Part III: A systematic change perspective The need to clarify underlying assumptions Members of NPMs (but also other actors) approach the monitoring work with a set of beliefs and assumptions about how change will happen. These beliefs shape their thinking about what conditions are necessary for success, which tactics to undertake in which situations, and what changes need to be achieved along the way.277 However, these assumptions are seldom made explicit and/or put to critical reflection, although this is what any thorough strategic approach with a view to maximising change requires. It is safe to say that not clarifying assumptions has detrimental consequences on the rigor of planning and performing of action. In the NPM context, it has a further problematic aspect: Given the legally required multidisciplinary composition of NPMs, it complicates proper communication among persons trained in different disciplines and thus having very different outlooks and probably basic assumptions about the social world. The recurrent theme of the legal outlook dominating the approach of NHRIs278 and human rights studies in general279 is best to be dealt with in this light. While research about and practice of introducing change perspectives stress this element of constant reflection on one’s basic assumptions as essential, it constitutes - at the same time - a fundamental challenge to implementation in practice.280 It requires an open mind which is able to think out of the box as well as adequate structures and time dedicated to it. Use of multidisciplinary composition of NPMs for follow-up action The need for interdisciplinary approaches is clearly recognised in the field of preventive monitoring. According to article 18 OPCAT, NPMs must be composed of persons with the required capabilities and professional knowledge. Such a multidisciplinary composition is necessary in order to achieve a comprehensive understanding of the situation in places of detention. The Regional Forum on the OPCAT implementation in the Latin American region stated in this regard: There is a need to integrate the respective knowledge of the different disciplines represented in the NPM into a fully transdisciplinary approach of the mechanism. Such an approach would allow the merging of the knowledge of the different disciplines, resulting, in particular, in a more complete understanding of the reality and the causes of torture and ill-treatment and of effective solutions to tackle them.281 It is quite clear that interdisciplinary perspectives should be present throughout the whole monitoring process, including follow-up.282 For example, with regard to the role of physicians and other health professionals, the APT says the following: A physician, or other health professional, can provide an invaluable contribution to the drafting of the report and recommendations, to the dialogue with the authorities, as well as to the follow-up of the implementation of recommendations. A medical perspective is vital in all reflections on preventing torture and improving the system and conditions of detention, including observations on legislative aspects.283 Most NPMs seem to use the multidisciplinary composition and/or expertise for their visiting work and less for follow-up measures, and engagement of experts from disciplines other than the legal is still mostly ad hoc and not systematic. An example of the use of multidisciplinarity in follow-up is the practice of the Bulgarian NPM which included its medical expert in discussions with the authorities regarding a new S Stachowiak, Pathways to Change: 10 Theories to Inform Advocacy and Policy Change Efforts (Organizational Research Services 2013) 1 [hereinafter: Stachowiak (2013)]. 278 International Council on Human Rights Policy (ICHRP), Performance and Legitimacy: National human rights institutions (2nd edn, 2004) 77. 279 M Freeman, Human Rights, An Interdisciplinary Approach (2nd edn, Polity Press 2011) 8. 280 Consultation with Amnesty International on 9 March 2015. 281 APT, Regional Forum in Latin America (2014) 29. 282 APT, Visiting Places of Detention: What role for physicians and other health professionals? (2008) 7. 283 Ibid 7. 277 - 96 -