Evolution of the Person-Centred Revolution

Keenan Wellar, MALiveWorkPlay.ca

@socialkeenan

@liveworkplay

Presented to theHSA Canada LearningCommunity forPerson-Centred PracticesAnnual GatheringApril 21, 2016Richmond Hill, Ontario

The original presentationincluded animations andother formatting that hasbeen removed for sharingpurposes. Notes that werenot visible to the audienceare shown here as slides.

Everyone is just a little flocking freakedout by this wireless revolution!

EVOLUTION

REVOLUTION

Is person-centred practice an example of evolution or revolution? For those who don’t feel like thinking that hard right now, if you can guess what the birds are saying you will win a free copy of my book. Congratulations! Now that you’ve had a few seconds to think about it, how many of you think person-centred practice is an example of evolution? OK, and how many for revolution? Interesting, thank you!

At my person-centredplanning meeting I toldthe agency how muchI enjoy defying gravity.They put me on a behaviour planand told my parents I need todevelop more realistic dreams.

If you are wondering why I would ask such a question, it comes from the realization that the conversation these two bovines are having is not udderly far-fetched from what people with intellectual disabilities, mental health issues, and many others are experiencing in our human services systems. I recently attended a regional meeting hosted by the Ministry of Community and Social Services which featured two presentations by Community Living associations in Algoma and Parry Sound. In both cases they had decided to close their sheltered workshops, and in 1 or 2 years both organizations had completed quite dramatic transitions to assets-based, person-centred, community-based supports. While each agency obviously evolved towards making this change, the resulting difference in the lives of the people they are supporting is most certainly revolutionary. I’ll return to this thought and explain why I think it’s important. But first, another opportunity to win a book.

EXCLUSION SEGREGATION

INCLUSIONINTEGRATION

Who would like to take a shot at labelling each of these boxes? Well done! Here’s your book.For those of you familiar with what is known as Developmental Services here in Ontario – which is our supports and services for people with intellectual disabilities – taking into account the cumulative work of the sector, thinking about where supported individuals live, and thinking about where they spend their time, in which box do you think the majority of our outcomes reside?[Note: the audience was about 40% segregation 40% integration with a smattering of votes for exclusion and inclusion and the rest chose not to answer]It seems we are not doing very well! Don’t worry, I have the answer on the next slide.

How should services be judged? The extent to which a given service delivers the result whereby supported individuals are:

• Sharing ordinary places with others in the community• Making authentic life choices• Developing their abilities• Being treated with respect• Having valued social roles• Growing in relationships

A version of this “Framework for Accomplishment” first appears in 1987 as a result of the work of Nirje, Wolfensburger, O’Brien(s)…and can be seen in the many refinements that follow, including the work of Pearpoint, Forest, Snow, Mount, McKnight…Sanderson

Is this a NEW idea?A potential modernization grant proposal?

Given our outcomes are still falling far short of an inclusive result, perhaps we need some guidelines of how we can do better! So here’s a suggestion of how we might speed up the evolution of service delivery in the pursuit of radically improved lives. What if these six bullets were our guideline? I see some of you with knowing smiles, yes, I’m busted, this Framework of Accomplishment has been around for just short of 30 years!

THEN (2010) NOW

The way systems respond to a person with labels like those attached to Royce is almost always reactive in nature: an increasingly restrictive approach that medicalizes unmet human needs as “behaviors.”

This approach tends to feed itself by INCREASING the likelihood and intensity of challenging behaviors.The making of a community monster instead of the making of a valued community MEMBER.

Royce is now 23 and wants to live on his own, says his father, Ralph.

But the family has been told he needs constant care, and that there are no resources available to meet his needs.

Home of his ownfor 5 years!

Working as aninventory specialistat Dow Honda for 3 years!

From front page (bad) news to a home of his own, a job, and a full life.

Easy? No. Overnight success? No. But what a result. And it all started by asking questions, listening, building trust, and ultimately earning the trust that is necessary to support anyone in the very intimate work of helping them pursue their own goals and follow their own dreams.

So what’s taking so long? Why are people like Royce still being put in cages instead of being listened to and supported?I was rather amused at a recent presentation on supported employment when it was suggested that perhaps more research would be required before we could move forward with ending site-based segregated programs. I was pleasantly surprised to find that I was not alone in the involuntary response of “NO MORE RESEARCH, GET ON WITH IT!”No offense to the consultants and researchers who keep getting contracts to do reports on why we need a person-centre approach, but let’s face it, even they are getting bored with past-facing studies. Let’s help enrich their lives by insisting on future-focused research that illustrates the incredible results of person-centred practices!

EXCLUSION SEGREGATION

INCLUSION

NOT VALUED NOT TOLERATED

TOLERATED VALUEDINTEGRATION

We do need to get on with it, and while I also recognize that we need to do so within a culture of learning and sharing, we also need to bear in mind that the delaying and stalling and ducking and dodging has a real human cost for supported individuals who are awaiting their personal revolution. We need to be clear that anything less than being included and valued isn’t good enough.I’m not speaking of this from on high. I am speaking of this having been a proprietor of segregated and integrated environments for many years. It seems like a lifetime ago that a colleague with the audacity to speak the truth about segregation changed my life, changed our organization, and in turn changed our impact on the lives of everyone we were supporting and everyone we have supported since.I am sure many of us here have had our a-ha moments thanks to the courage of others, and the only way to pay that forward is to arm ourselves with success stories and champion the benefits to anyone who will listen – and even if they won’t listen, tell them anyway. They might still hear you.

What does revolutionary change look like? Sometimes it looks like a buffet dinner!

Before I turn things over to the panel, I’ll close with a final brief story. At LiveWorkPlay we’ve recently taken the opportunity to work with some individuals who have taken the worst of what our systems have to offer, with a result of outcomes like hospitalization, criminalization, and generalized dehumanization. Such individuals are in need of the revolutionary change that only person-centred thinking can provide. Let me acknowledge that just because person-centred practice is the right thing to do, it is definitely not the easy thing to do. It’s at times exhausting, at times frightening, and often frightening and exhausting all at the same time. But the upside is endlessly encouraging and exhilarating for all concerned.With the exception of time with her family members or in clinical settings, Mary had not been out in the community for many months. After what must for her have seemed like decades of waiting, we started supporting Mary to move to a home of her own and re-engage with the community.This is no evolutionary process. Despite endless planning, it’s still radically messy as compared to a traditional medicalized approach. Of course it’s at times overwhelming for Mary too, as a person-centred approach represents endless possibilities for a revolutionary shift in her quality of life. Sometimes a journey of 1000 kilometres begins with a single step…into a Chinese buffet restaurant. This was Mary’s choice. This was how her journey would begin.With some nervous moments for Mary, and probably many more nervous moments for her life coach, earlier this month she did indeed enjoy her time at the buffet restaurant, where, of her own will, she pursued a careful plan of dietary pursuits, perhaps one of the first Chinese buffet enthusiasts in the history of Chinese buffet enthusiasts to plan for a balanced meal. As she began to relax and enjoy the experience, Mary decided to celebrate her success with a fortune cookie.

For my final book giveaway, I’ll take the first close guess as to Mary’s fortune.Thank you, and please enjoy these inspiring revolutionary panelists. Truly, the best is yet to come!

Let’s keep the conversation going.

You don’t need my business card, Google me: Keenan Wellar