# Health Education Development/Strengths-based approach

Much of teaching and learning typically focuses on what is 'missing' rather than on what is present or potential. A strengths-based approach recognises that people are able to do many things for themselves and with others. By asking were the growth-edge is we can scaffold learning opportunities that move people from what they know and can do now into what they can do with others for now with the goal of giving them the capacity to function on their own and with others in the future. Vygotsky has given us some language around this when he spoke of the "Zone of Proximal Development". He also emphasised the importance of social interaction and the "more knowledgeable" other which create the opportunities for learning. The more knowledgeable other does not have to be a teacher in the traditional sense; it can be a peer or a younger person who knows something we would like to master for ourselves.

## Learning activity instructions

Each week we hold a lectorial and a tutorial. The lectorial is a lecture involving audience participation. The tutorials are for discussing the and group activities relating to the topic, and for working on the assignments.
Lectorial
* Watch the videos in this playlist.
* Review the learning outcomes for this and previous topics and decide to what degree you are getting the point of the various topics and the whole subject to this point. How do you think that the materials, lectorials and tutorials are linked? How might your assessments be the clue?
* Read the story for this topic and the background. If you have time, see if you can find and scan the references and resources.
* Continue to read through and think about the various theories and models in Chapter Four of Health education: theoretical concepts, effective strategies and core competencies (WHO 2012) and read through Chapter Five (shorter chapter), Health education planning, implementation and evaluation, pages 39-47.
* Attend the lectorial and be prepared to develop an application for this subject of Vygotsky's Zone of Proximal Development combined with Bloom's Taxonomy .
Tutorial
* Review the activities for Team 5 (page 74) and Team 6 (page 95). The teams will have already been preparing; so, this instruction is for everyone else.
* Attend the tutorial and be prepared to participate in a ten to fifteen minute, peer-led strategy discussion on how to do well on the Critical Essay.

## What can Aboriginal and Torres Strait Islander health practitioners teach us about using a 'strengths-based approach' for working with 'vulnerable groups'?

Have you ever had someone always tell you what they thought you should do about different issues and things happening in your life? You probably do not mind someone occasionally telling you things; but, if you constantly had to listen to and be polite towards such people, it would get pretty tiring. Additionally, such people tend to overlook the real strengths that we might bring to a situation. Sometimes we have failed to achieve an aim because of a threshold issue. In other words, a little thing such as forgetting to put petrol in the tank might make us late for an appointment which costs us a chance for a job. It may have only been the one thing. You are perfectly able to both drive and do the tasks required. It was just the issue of thinking ahead that might save you grief in the future. On the other hand, had the potential employer realised that you had a problem with your car and that you were able to quickly arrange for alternate transportation to get to the job interview, that employer might just realise that you have salient strengths as well. A good employer or case manager will often work to remind people of this (Brun & Rapp 2001). If the employer also knew that you were supporting other members of your family who have run into systematically developed difficulties designed to keep you and your sort down and out, he or she may be more sympathetic to the positive role that they might take. In fact, they just might learn something about what it means to survive when your language, lore and land have been taken from you and given to others without your leave. The Irish found this out during Cromwell's time. The Aboriginal and Torres Strait Islander peoples have discovered this more recently. They have much to teach us.

## Background

A 'strengths-based' or 'salutogentic' approach takes a 'problem resolution' stance building on and extending the capacities that already exist and supports the "development of self-efficacy, increased self-esteem" and greater responsibility for change (Cox 2001). It supports empowerment, the ability to take control over the factors that influence our health so as to improve our health. However, it must also take seriously the political tendency to develop risk-based policies (Burnett & Maruna 2006). That is the important lesson of this topic. Please remember that the Latin root for 'vulnerable' (vulnus in the nominative case) means 'wound'. The plural of the root, vulnera, means, of course, 'wounds'. Vulnerable people, wounded people, have had something done to them that needs undoing. Finding out how to help them 'undo' this something can lead them back to a healthier place for both them and for the rest of us. But, it just might mean than we all have to change how we operate in terms of our conflicts and find culturally relevant means of dealing with issues that takes into account for the historical and current contexts (Crooks, Chiodo, Thomas, Hughes 2009). This often means allowing 'marginalised' groups to have a greater voice in creating and transferring the knowledge that influences their lives (Kana'iaupuni 2004). It also means allowing them a greater freedom to govern themselves. After all, this is the heart of the Universal Declaration of Human Rights. The Aboriginal and Torres Strait Islander peoples of Australia are showing strong leadership in this area for all of us to follow. The National Health Leadership Forum and the National Congress of Australia's First Peoples have issued a policy paper that outlines key dimensions of a 'strengths-based approach' that highlights the importance of: (a) recognising and valuing the various cultures to be found in Australia before and after colonisation, (b) empowerment, (c) sustainability, (d) continuity, and (d) health innovation (NCAFP/NHLF 2012:6). Their web-site is an important resource and can be found here:
    http://nationalcongress.com.au/health/
References and Resources
    Brun, C. and Rapp, R.C. (2001) Strengths-based case management: Individuals' perspectives on strengths and the case manager relationship. Social Work. 46(3):278-288.
    Burnett, R. and Maruna, S. (2006) The kindness of prisoners: Strangths-based resettlement in theory and in action. Criminology & Criminal Justice. 6(1):83-106.
    Cox, A.L. (2001) BSW students favor strengths/empoewrment-based generalist practice. Families in Society: The Journal of Contemporary Human Services. 82(3):305-313.
    Crooks, C.V., Chiodo, D., Thomas, D. and Hughes, R. (2009) Strengths-based programming for First Nation youth in schools: Building engagement through healthy relationships and leadership skills. International Journal of Mental Health and Addiction. (Published online:DOI 10.1007/s11469-009-9242-0).
    Kana'iaupuni, S.M. (2004) Ka'akalai Ku Kanaka: A call for strengths-based approaches from a Native Hawaiian perspective. Educational Researcher. (December):26-32.
    NCAFP/NHLF (2012) What does success look like? Measuring the success of the National Aboriginal and Torres Strait Islander Health Plan. Strawberry Hills, NSW: National Congress of Australia's First Peoples & The National Health Leadership Forum.

## Learning Outcomes

Upon completion of this topic, through your own investigations, group preparation, tutorial participation and lectorial explorations, you should be able to:
* Delineate the difference between a ‘strengths-based approach’ and a ‘deficit model’ in terms of their characteristics and their potential outcomes in both the short and long-term with regard to health literacy.
* Identify key documents and resources developed and disseminated by Aboriginal and Torres Strait Islander health practitioners that engage a variety of health related concerns with a ‘strengths-based approach’.
* Evaluate the suitability of such resources and practices for health education development among other ‘vulnerable’ groups in terms of class, gender and ethnicity.
* Relate how your own developing understanding of ‘salutogenic’ approaches to health could be used to assess the suitability of various health education or behaviour change models and theories in terms of the empowerment of ‘vulnerable’ groups.