Monday, July 27, 2015

Beyond “Entry Level”: The Need for DVE (Diagnostic Vocational Evaluation) Reform

This essay presents a problem in the DVE protocols and offers a solution designed to encourage Vocational Rehabilitation Evaluators to employ a client-centered approach to evaluation and counseling as opposed to the prevalent program-centered approach.

I. The Problem

A) The “Mean Push” Hypothesis

The “mean push” hypothesis [see Addendum 1] describes the unspoken protocol used by VR workers that focuses on the mean of capability/functioning as the ideal goal, that in effect uses its programs to “push” clients towards the mean. The push is in fact beneficial for below-the-mean scoring clients, supporting of expands vistas, empowering clients to achieve maximal functionality at a level that is as close to the mean as is practicable. Yet for “above-the-mean” capability clients, the effect of the “mean push” is detrimental.

The higher above the mean the client’s capabilities are, the more detrimental it is. This is because DVE protocols seek to accurately measure capabilities of those clients whose level is at, or below, the mean. Any client with capabilities above-the-mean, whether small, great or extraordinary will – as a result of a protocol of non-measurement – be placed in a vague, non-articulated “catch-all” category or class: “functional or better,” “average or better.”

B) Above-the-Mean Capabilities, Non-Measurement and its Consequences

The correlation of capability on the one hand and psychological suitability of a vocational goal for a VR client is on the other hand ignored by the “catch all” treatment and the impossibility of pinpointing capabilities with any semblance of accuracy. It should come as no surprise that Evaluators will often fail to encourage or support the proper goal that would best allow the client to be integrated socially in the work environment, to achieve suitable earnings, and to engage in activities that are not straining to the client due to their banality, repetitiveness, meaninglessness, with the result that the client is disengaged socially and emotionally from both work and social environment.

The “do no harm” principle is violated in that this improper protocol, a), alienates the client, perhaps exacerbating the clients’ diagnosed disability condition, and, b) interferes with achieving the true goal of the exercise, “suitable employment,” and, c) contributes to continued poverty and marginalization.

The higher the client’s proficiency the more extreme the of the created by the “mean push” is on the VR evaluation (the DVE).

The inappropriate attitude of Diagnostic Vocational Evaluators that is expressed by obfuscatory behavior (failing to accurately inform the client about the DVE process) and expressed by obfuscatory evaluation of results (exhibited by “capping” the reports, by misrepresenting, or failing to represent, actual measurable demonstrated capabilities, abilities and skills that can be derived from the tests conducted during the DVE) undermines the fulfillment of the VR standards that expressly delineated by law.

It should not be surprising that the client’s awareness that an Evaluator is untrustworthy, un-thorough and unconcerned with the veracity of the DVE process will produce an attitude on the part of the client that will exhibit a lack of confidence in, and a lack of respect for the professionalism of the Evaluator, and a lack of confidence in the resulting report’s veracity, accuracy and conformity with federal law requirements.

C) Violations of ADA Statute & Policy Directives

The biased treatment of above the mean capability clients violate – either directly or indirectly – the delineated obligations and requirements of law. Following is an itemized list of violations of requirements of federal law governing ADA mandated State Vocational Rehabilitation programs.

1) “Informed choice” (law term) – Clients are not informed in advance of the testing that their capabilities that fall above the mean will not be measure and recorded in the official DVE report. Thus when the client is made aware in what is in many cases the first test administered, the reading comprehension test, that the maximum score is “college admission level or above” the client often feels blind-sighted and quite justifiably thinks of the DVE procedure as unethical and improper, or at best, unproductive and irrelevant. “The employment goal also must reflect the individual’s interests and informed choice to the extent that those factors are consistent with the individual’s strengths, resources, priorities, concerns, abilities, and capabilities.” (RSA-PD-97-04)

2) “Individualized” (law term) – The tests meet the individualization standard for clients who are at the mean or below in capabilities, yet discriminated against clients whose demonstrable capabilities are “censored” from the DVE process and report, thus violating the individualized standard. “The State VR Services program is designed to assist individuals to obtain employment that is consistent with their strengths, resources, priorities, concerns, abilities, and capabilities (also referred to in this document as the “individual’s primary employment factors”). Designated State Units (DSUs) conduct an individualized assessment of the VR needs of each eligible individual to assist the individual in establishing in the IWRP an appropriate vocational goal that is consistent with this standard (7(22); ­102(b)(1)(A) and (b)(1)(B)(ii)).” (RSA-PD-97-04)

3) “Unique strengths, resources, priorities, concerns, abilities, and capabilities” (law term) – The 1997 Policy Directive uses the unequivocal word “must” when stating that the VR employment goal that is to be authorized by State VR agencies are to services be “consistent with the individual’s strengths, resources, priorities, concerns, abilities, and capabilities.” (RSA-PD-97-04)

4) “Maximize their employability” (law term) – “Consistent with the increased statutory obligations placed on state VR agencies, on August 19, 1997, the federal Rehabilitation Services Administration (RSA) issued a Policy Directive, RSA-PD-97-04. This directive requires state VR agencies to approve vocational goals and the services to meet these goals to enable persons with disabilities to maximize their employment potential. It represents a dramatic shift in RSA policy.” (S. Rep. No. 388, 99th Cong., 2d Sess. 5 (1986), as quoted in Polkabla v. Commission for the Blind, 183 A.D.2d 575, 576, 583 N.Y.S.2d 464, 465 (N.Y. App. Div.1st Dept. 1992)

5) “Maximize … economic self-sufficiency” (law term) – “Congress has stated that VR services are to empower individuals to maximize employability, economic self-sufficiency, independence and integration into the work place and the community through “comprehensive and coordinated state-of-the-art programs.” (29 U. S. C. § 701(b)

6) “Comprehensive and coordinated” (law term) – “Comprehensive and coordinated state-of-the-art programs of vocational rehabilitation.” (29 U. S. C. § 701 (b)(1)(A))

7) “Maximize … integration into the work place and the community” (law term) – “Congress has stated that VR services are to empower individuals to maximize employability, economic self-sufficiency, independence and integration into the work place and the community through “comprehensive and coordinated state-of-the-art programs.” (29 U. S. C. § 701(b)

8) “Highest level of achievement or a goal” (law term) –The court noted that the intent of Congress, in adding the maximization language, was: [T]o establish a program which would provide services to assist clients in achieving their highest level of achievement or a goal which is consistent with their maximum capacities and abilities. Id. at 365.” [Hager report; reference to Buchanan v. Ives, 793 F.Supp. 361 (D. Me. 1991)]

9) “Establish employment goals that are beyond entry level positions” (law term) – “RSA has stated that VR agencies must establish employment goals that are beyond entry level positions for those capable of more challenging work.” [Ronald M. Hager, Esq., “Work, Assistive Technology and State Vocational Rehabilitation Agencies The Vocational Rehabilitation Agency’s Obligation to Fund AT to Support Employment Preparation,” National Assistive Technology Advocacy Project, Neighborhood Legal Services, Inc., Second edition, Feb. 2013, p. i]

D) Client Experience in Dealing with the Process-Oriented Evaluator

The intent of the client who has high capabilities (and IQ in the higher ranges: “gifted” and above, or 130+) and who seeks to find an outcome that marches his cognitive skill and style with a proper employment outcome will, when taking texts and in fulfilling a written assignment, seek to demonstrate his highest level of ability.

Yet, in the program-centered environment of so many VR programs, including the DVE portion, the client will be shocked to discover his or her production and effort that was directed towards establishing a correct measure of his capabilities, is not only to go unmeasured and unreported, but also that the Evaluator will demonstrate an apathetic, indifferent attitude, sometimes a supercilious one, towards what seems (with true justification) to the client to be a matter of the utmost importance.

Evaluators who do not account for the of the disability diagnosis provided by knowledgeable expert sources will fail to meet the individualized standard in conducting the evaluation and in making recommendations. An example would be a client who is diagnosed with ADD (but who has a gifted IQ and is known to have high capabilities) will be treated in an authoritarian and demeaning fashion, will not be given information about the expectations he or she is expected to meet, will not have the option of informed choices to be considered, and will be pushed into tasks which exacerbate the ADD condition.

The ironic upshot of the process may end up being a damning recommendation that strips the client of all employment goal options except for those which his or her ADD (combined with high capabilities and extensive professional experience) would render impossible to endure, one that places him in an authoritarian environment, expected to perform petty tasks which induce extreme boredom, which give the client no hope of success or fulfillment of his potential in any important area: emotional, financial, intellectual, professional or social.

Vocational Rehabilitation practitioners are social workers. Despite this fact, those among them who adopt a program-centered approach to the DVE process and Vocational Counseling demonstrate, in situations like this, involving a client who seeks (and, in actuality, needs) to reach a vocational goal that is consistent with his capability level, what the handbook Direct Social Work Practice by Dean Hepworth et al., calls “inept behavior” in “dealing with a problem beyond their scope of practice.” The rigid program-centered Evaluator will often match the following description:

“Despite educational preparation, some practitioners demonstrate behavior that lacks the basic tenets of a helping relationship, for example, a lack of empathy or being in tune with those seeking their help; a lack of genuine and authentic concern; a lack of appreciation of different beliefs, lifestyles, and values.Their inept behavior may be attributed to anxiety, a lack of skill or experience, dealing with a problem beyond their scope of practice, or an inability to build collaborative relationships with clients.”

[Dean Hepworth, Ronald Rooney, Glenda Dewberry Rooney, Kim Strom-Gottfried, Direct Social Work Practice: Theory and Skills, 9th Edition (Brooks/Cole Empowerment Series), Brooks/Cole, 2013, pp. 556-7]

The DVE process and report are far to important to the life of the client to be allowed to be undermined by the unprofessionalism and mental limitations of an inadequate, unconcerned, and improperly prepared Evaluator.


II. Initiating the Solution

A. Eliminating the measurement/reporting “cap”

DVE must measure, as accurately and precisely as possible and report precisely as possible:

1) “academic achievement in reading, mathematics, and language” (language taken from a DVE report).

A “12.9+ grade equivalent level” is the maximum level posted on official DEV reports, yet the usage is misleading in that the DVE report states this level as “academic achievement,” implying it is an accurate measurement rather than the representation of the upper limit which will be noted in all DVE reports.

Addendum 2 below gives a 5-rank scale in which level 3 is roughly equivalent to “12.9+.” This scale offers two distinct ranks that are above the “cap” currently used in DVE reports.

2) “verbal and abstract reasoning.”

Results of tests implemented during the DVE must be scored and represented in the report accurately rather than being given the vague “capped” designation of “above average range.”

3) “writing skills”

This skill is tested in the DVE process through a “research and creative writing assignment.” Rather than reporting the misleading “capped” skill-level of “functional expression.” “Functional,” it should be noted, is a term that describes a level of minimal competency above the level that would require remediation.

Standard designations, used in testing these skills are more properly expressed in ranked terms, such as those in the “ACTFL Writing Proficiency Test Rating Scale” which included : “Superior,” “Advanced (“High;” “Mid;” “Low”), “Intermediate” (“High;” “Mid;” “Low”), “Novice (“High;” “Mid;” “Low”). (Note: This particular scale is designed to represent foreign language skills, thus it is not the proper scale for DVE purposes, but is given here as an example of a useful, properly ranked scale.)

B. Effect of eliminating the “cap”

The accurate reporting of skills will influence the judgment, opinions and aims of all parties in the VR process.

• The client will get a clear picture of capabilities, information that will influence his or her plans and choices.

• The Evaluator will be given the data necessary to formulate a report, give guidance and make recommendations that will; be consistent with a client-centered approach and with the requirements of law.

• The State Vocational Counselor will receive a report that is far more accurate, one that meets with the legally required “individualized” standard so that the Counselor may be better prepared to guide the client in a manner consistent with the directive’s requirement for services that assist the client in maximizing employability through making use of his or her “Unique strengths, resources, priorities, concerns, abilities, and capabilities.” (29 U. S. C. § 701 (b)(1)(A))

This will help to insure that the 1997 Directive is honored, at least at the DVE stage of the VR process.

This reform is a step in the direction of assisting clients possessing above average up to superlative skills, capabilities and capacities to gain necessary access appropriate social environments that include cognitive peers as well as to make use of their talents and problem-solving capabilities and inclinations to engage in work involving complex processes and creative problem-solving work activities. Clients whose disability and recent history (including temporary debilitating physical or emotional conditions which the client’s rehabilitative process is geared to overcome or even eliminate) has allowed him or her to become alienated from job market and community, due to the inappropriateness of available jobs that involve hostile environments that may exacerbate disabilities – such as a cognitive gap (or mismatch) of the client with tasks and with colleagues who are cognitively and culturally radically different – require appropriate employment contexts. Jobs that inculcate within the VR client of the very "highly capable" category, feelings of extreme boredom, which involve routine and rudimentary tasks, and which place the client in associations with work colleagues who are hostile to high achievement, a strong work ethic and unappreciative of the use of fluid intelligence in the workplace, which are so poorly paid the client becomes trapped on poverty and consequently becomes socially restricted and isolated (from peers and from family).

This reform will, it goes without saying, have no positive effect, however, if the other VR professionals involved in the client’s case fail to make appropriate is of the data on the client’s “unique strengths, resources, priorities, concerns, abilities, and capabilities.”

The DVE protocols in their present form work against the reforms of the 1997 RSA Policy Directive which require recalcitrant state VR program designers and VR social workers to eliminate the practice of pushing clients to lower rather than higher levels of achievement (and thus to lower levels of financial independence, self-actualization and social integration). As disability rights lawyer Ronald M. Hager, noted in his revised (2013) report on the rights of VR clients, “the law requires VR agencies to establish VR goals that are based on the individual’s interests and capabilities. Additionally, RSA has stated that VR agencies must establish employment goals that are beyond entry level positions for those capable of more challenging work.”

Only a client-centered approach that takes into serious consideration the “whole person” can fulfill the ethical and legal mandates that pertain – in particular to clients with superior abilities. Thus this first step in reform must be followed by an attitude, a protocol on the part of those professions engaged in providing such a client with VR services, that embodies a full scale reform that combats the counter-productive effects of protocols that are exhibited when service providers hold a program-centered, bureaucracy-centered, routine, rigid and regimented approach. Such an approach may, in actuality, not always harm all clients, yet when dealing with high capability clients, it will be the case that program-centered approach, characterized by lack of engagement on the part of the VR service provider, lack of familiarity with (and respect for) the client’s capabilities and needs (emotional, intellectual, financial and social) will, in most cases, grossly violate the “do no harm” axiom.

Another important consideration when VR agencies deal with high capability clients is the recognition of the fact that all VR providers involved in the case must be well-matched with service providing individuals who are properly qualified and able to comprehend and work with  the information conveyed to them by clients regarding his or her requirements (especially with regard to cognitive/IQ-appropriateness in vocational goals).

Respect for the client’s rights and goals is of paramount importance. In cases where the service provider has difficulty comprehending the clients communication of matters pertaining to business, marketplace economics, finance, “opportunity cost” to client resulting from avoidable delays in services being provided, employment goals involving high-level problem-solving and entrepreneurial attitude, it is necessary that the service provider elicit the assistance of a properly qualified professional (such as a senior supervisor).

The reforms discussed in this essay, despite having been delineated in the 1997 Policy Directive, and despite not having not been instituted by some States as of yet, is nevertheless establishes legally mandatory practices that must be followed by agencies, regardless of any given State’s failure to direct VR Service providers to follow the federal law.

It is to be hoped that this effort to clarify important failings of the DVE process will inspire service providers to alter their practices – out of their own professional integrity in an effort to properly serve the needs and requirements of all their clients including those who represent an exceptional class of client (whose “whole person” needs are just as great as those of the ordinary clients), rather than to remain focused on below-average-capabilities clients.



The “Mean Push” Hypothesis

1) Hypothesis: Dragging down one group and lifting up another.

Could there be a latent desire (perhaps fueled by a misapplication of notions of “equality” employed perversely to denote sameness in behavior and aptitude, rather than properly to denote equality of opportunity) on the part of VR professionals, expressed in their models, methods, programs, and evaluation techniques to drag down VR clients (a tiny minority of the total population of VR clients)  populating the right-hand side of the IQ bell curve, while at the same time exhibiting a sincere effort to lift up those populating the left hand?

Are Vocational Rehabilitation professionals inadvertently, or in some cases, deliberately, taking a VR client who has “gifted” or “very superior IQ,” persons who are capable of complex “fluid” thinking, and then implementing a series of actions (services), or inaction (denial of services) that would, in effect, attempt to make the client more disabled after implementation of VR treatments, than the client was before exposure to the VR system?

We might consider these questions in light of this observation: “… a sustained pattern of repeated errors, insensitive behaviors can cause psychological damage to clients.” [Dean Hepworth, Ronald Rooney, Glenda Dewberry Rooney, Kim Strom-Gottfried, Direct Social Work Practice: Theory and Skills, 9th Edition (Brooks/Cole Empowerment Series), Brooks/Cole, 2013, pp. 556-7]

My hypothesis that there might exist a unwritten policy, or a tendency at least, to unjustifiably and inappropriately “push” High IQ VR consumers towards the mean – a practice that clearly is harmful to the consumer in terms of both process and outcome – should be named the VR “mean push” hypothesis.

2) Expanding vistas vs. Constricting vistas

The VR “mean push” is predicated on an ideal goal of promoting averageness or sameness, rather than in seeking individualized suitability in the true, legally required, sense (“whole person” sense). It does not essentially fail or harm clients who can be seen as “below the mean” in cognitive ability (as well as skills) on the bell curve to be pushed towards functionality resembling the mean. This is an approach that seeks to expand vistas. Yet the “mean push” when applied to “above the mean” in cognitive ability, the approach is harmful in that it seeks to constrict vistas rather than expand them. The “mean push” while seeming to be predicated upon a concept of aggregate (society-wide) “equality” it in fact is seeking coerced sameness, and in fact treats individual members of different classes inequally. 

3) Parallel to Above average IQ clients: The DV “Mean Push” Hypothesis

With regard to the non-measurement of above-average abilities and aptitudes and the production of a generic “average or above” ranking of skills and abilities, replacing an accurate measure that the client reasonably would have expected to underscore the client’s hope for success, achievement, social integration and financial independence, we see a parallel akin what is described above as the VR “mean push” hypothesis. The area of the client’s positive self-perception which the client may see as the “shining light” of hope for self-improvement and escape from an unhappy status and way of life, is dashed to the ground – in favor of a bias towards “averageness,” a prejudice against talent, a stereotypical discounting of the “gifted” or High IQ client as “privileged” and undeserving of, and not in need of, the assistance that has been solicited.


U.S. Department of Education, Institute of Education Sciences, National Center for Education Statistics, PIAAC Proficiency Levels for Literacy.

Description of PIAAC literacy discrete achievement levels

• • •

Achievement level and score range - Task descriptions

Below Level 1: 0 – 175

The tasks at this level require the respondent to read brief texts on familiar topics to locate a single piece of specific information. There is seldom any competing information in the text and the requested information is identical in form to information in the question or directive. The respondent may be required to locate information in short continuous texts. However, in this case, the information can be located as if the text were non-continuous in format. Only basic vocabulary knowledge is required, and the reader is not required to understand the structure of sentences or paragraphs or make use of other text features. Tasks below Level 1 do not make use of any features specific to digital texts.

Level 1: 176 – 225

Most of the tasks at this level require the respondent to read relatively short digital or print continuous, non-continuous, or mixed texts to locate a single piece of information that is identical to or synonymous with the information given in the question or directive. Some tasks, such as those involving non-continuous texts, may require the respondent to enter personal information onto a document. Little, if any, competing information is present. Some tasks may require simple cycling through more than one piece of information. Knowledge and skill in recognizing basic vocabulary determining the meaning of sentences, and reading paragraphs of text is expected.

Level 2: 226 - 275

At this level, the medium of texts may be digital or printed, and texts may comprise continuous, non-continuous, or mixed types. Tasks at this level require respondents to make matches between the text and information, and may require paraphrasing or low-level inferences. Some competing pieces of information may be present. Some tasks require the respondent to
  • cycle through or integrate two or more pieces of information based on criteria;
  • compare and contrast or reason about information requested in the question; or
navigate within digital texts to access and identify information from various parts of a document.

Level 3: 276 – 325

Texts at this level are often dense or lengthy, and include continuous, non-continuous, mixed, or multiple pages of text. Understanding text and rhetorical structures become more central to successfully completing tasks, especially navigating complex digital texts. Tasks require the respondent to identify, interpret, or evaluate one or more pieces of information, and often require varying levels of inference. Many tasks require the respondent to construct meaning across larger chunks of text or perform multi-step operations in order to identify and formulate responses. Often tasks also demand that the respondent disregard irrelevant or inappropriate content to answer accurately. Competing information is often present, but it is not more prominent than the correct information.

Level 4: 326 - 375

Tasks at this level often require respondents to perform multiple-step operations to integrate, interpret, or synthesize information from complex or lengthy continuous, non-continuous, mixed, or multiple type texts. Complex inferences and application of background knowledge may be needed to perform the task successfully. Many tasks require identifying and understanding one or more specific, non-central idea(s) in the text in order to interpret or evaluate subtle evidence-claim or persuasive discourse relationships. Conditional information is frequently present in tasks at this level and must be taken into consideration by the respondent. Competing information is present and sometimes seemingly as prominent as correct information.

Level 5: 376 – 500

At this level, tasks may require the respondent to search for and integrate information across multiple, dense texts; construct syntheses of similar and contrasting ideas or points of view; or evaluate evidence based arguments. Application and evaluation of logical and conceptual models of ideas may be required to accomplish tasks. Evaluating reliability of evidentiary sources and selecting key information is frequently a requirement. Tasks often require respondents to be aware of subtle, rhetorical cues and to make high-level inferences or use specialized background knowledge.



Problems of the Program-Centered Approach (as opposed to Client-Centered or Person-Centered Approaches)

“Despite educational preparation, some practitioners demonstrate behavior that lacks the basic tenets of a helping relationship, for example, a lack of empathy or being in tune with those seeking their help; a lack of genuine and authentic concern; a lack of appreciation of different beliefs, lifestyles, and values. Their inept behavior may be attributed to anxiety, a lack of skill or experience, dealing with a problem beyond their scope of practice, or an inability to build collaborative relationships with clients. Ineptness and ethical practices on the part of social workers, such as abrasive, egotistical, controlling, judgmental, demeaning, patronizing, or rigid behavior can cause an appropriate negative reaction from clients. In these interactions, clients’ reactions can become a cycle of escalating conflict. For instance, a practitioner demeans an individual, an individual reacts, and so forth. It is not unusual for the professional to attempt to control by exerting his or her power and authority, which of course tends to cause another reaction from the client. Being habitually late or unprepared for appointments, appearing to be detached or disinterested, and under-involved are further indicators of troubling behavior. Most people will react to behavior that they view as disrespectful or unprofessional. In many cases, a practitioner would not tolerate similar behavior in a client.

“Ineptness is a serious concern which calls for corrective behavior on the part of the practitioner, through supervision, skill development, or self-reflection. Pathological behavior on the part of the social worker in which there is a sustained pattern of repeated errors, insensitive behaviors can cause psychological damage to clients.”

[Dean Hepworth, Ronald Rooney, Glenda Dewberry Rooney, Kim Strom-Gottfried, Direct Social Work Practice: Theory and Skills, 9th Edition (Brooks/Cole Empowerment Series), Brooks/Cole, 2013, pp. 556-7] (emphasis added)



Person-Centered Reforms in the USA & UK

A) 2001 (USA)

“The person at the focus of planning, and those who love the person, are the primary authorities on the person’s life direction.”

“The purpose of Person-Centered Planning is learning through shared action. People who engage in Person-Centered Planning may produce documentation of their meetings, proposals, contract specifications, or budgets. These are only footprints: the path is made by people walking together.”

[Amado, A. N. and McBride, M. (2001), Increasing Person-Centered Thinking: Improving the Quality of Person-Centered Planning: A Manual for Person-Centered Planning Facilitators. Minneapolis, Minnesota: University of Minnesota, Institute on Community Integration, p. 3]

B) 2001 (UK)

“Good management of learning disability services requires: strong partnership working: while learning disability has been at the forefront of making use of the flexibilities under the Health Act 1999, many areas have yet to achieve real partnership between health and social care. Joint commissioning has been slow to take off. Few areas have partnerships involving service users, their families and the wider range of agencies.
good planning to ensure that services are responsive:

“Few places attempt to have the individual’s aspirations, needs and views as the driving force for providing services.”

[“Valuing People: A New Strategy for Learning Disability for the 21st Century, A White Paper,” March 2001, Presented to Parliament by the Secretary of State for Health by Command of Her Majesty, UK, p. 21]

C) 2008 (UK)

Regarding the transformation of social care: “To do this will require a common assessment of individual social care needs, emphasising the importance of self-assessment. The role of social workers will be focused on advocacy and brokerage, rather than assessment and gate keeping. This move is from the model of care, where an individual receives the care determined by a professional, to one that has person centred planning at its heart, with the individual firmly at the centre in identifying what is personally important to deliver his or her outcomes. With self-directed support, people are able to design the support or care arrangements that best suit their specific needs. It puts people in the centre of the planning process, and recognises that they are best placed to understand their own needs and how to meet them.

“They will be able to control or direct the flexible use of resources (where they wish to), building on the support of technology (eg telecare), family, friends and the wider community to enable them to enjoy their position as citizens within their communities.”

[“Transforming Social Care,” Department of Health (UK), 17 January 2008 (Gateway Reference: 9337), p. 17]

D) “Person-centred planning”

“A central idea behind person-centred planning, is that services which are set up to respond to problems of social exclusion, disempowerment, and devaluation, can unintentionally make the situation of individual people worse (i.e. further disempower, devalue and exclude people). Person-centred planning is designed specifically to ‘empower’ people, to directly support their social inclusion, and to directly challenge their devaluation. One of the benefits of person-centered planning is that it can address the perennial “service problems” of ethnicity, gender, culture and age by starting with planning by or with the “whole person”. [From: “Person-centred planning,” Wikipedia, Jul. 28, 2015]

“Person-centred planning involves the individual receiving the service, with family members, neighbors, employers, community members, and friends, and professionals (such as physician/ doctors, psychiatrists, nurses, support workers, care managers, therapists, and social workers) developing a plan on community participation and quality of life with the individual. In contrast, traditional models of planning have focussed on the person’s deficits and negative behaviours, labelling the person and creating a disempowering mindset from the start.” [From: “Person-centred planning,” Wikipedia, Jul. 28, 2015]


No comments:

Post a Comment