Addictions: Competent Compassion?

Empathy & Compassion Word CloudToo often we loose sight of what it is we are trying to achieve. Too often we get embroiled in the systems that we work within. Sometimes we even forget why it is we do what we do… assuming we had a work ethos that we are proud of, other than simply to survive.

I recently read an article in the SMMGP / FDAP News (see here) which asked the question what is Competent Compassion; “what does that mean to you? In the field of Substance Misuse Management… Good Practice perhaps?

Irrespective of any associated commercial or academic interests, that the author may or may not have; the question also highlighted an important questions that many of us appear to struggle with in today’s world of KPI / VFM / PbR frameworks… What is “good practice” and how do we measure it?

Competent Compassion: We have guidelines and protocols to follow which are needed and generally helpful – but when it comes to evaluating what we do, it seems that the CQC are concerned with processes and structures, the commissioners mainly want to know about “successful completions” (still!) – and the GMC and NMC want to know all about our mistakes. (Read more)

Differing answers are often evident within many areas of health-care provision but perhaps even more so within the addictions support workforce. Particularly when the answer comes from the polar extremities of CEO and key-worker. The author of the piece, Dr Joss Bray, points out how – “Managers want their organisations to run smoothly and profitably” – whilst the ‘front-line’ workers are often way too busy – “just keeping their heads above water under the deluge of need.”

Sadly this is a common situation today; austerity measures have resulted in massive reductions to service funding and in turn, tighter budget controls are a significant impact, despite being a required measure of ‘effective’ (aka VFM) service delivery however; amongst all these ‘business’ considerations’ – are we adequately considering the impacts on ‘compassionate’ service delivery?

Compassion - Dalai Lama

Bray opines that “no one is actually looking at what is really important” and I would tend to agree with him, irrespective of the apparent differences around our personal beliefs. I would like to think, in this context, that many more in our line of work hold similar opinion and work ethics.

Bray’s view (and mine) is that ‘making a difference’ when supporting people is key… “In reality – the thing that makes all the difference to people is the quality of the one to one interaction between a person seeking help – and the person giving it.”

My belief is that, especially in healthcare services, the focus has become “successful completions” (in the case of addictions) or the equivalent measures in other settings. This is often driven by commissioning targets and means that an organisation that wants to retain and win new contracts has to make these outcomes their primary focus. (Dr Joss Bray)

It’s a little sad that too often it seams,; we have (in part) allowed ‘systems’ to dictate the services we deliver, instead of developing systems that support the kind of services we want to deliver!

In the following video, from the 2017 ISAAC UK event entitled Energised for Impact,  Joss Bray explains his ethos to delegates.

Dr Joss Bray is the founder of Competent Compassion and is the Clinical Lead for Drug and Alcohol treatment in the North East Prison Cluster (provided by Spectrum Health and CGL). He has also worked extensively in psychiatry, general practice, community substance misuse services and residential substance misuse treatment services.Dalai Lama - Kindness
Note: ISAAC is a network of Christian addictions and recovery workers. I am not a member of that organisation and this blog post is not an endorsement of their beliefs, mission or purpose.

One thought on “Addictions: Competent Compassion?

  1. Thanks for the comments Dave. Glad that we are in agreement on the basic issues here. And I prefer the term “realistic” to “cynical” – just makes me feel better when I think about my views on the current substance misuse treatment environment….!


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