Constructive Functional Diversity – mindset & language

Constructive Functional Diversity

A NEW, ENABLING MINDSET AND LANGUAGE

OF REHABILITATION

Philip PatstonCQSW, Dip App Soc Studs

Have you heard of these

conditions?

• Chronic Physiological Superiority Syndrome

• Ineptitude Imperfecta (Einstein’s Disease)

• Aesthetic Arrogance Disorder

• Chronic Physiological Superiority Syndrome

• Elite athletes

• Ineptitude Imperfecta (Einstein’s Disease)

• Geniuses

• Aesthetic Arrogance Disorder

• Beautiful people

Have you heard of these

conditions?

• Cerebral palsy

• Down syndrome

• Multiple Sclerosis

• Asperger’s syndrome

Have you heard of these conditions?

• Cerebral palsy

• Me

• Down syndrome

• People with a third copy of chromosome 21

• Multiple Sclerosis

• People with damaged nerve cell insulation covers

• Asperger’s syndrome

• People with unique ways of interacting socially, nonverbal communication, and/or restricted and repetitive patterns of behaviour and interests

Have you heard of these conditions?

Why do we use medical labels for some people

and not others?

• values, beliefs, attitudes

• sadness, a focus on loss, pity, denial

• shock, horror and devastation

• our own fear of losing function

• dysfunctionphobia

What needs to change?

• stop people thinking negatively in terms of impairment and disability

• facilitate a constructive change in their thinking about function

Edward de Bono

Emphasises the importance of precision in the use of words to become more expressive.

Positive thinking keeps us in undesirable situations if it immobilises us from action by perpetuating thinking good things about bad circumstances.

Constructive thinking moves us towards the desirable outcome.

CONSTRUCTIVE FUNCTIONAL DIVERSITY

(CFD)A new way of thinking

about function

IN A NUTSHELL

25% 75%

Four core elements:

1. Modes – how we function

2. Outcomes – why we function

3. Value (or desired state) – the level of importance placed on function

4. Capacity (or actual state) – the level of ability to function



about function

Modes – how we function

1. Biological function: chemical reactions in the brain, circulation, organ function

2. Aesthetic function: appearance, beauty, and attraction

3. Motor function (or physical function): coordination, movement, performing activities

4. Sensory function: Sight and hearing, taste, smell, kinaesthetic sensation

5. Cognitive function: thinking, reasoning, perform intellectual activities; intellect, intelligence

6. Social function: expressing and interpreting communication ;engaging in relationships; understanding social mores

7. Emotional function: experiencing, interpreting, understanding emotional feelings; emotional intelligence

8. Creative function: imagining solutions, innovating, designing, inspiring unique outcomes

9. Spiritual function: being rather than doing; higher beliefs about life and self, observing or expressing – through religion, ritual



about function

Modes – how we function

Sexual function?

Cultural function?

• involve all of the listed modes of function?

• may be better classified as outcomes?



about function

Outcomes – why we function

Task – work or assignment, which may be simple, useful, important or difficult

Job – paid trade or profession, something needing to be done or dealt with

Occupation – an activity on which time is spent, paid or unpaid

Role – the usual or expected function of someone, the part played in a given social context

Meaning – what something means, what someone intends to express

Utility – the quality or state of being useful or beneficial

Purpose – the reason something or someone exists



about function

Value (or desired state) – the level of importance placed on function

Capacity (or actual state) – the level of ability to functionCONSTRUCTIVE

FUNCTIONAL DIVERSITY(CFD)

A new way of thinking about function

Value and capacity

dynamic, changing elements

value changes all the time for individuals, groups, cultures and societies

match or mismatch in value and capacity determines level of functional synergy

people with common function more likely have higher levels of functional synergy than people with unique function because the capacity of common function matches the value of common function



about function

Value

measured internally and externally (in relation to a person’s internal or external experience)

• my own value in relation to my ability to sing well or understand meaning (internal)

• society’s value of being able to sing well or understand meaning (external)

relatively abstract and variable

can be changed (and does change) quite fluidly in individuals and groups.



about function

Capacity

also measured internally and externally

• ability to function without support or enhancement (internal)

• assistance to function provided by people or equipment (external)

impossible, difficult or unreasonable to change

• cf. Social Role Valorisation (SRV), Wolfensberger

• ‘enhancing competency and image (of the person and their surroundings) will result in positive roles being made a possibility for devalued people’



about function

Low functional synergy

Aesthetic

Unbalanced functional synergy

Aesthetic

High functional synergy

Aesthetic


(CFD)A new way of talking

about function



about function

Impairment/disability perspective

CFD perspective Explanation of term

Impairment, including functional impairment (ICF) – “significant deviation from statistical norm”

Unique function The distinctive capacity and value of function held by an individual or group

Diagnosis Origin of unique function The cause of or reason for an individual’s unique function

Disability; disablement (social model definition)

Functional bias The favouring of a certain capacity to function over another

People with disability(ies); people with impairment; disabled people

People with unique function People who hold a distinctive capacity and value around function

People without disability(ies); people without impairment; non-disabled people

People with common function

The majority of people who exhibit regular modes of functioning

To disable someone To exhibit functional bias The active demonstration of favouring a particular functional capacity or value

To be disabled To experience the impact of functional bias

The result of being a passive recipient of functional bias



Disability support (service or equipment)

Functional enhancement (system or device)

A system or device that enhances function by reducing functional gap or increasing opportunity

Independence/autonomy Functional synergy A match in functional value and capacity

Acquired impairment Functional realignment A significant change in functional capacity

Rehabilitation Functional reconfiguration The process to re-evaluate and change the relationship of functional capacity and value

Adjustment to impairment Functional reconciliation The outcome of functional reconfiguration

Limitation to activity (ICF) – “difficulty in performance of activity”

Internal functional opportunity/gap

The potential/latent value or capacity created a mismatch between functional value and capacity due to unique function

Restriction to participation (ICF) – “problems in involvement”

External functional opportunity/gap

The potential/latent value or capacity created by a mismatch in value and capacity due to functional bias



about function



Barrier (ICF) – “environmental factors that condition functioning”

Functional challenge (obstacle)

The potential value or capacity created by removing an obstacle which creates an external functional opportunity/gap

Disability (ICF) – “negative interaction between person and environment”

Functional dissonance The discord caused by the presence of a functional challenge



about function

Enabling rehabilitative

outcomes

Psychological benefit

create a shift in thinking for people who experience functional realignment (acquire impairment)

current binary paradigm requires people not only to survive the trauma of the incident that creates the realignment, but also to join the group of stigmatised people that they have feared (dysfunctionphobia)

creates the opportunity for a person with changed function to perceive their situation from a position of value rather than stigma.


outcomes

Understanding motivation to recover

Some people have higher motivation than others to reconfigure function (rehabilitate) after a traumatic incident. CFD may be able to offer an explanation.

If someone has lost capacity to function in a mode or outcome area that they highly valued, the impact will be greater than if they placed low value on that functional area.

If the person realises it will be impossible to regain that capacity internally, and isn't satisfied with the use of functional enhancements, this will affect motivation.

The options for successful reconciliation, therefore, are:

• to change the internal value placed on the affected area of function and/or

• to raise the internal value in another area of function where capacity has been unaffected


outcomes

Client directed practice

fosters practice where clients can direct the reconfiguration process

explores a dynamic landscape of functional modes, outcomes, value and capacity (internal and external)

choice whether measurement or interpretation are determined subjectively (by the client) or objectively (by the professional)

Contact me• Philip Patston

Managing DirectorDiversity New Zealand Ltd

• email [email protected]

• web www.diversitynz.com

http://www.diversitynz.com/

Constructive Functional Diversity – mindset & language

Education

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