LOSS OF AGENCY
What do we mean by loss of agency?
We have agency when we can see ourselves as captains of our own ships. Agency comes from both the mindset that we can control how our life develops and the opportunities to make meaningful decisions for ourselves. When we have agency, we feel more positive and motivated.
The effects of losing agency may show up in surprising ways: Your clients may have difficulty connecting how their choices could influence their outcomes. They may seem disappointed with a free product or service they were given. They may also hesitate to make important decisions, or make them impulsively.
In a famous experiment, nursing home residents who could arrange their own furniture, care for houseplants, and move about the facility as they liked were more active, healthier and happier than residents whose care and personal decisions were made by staff.
How can loss of agency affect health equity?
People who need to access social services have often experienced their choices being limited by poverty, stigma, discrimination, or other barriers. When we repeatedly experience having our choices limited, we start to feel that we lack control over our everyday choices or the direction of our lives. As a result, we may be less likely to set goals for ourselves and less motivated to achieve set goals. When we do achieve success, we may be less likely to give ourselves credit for it. When we experience a low sense of agency, we may also not note or take advantage of opportunities available to us to improve our health and well-being. Thus, structural barriers to health equity can be compounded by a low sense of personal agency.
Past models of social support have often been guided by a sense that the administrators of that support “know what’s best” for people who need it. But new models are empowering recipients of services to make their own decisions. Recent experiments, like the New Leaf Project in Vancouver, Canada, provided unconditional cash transfers to people without housing, who could use their money as they saw fit. Compared to a control group who received coaching and workshops instead of cash, the cash recipients moved into housing faster, spent less money on drugs and alcohol, achieved food security more quickly, and saved more for the future.
WHAT OTHERS HAVE DONE
Changing defaults to active choices including not having to choose; Co-designing services with clients
In California, staff at a youth mental health center reimagine what accessing support looks like by asking the youth to decide for themselves what works best for them. To start, youth can visit the center on their own – without a referral or guardian consent (for most services). When they visit, they get to choose on a tablet what service they want that day or choose no service at all and simply tour the space or find a quiet space to study. When accessing services, they are also offered options of open versus private spaces. Internally, the center staff also honor the youth’s voice in designing the services and space. They regularly engage local youth to brainstorm with them and advise them on decisions ranging from what services are most needed to what wall color feels the most welcoming.
Changing defaults to active choices
In Texas, a foundation transformed grantmaking by providing funds with no strings attached to those working on the front lines. In response to Covid-19, the foundation rapidly allocated its funding to small local nonprofits and made the funding unrestricted. With unrestricted funds, the nonprofits were able to creatively meet the urgent needs of the local communities. For example, one nonprofit that provides maternal care for women of color recognized the risk of going out to get food during Covid-19, and they were able to pivot and hire a caterer for these women. By providing funds with no strings attached, the foundation put the communities’ experiences first and trusted them to make the best calls.
This academic article reviews the theory and core features of human agency and its role in individual and social change. From the peer-reviewed academic journal Perspectives on Psychological Science.
This article highlights insights from studies on improving women’s agency. From the Abdul Latif Jameel Poverty Action Lab (J-PAL).
This website explains the cash transfer program for individuals without housing by the University of British Columbia and the Foundations for Social Change.
This academic article describes outcomes from the New Leaf Project: an one-time unconditional cash transfer to individuals without housing led to positive financial and housing outcomes. Preprint yet to be reviewed for publication in a peer-reviewed academic journal.
This academic paper shows how choosing their own responsibilities rather than having responsibilities chosen for them improved nursing home residents’ well being. From the peer-reviewed academic journal Journal of Personality and Social Psychology.
This report reviews studies on Universal Basic Income. From the Basic Income Lab at Stanford University.
This essay discusses considerations for using defaults versus having people make choices. From the Behavioral Science & Policy Association.
This article provides tips on increasing agency. From the Greater Good magazine published by the Greater Good Science Center at the University of California-Berkeley.
Dr. Jiaying Zhao
Associate Professor, Department of Psychology and the Institute for Resources, Environment and Sustainability, University of British Columbia; Canada Research Chair in Behavioural Sustainability
Dr. Gilberto Lopez
Assistant Professor in the School of Transborder Studies at Arizona State University.
Dr. Lourdes J. Rodríguez
Senior Program Officer for Women's Health at St. David's Foundation and Adjunct Faculty with the UTHealth School of Public Health Austin Regional Campus
Dr. Steven Adelsheim
Clinical Professor of Psychiatry at Stanford University and Director at allcove
Program Director at allcove
Brand and Communications Manager at allcove
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