constructive functional diversity – mindset & language
TRANSCRIPT
Constructive Functional Diversity
A NEW, ENABLING MINDSET AND LANGUAGE
OF REHABILITATION
Philip PatstonCQSW, Dip App Soc Studs
Have you heard of these
conditions?
• Chronic Physiological Superiority Syndrome
• Ineptitude Imperfecta (Einstein’s Disease)
• Aesthetic Arrogance Disorder
• Chronic Physiological Superiority Syndrome
• Elite athletes
• Ineptitude Imperfecta (Einstein’s Disease)
• Geniuses
• Aesthetic Arrogance Disorder
• Beautiful people
Have you heard of these
conditions?
• Cerebral palsy
• Down syndrome
• Multiple Sclerosis
• Asperger’s syndrome
Have you heard of these conditions?
• Cerebral palsy
• Me
• Down syndrome
• People with a third copy of chromosome 21
• Multiple Sclerosis
• People with damaged nerve cell insulation covers
• Asperger’s syndrome
• People with unique ways of interacting socially, nonverbal communication, and/or restricted and repetitive patterns of behaviour and interests
Have you heard of these conditions?
Why do we use medical labels for some people
and not others?
• values, beliefs, attitudes
• sadness, a focus on loss, pity, denial
• shock, horror and devastation
• our own fear of losing function
• dysfunctionphobia
What needs to change?
• stop people thinking negatively in terms of impairment and disability
• facilitate a constructive change in their thinking about function
Edward de Bono
Emphasises the importance of precision in the use of words to become more expressive.
Positive thinking keeps us in undesirable situations if it immobilises us from action by perpetuating thinking good things about bad circumstances.
Constructive thinking moves us towards the desirable outcome.
CONSTRUCTIVE FUNCTIONAL DIVERSITY
(CFD)A new way of thinking
about function
IN A NUTSHELL
25% 75%
IN A NUTSHELL
25% 75%
Four core elements:
1. Modes – how we function
2. Outcomes – why we function
3. Value (or desired state) – the level of importance placed on function
4. Capacity (or actual state) – the level of ability to function
CONSTRUCTIVE FUNCTIONAL DIVERSITY
(CFD)A new way of thinking
about function
Modes – how we function
1. Biological function: chemical reactions in the brain, circulation, organ function
2. Aesthetic function: appearance, beauty, and attraction
3. Motor function (or physical function): coordination, movement, performing activities
4. Sensory function: Sight and hearing, taste, smell, kinaesthetic sensation
5. Cognitive function: thinking, reasoning, perform intellectual activities; intellect, intelligence
6. Social function: expressing and interpreting communication ;engaging in relationships; understanding social mores
7. Emotional function: experiencing, interpreting, understanding emotional feelings; emotional intelligence
8. Creative function: imagining solutions, innovating, designing, inspiring unique outcomes
9. Spiritual function: being rather than doing; higher beliefs about life and self, observing or expressing – through religion, ritual
CONSTRUCTIVE FUNCTIONAL DIVERSITY
(CFD)A new way of thinking
about function
Modes – how we function
Sexual function?
Cultural function?
• involve all of the listed modes of function?
• may be better classified as outcomes?
CONSTRUCTIVE FUNCTIONAL DIVERSITY
(CFD)A new way of thinking
about function
Outcomes – why we function
Task – work or assignment, which may be simple, useful, important or difficult
Job – paid trade or profession, something needing to be done or dealt with
Occupation – an activity on which time is spent, paid or unpaid
Role – the usual or expected function of someone, the part played in a given social context
Meaning – what something means, what someone intends to express
Utility – the quality or state of being useful or beneficial
Purpose – the reason something or someone exists
CONSTRUCTIVE FUNCTIONAL DIVERSITY
(CFD)A new way of thinking
about function
Value (or desired state) – the level of importance placed on function
Capacity (or actual state) – the level of ability to functionCONSTRUCTIVE
FUNCTIONAL DIVERSITY(CFD)
A new way of thinking about function
Value and capacity
dynamic, changing elements
value changes all the time for individuals, groups, cultures and societies
match or mismatch in value and capacity determines level of functional synergy
people with common function more likely have higher levels of functional synergy than people with unique function because the capacity of common function matches the value of common function
CONSTRUCTIVE FUNCTIONAL DIVERSITY
(CFD)A new way of thinking
about function
Value
measured internally and externally (in relation to a person’s internal or external experience)
• my own value in relation to my ability to sing well or understand meaning (internal)
• society’s value of being able to sing well or understand meaning (external)
relatively abstract and variable
can be changed (and does change) quite fluidly in individuals and groups.
CONSTRUCTIVE FUNCTIONAL DIVERSITY
(CFD)A new way of thinking
about function
Capacity
also measured internally and externally
• ability to function without support or enhancement (internal)
• assistance to function provided by people or equipment (external)
impossible, difficult or unreasonable to change
• cf. Social Role Valorisation (SRV), Wolfensberger
• ‘enhancing competency and image (of the person and their surroundings) will result in positive roles being made a possibility for devalued people’
CONSTRUCTIVE FUNCTIONAL DIVERSITY
(CFD)A new way of thinking
about function
Low functional synergy
Aesthetic
Unbalanced functional synergy
Aesthetic
High functional synergy
Aesthetic
CONSTRUCTIVE FUNCTIONAL DIVERSITY
(CFD)A new way of talking
about function
CONSTRUCTIVE FUNCTIONAL DIVERSITY
(CFD)A new way of talking
about function
Impairment/disability perspective
CFD perspective Explanation of term
Impairment, including functional impairment (ICF) – “significant deviation from statistical norm”
Unique function The distinctive capacity and value of function held by an individual or group
Diagnosis Origin of unique function The cause of or reason for an individual’s unique function
Disability; disablement (social model definition)
Functional bias The favouring of a certain capacity to function over another
People with disability(ies); people with impairment; disabled people
People with unique function People who hold a distinctive capacity and value around function
People without disability(ies); people without impairment; non-disabled people
People with common function
The majority of people who exhibit regular modes of functioning
To disable someone To exhibit functional bias The active demonstration of favouring a particular functional capacity or value
To be disabled To experience the impact of functional bias
The result of being a passive recipient of functional bias
Impairment/disability perspective
CFD perspective Explanation of term
Disability support (service or equipment)
Functional enhancement (system or device)
A system or device that enhances function by reducing functional gap or increasing opportunity
Independence/autonomy Functional synergy A match in functional value and capacity
Acquired impairment Functional realignment A significant change in functional capacity
Rehabilitation Functional reconfiguration The process to re-evaluate and change the relationship of functional capacity and value
Adjustment to impairment Functional reconciliation The outcome of functional reconfiguration
Limitation to activity (ICF) – “difficulty in performance of activity”
Internal functional opportunity/gap
The potential/latent value or capacity created a mismatch between functional value and capacity due to unique function
Restriction to participation (ICF) – “problems in involvement”
External functional opportunity/gap
The potential/latent value or capacity created by a mismatch in value and capacity due to functional bias
CONSTRUCTIVE FUNCTIONAL DIVERSITY
(CFD)A new way of talking
about function
Impairment/disability perspective
CFD perspective Explanation of term
Barrier (ICF) – “environmental factors that condition functioning”
Functional challenge (obstacle)
The potential value or capacity created by removing an obstacle which creates an external functional opportunity/gap
Disability (ICF) – “negative interaction between person and environment”
Functional dissonance The discord caused by the presence of a functional challenge
CONSTRUCTIVE FUNCTIONAL DIVERSITY
(CFD)A new way of talking
about function
Enabling rehabilitative
outcomes
Psychological benefit
create a shift in thinking for people who experience functional realignment (acquire impairment)
current binary paradigm requires people not only to survive the trauma of the incident that creates the realignment, but also to join the group of stigmatised people that they have feared (dysfunctionphobia)
creates the opportunity for a person with changed function to perceive their situation from a position of value rather than stigma.
Enabling rehabilitative
outcomes
Understanding motivation to recover
Some people have higher motivation than others to reconfigure function (rehabilitate) after a traumatic incident. CFD may be able to offer an explanation.
If someone has lost capacity to function in a mode or outcome area that they highly valued, the impact will be greater than if they placed low value on that functional area.
If the person realises it will be impossible to regain that capacity internally, and isn't satisfied with the use of functional enhancements, this will affect motivation.
The options for successful reconciliation, therefore, are:
• to change the internal value placed on the affected area of function and/or
• to raise the internal value in another area of function where capacity has been unaffected
Enabling rehabilitative
outcomes
Client directed practice
fosters practice where clients can direct the reconfiguration process
explores a dynamic landscape of functional modes, outcomes, value and capacity (internal and external)
choice whether measurement or interpretation are determined subjectively (by the client) or objectively (by the professional)
Contact me• Philip Patston
Managing DirectorDiversity New Zealand Ltd
• email [email protected]
• web www.diversitynz.com