This is Part 2 of a four-part series introducing the BCA Holistic approach to mental health.
Quick summary: Edward Deming’s quality management principles have been adapted into the BCA Holistic approach to mental health which examines behaviours cognitions and affect as distinct yet interconnected elements within the broader human system. This framework clarifies longstanding confusions between thoughts and emotions offering practitioners more precise tools to evaluate and improve service delivery while addressing client needs through development relationships and cultural contexts. The result supports enhanced mental health outcomes better informed healthcare practices and policies that prioritise systemic consistency to foster genuine well being rather than fragmented interventions.
Edward Deming changed the world by looking closely at processes… for building cars. He is the reason Japanese car manufacturing evolved from being poorly built cars in the 1950’s into being a car’s quality gold standard. But in that moment in 1985, listening to the University of Michigan’s Professor Rothman discuss Deming’s concepts and approach, I thought to myself, “This concept could improve mental health services.” Of course, I had no idea how. But the idea lingered.
It took me over 20 years of casual thinking, random insights, and a few interesting detours, to level up my mental health experiences and understanding to adapt and integrate Deming’s concepts and statistical perspective of quality service delivery into the process of mental health.
I had a child psychology degree and some graduate school of social work courses, including programme research and evaluation, when I first heard about Deming’s concepts, but shortly after, I ran out of money and became temporarily broke and homeless. So, I stepped out of school and did temp work. Thankfully, I had effective communication skills and often ended up doing interesting quality process related work.
In 1989, after Grand Met bought Pillsbury, I temp worked for Boston House Consulting which was hired to understand how Pillsbury functioned. My first assignment was to gather documents because, “written communication forms reveal how an organisation functions.” I helped find out who sent forms, information contained on the forms, and who received them. This work expanded my understanding of communications to include the impact of forms and processes on what, how and why services are provided.
Another vital insight learned was about the importance of “pre-work” when volunteering at the Minnesota Center of Book Arts with paper artist, Amanda Degener. She published a hand papermaking magazine and needed volunteers to insert handmade paper samples into 3,000 magazines. The process usually took 3-4 hours for 5 volunteers. But 15 minutes after we started, everyone got hungry and left to get dinner. I already had dinner, so I stayed. I challenged myself to design systems to see how fast I could insert paper samples. I was able to adjust the set up between magazines and samples, until I could effectively insert 40+ samples per minute or 1,200 in 30 minutes. I finished all magazine inserts before they returned. And had levelled-up fun.
I have insights and experience with processes, but not a great approach to effectively evaluate processes. That is when I recalled my introduction in a statistics class on Edward Deming’s concepts of quality service deliver. Deming evaluated the whole system process and then broke it down into distinct parts. Then he expanded that view to include the effectiveness of the tools used to understand the process. On top of that he looked at the roles and functions of who overlooked and was in charge of directing, managing and harnessing the whole process. Then he went even one step further to understand why the process existed in the first place, its consistency of purpose, which brought the whole perspective back to understanding clients needs and the providers ability to provide services.
I took Deming’s quality concepts and shifted them around a bit, added in my experiences and insights with a client’s frequently expressed difficulties, dysfunctions and identified needs. And the expanded it to also include development, relationships, neurology, context, cultures and more building blocks of our complex lives. The end result shed a new light on how and why our behaviours, cognitions and affect are distinct aspects in the process of being human. I called this perspective a behaviours, cognitions, and affect, or BCA holistic approach to mental health.
The BCA Holistic approach begins the process to explore, expand and clarify the definition and tools for understanding mental health from a holistic perspective. When incorporating Deming’s concepts to pull apart, explore and re-build the various aspects of what it means to be human, a fair amount of confusions developed. Or, to be more precise, there was no line distinguishing cognition from affect. Thinking and emotions overlapped in definition and treatment. They are often treated the same way. An overlap that was and is still confusing.
A big question arose then, when exploring the mental health process of being human: “Does it matter if there’s a difference between emotions and thoughts?”
Dane Jorento, MSW, LICSW is a speaker available for keynotes, seminars, and workshops on mental health, emotional well-being, trauma, ADHD, self-esteem, relationships, and sexual health. His expertise includes BCA Holistic Therapy, EMDR, and DBT approaches.
