Change that leads to better lives

What are the underpinning values?

The focus is on inclusion
The Inclusion Web focuses mainly upon the people and places in the ‘community beyond services’. This means we are interested in activities that create opportunities to connect with other citizens rather than other people using health or social care services, rather than being restricted to private and solitary activities.

Living with ambiguity
People using the Inclusion Web have to decide which people and places to include and which to leave out. They then have to decide which of the segments or life domains to use to record those contacts. Sometimes this is tricky as life does not fall neatly into categories. The Inclusion Web faces this issue head-on and acknowledges that life is much more ambiguous than can be captured in a simple form.

Nothing about us without us
The Inclusion Web is based on values that include a belief in the integrity of the person and in the people who support them, and a conviction that user-defined evidence of changes will be of interest to researchers and service commissioners. As such, it must not be completed without the active involvement and full consent of the person and it is not to be used as a tool to capture staff or other people’s impressions in the absence of the person. Whilst a worker or supporter may provide assistance, we hope that people will usually write on the Inclusion Web themselves.

Perceived support
In general, it is the positive roles and the extent of support that the person recognises for themselves, rather than an outsider’s judgement, that is most valuable in protecting against stress. This is called 'perceived support' (see the seminal work by Poel).Meanwhile, the Recovery movement in mental health and the increasing focus on person-centred approaches across all services reinforce the point that it is vital to attend to the person’s own perception of their role and relationship network, rather than make assumptions. As Liz Spencer and Ray Pahl explain in their ground-breaking anthropological analysis of friendship:

"It is increasingly realised that it is not necessarily the actual support provided by members of a person’s micro-social world that is so important but the perceived support, since perceived support may act as a buffer against stress. People need to believe that they are cared for and loved, that they are esteemed and valued and that they belong to a network of communication and mutual obligation."[2] (page 28, here).

Stimulating change - for people who want to change
Some people are content with their current pattern of roles and relationships in the wider community. Perhaps they prefer to live a quiet life or maybe they have already made all the changes that they want. They may wish to use the Inclusion Web to find out whether they are losing their connections or potentially could develop new aspirations. Alternatively, you may wish to remove these individuals from your analysis. We have no intention of imposing a particular lifestyle on people against their wishes!

Where people are motivated to reflect and change, using the Inclusion Web is not expected to be a neutral exercise. It deliberately aims to provoke helpful reflection, insight and action by the person. This means that it may be difficult to untangle the effect of using the chart from the effect of any subsequent intervention.

Stimulating change - for health and social care organisations
The Inclusion Web may be introduced as part of a change management process that seeks to increase the focus on social inclusion. The values that have shaped the Inclusion Web are sometimes at odds with the traditional culture in the organisation and so the Inclusion Web is positioned at the line between the old and new ways of working. Its success or failure may depend on the extent to which new values and approaches are introduced respectfully and relentlessly.

Within an individual service, it is important to gain reassurance that the measure is being used in a consistent way. People who will be supporting others to complete the Inclusion Web should begin by observing a colleague conducting an Inclusion Web session in order to check out whether their session format and scoring is consistent with the guidance given in this resource pack and with other raters. Within a team using the Inclusion Web, a senior person may be appointed as an internal verifier to oversee the consistency of the process.

Every time a copy of the Inclusion Web is completed, there is a coaching opportunity. If completed copies are simply filed, this opportunity is wasted. However, if a manager or designated lead takes up the opportunity to coach practitioners or partners, then the following benefits ensue:

  • Compliance with the guidance set out here is increased.
  • The Inclusion Web becomes a more effective launchpad for creative support and therapeutic work.
  • Difficulties with using the Inclusion Web are identified and solutions are shared.

It is not meant to be a brief, quick exercise, unlike some measures which advertise as an advantage their short completion time. Completing the Inclusion Web is a thoughtful, reflective exercise that demands that the person and anyone supporting them pause and reflect together. If it is used in a superficial way, it will deliver superficial results. The focus needs to be on using the chart as a means to explore the person’s experiences, rather than just on getting the form completed as quickly as possible. Click here for more on the benefits of a slow approach.

Completing the Inclusion Web is an intimate exercise involving considerable self-disclosure. This means that it should be conducted in a one-to-one confidential way, rather than in a public place or with a group of others listening in. The best level of trust may be achieved by someone who has a longstanding relationship with the person, but with others, it is a stranger who achieves the greatest disclosure, as long as the proper conditions of respect and non-intrusive curiosity are established.

Cultural competence
The way in which people take up roles and make their relationships can be affected by cultural norms. When using the Inclusion Web, we need to be sensitive to this and take the opportunity to explore the way that each person uniquely understands and conducts relationships with their relatives, neighbours, associates and communities.

Such an exploration will be more meaningful and accurate when the supporter has some understanding of the cultural context of the person. Indeed, training in cultural competence may assist in clarifying and then helping someone to set aside any stereotypes that will interfere with genuine listening, whilst noticing how issues of identity, family and culture interact with the themes of exclusion and community.

Some people choose to conduct almost all of their interactions within or via a single dominant group or identity. In this situation, it is important to ensure that this choice is not seen as less valid than more diverse arrays, and that lives which are focused on a single life domain can be full of richness and subtlety.


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