Friday, 17 September 2021

The RESPECT Model

If we are to operate in a client-centred way, we need to be able to partner with our clients. We keep our focus on our clients, so we understand their context, their culture, their worldview, their needs. None of the mahi is about us... unless we run out of the required skills to do the work, and then we refer. We know all that, though sometimes we can be seduced by transactional delivery (see here for more on that).

When we guide new practitioners, while we have responsibilities to help them develop the skills they need for the world of work, we also need to remember our duty of care to their clients: all the people they are going to see over the course of their career. The resulting "RESPECT model [is] a [collaborative] tool discovered with [over 30] colleagues" (Mostow, 2015, 4:12) to assist that process of developing practitioners. The model's "goals of compassionate [client] care, sensitivity to diverse populations, interpersonal communication, professionalism, life-long learning, and practice-based improvement" (Mostow et al., 2010, p. S146-147) fit very nicely with client-centred career practice, despite the model having been developed for work in medicine. 

The model is an anagram, constructed of the following elements (Mostow et al., 2010, p. S148):

  1. Respect: show. "A demonstrable attitude communicating the value and autonomy of the [client] and the validity of [their] concerns". Example in practice: "Kia ora, ki Sam Young ahau. I am looking forward to working with you. What would you like me to call you?"
  2. Explanatory model: ask. Ask about "The  [client]s understanding of what causes their [issue], or what will" assist them. Example in practice: "What would you like to accomplish today?"
  3. Social context: ask. The "Impact of [client]'s life upon [their work] and of [work] on [their] life. Include stressors, supports, strengths, spiritual resources" which affect the client. Example in practice: "What do I need to know to better understand what is going on for you?"
  4. Power: share. Though providing "Access to status, control, resources, options, and ability to produce desired outcomes" for the client. Example in practice: "What would a successful outcome look like for you?"
  5. Empathy: show. Use "Verbal and nonverbal responses that validate [clients]’ emotions and cause them to feel understood". Example in practice: "I can see this feels difficult for you. That must be hard."
  6. Concerns/fears: ask. "Worries about [issues...are] often unexpressed" about outcomes. Example in practice: "Is there anything we can explore together that would make this less difficult?"
  7. Trust/teambuilding/therapeutic alliance: build, don’t assume. "Relationship[s are] built on understanding, power-sharing and empathy; [with the client] confident that" the practitioner is facilitating the client's best interests. Examples in practice: "How would you like to move this forward?" and "What would you like to see happen next?".

As we can see, this model can be used as a checklist for training. We can rehearse to help us ensure that - when we go live - we have REALLY connected with our client. While fairly simple, we can learn to check in with ourselves to ensure that we have applied these seven steps, and - through reflection - further developed the way we ask those questions of our clients to ensure an appropriate connection. 

The researchers who developed the RESPECT model initially developed it for use it with clients; with later work encompassing application to supervisees, and in 2015 were working on how the model can work with teams (Mostow, 2015).

It is a useful framework to develop our practice. 


Sam

References:

  • Marciano, P. (2011). Increasing Employee Engagement by Fostering a Culture of RESPECT™. https://www.slideshare.net/pamarciano/chester-county-shrm-respect-model-presentation-22511
  • Mostow, C. (21 Mar 2015). Bridging Difference and Power with RESPECT: A Relational Approach to Patients, Supervisees and Teams [video]. https://youtu.be/1e17cK544OQ
  • Mostow, C., Crosson, J., Gordon, S., Chapman, S., Gonzalez, P., Hardt, E., ... & David, M. (2010). Treating and precepting with RESPECT: a relational model addressing race, ethnicity, and culture in medical training. Journal of General Internal Medicine, 25(2), 146-154. https://doi.org/10.1007/s11606-010-1274-4
  • Mutha, S., Allen, C. & Welch, M.  (2002). The RESPECT Model. https://hclsig.thinkculturalhealth.hhs.gov/ProviderContent/PDFs/RESPECTModel.pdf

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