Working with complexity

28 March 2018

Lisa SmithLisa Smith

It’s been, aptly, a complex business, navigating the development and publication of a chaptered Research in Practice for Adults Evidence Review on working with complexity.

The book has four chapters that explore the following areas:

  • Helping families work with complexity
  • Complexity in working with the Mental Capacity Act 2005
  • Working with risk
  • Working across the life course with people who have a learning disability.

Working with complexity: Evidence ReviewEach chapter takes an area of practice that can be potentially complex and breaks it down - looking at ways to clarify and work through the complexity.

The rationale for producing this review comes from the notion that as human beings we are by our very nature, complex. As individuals, within the world we inhabit with our families, friends, communities and beyond we all experience complexity in our lives. When we come into contact with services, life becomes further complicated, or at least it can feel that way. In developing this review, we wanted to enable the reader to see that with thought, care and the application of a good deal of evidence, complexity can feel less challenging and become more navigable.

Expertly weaved together by Deirdre Ford, her introduction to the volume introduces us to complexity theory, which is then ably picked up in Clark Baim’s opening chapter on working with families, beginning with the quote:

‘For every complex problem, there is an answer that is simple, clear and wrong’ (Mencken 1920).

Together with a footnote explaining this often used misquote, complexity, even in our explanation of it, is very meta. He explores complexity in the context of the Care Act 2014 and the requirements of the Act in working in a multi-systemic and multi-disciplinary way.

The review then offers a chapter by Rachel Griffiths, looking at the Mental Capacity Act (MCA). She begins by enabling us to see that although the MCA can feel complex, its very purpose is to simplify and clarify this area of law. An excellent blog by Rob Mitchell eloquently explains:  

‘When it’s understood well, the Mental Capacity Act is the most powerful tool in the social work tool box. It defines a unique role for social workers of knowing legislation, understanding advocacy and the ability to interpret and enact keeping power and control with people. Person-centred enshrined in law.’

Our hope is this chapter enables that clear understanding.

Moving onto the next chapter we pick up the oft travelled road of risk, with a chapter co-authored by Simon Duffy and Jeanette Sutton. We are all familiar with the themes and discourse around ‘working with risk’ or as I prefer to frame it ‘enabling people to live their lives’. Our hope with this chapter is that it enables conversations to move on to thinking about the concepts of citizenship and freedom. Simon deftly puts this forward as our starting place, and as the authors say:

‘The challenge now is for the system to evolve to naturally accommodate both risk and rights, enabling people to live safe, good lives.’

And finally the chapter on working across the lifecourse with people with learning disabilities. Deirdre Ford and Lindsey Pike remind us how far the world has moved on and how far we have to go. Keilty & Woodley quote:

‘The legacy of the hospital routine still lives with many people who lived there, still needing tea breaks at set times and a cigarette on the hour every hour.’

This section reminds me of my time working in community mental health settings, (with many individuals having spent their lives in institutions and who then went on to live in community settings) where, rather than evolving and engaging with perceived complexity, practice sometimes seemed to be in stasis. My recollection was that it was the colleagues who had previously worked in the hospital that clung to routines when in community settings. Everyday a colleague taking the tea, coffee and sugar out of the kitchen cupboard, putting a tray on the worktop, putting paper towels on top of the tray and setting the kettle next to it to create a hot drinks ‘station’, just like they would’ve done on the ward. Practice wasn’t looking forward or even catching up with the setting, it was just continuing as it had always been. Lifespan approaches encourage us to look ahead with a person and their family to see what the future might look like – recognising that ‘complex needs’ are simply ‘human needs’.

I’m hoping there are no spoilers in this blog, but rather what I hope you will find to be a fantastically interesting read, as I found the process of piecing it together.

Related resources 

Working with complexity: Evidence Review

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