VALUE-BASED INTERVENTIONS IN THE COMMUNITY : FOUNDATIONS AND APPLICATIONS

1. VALUE-BASED INTERVENTIONS IN THE COMMUNITY : FOUNDATIONS AND APPLICATIONS Isaac Prilleltensky, Ph.D

2. Before you reply with enthusiasm to our plea for help, you should consider whether you are not merely engaged as magicians to avoid the crisis in the center of the ring. In considering our motives for offering you a role, I think you would do well to consider how much less expensive it is to hire a thousand psychologists than to make even a miniscule change in the social and economic structure ( Judge Bazelon, in the 60s, addressing a group of forensic psychologists).

3. WHAT IS VALUE-BASED PRACTICE? Value-based practice is concerned with the promotion of psychological theories and practices that reflect a cogent set of moral principles. Value-based practice is concerned not only with what IS but also with what SHOULD BE, and with the contributions psychology can make towards that end.

4. ORDER OF PRESENTATION RATIONALE PROPOSAL FOUNDATIONS APPLICATIONS CHALLENGES

5. RATIONALE • Psychology is concerned with describing and predicting behavior • Psychology has shied away from explicitly prescribing behavior However, we are, in effect, involved in creating culture and in prescribing behavior. Even if we don’t want to assume that responsibility, we make value judgments all the time. Hence, it’s better to be explicit about our values. • Psychology is concerned with what IS • Psychology has shied away from SHOULD If no one is concerned with how individuals SHOULD lead their lives, and how governments and societies SHOULD treat their citizens, then we are stuck with the status quo. Hence, psychology can and should contribute to creating a better society. Value based psychology is concerned with creating • A good life • A good society

6. PROPOSAL(What the SHOULD is all about)THREE TYPES OF WELLNESS Personal Wellness Relational Wellness Collective Wellness

8. A Matter of Balance • Foreground and background Collective well-being Personal well-being Relational well-being

9. FOUNDATIONS • Empirical research • Asking people what values are important in life • Historical and philosophical analysis • Examining what combination of values promotes wellness under what conditions

10. Basic Values for the Promotion of Well-Being

13. APPLICATIONS • Mental health practice (therapy and counselling) • Programs and policies • Psychological consultation

14. Applications in Practice

15. Effects of Values

17. Effects of Assumptions

19. Effects of Practices

20. AND NOW WHAT? WE APPLY THESE TOOLS TO DIVERSE SETTINGS CLINICAL AND COUNSELLING SETTINGS HEALTH SETTINGS EDUCATIONAL SETTINGS WORK SETTINGS COMMUNITY SETTINGS

21. Cycle of Praxis Philosophy Context What should be? What is? Action Needs What can be done? What is missing?

22. Guidelines for practice • include voice of client • consider role of social oppression • avoid pursuit of pathology • avoid blaming the victim • consider multiple levels of analysis

23. 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; and again, as with Venice, what needs to be done is far beyond the powers of any one individual. In such circumstances…the therapist can no longer afford the luxury of ignoring everything that is going on outside the consulting room.”

24. “Even when people do successfully change their high risk behaviors, new people continue to enter the at-risk population to take their place. For example, every time we finally helped a man in the MRFIT project to stop smoking, it is probable that, on that day, one or two children in a school yard somewhere were for the first time taking their first tentative puffs on a cigarette. So, even when we do help high risk people to lower their risk, we do nothing to change the distribution of disease in the population because…we have done nothing to influence those forces in the society that caused the problem in the first place. (Syme, 96, p. 22)

25. CHALLENGES 1. Axiological Angst 2. Cognitive fallacies 3. Implementation barriers

26. AXIOLOGICAL ANGST • Anxiety produced when mental health workers are asked to articulate the set of values underpinning their theoretical, investigative, and applied work. • When pressed to articulate their values, and asked what to do when their values conflict with the values of others (students, clients, etc), workers revert to relativism

27. COGNITIVE FALLACIES 1. Naturalistic fallacy From is (research) to ought (prescription) Corollary: Psychology is not enough 2. Philosophical fallacy From what should be to what is feasible Corollary: Philosophy is not enough

28. IMPLEMENTATION BARRIERS 1. Political barriers Pressures, conflicting interests, power differentials, etc. 2. Cultural barriers Culture of indulgence and hedonism. Disdain for communitarian values and fears of dogmatism when a set of values is proposed.

29. CHALLENGES FOR AGENT OF CHANGE 1. Congruence between values and actions 2. Commitment but no support 3. Commitment but no strategy

30. TAKE HOME MESSAGE Values out of balance, out of context, and out of control Three values for public policy LIBERTY EQUALITY FRATERNITY Three values for psychology PERSONAL WELLNESS COLLECTIVE WELLNESS RELATIONAL WELLNESS

31. TAKE HOME MESSAGE • IDENTIFY ONE SETTING WHERE YOU WANT TO BE AN AGENT OF CHANGE • USE CYCLE OF PRAXIS TO GUIDE EFFORTS • IDENTIFY A SMALL TASK FROM GUIDELINES WHERE YOU CAN EXPERIENCE SUCCESS • PARTNER WITH OTHERS IN PROCESS OF CHANGE • SUPPORT EACH OTHER • CALL A MEETING TOMORROW