Preventive, personalized, integrated, and ecological social intervention

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Instead of considering prevention as the opposite of intervention (understanding that, if prevention is successful, intervention will not be necessary) or as a type of intervention (different from others such as palliative, care or promotional), it is proposed here to conceive it as a castling, a dimension or added value that is always present, desirably, in the intervention. Preventive action is characterized by its precocity and proactivity and it aims to make other interventions unnecessary or lesser, possibly more intense and expensive.

The root of the personalization movements of the welfare services (and, specifically, social intervention) can be found in the independent life movement of people with disabilities or users of mental health services. In the specific field of gerontology, the person-centered model of care identifies as a reference client-centered psychotherapy, the models of person-centered planning (of disability care) mentioned above, the contributions of applied ethics (especially of bioethics, the various professional deontologies or the care ethic), the approaches linked to the concept of quality of life, case management or housing, understood as movement of reform, reconfiguration (and in some cases replacement) of residential care to the elderly.

The focus on the person or personalization of social intervention is consistent with a social intervention of ambitious objectives and high added value, far removed from the social control and traditional segmentation (and segregation). Supported by ethical values and rigorous knowledge, it recognizes the uniqueness and complexity of the situations and trajectories of each and every one of the people in their sexual, generational, functional, and cultural diversities. For this reason, it conceives social intervention (and its main framework: social services) as vertically integrated within the sectorial scope itself (to guarantee continuity and avoid fragmentation in the processes of social intervention, to strengthen attention to diversities in community proximity and avoid the labeling and segregation of people) and horizontally, in integrated intersectoral care, the third of the proposed characteristics.

Indeed, the organization of any activity is traversed by a tension between two dynamics: the dynamics of specialization and those of integration. The dynamics of specialization enables the division of activity between organizational units or, ultimately, people who are (more) able to take charge of each part and the dynamics of integration (coordination, collaboration or unification between those parties in processes and macroprocesses) seeks control, synergies, scales or interesting competitive positions. Technology, understood as the standardized and knowledge-based (scientific or other) way of carrying out the operative activities of each link of the value chains is a determining factor in the processes of specialization or integration.

Of course, a social intervention that wants to abandon the residual positioning of a social assistance in charge of social exclusion is ethically and technically obliged to propose a solvent model of addressing social complexity. At present, he paradigm that is being imposed internationally in this regard is that of an integrated care. Integrated intersectoral care is the appropriate framework for modulating, with elasticity and flexibility, the process by which social intervention becomes focused on its purpose and recognizing in (or proposing to) other interventions (health, labor, residential or others) its own purpose (as in the Housing First model, in which the accommodation of accompaniment is differentiated). At the same time, in the institutional framework of governance for territorial and social welfare, development and sustainability, the challenge of integrated care helps to see the importance of the fourth characteristic that we attribute in this section to social intervention: its ecological nature.

We speak of an ecological approach, a population approach or a structural approach from the moment we have understood that it is essential to intervene with individuals but also to influence their family, community and social environments in general. The territory (proximity) is a key reference because human beings are bodies embedded eco-dependently in physical spaces, although a questioning of the ‘community’ is necessary in its exclusively spatial/territorial dimension. The logic of space is replaced by the discourse of information flows, influence and networks of relationships. Be that as it may, both in the territorial proximity and in the digital layer, it is fundamental to analyze and deal with the social structures (macro, meso, and micro) that guide the activities, relationships, decisions, emotions, and knowledge of the people.

(Find here, please, the full text of the article in Psychologist Papers.)

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