Disruption and The Slow March of Progress


If you’ve been around at Able-Minded for a little while, you know that I talk a lot here about being brave enough to ask different questions and approach problems from new points of view.

I think this is what our industry sorely needs in order to stay afloat, I think it is what our profession needs in order to stay relevant and I think it is what our clients need from us if we’re going to help them re-engage with life, community and work.

So why is it so hard?

Recently,  I wrote about how Rehabilitation Counsellors can help their clients with chronic pain get off the hamster wheel of the search for a cure and start living their lives now. You can view the original post here.

I received a great comment that pointed out how difficult it is to change the way we do things (similar to how our clients might struggle with the idea of change - we’re not all that different) especially when not everyone is on board with a new approach.

I completely agree - change is hard. Doing things differently is hard - frustratingly so. And nobody seems to want to be the first to step into unchartered territory.

And I think this truth deserves a deeper look.

Why Our Industry Hates Disruption

Almost every technology and business outlet is talking about how disruption is creating new ways of getting things done.

Just look at Uber and Airbnb - disruption is big business and it gets attention. Customers are clambering for new solutions to their problems after feeling let down by the old systems and processes that didn’t get them what they wanted.

The same is true for our clients who come to us through systems of insurance, compensation and welfare. I know this because I've worked with these clients and I know their frustration first-hand.

So why are we so reluctant to embrace the new?

From Liz Lopatto:

“Right now, there’s a lot of cheerleading for “disruptive” opportunities…. though there are massive revenue opportunities in health care, “disrupting” patients’ lives can lead to death. “Ask forgiveness, not permission” works fine in software.

The medical field doesn’t move as fast as the software industry because moving fast and breaking things is fine for things but not for people.”
— http://www.theverge.com/2015/12/29/10642070/2015-theranos-venture-capital-tech-bubble-disruption

Spot on.

I’ve been terrified of trying something different with my clients because I was scared I was going to break them. I’ve clung onto process and procedure for dear life because I thought it was the only way to make progress happen and keep everyone happy.

In a world of rules and regulations, process feels safe.

Disruption just feels like a lawsuit waiting to happen. 

So it makes sense that we’re all a little hesitant to question the way we normally do things. It makes sense that we prefer to rely on GPs and specialists to determine our clients’ path forward because they have the expertise to make these decisions and dictate the next steps.

But the question I want to ask is this:

  • Did we really get into this profession to contribute to how disempowering it is for our clients to live with injury, illness and disability?
  • Do we want to encourage our clients to continue to take a backseat in their own recovery?
  • How’s this process actually working for us? Is it getting us or our clients better outcomes?

Ok, that was three questions, I realise I was being greedy there.

But at the heart of these questions is this: the disruption I’m talking about isn’t all that ground-breaking. It’s not illegal or unethical.

Its just polite.

pablo (3

The truth is, most of our clients just don’t get asked about what matters to them. Most clients get shuttled from one appointment to another, to rehash everything that isn’t working in an attempt to fix what’s broken.

This approach works perfectly fine when we diagnose a fault in a car, but it doesn’t help people get their lives back on track (or, to use industry speak, “improve their functional capacity”).

Most of our clients are never given an opportunity to consider whether this process is actually improving their quality of life, increasing their chances to engage with what they value and whether work could become a crucial piece in their personal recovery puzzle.

Disruption doesn't have to be big and brash and derailing.

That's the last thing we want for our clients. But a mindful, even quiet or gentle disruption - the kind that seeks more answers, a deeper understanding, a sense of curiosity - can create massive and meaningful change.

It's the kind of change that we, as individuals, can start creating now.

How many of us have asked our clients what they would like us to do differently than the other people they’ve worked with so far, or how they want this process to look and feel instead? That's a great way to find out the kind of disruption that our clients want see happen.

Asking our clients to evaluate whether their current course of action is actually helping them engage in what they value is unexpected, but still, polite and generally a good idea.

And I don't just mean values like "have less pain" or "not be depressed". These aren't values. Values are things you uncover when you keep asking questions about what's missing from a person's life right now - like "playing with my kids" or "feeling like I'm contributing" or "doing more of the things I used to enjoy".


But I can help them figure out how to engage with life by amplifying what can be done.
And I can help someone build a supportive environment that encourages and facilitates participation in what they value.

What if we focused on these things instead as a vehicle to better function and engagement?

What if health professionals, clients and everyone else involved worked in concert to facilitate change at this level, instead of what shows up on the certificate?

The thing about asking these questions is that they require us to get uncomfortable and step outside the process as we examine it, just for a moment, to see if it’s actually going to get us where we want.

What could some polite, mindful disruption help us achieve?

As always, you know I'd love to hear your thoughts.