Hodges' Model: Welcome to the QUAD: role

Hodges' model is a conceptual framework to support reflection and critical thinking. Situated, the model can help integrate all disciplines (academic and professional). Amid news items, are posts that illustrate the scope and application of the model. A bibliography and A4 template are provided in the sidebar. Welcome to the QUAD ...

Showing posts with label role. Show all posts
Showing posts with label role. Show all posts

Sunday, October 13, 2024

Dramatherapy 2 - Personal identity

'Dramatherapy helps make sense of the world. Just as Goffman (1971) regards society as dramaturgically constructed, for the social presentation of selves, so Kelly (1955) describes a process in which individuals 'try on for size' various views of themselves as perceived by other people, in order to select the ones which allow them to carry on social relationships with one-another. Understanding of the other person is achieved by the process of construing his or her world, or 'construct system'. Kelly uses the notion of constructs and construct systems to describe cognitive structures. A construct is basically way of registering the degree to which an idea is present in relation to other ideas:

A construct is like a reference axis, a basic dimension of appraisal, often unverbalised, frequently unsymbolised, and occasionally unsignified in any manner except by the elemental processes it governs. Behaviourally it can be regarded as an open channel of movement, and a system of constructs provides each man with his own personal network of action pathways, serving both to limit his movements and to open up to him passages of freedom which otherwise would be psychologically non-existent.
(Kelly, 1955:199)' p.164.

'The multifarious ingredients of dramatherapy, like those of a theatrical event, are not haphazard. They are closely related, either by similarity or difference, to one another. Where there is confusion, this too is distinguished: it is confusion as opposed to order. Structure is employed in a conscious or intentional way, in order to reveal its true identity as the means by which we perform the fundamental action of relating things, in order to plot our movements in the world we live in. By allowing us to distinguish from, structure permits us to relate to. Certainly, the mechanism of perception performs this action without any conscious intention on our part; drama, and dramatherapy, is consciously contrived to assist it in its critical function, helping it to achieve a particular kind of clarity, by providing it with the raw material for involvement with the objects of perception.'
p.167-168.

EVALUATING THE EFFECT OF DRAMATHERAPY ON THOUGHT-DISORDER

Construct Theory rests upon the proposition that ideas hang together in a trustworthy way because people's behaviour is basically consistent. If people behave inconsistently, the thinking which they induce will lose its articulation, because the sense we make of life demands continual validation from the people and events we base it on. Thus, confused experience of relationship is, at its most fundamental level, the same thing as confused thinking; when our ideas begin to lose their coherence this is because, for us, other people have begun to come apart'. When they no longer fit the model we have of reality, the model itself loses its precise definition. At this point, Kelly suggests, we make our model more vague in order to preserve its identity as a model of reality: reality is blurred, so our model is imprecise. Unfortunately, it may become too inexact to function as a means of communication with the world of people and events it is intended to represent. The task of therapy is to provide evidence of the world's conformity to the individual's model, thus validating that individual's constructs. Because a person's disordered thinking is primarily concerned with the way they construe people, it must be done personally; because it is the result of experience over a considerable time, it must be done systematically, or 'serially`.
pp.171- 172.

Note to self: 'It is' :: 'It is - as if ?'. p.166.

individual
|
INTERPERSONAL : SCIENCES
humanistic ------------------------------- mechanistic
SOCIOLOGY : POLITICAL
|
group

I


I


Greek theatre masks

Institutional masking


Grainger, R. Dramatherapy and thought-disorder. Chapter 11. In Jennings, S. (Ed.), (1992) Dramatherapy. Theory and Practice 2. London: Routledge.
(Apologies, punctuation in the above may not be accurate, and I no longer have the text.)

Saturday, October 21, 2023

National Survey of the Mental Health Nurses aims to understand reasons behind record vacancies


Researchers from the University of Southampton working with the National Institute for Health and Care Research (NIHR) are launching a national survey of the mental health nursing workforce.

Led by Professor Jane Ball (Professor of nursing workforce policy), it is the first to explore the work lives and wellbeing of registered nurses providing mental healthcare in the UK.

More details: 



The survey is open to nurses on the NMC register providing mental healthcare to any patient group, in any setting, and for any health and social care provider. It is completely anonymous and will take 15-20mins to complete. https://tinyurl.com/MHNurses

 

Thursday, October 12, 2023

Nursing observations: the need for Political inoculation in "Intro 101"

"Hockey's (1989b) typology of nursing activities as consisting of autonomous, derived and delegated elements suggests we should focus on the interventions which are initiated as well as undertaken by nurses. This is the core of nurses' work. It is what nurses do which is not done by other people. Nursing has always found it difficult to describe this core. Goddard's (Nuffield Provincial Hospitals Trust 1954) choice of the term 'basic' to describe this element of nursing work has had a disastrous influence not only on nurses' perceptions of the value of their work but also on the way in which nursing is regarded by other professional groups. It has been suggested that the term was used as a shorthand for 'fundamental' or 'essential' and that is has been systematically misinterpreted over the last three decadesby those who wish to use it to justify the horizontal division of nursing labour. Goddard demonstrated that basic nursing was undertaken by the least qualified and the lowest skilled. This observation might have sparked off a revolution in the delivery of nursing care but instead it has been and is used to justify the continued employment of unskilled labour in direct patient care." p.128.

*My emphasis: "... over the last three decades .." hence, since the early 1960s.


INDIVIDUAL
|
     INTERPERSONAL    :     SCIENCES               
HUMANISTIC --------------------------------------  MECHANISTIC      
SOCIOLOGY  :   POLITICAL 
|
GROUP




"The struggle between the twin poles of professionalism and bureaucracy is mirrored in that between the holistic, therapeutic approach in nursing, and that which is reductionist and functional (e.g. the task-centred approach to care).
To work successfully in such a climate demands considerable skills of nurses, for they must seek to change the nature of the organisation, or at least to neutralise its effects so that they can concentrate on therapeutic practice. Amongst these skills must be those of change agency." p.107. 

"Much of health care and particularly nursing is still organised along hierarchical and bureaucratic lines. To work professionally in such a system may in some way be seen as a contradiction in terms. The nurse may seek to exercise professional autonomy and make decisions about patient care (and indeed the organisation may seem to be encouraging him or her, at least superficially, to do so). Yet at the same time the nurse receives conflicting signals as others endeavour to exercise control over nursing practice such as doctors, senior nurses, finance directors, supplies officers and so on." p.107. 


In this book's final chapter: Paterson and Zderad's five Phases of Phenomenological Nursology.^

INDIVIDUAL
|
     INTERPERSONAL    :     SCIENCES               
HUMANISTIC --------------------------------------  MECHANISTIC      
SOCIOLOGY  :   POLITICAL 
|
GROUP

1. Preparation for the nurse knower coming to know.

(Hodges' model as a template - 'clean slate' also facilitating unconditional positive regard - openness to a new encounter - whether the first or subsequent.)

2. Nurse knowing the other intuitively.

(Intuition still has a role. A message: speak to a colleague - seek supervision!)

3. Nurse knowing the other scientifically.

(Reductionism is needed yet balanced with the humanistic esp. as the march (float ...) of the robots/AI follows apace.)

4. Nurse complementarily synthesising known others. 

(This is a purpose for Hodges' model, supporting the user to identify salient concepts and the relationships between them and their quality; then to reflect, think critically and move towards formulation.)

5. Succession within the nurse from the many to the paradoxical one. 

Nursing as Therapy
  (Tied to #4 above, but can emphasize health education, health literacy, co-production and co-creation with the patient - client. A collapse - in the synthesis with simultaneity of the individual and collective. Arriving at a conclusion and for the future of Hodges' model in theory and practice: an abstraction.)

Paterson J.G., Zderad L.T. (1976). Humanistic nursing. New York: John Wiley.
 

The conceptual scope of Hodges' model is demonstrated in how it can encompass other (all?) models of care and frameworks, including humanistic nursing.

McMahon, R. and Pearson, A. (1991) Nursing as Therapy. London: Chapman & Hall.
^Chapter 8 - Breaking the mould: a humanistic approach to nursing practice. pp.170-191.

Bought secondhand, 'Nursing as Therapy' caught my attention as I have read and wondered about 'assessment as therapy' across disciplines.