individualized support for peer support workers april 24, 2012
DESCRIPTION
Peer Support Worker presentation on Individualized Supports April 24 2012TRANSCRIPT
Hope Leet Dittmeier
Realizations
1024 Garden Creek Circle
Louisville, KY 40223
502-356-3874 (US); 087-116-1563 (IRE)
“Individualised Supports” Terminology Trickery!
oAre there distinctions between “Individualised,” and “Person Centred” and “Customised”?
oTerms often used interchangeably but are typically intended to signify high QUALITY.
oCalling the work “individualised” doesn’t necessarily make it so!
oWe can do harm even when using individualised approaches.
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Terminology Trickery!
oAn individualised plan does not necessarily make for individualised work.
oOnce individualised, not always individualised!
oIndividualised is used to describe both a methodology or way of doing the work and a set of beliefs about what constitutes good work.
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What Constitutes Good Work?
Discovering and appreciating people’s unique identity
oPeople have distinctive personalities, interests, gifts, experiences, backgrounds, etc.
oWe can not presume to know a person or understand their desires or needs by their labels, test scores, or history
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Understanding and portraying people in a positive light
oIndividualised work involves identifying people’s gifts and finding ways to illuminate them so that people become known in a positive way
oThe images we convey about people in the words we use, the visual images we share, the activities we engage in all portray strong messages about people to others
What Constitutes Good Work?
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Supporting people to find and use their personal power to direct their own lives
oPeople have the right to determine their own destiny
oPeople have the right to make mistakes
oPeople often need assistance to make productive decisions. We need to support people by:
Offering necessary information for people to make “informed” decisions
Teaching decision-making strategies
What Constitutes Good Work?
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Efforts that build relationships and community
oRelationships are everyone’s best protection and safeguard
oPaid relationships do not supplant “natural” ones
oRelationships with typical community members offer benefits that usually don’t occur as a result of relationships with other people seen as needy by society
What Constitutes Good Work?
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Meaningful relationships
oPeople can be good friends, neighbors, lovers, etc.
oMost of us have a great deal of personal knowledge about how to grow relationships
oIt is perhaps the most critical part of our work to facilitate relationships
What Constitutes Good Work?
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Promoting “typical” approaches, methods and life experiences
oCreating or utilising specialised places or programmes is incompatible with individualised work
oGrouping people based on their diagnosis is incompatible withindividualised work
oAsk the question, “Where and how would valued people . . .?”
What Constitutes Good Work?
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People are ready – just as they are – for community life
oSeverity of disability does not dictate the kind of lifestyle people can live
oAvailability of responsive supports does dictate the kind oflifestyle people can live
oIf we do our work well, virtually everyone can live in their ownhome in the community and can work
What Constitutes Good Work?
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Recognizing and addressing the impact of DEVALUATION
oDevaluation occurs when a person or group is PERCEIVED as different in a way that society values negatively, “deviant”
oDevaluation is a harsh reality in the lives of people with mental health diagnoses!
oMany individuals and groups are devalued: older people, overweight people, people from a different race or culture, poor people, people who have physical impairments, etc.
What Constitutes Good Work?
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Recognizing and addressing the impact of DEVALUATION
oMuch of devaluation is unconscious!
oEven people who are nice, intelligent, well-meaning and hard-working (including those working in human services) devalue others.
oThis results in people being treated in ways that would not be considered acceptable for valued citizens: abuse, neglect, and brutalization.
What Constitutes Good Work?
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Common Life Experiences of People with Disabilities
DISABILITY BECOMES LIFE DEFINING
– The disability becomes the focus of what people know and understand about a person – as if that is all that matters
– Decisions are erroneously made based on one narrow dimension of who a person is
Common Life Experiences of People with Disabilities
SEPARATED
– Distanced from valued society both physically and socially (institutions, special education, etc)
– Congregated with other people who are devalued
Common Life Experiences of People with Disabilities
DEPRIVED OF TYPICAL EXPERIENCES
– Lack of opportunities to learn ordinary things the way others would
– Exposed to non-typical circumstances, sometimes learning unusual habits
Common Life Experiences of People with Disabilities
CAST INTO HURTFUL NEGATIVE ROLES
– Object of pity– Menace – Patient– Burden– Client
Common Life Experiences of People with Disabilities
LONELY
– Fewer freely-given friendships– Disproportionate number of associations
with other labeled people– Sometimes stressed or absent family
relationships
Common Life Experiences of People with Disabilities
LOW EXPECTATIONS
People have very limited imaginations about what is possible
– What people can do– The roles people can play– The lifestyle that people can enjoy
Low expectations become self-fulfilling
Addressing Devaluation
o Making certain we don’t do anything to confirm or perpetuate the negative roles which have been cast upon people
o Minimising or disproving the negative roles which have been cast upon people
o Helping people maintain their valued roles or obtain new roles that fit who they are and that are highly regarded by other citizens
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It’s about ROLES
o A role is a noun, a title, something we are
o Helping people BE or BECOME what they can BE!
o Focus on roles instead of:
o Physical Presenceo Fixing peopleo Activitieso Care-givingo Protection
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Implementing this way of working
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The process of individualised work
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Getting to know the person
o Assessments with comparative scores
o Diagnoses and labels
o A thorough description of what a person CAN’T do
o Performance on one’s worst day!
oSpending time with people and those who know them well
oThe essence of who the person is
oAppreciation of what a person CAN do
oWhat’s possible with good support!
Deficiency-based focus Capacity-based focus
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oSpending time together – asking, observing, appreciating, challenging, wondering
oLearning from others who know and care about the person
oDiscovering potential not previously known or recognised
oUnderstanding the essence of who the person is
Getting to know the person
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Interpreting the facts
oThe person’s history and how it impacts them
oNumber & nature of current relationships, including voids
oCurrent devalued roles, including ways they are perpetuated
oPrevious and current valued roles, including desired/potential roles
oTalents and interests, especially those un-noticed
oSpecific vulnerabilities
oSuccess, especially what contributes to success
Getting to know the person
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The process of individualised work
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Determining what is desired
Not a simple question with readily available answers!
oAbsence of opportunity to know and understand the options
oThe low expectations the person and others hold
oThe courage to give voice to one’s dreams
oFear of failure
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oNot limited to what we are prepared to do, are already doing, or even know how to do
o“Sensibly unrealistic” ~ remembering that people’s potential is not typically evident
oLooking beyond the literal for the appetite behind people’s goals
oNo two will be the same
Determining what is desired
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Determining what is desired
Balancing Wants and Needs
o What is important to the person? What is their own vision for their life?
o What is important for the person?
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“What will have the most impact on improving the quality of the person’s life?
oWhat we know how to do well; our expertise
oWhat we are prepared to do quickly or easily
oWhat meets the needs of the provider
oWhat is more pleasant to address
Most pressing needs “Distractions”
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Determining what is desired
Visualizing the Person’s Desired Lifestyle!
oHome
oWork or contribution
oCommunity roles
oMeaningful relationships
oNew things to learn
Determining what is desired
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The process of individualised work
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Creating what is desiredA new role for most of us!
oImagination and creativity ~ “What will it take for . . . to happen?”
oCustom design ~ “Starting from scratch”
oNetworking ~ “Who would know/have . . .”
oResourcefulness ~ “Where would we find . . .”
oKnowledge of formal resources and how to access them ~ challenging the system
oDetermination
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Housing
oOf the person’s choosing
oFitting for the person
oIn typical home setting
oIn valued location
oAlone or with people chosen
oUnaffiliated with human service
oIn the person’s name, perhaps earning equity
oWho controls the front door? Who has keys?
Creating what is desired
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KEITH36 year old man
Unhappy/unsuccessful experience in group home and sheltered employment
Planning started in Oct 2006; moved six months later to own home March 2007
Keith’s Home
Autonomy from momPrivate DowntownAffordableWithin rolling of sports and music venuesGated, safeSmall, intimate developmentMasculine decorAccessible bathroomClean, neat, newView from indoorsFront-loading washer and dryer
The Benefits of Having A Home of One’s Own!
Control over the front door
Social status
Permanence
Relationships
Hospitality
Greater independence
Customized
Reflects personality and identity
First – what is family able to do, want to do, do well (that the person being supported find acceptable)?
Second – who else in the person’s social network might be interested in assisting the person in specific ways?
Third – what generic options for support are available in the community?
Fourth – what blanks do we fill with paid supports?
Creating what is desired
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OUR WORK INVOLVES THE ADDRESS OF . . .
IMAGE ENHANCEMENT
COMPETENCY ENHANCEMENT
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Images are conveyed by:
Appearances (clothes, accessories, hair, etc)
Activity (work, volunteer, movie, class, etc)
Language (describing someone by who they are as a person, not by their disability)
The people around you (settings, community, DSP’s, etc)
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Commitment
“Commitment is what transforms a promise into reality.
It is the words that speak boldly of your intentions.
And the actions which speak louder than the words.
It is making the time when there is none.
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Commitment
Coming through time after time after time, year after year after year.
Commitment is the stuff character is made of.
The power to change the face of things.
It is the daily triumph of integrity over skepticism.”
unknown author