Introduction Video
Dr. Brian Abery
Institute on Community Integration,
University of Minnesota
For far too many years, the services and supports received by people with disabilities were either program-centered and driven by what was available, or professionally-centered and determined by what those individuals providing supports thought was best for the person with a disability. This situation was the case whether the individuals in question were student still in school or full-fledged adults with all the capacities needed to create and work toward their own personal visions or dreams for the future. Left out of the decision-making process, people with disabilities rarely found themselves with support programs that facilitated their achieving in life what was important to them.
Person-centered planning (PCP) is a well-known approach to developing individual support programs that, over the past twenty-year has been widely used for people with a variety of disabilities. PCP was developed for better understanding of individuals with disabilities, their enhanced experiences, and effective problem-solving facilitation to achieve individualized and inclusive experiences. Although there are numerous approaches to person-centered planning, all frameworks are based on: (1) a set of values and strategies to support people creating a personal vision for their future based on desired life outcomes; and (2) plans for working toward making their vision come true. The person-centered planning process itself is geared toward providing that group of individuals who are support the focus person with a greater understanding of the individual’s:
Dreams and vision for the future
Core values
Gifts and capacities
Unlike traditional deficit-based approaches to planning that seek to align supports with remediation of a person’s deficits or challenges, person-centered approaches focus on the “positive possible.” This consists of assisting an individual with developing a social network or circle of support that will (a) respect their vision for the future; (b) encourage them to challenge themselves and try something new; (c) support their self-determination; and (d) marshal the resources needed to help the person make that vision for the future a reality.
There are a number of different types of person-centered approaches to support planning that while aiming for similar outcomes go about achieving these in slightly different ways. Essential Lifestyle Planning was developed originally for use with people with intellectual and developmental disabilities receiving residential services and supports. Making Action Plans or the McGill Action Planning System was originally used in supporting the educational inclusion of students with disabilities. This same group also developed Planning Alternative Tomorrows with Hope (PATH). PATH is used to support a person being able to create a dream for the future and then set short and long term goals, solve problems, and facilitate achieving desired life outcomes via action or support networks. A fourth approach is Personal Futures Planning (PFP). PFP in particular emphasizes the need for enhanced awareness the person with disability’s potential becoming a fully integrated and contributing member of the community.
More generally, PCP focuses on identifying a wide range of personal characteristics, abilities, and supports that are critical for an individual to succeed in inclusive community settings. It is a collaborative, goal-driven, and individualized approach focusing on community inclusion, positive relationships, respect, and competence (Claes, Hove, Vandevelde, Loon, Schalock, 2010).
Using person-centered approaches to support planning have been positively associated with improvements in social networks, closer contact with family and friends, greater involvement and engagement in group activities, and enhanced employment opportunities. A person-centered plan, however, is of little use if it is not implemented as intended and it would seem that all too often this is the case. Smull posited that after more than a decade of person centered planning, many people with disabilities have better support plans but not necessarily better lives. A person -centered plan therefore needs to be conceptualized as a necessary but not sufficient step to supporting people with disabilities to have better lives.
Person-centered service delivery means that “individuals’ values and preferences are elicited and, once expressed (potentially through person centered planning), drive all aspects of their services, supporting their achieving life goals.” This approach argues that service delivery must be directly tied to planning and what is important to the focus person and that service planning and provision must be conceptualized as an iterative process to maximize person-centeredness.
A key distinguishing feature of person-centered supports are that they are delivered in a manner that puts the desires and needs of the focus person ahead of the needs of professionals or the system. Boise and White note that providing person-centered care requires moving away from models in which “caregivers are interchangeable and care is organized by institutional routine, rather than a person’s needs and preferences.”
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Supports that are person-centered are known for their ability to empower the people who receive them. One factor associated with this empowerment is that support planning focuses not only on areas in which an individual is challenged but acknowledges, builds upon their strengths, gifts, and capacities. Mezzich et al. (2010) called for supports that were planned around the whole person, including both their strengths and the needs or challenges they faced. Person-centered supports therefore have the potential to be empowering supporting a person’s self-determination and sense of self-efficacy as well as opening up new options for users of supports.
Slideshow presentation on person centered planning and supports
Kinely Dema discusses developing her plan and pursuing her life goals. She represents Bhutan at the paralympics, but also is pursuing other entrepreneurship opportunities in embroidery and making potato snacks that she can sell. The ESRC-GCRF project has supported her in these efforts by providing logistical support through an inclusive employment coordinator (a new role we piloted in Bhutan), as well as some small material supports.