepticalof‘modern’rationalityasitispresented,especiallyinsocialsciences(Doesatriangleexistonlyinourminds?)Someonequestioningsimplisticaccountsofabsolutetruth(allyouneedtoknowabouthumanscanbegraphed)andnon-relativistideologies(thisisalwaysthecase),someonequestionningobjectiverealityormorality,ispost-modern.Theclaimofpost-modernismisthatscienceisnotwhollyobjective–humans‘spin’thedatatoaccordwithaparticularworld-vieworagenda.Truthiscontextualinpost-modernism.Whereveryousitalongthecontinuum,post-modernismdoesofferusefulconceptualtoolswithwhichwecanengagedominanttropes.Suchacriticalstanceisusefulbutsometimesequallyconfounding.
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Positivistsmighthuffatthispointandbemoan‘socialconstructionists’alittletoo
loudly,andbegintoargueitisofcourse‘self-evident’subjectandobjectare
distinctfromoneother-theymight,asDavidSilvermanadvocates,suggestpost-
modernistsdoanythingotherthanscience;butthentherearethepost-positivists
whosuggestourvaluesandtrainingandculture(ourwaysofbehavinginand
outsideourheads)doinfluencewhatweperceiveandseeandreport,regardless
ofthesulkingpositivistsinthecorneraskingoneanotherhowtheyaredoing.
Post-positivistsacknowledgebiasesontheirjourneytowarda‘fairlyobjective
accountofphenomena’.(Whereaspost-modernistsmightquestionwhether
realityexists,postivitstsmighthuffandsay‘ohcourseitdoes!Leapoutabuilding
toseehowwellyoufly’,whilepost-positivistsmightsay‘well,itdependshowhigh
thewindowis’).Positivistsmightargueknowledgeisbasedonabodyof(often)
replicatedfindingsaboutabaserealitywhereaspost-positivistssuggestthebest
wecanworktowardisanimperfectdescriptionofthisbasereality–theyeschew
absolutesinfavourofprobabilities.(KarlPopper’sfalsificationisanexampleof
post-positivistthinking,regardlessofwhatStephenHawkingssays.)
Regardlessofwhereyousitontheconstellationofparadigmsandfictions,we
mightagreeitseemsapparentthatalltoooftenthosedesigningsupportsystems
havenotmadeuseofthesethemselvesorforpeopletheylove.It’sinterestingto
askifadvocatesofcertaininterventionshaveexperiencedthesethemselves.
Peopledesignsystemsandinterventionsbasedontheirstandpoint.Iftheyhada
childusingspecialistsupportsystems,adifferentperspectivemightcontribute
differentdesigns.Evenifthedesignershavenodirectexperienceofusing
provision,involvingthepeoplewhodomaycontributetoasystemmore
responsiveandfitforpurpose.
Onestandpointaboutoldapplicationsofbehaviouralscienceheldconsequence
manipulationstobedominant,non-functionallydeterminedinterventions
legitimate,applicationofelectricshocks,shoutingandhurtingpermissible,allin
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ordertochangewhateverbehaviourtheyviewedasunacceptable–bethatone’s
smoking,self-harmingbehaviourorsexualorientation.(Ahistoricalodyssey
throughJABAisoftensalutary.)
Fromitsinception,PBSsoughttoincludethevoicesofpeoplewithwhomitis
applied:families,childrenandotherswhohadoftenbeenignoredaslacking
sufficientstatustobeheard.**Thepeoplewhoexperienceatechnologyhavea
vestedinterestintheirsubjectiveaccountsbeingheard.Technocratscanbenefit
fromlistening.PBSbalancestheknowledgeofthetechnocratwiththeexperience
oftheindividual.PBScanlegitimatelyconsidersubjectiveviewsasdata:
standpointsmatterinPBS.Thisis,ofcourse,apositionofcontinualtension.The
powerheldbytechnocratsmighteasilyswampothers.Includingthestandpoints
ofchildrenoradultsorfamiliesorstaffcanhelpcounter-balancethepower
practitionerswield.Powerissometimeseasytospotthroughethnographiceyes
thanothermodesofenquiry(Blaug,2010;Levinson,2010).
Oneobviouscontentionagainstincludingsubjectiveaccountsisreliability:butthe
realityseemstobeinter-observeragreementmeasuresdon’tmakeitoutofthe
classroomtoooften,meaningdatapresentedas‘objective’maynotbeanything
ofthekind.Theotherfactorisvalidity:doeswhatwemeasuremeasurewhatwe
say?WhatifQABF,MASetcmeasureindividualstaffopinionsandperceptions,no
more?Whatifourrecordingshowsachild’sbehaviourgainsattention,butour
analysismissesthechildgainsattentioninordertogainescape,too,oratangible
item,orafeelingofconnectednesswithsomebutnotallcarers?Ourstandpoints
informhowwecollectdata,whatdatawecollect,whichbehaviourwelookat,
andimportantly,howweinterpretwhatwe(subjectively)see.
**ThereisasceneinaMontyPythonfilm-TheMeaningofLife-whereawomanisabouttogivebirth.Sheissurroundedbymachinesandthetrappingsoftechnology,andsurroundedbythetrappingsofthepoweroftechnocrats.‘WhatshallIdo?’sheasksthedoctor.Thedoctorishorrifiedandresponds,‘Nothing,dear,you’renotqualified.’
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PracticeLeadership:ACalltoArms
PBSpractitionersoftenfaceacommondilemmainneedingtobeinfourplaces
simultaneously.Knowledgeiscostlytoacquire,expertiseexpensivetohireand
timeismoney:beinginhighdemandtohelpothersunderstandchallenging
behaviourandrespondtoitcoherentlyisbothanindictmentofthelackof
resourcesavailableandreassuringonewillneverbeshortofemployment.SoPBS
practitionersoftenworkthroughothers.
ThismeansoneofthechallengesforPBSpractitionersistobelesshero,more
hosttothelearningofothers.TogeneralisePBStoothers–parents,teachers,
servicestaff,peoplewithdisabilities–weneedtotrain&teachloosely.PBS
pracitionerskeeponeeyeonthetargetbehavioursthey’vebeenaskedtohelp
with,andoneeyeonthecompetenciesoftheecology(what’sreinforcingwhich
mediatorbehaviourthatcompeteswithPBS?)I’mhumblysuggestingwegrowa
thirdeyetokeepinviewouropportunitiestocontributetopracticeleadership.
Practiceleadershipisn’ttrainingasweknowit.Itisteachingbyshowing.(It’sthe
differencebetweentheoldapprenticeshiporlegitimateperipheralparticipation
approachtohelpingpeoplelearnaparticularsetofskills(Lave&Wenger,1991)or
culture,andgoingawaytoUniversity[ordoingstuffonline]fortwoyearstolearn
theoreticalresponsetohypotheticalbehaviours;it’sSkinner’spool-hallhustler
comparedtohisphysicist.)PBSpractitionersshouldthusremembertheverymany
hoursof‘formal’trainingtheyprovidewon’tresultinbetterqualityservice
automatically:“Trainingisonlylikelytobeeffectivewhenitissupportedby
managementleadership”(Mansell,1996,p.57).Trainingisinsufficient.Andhere’s
anissue.
Afteryearsofresearch,myoldbossbegantobefollowedbyalurkingsuspicion:it
followedhimalloverEuropeandAustralia,henoticeditathome,atwork,atplay.
Hesuspected…“Stafffeelthatmanagement’strueobjectivesarenotcongruent
withtheespousedcareobjectivesandthattrainedbehavioursdeterioratequickly
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atwork”(Mansell,1996,p.57).Mansellandcolleaguesbegantosuspectan
inverserelationshipbetweenseniorityandcompetenceregardingdirectworkwith
peopleusingservices:“justashouseleadersbecomelessskilledandlessinvolved
inworkwithclientsbecausetheyspendlesstimewiththem,sotheirmanagersare
evenlessuseasrolemodels”(Mansell,1996,p.57).
Ifmanagersaren’tconsideredlegitimatesourcesofknowledgeorskillsbystaff,if
theyarenotviewedasgoodexamples,leadershipwillcoalescearoundother
practitioners,becausepeoplewillorganisethemselveswhenajobneedsdoing.
Formaltrainingisoftenatoddswithpractice:arecipefordissonanceand
psychologicalcontractssnappingliketwigsinAutumn.IknowGaryLaVigna’s
soundbiteiswittyandoftentrue,thatthosewhodon’tknowhowtomanageare
managingthosewhodon’tknowwhattodo,butweallhaveexperienced
situationswherethosewhodon’tknowhowtomanagearemanagingthosethat
doknowwhattodoifonlytheywereallowed.Thisisthefirstlessonfrom
legitimateperipheralparticipationexperiencenotoftenespousedinthe
literature:toooftenmanagersknowlessthandirectsupportstaff.Oftenitisstaff
notmanagerswhoembodyandenactanenablingculture.
ItturnsoutJim’squalmscouldbetracedbackmanyyearstoothers,including
Gilbert:“Ihavefoundrepeatedlythataculturethatdoesnotworkwell-inwhich
peopleareunhappy,insecure,unproductive,anduncreative-wasdesignedbya
managerwhodidnotbeginwithcarefulanalysisofitsgoalsandvalues.This
analysis,thisteleonomicengineering,pursuesamethodastonishinglydifferent
fromthatofthesciences…Theengineerknowsinthemainwhatthegoalis,and
beginsbymakingadesignofthatendpoint”(Gilbert,1978,p.103).Gilbert,with
hismodel,showshowtoproducecompetentandincompetentecologies.
Gilberthelpfullyprovidedatabletoillustratethetacticsemployedtoengineer
incompetentperformance(Gilbert,1978,p.86);hesuggestsmostpeoplewill
recognisesuchtactics(p.12).
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Sd(Information)
[Antecedents]R(Instrumentation)[Behaviour]
Sr(Motivation)[Consequences]
EnvironmentalSupports
1.Don’tletpeopleknowhowwelltheyaredoing2.Givepeoplemisleadingdataabouthowwelltheyaredoing3.Hideexpectationsfrompeople4.Givepeoplelittleornoguidanceabouthowtoperformwell
1.Designthetoolsofworkwithoutconsultingpeoplewhousethem.2.Keepengineersawayfrompeopleusingthetools
1.Makesurepoorperformersgetpaidaswellasgoodones2.Seethatgoodperformersgetpunished3.Don’tmakeuseofnonmonetaryincentives
Individual’sRepertoireofBehaviour
1.Leavetrainingtochance2.Puttraininginthehandsofsupervisorswhoarenottrained3.Maketrainingunnecessarilydifficult4.Maketrainingirrelevanttothestudents’purposes
1.Scheduleperformancefortimeswhenpeoplearenotattheirsharpest2.Selectpeoplefortaskstheyhaveinstrinsicdifficultyinperforming3.Donotprovideresponseaids
1.Designthejobsoithasnofuture2.Avoidarrangingworkingconditionsthatemployeeswouldfindpleasant3.Givepeptalksratherthanincentivestopromoteperformanceinpunishingsituations
Fig.1Gilbert’sExampleofGrowingIncompetentEcologies(Gilbert,1978,p.86)
PBSpractitioners,becausetheyknowhowtodifferentiatetheirdiscriminative
stimulifromtheirmotivatingoperationwithouttheaidofasafetynet(a
textbook),cancontributetotheworkofleadersbysupportingthemtoactually
organisetheever-populardrinkinthebrewery.Further,becausePBSisablendof
personcentredandmoretechnologicaloptions,PBSpractitionersmaybeunlikely
topropogatetheideaofservicesasmachines;staffmatter(theyarenot
automatons,notyet),andinvolvingstaffisusefulatgainingtacitknowledgeof
what’sreallygoingon.Inpractice,manyPBSadvocatesfindmoreknowledge
amidstthesmokersinthegardenthanfrommanagersinfolder-lined,policy-
riddenoffices.Andallthisknowledgeaccrueswithouttheaidofadegree!(That’s
anothersalutorylesson:ifweonlylistentocertifiedequals,howcanwelistento
peopleusingservices?Ignoringisaslipperyslope,nottakingpeopleseriouslyisa
contagion.)
PBSpractitionersmighthaveinsightsintowhatthereinforcementfor
commissionerandcaremanagerdecisionsis,whatpayoffsoperateforservice
organisations,whatconsequencesariseformanagersgluedtotheirofficechairs.
PBSpractitionershaveanappreciationofthebootlegreinforcmentoperatingfor
staff,andoften,preciselywhatthepunishersandreinforcersareforinnovators
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(Mansell&Elliot,2001).(Innovatorsandwhistleblowersoftenareperceived
equallydoubtfully.)
SkillcomesfromtheAnglo-Saxon,meaningto‘discern’or‘discriminate’.These
daysskillsmeansyouhavebeenobligedtositthroughfourhoursofhealthand
safetytrainingtaughtbythemostboringindividualintheknownuniverseand
receivedacertificateofattendance.Youarepresumedcompetentifyou’ve
passedasimpletest(didthecandidatestayawake?)Itmayalsomeanyou’ve
completedFireTraining,ActiveSupportTraining,De-escalationTechniques
TrainingviatheInternet.Suchprogrammestendnottoresultinpeople
competentatdiscerningordiscriminating,merelyreproducingwhathasbeentold
them.We’velearnedtoteachpeopletocomplywithexpectedanswersmore
economically!(Aswe’velearnedtopassaccountabilityfortheconsequencesof
badteachingtothosetaughtbadly).There’sanarttodesigningtrainingtoensure
peoplepasstheexam,butit’sanartfewpeoplelivinglivesinservicesappreciate.
“Badsystemscreatebadsituationscreatebadapplescreatebadbehaviours,even
ingoodpeople,”(Zimbardo,2007,p.445).
ThirtyyearsagoBlundensuggestedquality-consciousservicesdrawperformance
indicatorsfromtheirvalues.(It’snotthenumberofteachingplansthatcount,but
thequalityoftheminhelpingpeoplelearn.)Blundennotedthatforgood
organisations,theviewsandexperiencesofcustomersarethekeyconcern
(Blunden,1988).Blundenarguedorganisationskeenonmaintainingqualityshould
focusonprocessandoutcomes,andthatthestructureofsuchorganisationsmight
belesshierarchical,moredemocratic,morefluid:“withsmallgroupsandtask
forcesbeingformedaroundthesolutionofparticularproblems.Theformal
structureoftheorganisationwouldnotbeallowedtogetinthewayofachieving
results.Staffwouldbeactivelyencouragedtoinnovateandtochampionnew
ideas.Therewouldberecognitionthatnotallnewideaswouldsucceed.Failure
wouldbetoleratedandlessonslearnedfromtheexperience”(Blunden,1988,
p.109-110).
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Blunden,drawingontheAmericanliteratureconcerningsuccessfulorganisations,
outlinedsomepracticalstepstoachievequality.Hefoundthatallstakeholders
shouldbeinvolvedin“definingandreviewingservicequality”(p.110)andthat
“theiractiveparticipationwillhelpensurethattheirinterestsarerespectedand
thatanydecisionsmadearelikelytobeputintopractice”(p.110).Givingpeople
usingservicesandthosepeopledoingtheworkalegitimatevoiceinhowthings
getdonecanhelpconstructaproductivecultureofpractice,itseems.
Blundenarguedoneofthechallengesforcommunityserviceswasthecreationof
aculturebaseduponsharedvalues;youcouldn’tsimplyemployanyonewithout
activelysupportingtheirlearningthroughtraining,coachingandmanagement.
Thismeantgoodmanagerspaidmindfulattentiontosuchthingsasrecruitment,
supervision,peerevaluation,andtheembodimentbymanagementandleadersof
thevaluestheysoughttoseeputintoaction.Staffandfamiliesandotherother
stakeholders,includingstaff,wouldnothavetosimplylistentotherhetoricofthe
organisation,buttheywouldseetheirmanagersandleadersenactingthevalues
everyday.IntheUKtoday,ifoneisreasonablyuprightandmoreoftenthannot
breathing,you’vegotajob.ArecentNHSleadershipcourseargueddemocraticor
dispersedleadershipwaspointless.It’shardlyencouraging,butsuchistheecology
encountetedbyPBSpractitioners.
BlundenalsocitedGilbert:botharguedhumanorganisationswoulddowellto
focusnotmerelyonbehaviourbutonaccomplishment.O’Brienadoptedthis
modelwhenhewroteoftheFiveServiceAccomplishmentsin1987.Whatpeople
doisthebehaviour.Whatpeopleachieveistheaccomplishment.Thereforewhen
reviewingthequalityofservicesitisimportantnotmerelytoconsiderwhatis
writtenandwhatpeopletellyou,notmerelytomeasurethepresenceofitems
assumedtoindicatequality,butwhatisactuallyachieved.(Doesthepersonhave
acareplan?Yes!Thereforethisisagoodservice!)“Itisunusualtoseeservices
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beingreviewedintermsoftheextenttowhichtheyenableclientstoexpandtheir
socialrelationshipsorlearnandeffectivelyusenewskills,”(Blunden,1988,p.111).
Blundensuggestshelpfulqualityassurancesystemsshouldbegearedtoward
action;alltoooftenthewrongindicatorismeasuredpoorlyandnotmuch
changes.(Ifweeachauditourselves,wetendtocomeoutasprettycoolhuman
beings.)Hierarchiestendtobureacractisesystemsandroutinisethem.Rationales
becomelostveryquickly.Rememberevenadysfunctionalsystemisfunctionalfor
somebody.EvenWinterbourneViewmetsomepeople’sneeds-tocoverup,tonot
bemorallyengaged,toprovideanoutofarea,out-of-sightprovision,tobully.
Blundennotes“theproceduresoutlinedhereseemlittlemorethancommon
sense”(p.114)butcommonsenseassumesalackofpolitics,alackofagendas,and
equitablepowerandfocus.Inthisway,commonsenseisnaive.Whatweknow
aboutpoliticsinorganisations,power-gamesinsystems,isthatresistanceis
fertile.Puttingvaluesintoactionishardanditrequirescompetentmanagement
andvisionaryleadership.“Howoftenismostserviceorganisationsdosenior
managersconcernthemselveswiththedetailsofhowtheserviceisinfluencingthe
livesofitsusers?”(Blunden,1988,p.114).WhatPBSpractitionersknowisthat
whentheyexamineecologies,theyencounterego-cologies.
Itisraretoseeactivepracticeleadership,managementbywanderingabout,
spendingtimeroutinelywithpeopleusingservicesandpeopleatalllevelsofthe
organisations.Thisisrarebecausestaffandpeopleusingservicesarenotreally
viewedasconsumers.Peoplewhobuyservicesareconsumers.Notpeopleusing
them.Notpeopleworkinginthem.
Practiceleadershipisanewnameforanoldskill:showingbydoing,leadingby
example,coaching,teaching,andbeingtheembodimentoftheculturetobe
grown.PBSpractitioners,knowingthefoiblesofhumansystemsaswellasthe
rationalscienceofouroftenseeminglyirrationalspecies,areunqiuelyskilledat
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leadingchangeandmodellingapproacheswithprovenoutcomes.Thereare
differencesbetweenmanagersandleaders:managersfollowthepathsetby
leaders;leadersdotherightthingwhilemanagersdothingsright(Bennis&
Nanus,1985;Shackleton&Wale,2000).
Commissioners:EnemyattheGateorPowerholdingOpportunity?
Ifsomeonedoesn’tknowhowtosingthePolishNationalAnthem,wecanteach
themtosingPolandisNotYetLost.Ifsomeonedoesn’tknowhowtocheckthe
‘facts’spunbypoliticians,wecanteachthemthat,too.Ifpeoplecan’treador
writeorbicycleorswim,that’salearningissuetobesolved.Ifsomeonedoesn’t
knowhowtocommissionaservicethatissuitableforthepersonwhoselifewillbe
livedtherein,canwenotteachthat,also?PBSpractitionersknowsomuchabout
hownottodothings,weshouldpassonknowledgeabouthowtodothingswell
tothoseresponsibleforbuyingsecond-rateprovision.Thisislessaboutresource
thanimagination;lessaboutclinical,moreaboutpoliticalenterprise.
Commissionersareskilledatbuyingthebestvalueprovisionthatturnsoutnotto
bethebestbyanyothermetric.PBSpractitioners,duetotheirknowledgeof
peopleandsystems,cancontributetothemakingofgoodandperson-centred
decisions.Wecanprovidereliableandvaliddataandstoriestohelp
commissionersmakemoreinformedchoices:here’swhyyoushouldfundthis,
here’swhyyoushouldn’tfundthat,andherearetheconsequencesforyouarising
fromboth.PBScanbescientific,person-centred,andpolitical.
BecauseintheUKbeingperson-centredinamanagerialistmilieuisanexercisein
callingbureaucratestomoralaccount-tomakeaccountancymoral-networksof
practiceandsupportarevitalforPBSpractitioners.Beingpartofacommunityof
practicecanprovideaplaceforidentities,aplaceofsanctuary,aplacefromwhich
practitionerscangatherstrengthandshareknowledge.Acommunityofpractice
identitycansupportpractitionerstoremainsaneininsaneplaces.
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WhentravellingaroundtheUK,inmeetingparentsandpeoplelabelledas
“having”behaviourothersfindchallenging,whenspendingtimeinprivateand
statutoryplacesofwork,PBSpractitionersoftenencounterthedominanceof
managerialismovervalues,theprocessingofpeopleasopposedtolisteningto
them,andoldpracticesthatneverwentaway.Thismustleadustowonderifwe’ll
evergettoValuingPeople.Thisalsoteachesusweneedtosupportoneanother
aswestrivefordoingwhatisrightwell.
PBSpractitionersthencancontributetothedecisionscommissionersmakeby
theirknowledgeoftheneedfor:
• Robust,reliable,validdatatoinformourconceptualisationofchallenging
behaviourandhowtorespondthatincludessubjectiveaccounts(wemight
thenseePBSpractitionersquestionthetropesmaintainingarelianceon
medication,restraintandotherarchaicpracticesto‘manage’challenging
behaviour,suchasaneedfor‘assessmentunits’[assesswhat?Assess
where?);
• Arecognitionofthebenefitsoflisteningandactingupontheexperiences
ofchildrenorpeoplewhohavefirsthandexperienceofPBS;
• Knowledgearisingfromexperienceandresearchinformingwhydangerous
culturescandevelop(wemightthenseePBSpractitionerstakealeadin
helpingorganisationsembedintheirstructuresinformedleadersand
methodsfordetectingearlysignsoforganisationaldysfunction);
• Providingcommissionerswithevidenceandstoriesofwhatworksfor
people(wemightseePBSpractitionersoffercommissionersstandpoints
thatcancontendwithdominatebeliefs.Wecanarmcommissionersto
argueforperson-centreddecisions).
PBSpractitionersmightfindthemselvesaddingtheirvoicestothoseofthepeople
theysupport,tocallforhumanrightstoberespected,forvaluestobeenacted,
andforpeopleineducationandservicestobeviewedasconsumersnotcattle;
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PBSpractitionersareengagedinasocialmovementforsocialjustice,notjust
clinicalexcellence.
ThedevelopmentofPBShasenrichedmainstreamABA;itisnowcommontohear
ofsocialvalidity,toembedcontextualfitproceduresintoclinicalwork,whereas
twentyyearsagothesethingswerenotascommon.Inthesamewayfunctional
assessmentandfunctionalanalysisarenowdefactoexpectationsofPBSwork,we
mustrememberthatestablishingthefunctionofagivenresponseisquitearecent
development.ThisisthegiftPBSbroughttotheparty.Perhapswecaninvite
commissionerstotheparty.
WhatPBSCanBringtotheParty
Engineeredsystemsforpeoplewithareputationforchallengingbehaviourneed
toencourageopen,questioningcultures,wherestaffareencouragedtothinkand
bepartofsolutions.Socialpsychologyisclear:groupsworkbetterwhenmembers
trustoneanotherandwhenthereisaclear,unambiguousgoal.Unclearecologies
canpromoteineptitude(Gilbert,1978).Callingonwhatwemighttermancient
history,“Manystudieshavefoundthattheexistenceofcohesivebondsbetween
co-workersisapre-requisiteforhighmoraleandoptimumperformanceofduties,
butthisdoesnotmeanthatallnormsthatariseincohesiveworkgroupscontribute
totheaccomplishmentofofficialtasks,”(Blau&Meyer,1971,p.49).
Bothfunctionalassessmentandpersoncentredplanningappealtothoseseeking
anunderstandingofapparentreinforcersandpunishersimpactingonan
individual’sbehaviour(Wagner,2002).Wherepersoncentredmethodsareartful
andoftenlookat‘thebigpicture’ofgoalsandaccomplishments,behavioural
approachesareembeddedinscientificculture,andoftenfocusonspecific
responsesthatmaycontributeto‘bigpicture’goalachievement.Personcentred
approachestelluswherewe’reheading,behaviouralapproacheshowtoget
there.GoodPBSpractitionersareskilledinboth.
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Whybothertoconsiderwiderecologocial(orego-cology)contexts?Without
understandingthesourceandpurposeofbootlegreinforcement,withoutknowing
competinginfluences,oursuggestions,evenifco-constructed,won’tamountto
much.That’sapragmaticanswer.There’salsothemoraldimension,aswellas
aligningourselveswiththelessonsfromthepast-ofnotcontributingtothe
powerlessnessofpeopleindistress.“Theliteratureshowsahighdegreeof
consistencyaroundthefeaturesofeffectiveapproachestoaccommodationand
supportforpeoplewithintellectualdisability.Theyarefundamentallylinkedtoa
focusonpositivesupportofpeoplewithdisabilityattheindividuallevel,andto
supportingandfacilitatingtheconnectionofthepersoninarangeofrelationships
andwitharangeofcommunitiesoftheirchoosing…Thesefeatureshavealsobeen
demonstratedtobeprotectiveofpeople’spersonalsafety.Thesefeaturesare
connected,however,toastrongphilosophicalandconceptualframeworkabout
controlandchoicebeingvestedinorclosetotheperson.Thehistoryof
accommodationserviceshasbeenoneinwhichcontrolanddecisionmakinghave
beenvestedinthestaffandmanagementwhoworkintheservices,”(Robinson
andChenoweth,2011,p.66).
Therefore,whenweteachPBS,whenwepractice-leadPBS,dowestressperson
centredecologies,attitudesandinteractions,asequallypowerfullyasbehavioural
methodologies?Whenweteachdoweemphasisecritiquesandlimitationsas
robustlyasweadvocateforfunctionalassessmentandanalysis?Whenweteach
PBS,howdoweteachpractitionerstogaintheviewsoffamiliesandpeople
requiringsupport?Whenweteachphysicalinterventions,doweshowthe
researchfocussedontheviewsandexperiencesofpeopleonthereceivingendof
suchapproaches?CouldweasPBSpractitionersdomoretoenhancethequalityof
lifeofpeopleweserve?Canweinfectthosesupportingthepersondailywiththe
passiontoseetheindividual’sgiftsaswellaschallenges?Supportingsomeoneto
learnhownottoneedtohurtthemselvesisnobleandconstructiveworkbut
leavingthemfriendlessandwithoutvoiceinpoorprovisionisunsupportable.
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Itisoftenthecasesurvivorsofmentalhealthprovision,parentsofyoungpeople
sentmilesfromhometosocalled‘assessmentandtreatmentunits’,peoplein
servicesgenerally,speakoftheiropinionsnotbeingconsidered,perhapsbecause
thestandpointofprofessionalsissopowerfulcomparedtopeopleusingservices.
Parentsandpeopleusingservicesareoftenlonelyandunheard.
CanPBSasafamilyofapproacheslearnfromtheseunsavouryandgeneration-
longexperiences?InmanywaysIwouldagreethattoprogress“weneedmore
evidenceandlessideology”(Rowe&Rudkin,1999,p.154)butideologyandvalues
informwhatisresearchedandcitedasevidence.
Wehavelearnedaspractitionerstoaskdifficultquestions,becauseourworkis
notsosimpleassayingJane’sbehaviourisunacceptable,here’showtochangeit
forthebenefitofJaneandeveryoneelse.Janemightbequitehappyself-harming
becauseitisabehaviourthatmakesupJane.Theacceptabilityofself-harmisa
subjectivestandpoint.ThepeoplejudgingJanetobeself-harmingmightdoso
throughthefogofcigarettes,alackofexercise,andanevangelicalbeliefinfree-
love.Janemighthaveanequallyvalidargumentthatthereferrershavetheirown
behaviouralissuestodealwith.
Inpersoncentredplanning,asinPBS,webeginwithahypothesis(abestguess)as
towhatourinformationtellsus.InPBSthistendstobedrawnfromdirect
observations,fromrecordsandtheexperiencesofgroupsofpeoplegained
throughinterviewsorquestionnaires.Wemightalsoasktheindividual
themselves.Inpersoncentredplanning,welike-wisediveintoopinionsfrom
thosethatknowtheperson,andifpossible,thepersonthemselves.Inboth
approaches,wethenintervene.“Somepeople’swaysofcommunicatingleavethe
importantpeopleintheirlivesunabletoheartheirviewsaboutalifethatwould
makesense,”O’Brienwrites.“Theseotherpeoplehavelittlechoicebuttocreatea
storywithavaluedandcentralrolefortheperson,whosepreferencesremain
ambiguous.Then,thesepeoplemakeadjustmentsbasedontheperson’s
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responsestotherealsettingsandexperiencesthatresulted”(O’Brien,2002,
p.412).Andwhilsttheseadjustmentsbasedonresponsesmaynotberecognised
asrobustdata,theapproachis.
Datacanalltooeasilybeconceptualisedasprobesintopeoples’lives.Thedatawe
collectbydefault,trainingormandatedbyouremployersmaynotbethedata
meaningfultotheperson.Thedatawecollectmaybepre-determinedbutthey
mightjustaseasilyberesponsivetothepersonandtheirsituation.Animpressive
exampleofthiscanbefoundinHolburn&Vietze’saccountofHal(2002).
DuringarecentteachingtriptoVeronaideologicaloppositiontoanything
remotelyassociatedwithbehaviourismwasencounteredamongsocialworkers,
thirdsectorworkers,academics,mentalhealthpractitionersandpsychologists.
ProbablyeventhegelatosellerhadanopinionhadIbeensufficientlybraveto
inflictmyItalianuponher.IfoundmyselfdefendingPBSrobustlybeforerealising
thatwithallmydefendingandcitingIhadmanagedtonotlistentotheir
legitimateconcerns.(ToparaphraseSeneca-wearebadpeoplelivingamongst
badpeople-weshouldgoeasyononeanother.)PBShasnoexclusiveonpeople
believingtheyareright.(Onesupposesacademicsareoftenpreytobecoming
argumentative(especiallywhenouridentitiesarecraftedaroundagivenposition)
and“apatheticallycontentiouslot”(Irvine,2009,p.255)bynatureandnurture,
perhaps.)Butlisteningtocriticsishelpful.
PBSpractitionersmaywellcontributeasmanyperson-centredinteractionprofiles,
activityschedules,communicationandrapportsupportplans,personcentred
methodologiesto‘assessment’astheydofunctionalassessmentsoranalyses.PBS
practitionersaremulti-skilled:theydon’tjustknowaboutchallengingbehaviour
butaboutpeople.PBSpractitionerscanusetheirskillsinmeasuringoutcomesto
extendthebenchmarksandproductscurrentlyusedtoincludelifestyle
satisfactionandqualityoflife,notmerelychallengingbehaviour;
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AreWeThereYet?DownstreamResponding&UpstreamAntecedents
Asanyinnovationgrowsinpopularitytheunderlyingprinciplesriskchanginginto
somethingnotintended:theirnamescaneasilybecomespiffyeuphemismsfor
businessasusual(Lovett,1996).Astheoriginatorsofpersoncentredplanning
haveoftenruefullyshared,seeingthemethodstheydevelopedlionised,
popularised,changedandbastardisedispainfulbutinevitable.PBSmethodscan
contributetopractitionersmakingsenseoutofseemingchaosandalltoo
apparentconfusionwhenthisclearunderstandingiscommunicatedtoothers-
thatbehaviourislawfulevenwhenawful.Wecanarriveatsharedsolutionsonlyif
wetakeseriouslythestandpointsofthoseweworkwith.Thoseweworkwithare
resourcesnotcases,partnersnotclients.
ThisbriefviewpointarguesforPBSpractitionerstokeepholdoftheirfocuson
broaderinterventions,tonotlimitthemselvestodiscreteresponsesbutto
lifestylesinsystems.PBSwouldloseitssoulifitdidn’tsticktoitsfounding
principles:subjectiveexperiencesareasvaluableasthedatawesocopiously
collect.Butofcourse,PBSisnotacorporealentity,ithasnonervoussystem,no
body,nosoul:PBSiswhateachpractitionerdoesandhowsheconductsherself
andhowvigorouslysheworksincollaborationwithothers.Sheachievesthisby
applyingtechnologytohumanproblemsinhumaneandinclusiveways.Ifour
fictitiouspractitionersimplystrollsin,collectsdata,graphsthefindings,and
makesrecommendation,withoutmeetingthehumanindistressorlisteningtothe
standpointsofmediatorswhodothehands-onwork,herworkismanythings,but
PBSitisn’t.Equallyobviously,thisviewpointisnothingnew.Meyer&Evans
arguedforsimilarconsiderationsin1993(theresponsestotheirpaperwere
telling,too)–nearlyaquarterofacenturyago.
Intheirwell-citedearlysynthesisofPBSresearch,Carretal.suggestedresearchers
“needtoaddressconsumergoals”(1999,p.85).TodayintheUKconsumersareall
toorarelythepeoplereceivingsupport,butrathercommissionersandoften
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distantcaremanagers.Soitislikelythesynthesis’srecommendationtoproviders
to“fixtheproblemcontexts,nottheproblembehaviour.Problemcontexts(i.e.,
environmentaldeficiencesandskilldeficits)arethefertilegroundfromwhich
problembehavioursprings”(ibid,p.85)havefallenondeafearstoomanytimes:
providersstillgetpaidregardlessoftheoutcomesexperiencedbypeopleusing
services.(Andifaplacmentfails,therearealwaysnewpeopletofillthevoids.
SuchisthemarketofchallengingbehaviourintheUK:here,marketandmoney
trumpspeople.)Despiterenamingaberrantbehaviouraschallengingthesame
explanatoryfictionsabound:theproblemistheperson,sofixtheperson.People
makealotofmoneyoutofthisfiction.
ThisviewpointsuggestsPBSpractitionerscanbringlighttoamurkymarketplace
simplybecauseofthedualdisciplinesentwinedwithinPBS:scienceandsubjective
experiences:
“Thestorygoesthatapersonwalkingalongsideariverseessomeone
drowning.Thispersonjumpsin,pullsthevictimout,andbeginsartificial
respiration.Whilethisisgoingon,anotherpersoncallsforhelp;the
rescuerjumpsintothewateragainandpullsthenewvictimout.This
processrepeatsitselfseveraltimesuntiltherescuergetsupandwalks
awayfromthescene.Abystanderapproachesandasksinsurprisewhere
heisgoing,towhichtherescuerreplies‘I’mgoingupstreamtofindout
who’spushingallthesepeopleinandseeifIcanstopit!’”
(Egan&Cowan,1979,p.3/4)
Theseauthorssuggesthumanservicesareinherentlydownstreamsolutionsin
partduetothemedicalmodel(whereevensocialproblemsaretypesofillness)
andthusrequiretreatment.Upstreamsocio-culturalsystemsimpacton
individualshugely-challengingbehaviourisapublichealthissue.AllthetimePBS
practitionersdealwithdownstreamconsequencesofupstreamantecedents,
we’reclosingthestabledoorlongafterthatparticularhorsehasbolted.Ifwe
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earnedadollareverytimewe’veheardacolleaguesigh‘sowhydidtheywaitfor
bloodtohitthewalls?Whynotcallearlier?’we’dhavetheentrancefeefor
Disneylandatleast.PBSpractitioners–byextendingthescienceofhuman
behaviourtosystems–arepotentialalliestothoseseekingupstreamsolutions.
Becauseweknowthevitalimportanceofabolishingoperations,ofearly
intervention,ofeducational,constructiveandsociallyvalidsolutions.Wewould
sellourknowledgeshortbynotconsideringthereachorapplicationpotentialsof
PBS.
PBSpractitionerscontinuetofightthesamebattlestheirpredessorsdidaquarter
ofacenturybeforethem:tofindthehumanamidstthedata,andtonotonlystop
perpetratingdehumanisingtechniques,butstopperpetuatingthemthrough
offeringevidencedandperson-centredalternatives.
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