A Working Alliance PersonCentred Planning and Employment Brian

A Working Alliance: Person-Centred Planning and Employment Brian Mc. Clean Brothers Of Charity Roscommon

Social Role Valorisation • • Raise consciousness Challenge perceptions Provide valued social roles Promote social inclusion Wolfensburger 1934 - 2011

From the bedroom door… • • • Mild intellectual disability Autism Schizophrenia Attended specialised treatment service till 18. Home for four years behind the bedroom door Suicidality Assaulted his mother Coercion and physically assaulted 4 month stay in acute psychiatric hospital

…To the Factory Floor • • • Rapport Shaping Diary Treatment of intractable medical conditions Mental Health Review Individualised costing Low arousal Residential Job Car Maintenance Class

A FIVE STEPS IN BEHAVIOUR SUPPORT Low Arousal Rapport Building Predictability Communication Incentives Mc. Clean and Grey, 2012 Journal of Intellectual and Developmental Disabilities Number of Incidents An Evaluation of an Intervention Sequence Outline in Positive Behaviour Support for People with Autism and Severe Escape-Motivated Challenging Behaviour Aidan B B + C A = Baseline B = Low Arousal C = Rapport Building D = Visual Sequencing E = Escape Communication Training F = Differential Reinforcement B B B + +C + C +D C + +E + D D + E + F Brendan Cormac Darragh Weeks

Readiness for Work • • Safety Exchange Heart Purpose Identity Engagement Paradise

Vision based planning Every person should have a vision statement of what is Important to him or her… Important for him or her… And a circle of support able to speak from a position of love and concern

Paradise • Positive Emotion • Flow • Meaning

To be seen and met as a fellow human being with the capacity to discover one’s personal vision is to be encouraged determine for oneself, the things that happen in one’s own life. If, as staff, our actions inspire others to dream more, to learn more, to do more and to become more, we are working as effective skilled helpers.

Not All Services Are Effective Mover (N = 20) Mean Non Mover (N = 22) Mean F df 1 df 2 Sig 132. 5 94. 0 21. 6 1 40 . 000 Autonomy 9. 6 5. 2 10. 5 1 40 . 002 Mental Health (HONOS) 8. 5 15. 5 10. 1 1 40 . 003 Adaptive Behaviour Scales – Challenging Behaviour 44. 6 38. 3 4. 8 1 40 . 034 Year of Birth 1973 1970 1. 0 1 40 N. S. Acceptability of the Vision Statement 57. 7 53. 5 7. 7 1 40 . 008 Working Alliance Inventory 66. 6 58. 5 26. 4 1 40 . 000 Acceptance of Risk -Taking 15. 2 13. 3 5. 5 1 40 . 024 Additional Cost Of Vision (€ 56) € 10, 813 3. 6 1 40 N. S. Empowerment Instrument 95. 5 92. 4 2. 8 1 40 N. S. Role Clarity 87. 1 85. 5 0. 4 1 40 N. S. Standards 21. 4 20. 2 2. 5 1 40 N. S. Adaptive Behaviour Scales – Support Needs

79% of the variance is explained Variable Entered into the Equation -2 Log likelihood Cox & Snell R 2 Nagelkerke R 2 Adaptive Behaviour Scales – Support Needs 39. 33 . 361 . 48 Working Alliance Inventory 20. 28 . 594 . 79

The Working Alliance The extent to which frontline staff and family members – agree about the goals – share a mutual respect and trust – have a common appreciation of the person