^{‘What Must Be Done?’}

Introduction

Should anything be done?  Why should we want to do anything about devaluation?  Is it necessary to do anything different with devalued groups?  What about the people society does not want to be helped?  Does doing something possibly endanger the devalued group?

Normalisation, SRV and Ideology and Science

Normalisation was set up as a programme for change- change the person, change the institution.

North American Normalization admitted upfront that it was an ‘Ideology’- that is to say that it told one what was necessary.

SRV as reformulated by Wolfensberger makes no claim to be a programme, nor an ideology.  It is a scientific consideration of what we know about people cast into lowly states.  It makes no claim to tell one what to do about this.

However, if one feels that ones wishes to do something to help people who are lowly, the SRV might help those people to decide what they should do for maximum benefit to the lowly.

The Necessity of Change?

SRV is silent when it comes to this issue, save to point out that much change occurs because of fads and styles and is often mediated by unconscious and potentially harmful thinking.

However, SRV is not silent about what actions should bring about the maximal positive change in the lives of the lowly.

If I Believe Change is Necessary, What Should I Do?

SRV would say that if you as an individual or as an organisation have made a commitment to address the plight of the lowly in the most effective way, then one should understand devaluation and why the lowly exist, and that you should study the science of what works best in rescuing the lowly.

What Most People Require to be Whole

Most people require ‘The Good Things in Life’ and need to avoid any or all of the Wounds.

People need Home, Work, Leisure, Education.

People need Friends, Colleagues, Family, Community

Given sufficient of the above, most people manage to maintain a semblance of a valued life.

People from devalued groups are often denied much of the above.  Great societal effort may be put into ‘helping’ tem or defending society from them at great cost to society and to the individuals devalued.  People are forced to undergo ‘cures’, ‘cares’, ‘therapies’, ‘treatments’ etc. which can be applied (at a cost) by paid semi-professionals.

What is overlooked is that the same amount of effort put into providing the Good Things in Life, avoiding the Wounds, and finding Home, Work, Leisure, education, Friends, Colleagues, Family, Community for these people might be far more effective and maybe even cheaper.

Social Role Valorisation Strategies

What Works and What Doesn’t

SRV states that people enter into a cycle of devaluation because of the accrual of negatives roles.

If people at risk of devaluation are to be rescued from this situation, then SRV would suggest that if we really want to help these people then we should help them to avoid negative roles that they might acquire or might have already and to emphasise  those positive roles that they currently have and to attempt to gain further positive roles.

Managing Roles To Improve Social Value

SRV would suggest that the primary way in which people may be assisted to a better life and to access to the good things in life and to avoid the Wounds is by possessing multiple valued roles.

These roles need to be ‘found’, entered into, fulfilled and protected.

Role Management

Specific suggestions for this are:

·         If people have valued roles, enhance, enlarge and protect them.

·         Avoid entry into any additional devalued roles.

·         Examine and support entry into new valued roles.

·         Remove people from devalued roles.

·         Reduce the signs of negativity from devalued roles.

·         If a person is forced into a continuum of devalued roles and it is impossible to avoid this, try to choose the least devalued option.

·         If you are sharing social space with a devalued person, be ready to surrender valued roles you have to that person wherever possible.

Defending Valued Roles

When people are devalued it is important to assess which valued roles they have been able to retain and to defend these against further attack.

For instance if the person being devalued is retired, it might be useful to reinforce the vocational role possessed before retirement and to ensure that the full amount of respect and value due to that role is maintained in retirement.

Another example would be to reinforce that the ‘schizophrenic’ in your care is also a competent mother, valued partner, good worker etc., especially when in remission or given good symptom relief.

Maintaining Valued Roles

Effort must to be made towards assisting people to maintain valued roles if they are in danger of losing them.

For instance, a person with Alzheimer’s Disease is at particular risk of loosing competencies and images that allow role fulfilment. Extra effort should be put into maintaining any current valued roles.

People with progressively deteriorating mental illnesses (schizophrenia, schizo-affective disorder) will require assistance with maintaining any valued roles that they have, especially whilst they are in relapse.

Acquiring Valued Roles

Another strategy would be to assist people who are not currently in a valued role to enter that role.

For instance, a person with youth-onset schizophrenia could be assisted to acquire valued roles such as flat-mate, worker, friend etc. instead of the unvalued roles of ‘waster’, ‘hospital patient’, ‘burden’, ‘menace’.

This acquisition of valued roles will of course require competence enhancement and image management.

Re-Valorising Roles

SRV maintains that a good way of rescuing people from the bad things that society does to them is to change the way that society ‘sees’ them by re-valorising their negative or neutral roles so that they become seen as positive roles..

In this way, roles that are not currently valued, or not recognised as having potential value may be focused so that they gain public approval and become valued roles.

For instance, a person with autistic spectrum disorder may have excellent musical or artistic or numerical skills. These could be seen as just side issues to their autism, but if sufficient effort is made, these roles could be re-valorised to become useful tools to help integrate the person into a group and to protect them from harm. However, care must be taken to ensure that such a person is not encouraged into the role of ‘freak’ by this effort. Interpretation must be positive.

Image And Competence Management

It is important that people with responsibility for helping people who are devalued attempt to improve the image and competence of such people to enable more valued roles or to maintain current valued roles.

This Image and Competence management should form part of any plan of care, the goal being the defence, maintenance or acquisition of valued roles.

Action At Different Levels

SRV requires that if you believe that people should not be devalued and harmed, then actions should to be made to rescue people from severe negative effects of social devaluation.

SRV is often criticised for making this effort only at a personal level: ‘trying to make the person fit into society. This is in fact not the case, and SRV insists that efforts should be made at all levels to ensure that people at risk of devaluation are better treated.

However, SRV does maintain that the higher up the socio-political ladder you travel, the harder change becomes. It may in fact be better for the person to be assisted to fit into an acceptable role rather than to make futile efforts to change society. This does not mean that such efforts should not be attempted, but if your main goal is to improve the life outcome of a person, efforts at more personal levels may be more effective.

The Four Levels

SRV suggests that there are four identifiable levels of intervention:

·         The Individual Person

·         The Immediate Social System around that person (family, friends, colleagues, workers in institutions etc.)

·         The Intermediate Social System that the person interacts with (people in shops, banks, organisations etc. plus those institutions themselves.)

·         The Larger Society- the socio-political-economic structures of society.

SRV maintains that intervention at all these levels is important, but assessment must be made of which level is the most important for the individual.

Action at each level may be made to affect both image and competence at that level to promote entry into and maintenance of valued roles.

‘Just Like Me’

Encourage any image, competence or role that will make it more likely that ordinary members of society will see the person as ‘Just Like Me’. As noted above, the more like a person one is, the more protective one is of them. The more roles that are shared, the more competent a person is, and the closer that person is in image to you, the more you will identify with them.

Why Change Is Difficult

Social devaluation is an immense problem and occurs in all societies and at all times.  Because of this it is easier to try to find explanations or excuses that allow one to deny or avoid the inevitability of devaluation.  For instance, rather than seeing devaluation as a pervasive society wide problem, we may blame its effects on ‘the management’, ‘the boss’, ‘the system’, ‘the government’, or even the person themselves.  This avoids the uncomfortable admission that we are all (as part of society) part of the problem of devaluation.

If we are forced to confront what individuals, groups of individuals, and society as a whole (hospitals, day services, community services etc.) are really doing to persons who are devalued, we would have to admit that society in general, and ourselves in particular, are agents in this process of harm.  It is a natural human defence to avoid such conflicts and to deny such an unpleasant reality.

The three main mechanisms for this reality avoidance are:

·         Denial

·         Blaming Others

·         Accepting but not caring (burn-out)

Additionally we have much invested in services that we are part of providing.  For instance,  we gain wages, companionship and meaning in our life from our work of helping others.  We may come to see this as more important than the actual work of helping others.

It flows from the above that it is often the most junior person who has the least to lose in challenging a system- the higher up you are, the lesser chance you stand of regaining such a position if you challenge a system and fail.

If such a service is challenged by an individual, the social system within that service may well conspire unconsciously to stigmatise and damage the person complaining.  The many reports into complaints made at Learning Disability and Psychiatric Hospitals in the 1970s-1980s give examples of such occurrences of ‘blaming the whistle-blower’.  The recent Ashworth Hospital Enquiry shows that this mechanism was still active only a few years ago.

Change is difficult and uncomfortable because people and systems at all levels have much invested in things staying the same.  We do not like change, even when it is possibly for the good of all concerned.  Additionally we must not forget the unconscious dynamic that may exist where people really believe that people who are devalued should be treated badly, although they would deny that that is their belief.

Summary

SRV is silent on ‘What Must Be Done?’.  All it says is that if one wishes to address the plight of the lowly in the most effective way, then one needs as full an understanding of the science behind devaluation as possible.

There are no easy answers to dealing with the plight of the lowly, but low-order, simple humanistic solutions may be much more effective than apparently high-order intensive and intrusive solutions involving care/cure/confine.