person centered planning stacey ramirez georgia state university university center for excellence in...
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PERSON PERSON CENTERED CENTERED PLANNING PLANNING
Stacey Ramirez
Georgia State University
University Center for Excellence
in Developmental Disabilities
Center for Leadership in Disability
Martha Veto
Georgia Sensory Assistance Project
Georgia State University
Department of Educational
Psychology and Special Education
GAPBS Conference December 5, 2009
Today we will…Today we will…
Review the History of Person-Centered Planning
Discuss Person-Centered Philosophies Examine Person-Centered Planning Tools Create a Relationship Map Share Stories of Person-Centered
Realities Blaze our own PATH Discuss Next Steps
Person Centered Person Centered PlanningPlanning
Helping people find a vision around the person
Looks for the Capacity and Gifts in every person.
Building Community around the person Respect Purpose Control Imagination
60’s - Principles of Normalization conceptualization of disability as not simply
being a medical issue, but as a social situation.
90’s – O’Brien, O’Brien, & Mount Reduce social isolation, foster friendships,
increase opportunities for preferred activities, develop competence, and promote respect
2000 – misapplied in service systems that have tried to adopt the process
History of Person Centered History of Person Centered PlanningPlanning
History of Person Centered Planning1990 Person
al Histories
Essential Lifestyle Planning
PATH
1985 New Hats
Families First
Group Action Planning
MAPS
1980 Getting to Know You
Individual Design Session
Personal Futures Planning – Beth Mount
24 Hour Planning
PhilosophiesPhilosophies
Not about…forms, or short cuts with paperwork or “hanging out with consumers”.
Supports a life lived on the individual’s terms A living situation chosen in a desired community A job that matches strengths and interests Selected support staff
Presume competence in a person’s dream Perceive behavior as communicative
Qualifications of Qualifications of FacilitatorsFacilitators Team builder behind what a person
wants to accomplish vs. service system needs
Presumes competence in the individual Non-judgmental Respectful Flexible Well-prepared Creative Humorous
Qualifications of Qualifications of FacilitatorsFacilitators Warm/friendly Assertive Empowers all participants Knows the community and its services
for those without disabilities Interprets behavior as communication Follows through Translates outcomes into plan of
service goals
Core ElementsCore Elements
The individual is the driving force The individual chooses those involved Individuals have gifts that provide a
valued role for them in the community Individuals have the ability & desire to
gain & maintain satisfying relationships Continual listening, learning and action
will help the person get what he wants in his life
Person Centered Person Centered Planning - AKAPlanning - AKA Whole Life Planning Personal Futures Planning Making Action Plans (MAPS) Planning Alternative Tomorrows
with Hope (PATH) Essential Lifestyles Planning My Future, My Plan
Personal Futures Planning
MAPsMaking Action Plans
PATH Planning Alternative Tomorrows with Hope
Using Person Centered Planningin School Settings
“All my son’s life professionals have come with little boxes to fill him into. What has been different with this is that we started with a blank piece of paper and a question”
How is Person-Centered Planning Different From Traditional School Planning?
Plans WITH not FOR the student (and family) Starts with abilities and interests, rather than
disabilities Provides a comfortable atmosphere for the student
and family Hear from the student and family FIRST Educational and other service providers have a
better understanding of family’s dreams and fears Offers a visual and immediate picture of the situation Provides helpful information to identify and prioritize
needs
When To Use a Person-Centered Planning Tool?
To prepare for times of transition To work around problems When you’re not sure what you are doing is
working When your team is not a
team When you can’t find a
good assessment that
provides good goals
The Traditional Approach to Introducing Your New
Student! Attention Seeking Behaviors Nutritional deficiencies Sexually Inappropriate
Behavior/Exhibitionist Problems maintaining friendships and
relationships Periods of screaming Drama queen
Another Approach to Introducing the Same Student
•Likes attention from adults
•Eats spaghettios for lunch every day
•Takes off clothes that are scratchy or have a tag
•Has no way to communicate with classmates
•Communicates frustration by screaming
•Shows us what she likes/dislikes clearly through
her behavior
MAPS to Answer Questions
1. History of the child-
experiences.
2. Dreams for
the student’s
future.
3. Nightmare of
the student’s
future.
4. Who is this
student?- Word Map
5. What are the person’s preferences?
6. How does this person communicate?
7. What an ideal day at school would look like?
8. Images for School & Beyond
9. What does the community have to offer?
Maps to Move From Knowledge to Action
Needs MapDetermining what’s needed to turn dreams into reality and overcome fears
Action Plan
Who, what, when
History Map
Purpose: To understand the life experience of the focus person and his or her family.
Illustrates:1. Positive experiences form the past to build on;2. Appreciation of traumas, loss & grief in life3. Celebration of accomplishments
Dr. B. Mount, 1991
Braiden’s History MapBraiden is born 12/29/87 in Jackson, MS
28 weeks gestationLung Problems/Renal Failure at 9 days old Dr. Wender . Braiden pulls through!
2 wks old
Surgery -intestines
Broviac catheterFirst
BottleLeaves NICU 5 ½ months
Home
Chase is born! 11 months later.
Chase developing, Braiden not as rapidly.
Willowood Pre-School –18 months. Great experience. Move to
Memphis - Stress
Angel born
18 months
Not as much support –new doctors, new findings
SuzannaPreschool – too high expectations
La Passe Preschool 1xmo
Move home to LR More support
Francis Allen School –Great transition Home
Swallow study –health, feeding
Where does Braiden go
from here?Single Dad
Ark. PediactricFacility
Braiden 5 yrsDad Chase & Angel not around as much
Braiden grows difficult to home visit. Family visits as often as possible.
Braiden growing developing
Happy – loves interactions Staff loves him. Staff changes OT, PT, SLP, nursing, teachers asst.
WHERE DOES BRAIDEN GO NOW?
Dream Map
Looks beyond the current reality
Think in terms of 5 year or 10 year increments
Forces the team to think about the future.
Can create goals for the present.
To go to a restaurant and order his own food To read To live on his own To be happy
To be able to talk To be an active community member
Aaron’s Dreams
Nightmare Map
Challenging to face Can help the team to
prevent the nightmare from happening.
Important to acknowledge the worst that can happen to strive to create the best for the child’s future.
Being picked on or neglected Being taken advantage of Not being able to eat on his
own Not meeting all his dreams Being underestimated Poor communication skills Become frustrated & give up Medical needs aren’t met
Aaron’s Nightmares
Who is the Individual? Word Map
All team members participate. Use words to describe the person. Vote on the three most descriptive
words of the individual.
Purpose: To gain a deeper understanding of who the person is & how he or she is perceived.
Illustrates:The power of wordsPositive characteristics that are
often overlooked
M. Forrest, J. Pearpoint, 1950
Who Is Braiden? Laid back
Happy
Fun Loving
Likes People
Survivor
Patient
Brave
Tolerant
Musical
What are the Person’s Preferences? What Works?
Dwell upon strengths rather than challenges.
Describes what the individual likes.
Provides a foundation to build upon in the areas of instruction, community experiences & employment.
Braiden’s Personal Preferences Things That Work!
• Silly Sounds (wind blowing• Whistling• Singing• Zippers• Buzzing noises• Vibrating toys• Rough rides – bumpy, concrete
bus• Ticklish• People• Whirlpools• IMAX• Red or yellow – reflective• Low lighting• Pink pom-pom• High contrast• Give time to look• Pos central to left• One on one attention
Things that Don’t Work• Lights Distract
• Being too hot
• In one position too long
• Being wet
• Teeth brushed
• Tongue brushed
Communication Map
Purpose: Shows how others are communicating to the student and how the student communicates
Illustrates that there may be a lack of communication taking place in the student’s life
Braiden’s Expressive Communication
Community
Family
Service Providers
“I like Wal=Mart IMAX”
Laughing awake
“I like flirting with you”
laughing “I like that”
Staying awake - attends
“Hi, Dad”
Big MacChooses book or music
Rocking Plate Closes eyes
“I don’t care about that”
“Whoa”
Startles to light“I don’t want to be alone”
frown
“having a good time.”
laughing“I’m wet or dirty”
Sticks tongue outInterest/
disinterest.
Eye gaze
Friends
What message Where/to whom
How His response
directives, directions Familiar people at home and
school
Verbal – when in front of him and have his attention
There is some question about how much understanding is
tied to the routine in which the directions occur
About 80% of the time he does what you ask, though sometimes you
have to ask repeatedly
“sit down” School Verbal direction and touch prompt (just recently started
needing extra prompt)
sits
“time to ….” (transition from favored activity)
Home, mom Multiple verbal prompts, rely on routine – must turn tv off before telling him what to do
next
Make unhappy noise
Comment about something
Home with mom and school with
Ms Jackson
Verbal, story telling, conversation
Smile, facial expression
Identify object School, speech, Ms Jackson
Verbal question, “show me the …”
Points to picture, symbol
Receptive Communication Map
John Ross has a severe-profound hearing loss. He wears a bone conduction hearing aid and enjoys music and responds to speech.
What would an ideal day at school look like?
Who is involved What role would
technology have? What about vision
services or orientation and mobility
The student would like to spend more time doing what?
Aaron’s Perfect Day
To learn something every dayTherapists help modify Therapy will be after schoolTeachers would have a perfect day too!I will go to McDonalds after school, play sports, get dirty and do my homework. Dinner with Mom
& Dad, then I put myself to bed by myself.
Needs Map
Skills we want the student to learn or that we need to learn- list.
Activities that we want the student to enjoy- list. (both on campus & in the community)
Adaptations that the student might need.
Supports that the student might need.
To be understood have a communication system
Strategies to develop peer relationships
Continued high expectations Inclusion
Strategies for peers To be challenged
Maximize therapy resources Better communication among team members
Daily schedule Choices Team that thinks outside the box Continued auditory development Team sharing new information
Aaron eating more independently
Imbedding therapies
Aaron’s Needs
Action Plan
Purpose: To determine next steps and assign tasks for moving forward.
Illustrates: Actions to be taken Person or persons responsible Timelines
Action Plan
Action StepPerson responsible
Timeline
1. Check with Vertell after Christmas about use of schedule.
Kate Before Jan. 24th meeting
2. Setup training with parents in Feb. Tracy By Feb 1st
3. Get clarification on Jan 11th training Kate 1/11
4. Set-up attention gaining protocol and train Roberta and David
Tracy Before Jan. 24th meeting
5. Continue to brainstorm leisure activities for classroom and dorm.
Team Before Jan. 24th meeting
6. Make grid for stickers in “shoebox” activity
Kate Before Jan. 24th meeting
7. Use totebag for Dee to carry communication book to related services.
Team Before Jan. 24th meeting
8. Ask Mary to write info sheet on Dee for new bus attendance, so they understand Dee and his system.
Alice Before Jan. 24th meeting
Using Person Centered Planningin Building Community
Who is invited to the Futures Planning meeting?
Relationship Maps
Pre-PlanningPre-Planning
Where does the individual want the planning event to be held? Where is the person most comfortable?
What does the person want to talk about at the plan?
What does the person want to NOT talk about?
Who does the person want to be a part of the planning process? Who does the person trust?
Who makes the person smile?
Pre-PlanningPre-Planning
Who should not be in attendance at the planning event(s)?
Are time, date, and location acceptable to the person and the family?
How will it be known if the person is happy with the process? Are there behaviors that the individual uses to communicate happiness or sadness?
Who will invite guests? Will there be snacks?
My RelationshipsMy Relationships
FamilyFriends
Community Service
Providers
Granny
Aunt Holly
Andy & Debbie
Grandpa Bobby
Ken & Carolyn
Sheila
Morris & Susie
Miss Faye
Miss Lois
Pam Peterson
Dru
Jerri Paschal
Support Coordinator
Mike & Heather
Jeff Smith
Cobb Parks & Rec
GCSS
YMCA
PM Mentors
Circle of Friends
Veterinarian
Emory AutismChurch
Special Olympics
Family Life
These are the People I can count on:
Building a Relationship Map
Friends Family
Family Life
Community Network
Personal Network
Service Providers
Please use this worksheet to help brainstorm your invitation list for the upcoming Person-Centered Planning Sessions. Family Life: Name the people you love most and who love you most in the center circle
Personal Network: People you rely on, with whom you exchange friendship and concern.
Community Network: Acquaintances, friends from the past, people who you mostly greet
FAMILY CIRCLEName the people you love most and who love you most in the center circle, the place of family life - people you trust the most, who know you best, who love and care about you.
PERSONAL NETWORKFamily, friends, neighbors, classmates, co-workers, church members, helpful teachers (or other paid people).People you rely on, with whom you exchange friendship and concern, triumphs, struggles, mutual interests.
COMMUNITY NETWORKAcquaintances, friends from the past, people who you mostly greet or acknowledge as part of your community life.
1. Put each person on the map as a stick figure with the person’s name. Indicate the nature of the relationship and how long you’ve known each other.
2. Put people who are most important closest to the center. Indicate intensity & strength of the relationship with heavier lines.
3. Highlight people in yellow who might be involved in your support circle.
4. Look at your map. What do you notice? Do you see any patterns or themes?
Circles of friends
Turn that Circle into a team and you will have a transition gem for your child’s life toolbox
LOOK AT THE PERSON CENTERED PLANNING PROCESS AS MUCH AS YOU LOOK AT ANYTHING ELSE!PERSONAL FUTURES PLANNING, MAPS AND PATH
What are the dreams for the future……
Base it on theperson's strengths,interests, values, aspirations, and choices.
Chris’ Dream to go to College
My Vision For A Life Well My Vision For A Life Well LivedLived Friends, Relationships & Friends, Relationships &
Community LifeCommunity Life Who do I want to be my friends?
Do I want to go to church?
How much time do I want to spend with my family?
What would I like to do for recreation?
Who can help me do what I want to do?
My Vision For A Life Well My Vision For A Life Well LivedLived HomeHome
Where do I want to live?
Who do I want to live with?
What kind of home do I want?
Who can help me live where I want?
My Vision For A Life Well My Vision For A Life Well LivedLived Work & Meaningful Day ActivitiesWork & Meaningful Day Activities
What job would I like?
Where would I like to volunteer?
What role would I like to have?
Who can help me do what I want to do?
TransportationTransportation
Will I be able to drive?
Is public transportation available to me?
Will I be able to navigate the community independently?
Who can help me with transportation?
My Vision For A Life Well My Vision For A Life Well LivedLived
Healthcare & RespiteHealthcare & Respite
Will I have access to private health insurance?
Will I be eligible for Medicaid/Medicare?
Is funded respite care available to me?
Is respite available through family or friends?
My Vision For A Life Well My Vision For A Life Well LivedLived
FinancesFinances
What are my resources?
What will it cost to support my vision?
What additional financial resources may be available to me?
Who can help me with financial matters?
My Vision For A Life Well My Vision For A Life Well LivedLived
Successful OutcomesSuccessful Outcomes
All successful person centered plans are unique, however the principles of PCP remain constant: Presume competence Use behavior as communication
Follow through with a plan is likely if the sessions appeared to be worthwhile to both the person and the guests.
Empowering to all the guests. Critical to review outcomes
Successful OutcomesSuccessful Outcomes
Leads to the honoring of a person’s preferences, strengths, and abilities
Implementation should reflect an individual’s dreams, desires, and needs
Outcomes that emerge from the planning process may appear difficult to realize – then analyze.
Remember the process is about relationships and building community
BLAZE OUR OWN PATH
1. Locate the North Star2. Generate Vision of a Positive Possible Future3. Describe the Now4. Invite Enrollment5. Decide to Get Stronger6. Identify Bold Steps: (Date)7. Organize the next month’s work8. Agree to Next Steps
THE NORTH THE NORTH STARSTAR
What are the images that capture your North Star – the direction of your PATH?
What dream do you most want to realize?
What images will guide you when you meet difficult situations?
THE NORTH STARTHE NORTH STAR What do you most want from your life? What matters most to you? What difference do you want to make to other
people…to your family…your community…your country…the earth?
What purpose do you want your life to serve? What does a good life mean for you? What drive you, form down deep inside? What do you want people to remember you for when
you are no longer here – what do you want your legacy to be?
When you get lost and discouraged, what values bring you back on course?
POSITIVE AND POSITIVE AND POSSIBLEPOSSIBLE
Trying on the future Decide your on time frame Imagine that today is (YOUR DATE). You
are taking time to celebrate and reflect on how far you have come since (INITIAL DATE).
Is this positive? Is this possible?
GROUNDING IN THE GROUNDING IN THE NOWNOW
Move back to the present
Look at present situation coolly and objectively
Describe where you are NOW
IDENTIFY PEOPLE TO IDENTIFY PEOPLE TO ENROLLENROLL
Who will you enroll to join you on your journey?
Who do you need to achieve your dream?
…starting with YOU!
GETTING GETTING STRONGERSTRONGER
Blazing the PATH will take energy and skill
You need to get stronger and stay strong
What knowledge do you need most? What skills do you need to develop? How can you stay healthy and well as
you work toward creating what you want?
DESCRIBING DESCRIBING HALF-WAY HALF-WAY THERETHERE
Review the Goal
You are half-way there (YOUR DATE)
What are the milestones that will let you know you are on the right track toward your GOAL?
THE THE NEXT NEXT MONTHMONTH
Success requires laser focus and action ourside this room.
Be VERY specific
Identify who will do what by when in order to move along your PATH.
THE THE FIRST STEPFIRST STEP What is the first thing you will do to start
this next part of your journey?
NEXT: Label your experience Give it a title Date and sign
It’s just pretty artwork without…
FOLLOW – UP, FOLLOW-UP, FOLLOW-UPFOLLOW – UP, FOLLOW-UP, FOLLOW-UP
Roadblocks to Roadblocks to Success at WorkSuccess at Work
ParentsParentsParentsParents
WHAT DID YOU WHAT DID YOU SAY?SAY?
Fear letting goFear letting go
Lack confidence in student’s abilitiesLack confidence in student’s abilities
Lack trustLack trust
Don’t view student’s work as a “real job” Don’t view student’s work as a “real job” with real responsibilitieswith real responsibilities
Success StorySuccess Story Works full-time Works full-time
on a farmon a farm Collects, Collects,
washes, dries washes, dries and packages and packages eggseggs
Performs other Performs other farm choresfarm chores
And, don’t forget to bring your student along for the Ride!
SELF DETERMINATION
Learning to let Grow
Because of …PERSON CENTERED PLANNING
I GO TO DINNER CLUB IN MY NEIGHBORHOOD
I SERVED AS THE GRAND MARSHAL AT DISNEY WORLD
I TOURED THE KITCHEN AT LONGHORN
21 people came to my May Person Centered Planning dinner!
WEBSITESWEBSITESInclusion Presshttp://www.inclusion.comPerson Centered Planning: MAPS and PATHS to the Futurehttp://www.ttac.odu.edu/Articles/person.html The Origins of Person-Centered Planninghttp://thechp.syr.edu/PCP_History.pdfA Resource List on Person Centered Planning www.allenshea.com/resource.htmlUtah Department of Human Serviceswww.hsdspd.utah.gov/personcenteredmodel.htmPerson Centered Planning: Introductionwww.ku.edu/%7Eican/modules/social/pcp/index.htmlMAKING ACTION PLANSSTUDENT CENTERED TRANSITIONAL PLANNINGwww.ric.edu/uap/publications/MAPS.pdf
When Planning for Adult Life, How is a "Life-style" Different than a "Program"?http://www.tsbvi.edu/Outreach/seehear/winter04/planning.htm
In Australia: Placing Parents and Families at the Center of OurPlanninghttp://www.tr.wou.edu/tr/dbp/pdf/may99.pdf
Building Authentic Visions: How to Support the Focus Person in Person Centered Planninghttp://www.communityinclusion.org/article.php?article%20id=31&staff%20id=42
WEBSITESWEBSITES
Contact Us:
Stacey RamirezCenter for
Leadership in Disability
Georgia State University
Martha VetoGeorgia Sensory
Assistance Project
Georgia State University