Self-management, Buurtzorg and the Solution Driven Method of Interaction (SDMI)

I’ve just happened across a copy of of Astrid Vermeer and Ben Wenting’s book Self-management: How it does work (Reed Business Information, 2016) (thanks to Andy Lippok).  The book is based on the experiences of setting up and running Buurtzorg, the home and community care providers who have been very successful in building a network of independent nurse teams which organise themselves with very little input from ‘managers’.  Vermeer and Wenting worked with Buurtzorg founder Jos de Blok, and are well-placed to share their experiences as well as setting out clearly how this model of self-organisation works, and what might get in the way of it working.

My eye was immediately caught by the emphasis on communicating with the Solution Driven Method of Interaction (SDMI), which forms a central strand of the process. As someone who has for over 25 years been interesting in the methods of Solution Focused (SF) practice, a communication framework developed from the work of solution-focused brief therapists Steve de Shazer and Insoo Kim Berg (see for example The Solutions Focus: Making Coaching & Change SIMPLE by Paul Z Jackson and Mark McKergow, Nicholas Brealey Publishing, second edition 2007), I was immediately keen to examine exactly what characterised SDMI and how is compares with SF.

The authors start by saying that SDMI is a style which ‘is concrete enough to allow all members of the organisation to apply it easily, but that nonetheless offers so many possibilities that it can also be used to solve complex problems’ (p. 111). Sounds good.  They go on to distinguish between problem-oriented and solution-oriented working – even better.  Some key distinctions made are (and I have tried to preserve the author’s words as far as possible in these summaries):

Problem-oriented working Solution-oriented working
Investigate the problem, look for its causes and then look for solutions on the basis of this information Takes the present as the start and looks forward to consider solutions in the future
Look at who is to ‘blame’, what you no longer want or what  you want to avoid Look chiefly at what you DO want, what you can do to improve the situation, and who or what is needed in order to achieve that
Work towards ‘coming up with a good description of the problem’ – which may take time Work towards ‘reaching a decision’ – as quickly as possible, to get people feeling comfortable again
Focus on analysing the past Focus on analysing the current and future situations and making a plan of action based on this. Analysing the past is sometime useful if a solution can’t be found immediately

 

The authors go on to talk about these principles of SDMI:

  • Conscious choices and responsibility

The assumption is that people are able to make conscious choices and are therefore able to take responsibility for their actions.  The more you make choices ‘consciously’ the less things ‘happen’ to you and the less you end up being surprised by unexpected consequences. This is not to say that people always want the responsibility… but in a self-organising team it’s a key element of how things work.

  • Respect

This is not (of course) about being addressed as Ms X or Mr X! Or even saying ‘with all due respect’ followed by a condemnation of the previous speaker.  It’s about wholehearted acceptances of differences between people. It’s only when these differences are accepted that we can get to a place where everyone is viewed as having something to contribute to a discussion, based on their own background.  These differences (in say experience, training or education) may make one person more suited than another to certain tasks and activities – but that doesn’t mean that someone ‘deserves’ a lower or higher position as a person.

  • Active energy

When we get into a situation that feels uncomfortable or unpleasant, we want to take action. We want to feel comfortable again as soon as possible.  That’s good thing, as combined with an SDMI approach we can get things moving relatively quickly.  Some people may choose ways which are comfortable for them but not constructive in their colleague’s eyes – perhaps blaming their mistakes on external factors.  Even here, the authors argue, there is a certain type of active energy – the person wants to turn away from the problem.

Five points to note in working with SDMI

The authors helpfully give these five points to prepare for discussions about change. There is no right order to these, they say, and they are interrelated.

  1. Goal: what do you want to achieve?
  2. Position: what do you have responsibility for? What can you decide for yourself? What can’t you? What are your skills??
  3. Working method: how are you going to achieve your goal?
  4. Communication method: communicating with each other in a clear and respectful way.
  5. Time: how much time do you have to achieve your goal – is there a deadline? How much time do you need? (p. 115-116)

SDMI and Solutions Focus (SF)

As many readers of this blog will know, Solutions Focus first appeared as Solution Focused Brief Therapy with the work of Steve de Shazer and Insoo Kim Berg leading the way in the late 1980s.  The key element has much in common with SDMI – making the starting point about what people want, rather than what’s wrong or broken.  This can have an energising and co-operative impact, with the shift in focus drawing the participants together as well as moving away from blame and complain.  There is then the ‘so are you prepared to do something’ part, where those involved are invited to take an active role in moving forward (as opposed to waiting for others to act, or for things to somehow change on their own).  In the world of therapy in particular, this was a radical stance thirty years ago and it continues in many places to be seen as a heresy; the idea that people cannot move forward until they have addressed the ‘inner causes’ of their strife hangs around like unhelpfully like the smell of kippers in the afternoon.

The principle of respect is also a key part of SF work, although we tend not to talk about it in such an upfront way.  Making sure everyone has a chance to contribute their voice, that different perspectives are welcomed, that everyone is listened to, that everyone is seen as their own unique self (‘Frank says he’s been having a tough time of it lately’) rather than as a diagnosis or cypher (‘37 year old male with depression…’) are all key elements of the practice.  We also take care to accept, acknowledge and affirm the experiences of all involved – the idea is not to try to decide whose side to be on, but to be multi-partial, to be on everyone’s side, in helping build conversations about positive change.

Possible extensions for SDMI (if desired or useful)

As I read it, Vermeer and Wenting are saying that SDMI is taught and used in Buurtzorg as a normal and everyday way to work together, particularly to resolve issues or conflicts and make decisions.  This is an excellent way to go about things in my view. SF, in its original therapeutic guise and now as an approach to personal and organisational change, was originally designed in the context of very tough situation indeed, where people were totally stuck, didn’t know what to do or think, and everything seemed impossible.  Most everyday management situations are not, thankfully, like this.  However, there are some extra elements in SF which might find some occasional use in SDMI where things are particularly difficult:

  1. Looking at what’s working

Establishing a shared idea of what’s wanted is only one element of SF practice. Another key piece revolves around looking at what is working already, rather than what is wrong or not working.  It is easy to persuade oneself that because something isn’t working, everything has to change. This is not normally the case at all – in fact, it is surprising quite how much of what’s happening now is valued, useful and worth keeping, even in difficult moments.

One practical way to do this is with a scale from 1 to 10.  10 is taken as ‘we’ve reached the better future with regard to this topic’, and 1 is something like ‘things are as bad as they could possibly be with regard to this topic’.  Asked this question, people will very often say 2 or 3, and may well say 5 or 6.  Whatever they say, the follow-up discussion is then ‘how come it’s a 3 and now lower? What’s working already?’.  This produces a solution-oriented discussion of the past and present. It’s good to keep a list of all the things emerging – these may be the basis of new actions to take matters forward, or at least a reminder that the team are not entirely useless.  As above, this kind of discussion usually has an energising and co-operative impact.

  1. Affirm people’s contributions, qualities, skills and strengths

As these solution-oriented discussions continue, it can become easier to see quite what valuable contributions are being made by different members of the team.  The team manager or team coach can ease tensions and help people feel valued by looking out for things to affirm and saying something like “Joanna, I am impressed with the way you always want to do the best for your clients. Thank you.  And Fred, it seems to me that you are a real stickler for accuracy in reporting, that’s very useful.”

Often we find that people get upset or start to withdraw if they are not being valued, or they don’t hear that they are making a contribution.  Valuing these contributions, qualities and strengths is a human way to engage people.  Two things can extend from this; firstly, the team coach must put on a set of appreciative eyes and ears in order to be looking for things to affirm, which sets up a constructive position from the start.  And secondly, if we can establish a norm where the team members affirm each other, that just builds the sense of mutual responsibility and support.  (By the way, my experience is that even if the giving of affirms is built into a routine, the impact of these is not devalued!)

  1. Look for small steps and experiments

SDMI looks to take decisions by consensus, according to Vermeer and Wenting.  This is an admirable goal – decisions reached in the face of considerable opposition are unlikely to bring long-term harmony. (Just ask 48% of the UK about that right now!)  Consensus means reaching agreements and decisions within the team with support from all, which of course means handling and working with objections and concerns.  Vermeer and Wenting’s book is very practical on this topic (and indeed overall) with lots of good how-tos presented and pitfalls discussed within the idea of self-managing teams.

In my experience, two things can make consensus-building easier.  One is to look for smaller actions rather than larger ones; the sense is then of gently exploring and finding ways forward rather than taking giant leaps. In difficult circumstances, look for even smaller steps, with reviewing and further discussion once they have been taken.  The second and complementary approach is to treat these small steps as experiments – we are trying this out to see what happens, rather than we are going o do this for ever and ever irrespective of the consequences.  Both of these make it easier for nervous or unconvinced team members to agree or at least acquiesce to the actions proposed.

Conclusion

Self-management: How it does work is an excellent book.  It is based on actual experience of developing a thriving and successful self-managing organisation, it is thoroughly practical with lots of specific how-to practices, and it is blissfully free of high-falutin’  and idealistic talk about the future of work, much more focus on the here-and-now.  It makes no claim to be the only way to self-organisation, but powerfully asserts that self-management is not only possible, it’s practical and it’s here.

The high profile given to SDMI within the book is a useful reinforcement of how what’s wanted, rather than what’s wrong, is such a powerful starting point for teams and organisations seeking to move forward together.  The traditions and techniques of Solutions Focus offer useful ways to expand and build from this where things are proving difficult or stuck.

 

References

de Shazer, S. (1988). Clues: Investigating solutions in brief therapy. New York: WW Norton.

Jackson, P.Z and McKergow. M. (2002/2007). The Solutions Focus. London: Nicholas Brealey Publishing

Vermeer, A. and Wenting, B. (2016). Self-management: How it does work. Amsterdam: Reed Business Information

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