CARE: Whether NHS or Social Care ...

C	A
R	E

Whether -
NHS or Social Care^*
what
C.A.R.E.
is crying out for is a
universal, shared, holistic and wholly integral conceptual framework.
Then and only then will the currencies^# of care be
transferable, translatable and transforming!

* Private, 3rd sector, religious order, or social enterprise ...
# Currencies does not just refer to finance.

h2cm - Being at the center of things [I]

The center of Hodges' model can represent many things:

an epistemological nexus for the transdisciplinary dependencies of our times
multidisciplinary coffee shop
self-care engagement stage
the chaos of all things
holistic harmony
integrated idyll*

More down to Earth and acknowledging this cruciform '+' structure as a mythic device, in addition to searching for the mysteries of the universe at the center we can also place the 'well' person there.

As the previous post on ADLs suggests the 'well' person can function on a basic level and has negotiated the four axes and the four and five fold knowledge domains. They can therefore be considered (sufficiently) wholly integrated. We are all travellers, constantly traversing these domains of experience consciously, unconsciously, expertly or with the awkwardness that denotes the novice.

Conversely and reflecting the model's utility: it is also possible to locate the unwell individual in the center too. In this instance the placement suggests impoverishment of experience, ongoing personal and social stasis and in the case of substance misuse the presence of specific disruptive focus and preoccupations. The person becomes lost to their potential, stuck in a 4:5-fold minima. They continue to travel chronologically, but the journey is spiral, self-iterative and diminishing by return.


However: what you can see you can change, or come to terms with.

*from Greek eidyllion, little picture (h2cm as a snapshot).

Image source: http://www1.lsbu.ac.uk/water/protein2.html

Simply the best... 4-Domains Pale Ale!

Drugs and alcohol
have permeated
our various cultures and
civilization for millennia.

Our models of health and social care should reflect this. ...

More to follow on drugs, dementia and the Berlin Wall.
I just had to get this out of my system ...

Image sources:

http://www.hbclark.co.uk/clarks-brewery.html
http://www.wordforwine.co.uk/jwlees/index.php
http://www.woodmoorbeer.org/Pages/Snordog_Kenya_Labels.html

Drugs, Policy and spent Energy

The ongoing controversy here in the UK over drugs policy amid the sacking of Prof. David Nutt - chairman of the Advisory Council on the Misuse of Drugs and since Friday the resignation of other members highlights the tension between the SCIENCES and POLITICS.

As a father, mental health nurse (and light imbiber of real ale and wine) all I know is that the government has been lobbied for decades by concerned groups over the risks of excessive alcohol consumption. With changes in alcohol licensing opening hours and pricing/tax it seems the government has the local town centres and community legislation it deserves.

Given the current spat you might think that within Hodges' model the SCIENCES and POLITICAL domains would be diametrically opposed? But no! There they are bosom buddies on the mechanistic side of the model.

Although the clue is in the title - advisory - as to the extent to which the government is bound to follow advice, the government's policy, advisory groups and policy should be in accord as far as the media and public are concerned.

Otherwise what price for evidence-based politics?

For individuals and communities alike we need order between the SCIENCES and POLITICS otherwise chaos reigns. Order does not just fall out of the tree. The issues here include at risk youngster's for whom exposure to cannabis might precipitate a psychotic episode; the granularity of a classification of drugs for legal purposes and that for clinical and social care. The debate is complex and takes work and energy on many levels. There are many dimensions to appreciate in this situation:


While very unfortunate, this is timely as I read Ben Goldacre's Bad Science.

You do have to worry about the position of
common sense.

There are other sources of heat already on the boil with many spillages to follow. These will arise from the friction of SCIENCE, climate change and policy. Ah bliss to live in interesting times. ...

Hodges' model: publications

The book chapter for Radcliffe Publishing is now in the hands of the editor. This is great step forward for Hodges' model (and me) in that the text considers the model within substance misuse care and services. To my knowledge the only other book chapter is that of Brian Hodges' in Hinchcliffe (1989) [please see the bibliography lower right].

The next project entails me completing my half of a paper on the application of Hodges' model in forensic nursing. My contribution introduces the model (with new text) to a forensic nursing audience and highlights why h2cm is of relevance to this very challenging specialised field of nursing. This is also a significant development being yet another clinical example and a co-authored effort. Collaboration with other people interested in and actually applying Hodges' model is definitely the way forward.

There are other topics that in championing h2cm would hit the sweet spot:

• Continuing the current vein - papers on clinical applications for the model in mental health, learning disability and health visiting. These are areas in which the model was first taught and originally applied. 

• The four original purposes for the model also compete for attention:

1. supporting holistic theory and practice;
2. reflective practice;
3. bridging the theory - practice gap;
4. curriculum development.

On that last theme, I need to type up a review of a book on curriculum development in nursing that will be featured here shortly. In the meantime if you have an essay, case study to complete, please bear h2cm in mind (and paper). ...

Hodges model: indicative concepts in Substance Misuse Care

Hodges' model
in substance misuse services

psychological dependence vulnerable individuals, education, risk, assessment, review, motivation to change, harm reduction,  motivational interviewing, appreciative inquiry, life skills, education, advice, feedback withdrawal, aggression, hallucinations, change, drug use history, measures, care pathways, contract, rapport, empathy	substance profiles, abuse, signs physical dependence, health status, pregnancy, research methods, evidence, diagnosis, co-diagnosis, staff awareness, statistics,  scientific advice, dissemination models: stepped care, training, forensic science - mental health, classification, interventions, physical access, stepped care models
dependents, family, social network social attitudes, vulnerable communities, community projects, self-help, e.g. A.A., socio-economic depreviation, systemic - family, group therapies Advertising, housing, casual drug use, work, employment, benefit incentives, re-integration, inclusion, community, neighbourhood policing, drug culture, media	supply, cost of drugs - alcohol health & social care policy, service interfaces, statistics Drugs strategy, funding, X-agency working, funding, GP contract, commissioning, "client contract-plans", National Treatment Agency, NICE, Home Office, legislation, crime, offending, re-hab. / specialist teams / treatment facilities, Government data, community prescribing, employers

Additional links:

Hodges' model: QUADS 'A4 page' with indicative generic content for the four care domains

The SOCIOLOGICAL links page includes Seven Ages, Public, Patients, & Carers...
The INTRAPERSONAL links page - Mental Health, Psychology, Therapies...
The POLITICAL links page - Economics, Policy, Citizenry...
The SCIENCES links page - Research, Drug resources, Anatomy & Physiology...

Can YOU add to the H2CM bibliography (now listed on W2tQ)...?

For readers not already aware, yesterday I started adding a bibliography to the blog. It is listed in the side-bar.

Links are included if applicable and these have been checked. I can supply electronic copies of most of these papers if you wish.

There are two publishing projects in process that are closely related to each other, covering substance misuse and forensic nursing.

On the forensic nursing front just over a week ago I met and greatly enjoyed speaking with -

Dr Michael Doyle
Nurse Consultant, Professional Lead & Honorary Research Fellow
Greater Manchester West Mental Health NHS Foundation Trust
Edenfield Centre
Prestwich
Manchester
M25 3BL

Apparently, Hodges' model is used and has quite a history at the Edenfield Centre. So Mike and I are working on a paper we will submit to a journal before the end of the year. More on this to follow.

In the hope that Erdos-Bacon Numbers might work for me, if anyone reading this has contact with community mental health nurses in the Isle of Man please get in touch. I understand they have used the model in the past.

Finally, should you be interested in applying Hodges' model in your nursing, social care, education or informatics theory / practice, do let me know h2cmuk @ yahoo.co.uk. I would be pleased to provide some paper - electronic resources and advice as needed.

August! Great Drupalcon soon!

Best regards everyone,

Peter J. (and yes that is me up there)

Book chapter: Substance Misuse and Mental Health

With the chapter on socio-technical structures within Hodges' model due to appear very soon there is news of an exciting further project - a different publisher with a more purely clinical and social care focus.

Between now and 1 May I have accepted an invitation to produce a chapter addressing the holistic aspects of substance misuse and mental health. More to follow and a deadline to work to ....