Innovation in care models is seen as a key mechanism for addressing demographic and financial challenges facing the care system. One such recent development are strengths-based approaches to social care and social work. A previous systematic review of the literature conducted by the Adult Social Care Research Unit (ASCRU) showed that little is known about the development and implementation of strengths-based approaches in adult social care and social work. The present study builds on existing evidence and the literature review noted above.
Aims
The overarching aim of this study is to understand how existing strengths-based models and approaches are being applied in the social care and social work arena in England. In addition, we wanted to explore how and why these have been implemented locally; and how these models are impacting on practice.
Methods
This study reports analysis of free-text answers from an online survey and semi-structured interviews with professionals involved in organising, managing, delivering, and commissioning strengths-based approaches to adult social care and social work. We invited eligible participants to take part in the survey between December 2020 and October 2021. Participants who took part in the survey – and agreed to be contacted for interview – were invited to discuss their experiences further and expand upon comments made in the online survey. These interviews were conducted between August and December 2021. Responses from the online survey and individual interviews were analysed separately using framework analysis.
Results
In total, 32 participants completed the online survey and ten participants took part in a one-to-one interview. Participants reported adopting strengths-based approaches in a fluid, flexible way – with the ‘Three Conversations’ (3Cs) model being the most common. While participants had a sense of what they felt constituted a strengths-based approach, many participants also stated that it was not distinctively defined and was difficult to articulate. Largely participants agreed that strengths-based approaches are relevant for everyone (either directly or indirectly) involved in or in receipt of social care or social work services. However, some participants suggested that they may not be as suitable for people with severe mental health problems or severe learning disabilities and/or people in crisis. Participants spoke about a range of outcomes/impact they felt had resulted from taking a strengths-based approach in their area of work. These included:
Participants reported a number of challenges related to adopting strengths-based approaches including: incompatibility of existing systems and organisational structures; workload pressures and a depleted workforce; limited resources including scarcity of community ‘assets’; applying this approach at crisis point; challenging a dependency culture and reluctance to adopting a strengths-based perspective in some situations. Participants cited strong leadership, organisational ‘buy-in’ and trust between all individuals (from senior managers to practitioners) as key to successful adoption and implementation. Attempts to ‘evaluate’ the impact of strengths-based approaches varied and included small-scale qualitative and quantitate data collection within local authorities.
Conclusion
Overall survey respondents and interviewees were optimistic about strengths-based approaches. Many described the positive impact it was having on their work, and on their ability to help and support people more effectively. Despite the fact that, in general, participants in the study had a very positive view of strengths-based approaches and could identify a range of benefits resulting from their adoption, there is only limited evidence of its effectiveness as a model. The challenge for researchers – and to some extent practitioners too – is how to meaningfully capture the nuanced impact of adopting such a multi-dimensional approach, including and particularly what, and how, it contributes to improved outcomes for adults with care and support needs and their families. A case study model, which permits the benefits of a strengths-based approach to be made visible whilst accommodating the complexity of the issues facing adults with care and support needs and the role of practitioners in helping to meet these is likely to be appropriate. The challenge for policy is how to operationalise and replicate the benefits, including better outcomes, of adopting a strengths-based approach. Changes in assessment and care planning (making them more outcomes focussed for example) may be one approach; a ‘top down’ strategy is unlikely to be appropriate on its own. It is evident that whilst ‘more aspirational practice’ helps to deliver a strengths-based approach this is only one element of a broader shift. The principles and values associated with adopting a strengths-based approach appear to be consistent with providing high quality social work and social care. The inherent requirement is that a strengths-based approach has to be at the centre of practice, with the prerequisite that for this to happen meaningfully it has to be underpinned by organisational and infrastructural commitment and support. Together these results can help to inform the development of an appropriate framework(s) or method(s) to evaluate strengths-based approaches applied in adult social care and social work in England and help policymakers to make evidence-informed decisions regarding investment in strengths-based approaches.