Peer Support Worker presentation on Individualized Supports April 24 2012

1. Hope Leet Dittmeier
Realizations
1024 Garden Creek Circle
Louisville, KY 40223
502-356-3874 (US); 087-116-1563 (IRE)
hope@realizationsllc.com

2. Presentation from Hope Leet Dittmeier November 2011 2
“Individualised Supports”
Terminology Trickery!
Are there distinctions between “Individualised,” and “Person
Centred” and “Customised”?
Terms often used interchangeably but are typically intended to
signify high QUALITY.
Calling the work “individualised” doesn’t necessarily make it so!
We can do harm even when using individualised approaches.

3. Presentation from Hope Leet Dittmeier November 2011 3
Terminology Trickery!
An individualised plan does not necessarily make for
individualised work.
Once individualised, not always individualised!
Individualised is used to describe both a methodology or way of
doing the work and a set of beliefs about what constitutes good
work.

4. Presentation from Hope Leet Dittmeier November 2011 4
What Constitutes Good Work?
Discovering and appreciating people’s unique identity
People have distinctive personalities, interests, gifts,
experiences, backgrounds, etc.
We can not presume to know a person or understand their
desires or needs by their labels, test scores, or history

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What Constitutes Good Work?
Understanding and portraying people in a positive light
Individualised work involves identifying people’s gifts and finding
ways to illuminate them so that people become known in a positive way
The 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

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What Constitutes Good Work?
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

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What Constitutes Good Work?
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

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What Constitutes Good Work?
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

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What Constitutes Good Work?
Promoting “typical” approaches, methods and life
experiences
Creating or utilising specialised places or programmes is
incompatible with individualised work
Grouping people based on their diagnosis is incompatible with
individualised work
Ask the question, “Where and how would valued people . . .?”

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What Constitutes Good Work?
People are ready – just as they are – for community life
Severity of disability does not dictate the kind of lifestyle
people can live
Availability of responsive supports does dictate the kind of
lifestyle people can live
If we do our work well, virtually everyone can live in their own
home in the community and can work

11. Presentation from Hope Leet Dittmeier November 2011 11
What Constitutes Good Work?
Recognizing and addressing the impact of DEVALUATION
Devaluation occurs when a person or group is PERCEIVED
as different in a way that society values negatively, “deviant”
Devaluation is a harsh reality in the lives of people with
mental health diagnoses!
Many individuals and groups are devalued: older people,
overweight people, people from a different race or culture, poor
people, people who have physical impairments, etc.

12. Presentation from Hope Leet Dittmeier November 2011 12
What Constitutes Good Work?
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.

13. 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

14. 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

15. 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

16. Common Life Experiences of
People with Disabilities
CAST INTO HURTFUL NEGATIVE ROLES
– Object of pity
– Menace
– Patient
– Burden
– Client

17. 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

18. 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

19. Presentation from Hope Leet Dittmeier November 2011 19
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

20. Presentation from Hope Leet Dittmeier November 2011 20
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 Presence
o Fixing people
o Activities
o Care-giving
o 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
Deficiency-based focus Capacity-based focus
o Assessments with oSpending time with people
comparative scores and those who know them
o Diagnoses and labels well
o oThe essence of who the
A thorough description of
what a person CAN’T do person is
o Performance on one’s oAppreciation of what a
worst day! person CAN do
oWhat’s possible with good
support!

24. Presentation from Hope Leet Dittmeier November 2011 24
Getting to know the person
Spending time together – asking, observing, appreciating,
challenging, wondering
Learning from others who know and care about the person
Discovering potential not previously known or recognised
Understanding the essence of who the person is

25. Presentation from Hope Leet Dittmeier November 2011 25
Getting to know the person
Interpreting the facts
The person’s history and how it impacts them
Number & nature of current relationships, including voids
Current devalued roles, including ways they are perpetuated
Previous and current valued roles, including desired/potential roles
Talents and interests, especially those un-noticed
Specific vulnerabilities
Success, especially what contributes to success

26. Presentation from Hope Leet Dittmeier November 2011 26
The process of individualised work

27. Presentation from Hope Leet Dittmeier November 2011 27
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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Determining what is desired
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

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Determining what is desired
Balancing Wants and Needs
What is important to the person? What is their own vision for
their life?
What is important for the person?

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Determining what is desired
Most pressing needs “Distractions”
oWhat we know how to do well;
“What will have the
our expertise
most impact on
oWhat we are prepared to do
improving the quality quickly or easily
of the person’s life?
oWhat meets the needs of the
provider
oWhat is more pleasant to
address

31. Presentation from Hope Leet Dittmeier November 2011 31
Determining what is desired
Visualizing the Person’s
Desired Lifestyle!
oHome
oWork or contribution
oCommunity roles
oMeaningful relationships
oNew things to learn

32. Presentation from Hope Leet Dittmeier November 2011 32
The process of individualised work

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Creating what is desired
A 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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Creating what is desired
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?

35. KEITH
 36 year old man
 Unhappy/unsuccessfu
l experience in group
home and sheltered
employment
 Planning started in
Oct 2006; moved six
months later to own
home March 2007

36. Keith’s Home
 Autonomy from mom
 Private
 Downtown
 Affordable
 Within rolling of sports and music venues
 Gated, safe
 Small, intimate development
 Masculine decor
 Accessible bathroom
 Clean, neat, new
 View from indoors
 Front-loading washer and dryer

37. The Benefits of Having
A Home of One’s Own!
Control over the front door
Social status
Permanence
Relationships
Hospitality
Greater independence
Customized

38. Presentation from Hope Leet Dittmeier November 2011 38
Creating what is desired
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?

39. Presentation from Hope Leet Dittmeier November 2011 39
OUR WORK INVOLVES THE ADDRESS OF . . .
IMAGE
ENHANCEMENT
COMPETENCY
ENHANCEMENT

40. 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)

41. 41
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.

42. 42
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