Individualized Support for Peer Support Workers April 24, 2012

Hope Leet Dittmeier

Realizations

1024 Garden Creek Circle

Louisville, KY 40223

502-356-3874 (US); 087-116-1563 (IRE)

[email protected]

“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.

November 2011Presentation from Hope Leet Dittmeier 2

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.


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


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



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



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



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



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 . . .?”



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



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.



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.



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


SEPARATED

– Distanced from valued society both physically and socially (institutions, special education, etc)

– Congregated with other people who are devalued


DEPRIVED OF TYPICAL EXPERIENCES

– Lack of opportunities to learn ordinary things the way others would

– Exposed to non-typical circumstances, sometimes learning unusual habits


CAST INTO HURTFUL NEGATIVE ROLES

– Object of pity– Menace – Patient– Burden– Client


LONELY

– Fewer freely-given friendships– Disproportionate number of associations

with other labeled people– Sometimes stressed or absent family

relationships


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


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


Implementing this way of working

November 2011 21Presentation from Hope Leet Dittmeier

The process of individualised work


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


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



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





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


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




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?


“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”



Visualizing the Person’s Desired Lifestyle!

oHome

oWork or contribution

oCommunity roles

oMeaningful relationships

oNew things to learn





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


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


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


OUR WORK INVOLVES THE ADDRESS OF . . .

IMAGE ENHANCEMENT

COMPETENCY ENHANCEMENT


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

Education

Individualized Support for Peer Support Workers April 24, 2012