Isaac Prilleltensky Peabody College of Vanderbilt University Isaac'PrilleltenskyVanderbilt'Edu Http:

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Isaac PrilleltenskyPeabody College of Vanderbilt
UniversityIsaac.Prilleltensky_at_Vanderbilt.EduHttp
//people.Vanderbilt.edu/isaac.prilleltensky

• Balancing Amelioration with Transformation in the
  Helping Professions

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Balancing amelioration with transformation

• TRANSFORMATION
• Prevention
• Root causes
• In natural setting
• Justice
• Communitarian
• Agents of change
• Attends to Power

• AMELIORATION
• Treatment
• Symptoms
• In the office
• Charity
• Individualistic
• Passive victim
• Neglects Power

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How can we balance our work with individuals?
Strengths
X
Detachment
Empowerment
Deficits
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How can we balance our work in the community?
Collective
X
Reactive
Preventive
Individual
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9/7/1854Removing the Handle
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Getting To The Bottom Of It.

• No mass disorder, afflicting humankind, has ever
  been eliminated, or brought under control, by
  treating the affected individual
• HIV/AIDS, poverty, child abuse, powerlessness are
  not eliminated one person at a time.

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Too Little, Too Late
CONTINUUM OF SERVICES
Wellness Promotion
Treatment
Prevention
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BUDGET ALLOCATION
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Prevention Helps
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The Story of Grameen Bank
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Justice and Well-being in Kerala
Personal Empowerment
Social Movements
Government Action
Processes
Collective Well-being
Relational Well-being
Personal Well-being
Social support Sense of cohesion
Tenancy laws Nutrition in school Distribution
Of resources Land reform
Infant mortality Literacy Nutrition Life
expectancy
Outcomes
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Affirmation Field in Helping Professions
Strength
Quadrant I Examples Voice and choice in
celebrating and building competencies,
recognition of personal and collective resilience
Quadrant IV Examples Just say no! You can do it!
Cheerleading approaches, Make nice approaches
Empowerment
Detachment
Quadrant III Examples Labeling and diagnosis,
patienthood and clienthood, citizens in
passive role
Quadrant II Examples Voice and choice in deficit
reduction approaches, participation in decisions
how to treat affective disorders or physical
disorders
Deficit
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Contextual Field in Helping Professions
Collective
Quadrant I Examples Community development,
affordable housing policy, recreational
opportunities, high quality schools and health
services
Quadrant IV Examples Food banks, shelters for
homeless people, charities, prison industrial
complex
Proactive
Reactive
Quadrant II Examples Skill building, emotional
literacy, fitness programs, personal improvement
plans, resistance to peer pressure in drug and
alcohol use
Quadrant III Examples Crisis work, therapy,
medications, symptom containment, case management
Individual
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New SPECs Three-year action research project
Oasis Center
Bethlehem Center
UNHS
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Balancing how we work

• Less
• Deficits-based
• Reactive
• Professional-driven
• Individual Family

• More
• Strengths-based
• Primary Prevention
• Empowerment
• Community Conditions

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New SPECs action research approach

• Structures
• T-Team
• Councils
• Affiliation groups
• Forums
• Workshops
• Task Forces (internal and external
• Principles
• Participation
• Power sharing
• Ownership
• Meaning

• Messages
• Meaning of SPEC
• Meaning of change process personally and
  professionally

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New SPECs at Oasis

• Values Clarification
• Philosophy Statement
• Defined Impact Areas
• Safety
• Participation Empowerment
• Significance Connection
• Justice Equality
• Agency-Wide Outcomes
• Individual family
• Community
• Program Activities Outcomes

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In every act, in every interaction, in every
social action, we hold each other accountable to
promote   Peoples dignity, safety, hope and
growth Relationships based on caring, compassion
and respect Societies based on justice, communion
and equality   We are all better when these
values are in balance   To put these values into
action, we will   Share our power Be proactive
and not just reactive Transform the conditions
that create problems for youth Encourage youth
and families to promote a caring
community Nurture visions that make the
impossible, possible   We commit to uphold these
values with   Youth and their Families Our
Employees Our Organization Our Community   This
is a living document. We invite you to discuss
it, to critique it, to live it
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New SPECs at MOB

• T-teams
• Multiple Stakeholders Represented
• Internal External Task Forces
• Affiliation Groups
• Internal
• Completed SPEC survey
• SPEC lunches
• Department Meetings
• External
• Building Social Fabric of Community
• Community Forum

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Strengths
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How Power Operates in SPEC?

• Not all elements of SPEC are equally
  transformative
• The more power equalization, the more
  transformative the intervention
• Some aspects, like S and P, are easier and less
  transformative than E and C
• Contradictory discourses about power and SPEC in
  intervention

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Major ChallengeRole Reconciliation

• We have to be able to reconcile our roles as
  helpers with our roles as critical agents of
  change

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Role reconciliation
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The potential benefits of this approach are
multiple

• First, clients or citizens would activate agency
  within them. They will no longer be regarded as
  victims of circumstances but as actors in change.
  
• Second, they will contribute to collective
  wellness by challenging the structures that cause
  the problems in the first place.
• Third, problems will no longer be regarded as
  individual concerns but as societal concerns.
• Fourth, health and well-being will be
  de-professionalized.
• Fifth, groups will be able to challenge the very
  structure that is supposed to help them, thus
  contributing to the accountability of mainstream
  institutions towards oppressed and marginalized
  groups.

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Conclusion

• A. It is only when we institutionalize critical
  consciousness that we have a chance of making a
  difference in the long run.
• B. It is only when we take control of health and
  well-being away from professionals that we have a
  chance of empowering the population,
• C. It is only when we activate the agency part
  within clients and community members that we can
  overcome passivity in the delivery and reception
  of services, and finally
• D. It is only when community members make the
  connection between their private ills and their
  public origins that they can be angry enough to
  make a difference in the institutions that
  dominate their lives.

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Its like Venice..
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Venices Lesson

• The psychotherapist, social worker or social
  reformer, concerned only with his own clients and
  their grievance against society, perhaps takes a
  view comparable to the private citizen of Venice
  who concerns himself only with the safety of his
  own dwelling and his own ability to get about the
  city. But if the entire republic is slowly being
  submerged, individual citizens cannot afford to
  ignore their collective fate, because, in the
  end, they all drown together if nothing is done
  (Badcock, 1982)

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Questions for discussion

• What factors enable and inhibit role
  reconciliation (between professional helper and
  agent of social change) in the helping
  professions and in community service
  organizations?
• How can we blend ameliorative and transformative
  approaches?