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Terry Couchman

Terry  Couchman
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This page is in preparation. Please help by pointing out inaccuracy, or areas that need clarification.

Hi Again,

Lets just recap from the 'home' page for a minute.

If we choose to write and speak simplistically, in Plain English, this satisfies most of us. If this writing (and these conversations) come from a more emotional perspective, this best expresses the frustrations experienced by many, if not most who work within and receive these services. This style can also succinctly describe 'felt' needs & 'felt' community & service 'obligations'. Obligations that, in fact, do exist for everyone who wishes to enjoy the wider benefits of  Community resources, as we will demonstrate. Unfortunately even Plain English can be confounding when it is difficult to understand 'why' a service is not available to you, when you 'feel' you need it and 'feel' justified in asking.

Unfortunately we now mostly live within very critical & rather self-centred societies, that are usually poorly persuaded by purely emotional arguments. When we are trying to get help from a service (that we are now beginning not to understand) emotional arguments are often all we have available to us. This emotional approach does not work well where: Money is at stake; Where demands on a service are excessive; There is an impact upon and a need for adjustments (or accommodation) by the local community, or service; Where services & issues (and you) tend to challenge peoples' existing assumptions & prejudices; Or, Where there is a lack of basic, understanding of Human Rights, Civic Entitlements, Legal Constraints, Civil Requirements and all the associated responsibilities that go with the benefits that we should 'all' enjoy.

Put simply; Plain English, with an 'emotional' slant, does not work well with the 'less socially attractive' Adolescent, Adult and Older Adult problems, needs services and social issues. The emotional concerns of the 'Child', by contrast, or comparison, does generate very adequate responses (although not always the best kind). It is easy to evoke a positive and supportive responses to a child, or children in distress. Child Care Professionals, or Child Protection Services, are more likely to be responsive to these more emotional presentations than the equivalent 'Adult Care' Services. If the issue is not critical, though, the likelihood of support is much lower.

So, If you are and Adult, or Adolescent, and your problem does not 'scale up' to a serious problem (yet); Or you are an an older child (or representing one) who is not at serious, immediate risk; Or, you are any age, are disabled and have a carer who is managing adequately; If you are obtaining a service but don't feel it is adequate, or good quality, but are safe; If you already have another problem, that is being addressed by another service; Or, quite frankly, if you are requesting a service and your face, or attitude doesn't quite fit, and there are no immediate risks; Any and all of these factors will reduce the chance of getting the service you requested, in a time scale that you feel appropriate.

On the other hand, over time, people with Visual, Hearing, Physical and Learning disabilities have tended to get a better 'Press' these days, but this is often obtained by 'emotionalising' the disabilities and to some degree 'disempowering' the people with these disabilities. To get the sympathetic responses, in order to raise the profile of these service users' needs, it is often felt necessary to resort to the same kinds of simplistic and emotional arguments that are used to raise the concerns for 'children in need'. There is nothing basically wrong with this but we are dealing with adults in this case and their wish is ultimately to be seen and treated as adults, being able to speak for and represent themselves,.

In general, simple, emotional argument (on its own, at least) does not work well with the professionals, who are firstly going to protect their position as 'experts', to some degree, retaining their expert language and concepts. These do have a significant 'key' effect in getting access to specialist services. More importantly, they also need these persuasive, 'rational arguments' to present to bosses and funders, in order to obtain the services for their Patients and Clients. This is now a significant, time consuming part of their job, if not the most efficient part of the process of providing the service.

Resources are scarce and they are often poorly organised. Providing a service to people, even children who are a emotional and psychological risk, is significantly rationed in various ways. It is often difficult to understand why this would be the case. Using the right language is often critical to getting a service. This is why it is important to understand these other, 'professional' languages, at least to some degree. This is a true for Health Workers seeking Social / Community Care funding & services, Social Care Workers seeking Health Care funding and services, or for Service Users and Family Carers, trying to gain access to some of these services.

You could, of course, try and rely upon the Professional you are approaching to 'translate' your needs (or those of you client of patient) into the appropriate language to obtain the service that was felt to be needed. If you do rely on this, you may be stomped; if they do not agree with that identified need. Knowing the appropriate language will help you ensure that the needs were adequately expressed in terms that were most likely get a beneficial result for you, or the person you are representing. It is very frustrating and can be distressing but it is how things are at the moment. To get any specialist help from mainstream, Health & Social Care institutions is quite a challenge, even for many professionals.

Whether we are Professionals, Volunteers, Family Carers &/or Service Users, we operate within, and with, very rational and somewhat intellectual, and what are often described as 'risk averse' (fearful) institutions. These institutions have become very skilled at: Defending financial resources; justifying some 'restrictive practices' (withholding help); protecting themselves from litigation; and also displacing general criticism onto others (including yourself). The more defensive these institutions and services become the more criticism they generate.

 It is a bit of a vicious circle of 'relative' ignorance with little 'transparency'. By this I mean; each bit of the service knows itself well, but other parts of the services relatively poorly. Any particular service is has to protect its scarce resources and seeks to displace demands onto other services where it can. In doing this they are not as open as they should be (not transparent as government would say). Other parts of the services do the same kind of thing and these is often a 'gap' in the middle and, for that matter, often at either end. Don't ask me why this is able and allowed to happen. frankly I find it incredible that this still goes on. The only viable explanation is, that it limits the take up of services and financial resources and forces people to further 'qualify' to obtain them.

These services and other resources, are barely adequate if they were used well. An institutions defensive character is partially due to the fact that it is realised they are not used efficiently and they are inadequate. Further more, they are constrained (or feel constrained) to publically admit this limitation in simple English. This is another reason to learn and understand the special language used. It is a real Catch 22. This means increasing amounts of resources are allocated to plugging the dyke (stopping the 'leaks'), rather than fixing the actual problems of providing appropriate and efficient, transparent & robust services, which tend not to produce 'leaks' (and other complaints). If you feel that this is dishonest, you are probably right.

It is a real irony that the level of criticism & litigation (suing) that Services Institutions experience, almost certainly correlates, or corresponds closely with  how 'defensive' (self protecting) the institutions & professions have become. This general defensive stance also colours, and often prejudices, the professional attitudes and practices. Individual professionals can also become defensive, even Family Carers and Service Users pick up on this and can even become apologetic in making their requests and demands, or else angry and increasingly over demanding, often seen then, as problem patients and clients. This is progressive  effect which often not fully recognised. It reduces the quality & effectiveness of the services we are all attempting to provide. As a consequence, institutions do not produce the kind of empowering (none-dependency creating) services that users and family carers would be inclination to accept.

Most of this happens outside the professional's control and is a consequence of the 'detached' 'executive' management attitudes, people who are not necessarily 'best fitted' to manage at that level, or who were never best fitted to understand the purpose of the services being provided (or, sadly, both). This is not unfair criticism of them. There is always a 'miss fit' when professionals become managers. Or if commercially orientated people manage 'people services'. There is a fundamentally different purpose and intention that contrasts 'social & health care' organisations versus 'products, commercial & financial service' organisations.

The more ideal arrangement would be  to have the professional / caring services and the financial / budgetary arrangements separated. Each side accountable to their own specialist chains of command. Currently, pretty well every 'purchased' service and change in circumstance, requires a separate funding applications and decision at a high managerial level.

Attempting to keep 'a foot in both camps', in this way, is almost impossible, with the constraints & demands that are unreasonably placed upon them. It is executive managers' job to make this clear to those who 'pay the piper', so I have little sympathy (especially since I have been there myself and had the courage to do this). This responsibility does not stop at Managers, though, we all have responsibility to demonstrate where systems fail to do their job, miss spend, inefficiently use public funds, or infringe human and statutory rights (even when by neglect or lack of foresight). We are not running a fashion show either. Some things are fundamental and shouldn't have to be part of a big experiment in style and fashion. Leave the economics to the bankers and backers of services and make sure they are there to 'facilitate' services.

To counter this tendency and to make an adequate stand for the rights and entitlements of service users, the community, and (not incidentally), to improve the quality of professional employment, practices and good will; We also have to present sound 'rational' arguments that effectively challenges established attitudes and practices. We have to prove (whether we like it or not), that the current way of doing things falls a long way short of the obligations they have, to provide a quality of service that is perfectly possible with the finances that are available. We also have to demonstrate, when given the chance to do so, how things can be improved.

If I were to stick to the simple argument alone these would be 'shot down' and dismissed very quickly. Emotional, passionate assertions have their part to play and I enjoy presenting issues in that way, but they are not adequate on their own to 'change' and 'improve' practices and services. If, on the other hand, we just stuck to the 'rational' arguments, supporting our case with logic and evidence, this would be tiresome and may tend to go over the heads of many. Some would feel overwhelmed and complain that such simple ideas and principles have to be presented in this complex way.

I actually agree with you (if that is how you feel). It is very frustrating that there are people (at any level) in the caring professions and services, who appear not to be capable of understanding and adjusting services to better reflect the needs and wishes of those who have to suffer them. Some people can be very 'dumb' in their sophisticated, intellectual, or rational understanding. This has always been the case. Institutions do have a 'dumbing down' effect and sometimes this is tantamount to bullying, neglect and mismanagement of people, services & resources (finances). Many professionals and Managers know this, others are in partial, or complete denial. It frankly embarrasses them.

I therefore ask you to trust us, at least  to begin with. The services do significantly fail us all and do not understand, as institutions, the real life situations and constraints that make us who we are! Hopefully you will understand this as we move forward. So, I ask you bear with us and 'trust' these intellectual arguments are doing their appropriate job 'else where' and accept that our emotional arguments are evidence of our genuine commitment to 'the cause' of community services, the empowerment of service users and the general improvement of conditions for committed professional, wanting to do a more effective and honest job.

In that process, I would also ask you to read and engage with these more rational arguments. They are understandable, but are designed to be very precise. These can almost certainly be improved upon without necessarily loosing precision and meaning. There will be some who are skilful at this already and will understand that simple changes 'can' change meanings significantly. The needed adjustments will have to be cautious but the debate is good and often sharpens the focus and arguments to our mutual benefit. Please respond and contribute. I promise we will take account of all contributions and make them available on the site, should you wish this, and accredited to you, should you wish this.

Please don't feel that this 'rational' understanding is beyond you, it probably is not. I used to find it very difficult to read and write in logical and rational ways, especially concerning social issues. I have a measure of dyslexia and problems maintaining attention, which has only improved with time and practice. It would be great if people would just trust in our integrity and expertise, unfortunately this is not always enough these days. Services are controlled by accountants and solicitors in large measure. We have to face realities and accept responsibility for ourselves also. Speaking out takes courage, unfortunately, because of how well defended these institutions are.

The formal process for specific complaint are there, use them. Even the worst examples of service have this channel, they are obliged to have this and to encourage service users and family carers to use the complaints (and suggestions) process. The better organised services use these as evidence for moving services forward. You will often get an apology (assuming you are judged to have a case) and there will at least be a local adjustment to meet your complaint. It is not, however, an effective way of getting (or seeing) a more general improvement of services. These institutional processes are slow, cumbersome and the issues often fall down the list of priorities, relative to keeping up the 'protection' & conserving finances.

There are also many initiatives for 'including' service users, family carers and ordinary members of the community, in the decision processes and development of 'people centred' community services. These are a welcome developments and a move in the right direction. Their failing is that they assume that this has to be limited to having a couple of more vocal members of representative groups, on a committee set up and organised by the 'institution'.

This limited arrangement is understandable, institutions often don't know of a more dynamic way of doing things. They work by committees. It has been some time since a 'service user' or a 'campaigning group' had a 'radical' impact upon 'local' services. Institutions take great ideas, get excited then pass them through committees, where powerful interested parties ponder, modify and make them safe for the existing provision. They cant help this, its in their nature remember. It can take months and even years for an idea to get into practice and by the time they do get to us, they are practically unrecognisable as new ideas. Ideas get corrupted and distorted by this process.

Take consolation that institutions are 'defensive'. It slows up 'over reaction' a little and leaves novelty and real progress to the rest of us. My love of science & technology gave me the focus and precision needed to win arguments for service users and employees, and for advancing services at the request of 'more insightful' service managers. This was in spite of the clever antics of accountants and solicitors and those managers who just want a quite life, few hassles and retire without having rocked the boat. The 'service user' sanctioned services, that were produced in this way, were usually more cost effective than the 'institutional' forms of service. They were also more readily taken up by other service users. It makes sense really, doesn't it. Well, apparently not to everyone.

My earliest experience of 'a disclosure' of a professional, who was concerned about the serious mismanagement of a service, was when I was under 11 years of age. This person was in considerable distress and had been suspended from his job. He came door to door to get local residents to understand the nature of the issue he had raised within his organisation. He was very polite, logical, clear in his thinking, committed to his principles, stuck to the facts, warned of the consequences for the community and had the greatest respect for local authority services generally. He was a 'systems' man. With all that, he was very frightened concerning the consequences for himself and his confidence  and mental health was clearly on a knife edge.

 I will never forget the effects on this very intelligent and committed person, even at the age of 11. It gave me a perspective on why professional people put up with such 'crap' from some managers and so much distortion from the basic principles & ethics of their professions & occupations. Fear is a big factor in people keeping quiet and not challenging the inefficient and inappropriate behaviour of managers and colleagues. This fear is not just the normal consequence of adult bulling and manipulating  (the kids kind), which is bad enough. It extends to undermining peoples good practices and confidence, by interference & judgments, often because it may shows others up as incompetent &/or failing in their duties. This modern fear comes out of the powerful use of 'intellectual' and more 'academic' arguments, to play 'mind games' with peoples commitments and emotions. So much for dignity at work, eh!

If you want to challenge these kinds of situations, you need to get organised within an existing support group of some kind and learn a little how the 'system' works, the language used and the channels to go through. You will eventually get a service but you may have to change the way you go about it. We are often too apologetic and do not clearly demonstrate the urgency of our needs and the developing risks to ourselves and others.

Just a final point. There is nothing in our emotional, or rational arguments (my own, or that of others), presented on this site, which is not substantially supported, by specific and more general evidence. This evidence has been gained and recorded during a 30 year operational research on my part, in the statutory and voluntary services. In addition are the anecdotes and reflective accounts of the experience of service users, past and present, including those who are currently being supported by the services. Much of this evidence is publishable, in that time has made it anonymous enough &/or adequate permissions have been gained to publish. Other evidence is in preparation for publishing, having made it anonymous enough to protect those who provided it.

Thank you for bearing with us and please contribute in any way you can. The provision of services to the community is an exciting venture and the constant improvement keeps us focused of who they are intended for.

See Also: Written Material

 

NOTE:

This Document is still at some stage of development. You are invited to respond and comment on its content and its logic. If you return to the document at a future date, you will be able to see its continued development, hopefully reflecting your own and others commentary.

I thank you, in advance, for any contribution that you make. Please also feel free to visit and contribute, in any valid way, to these and other social issues, through our Forums. There is also a Chat Room and protected Chat Space for more serious group discussions and individual counselling. Please feel free o use this space for your legitimate activities.

Copyright:

Although you will see very few reference to other formal writings in this document, I acknowledge general recognition to the discussions and debates that I have had with students, practitioners and clients over the years. Most of the ideas and theory has evolved through this rather pragmatic process (operational research), rather than any formal reading.

If any content of this document describes concepts, theory, or ideas that have been established else where, (prior to my writing, either here or else where - in part or in full), I acknowledge their entitlement to claim them as their intellectual property for financial purposes, if they can evidence this. I also reserve the right to retain them as my intellectual property, with due recognition to those who have made direct contributions, including other writers, should I identify such a past influences.

Other than this, I invite you to share and copy any content, to the benefit of intellectual debate and the benefit of individuals and groups, without restriction, other than it be used for constructive purpose, in the wider context of my writing.

Should you wish to use any material presented here 'as is', I ask that you then make reference to myself and the web site. The 'Reading Date' would be a useful 'publishing date' for the Current Edition. 1980 is the core publishing date for most of the basic ideas and theory (unless stated otherwise).

This 'Reading Date' may be an important part of this 'reference', as the document (by its 'internet fluid' nature) will be constantly changing and this may affect meaning and interpretation, for those following up on such a reference at a later date.

Thank you for your cooperation.

TRC. eMail: terry.couchman@visitweb.org

 

 

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