Knight's Journey

The provision of health and human services is an extremely interesting area of work and affects most Americans.  While working for a chaplain during the mid-seventies, I decided to make the provision of services to others my life's mission.  In recent years I have changed my focus from providing services to individuals and groups to assuring a higher quality of service through organizational training.  This section will include short articles that will focus on the resolution of problems within health and human services.  

Take a look at all of the valuable information available through the US Department of Health and Human Services at:

www.dhhs.gov

We Love Change, but....

During September of 2002, I was fortunate enough to hear Antowne Fisher speak in Detroit, Michigan. He was the keynote speaker at the Annie E. Casey Foundations Family to Family Conference. He presented some of the story from his book, Finding Fish, and spoke of the movie that débuted in late 2002. As he completed his speech, he received a standing ovation.

Later that evening I recalled the many speakers that I had heard during the dozens of national mental health, substance abuse and child welfare conferences that I had attended during the past 30 years. It dawned on me that, without exception, one type of speaker always received a standing ovation – the person who had turned his or her life around. Mental health and child welfare professionals are not unique in their love for a “change story”.

I believe that most people enjoy the uplifting testimonies of people who have changed. Professional helpers need to believe in their profession and they are all about change. Others simply enjoy the notion that people don’t have to be the same and they can change for the better. Regardless of the reason, most of us applaud those who have fought the odds, pulled them selves together, and emerged as a success. The phenomena of people’s admiration for those who have changed is perhaps America’s greatest paradox.

Although many of us are aware of the fact that the middle-class is shrinking, we don’t give a lot of thought to the causes or the consequences. Many of America’s poor and disenfranchised are continually trying to better their lives. They seek jobs, housing, medical care, and a better way of life. After years of effort, some simply give-up the struggle. Many of these individuals are neither homeless nor starving, but are underemployed. They work two and three jobs to simply survive. This is not a new story for this nation’s immigrants, but for many it is more difficult now than it was for their ancestors.

What is different now than a century ago? We have become a nation of fearful people. For example, intolerance has grown to epidemic proportions. As witnessed in the last presidential election, division among Americans is growing.  This division will continually impact our ability to provide quality services to those who are different than ourselves. 

The Centers for Disease Control and Prevention (CDC), in collaboration with a coalition of national partners, recently launched a public awareness campaign to help parents learn more about the importance of measuring their child's social and emotional progress in the first few years of life. The campaign, "Learn the Signs. Act Early," is designed to educate parents about early childhood development, including potential early warning signs of autism and other developmental disabilities.  Check out the new website for information in English and Spanish, www.cdc.gov/actearly or call 1-800-CDC-INFO (1-800-232-4656).

The Glass Ceiling of Best Practice

The term best practice has worked its way into the lexicon of human services.  I hear this spoken on a daily basis and often wonder if anyone really gives best practice any real thought.  Best practice is really a term that we can all agree on.  Who would be against best practice?  Who would say that they were for mediocre practice when they could be for best practice?  

The goal of human service agencies is to use best practice.  This is determined over time by models of practice that have been researched and have been determined as best – that deliver the best measurable results.  Best practice is a series of processes.  One can clearly see that certain models of research are best for certain applications.  However, the water becomes a bit muddy when we believe that we can teach workers best practice and then expect them to just do it. 

Social work is not social psychology.  Perhaps this is why social workers do not consider the facets of attitude formation and change that impacts best practice.  Then there are the aspects of attribution theory that deals whether we attribute outcomes to external or internal causes.  Cognitive dissonance theory helps us to understand why we need to make our feelings and behaviors congruent to minimize dissonance, thus explaining why we frequently justify our behavior.   

The height of the glass ceiling of best practice is determined as much by attitude as by process.   For example, the delivery of culturally competent services is a best practice.  One can attend training on cultural competence and can pass a test on the material.  However, is this going to make someone with a racist attitude suddenly become the epitome of cultural competence when delivering services? 

Knowing best practices is really the easy starting point.  Delivering best practice is entirely another issue.  The primary measure of the ability to deliver best practice is the extent to which each worker believes in the ability of those served to make life changes and to maintain those changes.  Without this key component, best practice will never get off the drawing board and into practice.