The Power of Consumers in Person-Centered Planning DBSA Conference September 2008 Larry Fricks Diane M. Grieder

Warm Up  Write 3 goals/areas of meaning you have for yourself on a piece of paper  Hand that paper to the person sitting next to you

3 A Plan is a Road Map  Provides hope by breaking a seemingly overwhelming journey into manageable steps for both the provider and the person served A E BCD “life is a journey…not a destination”

person-centered …the long and winding road… person-directed care

Some ideas… What is Recovery?

A journey – not a destination Recovery is…

Defined – by the person Recovery is…

After a year of study… the Commission finds that recovery from mental illness is now a real possibility. The promise of the New Freedom Initiative—a life in the community for everyone—can be realized. —The President’s New Freedom Commission, 2003 Is Recovery Possible?

A process, a way of life, an attitude, and a way of approaching the day’s challenges. It’s not a process for attempting to return to who the person was before. -- Pat Deegan Recovery is… Source:

The process of attaining a “life worth living.” Defined by the person’s interests, preferences, and dreams— Partaking in valued and respected roles with the rights, freedoms, and responsibilities of any member of our society. Recovery is…

 Mental health recovery is a journey of healing and transformation enabling a person with a mental health problem to live a meaningful life in a community of his or her choice while striving to achieve his or her full potential  National Consensus Statement, SAMHSA  What does recovery look like? Some examples:  Recovery means I am a full participant in the community and run my own life.  Recovery means I no longer think of myself as being “mentally ill”, and instead, think of myself as worker, parent, student, neighbor, friend, artist, tenant, lover, and citizen.  Recovery means I adapt to the stresses in my life and try to live life on life’s terms.- National Empowerment Center (NEC)  Next - Diane PDP slides

Traditional Stability Compliance Control Focus on deficits Low expectations Treatment Focus Comparison Recovery Hope for future Choice Partnership Focus on strengths High expectations

Traditional Learned helplessness Protection from failure Stabilization is the goal Treatment Focus Comparison Recovery Active participation Risk is supported Meaningful life is the goal

NOT… BUT… What do people with your diagnosis need? What do all people need? AND What do you really want? Person-Centeredness is…

Traditional Approach Available Resources Treatment Goals Available Supports Person Focus is on “Managing the Illness” Source: Foundations of Person-Centeredness, Level 1 Workbook

Person-Centered Approach Resources Dreams Natural Supports Person Focus is on “Promoting Recovery” 12 34

The person’s activities, services and supports are based upon his or her dream, interests, preferences and strengths Hallmark #1 Source: Foundations of Person-Centeredness, Level 1 Workbook

The person and people important to the person are included in planning and have the opportunity to exercise control and make informed decisions Hallmark #2

The person has meaningful choices, with decisions based on his or her experiences Hallmark #3

The person uses, when possible, natural and community supports Hallmark #4

Activities, supports and services foster skill to achieve personal relationships, community inclusion, dignity and respect Hallmark #5

The person’s opportunities and experiences are maximized and flexibility is enhanced within existing regulatory and funding constraints Hallmark #6

Planning is collaborative, recurring, and involves an ongoing commitment to the person Hallmark #7

The person is satisfied with his or her activities, supports, and services Hallmark #8

A Person-Centered Approach…  Sees the person as the expert in his or her life  Includes significant others and/or peers  Identifies hopes, capacities, interests, preferences, needs and abilities  Provides creative ways to align resources to the person’s goals In Summary…

What Can I Do?

27 Example  Goal Decrease depression  Objectives  assess medication needs  improve finances  develop appropriate vocational goals

28 Example  Goal Maintain psychiatric stability  Objectives 1. Attend appointments with PCP 2. Donna will attend psychiatric appointments

Building a Plan Request for services Assessment Services Understanding Goals Objectives Outcomes Prioritization Strengths/Barriers

Collaborative Approach  Team approach is key  Each discipline/participant brings its own area of expertise  Synergistic effect  Participation of person served and support system including peers (family, as appropriate), is essential

Strengths  Environmental factors that will increase the likelihood of success: community supports, family/peer support/involvement, work  Identifying the person’s best qualities/motivation  Strategies already utilized to help  Competencies/accomplishments  Interests and activities, i.e. sports, art

Questions to ask about Strengths  What have been your accomplishments?  What are your abilities?  Have you expressed any particular interests that have not been pursued?  What activities and interests do you engage in on a regular basis?  Do you now use community resources in your regular activity? Identify resources and your degree of satisfaction with current community resources.  What is unique about your abilities and interests?  What assets do you currently have that will be supportive of your recovery activities?

Identifying strengths Working in pairs:  Each pair take turns interviewing each other about two of your identified strengths, using the suggested questions to further explore and better capture these areas of strength in that person’s life.  What did it feel like to be asked these kinds of questions?  What was challenging about answering them?  How might you ask these questions in a better way?  What did you learn from this experience?

traveling the person-directed highway Road to Recovery and Wellness

35 Goals  Long term, global, and broadly stated the broader the scope the less frequently it needs to change perception of time may be culture bound  may influence expectations and participation  Life changes as a result of services focus of alliance / collaboration readily identified by each person  Linked to discharge / transition criteria and needs describes end point of helping relationship

36 Goals continued  Essential features attainable  one observable outcome per goal realistic written in positive terms  built upon abilities / strengths, preferences and needs  embody hope/alternative to current circumstances

What Do People Want?  Commonly expressed goals of persons served Manage their own lives Q uality of life Social opportunity Education Activity / Accomplishment Work Transportation Housing Spiritual fulfillment Health / Well-being Satisfying relationships... to be part of the life of the community

Hopes/dreams/goals Possible questions:  When you were a kid, what did you want to be when you grew up?  If you had a magic wand and could do or be anything, what would you wish for?  Who would you want to be there with you if you could realize your wildest dream?

Goals…  What part of the “wildest dream” are you willing to share with others / get help in achieving?  How have your dreams /aspirations changed from childhood to now?  What do you really want in your life in the future?

What can consumers do in PCP?  Help each other identify strengths  Help each other identify goals  Advocate for yourself  Know your rights around planning  Direct/take charge of the planning process –it’s your plan!

And, finally... “If you don’t know where you are going, you will probably end up somewhere else.” Lawrence J. Peter