Social pedagogical perspectives on fidelity to a manual: Professional principles and dilemmas in everyday expertise

Content of the article

First, we show how practitioners who perceive a given evidence-based manual as a well-thought-out idea to structure practice around, paradoxically deviate from the manual in an effort to ensure that the young people continue to participate in the programme. Next, we show how the deviations seem to structure themselves around a handful of guiding principles, such as values, the individual and the group, and we show how social pedagogues discuss the evidence-based manual in relation to what we name here as consensus-based conditional programmes or navigation methods. A key element of this is that when social pedagogues are asked about their preferred way of structuring practice, they point towards the navigation methods, since these allow for situated practice. We as authors choose to pursue this and present a UK example of a consensus-based conditional programme (based on values that allow and enable practitioners to facilitate change through drawing on their everyday expertise in situ) where situated practice is a foundation of the programme. Finally, we draw together our learning from Danish and British perspectives and identify areas for further research.

Doctoral research and an evidence-based manual

There are a number of MESTs in use across the world today – multi-dimensional treatment foster care (MTFC) and cognitive behavioural therapy (CBT) are perhaps good examples. Harbo examined the programme manual for aggression replacement training (ART) (Gundersen, Olsen and Finne, 2008) and how it was used in practice by qualified and experienced social pedagogues. To briefly summarise ART’s genus, in the 1990s a group of American psychologists developed the programme in relation to young offenders (Goldstein, Glick and Gibbs, 1998). The programme was used in a variety of ways in different countries and, in the 2000s, a group of Norwegian practitioners and researchers translated and adjusted the programme into a Norwegian edition (Gundersen et al., 2008). Around 2010, the political system in Denmark sought more transparency regarding social pedagogical practice and looked to Norway for evidence-based manuals. In this sense, evidence-based manuals are those that claim it is possible to reach predetermined goals if practitioners follow the detailed descriptions in the manual.

The Norwegian manual related to ART contains 167-page-long description of the 10-week-long programme, including 30 training sessions (Gundersen et al., 2008). The descriptions are highly detailed; for instance, the introduction element of each training session contains these steps (Gundersen et al., 2008, p. 14):

Welcome

• Bid the young people welcome

• Introduce guests if there are any

• Revisit the agreed rules

• ART-shout out …

Meanwhile, further into the training, a social skills session describes what practitioners must do (Gundersen et al., 2008, p. 33):

Define the social skill for the day: to offer a compliment (nr 8):

As the examples show, the level of detailed structure in the manual makes it possible to observe when the manual is not followed, for instance, if the trainers skip the ‘ART-shout out’ that is part of the introduction to the training session.

Research findings

Here we present examples of how the manual dictates a certain structure, how the social pedagogues in a specific situation do something different to the manual’s stipulations, despite their intentions to maintain a high degree of fidelity to the manual, and how they describe the conditions for their deviations during subsequent interviews.

Analysis

Gro’s descriptions present a dilemma between the manual’s requirement for a rather ‘high-paced’ practice and her understanding of learning as something that takes time. Gro took the time needed for Adnan to participate meaningfully, reflect on his homework and consolidate his learning, which, in turn, enabled him to feel ‘recognised’.

We link this description of learning to the concept of reflexivity in Luhmann (2000), which, in short, is a question of ‘communication communicating about communication’ (p. 507). In the example above, the reflexivity elicits Gro’s intention to enable Adnan to talk through his homework in present time communication in the training session. Gro creates a possibility for Adnan to experience how she and the group perceive his work; they can ask him about it and Gro has a chance to enhance what she sees as successful in his work. If Adnan had just handed Gro his homework to begin with as the manual stipulates, this possibility for reflexivity might have passed since the homework could then be regarded as one-way, first-order communication and not as a learning opportunity.

There are many elements in ART and it seemed that Gro had an intention to cover all the elements within the 45-minute training session, including the self-added element with the young people presenting their homework to the group. This calls for a fast pace in the session. The sociologist Niklas Luhmann (2000, p. 85) described how systems can arrange themselves in ways that enable the system to increase the speed of its own processes compared to its surroundings. In our understanding, the 10-week-long ART programme can be seen as a way to increase speed in social pedagogical processes regarding aggression replacement. In this way, ART is supposed to create a form of speed superiority. However, in the example, Gro finds it critically important to protract speed in order to create space for reflexivity and recognition, whereas the ART’s intended speed superiority does not seem to allow for reflexivity and recognition.

In our view, it seems as if recognition of the young people’s effort with their homework and the possibility for reflexivity in this example is induced by the social pedagogues as a precondition for the young people’s participation and learning in the ART programme, as is consistent with their professional practice ethic. ART does not contain expectations on reflexivity – as shown in the example above – or recognition in relation to seeing and listening to the young people in a subject–subject relation, nor does it contain an explicit value base. Rather the values are implicit in the structures, such as when we in the above see it as an element in social skills training to ‘look someone in the eye’ when talking to them. What becomes clear here is that the implicit values do not acknowledge that for some young people, looking an adult in the eye is seen as culturally inappropriate and potentially very rude. No acknowledgement of cultural difference is made within this manual, leaving professional practice potentially open to discrimination, especially if fidelity to the manual by the trainers is high.

We suggest that high fidelity to this manual in these social pedagogical perspectives seems to risk the young people’s active and meaningful participation in the programme, and that the extra layer of recognition and reflexivity, rather than diluting the programme, functions as a vital support structure to the method.

One could argue that no one would expect practitioners to follow the structure in such detail or to that degree of fidelity to the method. In line with this, the authors of the Norwegian edition emphasise that the manual is to be seen as an inspirational catalogue and that the practitioners should pick and choose among the different elements, according to the specific group of young people (Gundersen et al., 2008, p. 6). On the other hand – but on the same page – it is stressed by the authors that the programme is among the best-validated programmes in the field of aggression replacement (Gundersen et al., 2008, p. 6). Validation indicates that high fidelity to the manual/adherence is a precondition for reaching the desired effect (i.e. replacement of aggression). This can be perceived as a dilemma by ART trainers/social pedagogues: when is the fidelity high enough, which elements can be excluded and which have to stay? In the example, Gro does not dismiss the programme – she still insists on bringing the manual’s other elements into the session – her practice takes shape as a combination of ART, reflexivity and recognition. In the example there is a dilemma between speed protraction (reflexivity and recognition) and speed superiority (the fast-paced sessions). This tension is palpable when listening to the recorded interview.

Consensus-based conditional programme

In another interview, a social pedagogue offers a ‘solution’ to this tension with the suggestion of seeing the manual as not an evidence-based manual claiming effectiveness through high fidelity, but rather as a consensus-based conditional programme.

This interview shows how the social pedagogue ‘Lis’ introduces a training session that in the manual is named ‘Anger control’ (Gundersen et al., 2008, p. 82) by welcoming the young people to a session that addresses the theme ‘Handling emotions’ (Harbo, 2019, p. 127). In the interview she explains how relabelling the session with an emphasis on emotions instead of merely anger, allows the young people to participate in another way: if the focus is solely on anger, Lis says the young people may feel ‘like a bunch of criminals’. With the label ‘Handling emotions’, the young people can address whatever feelings they wish to address – not only anger.

In the interview, Lis explains how she has discussed different alterations of the programme with both colleagues and programme developers. According to Lis, they all agree that they do not wish to end up with 28 different kinds of ART, since that would not be evidence-based. On the other hand, Lis stresses that it would not be possible for them as trainers to work with ART if they were not allowed to be different as humans. When asked how this links to a claim of EBP, she describes how they ensure a kind of uniformity by teaming up in pairs as trainers, they exchange experiences, they use the same material and use team development days where they offer feedback to each other.

Lis changes the title of a session from ‘Anger control’ to ‘Handling emotions’ to ensure that the participants don’t feel labelled and to create space for them to address a range of feelings including, but not limited to, anger. She introduces the change to the programme developer as a way of adapting the programme and allowing for responsivity, but the idea is rejected by the developer with reference to the evidence base relating to anger, not to handling (other) emotions. In this way, the idea of maximising the programme’s potential is rejected by the developer, which could be said to lead to social pedagogues towards more flexible methods and programmes.

The same tendency is seen with Lis as with Gro, where deviations (recognition, reflexivity, changed session title) aim to ensure that the young people wish to continue their participation in the ART programme. In relation to evidence and fidelity, we see how Lis tries to maximise the programme when she connects evidence to team development days, discussions with programme developers, trainer teams and so on. In that sense, evidence is described here as consensus among experts, whereby they link it to their professionalism and their everyday expertise, and not to the research-oriented concept of evidence, related to high programme fidelity/adherence. This suggests that the social pedagogues see social pedagogy as a professionalism that supports ART, as opposed to acting social pedagogically ‘within’ the manual.

With Luhmann’s systems theory we can link the social pedagogical perspectives on programmes like ART to conditional programmes – those that are guided by the conditions for communication (Luhmann, 2000, p. 372). With an example from the health system, clinical guidelines are supposed to aim at specific diagnosis – that is if the diagnosis is A then the treatment is B (Knudsen, 2005, p. 7); the medical model of problem – treatment – cure. Hereby, the form of conditional programmes ‘if … then’ emerges. It is argued that ART addresses a problem or diagnosis (aggressive behaviour) that it seeks to treat (replace with prosocial behaviour), which leads the following to emerge: if there is aggression, then ART will address it. In the example with Lis, it seems as if she does not see the simple diagnosis of aggression with the young people. Instead she sees a broader selection of emotional problems which can still be ‘treated’ with ART. Thereby the form changes into: If problems with emotions, then ART.

Lis reveals a variety among the trainers in the way that they conduct the programme, which she calls a ‘human approach’ (Harbo, 2019, p. 138). This exemplifies how the social pedagogues expand the trainer role by adding an extra layer which, inspired by the systems theory found in Luhmann (2000), we define as the trainers’ ‘personal style’ (p. 371). In relation to the manual, it can determine whether certain elements of a personal style function according to the manual or not, and how this might affect fidelity to the programme.

In light of the body of research on fidelity in relation to evaluation of evidence-based manuals, these deviations can be seen as essential components for the success of the programme (Carroll et al., 2007, p. 3). If our interest was to strengthen the transformational change potential of ART, we could suggest that the concept of ‘recognition’ (Schibbye, 2010) was implemented by the social pedagogues in their adaptation of the manual. But our intention is not to engage in further development of the manual – instead we pursue the suggestions regarding consensus-based conditional programmes as approaches that seem to resonate better with the social pedagogues and their practice situations.

This leads us to suggest an understanding of the programme as a consensus-based conditional programme, which again leaves room and space for the trainers’ personal style and for concepts such as reflexivity and recognition.

Navigation methods and guiding principles

Practice fields such as social pedagogy or social work might call for different methodological approaches than evidence-based manuals, such as the ART manual, predetermine. Social pedagogical practice is described by Rothuizen and Harbo (2017, p. 22) as work in progress, supported by an inquiring approach, and performed on an imperfect foundation. In that sense it is argued that evidence-based manuals could inform rather than form practice (Rothuizen and Harbo, 2017, p. 24). Based on a literature review, Harbo and Petersen (2020) suggested that social pedagogues observe claims for causality and uniformity, as seen in MESTs for instance, as a challenge. This emerges in a broad variety of articles: Andersen describes the social pedagogical subject field as constituted by a wide range of factors that change over time and are difficult to unravel, making it unrealistic to define the optimal intervention to create tailored developmental changes for a specific child (Andersen, 2013). Frørup (2012) described social pedagogy as focusing attention towards content, processes and resources in specific situations. Mørch (2002) pointed out how it is absolutely crucial for social pedagogy to build on the complexity in the meeting between social pedagogue and a young person or a family. Only this can function as breeding ground for the social pedagogical approach (Mørch, 2002) and its coherent ethical framework for practice.

The Danish researcher Mogens Jensen (2010) suggested a differentiation between action-guiding methods such as MESTs and what he terms ‘Navigation methods’ (p. 197). In Jensen’s descriptions, MESTs can be seen as answers to already known problems that potentially can be solved in the same way day after day. Navigation methods, on the other hand, can provide different modus operandi to handle different situations – characterised by the dynamics and complexity described by Andersen, Frørup and Mørch– while at the same time helping the social pedagogues to assess whether the chosen modus operandi is coherent with working towards an aim decided with the young person (Jensen, 2010, p. 196).

In navigation methods, practice is navigated from guiding principles. Jan Jaap Rothuizen (2004, p. 151) explored guiding principles in relation to practice as different kinds of everyday life that exist and which humans are already part of, act within and contribute to. In this understanding, knowledge-based practice is not related to methods that work. Rather, the focus is on the possibility for the practitioners to, at any given time, reflect on whether practice is moving in the right direction (Rothuizen, 2004, p. 152). In this sense, guiding principles function as a sub-term for themes like aims, indicators or values, which all can function as guiding principles in the construction of what Rothuizen (2004) termed ‘assessment-relevant-knowledge’, as opposed to ‘know-it-all-knowledge’ (p. 154). More specific examples of guiding principles could be to be significant to each other, shared power or the relation between social pedagogue and young person. As it shows, guiding principles do not have to be complicated but can be almost obvious (Rothuizen, 2004, p. 162). One finds guiding principles when examining practice, since practice is where guiding principles of relevance can be found. It is useful to examine any elements in practice that raise doubt, either because they seem esoteric or because it is not possible to identify any kind of progress. In that sense, situations that cause surprise can initiate the construction of guiding principles, as shown with Gro and Lis’s experiences. The Family Learning Intervention Programme (FLIP) is an example of social care practice that structures itself around guiding principles.

Family Learning Intervention Programme (FLIP), London, UK

FLIP was established in 2014 as a radically different way to support birth, legal and substitute families to stay together when there is a risk that a child or young person may need to be brought into care or their care situation may be at risk of disruption or breakdown. Initially supported through an innovations fund from central government and now funded by the local authority, FLIP was established as a non-manualised intervention, founded on a strong value base that sees relationships, active participation, co-construction and collaboration with all family members and practitioners as central to its efficacy. The social pedagogue’s primary role is to facilitate supportive relationships within the group through ways that have real meaning for the family and can be sustained over time.

Whole families come to a large house in the countryside for about five days to work on their strengths and relationships in creative and meaningful (for them) ways. One of the central aims is to promote strong relationships between family members and the professionals supporting them, so the allocated social worker and other professionals come for all or part of the week, with the social worker as the lead professional. Social pedagogues and other FLIP practitioners support the family and other professionals to co-design a week that balances the need to address some difficulties with the need to notice and strengthen the positive aspects of this particular family’s life and relationships and to nurture well-being. Life can be tough for the families – FLIP is a way for them to put their usual life on hold for a few days to concentrate on what might usually be difficult to spend time on, be supported to devise their own solutions, to remind themselves of what is joyous in their family and to develop trust with the professionals supporting them. In this way FLIP can be seen as a place and space for families to find new ways of coping with reality through navigating and shaping their own stories. A social pedagogue coordinates the process, and a detailed daily schedule is created through choosing activities and interventions to address what is important to the family and agreed with all those involved. Often the team veer from the schedule, in agreement with the family, to respond to the needs of the group or individuals in the moment. They create spaces and opportunities for learning, for positive memories to be developed, for recognition, for appreciation and for emotional connection.

Meaningful participation

Participation is a key concept at FLIP and constantly in the minds of its practitioners, just as for the ART trainers described previously. Should a member of the family or group indicate that they don’t wish to participate in a particular pre-agreed activity, the FLIP team try to find other ways of actively engaging them and every family member. In this sense it is important for FLIP practitioners to ‘know what to do when you don’t know what to do’ (Rothuizen, 2019). They found that for one young person, his active participation in sitting-down sessions was very difficult for him, so the team veered from the schedule to include more physically active sessions, particularly at the beginning of the day. How this individual could actively participate was discussed with him and his foster carers prior to attending FLIP but, once at the house, more information emerged over time, leading the FLIP practitioners to adapt the schedule to his emerging needs and wishes. Through adapting the schedule (remapping the terrain) and helping the young person to participate more meaningfully, the foster family were able to see him slightly differently and in ways that they later transferred to other parts of their lives together. A small adjustment based on the guiding principle of participation helped the FLIP team navigate through a tricky moment, and this, in turn, had wider benefits for the young person and his carers, sustained over a longer period of time. High fidelity to the guiding ethics and values in delivering the tailored schedule can be said to have shaped the success of the programme.

FLIP as a consensus-based conditional programme

FLIP could be considered as a consensus-based conditional programme, founded on guiding principles (FLIP values and ethics) and utilising navigation methods (from the FLIP toolbox) to reach a set of shared and agreed aims. Rothuizen (2008, 2013) described the fundamental dynamics in social pedagogical work in his diagram ‘the task of pedagogue’, highlighting bridge-building and contact as key professional tasks in both the environment and the relationship. Nurturing the quality of contact and communication between family members and between family and professionals through attention to the individual relationships, the group’s dynamics and, perhaps crucially, the environment, are central to FLIP’s successes, together with continually building bridges between people and between people and their communities and society. Without the strong guiding principles and values, perhaps FLIP would only be able to respond to individual needs in limited ways, limiting its effectiveness and sustainability.

Conclusion

Harbo’s research considering the ART manual and Kemp’s reflections on FLIP show that social pedagogues provide added value to the ‘help’ that is sought, through applying guiding principles. Manualised interventions must allow for situated judgements guided by principles in order to ensure social pedagogy and social care practice provides sustainable help for change, and so that those engaged in programmatic interventions have the right support for meaningful individual and group participation and social connections (Kemp, 2015).

High-quality social care practice is not yet a given in the UK, as it is in many continental European countries. We argue that the time is ripe for the Danish and the UK governments to recognise the considerable added value that social pedagogues and social pedagogy practitioners can offer to our societies as a whole, and to marginalised groups in particular, and to invest in further researching the unique contributions of social pedagogues and social pedagogy practitioners in diverse situations.