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Lessons From the Field-- Part 2 : The 'Actions' of Attitude and Behavioral Change
Marlene Wiens
Acknowledgements
I would like to acknowledge the contribution of our partner organizations, Fundacion Amigos de los Ni–os Discapacitados para su Integracion a la Comunidad, FANDIC and Asociacion de Discapacitados de Piedecuesta, ASODISPIE and thank them for their confidence in relating their experiences. I would also like to thank the friends of the Canadian Association for Participatory Development for their encouragement and support.
Introduction
In Part 1, we examined the importance of leadership, passionate commitment and organizational competencies in making a community organization the best it can be. These qualities are not gained in a moment, but incrementally over a period of years. Critical reflection (or praxis) is an inherent part of incremental learning where "Change, if it is to occur, occurs first at the individual level-- it begins with self" (Wiens, p. 24). According to President Mkapa of Tanzania, 'Development cannot be imposed. It can only be facilitated. It requires ownership, participation and empowerment, not harangues and dictates' (DFID, 2005, p. iii). To be honest, "harangues and dictates" are a lot easier to dispense in our time-pressured world than facilitating "ownership, participation and empowerment". Depending on where we are starting from, empowerment may take a generation, even two.
For example, the zone in which one partner organization works, is characterized by suspicion and mistrust (see part 1). The neighbourhood is considered dangerous by the rest of the city due to a high level of violence and other social problems. Unemployment is high; socio economic level is low and education is limited. Human rights are rarely contemplated; people are looking out for themselves first and foremost. The culture is one of dependency as put by this mother of a disabled child:
I have thought and have talked with some mothers but here it is very difficult because we have a culture, a way of thinking that we should receive and receive, and when we call on them, few respond. But this work is mutual and if we don't work together once in awhile, we can't achieve anything. I have commented to various mothers because I always come to FANDIC, I like to do this very much. I don't know how we can change this culture that we should only receive (interviews in FANDIC, April 2004, translation by author).
It is difficult to encourage participation and ownership in an environment that has spawned dependency, but our partners are making steady progress. What is their strategy?
The purpose of this paper is to examine one partner's experience in facilitating attitude change amongst members of their community, and thereby gaining increased participation and commitment.
Attitude and Behavorial Change
Challenging adults to open their minds and hearts to alternative ways of thinking, to critically reflect on their assumptions they have about themselves and others, and to change their attitudes and behavior, is a difficult process according to Cranton (2002): "It is easier and safer to maintain habits of mind than to change" (p. 65).
Freire talked about conscientization or becoming conscious of our old perspectives and coming to see ourselves as having options for controlling our lives. It occurs when the perspectives we hold can no longer deal comfortably with information or experiences that are different from those perspectives. It involves empathy or taking the perspectives of others. In colloquial words, it means walking in another's shoes (Mezirow, 1978, 2002).
Attitude change may occur as a result of a significant or dramatic event that leads us to question our assumptions or it may be a process that occurs incrementally over time. It requires self-confidence, an increased sense of competency and a safe, risk-free environment in which to learn (Mezirow, 2002). In summary, attitude change is facilitated by a social environment where there is mutual learning, where we seek to understand the perspectives of others, where we gain new skills, and where we are safe and secure knowing we are accepted.
Our partner organization has been nurturing this type of social climate for several years and is now realizing the fruits of its labor-- increased commitment and a burgeoning sense of ownership. Learning has been mutual in that the organization has learned at least as much as their community members. Four prominent action-themes emerge from their experience: Build participation, build relationships, build knowledge and build social integration. These are actions that are best utilized concurrently.
Build participation
An organization can be very intentional regarding the level of participation desired for a particular program or activity by including it in the planning process. According to Pretty, J. N., Thompson, J. & Scoones, I. (1995, p. 61), there are seven levels of participation:
- 1. Passive participation where one person talks and the others listen. It is at this level that "harangues and dictates" occur; this is the level of giving talks or lectures in which there is little or no interchange of information.
- 2. Participation in information giving where people participate by answering questionnaires or surveys over which they have no influence. This method is typically used to gain quantitative information.
- 3. Participation by consultation where people from outside the community listen to the opinions of community members but do not involve them in defining the problem or solutions or in making decisions. Clinical therapy and medicine typically operate at this level of participation.
- 4. Participation for material incentive where the beneficiaries gain material benefit for work performed but are not part of the process of investigation and learning, so when the program is withdrawn, the community remains in the same condition. A service delivery model typically operates at this level.
- 5. Functional participation People form groups to complete the objectives of an external organization that makes the decisions. Community events, such as awareness raising or fund raising events may fit into this category.
- 6. Interactive participation in which community members are involved in joint analysis and make decisions that result in the formation of new programs or that strengthen existing programs. It is interdisciplinary and uses structured learning opportunities. Community members make local decisions and for this reason there is more sustainability at this level. Participatory Monitoring and Evaluation occurs at this level if community members are invited to take part in analysis and action planning.
- 7. Self-mobilization where the community members take action independent of the organization to change systems, services or programs. The community may make contracts and agreements to acquire necessary resources but maintains control. This level is typical of groups that engage in self advocacy.
The organization in the example of Part 1 was able to increase the level of participation of their community members from passively listening to talks and providing information during therapy sessions, as a result of conscious effort over time. They began the process by providing a safe environment for interaction during very non-threatening activities such as parties for children with disabilities and their families. At first they were pleased by the fact that people came and this attendance was used as a measure of participation, albeit passive participation. In time they sought to increase the level of participation by encouraging women to help in the preparation of the parties. The organization listened to their suggestions for party snacks and gave them responsibility to carry out that part of the program. As a result, the women gained skills in self-expression and cooperative collaboration, qualities of functional participation. Later still, the organization sought the collaboration of community members in helping to determine future direction of the organization. The community identified a community kitchen as something that would be helpful for the families and in time, the kitchen was born. As the kitchen gained structure, the women began to assume leadership in planning, that is, they started to make the decisions regarding the kitchen, thus demonstrating characteristics of interactive participation.
The incremental progression in participation occurred partly as a result of experimentation and critical reflection on the part of the organization. There was, however, one significant event that served as a transformative learning experience for the organization itself. This event was a workshop on Participatory Monitoring and Evaluation (MEP) facilitated by our Canadian organization. The participants of the workshop experienced a paradigm shift in their understanding of participation and how to facilitate it in their community members. From this time forward, they started to work differently with the children and their families; from this time forward they started to make real progress toward their goals of participation and integration. The change this made is described by the President of the Board:
Speaking about the families of children with disability, we have seen a great change because they now feel part of the Foundation; that the Foundation is theirs to a greater extent; that the Foundation is giving them more opportunities for them to participate jointly in the activities that the Foundation is proposing. This has been a great change because initially they wanted us to give and give and didn't like what we proposed. Now we ask them what they want first and the mothers are assisting the processes. We are in the initial stage of starting to change this difficult attitude in the mothers, but the fact that we have more leaders (amongst the mothers), that they are committed to doing things; that we are in an equal process, has resulted in them feeling that the Foundation is also theirs. This has been very positive. (Interviews in FANDIC, April 2004, translation by author).
Build Relationships
Relationship building is a multidimensional task that requires facilitation. Relationships are built on trust and are greatly influenced by the beliefs people have about themselves and others. Part of our job in Community Based Rehabilitation (CBR) is to encourage people to challenge their beliefs and we have found that practical projects focused on learning new skills are useful for this purpose. As individuals engage in a project with others, they learn to trust the people they are working with and in doing so, they open themselves up to new points of view that challenge their old way at looking at themselves and others. This is the first step to changing attitudes and behaviour.
An example of this type of project was the community kitchen. Besides learning something new, the women established friendships. The kitchen became a place for them to talk freely and to get things off their chest. It became a vehicle for them to take on new endeavors as a working team. In the words of the President:
The mothers are being resourceful and this is a change in them. We see more commitment. Now they don't wait until for you give, but are looking for solutions. They are buying things for the kitchen. They are looking for funds and are deciding what to buy. They are doing this on their own and not with the help of the community worker (Journal, November 2005)
Build knowledge
The example of the kitchen demonstrates how becoming involved in a learning experience can lead to a re-orientation of one's frame of reference. By means of a practical experience, the women changed from being dependent on the organization, to finding ways and means to accomplish what they wanted to achieve. They also changed their beliefs about themselves.
Adult Education literature describes three kinds of knowledge (Cranton, 2002): 1) Instrumental knowledge is derived from science and tells us about cause and effect. For instance, the doctor tells the patient that his/her symptom has a particular cause and that a particular medicine should be taken to obtain a particular result. 2) Communicative knowledge is "the understanding of ourselves, others, and the social norms of the community or society in which we live" (Cranton, p. 64). It is the key as to how to get things done and who we can count on. 3) Emancipatory knowledge is the product of critical reflection; it is self-awareness that frees us from constraints and is important for obtaining control of one's life and realizing one's dreams.
The women were building these three types of knowledge in the kitchen. They were learning to work with certain foods in a certain way to provide a certain result (Instrumental knowledge). They were learning to trust each other by sharing personal stories and by taking personal responsibility to get things done (Communicative knowledge). Lastly, they were learning skills in praxis and taking control of the kitchen. They decided what they wanted to achieve, investigated their options, and then took action to achieve the result (Emancipatory knowledge). The next time they want to achieve something new, they will have this experience upon which to build. The knowledge built as a result of these types of experiences builds personal confidence, pride in accomplishment and motivation for further achievement. It is the beginning of ownership that says, "This kitchen is mine and I want to make sure that it is the best it can be".
Facilitate Social Integration
One of the objectives of CBR is to promote social integration of people with disability through equal opportunities. Integration begins in the home where children learn social values and develop a self image. However, many parents face difficulties when a child with disability is added to the family. The majority of parents love their child with disability but they do not know what to do to help him or her. In addition, many have acquired cultural attitudes regarding disability that may cause them to see their child as someone to be pitied and/or protected from further harm. Many CBR programs work intensely with families to teach them how to help the child become more functional, more independent in the home and more valued as a family member. It sounds easy, but it is not, because to achieve this goal there must be a change in attitude and behaviour on the part of family members and perhaps on the part of the person with disability as well.
Integration of the child into family life occurs concurrently with building the family's knowledge about disability and by providing them with practical tools to improve the child's function. One such tool is a custom built device that assists the child to reach the next major developmental milestone, for example a standing device for a 2-year old child who has not yet learned to stand. The device not only assists a physical function but also serves to provide the child with additional opportunities for stimulation. In addition the family begins to look upon the child as a person with potential.
This was the case with a 5-year old girl with weakness throughout her body and a large, heavy head to support. As there was no chair in which she could safely sit, she remained on a floor mat, day and night. This position was not very stimulating for a little girl who had learned to talk and was quite social by nature. A custom chair with supports for her head, trunk and legs gave her a boost that opened up her world. Instead of shyly avoiding contact with strangers, she now engaged them with her smile and laugh. She had seemingly altered her perception of self and was ready to move forward. Her family responded by selecting a family member to be her activity leader for her home program and two years later she was able to sit independently in an ordinary chair with complete head control. The improvement was absolutely incredible; all she needed was a little nudge to get her over an obstacle. And this change had secondary effects: she learned how to draw, she started to eat independently and she gained control of her bodily functions.
The example above is one of a little girl integrating more completely into the life of her family. It can also be said that the family, especially her mother, became more integrated into the organization's community. Her mother's experience as part of the team who built the chair, developed in her a sense of appreciation for the volunteers who so valued her little girl as to give freely of their time and effort. Because she contributed to the design and construction, she gained knowledge of the principles involved and this enabled her to modify the chair when it became too small. This woman became a firm supporter of the organization's programs and a member of the community kitchen. Experience built upon experience served to change her attitude toward her child from one of hopelessness to one of motivation to get things done so her little girl would continue to improve.
Conclusion
Community organizations can facilitate attitude and behavioural change within community members by promoting practical experiences that challenge a person's concept of self and others. Actions that promote reframing of beliefs and change in behavior can be facilitated through projects that build participation, relationships, knowledge and social integration.
References
Cranton, P. (2002). Teaching for transformation. In J.M. Ross-Gorden (ed.), Contemporary Viewpoints on teaching adults effectively (pp. 63-71). New Directions for Adult and Continuing Education, no. 93. San Francisco: Jossey-Bass.
Department for International Development (DFID) (March 2005). Partnerships for poverty reduction: rethinking conditionality. A UK policy paper: www.dfid.gov.uk/pubs/files/conditionality.pdf.
Mezirow, J. (1978). Perspective Transformation. Adult Education, 28 (2), 100-110.
Mezirow, J. (2002). Learning to think like an adult: Core concepts of transformation theory. In J. Mezirow & Associated (eds.) Learning as Transformation (pp. 3-33). San Francisco: Jossey-Bass.
Pretty, J. N., Thompson, J. & Scoones, I. (1995). Participatory learning & action. A trainer's guide. London: International Institute for Environment and Development.
Wiens, M (2001). Zero to one in participatory development. Unpublished master's thesis, University of Calgary, Calgary, Alberta, Canada.
Submitted by
Marlene Wiens, MSc, BSC, BPT, Physical Therapist, Managing Director of CAPD
Email: marlene.wiens@shaw.ca
For further information about the Canadian Association for Participatory Development go to: www.globalsteps.org
This document will be available in Spanish at www.globalsteps.org/Spanish/Bienvenidos/Projects/Recursos/Recursos.htm
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