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You want to use a strengths based approach, but where do you start? What does it mean in real life? How do you ask strengths based questions to identify and understand your own, or another person's strengths?

Do you find you a strengths approach comes naturally to you? Or have you found it difficult? We are often more used to looking for problems, rather than looking at what is working. Looking at what is going wrong, rather than what's going right. Giving solutions instead of looking at what can be built on; finding out what solutions and resources a person, or group already has.

It seems even our brain may be programmed to catastrophise as a first response. Looking at the worst case, imagining what might go wrong.

I am definitely a "catastrophiser" (I made that up so don't worry about looking for a definition). A strengths approach and strength based questions still do not come naturally. It is still practice, practice, practice. At times I still find it difficult to find the right questions when my mind is yelling out solutions - OK and sometimes I do voice them out loud.

Starting Out with Strength Based Questions:

If you too are new to the whole idea, or you just want a few extra ideas, the following is a list of 50 strength based questions to get you started.
It is not complete. And it's definitely not in any kind of order. And I definitely would not recommend using questions 1 through to 50 as your interview.
To help you focus on finding out your own, or another's strengths and resources, select the questions that kind of fit. Alter the wording to suit the person, the situation,and your own style. None of this list is specific to brain injury, the questions could be tailored to any situation. Try them on yourself.

As a beginner it can be helpful to choose a small number of questions that you practice and use until you gain confidence. You can expand your repertoire as you become more confident.

When I started with strengths based questions, or now when feeling a bit out of my depth (which is often), I will begin with asking "What is working well for you?" and then add variations on the questions 1- 8 below.

Each question can be like a springboard to further questions. All with the aim of a person, group, or organisation, identifying their strengths;what they have to build upon; what they do well. They should be gentle questions, not challenging or confronting.

Consider strengths and resources as broadly as possible. This might include: the range of people and supports around a person; their health, both physical and emotional; resources such as financial, aids and equipment; beliefs and outlook.

50 Strengths Based Questions

1. Can you think of things you have done to help things going well?

2. What have you tried? And what has been helpful?

3. Tell me about what other people are contributing to things going well for you?

4. What could be going better?

5. What stops things working better for you?

6. What would be happening if things were working better for you?

7. What small thing could you do that would make a difference?

8. Tell me about what a good day looks like for you? What makes it a good day?

9. On a scale of 1 to 10 how would you say X is? What might make that score a little better?

10. What are you most proud of in your life?

11. What achievements have you have made? How did you make them happen?

12. What do you like doing? What makes this enjoyable?

13. What do you find comes easily to you?

14. What do you find you learn most easily?

15. What do you want to achieve in your life?

16. When things are going well in your life - tell me what is happening?

17. What are the things in your life that help you keep strong?

18. What do you value about yourself?

19. What would other people who know you say you were good at doing?

20. What would your family and friends say you were good at?

21. You are resilient, what do you think helps you bounce back?

22. What is one thing you could do to have better health, and feeling of wellbeing?

23. How have you faced / overcome the challenges you have had?

24. How have people around you helped you overcome challenges?

25. What are three things that have helped you overcome obstacles?

26. If you had the opportunity what would you like to teach others?

27. Without being modest, what do you value about yourself, what are your greatest strengths?

28. How could/do your strengths help you to be a part of your community?

29. Who is important in your life?

30. How would you describe the strengths, skills, and resources you have in your life?

31. What could you ask others to do, that would help create a better picture for you?

32. What are the positive factors in your life at present?

33. What are three (or five or ten) things that are going well in your life right now?

34. What is the most rewarding part of your life?

35. When now, or in the past, have you felt like you are making a difference, making a contribution? How did you make this happen?

36. What would make you feel you are making a contribution?

37. Tell me one, (or five or ten or more) things that you can do?

38. What makes you feel excited OR useful OR satisfied? Tell me about a time when you felt these feelings?

39. Tell me about a time when you responded to a challenge in a way that made you feel really on top of things?

40. How have you been able to develop your skills?

41. How have you been able to meet your needs?

42. What kind of supports have you used that have been helpful to you? How did the supports improve things for you?

43. Tell me about any creative, different solutions you have tried. How did this work out?

44. When you think about X (whatever it is that is stopping things going well) is there anything you can think of that could help in any way?

45. Can you think of one small manageable step that would improve X for you?

46. What resources such as community, people, aids, and equipment do you have now? Do you know of other resources that might be helpful for you?

Remember these are to get you thinking about strength based questions. There is much to learn about working from a strengths approach and you will hopefully find it is rewarding for you and for those you support.

Resources To Get You Started with Strength Based Questions

Here are three starting points that give you a range of different perspectives to think on;

Innovative Resources is the publication and resource site for St Lukes Bendigo and has a great range of resources.

Appreciative Inquiry Commons has all kinds of information and resources about appreciative inquiry and strengths based approaches.

Authentic Happiness is the site of positive psychology and Dr Martin Seligman.

Finally what about examples of strengths people have discovered after brain injury - is an article about people who have discovered artistic creative talents. And for a very public role model we can look to Gabrielle Giffords, and her inspirational recovery.
Please add to the list of questions, add resources, make suggestions, agree and disagree in the Comments below or send me a letter HERE.
And Finally:

To finish with today, an unusual but entirely understandable definition of strength for chocolate lovers everywhere!

"Strength is the capacity to break a chocolate bar into four pieces

with your bare hands

- and then eat just one of the pieces."

Judith Viorst

Support the Work of Changed Lives New Journeys

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50 First Strength Based Questions - Changed Lives New Journeys

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Do you find you a strengths approach comes naturally to you? Or have you found it difficult? We are often more used to looking for problems, rather than looking at what is working. Looking at what is going wrong, rather than what's going right.

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Social Care Institute for Excellence (SCIE)

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Published: March 2015
Last reviewed/updated: October 2022

Background

Mr R is a man in his late 60s living alone since the death of his wife. Mr and Mrs R had been married since they were both 18.

Mr R is retired. He previously worked as an engineer in the aerospace industry, taking relatively early retirement at 60 due to an increase in the severity of rheumatoid arthritis (diagnosed in his 20s) and a desire to spend more time with his wife.

The couple were known to the local authority due to Mrs R's physical health problems. Mr R acted as her carer and, with additional support from Mrs R's personal assistant, continued working until retirement. Mr R's needs had been supported following a carer's assessment, however his physical condition was never significant enough while his wife was alive to require a needs assessment in his own right.

Mr and Mrs R had a very small circle of friends and no significant relatives. Despite her physical illness, Mrs R was more outgoing and better able to form friendships. Mr R is shy and awkward in social situations; most of his relationships were formed through his workplace and did not extend beyond work.

Mr R has a son and daughter, one of whom lives abroad and the other lives 300 miles from the family home. While both enjoy a good relationship with their father, visits are infrequent, but loving and fulfilling when they do occur.

Following the death of his wife 18 months ago, Mr R has become increasingly depressed and isolated, rarely leaving his home and having little social contact with friends. He is neglecting his personal hygiene and his home is becoming increasingly messy, with unwashed plates and evidence of spoilt food in the kitchen. He is not eating properly and largely feels there is no point to anything any more. He is not taking his pain medication regularly and is experiencing increased lack of mobility due to his arthritis.

His only daily social interaction is with his neighbour, Mrs S, who has been friends with Mr and Mrs R for 30 years. She 'pops in' regularly throughout the day to check on Mr R, but limits the extent she helps because she does not wish to intrude on what she recognises as his very private nature. Mrs S doesn't feel comfortable offering him personal care. She regularly talks to Mr R's children to update them on their father's condition. Mrs S is fit and capable, being some years younger, and would like to provide more support to Mr R around the home but does not know how to begin the conversation about his needs without offending him.

In the past Mr R helped out at the local Scouts and Guides and volunteered in his children's school when his shift patterns allowed. This allowed him to be close to his children and also helped him overcome his shyness, as he was acting in what he saw as some form of official capacity.

His son and daughter have become increasingly concerned about their father's state of mind and physical condition, which is confirmed by their regular contact with Mrs S. Being familiar with the local authority support from their mother's case, they have requested a social care assessment for Mr R.

Preparing for an assessment

When preparing to make an assessment it is useful to ask yourself the following questions in relation to the legal duties for the Care Act 2014.

What needs to be taken into account to ensure the assessment is appropriate and proportionate?

How will you ensure a strengths-based approach has been considered?

How do the first two questions above affect the way this assessment is conducted?

Who will be involved with the assessment?

Does the assessor need to have specific training and expertise?

In preparing for the assessment, what additional issues or obstacles need to be considered (if any) - and how can they be dealt with?

Have you considered the individual's needs over an appropriate period of time to ensure that they have all been accounted for?

What is the impact on the whole family? Should there be a carer's assessment?

What information and advice would be helpful?

What preventative measures (to prevent, delay or reduce needs) will you consider?

Are there any risks of self-harm that need to be considered or assessed?

What else might you need to think about with regards to this example?

Ensuring the assessment is proportionate and appropriate

Mr R faces social isolation which is contributing to the deterioration in his mental health. He feels lonely and without a social network. Adopting a strengths-based approach in the assessment allows the assessor to work with Mr R to recognise not only the problems he faces but the:

strength of his existing, if limited, relationships

extent that people close to him value him and are willing to offer support

skills and experience he possesses that can be of value to others and might help to widen his social network.

In Mr R's case the assessor considered the following.

His personal network. Mr R has limited social contact but has very frequent contact with Mrs S, his neighbour. Mrs S offers limited support at the moment and has indicated that she would like to do more. The assessor explores the extent to which she is willing and able to provide support and it becomes clear that Mrs S would like to support Mr R to maintain his home to the standards that Mrs R previously expected, out of friendship for him and '... in memory of a dear friend'. However, Mrs S does not feel comfortable with the idea of providing personal care.

His personal resources and strengths. Mr R's mental health has deteriorated significantly due to the loss of his wife and any limited social contact he had in the past. The assessor takes time to explore with Mr R the extent of his previous social network and the activities he took part in, as well as the skills, knowledge and experience he has. At the same time the assessor considers local activities or facilities that match these existing strengths, either through their own knowledge or by working with local expert partners (CVS (Community Voluntary Services), Age UK, etc.) to assist in identifying social opportunities.

Proportionate

Severity and extent of needs. Mr R has physical and mental health needs that impact most of the specified outcomes in the eligibility criteria. Therefore the assessor involves a mental health professional.

Person's wishes, preferences and desired outcomes. Mr R is fully able to express his needs. His needs arising from loneliness and isolation and his physical condition do not have an impact on his capacity to understand the process, collate information and articulate his needs. However, his very low mood means the assessor will need to allow as long as necessary for the assessment to enable Mr R to express his views. This will require additional support from the mental health professional.

Potential fluctuation of person's needs. Mr R's mental health needs have steadily declined since the death of Mrs R, and more information is required to understand whether his mental health also fluctuates. Mr R's physical needs do fluctuate, particularly in relation to the seasons. The assessor seeks expert mental health advice to establish the likelihood that Mr R's mental health needs are likely to fluctuate. This involves consideration of Mr R's condition over a suitable period of time, taking account of the experience of mental health professionals of his low mood over the years and of the assessor's experience of dealing with people with similar conditions in similar circumstances. The views of Mr R's son and daughter are also taken into account.

Other information and assessments. Mr R is already known to social services from his carer's assessment and he has been seen regularly by local health care professionals. The assessor gathers - with Mr R's consent - all existing information: previous needs assessments; CPA (care programme approach) ; GP/district nurse's views, etc. This information is then examined to establish what is relevant at this point to avoid asking Mr R unnecessary/duplicate questions.

Relevance of assessment questions for the case: Mrs R has the appearance of needs across most, if not all, the eligibility outcome areas. As this is his first needs assessment all areas must be considered.

Appropriate

Proportionate. As above.

Communication needs. Mr R does not need any additional support for communication and he is capable of understanding questions, processing information and providing answers himself.

Means. A face-to-face assessment seems to be the most suitable method for Mr R, and when asked he chooses this. He does not want a supported self-assessment largely because he feels he will not be motivated enough to complete it by himself.

Location and timing. Due to his low mood and reluctance to leave the house Mr R prefers the assessment to take place in his own home. He feels that he is able to meet any time during the day, as his mood and condition are not affected by any particular circumstances, although he does request that visits take place after 10 a.m. to allow him time to be up and dressed.

Capacity and level of understanding. Given Mr R's low mood the assessor undertakes a mental capacity assessment to establish if he needs an independent advocate. The mental health professional establishes that Mr R has capacity to make informed decisions. However, they also highlight the importance of considering his current low mental state in the assessment process.

Process. Mr R will be sent the assessment materials in advance of any face-to-face meetings to allow him to prepare his responses, along with information about the assessment and support plan process.

Determining eligibility

Do the needs for care and support arise from a physical or mental impairment or illness?

Do these needs mean the adult is unable to achieve two or more of the listed outcomes?

As a consequence of being unable to achieve the outcomes, is there, or is there is likely to be, a significant impact on the adult's wellbeing?

Outcomes

Determination. The outcome of the assessment is that Mr R has eligible needs for formal services.

Condition 1. Mr R's needs arise from both physical and mental impairment.

Condition 2. Mr R is unable to achieve two or more of the eligibility outcomes, including: managing and maintaining nutrition; maintaining personal hygiene; being able to make use of the home safely. He has also disengaged with others around him and this may impact on maintaining relationships in the future.

Condition 3. As a result, there is a significant impact on Mr R's wellbeing, particularly in relation to physical and mental health, emotional wellbeing and personal relationships.

Next steps

How the adult's eligible needs might be met

A care and support plan is put in place for Mr R. The intended outcome is to support a level of independence and social contact that had existed in Mr R's life before the death of his wife.

The assessment identified that within the extent of his eligible needs an appropriate source of support for Mr R is the strength of his limited relationships with his former work colleagues and the extent to which he is able to engage in the community. This is discussed and agreed with Mr R, drawing on his own resources in this way:

The assessor explores with Mr R the extent to which he is currently comfortable with relying on support from Mrs S, and his views on the acceptability of her providing more. The assessor also explores with Mrs S how much more she would want to support Mr R and what impact this would have on her expected outcomes. The assessor agrees with Mrs S that she will:

continue to maintain regular social contact

provide Mr R with the current level of support

become more active in maintaining the home for Mr R and share this duty with a local authority-funded home support package, but not be involved in providing personal care.

The assessor considers Mr R's previous experience and strengths from a social point of view, including his experience as a volunteer and the significant benefit this has had in overcoming his social awkwardness. The assessor works with Mr R to establish his interests and with the help of the CVS identifies a local community centre that runs regular sessions introducing young people to the rich industrial heritage and social history of the area. The assessor encourages Mr R to volunteer his services to the group. Following suitable checks he begins to work with other volunteers of a similar age and background to develop sessions and present them to local young people. Working with people who have similar life experience involves him in an environment that is understanding of his physical limitations and supportive of his loss without putting either at the centre of the relationship. This initial contact leads to Mr R becoming more involved in the activities of the community centre, which is less than a mile from his home. He develops a small but important social network based on activities and knowledge he feels comfortable with, is experienced in and in some respects is a technical expert. This has the potential for a lasting and long-term positive impact on his wellbeing and may in time lead to him to volunteer for other roles, further extending his social network.

Taking account of the eligible needs which cannot be met from Mr R's own resources, services and support provided by the local authority include:

Sourcing an appropriate home support package to meet identified outcomes for Mr R. He is given a choice of the service provision to address, particularly the personal care Mrs S feels unable to provide.

Information on bereavement services to help address the difficulties Mr R faces after the loss of his wife. This has the potential to make a real and lasting impact on his long-term wellbeing.

A referral to the local community mental health team for an intervention from a community psychiatric nurse and support worker. This referral will concentrate on the specific and identified issues associated with Mr R's prolonged low mood following the death of his wife and will ensure that the care he receives from mental health services allows him to achieve his desired outcomes.

Links with the independent living team to consider any aids or adaptations to Mr R's home that could be made to improve access and his overall wellbeing.

Undertaking a benefits assessment to ensure that Mr R is receiving all the support he is entitled to.

Reflection points

What else did you think about?

What else might apply/be relevant in your authority?

What might you do differently?

What have you learned?

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Care Act practice example: Strengths-based approach in assessment | SCIE

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Published: March 2015 Last reviewed/updated: October 2022 Mr R is a man in his late 60s living alone since the death of his wife. Mr and Mrs R had been married since they were both 18. Mr R is retired.

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Mental Capacity through a strengths based lens

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Mental Capacity through a strengths based lens

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https://www.researchinpractice.org.uk/adults/news-views/2020/july/mental-capacity-through-a-strengths-based-lens/

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Positive relationships are central to a good life and this is reflected in our decision making. We generally do not make decisions in isolation, often asking friends and family to input their thoughts, so why should it be any different with assessing mental capacity?

In a previous blog I looked at safeguarding through a strengths-based lens, now we can consider how mental capacity, much like safeguarding, could be viewed the same way. So is strengths-based practice, like flares, back in fashion? Some like me, who have held onto the flares and bootleg pants, would say it never went out of fashion. Perhaps just as new trends have emerged in clothing forcing the flares to the bottom of the pile in your cupboard, our systems and processes haven't enabled us to fully practice in a way which enhances strengths-based practice. How might this then impact the approach we take when assessing people's capacity?

My interest in this topic has only intensified over the years and as I have applied curiosity, what has become so apparent to me is the importance of firstly understanding and interpreting the core principles and then thinking about how these are translated into someone's reality through a strengths-based lens.

Engaging with newly qualified social workers on this topic has been refreshing. They apply a curious mind set and sometimes make observations that some of us experienced professionals miss as they can see, feel and name the dissonance that becomes the constant for many of us in daily practice.

Important questions such as:

How specific should the decision be?

What are the right questions to ask?

How much detail do I give about the mental capacity process to the person when they appear quite confused?

Do I involve family in the test or should it be just between me and the person?

Firstly if you are asking these questions as a student or are newly qualified, I want to congratulate you and I do hope that your supervisors encourage and explore with you, your curiosity. Secondly I want to reassure you that these questions are ones which continue to haunt the mind of many practitioners.

Assessing mental capacity is not always as straight-forward as we would like it to be. It can be particularly challenging when working with people who self-neglect or have hoarding behaviours or where the person experiences fluctuating capacity.

Despite the principles guiding our practice we are all human beings with our own set of values and judgements. We certainly hold strong views of what is acceptable and unacceptable in society today and this varies from person to person. As practitioners we must be aware of our own biases. It can help to think about the feelings and thoughts that are impacting on the way you might be assessing someone's capacity and influencing your analysis and judgement. The key factor to determine is if the relationship is supportive and enabling or obstructive and disabling (Ruck-Keene and Kong, 2019).

When I think about my mother and her history, her life world and reflect on her pattern of decision-making, I shiver at the thought of someone assessing her capacity without one of her children present to support her. This is because she mostly always has made decisions through the support of others and through the lens of her religion and culture. I recall an interpreter being booked by the hospital for an important test she was going to have, whilst this is good practice and I support it, it does still present limitations when information is complex and the interpreter does not have the contextual information about the person's decision making orientation and how best they understand information.

Principle two of the Mental Capacity Act 2005 covers 'supported decision making'. What practical steps have been taken to support the person to make the decision? If relationships are key for someone in decision making then failing to include relevant others means a disregard of one of the core tenets of assessing capacity.

How might we avoid this? I would suggest, again through applying another tenet of the Act considering if the mental capacity assessment can be delayed, particularly for something non-urgent and instead using the time to build a relationship with the person. Understanding the role of relational others and their history and finding out what factors are going to potentially support decision making. In instances when the assessment of capacity cannot be delayed - such as a hospital discharge, we need to think about if the best interest decision can be delayed or be taken incrementally and avoid permanency.

A colleague recently shared she was having a conversation with an adult she was assessing. She was attempting to get an idea about their insight into their care needs and asked the person if he had any carers visiting him to support him during the day. His reply was 'carers -no carers'. His wife from behind whispered 'say helper'. She then rephrased the question with the world helper and immediately the man's response changed, as did the assessor's narrative and choice of words with input from his wife. This example beautifully and simply brings alive in my opinion some of the key messages in Alex Ruck-Keene and Camila Kong's insightful book.

To complete a mental capacity assessment when required is an intervention intended to respect someone's human rights. However, whether it does this is dependent on how it is completed. When the core principles of the Mental Capacity Act 2015 are followed, they provide the opportunity to bring to life the strengths-based approach.

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Mental capacity through a strengths-based lens | Research in Practice

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In a previous blog I looked at safeguarding through a strengths-based lens, now we can consider how mental capacity, much like safeguarding, could be viewed the same way. So is strengths-based practice, like flares, back in fashion? Some like me, who have held onto the flares and bootleg pants, would say it never went out of fashion.

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49. Strengths-based approaches – Martin Webber's blog

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James Caiels discusses his scoping review of strengths-based approaches in social work and social care.

Strengths- and asset-based approaches are widely used in adult social work. There are many models in use, though definitions are not always clear and data on outcomes is largely absent.

In this episode I speak to James Caiels who conducted a scoping review of strengths-based approaches with colleagues. This comprehensive review brought together 72 papers which summarises the extent of current evidence in this field. As we discuss, there remain many gaps.

James Caiels is a research fellow at the Personal Social Services Research Unit at the University of Kent. His research interests include the development and measurement of outcomes for social care, and the evaluation of policy initiatives in the health and social care sector. His recent work includes the implementation of strengths-based approaches in social work and social care.

The full text of the paper we discuss can be found here:

Caiels, J., Milne, A. & Beadle-Brown, J. (2021) Strengths-Based Approaches in Social Work and Social Care: Reviewing the Evidence, Journal of Long-Term Care, pp. 401-422

Some templates for your podnotes to assist your learning and reflections from episodes of the Social Work Research Podcast can be found here.

Credit

'Positive Energy' by Scott Holmes Music is licensed under a Attribution-Non Commercial 4.0 International License

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James Caiels discusses his scoping review of strengths-based approaches in social work and social care. Strengths- and asset-based approaches are widely used in adult social work. There are many models in use, though definitions are not always clear and data on outcomes is largely absent.

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A brief guide to... strengths-based practice for people accessing services

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A brief guide to... strengths-based practice for people accessing services

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A brief guide to... strengths-based practice for people accessing services

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Podcast - Strengths Based Conversations - supporting good practice

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Podcast - Strengths Based Conversations - supporting good practice

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NICE - Evidence for strengths and asset-based outcomes - A quick guide for social workers

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NICE - Evidence for strengths and asset-based outcomes - A quick guide for social workers

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NICE Evidence for strengths and asset based outcomes A quick guide

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SCIE Report - What next for strengths based areas - Nov 22

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SCIE Report - What next for strengths based areas - Nov 22