Friday, June 25, 2010


Yesterday Genevieve conducted follow-up dialogues with two of the participants in the hope and strengths group sessions Rachel and I recently offered for people with chronic pain. The interviewees were pleased and grateful. At our request, Genevieve was trying to find out just what it was about the process that had made them so. Those eager participants were doing their utmost to define it.
As I briefly glossed through the recordings it struck me that de-constructing a successful hope and strengths group for any population is a bit like eating a delicious cake and then accurately documenting the recipe. When it comes to cake, an inexperienced cook will savour the cake. An experienced cook may say something about the relative proportions of the ingredients. A person with knowledge about the chemical properties of the combined ingredients will speak to the fine points of its texture. Perhaps there is somebody who can document the process by which the heat of the oven transforms the goo in the bowl to the fine product on the plate. But it seems that nobody has yet been able to get around the reality that great cakes are constructed in test kitchens, either at home in labs. Would-be cooks just keep baking and baking, guiding themselves by the appreciation of the eaters, and they get better at it as they go. The cooks may or may not be able to explain the chemical combinations and molecular transformations that have made the cake what it is. About the best they can do is provide the recipe they used. Or is it the recipe they think they used, given that sometimes you just have to make adjustments because you notice that it doesn’t feel right?
When it comes to hope and strengths groups—and we’ve run a few of them lately—the ambiguity of what has occurred lies somewhere in the gap between the documented activities presented in each session—each offered for its own good reason—and the gratitude expressed in the evaluations. But here’s the problem—that thing that has consumed so much of my time when it comes to explaining the basis and success of hope work. Cake recipes are published in cookbooks. Cooks buy the books and start baking. We assume they will practice until they get it right if we give them the recipe, and we assume it isn’t important for them to know everything about how the process works before we give them the information they need in order to start the cooking. It seems to work pretty well.
Group work results, in contrast, are published in professional, peer-reviewed journals. Peer reviewed journals don’t let you publish a recipe until you have presented a complete summary of the properties of the ingredients and the experiments various people have done with them. By the time you’ve done half of that, you’ve exceeded the word limit, and there’s seldom, if ever, any room to present the recipe. If ever there is room, you usually have to leave out half the ingredients just to make it fit. As a result, there are very few places where practitioners can read detailed accounts about the daily work their colleagues do.
My hope is that the human services will some day have better respect for the value of practice, and will therefore put more emphasis on allowing the people who practice to present enough information about what they are actually doing so that others can try it out. Is there truly anything to fear if we move in this direction? What is the worst that could happen? After all, even though people bake cakes all the time, some better than others, it hasn’t threatened the professional respectability of the disciplined study of chemistry.

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