Strengths-Based Nursing Care
By Dr. Laurie Gottlieb
352 pages (paperback)
Springer Publishing Company
When I was asked to review this book, the idea of a "strengths-based" approach to care was not new to me; I had become aware of this approach through the earlier work of Dr. Gottlieb and her colleagues (Feeley and Gottleib 2000; Gottlieb and Rowat 1987; Pless et al. 1994) while I was working as a clinical nurse specialist at Holland Bloorview Children's Rehabilitation Centre during the late 1990s and early 2000s. I had implemented a professional development program for ambulatory care nurses at Bloorview using the McGill Model of Nursing, in conjunction with the Calgary Family Assessment and Intervention models (Wright and Leahy 2009), as the foundation for nursing practice. Given these experiences, I was excited to review Dr. Gottlieb's latest ideas regarding strengths-based care (SBC). I was also very interested to see how the idea of a strengths-based approach had evolved into a formal framework to guide nursing care.
Strengths-Based Nursing Care is divided into three major sections that reflect the theoretical foundations for SBC, the basic skills required to practise this approach and clinical examples from advanced practice nurses who have used SBC with families. These divisions in the book make logical sense; each section flows nicely into the next and lays a solid foundation for what follows.
The theoretical foundations of SBC are described and presented in Part One. This section of the book is divided into four chapters that focus on identifying and understanding SBC and the theoretical orientation, assumptions and values that underlie this approach. Dr. Gottlieb describes strengths-based care, how it has evolved over the past 30 years and why this approach is important in today's healthcare system. The historical overview of the evolution of a deficit-based approach to care is provided to illustrate the major differences between that approach and SBC. This discussion, along with an exploration of the values, beliefs and attitudes that underpin nursing practice, provides a solid foundation for understanding the SBC approach. The inclusion of what is meant by strengths, the language of strengths and the key characteristics of strengths reflects the comprehensive nature of the ideas developed in relation to SBC. This first part of the book is instrumental in setting the stage for the information presented in the next two sections.
Part Two describes the process of identifying nurses' strengths and the development of essential qualities for nurses to practise SBC. This section is also divided into four chapters that focus on essential nursing qualities, the "retraining" of senses, professional glaze and "reforming" of the social skills required to practise strengths-based nursing care.
SBC requires that the nurse become aware of his or her own strengths and weaknesses as well as how his or her behaviour affects the person and family and how the person and family's behaviours affect the nurse's responses. This approach also requires nurses to have other qualities such as strengths of mindset, knowledge and knowing, relationships and advocacy. For example, strengths of mindset relate to "a certain way of thinking and [are] reflected in a person's attitude and values that affect a nurse's judgment, thinking, and consequently her behaviour" (Chapter 5). This group of strengths includes "mindfulness," which is necessary for the development of a therapeutic relationship, particularly for the practitioner. Each of these categories of strengths is fully articulated and explored. Many examples from practising nurses are presented to illustrate each of the categories of nursing qualities. In addition, Dr. Gottlieb describes techniques for how to practise each quality.
The "retraining" of the eight senses for nursing practice is explored in the context of professional nursing education using Benner and colleagues' (2010) latest ideas describing new approaches to learning. Dr. Gottlieb introduces the five "outer" senses of living such as eyes, ears, nose, mouth and skin, and three inner "senses" of awareness such as internal bodily sensations; thoughts, feelings and intentions of oneself or another person; and relational sensing (intuition). Based on this perspective, the reforming and retraining of social involvement skills to become a professional nurse are described in great length. Throughout this section of the book are numerous examples of these ideas in practice.
Part Three is focused on identifying and describing SBC in practice. This section is divided into two chapters that outline the process for uncovering and discovering strengths in our practice with families. The phases of this approach, and the major activities that take place within each phase, are identified and described. Included in this description are the strategies and techniques that nurses can use to discover and uncover strengths with families in their clinical practice.
Overall, Strengths-Based Care is an important and timely contribution to relational nursing education and practice. I would highly recommend this book to nursing students and practising nurses at various levels within the education and healthcare systems.
About the Author
Reviewed by Karen LeGrow, RN, PhD, Assistant Professor, Daphne Cockwell School of Nursing, Ryerson University, Toronto, ON
Benner, P., P.H. Kyriakidis and D. Stannard. 2010. Clinical Wisdom and Interventions in Acute and Critical Care: A Thinking-in-Action Approach (2nd ed.). New York: Springer.
Feeley, N. and L.N. Gottlieb. 2000. "Nursing Approaches for Working with Family Strengths and Resources." Journal of Family Nursing 6(1): 9–24.
Gottlieb, L. and K. Rowat. 1987 (July). "The McGill Model of Nursing: A Practice-Derived Model." ANS: Advances in Nursing Science 9(4): 51–61.
Pless, I.B., N. Feeley, L. Gottlieb, K. Rowat, G. Dougherty and B. Willard. 1994 (July). "A Randomized Trial of a Nursing Intervention to Promote the Adjustment of Children with Chronic Physical Disorders." Pediatrics 94(1): 70–75.
Wright, L. and M. Leahy. 2009. Nurses and Families: A Guide to Family Assessment and Intervention (5th ed.). Philadelphia: Davis.
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