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Social Role Valorisation, Personal reflections

The good life

A question of values

A new approach to service delivery

Review of literature


The good life:  (Top)

Today disabled people generally have more opportunities to access social activities (shopping, movies, functions etc) that most of us take fore granted. Various government policies are designed to allow entrance to buildings, parks and other venues so that disabled people could participate in and share the same experiences as others in society.

The goal of the human services is to make a positive difference in a person's life. There are things we can change (values, attitudes, behaviours, cultures etc.) and things we can't change (available resources etc.). By enabling people to fulfill their needs, develop community networks, participate in activities and share experiences within their community, they have the opportunity to become valued members of their community. Conversely, by enabling each community to fulfill the needs of its members, to foster and develop personal networks within that community, to facilitate strategies, solutions and activities so that all members have the opportunity to participate in those activities, and connect with other members through shared experiences and valued relationships, the community has the opportunity to become valued by its members as well as other communities that it is a part of. By providing each community with the skills and resources and valued roles that include people with high support needs, these people have an opportunity to participate in activities, share experiences with others and become valued members of each community.

"The good life" means different things to different people. Only by developing the necessary skills, networks and valued relationships within his/her community (living, recreation, education or employment) can a person participate in, and become a valued part of their community. The needs of the person also needs to be balanced with the needs of the community in providing the most appropriate outcome for the person (people with high support needs will need a more structured setting than people with low support needs).

"The good life" could be described as: having the opportunity to participate in activities and share experiences etc (whatever the setting, structured or unstructured), in a positive way, where all the participants have valued roles. Although the settings are more structured and therefore more restrictive, it is possible for people with high support needs to have as good a life as possible that is most appropriate to their needs. (See also Disability services role models).


A question of values:  (Top)

One key element in the discourse of disability is the idea of values. Values form the basic premise and motivation in any human endeavour. We do something because we find value in, or attach a positive value on the activity or the outcome of the activity. Conversely, we do not do something because there is no value in the activity, or the outcome of the activity is negatively valued. The idea of values is purely personal in their conception and execution. However, these values come from somewhere. They may come from our parents, family, peer group, the community or the society that we live in. They also come from our experiences. Values are also based in knowledge and understanding of the world around us. They are also based in ignorance, myths and legends. They are also based in culture and history. Values determine how we interact with others and the world around us. We consciously and unconsciously make value judgements about ourselves and others around us.

Often there are a set of values that we use in these associations ...
... Do we value one thing or another?
... What is the value placed on something over something else?
... What happens when something happens that does not fit into our set of values?

I would argue that the idea of value is neither positive nor negative, but rather determined by our own needs at the time. In fact, the idea of values is such a nebulous concept that it would be better if the idea does not exist at all. Values are no more than an attempt to rationalise what we do and the way we do it. If I choose to starve, rather that steal food, I may be making a decision based on my respect of someone else's property, or that the food is not fit to eat. You may say that it is a positively based value. You may also say that it is a negative based value. The idea of a positive or negative value is meaningless, and that the value (positive or negative) we put on the value is determined by our needs at the time, the family and culture we live in and the society that we participate in. Gold, for example, is highly valued in society today. But how much value is it if a person is in the desert with no food or water.

Some may say that values are based in some form of truth or reality. But what is truth and what is reality? But wait a minute, you may say, and then quote some meaningful passage from some great philosopher. This is true and I do not disagree with your argument, however any philosophical idea or concept is only an attempt to rationalise a particular point of view. While this point of view is based in the real world and the observation of human behaviour within the real world, it can only describe the truth of the reality as the observer sees it. Others would say that values (or even a lack of values) are part of a journey towards discovery and enlightenment. Others would say that values also come from ignorance and misunderstanding. That values come, not from our own experiences, but from a perceived or imangined positive or negative outcome of an activity. Again, I would not disagree with you. I am not going to critique every philosophical point of view, there are already volumes written about the advantages or disadvantages of any theory. There are a lot of different perspectives on human behaviours and interactions, and it could be argued that they are all right according to the particular perspective of the author at the time of writing.

Any way, the point that I am trying to make is that unfortunately, values are an important part of the way we see ourselves and interact with each other. This happens at all levels. At the personal level they allow us to live with each other where everyone has the same attitudes and expectations in how we treat each other. At the family level these vales determine how the family succeeds or fails in being a family. At the community level we generally have different sets of values that are learned or experienced through participating in the community. Communities require a different set of values that are often forced on us by others in the community. The way I treat others in the community is often quite different to the way I treat others in the family. If I go outside the normal expectations of what is acceptable in the community I am disciplined by the community. These community expectations determine the community values or value systems of the community. These values (positive or negative) are often defined by the culture, history or conventions accepted within the community. Each community has its own value systems, just as each family has its own value systems. While there may be some common elements in the value systems of each community or family, they are unique to that community or family. Just as families and communities use values as a means of conforming to a standard or social morm, societies also have a system of values that are used to provide some form of stability, as well rationalise it's activities within society. These social values are also determined by the collective members within society.

Values are also an important part of the institutions that define our families, communities, and the society that we participate in. Institutions are a part of the social construction of the community, and the society that we live in. Without the institutions and the values that are a part of those institutions, communities and societies can not function properly (see Dysfunctional communities).

I would also argue that ethics, morals and honour are based on a set of values that defines our relationship with ourselves and the others that we associate with.

Ethics:
I prefer to think of ethics as a principle or set of principles of cause and effect. While ethics are based in social values (the sanctity of human life, the respect of others property etc), the underlying principle is that by acting in a way that deprives another person of something that is valued by the person, I am creating a situation that is distressful to the person, which deprives the person of fulfilling his or her needs and living a fulfilled life. Another society may value the collective rather than the individual members. Property may be seen as being owned by the group rather that the individual. The principle then is that in order for the group or community to survive, all property belongs to the group or community. These ethics can not be rationalised or changed according to our mood, or the situation in which we find ourselves in. Who is to say which principle is right or wrong? It is the values that we live by, through our experiences and understanding of the world around us that determine which principle is right or wrong. Communities are generally a mixture of both principles, where we bring something to the community that is valued by the community. We share skills and resources and find value in being a part of the community. We also have our own skills and resources that we use to fulfill our own needs.

Morals:
I think that morals are a rationalisation of a set of values that can be reordered or prioritised according to the situation i.e.: I believe in the sanctity of human life except where my life is being threatened. Morals are used to set the agenda of the community or society. Society may say that it is not ok to do something at a personal level, but it is ok to do it on a social level. Societies legitimise a behaviour that may be against a person’s value by rationalising the new behaviour in a way that it is acceptable

Honour:
Honour is about a set of social values, rather those personal values. We talk about what is the honourable thing to do in a situation, or, worthy of honour, or dishonourable. Honour is all about what society would expect a person to do in a situation rather than what the person would do. The expressions "the honour of the family", or "in my ancestors honour" all declare something that is greater than the person, and whatever values the person has are less important than the honour of the family or society that the person is a part of. Honour is also a form of submission to the values of institutions that we live in. We may honour the diseased, elderly or some senior person as a sign of respect for the person and what the person represents. Honour is also a role model that is used to inspire others to achieve greater things that they may not even dream of.

The above shows thar there are actually two different sets of values that drive personal endeavours. There is a personal set which we use in our personal lives, and a social set that allow us to participate in society. The accepted social values that were used 40 to 50 years ago, are considered inappropriate and devaluing these days and reflect the changing social landscape that we live in today. The same thing happens in any social setting, where the use of terminology to describe a social group becomes outdated. Just as fashion reflects the era in which it was fashionable. Language also reflects the society in which it was used. Each new generation creates its own vocabulary. Think about the words that are used to describe "Disability". What meanings do we attach to these words today? What words were used 40 to 50 years ago to describe the same things? How will people in 40 to 50 years time describe the terminology we use today in describing people with high support needs? Will "disability" be a dirty word?

I like to think of social values as the glue that holds everything together. This glue may be strong (in the sense that everybody shares the same social values) in some areas and patchy in other areas. It is the common values of the community that provide the motivation for the members to see themselves as a part of that community. There is a value in being a part of the community. While new communities may have different roles, institutions and values to the communities 100 years ago, those values still provide the roles and institutions of the members of the community, and the roles and institutions of the community within society.



The relationships between Roles, Institutions, Values and members in the community.


A new approach to service delivery:  (Top)

Scheerenberger, Goffman, Narje, Wolfsnsberger and others have written about the plight of people with intellectual disabilities. SRV was intended as a vehicle for social change, not the social change itself (Joe Osburn: An Overview of Social Role Valorization Theory). We are shown that these people have the same feelings and needs as ourselves, and therefore have the same rights in participating in valued relationships and activities i.e.: that they are just like you and me. While theory has been effective in providing a better quality of life for people with disability, institutions and institutionalisation is still here today in all parts of society (and will always be). Whether these are used for good or bad depends on the values of the culture of the society in which they are being used.

People with high support needs are also a minority group, and as a consequence, will have the same problems as other minority groups in respect to being assigned a devalued status.
We actually see exactly the same thing has happened today where a group of people (Muslims) are devalued as a group because of the behaviours of some extremists within the group. The same thing happened with the Germans, the Chinese, the Japanese, people that smoke, are over weight  etc. etc. etc. The same thing can happen to any group at any time.

While the intentions are good in as much as people with disability have the opportunity for a better life, there has also been some damage along the way. in as much as it has created a split within the human service profession as to the best approach to service delivery.
While theory was appropriate for the 60's - 90's, I feel that there needs to be some reassessment in the policy making process towards service delivery and outcomes (especially in the current economic climate).

The traditional methods of service delivery of social work and disability services seem to be opposed to each other:
… Social work looks at the community and the social barriers that people have in participating in a community.
… On the other hand, disability services looks at the personal barriers (their social roles) that people have in participating in a community.
(Connectedness and Citizenship: Redefining Social Integration)

There is a great deal written about normalisation, social integration, empowerment, SRV etc. from the perspective of people that have a physical or intellectual disability (how the community should do this and that) and very little (if any) about providing a valued role for communities towards becoming empowered in providing for the needs of people that have a physical or intellectual disability. There is a huge resource out there about empowering communities, but for some reason best known to themselves, this resource has generally been ignored.

My feeling is that the current theory can not cope within the current social climate, A new approach is needed to meet the changing needs of communities within the current social framework. New technology means that the members are healthier and live longer today. The members are also getting older which means that pressures on existing services are increasing from year to year. Communities are also being redefined as each new technological innovation redefines our relationships with each other. I think we need a new perspective on our role in supporting people with disability in today's society. I also believe that the future of the human services lies in a balanced approach, where both paradigms complement and support each other in service delivery.

We should use the past as a reminder and a guide in the future towards building better communities. By redefining its role as a service to humanity, the service provider has a different perspective on its own role in promoting and supporting people that have a physical or intellectual disability and the role of communities in being a part of the process.

Just as communities of 2nd and 3rd generation unemployed in England and Europe have lost the skills to actively engage in a productive work culture (Their parents and others have not provided the necessary roles - getting up to go to work etc.), and therefore depend (are dependent) on social welfare, so too, communities have lost the skills (or never had them) in providing for the needs of people that have a physical or intellectual disability.

Originally families of people that have a physical or intellectual disability got together to support each other and develop social networks. Even though this was a small start, the parents still had ownership. Over a period of time the group evolved into a service provider. The parents lost ownership in providing for their needs. The current generation is growing up in a society where service providers provide direct intervention in the care of people with disability and the community supports these activities. They see the ads, read the literature. Their families and peers strengthen this culture and so it becomes the social norm.

Today we see all sorts of charities, benevolent societies, fundraising organisations, associations etc that support disadvantaged people in society. These support groups have a valued role in providing services to the wider community, or supporting people that do not have any personal support structures. These support groups also need wider community support in order to provide the services to their members. I know this because I get numerous phone calls and letters asking for support and donations. TV and the radio also remind me of the valuable services these groups provide in society. Unfortunately, I have limited resources, and there is no way that I can support all these groups. I have to make some decisions in who I can support. These decisions are generally based on the profile of the service. The higher the profile, the more likely I am inclined to support the service. There is always the problem that if there is to much exposure to the promotions of a service I may become desensitised to the service, or that there are others that support the service and I don't need to contribute. Another problem is that a person or group of people that most need support are the least likely to receive the support if the service does not have a high profile. While I may choose to support a service with a low profile, the chances of others supporting the service are less than if the service had a high profile.

As new technology and scientific understanding of various human conditions and ailements increases, new support groups are created to provide for the specalised needs of these groups. Today these services are specialised in and designed around a specific characteristic or need. These services generally have a scientific knowledge base as well as a set of interventions that are designed to provide the best outcomes for their members. These programs are built on the idea of evidence based practice. The more specialised the service is, the less involvement the wider community has in the activities of the service.

We as a human service need to build better communities, within the wider community, that actively support people that have a physical or intellectual disability, within the current social structure and government hierarchy (Law, policies etc.).

… Communities that have clearly defined roles/goals
… Communities that have shared beliefs, values, cultures (institutions).
… Communities that have clearly defined boundaries
… Communities that have ownership of their members
… Communities that provide valued roles for their members
… Communities that communicate effectively with their members
… Communities that can depend on their own skills/resources
… Communities that balance their own needs
… Communities that can share and draw on skills/resources where needed

A community that supports itself is an empowered community.

There are issues such as who is going to pay for wages and services, how are the resources going to be distributed, medical issues, legal issues etc.
This will not happen next year, or the year after, but it is something we need to work towards.


Review of literature:  (Top)

The literature that was reviewed was mainly that which was available on the internet in 2000.
While there is a huge resource, most of the material I was interested in was published in various journals that I was unable to access.

Topics of interest were:
SRV
Disability service groups and organisations
Community
Society
Roles
Institutions
People with disability/history
The service provider
Theory and service delivery
Government policy and practice

The literature was reviewed within a set of criteria:
1) What is the intention or perspective of the literature?

2) The setting/s:
What setting/s are described and how are they relevant?
What is the role of the setting/s?

3) The stakeholder/s:
What stakeholder/s are described and how are they relevant?
What is the role of the stakeholder/s?

4) How do the stakeholder/s relate to the setting/s?

I used Google as the search tool to find the relevant literature.
Of the material that I was able to access I found that the literature covered three broad categories:

1) Information about a particular service provided by a service provider:
A school or university has a service that is designed to help the user access some service or funding etc.
A description of the services provided by a disability service organisation or group.
Information on how the service user has benefited from the service.
Guidelines on gov policies and regulations and how to access gov funding
A list of available services and resources and how to access these services and resources.
Various strategies and useful information in developing/providing a service.

2) Information on research and findings that have been carried out:
Statistical information
Conclusions
Recommendations

3) Theory
Describing the observations or behaviours within a context in order to explain and predict outcomes that are consistent within the context.
To gain an understanding of what is happening.

Most of the literature was Information about a particular service provided by a service provider (1): there was some information on research and findings, but this was out of date. There was some information on theory, but this was very little and mostly out of date.

The conclusions below are based on literature accessed on the internet as well as my own experiences and does not take into account any material that is unpublished or more up to date.


1) Very little has been written about the role of the community in SRV

2) There has been very little written about the role of service organisations in SRV

3) I feel that there is a lack of understanding in the concept of roles, institutions and community, and how they relate to providing a better quality of life for people with high support needs and being a part of their community. Yes, the situation has improved dramatically in the last 20 years or so where people with high support needs have valued roles in their community, but I feel that this is more accidental than by design - that most successes are due to the person's own resources. There is very little literature available about the problems and failures when applying SRV or placing a person in a community setting. There may be literature available regarding this, but I was not able to find it.

4) There is little or no literature describing societies and communities that looked after people with high support needs.

5) The literature describing people with an intellectual disability historically has been biased in describing their situation as different to other groups in the community. When seen in the context of the available resources, skills and knowledge at the time, these people were treated the same as other groups (poor and destitute, sick, elderly, criminals etc.).

6) When developing strategies and programs towards inclusion in community activities for people with high support needs, the focus has been from the person with the disability and there seems to be very little community involvement in the process.

7) I feel that there is very little written about people with disability and significant others that manage to develop community networks and relationships through their own resources.

8) While there has been a great deal written about the institutions, buildings etc. within the context of people with disability, there is little written within the context of the community.




When providing the most appropriate care for people with high support needs ...
1) The community is not where the person is living, but where the person participates, shares experiences and has valued relationships with others.
2) People with high support needs (severe disability, aged etc.) will always need support structures as a part of their lives.
3) The amount of participation in a community (living, education, employment or recreation) is directly related to the skills and resources of the person, and, the skills and resources of the community that the person wishes to participate in.
4) Institutions are going to be around in one form or another whether we like it or not, It is the way that they are used that is the problem.
5) The institutions of a society towards a particular group determine the way the group participates in society.
6) The institutions of a particular government department, organisation, profession or service define the way the person is supported within that society.
7) Facilities that support people with high support needs do not need to be the nursing homes or prisons in the sense that they are today, but can become warm inviting community places that offer a range of services to the community, as well as be a part of the wider community within that society.
8) People with high support needs are a minority group in our society, and will have the same problems as other minority groups in being a part of society.



Peter Anderson
http://www.psawa.com

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