Taking the “Should” Out of Social Good

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A recent movie, The Interrupters, features CeaseFire, an organization aimed at combating violence in Chicago. CeaseFire has been effective because it uses a public health approach to urban violence—going out into the community to meet with victims of violence to “contain” an outbreak and ensure there will be no retaliation. CeaseFire’s approach is best explained in a 2008 New York Time Magazine article by Alex Kotlowitz:

CeaseFire’s founder, Gary Slutkin, is an epidemiologist and a physician who for 10 years battled infectious diseases in Africa. He says that violence directly mimics infections like tuberculosis and AIDS, and so, he suggests, the treatment ought to mimic the regimen applied to these diseases: go after the most infected, and stop the infection at its source. “For violence, we’re trying to interrupt the next event, the next transmission, the next violent activity,” Slutkin told me recently. “And the violent activity predicts the next violent activity like H.I.V. predicts the next H.I.V. and TB predicts the next TB.” Slutkin wants to shift how we think about violence from a moral issue (good and bad people) to a public health one (healthful and unhealthful behavior). 

That last comment caught my attention. To see improvement on violent activity, we must change our frame from a moral one to one centered on public health. We must separate the person from the behavior.

None of us enjoys being called a bad person. We tend to resist judgment, to dig in our heels and prepare for battle. This is why efforts to tell people what they “should” do often fail. When people feel that their skills and inherent abilities are being questioned, they become (quite understandably) defensive. To create behavioral changes, we must be able to separate the behavior from the individual. And, to be sure, the creation of this disconnect has worked effectively in other areas.

In the medical field, we have seen the emergence of “No Fault Hospitals.” In these places, mistakes are talked about openly. When accidents or patient deaths occur, meetings are held to discuss the mistakes, not to assign blame. This has the potential to promote honesty and openness, and – one would hope – lead to better practice over time. This approach is not without detractors, and we all could imagine the frustration experienced by patient families when no one is “held accountable” for a medical accident. But, over time, this approach has been shown to lead to improved patient safety outcomes.

We see the opposite in America’s classrooms. Little separation exists between the idea of a bad teacher and the idea of bad teaching. With increasing frequency, it is impossible for teachers to speak honestly about shortcomings or failures of their teaching without the fear of facing termination. A few successful educator-led programs, like PAR in Montgomery County, do provide support in a safe environment, and the results demonstrate the effectiveness of such an approach. After being supported to improve, those teachers that continue to struggle often choose to leave, understanding that the classroom might not be the place for them to exercise their vocational strengths. Those teachers who are open to increasing positive teaching behaviors (without fear of termination) often see dramatic improvement.

Humans tend to be backward-looking with an inclination toward retrospection, analysis, and judgment. But, what if this need to judge inhibits our ability to improve? CeaseFire has contributed to significant decreases in gun violence (a 16-27% decrease in shootings and attempted shootings when compared to neighborhoods without the intervention) by intentionally avoiding participation in backward-looking (law enforcement) efforts.

We must consider the consequences of our focus on consequences. Rather than what one should have done, we must focus on what one has the opportunity to do. In Chicago and Montgomery County, we are seeing examples of what can happen when we depersonalize a behavior we’d like to change.

It is up to each of us to push this transition from a moral mindset to one focused on a public health framework. A medical mistake cannot, with certainty, identify a mediocre physician. Similarly, a bad classroom session does not indicate a hopeless teacher. Slutkin says he “wants to shift how we think about violence from a moral issue (good and bad people) to a public health one (healthful and unhealthful behavior).” Bringing that same mentality to all our work toward social good is a necessary step toward securing a better future.

Photo credit: Jacob Anikulapo 

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