• Is it okay to talk about power?

    In this work we do, where organizations are delivering services to marginalized populations, and where intrapreneurs and entrepreneurs are trying to bring change, power is a real problem. We all know it and wrestle with it. When the music stops and we are exposed as having it, a near panic sets in. How did we end up with it? How do we pass it on? We become instantly flustered and self-conscious, sensing a challenge to our very legitimacy. Which it is. We confess we need to do better, even if we’re not sure how, though perhaps we do and can sketch out our plans or intentions. And the moment passes. Sort of. Because no matter how often the music stops, we always seem to be holding it.

    In my world of support to adults with intellectual disabilities, this gets even more complicated. People without disabilities are ultimately controlling and managing the affairs of those who have disabilities because those receiving services usually struggle to understand what’s in their own best interests, and what sorts of things/behaviours/conditions will advance it and what will harm it. The more someone in our services understands their own needs and how to meet them, whether immediate or existential, the more organizations are supposed to empower them (I was going to say, “return their power to them,” but many haven’t had much power to begin with). The less understanding there is, the more organizations hold power. It’s more complicated and nuanced than that, but that’s the essence of it.

    It’s why my hackles rise when I hear service providers talk about how persons with disabilities and their families drive their services. I have never seen it. Ever. A sprinkling (or even a majority) of representation among board or association members doesn’t translate into real power. Being survey respondents, focus group participants or advisors is not decision-making, and it pertains to only a fraction of the thousands of decisions that are made daily. If anything, such roles and tools can defend mediocrity more than drive services because “people seem satisfied” and “this is what they choose/want.”

    Decisions that have to do with persons with intellectual disabilities are frequently proxied to others: parents, siblings, front line workers, managers, legal representatives, etc. Even disability rights and empowerment movements, and disability pride, are fundamentally spearheaded by allies without intellectual disabilities. Because these sorts of undertakings require sophisticated political, cultural and linguistic strategies, as well as the ability to plan and resource them. From a civil rights perspective, it’s a surreal dynamic. And precious little discussion of it, which I find equally surreal. Probably because no one likes to talk about the extent of the power they actually wield.

    To make things worse, even were service delivery associations to give up power and control, they may still be on the hook for what happens. They are legally, contractually and ethically responsible for the wellbeing of those they support (and immediate needs get priority over higher-order ones). Letting others decide what is going to happen, while still being accountable for the result, is hard—especially when associations can be sued, censured, or lose funding, and employees can be disciplined and/or dismissed. Layer on top of this the fact that we are dealing with complicated systems that require consistency and predictability, that are required to submerge variability and individuality in order to universalize processes, and the culture of control that emerges permeates everything. Of course, this is a broad stroke analysis, and there are lots of exceptions and deviations, but I think this is generally right. 

    So what to do? 

    First, I think we need a much more sophisticated and practical discourse around power. Both power and freedom are too often regarded solely as ends and not as means. Freedom to do what? Power for what ends? To answer that question we need a moral framework, and I am inclined towards one that posits human self-actualization as that end. Or, in Paulo Freire’s words, “the completion of being.” No one can achieve someone else’s actualization; we must each pursue our own. Without our own power, without the freedom to pursue such an end, we are prevented from achieving it. We are dehumanized. And those who hold onto that power are inhumane.

    But what happens when people face circumstances wherein their freedom and power works against their own completion? When they don’t really comprehend what constitutes self-realization or how to go about achieving it? Or when they are so wounded, or so misused, that they would choose their own ongoing annihilation or desecration? When one’s circumstances are so severe that overcoming them, and self-overcoming, seems impossible? When people are not really free at all, despite the formal ability to act? Is the imperative to ensure that they still have the power and freedom to determine their own path, or is the imperative to intervene—to take away someone’s power and/or to assert our own in order to safeguard a being that is at risk of disintegration? Because we hallow it, even when it does not, or cannot, hallow itself. 

    This is a fraught question, I know, and any answer is brimming with danger.

    That said, I think that sometimes power is legitimate and what is called for is neither social judgment nor tokenistic maneuvers, but a clear ethical framework for how power ought to be applied and when it ought to be ceded. If our work adopted a moral-existential framework which had human fulfillment as the end, and which recognized that people required their own power and freedom as a means toward that end, then we might find grounds for both exercising institutional power and to challenging it. 

    Too often, the way power is wielded is oppressive, dehumanizing and humiliating. Even though it comes with offers of intervention and support, it’s not necessarily constructive. Systems can reduce people to their immediate needs and fail to see them as humans in search of purpose and fulfillment. In endless “helping” mode, organizations may fail to see what others have to offer, and where there is no reciprocity there is dependency and shame. Where interactions are transactional rather than relational, the self is debased (for everyone in those interactions). Depending on the amount of exposure to this sort of thing, people can internalize the way they are seen and treated. As Foucault showed us, when people internalize the gaze of others, when they see themselves as those with power see them, they learn to oppress themselves. 

    I would argue that the problem here is less that these systems have power (they will always have some sort of power), and more about how they are using it and what results from it: are they benefiting or endangering the being of those they support? This is how we would know whether the possession or exercise of power is legitimate or illegitimate. Does it advance being or diminish it? Does it lead to purpose and agency or to stagnation and surrender? Does it expand possibilities or shrink them? 

    Whether or not this sort of position resonates with others, I hope it at least gets us talking more openly and critically about power. It’s the elephant in the room, the poison in the chalice, the hot potato that no one wants to talk about. And I think it’s problematic when there is so much at stake that we can’t openly talk about, and when right-thinking or wrong-thinking seem to be our only options.

  • On the misuse of user satisfaction surveys in social services

    User satisfaction surveys are perhaps the most problematic tool used by social service agencies to assess performance. Not only is self-reporting notoriously unreliable, especially when proxies are involved (families, circles or staff responding on behalf of users), but it can make service users complicit in validating services that are not helping them and that may even be doing them harm.

    1. Satisfaction is not an indicator of efficacy even though it is often confused as such by service delivery organizations, funders and accrediting bodies. Personal satisfaction tells us about someone’s feelings and impressions, it does not tell us about what actually happened. The taste of a thing is very different than its nutritional value.

    Worse, setting satisfaction metrics as effectiveness targets in outcomes reports is a category mistake because our perceptions are likely to differ from reality. To equate them is like saying we can advance scientific knowledge if we can increase people’s perceptions that they have it. In fact, it is quite possible for people to receive a very poor service and yet rate it very highly.

    2. Service recipients’ exposure to other services, or to different categories and types of services, or to a range of interactions and outcomes, may be limited. Without this wider exposure in which to ground feedback, levels of satisfaction becomes less helpful/informative because service users have not had an opportunity to develop and refine their expectations. We may feel good that someone who has been in our services for a long time rates them highly, but would they still do so if they had sampled others sorts of services? Without that exposure, satisfaction surveys can become fishbowl applause, supplying services with a false sense of desirability.

    3. Social service organizations often emphasize safety, sanctuary and satisfaction over catalyzing personal growth and social transformation. When that happens, they can create contexts that are caring, fun and social, but that don’t actually launch people into good lives. Instead, they can foster regression, complacency and ongoing dependence. High satisfaction with those services should not be taken as an affirmation, but as an admonition that we are not fulfilling our ultimate mission to help people live fuller and better lives. Satisfaction can be inimical to good outcomes. Consider, for example, Fenton’s study around paying doctors according to levels of patient satisfaction: it resulted in higher health care costs, because doctors were more likely to prescribe tests and treatments to satisfy patient expectations, and much higher mortality rates, because they were less likely to challenge patients around unhealthy habits.

    User satisfaction surveys have a place in social services to the extent that they provide us with information around how users are experiencing our services. But too often the preponderance of “outputs” reporting and absence of good outcomes data means satisfaction surveys become substitutes for quality. We think that if those receiving services are satisfied with what we think is important, and if they would recommend us to others, we must be doing good work. That is a fallacious conclusion. More importantly, from an ethical perspective, we run the risk of enlisting the voices of service recipients to validate services that ought not to be validated.

  • Inviting Arts & Humanities into Social Services

    This piece of writing was first produced for the Centre for Welfare Reform on August 23, 2017. I am republishing here as I am hoping to advance this topic in a series of experiments and writing over the next while.

    From June 12-14th 2017, we spent time with Exeko, an organization in Montreal that uses the arts and philosophy to advance social change. Sounds esoteric and highbrow – but it wasn’t. It was the opposite of that. It was about reclaiming our collective humanity, and with it, recovering a more productive ground to our work. Too often, the social services sector gets stuck on basic needs – food, shelter, clothing. Safety. Getting By. Coping. Our craft has been about supplying that stability.

    But somewhere, we lost sight of the deeper things.

    Beauty. Meaning. Hope. Mystery. Love. 

    We forgot that these things are perhaps more basic.

    Without them, we cannot live.

    Without them, the other things merely prolong our deaths.

    The arts and philosophy are ways we have always tried to uncover, recover, create and cultivate meaning. Perhaps it is time to bring them into our everyday practice. To see if we can blend it into our professional codes and training, our protocols and strategies. This shift is about asking whether we might do more than feed and clothe the body, but whether we might also feed the soul, nourish the imagination, strengthen the spirit, and engage the intellect. This shift recognises that the levers of change lie less in things, and more in how we see our world and ourselves.

     June 12th

    At the Museum of Vancouver, and against the beautiful backdrop of an ocean inlet and the North Shore Mountains, about 100 people gathered to hear how the arts and humanities might assist them with the change they want to see in the world.

    A couple things stood out from this presentation.

    First, the notions of intellectual marginalization and intellectual emancipation. The former is about how our assumptions around people’s intellect inhibit us from having important conversations with them. This includes not inviting them to participate in problem-solving and idea generation, even when the subject-matter is about them. We assume that “proper” reflection and analysis is beyond their grasp, and we dismiss their sensibilities, wisdom and experience as flawed, or not material, or not relevant. In this way we condemn them to powerlessness. And, in our conceit, we don’t invite critical perspectives to help us understand and navigate complexity.

    Intellectual emancipation occurs when one is able to overcome the things that are holding one intellectually captive. This recognises the essential role that thought and imagination plays in dislodging the yoke of oppression–to understand the shape of the barriers within ourselves and within the world, and to cast our vision past them. It enables us to discern the gaps between what is and what could be, and to become active agents of change. There can be no overcoming or self-overcoming if we are unable to problematize our circumstances nor imagine our possibilities.

    When one is intellectually marginalised and treated as intellectually inferior, it is impossible for intellectual emancipation to occur. One is not invited to criticize, construct or negotiate our institutional norms and social conventions. When we assume the intellectual inferiority of the people we serve, we strip them of voice. Of power. Of their futures. In this way we diminish ourselves as “oppressors,” and we diminish the greatness in “other” and the world.

    Second, the notion of the presumption of intelligence. This is not a philosophical or scientific proposition; it is an ethical posture. It is a conviction that (1) all intelligences and perspectives matter and are needed to co-create a better world and (2) emancipation is the moral rejoinder to oppression and (3) treating others as intellectual equals–that is, as persons whose perspectives, sensibilities, and experiences are just as relevant (and irrelevant) as others–expands the possibilities of self and world, which is morally preferable to restricting them.

    Where notions of intellectual inferiority are imputed, intellectual marginalization prevails, and possibility is severely constricted. The Pygmalion effect means that people internalise and perform the perceptions we have of them. When we treat people as inferior, which is how perception is manifested, they come to embody those preconceptions and the possibilities for themselves and their role in the world are greatly attenuated. When we treat people as equals, their possibilities greatly expand. One disposition shrinks opportunity, one opens it up. What does our duty require of us?

    Sure, someone could always ask:

    “suppose there were ways to definitively measure all aspects of intelligence? Wouldn’t we then have to concede that some intelligences are superior or inferior to others? In such a case, wouldn’t we need to dispense with the presumption of intelligence and realign our attitude to recognize the fact that some people might be less intelligent than others?”

    The answer is: “I don’t care” (regarding perfect scientific measurement) and “no” (regarding the attitude adjustment). It doesn’t matter.

    The deficiency that matters is around inclusion, not intelligence. It is a choice whether to organize the world along superior and inferior lines, or among lines of equality. When we choose the latter, we grow possibility, inclusion and the foundations of a democratic society. When we legitimize marginalization as a natural and logical state of affairs, we dehumanize and disempower others, and our society is the poorer for it.

     June 13th

    With this as background, what are the implications for the disability sector? With some leaders and thinkers from disability organizations, we parsed through what the implications of this might be for us.

    The first observation is that this notion of shifting practice so that we can more intentionally address deeper needs such as meaning, beauty and hope, is neither a criticism of what we do, nor a replacement for it. It is completely complementary. Our work until now has been important work. Critical work. At the same time, the focus of the social services sector on basic needs has created the gap that small organizations like Exeko are trying to address. Can we create a model in BC that infuses arts and philosophy into our everyday practice so that we are addressing both basic needs and the deeper ones?

    Once upon a time, our organizations were among the champions of change. We stood with families to close the institutions and turn social conventions and expectations on their heads. Can we do it again? And what would our role be?

    Certainly, it is not our role to intellectually emancipate others–that is an absurd pretension. We can only emancipate ourselves. However, we do have a role in constructing the conditions under which people can have opportunities to pursue self-overcoming and empowerment, to pursue beauty and meaning. But what is that role? Is it just about getting out of the way? A resourcing role? A credo? Pressing for systemic shifts in practices or assumptions?

    Every locality is different–each has it’s own history, it’s own collection of people, assumptions, values, protocols, norms, culture, etc. This is, in effect, is its terroir. What is the terroir of British Columbia, and the disability sector more specifically, that will allow experimentations to fill the gaps in our present system? Our intent is not to simply import Exeko’s approaches and to transplant them into our local context. The context is so different, they may not take. Rather, we should be thinking about what would make sense in BC and what would be more readily nourished, adopted and/or spread. What is the soil of our system, and what can be more readily grown in it?

    In Exeko’s context, it made sense for them to become event-peddlers. They were not delivering services, rather, they were showing up in the contexts of services and prompting completely different conversations. They opened up space to talk about things like story, music, and justice–not accidentally, or on the fly, but with forethought and intent. They brought in subject-experts to participate. Over time, attendance grew, self-expression grew, everyday conversations changed, culture changed. People changed. This should not be surprising. While the meeting of basic needs keep us alive and safe, it is the confrontation with beauty, meaning and love that summons us to our lives. That instructs us in our own value and worth. That urges us to wrest back control from the people and things that are stealing our futures.

    Can we introduce something like this into the context of our services, though preferably not as a traditional sort of program or curriculum. Can professional staff, rather than observing these conversations, convene them? Can the people we serve convene them? Can we fill the gap with something different than what usually fills gaps in our professional systems? For example, do we need to assign a trickster role within our organizations (a character in aboriginal mythology that disrupts norms and conventions and prompts change)?

    And where better to begin than with the language of “disability” which captures and ensnares people, which makes them, represents them, and situates them in a specific sociocultural context? Language is powerful; it is a power that the ancient spell-casters intuited. Today, within the disability context, it is our social, academic and professional Institutions that cast the spells of making and unmaking. Is it time to invite our poets, musicians, story-tellers and philosophers to make the incantations? To teach people with disabilities to become their own spell-casters? Is it time to be enchanted by new meanings? What if we invited them to reflect with the people we serve on language and identity and to create new meanings, new inflections, richer nuances? There is much ado on identity and representation politics within the academic literature and popular media, but persons with intellectual disabilities are severely underrepresented in those arenas. Do we bring arts and philosophy to bear, first, on language and identity? Self-discovery, excavation and creation?

    Lastly, we will need to keep evaluation in mind–it’s a tricky thing. How do we measure culture shift? Social transformation? Emancipation and opportunity? Are there ways to get at flourishing and happiness (yes, though they may be onerous). That said, what matters to whom, and how we count it, is often about power and politics. Can we see evaluation less as a funder-driven requirement, and more of a means of enquiry that helps us to detect patterns around shifts in identity, emotions and wellbeing? And over time? Can we avoid the philosophical debate between positivism v constructivism (and the rabbit hole of what is knowable and how), and take a pragmatic position that focuses simply on learning and growth in individuals?

    So, what next? 

    It seems that we are agreed that it is time to address deeper needs, and that to do so, we will want to draw from the wisdom of the arts and the humanities. Do we begin with a creed? An invitation? Another conversation? Or do we each undertake to try something ourselves or within our organizations, something that adds light to our path?

    While the existential imperative to live fully must not be held hostage to a planning process, but must be answered daily, the more that we can plan and strategize together, the better hope we have of being able to create abundant conditions for human flourishing.