'Painting the worst picture'

What this means 

While strengths-based working is talked about in social care, the Leading The Lives We Want To Live group reflected on how often, in order to obtain the services they were entitled to, they had to concentrate solely on the negatives. 

This deficit-based approach undermines self-esteem and means that the considerable knowledge people have, alongside their carers and families, is not used. 

How does it feel to have to paint the worst picture in order to get services you're entitled to?

In this video, Martin Robertson talks about how it feels to 'paint the worst picture' in order to access services and support:

All we want is an honest conversation. What can we realistically do to improve our situation?

The research 

The Care Act 2014 guidance explicitly refers to a strength-based approach, as it states local authorities should ‘…include consideration of a person’s strengths and their informal support networks as well as their needs and risks they face’ (Department of Health and Social Care, 2023, section 2.22). 

The second part of that quote is important, because it highlights that a strengths-based approach does not ignore or minimise risk and need. Instead, it takes a holistic approach, where practitioner and person work collaboratively to use that person’s strengths as a part of the way to address their needs (Guthrie & Blood, 2019; Sutton, 2020). The deficit (or pathogenic) approach, by contrast, focuses solely on needs and problems and sets out to fix them (Local Government Association, 2020). 

Austerity has been identified as the most significant barrier to strengths-based approaches becoming truly embedded (Ford, 2019). Another key reason for the persistence of deficit-based approaches identified by the Local Government Association (2020) can be found in traditional evaluation and reporting. Moving away from counting processes and outputs to something that more meaningfully captures wellbeing outcomes (see Acknowledging and valuing the positives) is a key organisational shift. 

Finally, the research that underpins social care can also be guilty of a deficit-based approach. Over a decade ago, McGovern (2011) specifically sought to challenge the deficit model of dementia within her research, which looked at how couples maintained emotional and physical intimacy even with progressive memory loss, difficulties with language and speech, physical frailty and other dementia symptoms. This, she wrote, attempted to challenge the dominant trend in dementia research that ‘…tends to focus on the losses that result from cognitive and, ultimately, physical decline’ (McGovern, 2011, p.679). Since then, other researchers such as Rahmen et al. (2018) have argued for specific recognition of the assets of people with dementia rather than simply measuring and counting their health and wellbeing deficits. 

What you can do 

If you are a senior leader: Along with the material in Acknowledging and valuing the positives, the Leading The Lives We Want To Live group challenges you to think differently about the communities you serve, and how your organisation measures success. 

All organisations will be at different stages in their journey towards strengths-based working. The only way to honestly evaluate how far you have come in this is to consider the experiences of people who draw on social care. The people who made up this group had all had experiences of being treated as their condition, impairment, or caring role rather than as a person, even if an organisation seemed to celebrate strengths-based working. What is the experience of your citizens when it comes to empathy and kindness? How can you translate this into what is measured, how services are developed, and how practice is conducted? 

Further information 

Read  

Research in Practice has published a Strategic Briefing on Developing strengths-based working. 

Think Local Act Personal has a report on culture change underpinning strengths-based practice in social care, including numerous examples.