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Disability & Society, Vol. 10, No. 3, 1995

Individual Planning with Adultswho Have Learning Dif® culties:key issuesÐ key sourcesPETER GREASLEYDepartment of Psychology, University of Leeds, Leeds LS2 9JT, UK

ABSTRACT For many people with learning dif ® culties the quality of individual assessment and

planning can play a crucial role in their personal development. However, for many service

providers, and service users, there is limited knowledge of current approaches and recent

developments in this area of work. This article aims, then, to provide a brief overview of the

key issues and key sources of information in the ® eld of individual planning. A number of issues

relating to the implementation of Individual Programme Plans are discussed. Particular

attention is paid to the development of more recent approaches, such as Personal Futures

Planning, which aim to place greater emphasis on self-advocacy and the involvement of

`non-service providers’ in assessment and planning.

Introduction

In recent years the quality of individual assessment and planning with adults who

have learning dif® culties has become an increasingly important issue. As a recent

Local Authority Circular (Department of Health, 1992) concludes:

Local Authorities should plan to shift away from services based on attend-

ance at the traditional adult training centre towards an approach to day

services based on individual assessment and programmes ¼ The aim

should be to move towards a personally planned program me of day

activitiesÐ social, educational, vocational and leisureÐ which make use of

ordinary community facilities wherever practicable. (para 18)

It would appear, however, that sources of information providing clear guidelines to

approaches in the ® eld of individual assessment and planning are, for many service

providers and service users, somewhat at a premium.

Hence, according to the Social Services Inspectorate (Department of Health,

1989), in a report on a national inspection of day services for people with learning

dif® culties, there is a great deal of ignorance and confusion about the nature of

assessment and planning: `A common ® nding was the failure to understand the ¼

353

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354 P. Greasley

ongoing nature of assessment, and the need for individual plans to generate activity

and review’ (p. iv). And whilst

all agencies were committed to ª assessmentº and most to individual

programme plans [IPPs] ¼ assessment seemed frequently to refer to the

administration of a number of tests and not to a process which would

evaluate the abilities, strengths and weaknesses, and potential areas of

development of clients. Nor was it seen as the base for a plan with both

short and long term goals which would generate activities which would be

subject to review. (p. iv)

Indeed, the Social Services Inspectorate reports that comments such as `units were

confused about the function of assessment and IPPs’ and `some staff did not appear

to appreciate the use of assessment in formulating a structured programme for

clients’ `were not uncommon’ (p. 19).

In the course of my research on the LEAF Project [1], which has involved

liaison with professional workers, carers and people with learning dif® culties, this

general lack of knowledge and, indeed, confusion about the nature of individual

plans has been very apparent. This is not surprising, since the majority of services do

not operate an individual planning system. The Social Services Inspectorate report

found that

seventy-® ve per cent of clients in ATCs [Adult Training Centres] in the

sample [day services, and a small selection of residential units, in a

representative sample of 13 local authorities] had no individual programme

plan recorded in their ® le and [only] 35 per cent in special care units.

(p. 21)

Furthermore, those IPPs which did exist were of `variable quality’ (p. 22). Similarly,

in a survey of Community Mental Handicap Teams throughout Wales, reported in

McGrath (1993), it was found that proposed development of individual planning

systems `was disappointing. Only ® ve teams [out of 37] reported IPs [individual plans]

for a quarter or more clients and about a quarter of teams had done none’ (p. 18).

These ® ndings are consistent with my own research on the LEAF Project: individual

plans were the exception rather than the rule in most service settings and, for the

majority of professionals and carers, there was limited knowledge about individual

planning (i.e. the underlying principles and design, recent literature). If quality

assessment and planning is to be achieved, an awareness of good sources of infor-

mation on the various approaches, techniques, issues and debates in this area of work

is essential. When sources of information were offered by the LEAF project this was

welcomed and gratefully received. This article will, then, provide a brief overview of

the key issues and key sources of information in the ® eld of individual planning.

Individual Program me Plans

The concept of Individual Program me Planning has developed as a method to `assist

people who deliver services to focus on the unique needs of the individual receiving

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Indiv idual Planning 355

those services and to ensure that he or she has a major say in planning his or her life

and determining the help he or she receives’ (Blunden et al., 1987, p. 1). Typically,

the procedure begins with a scheduled planning meeting involving key people in the

person’ s life (arranged by an IPP chairperson). A keyworker then compiles infor-

mation on the individual’ s background, current situation, strengths and needs for

discussion at the meeting. The planning meeting is then held to discuss overall aims

and to produce a written plan of action recording long-term and short-term goals,

the strategies for achieving these goals, and the people responsible for helping the

individual to achieve these goals. The activities speci® ed in the plan are then

implemented and later reviewed at the next planning meeting (often held at

six-monthly intervals). The IPP is promoted as a valuable forum for communication

with all concerned, for making shared decisions about priority needs, and to provide

information for the development of future service requirements. Excellent introduc-

tions and guidelines are provided in Blunden et al. (1987), Jenkins et al. (1988),

Chamberlain (1990), and Guinea (1991).

Having a good working model does not, however, guarantee unquali® ed success

and it is important to learn from the problems experienced by others. Fleming

(1985, 1988), Humphreys & Blunden (1987), and Wright & Moffat (1992) have

investigated the effectiveness of IPPs in a variety of service areas (e.g. hospital,

hostel, Adult Training Centre). Recurring issues of concern which are discussed

include: level of commitment and support from professionals, problems with goal

setting, over-complicated documentation, and inadequate training of staff. Several

other articles reporting on the development of individual planning systems in

particular service settings are also availab le: Throne et al. (1977), Schachter et al.

(1978), Page et al. (1981), Stevens & Yu (1985), Jacobson (1987), Read (1990).

It is important to be aware, however, that a number of criticisms have been

levelled at the traditional IPP system of assessment and planning with an increasing

amount of literature reporting a dissatisfaction with this approach, e.g. Brechin &

Swain (1987), Mount & Zwernick (1988), Smull & Harrison (1992), Simons &

Carter (1993). Sutcliffe & Simons (1993). These include the following issues:

· Goals being set often re¯ ect `service related ’ aims rather than `client-related ’ aims.

Since IPPs are initiated and controlled by service providers they can tend to focus

on issues important to them, prescribing training goals and learning schedules that

correlate and accord with established institutional routines. As O’ Brien & Lovett

(1992) comment:

When uniformity and predictability are primary system values, `individual

program planning’ functions to decrease uncertainty and variety through a

regulated, impersonal (`objective’ ) process of judgement that speci® es

people’ s daily routines in the pre-existing service option that best matches

their disabling condition. The purpose and effect of individual program

planning is to make the system more stable by drawing clear boundaries

between staff and client and by teaching staff and families and people with

disabilities a way to think about people’ s needs that matches the system’ s

routines (p. 4).

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356 P. Greasley

Within such a scenario the formulation of training programmes designed to

remedy educational, behavioural and social `inadequacies’ can tend to take pre-

cedence over more general issues of desired lifestyle (e.g. living arrangements, work

aspirations, leisure pursuits).

· Insuf® cient involvement of client and carers in the assessment and planning

process. Clients and families often feel they have little control over the process.

This can be exacerbated by the unequal power status between service-users and

professionals. As a result, client and carers can become `passive recipients’ of the

service. An investigation by Crocker (1990), for example, concludes that the

STEP individual planning procedure (see Chamberlain, 1990) `emerges as a

rather incomplete recipe for client involvement and one which has the potential to

create an illusion of progress while obscuring some of the dif® culties inherent in

client involvement’ (p. 106). Though Chamberlain (1992) argues that this is more

a re¯ ection of how his package was actually implemented in that service setting:

¼̀ client involvement is a function of the service system in which the person lives,

not a function of any documentation used’ (p. 73).

· Too much emphasis on personal inadequacies relating to educational and social

competencies with too little attention to personal strengths and capabilities. This

often results in what has been referred to as the readiness model (Wilcox &

Bellamy, 1987) whereby the individual is subjected to endless training pro-

grammes in preparation for the `real thing’ (such as work or living in the

community) in the distant future, and is thereby denied the valuable experience of

learning in situ.

`Alternative Approaches’ to Individual Planning

In light of these criticisms directed towards the traditional service-led IPP a number

of other models for assessment and planning have recently emerged. These `alterna-

tive approaches’ place greater emphasis on the principles of self-advocacy (making

choices, self-determination etc.) with a greater role being played by the person with

learning dif® culties in planning their own future. The result is a more user-led,

person-centred approach to assessment and planning.

Hence, in Brechin & Swain’ s (1987) Shared Action Planning (presented as a

`revised approach to Individual Program Planning’ (p. vii)), the individual with

learning dif® culties is encouraged to take a more active role in their assessment and

planning with the emphasis being placed, less on learning particular educational and

social skills , more on making choices, expressing wishes and setting their own

agenda for the future. The power and control of the whole process is placed more

® rmly with the individual along with the support of key people in their lives such as

family, friends and neighbours:

Behind the ideas in Shared Action Planning is a commitment to those

people who usually have least opportunity to develop and express their

views about what should happen next; people such as parents or un-

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Indiv idual Planning 357

quali® ed staff, who may be closely involved but lack the power or infor-

mation to make key decisions; and people with learning dif® culties them-

selves, who may these days be `consulted’ , but lack the time or opportunity

to develop their ideas properly. (1987, p. viii)

Assessment, according to Brechin & Swain (1988), should be viewed as a `continu-

ing process of discussion, shared experiences, observation and negotiation between

the individual, key people, and also others such as professionals, who may be able

to communicate relevant and useful information and suggestions’ (p. 20).

The whole process of assessment and planning, they emphasise, should begin

with individual aims and aspirations and how they relate to opportunities in the

environment, `so that questions of assessment can be as helpful and relevant as

possible’ (1987, p. 21). This is an important point. As Middleton (1994) argues,

assessment should not be a `style exercise to measure the person against some set

standard of achievement, performance or behaviour. If it is to be needs led, it has to

start with individual hopes and aspirations’ (p. 10). A good assessment, she says,

should not collect `data for the sake of it’ (an encyclopaedic checklist on strengths

and weaknesses for example), it should collect only relevant data and talk about

`aspirations, frustrations, lack of resources or disabling environments’ (p. 11).

In Shared Action Planning less importance is placed on the assessment of

individual skills and abilities with greater attention directed towards present circum-

stances and opportunities. There is a

shift away from the emphasis on making people with mental handicap

change Ð from what they can do now, to what they ought to do next. This

is often what tends to come out of Individual Program me Planning. The

emphasis here has been broadened. Maybe other people need to change

their behaviour; maybe other opportunities need to be created. (1987, p.

viii)

As Brechin & Swain point out:

From the individual’ s perspective the problem is not so much the

dif® culties with learning, the struggles to acquire social skills, or the

medical explanations for their problems. The problems they see are the

dif® culties and obstacles people put in their way; the experiences, opportu-

nities (or lack of them), attitudes and conditions of society they have to face

as a result of being labelled `mentally handicapped’ . (1987, p. 84)

This emphasis on self-advocacy, lifestyle issues and the involvement of `non-service

providers’ forms the underlying basis of Personal Futures Planning (O’ Brien, 1987;

Mount & Zwernik, 1988; Mount, 1990; O’ Brien & Lovett, 1992). Personal Futures

Planning aims to promote a `new way of thinking’ by placing emphasis on quality of

life experiences and the importance of `informal’ support from `non-service providers’

(family, friends, co-workers) who can play a key role in supporting the individual’ s

vision of the future.

Quality of life experiences are expressed in terms of what are known as the ® ve

accomplishments (O’ Brien, 1987) derived from the principle of normalisation (O’ Brien

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358 P. Greasley

& Tyne, 1981). The ® ve accomplishments, viewed as essential for achieving an

acceptable quality of life, look at strategies to increase the individual’ s community

presence, choice, competence, respect, and community participation. As Mount & Zwer-

nick (1988) say:

Personal Futures Planning provides strategies to increase the likelihood

that people with disabilities will develop relationships, be part of com-

munity life, increase control over their lives, acquire increasingly positive

roles in community life and develop competencies to help them accomplish

these goals. (p. 3)

These quality of life experiences should be used as guides to the planning activities

and objectives involved in building a vision of the futureÐ rather than special

learning schedules designed to redress particular `de® cits’ of the individual. Indeed,

the process assumes a `ready-now’ model: `The objective of planning, service, and

support is to provide good, day-to-day experiences now. It is unnecessary and

undesirable to discount the present with activities whose sole rationale is to get a

person `ready’ for desirable experiences at some distant date’ (O’Brien, 1987, p.

176).

Thus, we have a paradigmatic shift of perspective, where the focus turns from

changing the individual to changing the environment. Instead of asking how the

individual can be prepared (`made ready’ ) for living and working in the community,

we might ask how the community can be prepared for the individual (organising

social supports etc.). Personal Futures Planning (like Shared Action Planning) aims

to promote a climate of `mutual adaptation’ where:

¼ services change to create new supports for the person and then the

person responds to the demands and the rewards of the new situation. This

sequence contradicts the tradition that people with disabilities must change

themselves as a condition of entry to new opportunities: environments

effect change more powerfully than training can. (O’Brien & Lovett, 1992 ,

p. 3)

With these underlying values the approach places great emphasis on discovering

capacities: `Personal Futures Planning emphasizes the capacities or talents of an

individual. Uncovering these qualities begins in the ® rst step of the planning process

with the creation of a personal pro ® le’ (Mount & Zwernik, 1988, p. 9). It is

surprising how easy it is to fall into the habit of producing a personal pro ® le which

concentrates on `inadequacies’ , describing the person from the perspective of

objective assessments of abilities (or rather disabilities) and ending up with a list of

things the person has dif® culty performing, personal problems and past failingsÐ in

Mount & Zwernik’ s terms a `de® ciency description’ . For some excellent examples

contrasting the two approaches see Brost & Johnson (1982), Mount & Zwernik

(1988), O’ Brien & Mount (1991), Booth & Booth (1993) and, with particular

reference to seeking employment, McLoughlin et al. (1987), Callahan & Nisbet

(1992).

Building a `circle of support’ is viewed as `critical to the successful implemen-

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Indiv idual Planning 359

tation of a futures plan’ (Mount & Zwernik, 1988, p. 27). A `circle of support’ is a

group of people who meet on a regular basis to provide help and support in

accomplishing visions and goals. The emphasis is on `non-service providers’ Ð

friends, family, co-workers, neighbours (people outside the system who are not paid

to be there but are involved because they care) who can help in `building bridges’

to everyday community life (e.g. ® nd jobs, join associations). Such people, being

`outside the system’ , can also act as valuable advocates, helping to overcome various

`system barriers’ such as agency practices which can stand in the way of the

individual achieving a particular dream or vision for the future (Beeman et al.,

1989).

Unfortunately, there is little empirical evidence availab le which records the

relative outcomes of these approaches. However, Mount (1987) conducted a study

comparing the outcomes for six people using Personal Futures Planning with those

for six `control’ participants using Individual Programme Planning. In follow-up

surveys conducted a year later it was found that, whereas the IPP process produced

no signi® cant changes in lifestyle, the PFP process produced `many positive changes’

for the individuals. Though, as Mallette et al. (1992) comment, `it was unclear,

however, the extent to which these changes could be directly attributed to the PFP

process per se’ (p. 180). Clearly, the value of assessment and planning processes

should be subject to evaluation of outcomes. In this respect, it is interesting to cite

a planning model referred to as the Lifestyle Development Process (Mallette et al.,

1992) which `incorporates the values and many of the procedures’ of Personal

Futures Planning, and includes `outcome measures to evaluate changes in the target

individual’ s social and activity patterns and to evaluate intervention effectiveness’ (p.

180).

The principles of self-advocacy and consumer empowerment are at the fore-

front of literature produced by the Governor’ s Planning Council on Developmental

Disabilities, Minnesota (1987, 1993). In particular, Read My Lips: it’ s my choice ¼

(Allen, 1989) provides a `resource guide’ for assessment and planning which is

written and designed with service users in mind (people with learning dif® culties

who can read or advocates for those who cannot read). The guide, which is

presented as `a tool for expanding freedom of choice for consumers’ , provides a

number of ideas for developing consumer-oriented needs assessments, consumer-based

service plans, and methods of consumer based evaluation. For example, there is an

Individual Programme Planning Guide which has been designed to help people with

learning dif® culties `become more involved in writing their own service plans’ , and

an Individual Supported Employment Guide designed to help people with learning

dif® culties and their advocates or parents `become more involved in writing their

own supported employment plan’ [2].

A few words of caution for anyone contemplating introducing these `user-led’

models of individual planning. A method of individual planning which promotes

self-advocacy and, moreover, a general shift in power and control over the assess-

ment and planning process from service providers to service users may, inevitably,

meet with some resistance from professionals. This may be perceived as a challenge

not only to professional expertise and control but also to institutional practice.

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360 P. Greasley

Perhaps a more important issue than matters of procedure (i.e. which particular

planning model you use) is the need to change attitudes and expectationsÐ of

staff, parents and individuals with learning dif® culties themselves. Promoting self-

advocacy and independence can be an unsettling experience for all concernedÐ

especially parents:

`For 20 years my son has come home and gone upstairs to play his tapes.

Yesterday he came back and said he wanted to go to the pub!’ (Irate parent

quoted by day centre manager) (Sutcliffe & Simons, 1993, p. 92)

Advocates of user-centred planning may have to contend with understandable

resistance from staff and parents who, having established a safe and predictable

pattern of life for their `charges’ , do not want the existing status quo being

threatened by, what may be regarded as, new `trendy’ ideas. Whilst such anxiety and

resistance to change is understandable, the alternative inertia can be hard to accept:

in response to an attempt by the LEAF project to recruit suitable candidates from

one day centre to go through an assessment and planning process akin to Shared

Action Planning and Personal Futures Planning we were met with suspicion and

scepticism. One parent refused point blank for her son to be involved: `my son’ s been

assessedÐ 10 years ago’ . Clearly, strategies of persuasion portraying the ef® cacy of

such methods are a necessary prerequisite to their introduction (for example,

showing images of what can be achieved with the right techniques, support and

expectationsÐ especially in the ® eld of employment for people with severe learning

dif® culties).

Loosening the reins will always be a dif® cult step, as it is with most caring,

protective `parent± child ’ relationships. But the importance of promoting self-advo-

cacy cannot be over-emphasised. Many people with learning dif® culties are used to

having things done for them, thereby creating and reinforcing a dependent and

passive role in the services that they receive (cf. Barton, 1989). It is not only the case

that if you `act like a child you will be treated like a child’ , it can also be the case

that if you are `treated like a child you will act like a child’ . Similarly, if our

expectations are low then our achievements will be few.

Conclusion

It has been the aim of this article to provide the reader with a brief guide to the

available literature along with discussion of some of the key issues raised in the

design and implementation of individual assessment and planning procedures for

people with learning dif® culties. Whether you agree with the idea of individual

`life-plans’ or not, for many people with learning dif® culties (and indeed for anyone)

they can provide a useful framework for facilitating discussions about present and

future needs, skills and opportunities, and personal interests and wishes. The extent

to which this is achieved will depend on the quality of the design and the values

underlying the approach to individual planning. It is for this reason that profession-

als, and service users, should be aware of the various materials which are now

available to guide them in this area of work.

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Indiv idual Planning 361

Acknowledgements

I am especially grateful to Wendy Calvert for her constructive comments on this

artic le. I would also like to thank Malcolm Davies (Hesley Foundation Manager),

Jill Osborne and Frank Carter, along with all other colleagues who have been

involved with the LEAF Project.

NOTES

[1] The LEAF Project, funded jointly by the Barnsley and Doncaster Training and Enterprise

Council and the European Social Fund, at the Hesley Foundation (Registered Charity No.

1001742), Hesley Hall, Tickhill, Doncaster DN11 9HH. The purpose of the project is to

produce an individual assessment and planning guide for unemployed adults with learning

dif® culties.

[2] Our own research at the LEAF Project has attempted to take this format a stage further in

a `user-friendly’ assessment and planning document which is designed for the user as their

property. The document, which is called MY WAY to emphasise the user’ s perspective in

assessment and planning, incorporates many of the values, ideas and formats found in IPPs,

Shared Action Planning, Personal Futures Planning, and Vocational Pro® ling. It has been

designed so that the information contained therein may be transformed into a personal CV

to be presented to employers, employment agencies or training agencies (or any other

interested parties to whom this information would be useful). M Y WAY is currently being

piloted by the Hesley Foundation.

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ALLEN , T. (1989) Read My Lips: it’ s my choice (St Paul, MN, Governor’ s Planning Council on

Developmental Disabilities).

BARTON, L. (Ed.) (1989) Disability and Dependency (London, Falmer Press).

BEEM AN, P., DUCHARME, G. & MOUNT, B. (1989) One Candle Power: building bridges into com-

munity life for people with disabilities (Manchester, CT, Communitas Communications).

BLUNDEN R., EVANS, G. & HUM PHREYS, S. (1987) Planning with Individuals: an outline guide

(Cardiff, The Mental Handicap in Wales, Applied Research Unit, St David’s Hospital).

BOOTH, W. & BOOTH, T. (1993) Accentuate the positive: a personal pro® le of a parent with

learning dif® culties, Disability, Handicap and Society , 8, pp. 377± 392.

BRECHIN, A. & SWAIN, J. (1987) Changing Relationships: Shared Action Planning with people with a

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BRECHIN, A. & SWAIN, J. (1988) A share of the action for consumers, Community Living,

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BROST, M. & JOHNSON, T. (1982) Getting To Know You: one approach to service assessment and

planning for individuals with disabilities (Wisconsin Coalition for Advocacy, distributed in

Britain by CMHERA).

CALLAHAN, M. & NISBET, J. (1992) The Vocational Pro® le Strategy: an approach to individualized

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73± 74.

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