Autonomy Support

Tree of handsOver my years of reading and experiential learning, I’ve understood that there are three fundamental elements relevant to a human being’s psychological well-being1:

  • Competency;
  • Autonomy; and
  • Relatedness

Competency (‘sense of efficacy’) refers to our need to produce desirable outcomes; to be effective whilst experiencing an agreeable level of challenge in doing so; and to experience mastery. Basically, we want to be good at stuff, and we like getting better at it.

Autonomy (‘sense of volition’) refers to our need to feel ownership of our actions; to perceive that we have choices and can self-determine what to do and/or how to do it. As per my previous post (The comedy of…), the opposite of autonomy is control. Put simply, autonomy is the freedom to decide for yourself.

Relatedness (‘sense of caring relationships’) refers to our need to feel connected with others; to care about, and be cared about by, others without ulterior motives.

Together, these three are what makes life meaningful. It follows that they are necessary for meaningful work to occur and should therefore be front-and-centre for anyone (and everyone) trying to design an effective management system.

  • If you get this right, then just wow, what a place to work!
  • If you get it wrong… no prizes for guessing what that might look like.

I want to focus this post in on the autonomy piece, and how those in management positions can (and should) interact:

What’s so good about this ‘autonomy’ malarkey?

Edward Deci writes that:

When autonomous, people are fully willing to do what they are doing, and they embrace the activity with a sense of interest and commitment. Their actions emanate from their true sense of self, so they are being authentic.”

Autonomy fuels growth and health, because it allows people to experience themselves as themselves, as the initiator of their own actions. The person who feels competent and autonomous, who directs his or her own life, is immeasurably better off than a person who does not.”

Now that’s going to be a powerful force if we can create the conditions for it to occur!

“The key to whether people are living autonomously is whether they feel, deep within themselves, that their actions are their own choice…The main thing about meaningful choice is that it engenders willingness.”

I should note that there are whole bodies of research performed over decades that powerfully back these statements up.

Being in a ‘one up’ position

Deci uses the ‘one up’ language to refer to a person having a role ‘one up’ a hierarchy in respect of another. It applies across many situations, including:

  • a parent/ guardian to a child;
  • a teacher to a student;
  • a manager to a direct report; and
  • a ‘case manager’ to a client

I’m particularly interested in the last scenario. There are heaps of public sector roles in which someone in (what can generically be referred to as) a case management position has the goal of assisting their client to get to, and stay in, a much better place.

Examples include:

  • a probation/corrections officer with a prisoner
  • a nurse/medical worker with a patient
  • social workers and benefits officers with their clients
  • ….and on and on and on

A ‘one up’ working with their client

A conventional approach to case management is often one of control. It starts with a prescription (“I’m the expert here – this is what’s needed”) and then direction (“and therefore this is what you need to do”).

Deci writes that there are two potential responses to control – compliance or defiance.

The problem with compliance is that the person isn’t actually doing it for themselves, they are ‘going through the motions’. Any outcome is most likely to be superficial, short-lived and requiring of continual (and potentially escalating) maintenance.

..and the (rather obvious) problem with defiance is that you’ve got them running in the wrong direction!

“Compliance produces change that is not likely to be maintained, and defiance blocks change in the first place.”

There are many people out there that distinctly dislike attempting to control others and go in the other direction of permissiveness – i.e. letting people ‘get away with [whatever they want]’. This isn’t healthy – for the client, the system or society. There is a need for a degree of structure, with limits and consequences.

Control spectrum 1

The risks2 of operating anywhere on the control spectrum include: undesirable and/or ineffective behaviours; a lack of personal responsibility; and the creation of dependency (on the system).

Introducing the concept of ‘Autonomy Support’

Neither control nor permissiveness are what’s needed for people/clients to achieve meaningful and sustained outcomes. Instead, we need to adopt a totally new orientation that is perpendicular to (i.e. removed from) the control spectrum.

Deci introduces:

Autonomy Support [as] a personal orientation you take toward other people.

It requires being able to take their perspective – being able to see the world as they see it. It thus allows you to understand why they want what they want and why they do what they do.

As an autonomy supportive [Case Manager], you would be building an alliance with your [Client] and you would engage new situations from that perspective.”

Put simply, Autonomy Support starts from the position that we ‘get’ that a person’s autonomy is key, and therefore our role is to support (nurture, enable, and enhance) a client’s ability to ‘work it out and/or do it for themselves’. This might take some up-front time and effort, but it is undeniably worthwhile.

Control spectrum 2

Right, so that sounds lovely, but how do we go about it?!

How to promote autonomy

The following diagram is my summary of the key points from Deci’s work, which I’ll then attempt to explain and open up. It represents the dynamic collaboration between two people (the person and a ‘one-up’):

Autonomy Support from Paint

The two prominent points are that:

  • The most important role of the ‘one up’ is to fully and continually understand (the situation, the context, the immediate and emergent needs, what really matters and so on); and
  • most important for the person/client is to feel like they are in control (autonomous), and this will be achieved through the ‘one up’ providing them with real and meaningful choice.

…but, as you can see, there’s more to it than this. Taking each piece in turn:

Understanding: “to relate to others as human beings, as active agents worthy of support, rather than as objects to be manipulated…It begins with listening openly.”

Put another way, if we don’t really understand what’s going on, how on earth can we expect to help them get to where they need to be? If we merely assume, judge and cajole, we will most likely make matters (much) worse.

Knowledge: This point refers to the person’s/client’s knowledge. If we are going to provide them with choice, then it is our responsibility to ensure they have the necessary knowledge to reasonably decide. It would be unfair not to do so!

Choice: This is perhaps the central point but there are some clarifications to be made:

  • In some situations, we may not be able to allow choice in the ‘what’. If this is the case, we should turn to providing choice about the ‘how’ to go about the what.
  • Sometimes the offering of choice isn’t appropriate…HOWEVER, we need to be very careful that we haven’t conveniently ‘presumed’ this simply to control.

Deci notes that a usual critique is that ‘[my person/client] doesn’t want the choice – they want to be told what to do’. He goes on to write that:

“If [this is true] it is because people have been pushed to that point by being overly controlled in the past.

If you control people enough, they may begin to act is if they want to be controlled. [This is] a self-protection strategy…

People adapt to being controlled and act as if they don’t want the very thing that is integral to their nature – namely, the opportunity to be autonomous. They probably fear that they will be evaluated – perhaps even punished – if they make the ‘wrong’ choice. And they may well be.

Being autonomy supportive can be very difficult, especially with people who are accustomed to being controlled…we have to be patient…to work with [them] to reawaken what is basic to their nature and what will almost surely lead to more positive results.”

Limits: Remembering that we aren’t about permissiveness, we will need to be clear on societal limits to a person’s choices and actions.

“Supporting autonomy does not mean condoning irresponsibility, nor does it mean allowing people to engage in dangerous or harmful acts. Central to promoting autonomy is encouraging people to understand where their rights end and others’ rights begin. Setting limits is a way of communicating about people’s rights and about constraints that exist in the social world. As such, it helps people to learn to be responsible in making their choices.”

Some considerations in setting limits:

  • The person/client should (where possible) be involved in setting the limits, rather than having them unilaterally imposed upon them
  • The reasoning for any limits needs to be well understood by the person/ client, together with the likely consequences of breaking them
  • We should aim to keep limits as wide as possible, and allow choice within them
  • Limits should be communicated in factual, rather than controlling, language

Consequences: “Once limits are set and the consequences communicated, it is important to follow through, else one is undermining one’s own credibility.”

Some key points on consequences:

  • Consequences must be appropriate to any lapses or contraventions. This MUSTN’T be about punishment or attempting control. It should be about encouraging responsibility
  • The person/ client should be free to choose whether they stay within the set limits…and then experience the (previously communicated) outcomes of whether they do or don’t.
  • However, if we (the ‘one up’) don’t follow through, we are really back at permissiveness.

“…it is easy to confuse autonomy support with permissiveness [because] people find it hard to admit that they are being permissive, so they mis-portray their permissive behaviour as autonomy support.

Permissiveness is easy, but autonomy support is hard [yet ultimately rewarding] work”

Control spectrum 3

Reset and repeat: and finally, if and when a person/ client chooses a given course direction (whatever direction this may be), we are dynamically back at understanding.

We don’t judge a client for their choices, we work hard at understanding more deeply why they made them, so that we can go round the ‘autonomy support’ loop until we and they succeed.

In Summary:

It’s not about saying ‘No’ (Control) or ‘Yes’ (Permissive)…it’s about moving from an overly simplistic view and on to real understanding and valuable human interactions.

It may be hard (in the short term) but hugely effective (over time). Conversely, we may be surprised at how easy it is – many a client is just stuck, waiting to be understood!

Future Linkages from this post:

I’ve got a couple of related topics that should ‘dangle’ off this post. They are:

  • ‘Motivational Interviewing’: Discussing a method that fits with equipping those in case management roles with the skills to be autonomy supportive; and
  • ‘Decentralisation 2.0’: Discussing how the central and support functions of large service organisations should interact with their sites to enable, rather than (attempt to) control.

I haven’t written them yet…but I hope to find the time to do so.

Footnotes

1. These three elements are central to Deci and Ryan’s ‘Self Determination Theory’

2. These risks apply equally to the person/client and the ‘one up’ person/ case manager!

3. All quotes from Deci in this post come from his highly readable book titled “Why we do what we do”

One thought on “Autonomy Support

  1. I have found it significant that folk tend to inherently carry the seeds of their own failures within their memories of past experiences. In perceiving the response to Compliance or Defiance the motivational
    directive begins with subconscious reactions to previous experiences that colour and distort the potential desired responses.

    Like

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