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DISABILITY JUSTICE PROJECTTherapeutic Approaches to Guiding Change within

Disability Justice

FACILITATOR’S GUIDE

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This is a one day training package that will require the following resources:

Abbreviations used in Facilitator Guide:PPT: PowerPointPH: Participant HandoutDJP: Disability Justice ProjectCJS: Criminal Justice SystemMI: Motivational interviewing

No. Resource Check

1. Projector (venue booking will confirm)

2. Whiteboard & markers (venue booking will confirm)

3. Laptop

4. Speakers for AV presentations

5. PowerPoint Presentation

6. Copies of videos file

7. Participants’ Handbooks (one for each participant)

8. Copies of Training Evaluation forms

9. Sign-on sheet

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The Therapeutic Approaches to Guiding Change within DJP workshop largely focuses on two approaches, aimed at supporting people to make choices that have significantly impacted on the way in which change is approached and supported in a range of settings. Initially this workshop will focus on the principles underpinning recovery and recovery-oriented practice, principles which parallel the move towards person-centred practice in the disabilities context (Handley et al., 2012; FaCS, 2009; 2014). Whilst having its origins in the mental health context, there is a growing movement towards applying recovery-oriented approaches in a range of other contexts such as intellectual and learning disabilities, forensic mental health, AOD and acquired brain injury.

Secondly, this workshop will focus on the use of motivational interviewing (MI) as an evidence-based approach for guiding people who are struggling with change. MI is underpinned by humanistic principles and utilises person-centred strategies. There is a growing body of work that supports the use and adaption of MI when working with people living with the impact of cognitive impairment. There is also a rapidly expanding adoption of the use of MI in correctional settings. The ultimate purpose of this workshop is to focus on approaches, strategies and skills for effectively supporting people to make choices, to navigate the process of change and to ultimately break the cycle of involvement with the criminal justice system.

Outcomes from today’s workshop:

By the end of this one-day workshop, it is expected participants will be able to: Explain the principles of recovery and how these principles apply to the disabilities context Describe recovery-oriented practice and how recovery approaches can be utilised when working with people living with cognitive

impairments Discuss the spirit and processes of MI as an approach for guiding change Explain how MI can be adapted and applied when working with a range of people involved with the CJS. Demonstrate strategies for supporting people to change.

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TRAINING PLAN

Time Slide Session content Resources / Page

Prior to 9.30am start

Slide 1Welcome

Preparation Welcome participants Attendance sign on – have sign on sheet and pen available for participants Name tags – use stickers and whiteboard marker

Participant Handbooks

WhiteboardAttendance

sheet and penName tags

9:30 – 9:45am Slides 2 - 6 Welcome Housekeeping Focus of DJP Content of Workshop

Introduction Acknowledgement of Country

Welcome and introduction - Explain that this workshop was developed in collaboration with ACWA, LWB and IDRS.

Housekeeping - identify exit procedures, toilet locations, mobiles off

Group Agreement – verbal or written up on whiteboard

Rationale for DJP – refer to pages 2 - 3 PH

Content of Workshop – refer to page 4 PH. Reinforce the point on the bottom of page 4 and PPT 6 regarding further training on recovery-oriented practice and motivational interviewing.

Pages 1 - 4

9.45– 10.30am Slides 7 – 21 The Language of

Recovery MHCC Language

Guide

What is Recovery?Open with a discussion about the importance of language within the

recovery and recovery-oriented practice context, referring to page 5 of the PH. Refer to the MHCC Recovery-oriented Language Guide (PPT 8).

Pages 5 - 11

SpeakersVideo – ‘True

Recovery’ 2.38

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What is Recovery? Defining Recovery Determinants of

Recovery VID – True Recovery Star of Recovery Core Features of

Recovery Aboriginal

perspective on Hope Self-determination Self-advocacy Lived Experience

Activity One PPT 9 : Ask the group to discuss the four questions in Activity 1 (pge 6 PH) in pairs with the person next to them. Regroup and record some of the responses on the whiteboard.

Refer to PPT slides 10 - 12 to reinforce the definitions.

Highlight the determinants of recovery as per Lambert’s Pie – PPT 12.

VIDEO: Show video ‘True Recovery’ then discuss the ‘take home message’ the woman presents in the video.

Introduce the Star of Recovery (PPT 14) and discuss the point that recovery represents a paradigm shift. Reinforce the information referring to page 8 of PH.

Activity Two PPT 16:

Show PPT slide 15, describing the core features of recovery. Divide the group into four smaller groups and allocate one of the core features of recovery to each group (page 9 PH). Instruct the groups to only answer the feature allocated to their group and the two questions. Regroup and briefly discuss the groups’ responses.

Show PPT slide 17 and mention the importance of hope when working with Aboriginal people. Discuss the parallels when working with people living with disabilities and in particular, people caught up with the criminal justice system.

Refer to PPT slides 18 and 19 to reinforce two key concepts that are central to recovery – Self-determination and Self- Advocacy.

Referring back to the group’s responses to the question regarding ‘lived

mins

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experience’ in Activity One, show PPT slide 20 and discuss that lived experience is at the core of recovery.

Activity Three PPT 21: discuss with the whole group the questions in activity 3 (page 11 of PH) regarding the importance of lived experience to the recovery paradigm and at the core of recovery-oriented practice.

10:30–11:00am Slides 22 – 26 Recovery-oriented

Practice Finding the Right

Balance Guiding a Balance of

Risk 3 Types of Choices

Recovery-oriented PracticeReinforce the point that “recovery is what a person does, recovery-oriented

practice involves supporting a person in their recovery” (PPT slide 16)

Introduce the ‘Neglect-Overprotect Continuum’ (page 13 of PH) and discuss the importance of finding a balance between a person’s dignity of risk and a worker’s/service’s duty of care. Discuss the points on pages 13 and 14 of PH and PPT 20.

Refer to the ‘Three Types of Choices’ and discuss the importance of workers thinking critically when supporting a person in their choices.

Activity Four PPT 26: Divide the group into small groups of three and instruct the groups to discuss the scenario on page 13 of PH. Regroup after 10 mins and take feedback on how the participants could support ‘John’ to make choices safely.

Pages 12 to 13

11.00 – 11.15 Morning Tea Break

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11:15 – 12:30 Slides 27 - 34

Being a Recovery Guide

Role of Recovery Guide

Tools to Support Recovery

Vid - Staying Strong Plan in Action

Recovery and Intellectual Disability

Taking Time Framework

Further Learning about ROP

Being a Recovery Guide

Introduce the concept of being a ‘recovery guide’, referring to the continuum between directing and following on PPT 27 (this will be discussed in more detail in the motivational interviewing section after lunch)Reinforce the points essential to the role of a recovery guide by referring to page 14 of PH and PPT slide 28.Discuss some of the tools that can be used to support a person’s recovery (PPT 29 and PH page 15).

VIDEO: Show video of “Staying strong plan in Action” (7 minutes) then discuss.

Activity Five PPT 31 : Refer to the ‘Stay Strong Plan’ found in Appendix One of PH pages 37 - 39.Divide the group into smaller groups of 3 and instruct them to practice using the ‘Stay Strong Plan’ in reference to the scenario involving ‘Jenna’. Regroup after 15 minutes and take feedback on the usefulness of the tool.

Discuss the application of recovery-oriented practice in the disabilities context, referring to page 16 of PH. Discuss the Taking Time Framework (PPT 33) in reference to working with people living with disabilities who have experienced trauma. Discuss the fact that the Framework reinforces the importance of using a person-centred approach and that the values underpinning the Framework clearly parallel the principles of recovery-oriented practice.

Pages 14 to 17

Appendix One, pages 37 - 39

Video: “Staying Strong Plan in Action” – 7 mins

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12.30 – 1.15 Lunch Break1:15 – 2:45 Slides 35 – 49

Motivational Interviewing

Definition of MI MI Framework Spirit of MI A Continuum of

Styles Persuasion – What

goes Wrong? Ambivalence Vid - An interview

with William Miller The Righting Reflex

Introduction to Motivational Interviewing (MI)Explain to the group that MI is an evidence-based approach that can be utilised within recovery-oriented, person-centred practice. Also explain that the sessions this afternoon will provide a broad overview of the MI model and that more extensive training is available for those who are interested in expanding their knowledge/skills.

Refer to PPT slide 24 and explain that MI was largely developed by William Miller and Steve Rollnick – see 3rd edition of MI book.Provide a definition of MI, referring to page 18 of PH and slide 36.Introduce the MI framework and explain the different components of the model. Refer to PPT slide 38 and discuss the ‘spirit’ of MI, reinforcing the point that MI is more than ‘clever techniques’. Refer to the information on page 19 of PH describing the elements within the spirit of MI.

Refer back to the concept of the continuum of styles – ‘Directing-Guiding-Following’, explaining that MI sits in the middle and draws on both directing and following.Instruct the group to form pairs for the next three activities that aim to highlight the differences between directing, guiding and following. Reinforce that the aim of these three activities is to highlight what happens for the ‘speaker’ in response to the different styles. Therefore it is important for the

Pages 18 to 22

Video: An interview with William Miller – 8.42 mins

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Time Slide Session content Resources / Page‘helper’ to keep to the task as described on the slides. Also explain that these activities work best when the ‘speaker’ chooses something that they want to change – it is not a role play.

Activity Six PPT 40: Refer to the instructions on PPT slides 40 – 42. Explain to the ‘helper’ that they have 5 minutes to ‘help’ the ‘speaker’ to change. If time permits, swap roles. Regroup and take feedback from the ‘speaker’ – discussing what they heard themselves say in reaction to the direction (hopefully you will get statements such as “I heard myself saying yes, but…” ). This should then generate a discussion about ‘change talk’ vs ‘sustain talk’ and lead into a discussion about ambivalence people experience when trying to change.

Show ppt slides 43 and 44 and reinforce the point about ambivalence being a normal human reaction in the context of change.VIDEO: Show brief section of an interview with William Miller. Discuss the concept of the ‘Righting Reflex’ as per PH page 21 and PPT slide 46.

Activity Seven PPT 47: instruct the group to return to the pairs they were in for Activity Six and rerun the same conversation, with the ‘Helper’ now simply ‘following’ the speaker (referring to the instructions on PPT slide 47). Instruct the pairs to swap roles if time permits. Regroup after 10 minutes and take feedback from the ‘speakers’. It is likely that participants will say things such as “it was good to feel heard BUT it wasn’t enough. I wanted the listener to say more!”

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Revisit the definition of MI.Activity Eight PPT 49: instruct the participants to return to the same pairs as for the last 2 activities, explaining that this is the last version of this conversation about change. Instruct the ‘listeners’ to refer to the questions/instructions on PPT 49 and page 22 of PH to begin to guide the ‘speaker’ towards considering change. Swap roles if time. Regroup and take feedback on the differences between the three styles of listening.

2.45 – 3.00 Afternoon Tea Break3.00 – 4.15 Slides 50 – 60

Vid - MI Explained MI Processes Engaging Aboriginal

Perspective on Engaging

Getting Moving with OARS

Exchanging Information

Preparatory Change Talk

Mobilising Change

Motivational Interviewing in ActionVIDEO: Show video explaining what MI looks like in action.Introduce the four processes of MI, referring to PPT slide 51 and the

information on pages 23 and 24 of PH.Reinforce the importance of cultural awareness when engaging Aboriginal

people (see PH page 24 and PPT slide 53).Discuss the use of the OARS as foundation, person-centred skills that are

used in a particular way to reduce ‘sustain talk’ and to evoke and reinforce ‘change talk’.

Introduce the ‘Ask-Provide-Ask’ strategy as a person-centred way of providing information, utilising the ‘spirit’ of MI. Talk through the information on page 26 of PH, explaining the components of the strategy.

Introduce the concept of ‘Evoking Change Talk’, explaining that ‘change talk

Pages 23 to 31

Video: MI Explained 7.46 mins

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Talk Applying/Adapting MI Learning MI

has two components – preparatory (or getting ready) change talk and mobilising change talk (when the person is ready to take steps towards change). Provide an overview of the Change Talk Strategies on pages 27 to 29 of PH

IF TIME - Demonstrate the use of the ‘Evoking Change Talk’ strategies, asking for a volunteer from the group. Refer to the scenario involving ‘Jenna’ for the demonstration.

Activity Nine PPT 58: divide the group into small groups of three and instruct them to discuss the application of MI skills and strategies, revisiting the scenario involving ‘Jenna’ as per page 29 of PH.

Provide information about the adaption of MI when working with people living with cognitive impairment (as per pages 30-31 of PH). Also discussed the application of MI within mental health and justice settings

Inform the group of resources for continuing their learning of MI as per the information on PPT slide 60.

4.15 – 4.30 pm Slide 61 – 62 Reflection on Today’s

Workshop

Wrap Up and EvaluationInstruct the participants to complete the reflective question on page 33 of

PH.

Pages 32 to 36

Evaluation forms

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Further DJP Training and Resources

Ask the group for feedback on what they will take away from the workshop.Refer participants to the reference and resource list on pages 34 to 36 of PH

and encourage them to read further on the topics introduced in today’s workshop.

Handout evaluation forms and ask the group to complete them.Provide a summary of what was covered in today’s workshop.Discuss other DJP face-to-face and online training that will be coming up this

year as well as other resources available on the DJP site.

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