Person Centered Thinking Day 1 Developed by Michael Smull with Bill Allen, Marc Archembault, Sherrie Anderson, Mary Lou Bourne, Amanda George, Cherie Goss,

Person Centered ThinkingPerson Centered Thinking Day 1Day 1

Person Centered ThinkingPerson Centered Thinking Day 1Day 1

Developed by Michael Smull with Bill Allen, Marc Archembault, Sherrie Developed by Michael Smull with Bill Allen, Marc Archembault, Sherrie Anderson, Mary Lou Bourne, Amanda George, Cherie Goss, Julie Malette, Anderson, Mary Lou Bourne, Amanda George, Cherie Goss, Julie Malette,

Michael Steinbruck, and Nolda WareMichael Steinbruck, and Nolda Ware

Not just better Not just better plans…plans…

Help people get better Help people get better liveslives

© The Learning Community for Essential Lifestyle Planning, Inc. 2006

ServiceLife

CommunityLife

• Important for addressed

• No organized effort to address important to

• To and for present• Active circle of support• Included in community life

• To and for present

• Closest people are paid or family

• Few real connections

Moving from Service Life to Community LifeMoving from Service Life to Community Life

A Good Paid Life

Focus on connecting, building relationshipsand natural supports‘Important to’ present

‘Important to’ recognized


A Good Paid Life

ServiceLife

CommunityLife

Moving from Service Life to Community LifeMoving from Service Life to Community Life

• Important for addressed

• No organized effort to address important to

• To and for present• Active circle of support• Included in community life

• To and for present

• Closest people are paid or family

• Few real connections


Good plans create a kind of mirror – they reflect how Good plans create a kind of mirror – they reflect how people want to livepeople want to live

Discontent comes from comparing what is with what Discontent comes from comparing what is with what could becould be

There are 2 kinds of discontent:There are 2 kinds of discontent:

•Optimistic Optimistic

•CynicalCynical

Discontent is the engine of changeDiscontent is the engine of change


A history of acting on things that can be changed A history of acting on things that can be changed immediatelyimmediately

Honesty about those things that take timeHonesty about those things that take time

Signs of progress in acting on the things that take Signs of progress in acting on the things that take timetime

Where change is new trust must be createdWhere change is new trust must be created

Optimistic discontent requires trust based on-Optimistic discontent requires trust based on-


One of the things that good plans do is hold a mirror One of the things that good plans do is hold a mirror up to the system and create discontent with what is. up to the system and create discontent with what is.

Without hope for change this level of discomfort Without hope for change this level of discomfort becomes intolerable.becomes intolerable.

Without hope for change you get denial, distortion, Without hope for change you get denial, distortion, or departureor departure

People say this is no different from what we have People say this is no different from what we have always been doingalways been doing

Plans are distorted to suggest that what people Plans are distorted to suggest that what people want is what is already offeredwant is what is already offered

The people who have the most passion for change The people who have the most passion for change leave (depart) when they see no hope for changeleave (depart) when they see no hope for change

Cynical discontentCynical discontent


Level 1 change – Level 1 change –

those changes that can be made without becoming a those changes that can be made without becoming a change target – change target –

without changing core structures, responsibilities, without changing core structures, responsibilities, etc.etc.

E.G. – helping people with their morning rituals, E.G. – helping people with their morning rituals, honoring what is important that doesn’t require that honoring what is important that doesn’t require that people move or major changes in staff people move or major changes in staff responsibilities responsibilities

2 levels of change2 levels of change


Level 2 changes –Level 2 changes –

Changes that make you a change targetChanges that make you a change target

New responsibilities, practices, structuresNew responsibilities, practices, structures

2 levels of change2 levels of change


Supporting Dreams

Being “Mindful” & Recording Learning

Recognizing and Sorting Important To and Important For& Finding the Balance Between

Them

Defining Staff Roles and Responsibilities

Matching Staff and Those Using Services

Learning, Using and Recording

Communication

Supporting Relationships, Community Connecting

• Learning Log• The 4 Questions• Working/Not Working

Skills needed to support peopleSkills needed to support people


Person Centered Thinking Skills - 1 & Person Centered Thinking Skills - 1 & 22

Person Centered Thinking Skills - 1 & Person Centered Thinking Skills - 1 & 22

• SkillSkill = Sorting important to = Sorting important to from important for from important for (and finding a (and finding a

better better balance between)balance between)

ToolTool = Important to/for = Important to/for sort/tablesort/table

• SkillSkill = Determining staff = Determining staff responsibilitiesresponsibilities

ToolTool = The donut = The donut


Important to Important for

Supports wanted and

neededSkills needed

Personality Characteristics (Present/Absen

t)

Shared interests

(nice to have)

Person Centered Thinking Skills - 3Person Centered Thinking Skills - 3Person Centered Thinking Skills - 3Person Centered Thinking Skills - 3

For each person – what are the…


Person Centered Thinking Skills - 4Learning, using, and recording communicationPerson Centered Thinking Skills - 4Learning, using, and recording communication

What is happening ______ does We think it means We should


Person Centered Thinking Skills - 5 Person Centered Thinking Skills - 5 Three Mindful Learning ToolsThree Mindful Learning Tools


Tool #1:Tool #1: Analyzing situations using “What works/doesn’t work” Analyzing situations using “What works/doesn’t work” (also known as “makes sense/doesn’t make sense”)(also known as “makes sense/doesn’t make sense”)


What works/makes senseWhat doesn’t work/make

sense

Pers

on’s

Pers

pect

ive

Sta

ff’s

Pers

pect

ive



Tool #2:Tool #2: Using the ‘4 Questions” to focus on Using the ‘4 Questions” to focus on learning and acting on that learning and acting on that

learning –learning –

•What have we tried?What have we tried?

•What have we learned?What have we learned?

•What are we pleased about?What are we pleased about?

•What are we concerned about?What are we concerned about?

And thenAnd then

•What should we try/do based on what we What should we try/do based on what we have learned?have learned?


? ??

?



Tool #3Tool #3: The Learning : The Learning LogLog

•Using the learning log Using the learning log to replace typical to replace typical notesnotes

•Creating a learning Creating a learning log for the people log for the people who use serviceswho use services


Have our own dreams and our own

journeysHave opportunities to meet new

people; try new things; change jobs; change who we live with & where we

liveHave what/who is important to us in

everyday life; people to be with; things to do, places to be

Stay healthy & safe (on our own terms)

Each of us want lives where we are supported by & contribute to our

communities

© The Learning Community for Essential Lifestyle Planning, Inc. 2006 (with apologies to Abraham Maslow)

Terminal IrritationTerminal IrritationTerminal IrritationTerminal Irritation

* Used with permission from Dave Coverly, Speedbump Comic

A Promise to listenA Promise to listen

to listen to what is being said and to what is to listen to what is being said and to what is meant by what is being saidmeant by what is being saidto keep listeningto keep listening

A Promise to act on what we hearA Promise to act on what we hear

to always find something that we can do today to always find something that we can do today or tomorrow or tomorrow to keep acting on what we hearto keep acting on what we hear

Person centered planning is a set of promisesPerson centered planning is a set of promises


A Promise to be honestA Promise to be honest

to let people know when what they are telling us to let people know when what they are telling us will take timewill take time

when we do not know how to help them get when we do not know how to help them get what they are asking for what they are asking for

when what the person is telling us is in conflict when what the person is telling us is in conflict with staying healthy or safe and we can’t find a with staying healthy or safe and we can’t find a good balance between important to and good balance between important to and important forimportant for


Person centered planning is a set of promisesPerson centered planning is a set of promises

UnderstandUnderstand

What you hear depends onWhat you hear depends onwhat you are listening forwhat you are listening for

ListenListen


What is important to a person includes only what people are “saying”:

with their words

with their behavior

When words and behavior are in conflict, listen to the behavior.

Important to


What is important for people, includes only those things that we need to keep in mind regarding–

Issues of health or safety

What others see as important to help the person be a valued member of their community

Important for


Importantto

Importantfor

Importantto

Importantfor

Health and Safety Health and Safety Dictate LifestyleDictate Lifestyle

All Choice, All Choice, No ResponsibilityNo Responsibility

Importantto

Importantfor

BalanceBalance



sense•Shopping daily for favorite

things

•Having lots of jewelry and no one getting into them without my ok

•Having my sister Joanne in my life

•Lots of blue, red and black clothes

•Polished nails, many colors & layers

•Living with Teddy, the Yorkshire

Sleeping on my bed at night Snacks from my plate In my lap when I watch TV

•Staff don’t let me drink what I want

•Teddy leaving me during mealtimes

•Having no work to do at WAC, Inc.

•Staff not letting me buy things I want

•Favorite people doing activities with her, especially John Dandy

•Keeping Julie from falling – reminders to use her walker

•Level blood sugar - staff knowing signs of low and high blood sugar

•Joanne is active in Julie’s life

•Planning before she goes shopping

•Julie is less steady on her feet and falling more than she used to

•If you don’t make a plan with her before shopping, she will want to buy more than she has money for – Julie may get very upset which can alter her blood sugar

•Julie gives Teddy food off her plate.

Julie’s

pers

pecti

ve

Sta

ff’s

pers

pecti

ve

JulieJulie

What is important to Julie? What is important for Julie?

What else do you need to learn/know?


Julie – Answer SlideJulie – Answer Slide

What is important to Julie? What is important for Julie?


Relationship with TeddyHaving some control –• Over what happens with Teddy• What she buys/wears• Her things Shopping a lotHer sister &John Dandy in her lifeStaying busy at the day serviceDrinking as much as she wants

Keeping diabetes under control• Monitoring blood sugar, giving insulin• Weighing her food• Controlling amount she drinks• Helping her stay calmSupporting her relationship with TeddyKeeping her from fallingPlanning in advance/budgeting in advance for shopping

• How interested/involved is Julie in her diabetes management?• What about “no work to do at WAC, Inc bothers her?•Is John Dandy really important to her?


If I had an hour toIf I had an hour tosave the world, I’dsave the world, I’dspend 55 minutesspend 55 minutesdefining the problem.defining the problem.

-Albert Einstein -Albert Einstein

If I had an hour toIf I had an hour tosave the world, I’dsave the world, I’dspend 55 minutesspend 55 minutesdefining the problem.defining the problem.

-Albert Einstein -Albert Einstein

USE JUDGEMENT& CREATIVITY

CORE RESPONSIBILITIES

NOT OUR PAID RESPONSIBILITY

Inside a Person’s Life


Not our paid responsibility

Use judgmentand creativity

Core responsibilities


What you try! (e.g. put on my sweater, cleaning cabinet tops, etc.) Help me find a meaningful job. Help me find other ways to communicate with those that can’t communicate with me.

Don’t interfere with the private time I spend with my friends. I don’t need an interpreter. They are my friends and we communicate. Don’t interfere with how I choose to handle the love interests in my life. I will ask for any advice I want from whom I want.

Examples from Inside Libby’s Life

Support independence: Look for things she can do on her own, the last item of clothing that she puts on must be put on herself (she wants you to set it up and let her do the rest) know how she communicates and take the time to communicate with herHelp her stay healthy: Provide G-tube care and at least 1,500 ccs of fluid a day. She doesn’t feel thirsty (you keep track), an occasional glass of wine (drinks through the g-tube).

Harry #1Harry #1

What is important to Harry? What is important for Harry?



Harry #1 – Answer SlideHarry #1 – Answer Slide



To attract women

To spend his money as he wants

To have George’s permission

To learn what to wear with minimum pain

To learn to manage his money

What does Harry understand about –• Managing his money• Attracting women, dating• Where it is appropriate to wear what


Harry #1 – George’s DonutHarry #1 – George’s Donut







Whether or not he buys the shirt.


What you do/try to help Harry makean informed choice

about –

The odds againstthe shirt being a “chick magnet”

Spending ½ his money for 2 weeks on

1 purchase


To help Harry makean informed choice –

About the shirt

About his money

Starts with asking why he wants

the shirt


Harry #2Harry #2







To be around this woman, have her “recognize” that she wants him. To have control and power over her.

To know the legal consequences of stalking

To stop stalking

To understand that stalking doesn’t work to get an intimate relationship

• More about the past history of this or similar behavior?

• How dangerous is he?

• Does he get what we think he gets out of stalking?

• Has he ever had a “regular adult” relationship


Harry #2 – Executive Director’s DonutHarry #2 – Executive Director’s Donut







To help him getsex or keep him out

of jail at all costs


Short term – Howyou keep the woman

safe until you can get him treatment

Longer term – howyou learn, acting on

what you learn,figuring out how he

can get what isimportant enough to

him that that hewill participate in

treatment


Short term -Keep the woman safe and in

the process keep himsafe (and out of jail)

Longer term – teachrelationship skills,

figure out why he isstalking, any pattern,

and deal with it,seeking a way for

Harry to live safelyin the community


BobBob

What is important to Bob? What is important for Bob?



Bob – Answer SlideBob – Answer Slide

What is important to Bob? What is important for Bob?


To be one of the guysTo keep his friendsTo be in charge of his own lifeTo have a “typical” lifeTo stay healthy

To stay healthy –Take his medications as prescribedStay out of the hospital/not cycleTo be connected to his community

• How dangerous is it for him to go off medication and have a couple of beers?• Would it be OK for him to drink 1 or 2 beers and be on his medication?• Is there another medication where 1 or 2 beers would be OK?• How well does he understand the risks that he is taking?• Would he be willing to drink non-alcoholic beer? • What role does his girlfriend play in this?


BobBob





Bob – Answer SlideBob – Answer Slide


Whether or notBob drinks

What Bob’s psychiatristdoes in response to

the information


What you do to meetyour core responsibilitiesaround helping him make

an informed choice –

Informing Bobof the risks

Educating yourself

Exploring alternatives

If part of the “problem”is the response of thepsychiatrist – helping

Bob find another


Helping Bob make an informed choice

Informing Bob of therisks of his behavior

Informing yourself of the actual risks and

alternatives

Making sure that Bob’s psychiatrist knows about

Bob’s drinking

Making an effort to explore with Bob

alternative ways to getwhat is important to

and important for him© The Learning Community for Essential Lifestyle Planning, Inc. 2006


Recording learning for Charlie What we have learned about what is:

IMPORTANT TO IMPORTANT FOR

INSTRUCTIONS FOR SUPPORTORS: for a good balance between important to & important for, what other people need to know or do.

What do we need to learn or figure out?


Recording learning for Charlie What we have learned about what is:

IMPORTANT TO IMPORTANT FOR

Water not too hot, likes it at 105 ° The lift at the pool must be available

A long soak, floating on his back To always have someone with him,supporting him in the water

Not to get rain on his face Making sure water is never over 107°

Having Aaron support him in the waterINSTRUCTIONS FOR SUPPORTORS: for a good balance between important to & important for, what other people need to know or do.

• Call ahead to make sure that the pool’s lift is available• Have a way to shield Charlie’s face when it rains • Don’t go in if water temperature is too hot (105 ° is good)• Charlie loves to ‘float’ on his back, always support him.

What do we need to learn or figure out?

How does Aaron support Charlie to float? Is it ok for others to support him?How hot is medically ‘too hot’ for Charlie? What’s a good temperature range?How long to soak? What’s too short for Charlie and what’s too long medically?


As the person supporting Charlie to go hot tubbing…









Whether or not others in the tub

“connect” with Charlie

Whether or notCharlie enjoyed himself

(as long as youmade an effort)


Helping Charlie meet other people who are inthe tub while Charlie is

there

How you help Charlie to enjoy himself


Calling to make surethe lift is operating, don’t go if it is not

Making sure watertemp is less than 105°

Being trained to properlySupport Charlie in the

hot tub and do it

Checking weather beforeyou go – if rain is likely,

bring an umbrella

Making an effort toensure that Charlie

enjoys himself



sense•Shopping daily for favorite

things

•Having lots of jewelry and noone getting into them without my ok

•Having my sister Joanne in my life

•Lots of blue, red and black clothes

•Polished nails, many colors & layers

•Living with Teddy, the Yorkshire

Sleeping on my bed at night Snacks from my plate In my lap when I watch TV

•Staff don’t let me drink what I want

•Teddy leaving me during mealtimes

•Having no work to do at WAC, Inc.

•Staff not letting me buy things I want

•Favorite people doing activities with her, especially John Dandy

•Keeping Julie from falling – reminders to use her walker

•Level blood sugar - staff knowing signs of low and high blood sugar

•Joanne is active in Julie’s life

•Planning before she goes shopping

•Julie is less steady on her feet and falling more than she used to

•If you don’t make a plan with her before shopping, she will want to buy more than she has money for – Julie may get very upset which can alter her blood sugar

•Julie gives Teddy food off her plate.

Julie’s

pers

pecti

ve

Sta

ff’s

pers

pecti

ve


senseP

ers

on

’sp

ers

pecti

ve

Sta

ff’s

pers

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ve

USE THIS INFORMATION TO BUILD THE

AGENDA

FOR THINGS THAT ARE TO

STAY THE SAME

USE THIS INFORMATION TO BUILD THE

AGENDA

FOR THINGS THAT NEED TO

CHANGE

Disagre

emen

ts



sense

Pers

pect

ive o

f N

ew

puppy’s

Ow

ner

Someone brings home a new puppy. Given your own experiences and those that you have heard from others, what does and does not make sense about having a new puppy in the house.


sense

Pers

on’s

Pers

pect

ive

Given the medication that someone is taking…

Sta

ff’s

Pers

pect

ive


sense

Pers

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ve

of

Pers

on

S

up

port

ed

You

rp

ers

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Su

perv

isor’

sp

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Looking at how you are doing in your work…


senseK

ath

leen

’sp

ers

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Moth

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Sta

ff’s

pers

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senseRelationships with friendsHaving her scissors at homeCutting PatternsDressing in her own styleDoing things where she stays cleanSewing at home and making her clothes

Not getting to use HER scissorsGetting dirty & doing jobs that involve cleaningHaving to do bearingsHaving to do work that she doesn’t likeNot being listened to

Kathleen has a place to go during the daySpending time with KathleenSewing togetherKathleen is never left alone at home or workshop

Her schedule has to follow the workshop’sKathleen can’t bring her own scissors to workThere is not enough pattern work for herKathleen will open the door for anyone

Kathleen does what she is toldShe has a behavior programShe uses whatever scissors she getsShe follows the rules most of the timeThat she meets the “criteria” before being considered for enclave work

Kathleen will not follow the rules consistentlyThat Kathleen insists on using certain scissorsThat Kathleen doesn’t want to get dirtyThat Kathleen doesn’t like the other jobs that are available

Kath

leen

’sp

ers

pecti

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Moth

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Sta

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In pairs4 minute turns for all 4 questionsListener gives good attentionThinker talks 4 minutesSwapShare ‘freshest thinking’ with the group in a roundPost 1-2 of the ‘best’ ideas per question

Adapted from Kline, Nancy. (1998). Time to Think: Listening to Ignite the Human Mind. Cassell Illustrated.

Shared TalkShared Talk

What did you learn?

What will you try based on what you learned? (what will you start on right now?)

What do you think you can accomplish?

What will your challenges/obstacles be?

What did you learn?

What will you try based on what you learned? (what will you start on right now?)

What do you think you can accomplish?

What will your challenges/obstacles be?

4 Questions4 Questions


www.elpnet.newww.elpnet.nett

for more information go to:for more information go to:

Michael Smull

[email protected]

410-626-2707

3245 Harness Creek Rd

Annapolis, MD 21403

or contact:

Person Centered Thinking Day 1 Developed by Michael Smull with Bill Allen, Marc Archembault, Sherrie Anderson, Mary Lou Bourne, Amanda George, Cherie Goss,

Documents

learning community

essential lifestyle

learning log

services learning

sorting important

important toimportant

mindful learning tools

natural supports important