Practice guidance version 4 0

1

Connecting

People

Intervention

Practice Guidance

Version 4.0

2

Contents

3 Introduction

6 The model

10 Case studies

13 The agency

19 The practice

25 The individual

31 The worker

37 Conclusion

38 Additional resources

3

Welcome to the Connecting

People Intervention

Practice Guidance!

Introduction

This manual has been developed in re-

sponse to a need to have practice guidance

on effective ways to connect vulnerable

people to others in their local community.

Connecting people has been identified as

one of five ways to wellbeing.4

There is evi-

dence that having good social connections is

important for your well being and helping

you to get on and get ahead with your life.

However, there is little guidance

available for health and social care workers

about a complete process that will help iso-

lated people connect more effectively with others.

This guidance is aimed at both teams and individual practitioners. Whole teams

need to be able to support the ways of working described here to facilitate individ-

ual practice. However, each team member needs to be familiar with the interven-

tion model so that their practice can be shaped accordingly.

The practice guidance provides the what - explaining how the intervention works.

The training that accompanies this manual provides the how for workers who will

be using this intervention to help the individuals that they work with as effectively

as possible. Training will include familiarisation with the model, development of

necessary skills to implement it, and ongoing support from the research team be-

hind the intervention as well as other agencies using the model.

1. Lin, N. & Erickson, B. (Eds.) (2008) Social capital. An international research program, Oxford, Oxford University Press.

2. Holt-Lunstad, J., Smith, T. B. & Layton, J. B. (2010) Social relationships and mortality risk: A meta-analytic review. PLoS Medicine, 7 (7), e1000316.

3. Webber, M., Huxley, P. & Harris, T. (2011) Social capital and the course of depression: Six-month prospective cohort study. Journal of Affective Disorders,

129, 149-157.

4 Five ways to wellbeing: http://neweconomics.org/projects/five-ways-well-being

Social connections are

good for you! Research has found that

social networks help you to

find work1, live longer

2 and

to improve your mental

health3 and quality of life

3.

4

About the Connecting People Intervention

The Connecting People Intervention is the result of a two-year study of practice5 in

six health and social care agencies (see box below). In this study we explored how

workers help to connect people with others, either directly or indirectly. We found

that connections were primar-

ily made with others within

the same agency, but there

were some examples of

good practice in connecting

people beyond the agency

they were involved in.

The aim of the Connecting

People Intervention is to

help workers in supporting

service recipients to

connect with people beyond

health or social care agencies.

These may be neighbours or people living locally. They may be people interested in

the same hobby, sport or leisure pursuit. They may even be family or friends with

whom the individual has lost contact....there are many possibilities.

Based on ideas from social capital theory (see box on the next page), the Connecting

People Intervention aims to enhance the diversity of individuals social networks. It

is not prescriptive about the size or quality of networks. It is up to individuals to de-

cide how many people they want or need to be in contact with. However, it aims to

ensure that people know others outside of health and social care services in addition

to those within them. Sometimes

workers may need to act on behalf

of their clients to them to move for-

wards.

These new links and the resulting

increase in social capital are

achieved through a dynamic series

of processes involving both the

worker and the individual. The Con-

necting People Intervention model is

not a traditional linear process of a worker doing something for or with the individ-

ual and an outcome occurring as a result of this.

5 Connecting People study page: http://connectingpeoplestudy.net/

Research was conducted in these agencies. Extracts from interviews, field notes and reflections are

included in the guide to add perspective to the model.

BlueSCI, Trafford

Hestia, London, and Kingston RISE, Kingston

SHARP, Lambeth

Start Again Project, Birmingham

STEP, Somerset

W. Kent EIS, Kent

A big thank you to all of those who took part!

5

The Connecting People Intervention

model has been developed from our

study of existing good practice. We

have taken the best bits from several

organisations and combined them with

principles such as co-production (see

box). Many of its elements will there-

fore be familiar to many people. Its

distinctive approach comes in drawing

together all these different compo-

nents of practice into one place to cre-

ate a unique and dynamic model that is

grounded in lived experience. The language has been kept simple and friendly

throughout this Practice Guidance, in order to ensure that it remains accessible and

engaging to as wide a cross-section of people as possible.

We hope that the intervention will benefit individuals accessing services, but that it

will also help workers with their practice, and agencies with a more cost-effective

way of working.

How the Intervention Works

Due to the dynamic nature of the intervention, there is no set method to achieving

success. The following pages show each stage of the process, but these can be

modified to suit the needs and time available of the worker-individual partnership.

Similarly, the intervention does not specify exactly what the individual and worker

should do within this process as it is up to them to co-produce the activities. We do

however anticipate that new social connections may be made at any point in this

process.

We do not wish to encourage the individual to become dependent on the worker.

At the core of the intervention is the trusting, equal relationship that is built up to

form the base for the individual to achieve their own independence. The individual

is just as responsible as the worker for the success of the intervention process. In

turn the worker needs to be sure to really learn from the individual to ascertain

what exactly they want to get out of the process.

Over the page is a diagram of how the intervention works for your reference.

A more comprehensive version can be found on the A3 pullout included with this

Practice Guidance.

Social Capital: Social capital refers to the potential bene-

fits which accrue from social relationships

between people .

Co-production: Both service users and service providers

develop and provide the service together.

Social participation: Leaving the house to engage with a social

activity with other people

6

Enhanced

social

network

knowledge

Worker

PartnershipEquality

Agency

Developing

skills,

relationships

and resources

with this

individual and

for the future

Shared

processes

Potential

Barriers

The Model You could annotate this page with any groups, local organisations or other elements specific

to your agency and make the model more relevant to your own practice

7

Enhanced

social

network

Individual

PartnershipEquality

Agency

Shared

processes

Developing

ideas, goals,

and

confidence

and working

to attain and

expand on

these

Potential

Barriers

You could annotate this page with any groups, local organisations or other elements specific

8

The model explained

The aim of the Connecting People Intervention is to rotate the green and blue

wheels seen in the model. These represent cycles of discovery for both the worker

and individual, which result in the

development of new social con-

nections and social networks.

At the heart of the intervention

process is the equal, positive part-

nership between the individual

and the worker. The symmetry of

the model demonstrates this im-

portant aspect of the intervention,

and every effort should be made

to maintain as much equality and

balance as possible, despite barri-

ers such as social workers being

responsible for the funding of

their clients.

The worker and the individual start by having a conversation as to exactly how they

want this relationship to work. They then map out the individuals existing social

network. They may do this by ranking the people in the individuals life in concen-

tric circles extending outwards from the individual and those closest to them in the

inner circle (see image). Then, both worker and individual discuss and write down

their own strengths or assets. These may be their interests; things which they/other

people think they are good at; or their unique qualities. They will draw on these as-

sets throughout the process of the Connecting People Intervention. Finally, the

worker supports the individual to explore their life goals and to discuss what they

would like to achieve. In individuals with higher support needs, these processes

may need to be led quite actively by the workerfor example through trial and re-

action, or respectful guessing.

The individual needs to be encouraged to think beyond what the service could pro-

vide and to consider new opportunities which they had previously not thought pos-

sible. Together, the worker and individual select a goal, or a series of goals, to work

towards.

The processes of mapping social networks, exploring assets, and talking about goals

aid the formation of the relationship and the task of bringing the individual to the

point where they are ready to move forward.

Social Network Mapping

9

However, before the wheels can start to spin, the worker and individual both need

to be prepared to work together, to engage in new situations, and to meet new peo-

ple. The shared development of objectives and activities is depicted at the centre of

the model because it represents the co-produced activities.

The way that the green and blue wheels overlap further illustrates this partnership.

They are interlocked to represent the fluidity of the process and the uncertainty

about when, or if, new social connections are made, as well as the interdependence

that worker and individual share in order to continue moving forward.

The individuals journey (represented by the blue circle on the right) is the focus of

the intervention process. In achieving his or her goals, the individual is, for example,

exposed to new ideas; introduced to new people and activities; and supported to

develop skills, interests and social confidence.

The green circle on the left represents the workers journey, and is of equal impor-

tance to that of the individual. Along the way, the worker may develop self aware-

ness and self confidence, along with the desired end product of an improvement in

their knowledge of social networks available to the individuals that they work with.

The worker also needs to look out for barriers which may prevent the individuals

blue wheel from rotating. These work in the opposite direction to the intervention

cycle and can pose considerable challenges for some individuals. These barriers will

present the worker with a number of challenges, and helping the individual to over-

come them is likely to be the most time-consuming element of their work. They

may also need to provide extra support and reassessment for the individual. Addi-

tionally, they may face barriers themselves which could need to be faced in order to

develop their own networks, and form an effective partnership.

The worker-individual partnership described here takes place in the context of a

supportive agency, which is shown at the bottom of the model to illustrate its cru-

cial, underpinning nature. An agency needs to encourage their workers to form new

ideas and ways of doing things, and share the principles of the Connecting People

intervention. A positive physical environment is also important, as well as good

methods of sharing knowledge that prevent reliance on a particular staff member

for information.

If all of these processes occur to some extent, the model shows the outputs of

social network development for the individual, and social network knowledge de-

velopment for the worker. This as has already been emphasised can occur at

any time during the process, and will do so to different extents in each situation.

The intervention aims to create new links for the individual beyond any health or

social care services which they may be receiving, and is seen as successful if this oc-

curs at any level.

10

When I first met Greg he was very nervous as he perceived our service to be the judges of whether or not he could keep his

Personal Budget. It was important to make him feel at ease straight away by being friendly, having a bit of banter with him about the

football (Im a United fan and theyd just won against City), and above all being very open about the process. I could tell he was a man

who got confused by the paperwork (dont we all!) so whereas with some clients I go through the forms bit by bit, with Greg we just

spoke and I filled things in after our session.

I get a lot of clients through the door as the nature of our service means we see a lot of people once every few months, so I always keep

a record for myself of what we spoke about

To work effectively I have to have really strong knowledge of all of the available services out there and constantly be looking

for new ideas of where someone could go, where they could try out. Here at our base we have a big table full of leaflets, fliers, and all

sorts of information about different schemes in the area, which helps with inspiration if you are a bit stuck.

With Greg it was relatively easy as he was keen to become more active so a gym referral was the obvious choice. Then beyond that I

remembered a local running club that I had heard good things about so after chatting with them about being supportive of Greg, put

him in touch with them too. Because I dont see him very often we try and set clear goals each time that he can then manage with the

help of other people. This last session, we decided that he should go for a commitment goal as Greg has had problems attending some-

thing regularly due to his depression. We spoke with the gym and Greg decided to attend a regular kick-boxing class there, committing

to attend every week. Greg also wanted a tangible target, so I investigated and with the help of the running club found a 5km run that

Greg is going to enter in three months time.

Greg has good insight into his condition and knows that exercise and keeping busy helps stop his low mood, whereas sitting in

the resource centre does not help. It is all about having solid goals to keep him moving forwards in the direction that he wants to go.

When Deloris first came to the service she had recently lost her husband. She was coping reasonably well but several months af-

ter the loss her sadness had not improved and seemed to be getting worse. At the time that I met Deloris she was clinically depressed but

seeking change in her life. Deloris has two daughters who live in London and Birmingham with their families. They visit on occasion and

have expressed concern over Deloris situation but are unfortunately unable to be involved on a daily or weekly basis.

Through our initial assessment and building a relationship of trust, I could tell that her depression stemmed very much from her

loneliness and isolation. At aged 72 and living in a rural area, her husband and the couple friends they had together were her main source

of social contact for many years. Although mobility was not an issue, she has deteriorating sight and is therefore unable to drive. When

Hugh passed she found it difficult to leave the house and connect with others.

Because she was motivated to recover from the depression we initially worked on exploring her interests (past and present) and setting

achievable goals for getting out of the house and connecting with others.

Many of the other service users I work with have mobility issues, making it increasingly difficult to leave home and get connected

to others. Aside from her inability to drive, she is still able to get out of the house. She can walk to the local shop but the buses to larger

towns only run once per day.

Together we decided to look for activities in the area that Deloris could get to on the bus, and set goals initially to leave the house twice

per week. I was able to take her to some activities but wanted to be sure these were opportunities to meet new people so that she could

continue getting involved without me.

When Jack first approached us, he wasnt doing much and was outwardly angry and frustrated. He was bullied at school and had

no friends and said it was because he was different. He had no self-esteem and was even alienating his family. We needed to put Jack at

ease straight away because he was visibly upset about the state of his life, we thought the best way to tackle Jacks issues was to identify

some opportunities for him to develop his own networks. At first we tried to build a relationship by simply talking to Jack openly. We

wanted to find out what he enjoyed doing and discovered that football was a passion for Jack. Someone I knew was already part of the

local football team, so I utilised this contact and this person became a buddy for Jack and took him along to a football session. This proved

to be a meaningful place for Jack to be and his confidence grew, not only that but others started to see the assets in Jack. He has made

friends and has discovered he is a good leader and teacher so has been looking into becoming a coach. This success has led to Jack seeking

out more opportunities to become involved in the local community, and a new idea that Jack identified was going to a reading group. To

begin with, we werent sure what reading groups were available that Jack would be able to get to easily, so we contacted the library who

knew of one that had just started a couple of months before. At first the leader of group seemed reluctant about Jack attending and

seemed to have incorrect perceptions of what he would be like, however after talking with them and agreeing to go with Jack to the first

session, the leader agreed and when they had spent some time with Jack, their attitude changed completely and they could see the great

potential in Jack and were inspired by him. Attending this group enables Jack to be included in a totally different environment to the foot-

ball club and we can see that it is turning out to be marvellous for his mental capacity and has led to all sorts of people realizing that he

isnt different at all!

Case Studies Here are some case studies showing the model in action across a range of client groups and services. Each is seen from both the

11

I was really not looking forward to meeting Vish because I had heard from friends in the mental health system that as soon as you

stop getting a full time care coordinator, your support and your benefits start to stop too. Vish was nice though, he had some similar in-

terests to me and I didnt feel as scared about what this meeting meant after a few minutes in the room with him. He was really reassur-

ing about it all and didnt sit behind a desk with loads of official documents and stuff, it just felt like we were having a chat about what I

liked to do and what I wanted to be doing in the future. He reassured me that I wouldnt have my Personal Budget stopped as long as I

needed it, and that if it did happen it would be because I was doing other things that didnt require one any more. I had never thought of

it that way before.

It was weird because even though I sort of knew that I wanted to do more exercise, Vish helped me work out what exactly I could

be doing and put it into small bites of tasks. I had been sitting in a mental health resource centre not really doing much up until recently

when my Personal Budget was up for review, and I think that had maybe made things worse. I had been quite worried about just going to

the gym as I feel pretty unhealthy compared to how I used to be before I got ill, so when Vish told me that he knew the people at the gym,

and that the staff there were really supportive I felt a lot better.

He also told me about the local running club and put me in touch with them. Ive been going once a week to that since our session, and

feeling a lot fitter. Its really nice to go somewhere where the point of the activity is just to run its not some medical thing where every-

one talks about their illness and stuff.

After we spoke about the running club, we decided no time like the present so spent the remainder of the time visiting the local

gym and getting the induction form filled in. I know that Vish only has a bit of time with me so it felt good that he could come and do

that. I am not seeing him again until our next session which is a few months, but the goals that we have set are keeping me busy I have

a 5km run quite soon which I am trying to get a PB in! He wants to know how I do so I will email him after it.

All in all, Vish has provided me with all the support he can, and has linked me in with people that can help me get back on track

and that have the time to spend with me, and all doing activities that I am actually interested in.

From the beginning I really enjoyed my time with Kay. She came round to see me every week or so and wed have a cuppa and start

chatting. I never felt like she was just testing me, or asking too many questions. You know how some support workers are, they seem to be

ticking boxes rather than getting to know a person. I never felt that way with Kay. She was friendly and never pretended to have lived

through my experience. She let me share details about my life and I felt that she understood, without necessarily having lived it herself.

We started talking about my hobbies and interests and sometimes I dont feel like I have many at all. But she helped me to think

back about what Hugh and I used to do together. He was a farmer and was quite involved with the union of farmers in the county. When

they met together, I would go and see the wives, but hadnt been since he passed away. I wasnt so sure that I could go back to this group

without Hugh. Kay suggested we go together. Her brother is also a farmer in the area and we decided to go to the meeting together for a

few times so that she could introduce me to a few people.

Well the first time I was really nervous. I hadnt been out to see people much recently and I didnt know how others would react to

my being there. Also, I worried that people wouldnt be the right age. Sometimes I feel that I have nothing in common with people from

the younger generation but those in my age group have many more health problems than I do. Its all they talk about sometimes! But at

the first meeting I recognised a few people and was happy to have Kay there with me. It took a few meetings before I felt ready to go on

my own but Ive met one woman who lost her husband too and were now able to go to the meetings together. Next week were planning

to go to the travelling cinema that comes to the area once per week. Im still seeing Kay regularly but with meeting new people I feel less

anxious about leaving the house.

I was so annoyed when my family said they didnt know how to be around me anymore, and I should go see someone. I thought

they wanted to get rid of me so was really scared when I first went to meet Eric but when he explained that I could meet with him whenever

I wanted to I felt much more relaxed. I felt I could speak with him really easily because he was so relaxed and friendly, that first meeting all

we did was chat about what I liked doing! Looking back I just think how lucky I was to get the chance to meet him, and all the other people

who worked there! I love my buddy! He helped me so much when I was feeling like I had nothing to live for. He found out that I like to play

football every day and have found that Im even good enough to teach other people. I took a football book to my book group and everyone

loved it! I feel so excited to be sharing my love for football with lots of different people. It feels good to be able to know more about some-

thing than other people! Im reading a book about a farm now which is totally new to me but Im actually enjoying it, my friend from the

reading group told me to read it, Im glad I listened to her! My Dad says I have grown up a lot and Ive started to feel a lot closer to my fam-

ily lately. I love waking up in the morning and getting excited for what the day might bring.

Worker and individual, NHS assessment team, mental health

Worker and individual, community NHS team, older adult mental health

Worker and individual, third sector resource centre, learning disabilities

Here are some case studies showing the model in action across a range of client groups and services. Each is seen from both the worker and the individual perspective

12

In short

The agency in which this practice occurs needs to be supportive to the out-ward-facing nature of the intervention and embedded in its local community

to ensure that connections can be facilitated. (see page 13)

The intervention process itself begins with a discussion about the in-dividuals strengths, assets and interests. S/he is supported to develop his or

her own goals which the worker will support them to achieve. (see page 19)

The individual needs to be supported to overcome barriers which they may face in the process of achieving their goals. Workers may need some assis-

tance from their teams with this. (see page 25)

The worker needs to be open to expanding their network of contacts which may be needed to be drawn upon to assist the individual. (see page 31)

How to use this manual

This manual does not provide step-by-step guidance on how to help people to

make new social connections. As we have discovered in the Connecting People

Study, there is no one way to do this. How this process will work will vary from

individual to individual. Instead, this manual provides a framework for practice

which should assist workers to adapt flexibly to the strengths, needs and de-

sires of the individuals they are working with. For more practical suggestions

on how to use the model, we will be running training sessions for workers

alongside this manual.

Feedback We are seeking feedback on this guidance and wish to ensure that it is fit for

purpose. If there are aspects which you wish to discuss with us, please let us

know. Our contact details can be found at the back of this guide, along with

links to useful resources and more.

We hope that you find this manual useful to your work.

13

The agency The influence of the agency is depicted in orange on the diagram. As you

can see, it underpins the entire intervention, and is an integral factor in both

the shared processes of the model as well as providing support for the

worker and for the individual.

Without a supportive agency, it is unlikely that the processes depicted will

occur. There are a number of features characteristic of a supportive agency,

including modelling of good practice, skill sharing, community engagement

and good local knowledge. These aspects create the security necessary to

allow the workers within it to do their jobs well, and the individuals access-

ing their service to feel confident enough to make progress.

An organisation also needs to know its limitations and its barriers, and the

can do attitude of its workers needs to be echoed to try and overcome any

issues. Workers need to know that they can use their initiative and try new

things whilst being supported by their agency, in order for ideas to prosper.

In addition to this, the agency can provide a physical environment which fa-

cilitates social connections and can provide useful connections with commu-

nity resources which individual workers may not have. Shared knowledge of

the local and wider communities and a thorough understanding of the in-

tervention model held by the agency can prevent interventions failing when

workers leave. Comprehensive handover procedures in this event are also

necessary, as individuals may have built up a strong relationship with their

worker rather than with the agency as a whole. These factors can also help

to reduce reliance on individual workers who may be the only ones to hold

connections within the local community.

The environment in which the agency works is also keysupport from other

local organisations, and funding bodies is very helpful when an agency is try-

ing to complete this sort of work. If there is competition between organisa-

tions due to funding or another issue, jealous or unhelpful attitudes may ap-

pear that can impact negatively on the agencys work.

14

Enhanced

social

network

knowledge

Potential

Barriers

Worker

PartnershipEquality

Developing

skills,

relationships

and resources

with this

individual and

for the future

Modelling of good practice Skill sharing

Physical environmentCommunity resources

Help accessing the service

Agency

These three factors are key to assist the worker and the individual to

start moving forward with the intervention:

The Agency: explained

Physical Environment

This will obviously vary according

to facilities available.

However, it needs to be as inclu-

sive as possible. Creating a non

statutory ethos is key to engaging

individuals who do not identify

well with typical NHS settings.

For example, no sharps cupboards,

dont lock equipment away, en-

courage service users to assume

front line positions e.g. answering

phone, working on a reception.

Community resources

An agency should aim to link in

with other local resources in order

to help an individual feel less segre-

gated and more grounded when

accessing their servicethis will

increase the likelihood of atten-

dance.


The agency can play a key role in en-

couraging an individual to attend a

service:

Creating a welcoming environment

e.g. a caf;

Not forcing paperwork on an individ-

ual as soon as they start attending.

15

Enhanced

social

networkPotential

Barriers

Individual

PartnershipEquality

Developing

ideas, goals,

and

confidence

and working

to attain and

expand on

these

Community engagement Local knowledge



Agency

The underlying ethos of the agency has to support the whole inter-

vention process

Community engagement

Agencies should invite community members and groups

in wherever possible. This reduces the stigma of mental

health services. It is great if they can utilise mainstream

community resources wherever appropriate.

Local knowledge

There should be a database of

local knowledge within the

agency. Although staff will

build up their own connec-

tions the agency should col-

laborate with staff to produce

a record of useful links that

can be passed on to other

workers. Agencies should also

be familiar with relevant facili-

ties in the wider area.

Modelling of Good Practice

It is helpful for an agency to set an example from the top down for all of its staff.

Barriers and boundaries need to be clearly set out within policy to allow staff to feel confi-

dent in sharing and being a real person to the individuals that they work with.

Skill sharing

An agency should not keep its skills

and resources private. Sharing knowl-

edge is really key whether this be a

skilled staff member going and help-

ing other community organisations, or

being happy to share policies and pro-

cedures. By keeping an open mind

and creating a sharing ethos, the

agency is opening up more opportuni-

ties for itself.

16

Enhanced

social

network

knowledge

Potential

Barriers

Worker

PartnershipEquality

Developing

skills,

relationships

and resources

with this

individual and

for the future

Modelling of good practice Skill sharing



Agency

The Agency: case studies

Physical Environment

My first impressions were of a very

light and airy place, the standard of

the art on the walls was amazing,

and no one was sitting at a loose

end. Even those who were at the

computers were conversing whilst

they looked on the internet. The

place had quite a buzz to it.the

caf set up meant that nervous in-

dividuals could just have a cup of

tea without feeling that they had

to engage further...

-field notes, researcher

Community resources

The agency s football groups link

with a local college and the FA. The

chance of being scouted encour-

ages individuals to attend the

groups, play the matches, and en-

gage with the other beneficial ser-

vices offered by the agency.

- reflections, researcher


Thats where I learned if people ever

wanted to come here and they didnt

actually want to (travel), Id go and

meet them and come down with them

- extract from interview, volunteer

The whole building has a buzz about it, a

good feeling. I always go away, even if I felt

miserable when I had come, I always go away

feeling good. Because you come here and you

can sit down and realise that your problems

are not that bad and everyone has their own

problems. And everyone who comes here has

problems and thats why they come here but

they dont bring it out here

-extract from interview, service user

17

Enhanced

social

networkPotential

Barriers

Individual

PartnershipEquality

Developing

ideas, goals,

and

confidence

and working

to attain and

expand on

these

Community engagement Local knowledge



Agency

Modelling of Good Practice

Ethos training from the outset means that new starters in the organisation whether these be

staff or volunteers - are aware of how the agency is run and how they fit into this ethos

- reflections, researcher

Skill sharing

The agency sent policies and contacts through to another local

organization, who had lottery funding to set up but are now strug-

gling to sustain the service. They see it as leading from the front,

and passing on knowledge is one way to continue being a success

and your ethos/philosophy being shared

- field notes, researcher

Local knowledgedisplayed at

centre within the 5 ways to

wellbeing framework

we built this metaphor which was its this lovely picture of a table with all

the stuff we deliver on top of it, but underneath it is all the procedures

like you cant see them, in a big chest and its sort of locked up so you

dont see any of it...

-extract from interview, co-director

Skill sharing

There is a culture that everyone wants to learn a little of everyone

elses role. This will allow knowledge to be shared beyond a single

person holding everything (and thus avoid the issue of it all being

dependent on one member of the team).

- field notes, researcher

Community engagement

weve linked up with LOCOG, which is the Lon-

don Organising Committee for the Olympic

Games...they provide volunteering roles within

the Olympics. So weve been able to throw some

of our guys down that route. And then its down

to them really to take it on

- extract from interview with two staff

18

More information taken from the

participating organisations

Interactive website at BlueSCI allows for individuals to keep up to date

The importance of the environment external to the agency is highlighted in this quote

from a Commissioner:

I think weve been more supportive, a lot more supportive and hands on possibly than

other commissioners might be in other areas and I do think thats helpful ...

And commissioners have the overview of how the organisation compares to others:

They represent a belief in dynamism and proactivity in pursuit of outcomes - whether

these be organisational, community wide or for individuals

19

The practice

The practice refers to the active process that occurs within the intervention.

The intervention model is a very dynamic process with lots of potential for

change and modification. It is not simply instructions to follow which will

result in a particular outcome occurring. We have used two interlocking cir-

cles to represent the fluidity of the process and the uncertainty about when,

or if, social network development will occur. There is room for experimenta-

tion within this practiceit is intended just to provide a framework to work

from.

The shared components of the model are represented in purple, and are lo-

cated at the very heart of the model. They consist of:

The partnership: the relationship built between the worker and the individ-

ual is key to the success of the intervention. It must be an equal relationship

where both parties feel able to comment and change as necessary. The

partnership should be discussed openly from the start, and the conversation

conducted on a level playing field. Other factors key to the partnership in-

clude confidence, flexibility, lived experience, openness, hope and trust.

Although there will be differences between partnerships, it is clear that this

needs to be built over time. First impressions are critical and a consistency

needs to be there in order to allow an individual accessing the service to

open up to a staff member in their own time.

Shared development of objectives and activities (represented by the

square in the middle): This is the crucial part of the model as it represents

the co-produced activities. When the worker and individual meet for the

first time in the context of this model, they discuss the life goals of the indi-

vidual and they develop a realistic strategy together to help him or her

achieve this. The activities may be in the context of what the agency pro-

vides or it may be additional to that.

Some underpinning elements of these activities may include network (and

asset) assessment; objective development; inspiration; facilitation; meet-

ing expectations; orientation; sign-posting; skill recognition and feedback.

20

Enhanced

social

network

knowledge

Worker

Agency

Shared

processes

Developing

skills,

relationships

and resources

with this

individual and

for the future

PartnershipEquality

Confidence

Flexibility

Lived experience

Openness

Hope

Trust

Shared

processes

Network assessment

Objective development

Inspiration

Facilitation

Meeting expectations

Orientation/signposting

Skill recognition

Feedback

The partnership:

The Practice: explained

EQUALITY: This is really keythe worker must be on the same level as the individ-

ual. This needs to be achieved through mutual respectjust as impor-

tant from the worker as from the individual. There is no reason that the

worker cannot take on board comments or suggestions from the individ-

ual to aid their own work, or their wider lives. Similarly, workers can use

examples from their own lives to help the individual that they work with,

where appropriate.

Sessions should be conducted at a location and time chosen by the pair.

Flexibility:

The partnership can be very flexible,

and not bound by paperwork. If an

organization feels that they need pa-

perwork to document meetings and

the process, then it works best for this

to be minimal and interactiveboth

worker and individual should play a

part in filling it in.

Anything above and beyond this

should be completed by the worker

after the session.

Lived experience:

Some service users say that the best

workers are those who have been

through a similar experience to them-

selves. Whilst this is not always feasi-

ble/appropriate, workers can make an

effort to understand aspects of their

clients livesfrom listening to them

talk, to going away and researching a

clients interest to fuel conversation

the next time.

Trust:

This is really important to the individual

a worker will build the trust and re-

spect of their client by ensuring that

they are not late to meetings, and keep-

ing in good contact with them about

arrangements.

21

Enhanced

social

network

Individual

Agency

Shared

processes

Developing

ideas, goals,

and

confidence

and working

to attain and

expand on

these

PartnershipEquality

Confidence

Flexibility

Lived experience

Openness

Hope

Trust

Shared

processes

Network assessment


Inspiration

Facilitation



Skill recognition

Feedback

The shared processes:

Network Assessment:

This is a shared process. It can be

formalnetwork mapping; e.g.

draw me three circles, list who is in

the inner circle and closest to you,

or less formal e.g. a discussion about

who is important in your life and

why.

Inspiration:

Ideally this will come from the individ-

ualtheir dreams and aspirations. Open

questions could promote ideas and discus-

sion, or tools such as an activity timetable

used to pick something new to try. Moti-

vational interviewing can also be used at

this point to identify how best an individ-

ual can move forward.

Feedback:

This needs to be a two-way street with the worker helping the individual to reflect on how they

are progressing, possibly using written notes to gauge progress. The individual will also be able to

comment on the workers performance. This can be achieved if the relationship is very equal face

to face, but a good structure for making comments, complaints and suggestions is also pretty cru-

cial within the agency. Good questions to ask both yourself and to the individual include am I

asking the right questions?, How will we know this is helpful?, and Is this a helpful conversa-

tion?. This allows constant monitoring of how effective the practice is proving to be.

Skill recognition/orientation/signposting:

All of these require the worker to constantly think outside of the box and see as

many opportunities as possible for their client. They need to use their resources,

networks and experiences to help the individual find the best available new oppor-

tunities. Matching individuals according to a shared interest can work wonders,

although care should be taken when doing this. Individuals need to fill valued roles

within the community rather than remaining outsiders

Facilitation:

Some individuals may just need help determining how they

want to move forward, and they can achieve the rest. How-

ever many who may be more anxious will need help taking the

first step. Aiding with the setting up of meetings or introduc-

tions to a new activity goes a long way to overcome nerves.

the willingness to work flexibly and accompany the client to

new activities until they feel comfortable. Using the stages of

belonging to understand at what level an individual needs a

worker to help with can be a useful tool.

22

Enhanced

social

network

knowledge

Worker

Agency

Shared

processes

Developing

skills,

relationships

and resources

with this

individual and

for the future

PartnershipEquality

Confidence

Flexibility

Lived experience

Openness

Hope

Trust

Shared

processes

Network assessment


Inspiration

Facilitation



Skill recognition

Feedback

The Practice: case studies

Flexibility

We met initially each week at a

coffee shop or somewhere where it

just felt like we were having a

chatit never felt like we were go-

ing through questions or filling out

forms. After a while we used to

meet less and left oftenthe de-

crease in intervals was always

something I felt comfortable with

though

- extract from interview, individual

Equality

Office staff and admin staff would come and

get involved, so youve got this real mix of peo-

ple. And you had no idea who was a patient,

who was staff, who was a visitor, who was a

volunteer. It was completely about the activity

and engagement

-extract from interview, director of service

Objective Development

They are not coming to be pressured,

what are you going to do with your life,

you know and so what we try and do

with the service is make it very much user

led, so they come along.we dont say

after 4 weeks, you are going to do

this,...we monitor their progress so you

know, after 4 weeks our health advisor

would be having those conversations

with them, and finding out what it is they

are trying to do

-extract from interview, worker

Skill recognition

I think (there is) something around reconceptu-

alising a service user: if you reconceptualise

what your relationship with your service pro-

vider is into one where youre giving something

back, then actually thats a more empowering

position to be in and it values the fact that actu-

ally everyone who comes into our services has

something to give...we now have two staff in the

s.u. involvement team who are service users

too...one were encouraging to do more train-

ing...shes a very very good trainer and

speaker...so we are trying to build her skills

around that. -extract from interview, worker

Feedback

It (support session feedback) was brilliant because it was a summary of your conversa-

tion...it kind of contextualised what youd done and what youd achieved over the last

month: we discussed that you were going to go and see this, you were going to do that,

and you were going to give up smoking, and things like that you know.theres a lot of

things going on in there which you didnt realise but you were going forward all the time

23

Enhanced

social

network

Individual

Agency

Shared

processes

Developing

ideas, goals,

and

confidence

and working

to attain and

expand on

these

PartnershipEquality

Confidence

Flexibility

Lived experience

Openness

Hope

Trust

Shared

processes

Network assessment


Inspiration

Facilitation



Skill recognition

Feedback

Facilitation

Due to a semi-paralysis down his left-hand

side, he could no longer carry his equipment

and therefore had had to stop fishing. The

agency put him in touch with someone else

who was interested in fishing, who wanted a

companion to do this with. The pair now go

fishing together regularly, and the gentleman

has reported an lift in his mood as a result of

attending the service.

Field notes, researcher

Network Assessment

in that handbook now were asking each man-

ager to build a resourcelike a community re-

source and weve got two blank pages basically

for that with all of the different resources in the

community that people can access

Extract from interview, worker

Equality

Were heavily in control in a sense and then were trying to empower them to take

control at the end of our contact with them, that thats changed and that theyve be-

come in control. Its what were aiming for

- extract from interview, worker

I chip in, tidy up, setting up the flat, you know, putting on the cot linen...


Openness and objective development

look, were going to establish a partnership here Ill provide as

much guidance as I can, as much support as I can, but the duty

work, you have to do it. Because this is your life. This is not about

me, this is about you. So usually, I use that kind of approachI

always say to them, look, I dont have any kind of clinical train-

ing, so were not going to talk medication, were not going to talk

symptoms, and things like that. What we are going to talk is

what you need, what you want, and where you want to be.


It (support session feedback) was brilliant because it was a summary of your conversa-

tion...it kind of contextualised what youd done and what youd achieved over the last

month: we discussed that you were going to go and see this, you were going to do that,

and you were going to give up smoking, and things like that you know.theres a lot of

things going on in there which you didnt realise but you were going forward all the time

-extract from interview, individual

24

More information taken from the

participating organisations

The process of empowering the individual is a

tricky one: there is a balance between mollycod-

dling them and risking relapse if a worker pushes

too hard. It is also important to keep the process

moving forward, rather than finding a state where

the individual feels comfortable with their level of

empowerment and sticking there for too long.

If you focus on the process and making sure the

process is empowering, making sure that the values

that we would like to bring into the relationship are

actually brought in and evidenced into the day to

day interactions with people then the outcomes that

we would like i.e. people feeling confident to go out

and do different things meet other people engaging

with the one to one work but also engaging with the

wider activities happen naturally. Because its only

through process that people change, its only

through the moment to moment interaction with

someone that someone can feel better.


Matchmakinga good or bad idea?

Workers who find two individuals with similar interests often want to link the pair up. This would re-

sult in an increase in social capital for both. However, company policy often prohibits this due to con-

fidentiality issues and risk levels. A worker should discuss with other staff before making a link.

Youd love to be like a matchmaking agency and be able to go, oh my god, I know this person, but I

mean I think thats kind of, their place to do that. And thats where they gain those skills, getting their

confidence up to have those conversations with people to know its going to be alright.


I meet them both individually and we do the same things. They want to go to the same town, they

want to go to the same computer game shop. And that gets me thinking, I dont need to do this with

you, you could do this together. But obviously, you know, confidentiality and their own issues...its

very difficult. . potentially, they could be really good friends. But, you cant force people to be

friends and...its a bit of a political mine field - extract from interview, worker

25

The individual

In order for the intervention process to work effectively, there is the pre-

requisite that the individual needs to have some enthusiasm for engaging in

this process and ownership of it. In other words they need to have a wish

to change. A level of enthusiasm can be encouraged/inspired by a skilled

worker, but for the process to work in the long term the individual has to

take responsibility for themselves, and must have a desire to do this.

This is often a major challenge, especially when individuals suffer with high

levels of anxietyin other words there are cases where an individual may

want to change but does not have the confidence to start on the journey. A

worker must be sympathetic and flexible to allow the individual to choose to

start the process and move forward in their own time. A worker also needs

to listen to how large or small a goal the individual wants to setthey may

see a small amount of social networking as sufficient for their wellbeing.

An individuals journey is represented by the blue circle on the right of the

model. This is the focus of the intervention process as it is where the social

network development is expected to occur. We expect it to involve the indi-

vidual being exposed to new ideas; being introduced to new people and

activities; the development of skills and interests; development of social

confidence; and building currency (both personal and social). We have de-

liberately omitted any details about what the individual and worker might

do within this process as it is up to them to co-produce the activities.

We believe that social network development may occur at any point as a

by-product of the process.

Barriers to social network development (represented by the smaller circle

to the right of the model) work in the opposite direction to the intervention

cycle and can pose considerable challenges for some individuals. These may

include stigma; cultural factors; physical health problems; complicated ex-

ternal lives; poor attitudes of self and the organisation providing the con-

text for the intervention; bad social capital; lack of information; or poor

access to services. These barriers present the worker with a number of chal-

lenges, and are likely to be the most time-consuming element of their work.

26

Worker

Agency

Developing

skills,

relationships

and resources

with this

individual and

for the future

PartnershipEquality

Shared

processes

Enhanced

social

network

knowledgePotential

Barriers

The worker and agency must help the individual to help themselves

move forward:

The Individual: explained

Barriers

Stigma: By grounding the service within the wider community, and linking individuals by a common activity

rather than illness, the stigma of a separate mental health service reduces. Self-stigma can also be reduced

by encouraging the individual to attend large-scale organisational events, as there are likely to meet people

that they can relate to. This is seen as a key issue by workers and individuals alike, and is really important to

tackle effectively.

Physical health: Workers need to be sensitive to physical health issues when suggesting activities, and ensure

that they are inclusive to allow the individual to take part fully.

Complicated external lives: Although family etc should be included where appropriate in the process, the

individual should keep ownership of the process and prioritise their journey as something that they will do

for themselves.

Attitude of self/of organisation: Staff working with an individual with a self-limiting attitude should encour-

age them to take very small steps forwards, for example attending just one appointment or making just one

phone-call.

The agency should strive to support people to move on rather than be an overly nurturing, protective place.

The individuals journey

As stated in the introduction to this section, the processes occurring here are unique to each worker-individual

pairing, and need to be flexible and dynamic to the situation.

The crucial idea to keep in mind is that this is not a linear process. Individuals move as part of a cycle. Their

own attitudes and experiences mixed with the impact of the opportunities around them, the workers efforts,

and the agency create a different experience for each person. Some may move around the stages of the cycle

more quickly than others, and some may skip stages. A worker needs to expect the unexpected, as results may

occur earlier or later than were preconceived, and opportunities need to be seized as they come up.

Social network development and the building of social capital is the end goal of the process, but this may occur

as a by-product of any one of the stages on the model. An individual may move through the cycle and build

their social network up but still want more support in which case the cycle could start again with new oppor-

tunities being identified.

Barriers continued:

Bad social capital: If an individuals network is impacting negatively on them they should be encouraged to seek out

alternatives.

Access to service: Workers should accompany individuals where necessary. If a service is geographically governed,

knowledge of similar services nearby is important.

Lack of information: The service must be promoted clearly in a variety of different locations. The inclusion/exclusion

criteria must be evident (e.g. an age restriction or a referral from CMHT needed).

Cultural factors: Individuals from tightly knit cultures may be less likely to access mainstream services and allowances

must be made for these groups.

27

Enhanced

social

network

Agency

PartnershipEquality

Shared

processes

Individual can leave

and re-enter the

intervention at any

point of the cycle

as desired/required

IndividualOwnership

Enthusiasm

Introduction to new people

and activities

Development of

skills and interests

Building currency

Catalysing ideas

Development of

social confidence

Potential

Barriers

Potential

BarriersPhysical

healthAttitude:

self/

organisation

Lack of

information

Access to service

Stigma

Bad social

capital

Diversity

factors

Complicated

external

lives

Freedom to leave and return

The individual should be encouraged

to engage with the intervention proc-

essthrough the positive conse-

quences that they begin to witness,

the reinforcement of the new confi-

dence and experiences that they begin

to experience. However, the individ-

ual should never be forced or con-

tracted to spend a minimum number

of weeks on the intervention. Please

note that the intervention process is

different to attending the service as a

whole. People can still access the ser-

vice without feeling they must con-

tinue with the intervention. They may

re-enter the intervention at a different

stage to where they left it.

Moving on

Where protocol allows, it is best that

an individual never feels that they

cannot re-access the intervention, or

the service within which it occurs.

The best results of people moving

on seem to come from organisations

where individuals see an open door

that they can re-enter as necessary.

This seems to allow people to have

the confidence to try new things,

acting as the back up that they need,

until they no longer think about it.

The stages of the process

A worker needs to be able to gauge at what stage the individual is in the process in order

to judge when and how to move forward.

Generally, increased personal confidence, an increased attitude of ownership towards a

task etc, and a more forward looking attitude are signs that an individual is comfortable at

a stage and that it may be time to move forward. Body language and a change in the sup-

port that they ask for are other hints that can be monitored to determine this.

If an individuals network is impacting negatively on them they should be encouraged to seek out

Workers should accompany individuals where necessary. If a service is geographically governed,

The service must be promoted clearly in a variety of different locations. The inclusion/exclusion

Individuals from tightly knit cultures may be less likely to access mainstream services and allowances

28

Worker

Agency

Developing

skills,

relationships

and resources

with this

individual and

for the future

PartnershipEquality

Shared

processes

Enhanced

social

network

knowledgePotential

Barriers

.

The Individual: case studies

Bad social capital

Because even though Ive got friends to hang around

with, some of them are not very good friends. Some of

them drink, (do) drugs, and even though I drink the odd

time, but, they do drugs and you know, its just sort of

like, theyre wrong ones, do you know what I mean?

And I want to hang around with decent people who

want to get their life in track and not destroy their life.


Initiating the process

...people come into this sort of situation for the

first time theyre testing it because thats exactly

what I used to do, you put your foot in the door

and take it back out again. Maybe a couple of

months down the line theyll put 2 feet in the door

and try. Youve got to remember a lot of these

people have been shells for years and years and

yearsthey dont trust anybody, its hard to really

sort of like to befriend all at once so youve got to

take a short of gradual you know process cause

you can frighten people away just as easily.

-extract from interview, service user volunteer

Attitude of self/organisation

One part of it is fear cause they tell you ok youre

better now, and you got some idiot telling you youre

better because youve ticked all the boxes and youve

gone through your programme and there are people

still in therapy and they look a lot worse than you

cause you seem to be ok then youre ok.

- extract from interview, service user volunteer

Because sometimes individuals dont want to engage,

thats a decision theyve made, theyre not ready


Barriers

If someone had difficultyit would be about

sitting down and working through it and what it

was that there were barriers that make it diffi-

cult for them to get to the group. Is there any-

thing that we could put in place that would

make it easier for them to do that? Is there

somebody else that they might want to come

with them? That might make that easier?

Would they perhaps want to come for part of

the groups


Building currency/social network development

People swap contact details and decide to go out

socially with each other and make contact on

Facebook. But theyve got a shared experience to

start with. And it just develops.

- extract from interview,

Ill say, well I dont know the answer to this but

what we could try is Googling this? so its almost

like, youre sharing, you have social capital... That

whole ability to think and research and connect.

Youre almost modelling it.


29

Enhanced

social

network

Agency

PartnershipEquality

Shared

processes

Individual can leave

and re-enter the

intervention at any

point of the cycle

as desired/required

IndividualOwnership

Enthusiasm

Introduction to new people

and activities

Development of

skills and interests

Building currency

Catalysing ideas

Development of

social confidence

Potential

Barriers

Potential

BarriersPhysical

healthAttitude:

self/

organisation

Lack of

information

Access to service

Stigma

Bad social

capital

Diversity

factors

Complicated

external

lives

Leave and re-enter the cycle

She doesnt see herself as having

stopped interacting with the ser-

vice altogether, as she still goes

back from time to time and

would like to volunteer in the fu-

ture field notes, researcher

Development of skills and interests

I dont think it matters if youre only doing one thing a

week but the one thing you week youre doing is so fan-

tastic that you can go home, if its an art class and be

painting and doing a lot of stuff on your own


Development of social confidence

...what we talk about is, not piling lots

and lots of activities into, into your week.

But having regular exposure, so having an

hour a day, go to the gym or even four

hours a week, go to the gym. Just con-

stantly go and then sooner or later, you

become acclimated to the environment

and you become a lot more confident in

that environment and then you can ex-

pand those experiences.


Exposure to new ideas

Its giving them ideas, new ideas that they might not have thought of before I think really.

So I throw a lot of things out that might not necessarily apply to them. But generally theyll

find something thats interesting and think...


...well, straight away, they said, are you interested in the activities. And as far as I, I was-

nt interested, I was like, nah, Ill just use the team for the doctors, just to go and talk. But

then later on...I used the services, the activities...Ive been playing football for two years

with them now.


I see the, the exposure to new ideas as being a joint thing as well because Im constantly

being exposed to new ideas from my clients that make me question quite a few things. Have

I got that? Am I clear in my mind when I think about that? So I do find that working with

people is kind of a thought provoking kind of process. So its not introducing clients to new

ideas. Theyre introducing us to new ideas. And so thats a fifty-fifty kind of split up


Building currency/social network development

People swap contact details and decide to go out

socially with each other and make contact on

Facebook. But theyve got a shared experience to

extract from interview,

worker

Ill say, well I dont know the answer to this but

what we could try is Googling this? so its almost

like, youre sharing, you have social capital... That

whole ability to think and research and connect.

Youre almost modelling it.

30

More information taken from participating

organisations

Below are some extracts of interviews showing the individuals

perspectives of the process

Yes the organisation did help me to move on, but not in an obvious way, in other words I did not

feel pressurised to stop attending. The idea of going to university to study to degree level was

something I had thought about in the past, but never really thought I would do this. At a group

session I mentioned this but was not going to do anything about it, until (my worker) encouraged

me to do something about it, and I applied to college and was accepted onto an access course.

On the first morning (my worker) met me at the college to reassure me that I was able to take this

route. II went on to complete the course, and was accepted on to a History BA (hons) course, which

I completed earlier this year and gained a 2:1

If it was not for (the organisation) I doubt very much I would have gone into higher education.

Ive come through the hospital and hostel, Ive been through prison. And Im nearly getting my own

place, on my feet. And once I do get that, I want to be looking at education, you know, part time edu-

cation, preferably evenings. Something, Im going to enjoy doing something that I have a future in.

everyones got assets: when youre ill and

particularly when youve got mental health

problems you forget about them and theyve

got to be coaxed out.

Well I find that shes (the worker) quite clever, shes

quite good at analysing and making me think and un-

derstand the way I think about things, like prob-

lems...like going out, she, shes been getting me to

think about what it is that I dont like about it. And she

taught me to understand that even though I dont feel

like doing some of it. If I do, then Ill benefit from it.

31

The worker Just as the individual must be enthusiastic and have the desire to move for-

ward, there are also pre-requisites of the worker in order to ensure that the

intervention is as successful as possible. An empathic worker, who under-

stands the factors that impact on the individual will find the best way to

work around these problems. The worker should hold a can-do attitude and

be driven to see the possibilities in situationsbe this forming new relation-

ships, learning new things or exploiting existing contacts ...they need to be a

natural networker, or to be able to link individuals with others who are.

They should also see the value of an individuals existing networkothers

may know useful things that are invaluable to the individuals progress.

Workers need to think creatively to help an individual to think of new ideas.

If an individual cannot find inspiration, a worker can help them to be in-

spired. This can be aided by the worker letting their personality shine

through in their jobagencies should know workers interests and allow

them to be resourceful people in their own right, rather than simply facilita-

tors to link the individuals accessing the service to other contacts.

The workers journey is as important in the intervention process as the indi-

viduals. This assumes that the worker will need to develop their own social

network knowledge in order to support the individual on their journey.

Workers will need to build relationships; foster trust; identify opportuni-

ties; engage with the local community of the individual; develop their own

networks and resources; adapt to new ideas; and utilise their contacts in

the process of supporting the individual they are working with. At any point,

they may need to provide extra support or reassess their involvement with

the individual, whilst the individual may seek advice from the worker.

Along the way, the worker may also face barriers, including a lack of local

knowledge, poor systems, a lack of resources, and most importantly an un-

helpful attitude. These need to be addressed to allow their own develop-

ment of social network knowledge, as well as an effective partnership with

the individual to be created. The worker should never do something for the

individual, instead they should help them to do it for themselves.

32

Shared

processes

PartnershipEquality

Agency

Enhanced

social

network

knowledge

WorkerWorker

Empathy

Can-do attitude

Natural networker

Extra Support

Reassessment

Adapting to new ideas

Utilising contacts

Building

relationships

Fostering trust

Developing own networks

and resources

Engaging with local community

Identifying opportunities

Attitudes

Lack of

resources e.g.

time, funding

Poor processes/

bureaucracy

Lack of local

knowledge

Potential

Barriers

Extra support and reassessment

The path to recovery is not a smooth one and individuals may progress substantially before encountering an issue, or

relapsing. To help this, the worker can monitor the individual in a sensitive fashion to allow for extra support where

necessary. This may come in the form of meeting them more frequently, or re

their confidence is built up once again. Conversely, if the individual is leading a relatively independent lifestyle then

calls or text messages can be less intrusive than a structured, regular meeting. Over time as the individual becomes

more integrated with their new social networks, the role of the worker should become less important. Accurate as-

sessment of when and how to drop back and allow the individual to go it alone is crucial.

Building relationships:

Positivity and optimism from the outset is invaluable..

Different workers gave different ideas for engaging indi-

viduals. These included:

Using humour to create a bond and creating an environ-

ment where there was a free reign to take the mick out of

one another;

Sharing some information about yourself to find common

ground;

Sharing your own experiences of mental health;

Simply smiling and using open body language to make the

individual feel as comfortable as possible.

Identifying Opportunities

It is useful to be constantly on the look out for new opportu-

nities in the local area, through both information given out

by their agency and also their own research. They must be

dynamic and use their imagination to think creatively about

finding new opportunities. If they come across something

of interest, they should share with their wider team to allow

this knowledge to be effectively utilized.

Fostering trust

To build trust, the reliability and punctuality are really important at key work sessions.

They could also try to remember or note down key details to ask about the next session,

which encourages feelings of trust within the individual: that the worker really is inter-

ested, and really does care what they think and say.

Trust goes beyond this, however, and takes time to build up with an individual. The way

that a worker acts as an individual gets to know them will be the biggest tool to build (or

to not build) trustindividuals need to know a worker means what they say.

The Worker: explained


Creating bonds with the community allows the individual who the

worker is helping to easily pass from mental health specific ser-

vices into the mainstream. If the worker has contacts in the local

area, this transition is aided...for example a college admissions

tutor will be more sympathetic towards a new admission.

Additionally, having these eyes and ears in the local area provides

a more comprehensive knowledge of potential opportunities for

the future.

Knowledge of relevant facilities further afield will help the individ-

ual to branch out more to follow a special interest. It is important

to remember that a swimming pool or cinema is somewhere that

an individual goes with a friend, not to make a friend

Barriers

Of all of these barriers, the attitudeof staff, agencies and other

organisationshas been cited as the hardest to overcome.

Good working relationships within and outside of the organisation

can help this.

Breaking larger barriers into smaller, more manageable problems

with single solutions can also aid workers with overcoming barriers.

33

Shared

processes

Individual

PartnershipEquality

Agency

Developing

ideas, goals,

and

confidence

and working

to attain and

expand on

these

Enhanced

social

networkPotential

Barriers

Extra support and reassessment

The path to recovery is not a smooth one and individuals may progress substantially before encountering an issue, or

relapsing. To help this, the worker can monitor the individual in a sensitive fashion to allow for extra support where

necessary. This may come in the form of meeting them more frequently, or re-attending a group with them until

their confidence is built up once again. Conversely, if the individual is leading a relatively independent lifestyle then

calls or text messages can be less intrusive than a structured, regular meeting. Over time as the individual becomes

more integrated with their new social networks, the role of the worker should become less important. Accurate as-

sessment of when and how to drop back and allow the individual to go it alone is crucial.

Building relationships:

Positivity and optimism from the outset is invaluable..

Different workers gave different ideas for engaging indi-

viduals. These included:

Using humour to create a bond and creating an environ-

ment where there was a free reign to take the mick out of

one another;

Sharing some information about yourself to find common

Sharing your own experiences of mental health;

Simply smiling and using open body language to make the

individual feel as comfortable as possible.

Developing own networks and resources

This can often be a by-product of the research

completed to find opportunities for the individ-

ual. These new opportunities should be recorded

rather than forgotten about, and again shared

with the agency as a whole if appropriate.

If the worker has a particular area of interest

then they may take time to build up knowledge

of this, as it will improve their own skill set and

allow them to potentially be more useful to an

individual in the future.


A dynamic agency will change frequently and the worker needs

to be enthusiastic about this rather than see it as a hassle.

If the individual changes their ideas, it should be taken as a posi-

tive thing as they are taking ownership of their recovery journey.

If the change feels like a step back then a discussion should be

held about what makes this new idea attractive.

Utilising contacts

A worker must have the confidence, and be supported by their agency, to use the contacts and

resources that they have built up in order to help the individual to progress. A file of numbers

and email addresses built up by the agency will simply go stale and connections will fade if they

are never used.

Workers could consider using their personal contacts if the contact could provide something spe-

cific for an individual. However, company policies and boundaries should be taken into consid-

eration when doing this.

34

Shared

processes

PartnershipEquality

Agency

Enhanced

social

network

knowledge

WorkerWorker

Empathy

Can-do attitude

Natural networker

Extra Support

Reassessment


Utilising contacts

Building

relationships

Fostering trust

Developing own networks

and resources


Identifying opportunities

Attitudes

Lack of

resources e.g.

time, funding

Poor processes/

bureaucracy

Lack of local

knowledge

Potential

Barriers

The Worker: case studies

I try to make the individual laughI cultivate

an atmosphere of humour in my ses-

sions...sometimes people are laughing at me

but they are laughing together at a common

cause, and this makes them bond

- extract from conversation, volunteer

The empathic worker

I think what youre doing is that youre

understanding people, what its like for

people, other people to, in terms of social

interaction, what its like for other people

when they might lack the confidence to

go out and meet other people.


Building relationships

I will, kind of, smile, encourage them, because

really, it is not that easy, not very easy for any

human being, when you have someone, that

you dont know, before, coming into your life...I

have at the back of my mind, my conversation

is giving them that assurance.


Identifying Opportunities

I guess if someone wants to work in a gallery, what

about an arts suppliers or what about WH Smith? Or

what about a library, which have links to kind of the arts

and stuff like that. What about theatre?...Its just trying to

think creatively...if someones interested in art, thinking

about all the arts and, those kinds of places. It could be

music shops and it could be the cinema. And then through

talking about these things: oh actually I would quite like

to work there. - extract from interview, worker

Fostering Trust

So for us to make that attachment stronger, we

have to keep to the time...if you promise to do any-

thing for them, be sure you keep to it. If theres any

changes, you inform them immediatelyIf Im going

on annual leave, I will let them know, I will inform

them when Im going, when Im coming back and

any other contact number, office number if they

need to talk to somebody...we put all those plans in

place - extract from interview, worker

35

Shared

processes

Individual

PartnershipEquality

Agency

Developing

ideas, goals,

and

confidence

and working

to attain and

expand on

these

Enhanced

social

networkPotential

Barriers

Extra support/reassessment

(I) try and work out with them exactly what it was that was

stopping getting them from whatever they needed and was it

a very particular thing like, I dont know, they were intimi-

dated by being in that space or felt uncomfortable. And try to

work with them to overcome that hurdle. I think that

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