So, you want to be person centered. That’s good! It means that, like most contemporary organizations that serve those in need, you are familiar with the terminology regarding this standard of excellence in the field and you are motivated to explore what it means. But what is it all about, anyway, and how is it different from what we’ve always done? Because, let’s face it, who hasn’t committed themselves to this field without a heartfelt belief that they want to make a positive difference in the lives that they touch? Isn’t everyone “person centered” then? Why don’t we start with what it isn’t:
- It isn’t a variation on “the customer is always right”. – This standard customer service mantra is worthy, but conducting supports for a person in a manner that adheres to person centered thinking is not simply another version of superior customer service. It’s much, much more.
- It isn’t “individualized” care plans. – Whether a nursing care plan, an individual education plan or an individual rehabilitation plan, everyone uses some system for bringing assessments of need down to some form of action planning that is specific to each person. It’s been a best practice for decades and in many cases is required by funders. However this doesn’t mean that the broader system around which service are provided has a culture that is person centered or that the path is cleared of obstacles for those who want to work to insure that the day-to-day experience of the person receiving services is personalized.
- It isn’t an approach where the person always gets what they want. – There are restrictions on available resources in any system and the process of service delivery is always an effort around negotiation. Depicting person centered designs in this way risks the perception that it is an idealized or unrealistic way of thinking or, perhaps worse, not affordable.
- It isn’t only person centered planning. – Organizations that have embarked on the journey to bring person centered thinking across all aspects of their work have determined that good planning alone is not enough. It is an important component but if a great plan is put into storage and the old dynamics remain when staff return to their assignments that frustrate or draw them away from their best intentions to be person centered then very little progress is made. In fact, from the perspective of the person receiving support it can be a devastating experience. Person centered planning encourages levels of self-disclosure and honesty from the person that is served as well as promises on the part of support staff. If the total organization is not in alignment with person centered thinking then the planning process could simply contribute to cynical discontent and withdrawal on the part of employees and the person who is supposed to be benefiting from the support system. More damage than good could result.
There are a core set of strategies and skills that make up what has come to be known as “person-centered thinking”. They have emerged over the past couple of decades as approaches that can be taught to and adopted by organizations that are committed to engaging with those that they serve in a manner that is dynamic, evolves over time and results in less of a transaction of service “delivery” and more as one that involves transformative engagement that leads to an experience by the person of being able to lead their lives free to make positive choices that result in meaning and fulfillment. It is dynamic because it includes a fundamental shift in the accepted power relationships with the person being served. Too often, the common practices of service “deliver” slip into concerns around compliance and control. On the other hand, if the way you engage the person you want to assist is structured in ways that validate their rights for power and control, then you can achieve a shift to “power with” the person and protect against devolving into the more common characteristic of professional service that assumes “power over” the person being supported. Person centered approaches evolve over time because the person evolves over time and so does the personnel and general environment within which the organization functions. For this reason, your commitment to being person centered must be long-term in nature and your discipline in being self-aware and willing to change must not falter.
We can use a thought experiment to get a better handle on person centered thinking. One way that we can frame what we mean by person centered approaches is to think of it as “personalization”. In the United Kingdom that is a common term used to describe the approach. Imagine that your job is to design an event or a journey for someone else that is personalized – let’s say a vacation, a wedding, a college search or even a career plan. What would be the very first thing that you would do and what would be the thing that you would return to so that your results will truly be personalized to your client? The answer, of course, is that you would ask questions; you would engage in an inquiry. If you Google “vacation planning” or “wedding planning” you’ll come up with descriptions of an inquiry that starts out very broad and goes very deep. What is important to you? What have you always dreamed of? What would you like to avoid? What do people say are your best qualities? What would you like to be known for? Are there any special accommodations needed? What have you found to be the best way to support you in these accommodations? Describe an experience where you felt most at peace or truly fulfilled; what were the main features of that experience? Have you had experiences where someone tried to help and it didn’t work out and you’d like to avoid that in the future? What things are “must haves”? What things are “like to haves”? These questions would be asked repeatedly before, during and after the engagement. Someone who is a professional planner – for weddings, for careers maps, for vacations – learns very early on that their success depends upon their adoption of the position of a student with their clientele being their teacher. And as with any good student, they meticulously take notes and organize them in a way that is useful for their work later on. These are also some of the main features of the person centered thinking strategies that an introductory workshop will teach participants.
Let’s look at some areas of your organization and see if they can be opened up to new person centered approaches.
- Personal Values – Your organization seeks to have current and thorough clinical assessments of the people that you support. You are careful to insure that you are aware of the unique health care priorities for the person and that the places that the person travels are safe. You also make sure that there are good opportunities for socializing and making connections with other people. You do this because you know that a quality program insures that the things that are important FOR a person are addressed. You also do all of these things because they are imbedded into certification and licensure requirements. How familiar are you with what is uniquely important TO the person that you serve? Do you have a variety of sources and ways to find this out? If you learn it, how often and how well do you document it and make sure that every new care person in their life is aware of it…before they are assigned responsibility for care? Do you have systems in place to figure out how what is important to a person is put into balance with what is important for them?
- Discovery And Listening To The Person That You Support – You have a daily schedule established for the person that you serve. This is another thing that is often required by regulation. Before the schedule was created did you know what contributes to a good day for that person? How about a bad day? Is this knowledge systematically shared with each person who is responsible for the daily schedule? Are schedules arranged to promote “good day” experiences? Do you know the unique routines and unique rituals that bring comfort to the person or that are a part of their heritage or family traditions? Is it shared? And what is shared with others when this person is first introduced? Is it what everyone likes and admires about them or is it their reputation, risk factors and the list of what is important for them? Are you having your staff collect daily information that is studied later for indicators of the unique communication style of the person and then used to create a collective description that is shared with everyone?
- Everyday Learning – You hold department and team meetings and a regular part of the agenda is dedicated to addressing the challenges that some of the people that you serve are experiencing and thus challenging the capacities of the staff. Do you have standing practices or tools at hand that look at what is working or not working from multiple perspectives? Do those practices insure that everyone’s voice is heard? You have staff record information each day about their experiences. Is it designed in a way that is rich in information so that it can be used as a resource later on for learning about the person’s best support strategies, what is important to them, what brings them comfort or what works or doesn’t work as a support strategy?
- Management and Supervision – You hire direct support professionals that end up spending the most time with the people that your organization serves. You make sure that they meet the basic qualifications for the job. Are their backgrounds, interests and style matched with what you know about the person that is being served? Are they clear about what is their core responsibilities, what is not their responsibility and, also, the areas where they can explore and try creative approaches in their work? Do these knowledgable staff get invited into service planning as a matter of policy?
A basic two-day workshop in Person Centered Thinking offers practical skills and tools that address all of these areas. The skills have been refined across many types of organizations serving many different people; older persons, people with behavioral health challenges and people who have intellectual disabilities, to name a few. They are in practice across the globe and a regular process of continuously refining their structure and application remains in place. In fact, if your organization becomes part of the worldwide network of organizations that bring person centered thinking into their core practice then you will be invited into this learning and refinement process. The goal of the workshop is to expose the participants to the basic skills and give everyone sufficient practice and comfort with the approaches so that they can describe them to colleagues and explore ways of putting them into place in their daily work. Some of the skills can be applied immediately without permission. Others will require approval and adoption by a supervisor. Still others may not be fully applied without changes in policy. This is where a commitment from the top leadership of an organization is essential. So, if you want to be person centered, bring this training into your organization and have people at all levels learn the basic skills, put systems into place to practice and build competencies and, finally, commit your organization to making these practices a matter of habit that will translate into full, respectful and meaningful lives to those that you support.
Two-day workshops are available through Bridges – Professional Development Center for Person Centered Values