endeavour for excellence

These notes are the intellectual property of Hope Leet Dittmeier and Genio. They are a resource for participants in the Endeavour for Excellence programme and should not be used as a foundation for practice by those who have not undertaken Endeavour for Excellence training.


Endeavour for Excellence

Hope Leet [email protected]

Week 1


An SRV-derived

Theoretical Framework

2


What is our mission?What is the primary purpose of our work?

What kind of outcomes or results do we hope for?

“THE GOOD LIFE”

3


Universal good things of life

Family

Home

Belonging

Friends

Work

Safety and Security

Opportunities to develop one’s abilities

Respect, honesty & fairness

Being treated as an individual

Having a say

Access to community places

Ordinary social life

Contributing

Good health

4


Why is it different?

Why do so many people who rely on our supports not have the very things most of us enjoy and describe as the “good life”?

5


Devaluation - A harsh reality

Someone is seen as outside the norm, different

The difference is viewed in a negative way

6


What society valuesNarrow definition of beauty

Physical strength/ability, athleticism

Productivity

Material belongings/wealth

Competence, intelligence

Survival of the “fittest”

Youth, newness

Dominance

7


Valued vs. devaluedPerson w/deformityDependent adultUnemployed manLazy teenPoor/homeless personSomeone on the dolePerson w/intellectual disabilityIlliterate person

Movie star/modelAthlete/championProfessionalHomeownerMillionaireSurgeon, solicitorInstructor, university graduate

8


Perceived devaluationDevaluation is not about people’s

inherent worth, but their perceived worth – it is in the eyes and minds of others

9


DevaluationHow important or deeply held by observers

are the values perceived to be violated by the person or group

How many values are perceived to be violated by the person or group

The degree to which the values are perceived to be violated by the person or group

10


Unconscious devaluationDevaluation can be conscious, but

is more often unconsciousEven enlightened, kind, progressive

people (including human service workers) devalue others

11


Devaluation mattersDevaluation explains why people don’t

have equal access to the good things in life that others do

Being devalued results in the likelihood that bad things will happen to you, that you will be treated in ways that wouldn’t be tolerated for/by valued citizens

12


It isn’t the functional impacts of disability:

– Reliance on a wheelchair– Lower intellectual capacity – Poor sight or hearing

that pose the biggest challenge to quality of life

It is the impact of the common life experiences that people face as a result of being devalued

Common life experiences

13


REJECTIONBy:

Family

Neighbors

Community

Service workers


14



Nonhuman

Menace, evil, or object of dread

Trivial, or Object of Ridicule

Object of Pity

Burden

Child

Holy Innocent

Client

Sick

Dying, dead, better off dead

CAST INTO DEVIANT ROLES

15


Supported in valued-tainted locationsGrouped with people in image-impairing waysExperience value-impairing methods and activitiesBizarre or negative names and labels to people,

programs, services, logosPersonal appearance neglectedServices funded with image-tainted monies or

devaluing appeals

STIGMATISEDCommon life experiences

16


Being the scapegoat for anything bad that happens

Being suspected of belong to more than one devalued group

Being cast into more than one deviancy role

Being treated worse for a suspected or real offense than are valued people

Upon being vindicated, receiving less restitution, if any

MULTIPLE JEOPARDYCommon life experiences

17


Physically

Excluded: Architectural barriers

Segregated: Separate places

Confined: Prisons, nursing homes

Ejected: Expulsion, banishment

Destructed: Assault, euthanasia, capital punishment

DISTANCEDCommon life experiences

18


Socially

Avoided, ignored

Degrading treatment

Even within service: badges, keys, separate dining areas, different toilets

DISTANCEDCommon life experiences

19


Being made/kept dependent by family and services

Having to follow arbitrary rules

Having little say about things that have personal impact

Being moved about

Having one’s associations controlled

Being deprived of legal rights

LOSS OF CONTROL/AUTONOMYCommon life experiences

20


Often the cause of discontinuity is a result of rejection

Devalued people get moved around more often, even within the same organization

People often get moved against their will and with little notice, almost always interpreted as being “for their own good”

Sometimes people don’t have the resources and ability to cope or to stay in contact with those left behind

PHYSICAL DISCONTINUITYCommon life experiences

21


Impact of physical discontinuity on people includes:

– Disorientation or confusion– Lowered performance– Insecurity– Loss of possessions– Relationship loss– Stress– Illness and death

PHYSICAL DISCONTINUITYCommon life experiences

22


People often don’t have the skills or resources to stay in touch with others

People are often abandoned by others

High turnover and reassignment in service results in little continuity even with those paid to be in relationship

RELATIONSHIP DISCONTINUITYCommon life experiences

23


Sometimes stressed or absent family relationships

Disproportionate number of relationships with other devalued people which doesn’t afford the same degree of social capital

Formal services rarely recognize or address this need adequately

Substitution of artificial/paid ‘friends’

LONELINESSCommon life experiences

24


Disability becomes life-defining and primary determinant in decisions

People are often not well-known for their unique identities

Vast majority of supports are provided in group settings

DEINDIVIDUALISATIONCommon life experiences

25


People are kept poor in order to receive necessary supports

People don’t have equal access to employment opportunities

People’s belongings are not valued or protected in many settings

People are less likely to inherit from their families

MATERIAL POVERTYCommon life experiences

26


Lack of opportunities to learn ordinary things in the ordinary developmental sequence

Exposure to non-typical models of behavior and custom

Absence of relevant and potent educational programming

LACK OF TYPICAL LIFE EXPERIENCES


27


Low expectations related to a person’s potential

Few real investments made in a person’s future

Exposed to programs and experiences that have little meaning to the person

Time not well spent

Lack of potency in interventions

HAVING ONE’S LIFE WASTEDCommon life experiences

28


Devalued people at increased risk of physical and sexual abuse

Devalued people less likely to report or to be believed

Institutional culture provides few safeguards

Perpetrators rarely held to same accountability as others

ABUSE AND BRUTALISATIONCommon life experiences

29


People often regret causing hardship on their families

People are sometimes poorly treated by carers

Respite is evidence of “burden” mentality

AWARE OF BEING SOURCE OF ANGUISH


30


Lack of experience poorly prepares people for valued involvement in the valued world

People often have insecurities and lack of confidence

People often see themselves as not fitting in or belonging

FEELING ALIEN IN THE VALUED WORLD


31


Preoccupation with one’s own condition

Feeling/being/acting like an alien in the world

Sorrowing over all the good things one has missed and the bad things one has suffered

A sense of worthlessness, dislike of self

Insecurity

Fear of failure and resulting avoidance

Searching for the abandoner

Likely impacts of devaluation

32


Fantasy and inventions about positive relationships that don’t exist

Seeking/demanding physical contact

Testing of the genuineness of relationships

Withdrawing from contact and/or reality

Turning the hurt into resentment or hatred

Rage, perhaps even violence, at the world or self

A sapping of physical and mental energy

Likely impacts of devaluation

33


The relevance of woundedness

We must avoid services which continue to impose wounds on people – congregation, loneliness, low expectations, etc.

We cannot use our own valued life experiences as a framework for understanding where people are at the moment

34


Social rolesHow we are known by others

What defines who we are

The place we hold in society

“I am a . . . (noun)”

What we become over our lifetime

35


Social rolesA socially expected pattern of

– Behavior– Responsibilities– Expectations– Privileges

36


Roles have a big impactOur image in the eyes of others

Our own self-image

Acceptance and belonging

Degree of autonomy and freedom

Opportunity to make our contribution

Quantity and quality of relationships

Personal growth and development

Material possessions

37


Valued & devalued rolesA role may be positive or valued

- good neighbor, student, member

A role may be negative or devalued

- client, eternal child, object of pity

38


Social rolesRoles may be:

– Imposed ~ assigned by others– Chosen ~ selected and pursued

Roles may be:– Inherited ~ born into– Earned ~ accomplished

Chosen and earned roles are most highly regarded

39


Social rolesCertain valued roles are expected:

– Family roles ~ daughter, uncle, grandparent

– Adult roles ~ employee or student

– Irish citizen ~ contributor, good neighbor

40


Primary goals of SRVProtect the socially valued roles held by

the person

Avoid adding new negative, devalued roles

Escape or disprove negative roles that have become a part of a person’s identity

41


Primary goals of SRVEnter into new valued roles (i.e., roles

that most of us take for granted such as neighbor, church member, volunteer, employee, etc.)

Defend and embed socially valued roles

42


Common goals of serviceMinding people

Protecting people

Entertaining people

Changing people

Evaluating people

Keeping people busy

43


From activities to rolesACTIVITY

Going to church

Working

Swimming

Cooking

Taking a class

Painting

ROLE

Church member

Employee

Swimmer

Cook

Student

Artist

44


Role communicators - ArtistThe physical environment

The people associated with a person or group

The behaviors that are expected and the activities engaged in

The language and words that are used

Other imagery such as possessions

Studio space, art galleries,

Artists, art instructor, art shop cashiers

Taking classes, exhibits, giving art as gifts, shopping for supplies

Canvas, pastels, acrylic, impressionistic, form

Art supplies, original art in home

45


Primary SRV strategiesImage Enhancement

Competency Enhancement

46


Image enhancementImage is conveyed by:

– Physical appearance of the person– Physical appearance of others associated

w/the person– Proper social etiquette and skills– What is said ~ words, topics– Physical surroundings– Possessions and belongings

47


Competency enhancementCurrent functioning does not predict a

person’s capacity

Teach relevant skills using:

– The power of imitation and modeling– Positive role expectancies– High expectations– Strategies that reflect how a person best learns– Potent systemised instruction methods

48


Role expectancy and circularityPeople become

what they are expected to be

Self-fulfilling prophesy

Breaking the vicious cycle

49


Culturally valued analog“What happens for valued citizens of the

same age and gender?”

Which can be encountered with at least reasonable frequency in the valued sector of society

With which most members of society would be familiar

Of which most members of the society would hold most positive expectations and images

50


Model coherency“Are we doing that which is most useful?”

Relevance – does the support match what the person needs most? Are we addressing the person’s most fundamental and most pressing needs? Quality

Potency – is the support sufficient enough to bring about desired results? Is there enough of the right support? Quantity

51


Conservatism corollary“Bending over backwards”

Heightened vulnerability– Prevailing stereotypes– Impact of wounding experiences– Lack of protection afforded by valued roles– Multiple jeopardizes

52


Conservatism corollaryPositive compensation for disadvantage

– Disprove common stereotypes by seeking roles that contradict

– Beyond normative– Strive for the most highly valued options

53


Personal social integration and valued social integrationAdaptive participation by a devalued person

In a culturally normative quantity of contacts, interactions, & positive relationships

With ordinary citizens

In normative shared activities, that are part of recognizable roles, and

Carried out in a valued physical & social setting

54


Personal, valued social integrationStrategies:

Address characteristics and conditions of person which are apt to elicit rejection (anxiety, habits, images, roles)

Help community members identify with person (commonalities, cooperative tasks, invitation)

Recognize and reinforce any integrative gestures or acts by community members

55


Personal, valued social integrationAdvantages:

Protection of welfare and safety

Enhancement of competencies

Higher, more normative expectations

Access to good models

More variety of experience

Enhancement of person’s image

56


Non-programmatic issues that constrain programmatic onesFunding

History

Legal issues

Political

Staffing

Personalities

57


High-Quality

Individualised

Supports

58


Confusing TerminologyAre there distinctions between ‘individualised’ and ‘person centred’?

The concept of individualising is not at all new

Calling the work ‘individualised’ doesn’t necessarily make it so!

It isn’t reasonable or ethical to focus solely on one person at the expense of those in their intimate personal network

59


Confusing TerminologyWe can still do harm when using one-person-at-a-time methodology

Once individualised, not always individualised!

Term typically intended to signify high quality

Individualised strategies embrace a presumed ideology about what constitutes good work

60


Sequence matters!Typically services are pre-designed based on professional ideologies about what people need

Decisions are made before knowing who will avail of the service

People ‘fit into’ the model

61


Process of individualised practice

62



63


DiscoveryGetting to know people in a different way

Focusing on:

– Capacity– Commonality– Contribution/Citizenship– Context

Thinking about potential and possibility

64


Getting to know the person differentlyDeficiency-based focusAssessments with

comparative scores

Diagnoses & labels; levels of intellectual disability

A thorough description of what a person CAN’T do

Capacity-based focusFinding what people have

in common with others

Appreciating what a person CAN do; finding their gifts

What’s possible with good support!

65



66


What is individualised planning?Variety of methods or tools

– Personal Futures Planning– Essential Lifestyle Planning– PATHFocused on one person

Positive possibilities

Rich in valued roles and meaningful relationships

Customized supports

67


What individualised planning is NOT– Only accomplished

using colored markers!– Just documenting the

answers to simple questions

– Giving people whatever they want

– Ignoring people’s most fundamental needs

– Sticking only to what we know how to do

68


Defining a desirable lifestyleA HOME of One’s Own

– Of person’s choosing, in typical setting, with people chosen

Valued Social ROLES

– Adult, citizen, neighbor, sibling, aunt/uncle, employee, volunteer, artist, member, friend

RELATIONSHIPS

– Disproportionate number of friends with disabilities– People need intentional support to cultivate meaningful

relationships with ordinary citizens

69



70


Resource developmentMobilizing and creating desired supports:

– How do valued citizens go about this?

– What places and resources are used by others?

– Who is in the best position to assist?

71



72


The proper use of formal supportsFirst – what is family able to do, want to do, do well

(that the person being supported finds acceptable)?

Second – who else in the person’s social network might be interested in assisting the person in specific ways?

Third – what other options for support are available in the community?

Fourth – what blanks do we fill with paid supports?

73


Service deliveryRelevant and thoughtful safeguards

Teamwork ~ layers of people working together to make good things happen

Effective leadership that provides vision, inspiration

Competent management of supports and assisting people to play a bigger role in managing their supports

Flexibility, flexibility, flexibility and more flexibility

74



75


Evolving as we learnSome of the assumptions we had will be wrong

and need correcting

We will learn things about people that we didn’t know before

People will grow and develop and their interests, opportunities and needs will change

People will, hopefully, become less reliant on us

A culture of mindfulness and reflection is needed

76


77


Partnership and

Empowerment

78


PartnershipIs hard work!

Takes time

Requires nurturing

79


Shared valuesAgreement about what is worth working toward –

‘common ground’

Consensus about how to treat one another, especially in the face of adversity

Recognition and respect for one another’s ‘non-negotiables’

80


Shared responsibilityDoing ‘with’ one another vs. doing ‘to’ or even

doing ‘for’

Balancing investment and effort between parties

Taking responsibility for our actions - regretting our errors

81


Mutual respectHonoring one another’s previous experience

Recognizing one another’s expertise and perspective

Having clarity about each party’s boundaries

Portraying one another in positive ways

82


Role clarityNatural investments of people being supported

and their families

Proper purview of service

Clear expectations

Being ‘friendly’ but not being friends

83


Effective communicationBeing honest

Discussing differences or disagreements

Keeping one another informed

Maintaining confidentiality

84


Conflict managementNot about IF things go wrong, but WHEN things

go wrong

– Notice the learning– Create a positive and productive outcome– Avoid blame

85


Interpersonal identificationPeople who identify with others will generally

– Want good things for the others– Want to be with the others– Communicate good things about the

others– Want to please the others; do what they

ask– Possibly want to be like the others

86


Strategies for Fostering Interpersonal IdentificationImprove the approachability of each party by the

otherImprove the likelihood that when contact occurs,

it is positiveFind and emphasize commonalities shared by

the partiesEngage each party in experiences that help

them see the world through one another’s eyes

Foster each party’s sense of responsibility for one another

87


Roles of SupportersAdvisorMentorTeacherInformerProblem-solver

88


Role of Family and GuardiansExpert regarding the personAdvocate for what is bestAuthority to make decisionsHistorianFinancial managerHolidays‘Back-up’ by design

89


First Steps on the journeyFull disclosure of our intentions

Agreements about the process

Discussion of roles and responsibilities

Appreciating what is non-negotiable

A ‘walk in the other’s shoes’

90


EmpowermentIs hard work!

Takes time

Requires intention

91


Preaching to the Choir!Starting with the assumptions that you

already believe:

– People are entitled to be the determiners of their destiny.

– People are able, with support, to make more decisions than they do now.

– It is our responsibility to make choices available and to help people make good decisions.

92


Why is it so important to us to make our own decisions?

Which choices matter most to us?

What choices do we NOT have?

What do we do when we have a difficult decision to make?

93


Choice is Developmental

People do not learn how to make good choices overnight.

94


Choice is usually an Interdependent Activity

People typically rely on trusted allies to help them make good decisions.

95


Choice is Relational

People who care about someone will typically try to influence them to make ‘the right’ decisions or at least not make devastating decisions.

96


Choice involves Complex Options

Most genuine choices are not a simple ‘yes/no’ or ‘either/or’ or ‘right/wrong’ proposition.

97


Choice involves Responsibility

People typically recognize and consider the impact their decisions have on others.

98


Choice implies Having Options Available

People we support won’t have genuine choices unless we embrace service strategies that actually afford personalized options – where, who, how, when, etc.

99


People Tend to Choose ...What is familiarWhat is certain, less riskyWhat is simple, concreteWhat is quick, immediateWhat requires less investmentWhat they think others want them to choose

100


Non-Authentic ChoosingRhetoric - using the word “choice” doesn’t

necessarily mean people have/had a choice

“They” prefer . . . never honors individual choice

Coercive circumstances which favor the needs of others, particularly the service system

101


Abandoned to ChoiceStanding by to observe people making

dangerous decisions is not supporting choice, it’s irresponsible and maybe abusive

“Suffer the natural consequences” often means punishing people for what they don’t understand

Recognizing our role in the cycle of failure

102


Necessity of RelationshipSeeking an open, honest, balanced, mutual,

reciprocal, ‘friendly’

Over time ~ gradually proving oneself

Knowing the person vs. fixing them

Understanding vs. blaming

Accompanying vs. controlling

Milton Tyree

103


Strategic Support for Making Choices

Advocate for people’s right to make decisions.

104



Provide a comfortable and safe atmosphere for people to make decisions.

105



“Veto power” – at a very minimum, the right to say “NO!”

106



Informed choice - providing accurate and relevant information in ways that people understand

107



Teach people strategies to use in making good decisions

108



Help people learn from their experiences

109



When necessary, embrace a partnership or joint responsibility with gradual shift of power

110



Provide safeguards to keep people from experiencing irreparable harm

111


Support RolesPartner – “Let’s work on this together.”

Advisor – “This is how I look at it”

Informant – “You need this information”

Teacher – “One way to weigh your options is . . .”

Cheerleader – “You did it – I knew you could!”

Connector – “I would love for you to meet . . .”

Analyzer – “What could we have done differently? What did we learn?”

Assurer – “It’s okay. Remember, you’re still new at this.”

112


Discovery

The Distinctive

Identity Portrait

113


DiscoveryDiscovery seeks to understand who the person is

in as many aspects of life as necessary to inform the subsequent plan

Discovery is a systematic and intentional set of in-depth activities designed to uncover a person’s assets, interest, and conditions for success

Discovery is an optimistic process, focusing on strengths rather than deficits

Discovery translates information into possibilities

114


DiscoveryDiscovery seeks to identify information about

the person’s life, not create evaluative data regarding performance

Discovery information is intended to be a guide for matching a person to fitting roles

Discovery identifies a person’s complexities and challenges for the purposes of matching, negotiation and supporting the person in new roles

115


The essence of discoveryDiscovery: to gain

insight or knowledge of something previously unseen or unknown; to notice or realize; to make known, to reveal

116


What we usually know about the people we try to assist – just the tip of the iceberg

We need to know much more

The iceberg analogy

117


Skills needed in discoveryIntentionality

Observation

Curiosity

Detail-orientation

Discernment

Translation

Positivity

Thoroughness

118


Interests“What would you like to do?” can be counterproductive!

– People have been deprived of typical experiences of the valued world,

– People have had a very limited “menu” from which to choose,

– People might not know their own talents and interests

Look at activities person engages in without being expected to do so, what is naturally motivating

Provide opportunities to explore new possibilities

119


Assets - skillsWhat person can do, is good at doing

Creating an vivid description of abilities:– Pour liquid into a cup– Hold item and drop into a slot– Turn head toward sounds– Enter data into excel spreadsheet– Meditate effectively

Noticing all volitional movements

What a person might be interested in learning

120


Assets - knowledgeWhat information a person knows or is seen

as an expert in:– Reptiles– Irish history– 80’s music legends– Automobiles– Weather– Catholicism

121


Assets - personalityPersonal traits that are engaging, inspiring,

likeable, impressive, honorable

What people who love the person would say about them:– Fun to be around– Can keep a secret– Never gives up– Considerate of others– Is a peace-maker

122


Assets - lived experiencePotential contribution based on personal life

experience:– Survived cancer– Successful with weight watchers– Lost a parent at a young age– Grew up in the Jewish tradition– Survived institutionalisation– Learned to manage diabetes

123


Assets - passionWhat a person cares deeply about:

– The environment– Alzheimer's– Justice– Accessibility– Animal rights– Health care– Beauty

124


Assets - resourcesWhat resources or belongings a person has

that might be shared– Transportation – Tools– A place to meet– Time– A computer

125


Assets - connectionsWhat personal connections does the person

have that might be shared, what networks they have access to:– Family– Friends– Neighbors– Membership– Parish

126


Conditions for successTask performance

Minimal need to stand, physical activity

Instructional strategies

Modeling, repeated practice, visual prompts

Environmental conditions

Indoors, well-lit spaces, intimate groups

127


Conditions for successSupportive strategies

Even voice tone, encouraging comments, proactive planning

Supports needed

Job coach training for 1 to 4 weeks, personal assistance, transport

Conditions to be avoided

Hot temperatures; novel situations

128


The discovery processExplain the process to the person and family

Confirm that the ultimate goal is (supported) valued opportunities in typical community

Address questions and concerns

Conduct home visit

Survey neighborhood resources

Ask about routines and responsibilities

Interview others

129


The discovery processIdentify favorite familiar activity and participate

with the person

Suggest and participate in an unfamiliar activity with the person

Review files, and other information about the person

130


Discovering fitting opportunities

Assets

ConditionsInterests

131


Discovering fitting opportunities

Good w/numbersPrecise

Great social skills

SittingTask

demonstratedIndoors

SportsHistory

Reading

132



Thank you

www.genio.ie

endeavour for excellence

Documents

excellence programme

excellence training

excellencehope leet

good life3

ones abilitiesrespect

wolfensbergers checklist

honesty fairnessbeing

primary purpose