Recovery-promoting Competencies An Employeeâ€™s Guide
Introduction Competencies ● ● ● ●
Recovery ● ● ● ●
What are competencies? Why is it important to have a competency model? How was the Recovery-promoting Competency Model developed? The Competency Model
Hope Relationships Identity, Meaning and Purpose Choice and Control
The RECOVERY-PROMOTING Competency model Using the competency model to help you achieve peak performance
● The aims of managing performance, learning and development
● Getting the best out of meetings to discuss your performance,
learning and development
Recruitment and selection
Preparing for a competency based interview During the interview
1 Introduction There is a move towards evidence-based practice and assessing competence in the mental health sector. This Competency Model is easy to use and is designed to help you do your job well. It is based on the values associated with a recovery orientation. Your organisation may use this Recovery-promoting Competency Model to: ●
assess you as a candidate during an interview
your competence during supervision and performance management meetings to help you be successful and enjoy your work
help you to see what training would be most suitable for you now and in the future.
Becoming really familiar with and skilled in recovery-promoting competencies will help to build your confidence and ability to support people in their recovery journey. The competencies are also useful life skills to have. Any recovery orientated tools your organisation uses, such as the Recovery Star, will also be much more effective when being used by someone with strong recovery-promoting competencies. Before explaining how you and your manager might use the competencies we will look at what is meant by competencies and by recovery.
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Training To book training on the competencies, competency based interviewing, performance management, the Recovery Star or to discuss your training needs contact us on 020 8313 9725.
Sally Lawson, Head of Training and Consultancy at Community Options and Student Researcher at King’s College London
2 Competencies What are competencies? Competencies are the blend of skills, knowledge, motivation, attributes and attitudes that combine into behaviours that enable you to be competent and successful in the way you perform your job.
Why is it important to have a competency model? Using a competency model helps you to know what standards of behaviour are expected of you and helps you to perform at your best. You can use the model to reflect on how you perform at work. The model in this booklet concentrates on behaviours that tend to help and hinder recovery. Ultimately the model is there to help us support people in their recovery journey. The model can also be very useful to help managers be more objective during the selection process and during performance appraisal by focusing on the behaviours that really count.
How was the Recovery-promoting Competency Model developed? The model was founded on the results of research using job analysis techniques. The research was supervised by Kings College London with approval from the Psychiatry, Nursing and Midwifery Research Ethics Sub-Committee.
The Competency Model Four recovery-promoting competencies came out of the research: ●
eveloping meaningful relationships with people and supporting them to develop relationships with D others
Empowering people and facilitating their capacity to make choices and take control of their recovery on a well-informed basis
Inspiring hope in others and maintaining a personal sense of hope
Supporting the development of self-esteem, identity, meaning and purpose
Additionally two other strong themes were apparent. These are: ●
Team and partnership working
Commitment to a high quality service and continuous learning
Some behaviours help recovery and some get in the way so the model lists both. They are not always opposites of each other. You may be able to think of additional things from your own experience at work and in your own life. This model is designed to help you and your manager discuss your competence in relation to the work you do and some of the things listed will be more important than others.
3 recovery There are many meanings and definitions of the term recovery. There are two main uses of the word in the context of mental health. Firstly there is the concept of clinical recovery, defined by the remission of symptoms and restoration of functioning as assessed by the clinician. A more recent understanding, strongly influenced by the views of people who experience mental illness, is that of personal recovery, defined by subjective experiences and living a full life in the context of an enduring mental health condition. For the purpose of this guide, recovery is seen as a process with different outcomes for different people as defined by them personally. The concept includes recognising people’s strengths, vulnerabilities and resources, their capacity to be resilient, learn and grow and successfully contend with potentially distressing experiences and symptoms of mental illness. The recovery process is a personal one, involving recognition that recovery is possible and requires the willingness to take responsibility for working towards it. You can play a significant role in facilitating or impeding an individual’s recovery journey. Subtle as well as obvious differences in your behaviour will make a big difference to a person’s identity and self-esteem, sense of being able to take control, potential to make choices and hope for the future. The most frequently cited definition of recovery, also referred to in the cross-government’s mental health outcomes strategy for all ages, is that of Anthony (1993) who describes recovery as: A deeply personal, unique process of changing one’s attitudes, values, feelings, goals, skills and/or roles. It is a way of living a more satisfying, hopeful and contributing life even with the limitations caused by illness. Recovery involves the development of new meaning and purpose in one’s life as one grows beyond the catastrophic effects of mental illness. The recovery approach takes into account that experience of symptoms, effects of medication, stigma, discrimination, disempowering services and lack of opportunity can all have consequences for self-esteem and life satisfaction. Recovery is often about changing one’s relationship with mental illness, redefining oneself potentially being as important as symptom alleviation. There are a number of themes that emerge from all the books and articles about recovery. Four key themes are outlined below.
Hope A sense of personal hope makes a real difference to a person on their recovery journey and, along with personal courage, is often what enables people to grow and to cope with the challenges they face. Hope is often inspired or sustained by others who demonstrate a belief that positive change and a satisfying life is possible. Your role is therefore critical. Many people report that someone expressing belief in them as a person and believing in their capacity to recover has made a big difference to their recovery. For some people it has been a turning point. Two types of hope are important, hope in general and hope regarding specific goals or issues. Hope is not just about a feeling. Hope manifests itself in many ways including: ●
Having personal goals
Having a sense of direction
The willingness to find ways of achieving aspirations
The ability to persevere.
You need to be able to demonstrate and express your own sense of hope and optimism, including recognising and valuing a person’s progress, strengths and investment in their journey. It involves focusing on possibilities and celebrating success. Hope can be inspired by hearing about the success of people who have had similar experiences. Everyone can play a part in sharing encouraging stories. Research suggests that hope is open to being strengthened. In clients this may be through recoveryoriented services, peer support and staff behaviour.
For some people their sense of hope is closely linked with religious or spiritual beliefs that provide meaning and a reason to carry on through distress.
4 Recovery (continued) Relationships Personal accounts and research suggests that having emotional and practical support, someone being there for you and the capacity to maintain relationships with peers, family and friends is important in recovery. Many people have found that forging new connections and finding roles where they can help others and validate their experiences has been instrumental to recovery. You play an important role in offering empathy and understanding, being there and offering encouragement. When it comes to relationships, your role is twofold. Firstly to be a person that can be trusted to act with integrity, respect and warmth (in order to build up a positive and trusting relationship) and secondly to support the client in developing the type of connections and relationships they want with others of their choosing.
Identity, Meaning and Purpose Regaining or maintaining self-esteem and self-respect, along with learning to see illness as just one aspect of self (as opposed to a dominant aspect of one’s identity) is often cited as an important aspect of recovery. At times of distress, aspects of identity (such as artist, keen gardener, and cultural identity) and roles (such as manager, friend, parent, student), get overshadowed by an identity as someone who is mentally ill. Selfacceptance, reconnecting with personal strengths, finding pleasure in interests and abilities along with meaningful roles are all aspects of recovery. Gaining a new perspective on the past, finding a helpful explanation to make sense of earlier experiences and creating a new meaning and purpose can contribute to the recovery process. Meaning and purpose can be derived from many sources e.g. religious and spiritual beliefs, having something to give, activities, employment and working towards dreams and goals. You can play a role in providing the right environment to nurture the growth of self-esteem and identity. Treating people with dignity, offering acceptance and affirmation, focusing on strengths and responding to the whole person can make a significant impact on a person’s positive self-identity. Recognising the expertise and unique character traits of each individual is vital. You can also provide a person with support to overcome stigma and self-stigma and can take a person’s dreams seriously, engaging with what is important to the client.
Choice and Control An increasing sense of knowledge about mental health and illness and an understanding of potential recovery stages and possibilities can contribute to recovery. Learning to deal with loss and developing further self-awareness, along with the increasing willingness and capacity to take control in the recovery process are often features of a recovery journey. Many people cite the moment they decided to actively participate in making the changes they wanted to happen as a significant step. For some people recovery might involve developing self-help strategies. These may include finding ways to manage symptoms and setbacks, to reduce the social and psychological effects of stress and ways to gain a greater sense of wellbeing. For some people it will involve making choices about lifestyle to manage factors that facilitate physical and mental health.
You can provide information, support a person’s capacity to make informed choices, explore options and risks and discuss the implications of decisions with clients. Sometimes a desire to help can lead to disempowering behaviour so it is important to keep this in mind.
5 RECOVERY-PROMOTING Competency Model Developing meaningful relationships with people and supporting them to develop relationships with others Positive indicators
Is authentic, genuine and sincere. Interacts based on honesty and integrity.
Lacks insight into the impact of their own behaviour on others.
Shows acts of kindness, nurturing, compassion, encouragement and caring that do not undermine independence.
Is abrupt, abrasive, authoritarian and disrespectful. Does not take into account the reactions of others.
Initiates / invites engagement, conversation, rapport-building and spends time with service users on a one-to-one basis. Promotes involvement in groups. Enters into discussion about light issues and service user interests as well as troubling or distressing issues. Is accessible.
Avoids some clients and neglects to give fair amounts of attention to people based on their needs. Does not make an effort with people who find it difficult to communicate.
Offers emotional support, the sense of being believed in and ‘being there’ for the person. Maintains good relationships with, and involves peers, family and friends whilst respecting the services user’s choice in this respect. Promotes constructive relationships in the community. Encourages and supports the service user to build connections, and to develop and maintain good relationships and to offer support to their peers, family and friends. Creates an inclusive culture. Shares in appropriate humour and fun. Relates to and values the person as a whole, treating the person with dignity and respect. Builds bridges within the community and with other organisations. Promotes the respect of, and value of, individuals in the community. Reflects on their own motivation, attitude and behaviour to help them form good relationships with individuals. Tries to understand what people are communicating when they are not using words.
Does not adapt communication to cultural norms or personal preferences. Does not set appropriate boundaries. Is not able to draw the line between support work and therapeutic work. May become easily upset in distressing situations due to ‘personal compassion’. Reacts emotionally and / or retaliates in challenging situations. Can become overwhelmed in conflict or emotional situations and lose perspective. Ignores or belittles others’ feelings. Does not keep to their word. Undermines trust. Is inconsistent in their treatment of others.
RECOVERY-PROMOTING Competency Model
Demonstrates empathy, understanding and active listening to put people at their ease and encourage them to open up.
Operates with boundaries that limit engagement to tasks. Communication style is guarded, remote and detached.
6 RECOVERY-PROMOTING Competency Model (continued) Empowering people and facilitating their capacity to make choices and take control of their recovery on a well-informed basis Positive indicators
Shares information and explains reasons for actions. Discusses the recovery process, self-help, coping strategies and stages involved in loss and change.
Excludes service users from discussion and decisions. Creates a climate of ‘us and them’.
Asks for permission when offering practical support and does things ‘with’ the person (instead of ‘for’ the person). Enquires about preferences and offers choices and options. Respects the service users’ wishes and fosters selfdetermination.
RECOVERY-PROMOTING Competency Model
Actively addresses power imbalances and encourages assertive behaviour. Makes adjustments that enable the person to take control. Has a good understanding of mental illness, social and clinical recovery, reasons for and signs of relapse. Has knowledge about the impact of an individual’s diagnosis on their behaviour, emotions, worldview and capacity. Uses this to help understand and support a person without letting it dominate their thinking. Acknowledges when a person is taking control, responsibility, actively engaging in strategies to stay well and managing setbacks. Shares knowledge on mental and physical illness and wellbeing. Facilitates active choices and participation in services and treatment. Discusses how to take steps towards independence. Supports the person to take control over problems and illness and encourages active participation in the process of recovery.
Concentrates on getting tasks done (such as cleaning) as opposed to sharing the task with the service user. Does not offer explanations regarding decisions, action and alternative options. Does things for people rather than enabling the person to do what they can. Asserts own power and authority. May have a need to be seen as strong. Explains away behaviours as being due to a diagnosis, inappropriately. Judges a person without taking into account their diagnosis, for example labelling someone as lazy when they are severely depressed. Is directive or parental.
7 RECOVERY-PROMOTING Competency Model (continued) Inspiring hope in others and maintaining a personal sense of hope
Holds, acts on and cultivates an optimistic view of the future. Demonstrates the belief that good can be brought about. Offers reassurance and takes steps to restore hope for the future and the opportunities it holds.
Judges people’s ability and motivation and ‘writes them off’.
Demonstrates future-mindedness by initiating positive discussions on dreams and aspirations for the future. Takes time to understand what the person wants.
Colludes with low goals and does not encourage goal setting.
Helps the service user to set motivating goals, framed in positive language.
Does not make the effort to find out what a person can do.
Gives up quickly when others lose interest or fail. Does not try alternative routes to success.
Does not believe change is possible.
Encourages self-belief and challenges selflimiting beliefs. Views service users as responsible and capable. Shares relevant success stories of other people with similar mental health issues. Celebrates small steps and works on making a difference for long-standing service users. Encourages people to do things that they enjoy, try new things and take some chances and manage risks. Models perseverance and helps others to ‘not give up’. Explores options with service users regarding different ways they can move towards their goals. Influences and seeks means to achieve goals with the service user. Thinks and acts on what a person needs for independent living. Strives to make improvements.
RECOVERY-PROMOTING Competency Model
Notices, praises and helps others see the positives including progress, achievements from the past and present, abilities, strengths and personal characteristics.
8 RECOVERY-PROMOTING Competency Model (continued) Supporting the development of self-esteem, identity, meaning and purpose Positive indicators
Treats people fairly, thinks rationally, keeps an open mind and does not let personal feelings and beliefs bias decisions and quality of service.
Judges quickly without weighing the evidence from all angles.
Seeks to understand the person and the influences in their life at present.
Makes critical comments, accuses and attaches blame. Holds negative, pre-conceived ideas.
Supports the service user to personalise their environment. Where relevant, facilitates the person to consider incorporating things that are meaningful to their identity and culture.
Talks down to or patronises the person, or is dictatorial.
RECOVERY-PROMOTING Competency Model
Regularly gives encouragement and genuine affirmation. Recognises and values services users’ contributions and expertise. Treats people with dignity. Helps people to see mental health as only part of the self, not as a definition of the whole person. Supports the person to confront and overcome stigma and change other people’s expectations. Reinforces self-respect. Is polite, tactful and diplomatic. Finds out what is ‘important to’ the person. Respects the service users’ religious/ spiritual beliefs and supports them in sustaining or finding meaning and purpose while recognising personal choice. Supports access to networks in the community. Offers support and encouragement in pursuing and reconnecting with meaningful activities and roles.
9 RECOVERY-PROMOTING Competency Model (continued) Generic competency â€“ Team and partnership working
Is loyal to the group.
Is unaware of the skills within the team.
Takes on a fair share of work.
Contravenes policies and procedures.
Adopts a consistent and agreed approach with colleagues to clients. Sticks to a strategy once it has been agreed.
Does not ask for the opinion or advice of others and believes that they do not need it.
Is aware of the strengths and abilities of team members. Calls on the expertise of colleagues and external partners or specialists. Is honest and open with team members. Proactively shares relevant information with the team without breaching client confidentiality.
Completes work on the checklist and leaves other work for the next shift. Does not treat other team members with respect. Undermines agreements made with team members and the service user. Is competitive more than collaborative. Adopts a blame style. Finds it difficult to take advantage of opportunities for shared learning.
Is sensitive to the needs of colleagues, offers help and support. Invests time and effort in developing positive working relationships with team members. Engages in a team sense of purpose. Is aware of and guided by team goals. Keeps the whole team in mind even when working alone. Has a sense of mutual accountability.
RECOVERY-PROMOTING Competency Model
Participates in discussions with colleagues and contributes ideas to determine an approach that is best for the client.
10 RECOVERY-PROMOTING Competency Model (continued) Generic competency â€“ Commitment to a high quality service and continuous learning Positive indicators
Proactively reflects on their practice on a regular basis.
Thinks they have nothing left to learn.
Is honest when things go wrong and seeks opportunities to learn from mistakes. Is willing to change their mind.
Tries to explain away things that go wrong or cover it up rather than exploring openly to gain deeper understanding.
Updates their knowledge on best policy and practice.
Has preconceived ideas of how to do things based on an institutional model.
Embraces new approaches and is proactive in identifying their own training needs. Asks questions and seeks advice on the best way of approaching things where necessary.
RECOVERY-PROMOTING Competency Model
Takes a pride in doing the best possible and will go out of their way to support a team member or service user. Is proactive. Tries to anticipate what is needed and what more they can do. Considers the impact of what they do on their service and organisation as a whole.
Needs a great deal of direction. Does not volunteer to take things on and waits to be asked. Does not think about how they can apply what has been learned from training to their work. Considers constructive feedback or questioning and the suggestion of reflection a personal attack on their work. May avoid people who give feedback or challenge othersâ€™ practice. Does not generate new ideas. Does the minimum necessary. Prefers an easy life. Does not put the clients first.
11 Using the competency model to help you achieve peak performance
The aims of managing performance, learning and development are: ●
To promote good practice
To encourage you to take responsibility for reflecting and learning from experience
To help you to be clear on what your responsibilities are and the required standards
T o provide a safe space for you to receive support and discuss areas of concern (for example if personal issues have surfaced as a result of your work, you have been distressed by an event or are worried as to whether you have handled a situation in the best way possible)
To review the impact of training on your performance and discuss your training and learning needs
To recognise your strengths, achievements and contributions to the organisation’s objectives
Getting the best out of meetings to discuss your performance, learning and development ●
s part of your everyday work, reflect on what is working well and what is not working so well. Have a A look at the positive and negative indicators of the competencies to see if these help you understand the situation, your behaviour and the outcome. Acknowledging both the positive and negative indicators can help you identify trends and improve your performance.
Do some preparation before the meeting. Think about:
• • •
what work has been done since the last session? what did you do well and what strengths have you shown? if there are problems, what help do you need and what ideas do you want to discuss?
hen you and your manager agree actions to be taken, make sure you know who is going to do what W and by when. You or your manager may make a record of this to share.
our manager is likely to arrange sessions on an agreed regular basis and also engage in conversations Y on a frequent basis. If this is not happening you can ask for a meeting. Most managers will appreciate you taking an active role and will see this as an indication of your motivation.
hen you have identified areas where you want to improve, think about a variety of ways that you W develop. Training courses are one solution but there are many others such as observing someone else, noting what they do well and discussing this afterwards, seeking feedback from your manager, colleagues, clients and partners, reading and coaching. People are generally more comfortable giving feedback if you are proactive and ask for it.
eflect back since you last met to see if there are any incidents/situations that have had a negative R outcome. Have a look at the negative indicators for the most relevant competencies to see if these may have contributed. Also have a look to see if there are any examples for the positive indicators that may have helped.
USING THE COMPETENCY MODEL TO HELP YOU ACHIEVE PEAK PERFORMANCE
Some organisations use competency models to help managers have constructive discussion with staff about how they are doing their jobs and to help them to identify training needs.
12 Recruitment and selection The interview is one of a range of selection methods that aims to make a prediction as to how well you will do a job in the future. It often plays a significant role in the selection process. Many organisations now use the competency based interview. It consists of questions aimed at getting you to talk about things that you have done that are relevant to the job competencies. Questions will be tailored to the job you are applying for and the type of setting you will be working in.
Preparing for a competency based interview Before the interview, read through the competencies to become familiar with them. Reflect on your work over the last year or so, or in your most relevant jobs, and think of examples of where you have used these competencies. Remember what you did and what the outcome was. Take time to think about situations other than work when you have used these competencies. It might have been as a volunteer, as a parent, carer or friend or in one of your leisure activities. Naturally employers are very keen to hear about your work-related examples but it is also acceptable in an interview to draw on experience in other situations where you have used the relevant behaviours. Do think of more than one example per competency. You will find it helpful to look at the indicators for each competency to prompt you to remember examples of the various behaviours. No one is perfect so think of situations where each of the competencies was relevant and the outcome was not as you wished, or you discovered you had some areas for your own development. Think about what you learned from these occasions. Sometimes it is hard to think of things we do well. Not everyone is good at recognising their strengths. If you are struggling to think of examples, you might want to ask colleagues to give you feedback. This is a good way of becoming more self aware and building on your strengths.
During the interview
RECRUITMENT AND SELECTION
Remember that the interviewers do not want to catch you out. They want to know what you have done in the past and how you have used the competencies in work and, where appropriate, in other aspects of your life. Their intention is to ask you questions that will help you to show what you have done that is of relevance. Before asking you questions on each competency a member of the panel will describe the competency to you. Listen carefully to this as it will help you pull out from your experience what is most relevant. If the panel are about to ask you about teamwork and partnership working they might say something like this: “Although there will be many occasions when you have to take your own initiative or might be supporting someone on a one-to-one basis, it is important to remember that you are part of a wider team, sometimes involving staff from other organisations. We are now going to ask some questions that address teamwork and partnership.” Listen to the questions carefully and take your time to think of your answer. You will often be asked for specific examples. The more you can tell the interviewer about what you did, rather than talking in vague or general terms, the better. Often the style of the question is along the lines of “Can you tell me about a time when……..? What did you do? What was the result?” Here is an example for teamwork and partnership working. “Can you give an example of where you have had to call on the expertise of someone within your team or from a specialist to help you in your work? What influenced your decision to involve others and what did you do?” Sometimes you will get asked to give a second example in an interview. Do not let this throw you. It does not necessarily mean that the first answer was not what the panel were looking for. If you need to, do ask the interviewer to repeat the question. They would prefer to be confident you have understood what they are looking for. You can expect the panel to be attentive but a good interview panel will be careful not to give you any feedback on your answers during the interview. Some panels will give you feedback on request once the selection process is complete.
13 Recommended reading Brown, W. and Kandirikirira, N. (2007). Recovering mental health in Scotland. Report on narrative investigation of mental health recovery. Glasgow: Scottish Recovery Network. Faulkner, A. and Layzell, S. (2000). ‘Strategies for Living. A report of user-led research into people’s strategies for living with mental distress.’ London: The Mental Health Foundation. HM Government/DH. (2011). No health without mental health. A cross-government mental health outcomes strategy for people of all ages. Repper, J. and Perkins, R. (2003). Social Inclusion and Recovery. Edinburgh: Balliere Tindall.
Competencies are the blend of skills, knowledge, motivation, and attitudes
Slade, M. (2009). Personal Recovery and Mental Illness. A Guide for Mental Health Professionals. Cambridge: Cambridge University Press.
2a Fielding Lane, Bromley, Kent BR2 9FL tel: 020 8313 9725 fax: 020 8313 9703 email: firstname.lastname@example.org web: www.community-options.org.uk