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Hierarchies of Understanding & Need for Collaboration: Transformation on Person & Population Levels (1/2)

By: Ken McGill, EdS, LMFT

PART I

TCOM-Shared Vision for Change

What do people think when asked about how to develop a ‘shared-vision’ for successful changes within the human services field? The question gets at the core of what is needed when we focus on accomplishing transformational change to systems that have been historically unfair to many throughout society. Many would say that it can be quite difficult to fully answer the question while developing a plan to successfully move toward equity for all.

However, it is the framework of Transformational Collaborative Outcomes Management (TCOM) which can serve as the true catalyst to move beyond philosophy. TCOM’s foundation has already shaped a shared vision in human services: “helping people achieve their health and wellness goals as they navigate healthcare, child welfare, justice, behavioral health, education, and other complex systems.” These ‘health and wellness’ components together comprise a whole-person approach, and the TCOM tools can be used to support a whole-person understanding of those we serve.

For a successful incorporation of the ‘whole-person care’ approach, it is important to acquire a thorough understanding of the person’s needs and strengths in their specific life domains, including home, school/work, and community. We now know that early adverse childhood experiences (ACEs) play an active role in later-life health and wellness. In addition, social determinants of health (SoDH) have been recognized as the health-promoting factors which are found in an individual’s living as well as educational/working conditions (such as the distribution of income, wealth, influence, and power). Research shows that, rather than behavioral risk factors or genetics, it is these factors that serve as the influencing components for the risk of disease, or a vulnerability to diseases and/or injuries. In addition, economic and social conditions play a role in both individual and group differences relating to overall health status.

Maslow’s Needs Towards Understanding Whole-Person

It was almost 80 years ago when Abraham Maslow, an American psychologist, shared his hierarchy of human needs in his 1943 paper “A Theory of Human Motivation”. Maslow’s concept of individual motivation captures only a portion of the equation for self-actualization. When we include influences like ACEs and SoDH, the hierarchical pyramid structure falls short of a full understanding of whole person within context. It is only when you use a TCOM lens to the needs structure that it transforms into a complete picture of the overall hierarchy for understanding of both needs and strengths.

If we look at Maslow’s pyramid as a surface or ‘conscious’ level motivation of the human spirit, it is incomplete as we must also include those factors which fall outside the locus of control and/or those below our conscious levels which may influence or inhibit motivation. It is often these factors that play a powerful role in outcomes rather than the motivation levels of the individual. We can then conceptualize this more broad view of need (using a diamond form/shape) as Hierarchies of Understanding:

Hierarchies of Understanding: Needs for Collaboration-Whole Person Care
Hierarchies of Understanding: Needs for Collaboration-Whole Person Care

Systems of Care-A Step Towards Whole-Person Care

The concept of systems of care goes back to the mid-1980s, but it was not until 1992 that systems of care (SOC) became part of a national initiative. The national SOC movement can be credited directly to Congress’s establishment of the Children’s Mental Health Initiative (CMHI) within the Substance Abuse Mental Health Services Administration (SAMHSA). The national movement’s goal was to improve policies, organizational, and financial structures to achieve ‘improvements in children/youth & family service delivery systems.’ The final results were better outcomes for children, youth, and families involved in SOC.

Systems of care brought to the table those who were working with children, youth and families. The next step in SOC’s evolution is to ensure that collaboration efforts are strong enough to meet not only Maslow’s pyramid of needs but also those needs outside of the individuals and families. Often when we think of ‘systems,’ images of an obtuse amalgamation of inanimate components or parts come to mind. However, it is far from absolute truth when we define the human service fields, especially connected with child welfare, education, mental/behavioral health, and primary care. In fact, one definition of the human services field is:

The field of Human Services is broadly defined, uniquely approaching the objective of meeting human needs through an interdisciplinary knowledge base, focusing on prevention as well as remediation of problems, and maintaining a commitment to improving the overall quality of life of service populations. The Human Services profession is one which promotes improved service delivery systems by addressing not only the quality of direct services, but also by seeking to improve accessibility, accountability, and coordination among professionals and agencies in service delivery. (National Organization for Human Services)

Helping Hand image

It is through this broad definition that an inter-connectedness develops, which brings the field up to the level of TCOM. To solidify this point, this quote captures the very essence of the transformational aspirations of our field: 

Human services in practice is driven by a sense of humanity, but there’s so much more to it than simple charity. Behind it is a philosophy that understands that by helping individuals overcome trying circumstances we contribute to a thriving and successful society. Human services is as much about the collective as it is about the individuals it serves.

(HumanServicesEDU.org)

In part 2 of this blog, we will discuss how transformational change of the whole person requires collaboration and creative solutions.


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