Transcript Outcomes - Learning Community

Person Centered Thinking
Day 1
Presented By:
© TLC-PCP 2012 www.learningcommunity.us
The Learning Community for Person Centered Practices
envisions a world where all people have positive control over
the lives they have chosen for themselves. Our efforts focus on
people who have lost or may lose positive control because of
society's response to the presence of a disability. We foster a
global learning community that shares knowledge for that
purpose.
© TLC-PCP 2012 www.learningcommunity.us
Person Centered Thinking
underlies and guides respectful listening which
leads to actions, resulting in people who:



Have positive control over the life they desire and
find satisfying;
Are recognized and valued for their contributions
(current and potential) to their communities; and
Are supported in a web of relationships, both
natural and paid, within their communities
© TLC-PCP 2012 www.learningcommunity.us
What are person centered thinking skills?
 A set of skills that reflect and reinforce values that:






Propel the learning cycle
Help us support rather than fix
Work for humans
Work at every level in the organization
Build the culture of learning, partnership, and
accountability
Affirm our belief that everyone can learn
© TLC-PCP 2012 www.learningcommunity.us
Help people get better lives
Not just better paper
© TLC-PCP 2012 www.learningcommunity.us
Purpose of the day
Learn how to
1. Use person centered thinking skills to
gather a deeper understanding of the
people we support
2. More easily organize that learning to
inform our efforts to help people get the
lives they value
© TLC-PCP 2012 www.learningcommunity.us
How Today Works
• Work in groups
• Learn methods that anchor person centered practices
•
•
Organizing Concept: Important TO and FOR and finding the balance
between them
Managing our support role using the Donut
• 3 Problem solving SKILLS that help us use what we are
learning every day
•
•
•
4 + 1 Questions
Learning Log
Working/Not Working
© TLC-PCP 2012 www.learningcommunity.us
Working Agreements for the Day






Cell phones on vibrate
Misery is optional
Respectful listening
All questions are valid
Only share what you are comfortable sharing
The trainer is always right 
© TLC-PCP 2012 www.learningcommunity.us
Introducing the Core Concept:
IMPORTANT TO
AND
IMPORTANT FOR
AND
THE BALANCE BETWEEN THEM
© TLC-PCP 2012 www.learningcommunity.us
Important TO
What is important to a person includes those things
in life which help us to be satisfied, content,
comforted, fulfilled, and happy. It includes:
•People to be with /relationships
•Status and control
•Things to do and places to go
•Rituals or routines
•Rhythm or pace of life
•Things to have
© TLC-PCP 2012 www.learningcommunity.us
Important FOR (Part One):
•
Issues of health:
― Prevention of
― Treatment
of illness / medical conditions
― Promotion of
•
illness
wellness (e.g.: diet, exercise)
Issues of safety:
― Environment
― Well
being ---- physical and emotional
― Free
from fear
© TLC-PCP 2012 www.learningcommunity.us
Important FOR (Part Two):

What others see as
necessary to help the
person:
― Be
valued
― Be
a contributing member
of their community
© TLC-PCP 2012 www.learningcommunity.us
Moving from Service Life to Community Life
Community
Life
A Good Paid
Life
Service
Life
‘Important to’ recognized
‘Important to’ present
Focus on connecting,
building relationships
and natural supports
• ‘To’ and ‘for’ present
• ‘Important for’ addressed
• No organized effort to
address ‘important to’
• Closest people are
paid or family
• Few real connections
• ‘To’ and ‘for’ present
• Active circle of support
• Included in community life
© TLC-PCP 2012 www.learningcommunity.us
Wkbk pg 5
Moving from Service Life to Community Life
Service
Life
A Good Paid
Life
• ‘Important for’ addressed
• ‘To’ and ‘for’ present
• No organized effort to
address ‘important to’
• Closest people are
paid or family
• Few real connections
© TLC-PCP 2012 www.learningcommunity.us
Community
Life
• ‘To’ and ‘for’ present
• Active circle of support
• Included in community life
Discontent is the first necessity of progress.
-Thomas
Edison
© TLC-PCP 2012 www.learningcommunity.us
Discontent is the Engine of Change
•Anything you are happy with, you want to stay the same
•You are only interested in change when there is discontent
There are there are 2 kinds of discontent
 Cynical
 Optimistic

We have too much cynical and
 not enough optimistic
© TLC-PCP 2012 www.learningcommunity.us
Cynical Discontent
When you have discontent without hope you get
cynical discontent.
Cynical discontent results in:
© TLC-PCP 2012 www.learningcommunity.us
Optimistic Discontent
Requires hope based on trust that is created when there is:
•
A history of acting on things that can be changed
•
Honesty about those things that will take time to change
•
Progress in acting on the things that take time
Where cynical discontent is dominant…
…trust must be created
© TLC-PCP 2012 www.learningcommunity.us
Levels of Change
Level 1
Any change that results in a positive
difference in the lives of people who use
services or in your own work life.
Level 2
Any changes an organization makes to it’s
practices, structure or rules that result in
positive differences in the lives of people.
Level 3
Any change in practice, structure and rules made at
the system level. These changes have an effect on
many organizations, and therefore many peoples’
lives.
© TLC-PCP 2012 www.learningcommunity.us
Overview
Day 1 and Day 2
•Day 1 – working in groups
•Day 2 – working in pairs
© TLC-PCP 2012 www.learningcommunity.us
Management
Skills
Important To
Important For &
The Balance
Between
Everyday
Learning Skills
Discovery/
Listening Skills
© TLC-PCP 2012 www.learningcommunity.us
Sorting Important to from Important for
(and finding a better balance between them)
Important To Important For
© TLC-PCP 2012 www.learningcommunity.us
Discovery/Listening Skills
6 methods for collecting information
Relationship Map
Rituals and Routines
Good Day/Bad Day
Two Minute Drill
Communication Chart
 Reputations
© TLC-PCP 2012 www.learningcommunity.us
The “Relationship Map”
1st Discovery Skill
Family
People Map
for:
People
whose job is
to support
me at home
and other
places
People who
support me
at work or
school
Friends
© TLC-PCP 2012 www.learningcommunity.us
Rituals and Routines
Rituals guide us through our days and bring
consistency, comfort and control
•
•
•
•
•
•
Morning
Bedtime
Mealtimes
Transition
Birthday
Not Feeling Well
Cultural/Holiday
• Spiritual
• Vacation
• Comfort
• Celebration
• Grief/Loss
•
© TLC-PCP 2012 www.learningcommunity.us
Good Day/Bad Day
What is a good day like
for this person?
What is a bad day like
for this person
(or a stressful or really
difficult day)?
© TLC-PCP 2012 www.learningcommunity.us
Listening to Behavior…
A Communication Chart
What is happening
_____ does
We think it means
© TLC-PCP 2012 www.learningcommunity.us
And we should
Everyday Learning Skills
• 4 + 1 questions
• Learning Log
• Working/Not Working (also called “What
Makes Sense/Doesn’t Make Sense”)
© TLC-PCP 2012 www.learningcommunity.us
4 + 1 Questions
• Using the “4 questions” to focus on learning and
acting on that learning –
–
–
–
–
What have we tried?
What have we learned?
What are we pleased about?
What are we concerned about?
• And then the “+1” question – What should we try/do based on what we
have learned?
© TLC-PCP 2012 www.learningcommunity.us
Learning Log
Using the learning log to replace typical progress notes
Date
What did the
person do?
(What, where,
when, how
long, etc.)
Who was
there? (Names
of staff,
friends,
others, etc.)
What did you learn about what worked
well? What did the person like about the
activity? What needs to stay the same?
© TLC-PCP 2012 www.learningcommunity.us
What did you learn about what didn’t work
well? What did the person not like about
the activity? What needs to be different?
What doesn’t work/
Makes sense
Doesn’t make sense
Staff’s
perspective
Parent’s
perspective
Person’s
perspective
What works/
© TLC-PCP 2012 www.learningcommunity.us
Management Skills
• Donut Sort
• Matching
© TLC-PCP 2012 www.learningcommunity.us
The Donut Sort
Defining Staff Roles and Responsibilities
Core
Responsibilities
Creativity & Judgment
© TLC-PCP 2012 www.learningcommunity.us
NOT OUR USUAL
RESPONSIBILITY
A Matching Profile
For each person – what are . . .
Supports wanted
and needed
Skills needed
Personality
Characteristics
Needed
© TLC-PCP 2012 www.learningcommunity.us
Shared Common
Interests
(would be nice
to have)
Management
Skills
Important To
Important For &
The Balance
Between
Everyday
Learning Skills
Discovery/
Listening Skills
© TLC-PCP 2012 www.learningcommunity.us
Day One
Beginning
• Practicing Person Centered Thinking Skills
• Applying What We Learn
© TLC-PCP 2012 www.learningcommunity.us
Each of us want lives where we are
supported by & contribute to our communities
Have our
own dreams and
our own journeys
Have opportunities to meet new
people; try new things; change jobs;
change who we live with & where we live
Have 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)
© TLC-PCP 2012 www.learningcommunity.us
Terminal Irritation
* Used with permission from Dave Coverly, Speedbump Comic
© TLC-PCP 2012 www.learningcommunity.us
The Importance Of Environment
Healing
Toxic
Tolerated
Supportive
Power Over
Power With
Growth Occurs Here
© TLC-PCP 2012 www.learningcommunity.us
Implementation of Person Centered
Practices is:
A Promise to listen
•
•
To listen to what is being said and to what is meant by what is
being said
To keep listening
A Promise to act on what we hear
•
•
To always find something that we can do today or tomorrow
To keep acting on what we hear
© TLC-PCP 2012 www.learningcommunity.us
Implementation of Person Centered
Practices is:
A Promise to be honest
• To let people know when what they are telling us will take time
• When we do not know how to help them get what they are asking
for
• When what the person is telling us is in conflict with staying
healthy or safe and we can’t find a good balance between
important to and important for
© TLC-PCP 2012 www.learningcommunity.us
What you see/hear depends on
what you are looking/listening for
Look/Listen
Understand
© TLC-PCP 2012 www.learningcommunity.us
This is an awareness test…
TLC-PCP
2012 www.learningcommunity.us
The Core Concept:
And a core skill
Important to and Important for
and
the Balance between them
© TLC-PCP 2012 www.learningcommunity.us
Sorting Important To from Important For
(and finding a better balance between them)
Important To
© TLC-PCP 2012 www.learningcommunity.us
Important For
Important TO
What is important to a person includes those things
in life which help us to be satisfied, content,
comforted, fulfilled, and happy. It includes:
•People to be with /relationships
•Things to do & places to go
•Rituals or routines
•Rhythm or pace of life
•Status & control
•Things to have
© TLC-PCP 2012 www.learningcommunity.us
Important TO
• Includes what matters the most to the
person – their own definition of quality of
life.
• What is important to a person includes
only what people “say”:
― with their words
― with their behavior
When words and behavior are in conflict,
pay attention to the behavior and ask “why?”
© TLC-PCP 2012 www.learningcommunity.us
Important FOR
– Issues of health:
―Prevention of illness
―Treatment of illness / medical conditions
―Promotion of wellness (e.g.: diet, exercise)
– Issues of safety:
―Environment
―Well being ---- physical and emotional
―Free from Fear
– What others see as necessary to help the person:
―Be valued
―Be a contributing member of their community
© TLC-PCP 2012 www.learningcommunity.us
Important To and For
are Connected
• ‘Important to’ and ‘important for’ influence each
other
• No one does anything that is ‘important for’ them
(willingly) unless a piece of it is ‘important to’
them
Balance is dynamic (changing) and always involves
tradeoffs:
– Among the things that are ‘important to’;
– Between important ‘to’ and ‘for’
© TLC-PCP 2012 www.learningcommunity.us
Finding the Balance
• We all make tradeoffs between the many different things
that are important to us.
– Some people may love living in a particular place.
– And are willing to make the tradeoff when living there means a
longer commute to the work they love.
• We also make tradeoffs between what is important to us and
what is important for us. These tradeoffs can be temporary
OR long term solutions.
― Fun time with my friends is important to me. Having a clean house
is part of being valued by my friends. House cleaning occasionally
comes before having fun with friends.
― Expressing personal opinions and speaking my mind is important to
me, but not cussing in front of my neighbors is important for me
© TLC-PCP 2012 www.learningcommunity.us
Health and Safety
Dictate Lifestyle
© TLC-PCP 2012 www.learningcommunity.us
All Choice
No Responsibility
© TLC-PCP 2012 www.learningcommunity.us
Balance
Important
FOR
Important
TO
© TLC-PCP 2012 www.learningcommunity.us
Staff’s perspective
Julie’s perspective
What works/makes 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
Terrier
• Sleeping on my bed
• Snacks from my plate
• In my lap when I watch TV
• 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 Julie goes
shopping
What doesn’t work/Doesn’t make sense
•
•
•
•
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
• Julie is less steady on her feet and
falling more than she used to
• If you don’t make a plan with before
shopping, Julie 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
© TLC-PCP 2012 www.learningcommunity.us
Julie
What is important to Julie?
What is important for Julie?
What else do you need to learn/know?
© TLC-PCP 2012 www.learningcommunity.us
Wrkbk pg 17
Julie – Answer Slide
What is important to Julie? What is important for Julie?
Relationship with Teddy
Having some control –
• Over what happens with Teddy
• What she buys/wears
• Her things
Shopping a lot
Her sister &John Dandy in her life
Staying busy at the day service
Drinking as much as she wants
Keeping diabetes under control
• Monitoring blood sugar, giving insulin
• Weighing her food
• Controlling amount she drinks
• Helping her stay calm
Supporting her relationship with Teddy
Keeping her from falling
Planning in advance/
budgeting in advance for shopping
What else do you need to learn/know?
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?
© TLC-PCP 2012 www.learningcommunity.us
Staff’s perspective
Julie’s perspective
What works/makes sense
• Her relationship with
Teddy
• Feeding Teddy from her
plate (food = love)
• Feeding Teddy the same
food she is eating
(people food)
• Julie’s relationship with
Teddy
• Removing Teddy from the
dining room during
meals; monitoring Julie’s
food/drink intake
accurately
What doesn’t work/
Doesn’t make sense
• Staff removing Teddy during
meal times
• Teddy barking and being
upset at being locked in the
back room
• Feeding Teddy dog food in
his own bowl
• Julie feeding Teddy from her
plate
• Inaccurate monitoring of
Julie’s food/drink intake when
she feeds Teddy from her plate
• Teddy barking in the back
room and upsetting Julie and
other residents
• Teddy’s long-term health if he
eats too much “people food.”
Example of Working/Not Working Focused for Action
© TLC-PCP 2012 www.learningcommunity.us
Management Skills
Sorting Important TO and FOR is a skill that works with all the other
SKILLS
 Donut Sort
• Matching
© TLC-PCP 2012 www.learningcommunity.us
Ask Yourself “What do we know?”
Before asking “What do we do?”
If I had an hour to save
the world, I’d spend 55
minutes defining the
problem.
~ Albert Einstein
© TLC-PCP 2012 www.learningcommunity.us
Inside a Person’s Life
Defining Staff Roles and Responsibilities
Core
Responsibilities
Judgment &
Creativity
NOT OUR USUAL
RESPONSIBILITY
© TLC-PCP 2012 www.learningcommunity.us
Harry
What is important to Harry?
What is important for Harry?
What else do you need to learn/know?
© TLC-PCP 2012 www.learningcommunity.us
Wrkbk pg 20
Harry – Possible Answers
What is important to Harry?
To attract women
What is important for Harry?
To spend his money as he wants
To learn what to wear that will
cause minimal pain and
embarrassment
To have George’s permission
To learn to manage his money
What else do you need to learn/know?
What does Harry understand about –
• Managing his money
• Attracting women, dating
• Where it is appropriate to wear what
© TLC-PCP 2012 www.learningcommunity.us
Harry – George’s Donut
Core
responsibilities
Use judgment
and creativity
© TLC-PCP 2012
www.learningcommunity.us
Not usually our
responsibility
Wrkbk pg 21
Harry – Possible Answers
Core
responsibilities
Use judgment
and creativity
Not usually our
responsibility
To help Harry make
an informed choice –
What you do/try
to help Harry make
an informed choice
about –
Whether or not
he buys the shirt.
About the shirt
About his money
Starts with asking
why he wants
the shirt
The odds against
the shirt being a
“chick magnet”
Spending ½ his money
for 2 weeks on
1 purchase
© TLC-PCP 2012
www.learningcommunity.us
Harry…
…The Rest of the Story
© TLC-PCP 2012 www.learningcommunity.us
Harry #2 – Answer Slide
What is important to Harry?
• To be around this
woman, have her
“recognize” that she
wants him. To have
control and power over
her.
What is important for Harry?
• To know the legal
consequences of stalking
• To stop stalking
• To understand that stalking
doesn’t work to get an
intimate relationship
What else do you need to learn/know?
• 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?
© TLC-PCP 2012 www.learningcommunity.us
Harry #2 – Possible Answers
Core
responsibilities
Use judgment
and creativity
Not usually our
responsibility
Short term -Keep the
woman safe and in
the process keep him
safe (and out of jail)
Short term – How
you keep the woman
safe until you can get
him treatment
To help him get
sex or keep him out
of jail at all costs
Longer term – teach
relationship SKILLS,
figure out why he is
stalking, any pattern,
and deal with it,
seeking a way for
Harry to live safely
in the community
Longer term – how
you learn, acting on
what you learn,
figuring out how he
can get what is
important enough to
him that that he
will participate in
treatment
© TLC-PCP 2012
www.learningcommunity.us
Bob
What is important to Bob?
What is important for Bob?
What else do you need to learn/know?
Wrkbk pg 22
© TLC-PCP 2012 www.learningcommunity.us
Bob – Answer Slide
What is important to Bob?
To
To
To
To
To
be one of the guys
keep his friends
be in charge of his own life
have a “typical” life
stay healthy
What is important for Bob?
To stay healthy –
Take his medications as prescribed
Stay out of the hospital/not cycle
To be connected to his community
What else do you need to learn/know?
•
•
•
•
•
•
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?
© TLC-PCP 2012 www.learningcommunity.us
Bob
Core
responsibilities
Use judgment
and creativity
Not usually our
responsibility
© TLC-PCP 2012
www.learningcommunity.us
Wrkbk pg 23
Bob – Answer Slide
Core
responsibilities
Helping Bob make an
informed choice
Informing Bob of the
risks 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 get
what is important to
and important for him
Use judgment
and creativity
Not usually our
responsibility
What you do to meet
your core responsibilities
around helping him make
an informed choice –
Whether or not
Bob drinks
Informing Bob
of the risks
What Bob’s psychiatrist
does in response to
the information
Educating yourself
Exploring alternatives
If part of the “problem”
is the response of the
psychiatrist – helping
Bob find another
© TLC-PCP 2012 www.learningcommunity.us
Moving from Service Life to Community Life
Service
Life
A Good Paid
Life
Community
Life
Bob
• ‘Important for’
addressed
• No organized effort
to address ‘important to’
© TLC-PCP 2012
www.learningcommunity.us
• ‘To’ and ‘for’ present
• Closest people are
paid or family
• Few real connections
• ‘To’ and ‘for’ present
• Active circle of support
• Included in community life
Moving from Service Life to Community Life
Bob
• ‘Important for’
addressed
• No organized effort
to address ‘important to’
© TLC-PCP 2012
www.learningcommunity.us
Community
Life
A Good Paid
Life
Service
Life
Bob moves from
community life to the
Special Pool Hall at Day
Hab
• ‘To’ and ‘for’ present
• Closest people are
paid or family
• Few real connections
• ‘To’ and ‘for’ present
• Active circle of support
• Included in community life
Everyday Learning SKILLS
 4 + 1 questions
• Learning Log
• Working/Not Working (also called “What
makes sense/Doesn’t make sense)
© TLC-PCP 2012 www.learningcommunity.us
4+1
What you have done to improve your health and safety?
What have you
tried?
1
What have you
learned?
2
What
are you
?
pleased about?
3
What
? are you
concerned
about?
4
+1 – Given your learning what will you do next?
______________________________________________________
______________________________________________________
Wrkbk pg 29
____________________________________________________
© TLC-PCP 2012 www.learningcommunity.us
4+1
Pose the question you want people to answer
What have you
tried?
1
What did you do?
When did you do
it?
Who else was
there?
What have you
learned?
2
What did you
learn from your
efforts?
What
are you
?
pleased about?
3
What
? are you
concerned
about?
4
What did you like
about what you
tried?
What challenges
did you
encounter?
What went well?
What didn’t you
like about what
you tried?
What worked for
you?
What didn’t work
for you?
+1 – Given your learning what will you do next?
_____________________________________________________
_____________________________________________________
_____________________________________________________
© TLC-PCP 2012 www.learningcommunity.us
What we have done to address Liz’s
malnourishment
What have we
Tried
 Healthy
frozen meals
 Daughter
cooking a
week’s worth
of food for her
 High protein
shakes 2x a
day
What have we
learned
She doesn’t like
processed food
Will almost always
eat daughter’s
home cooked food
Protein shakes
work really well
 If she is having a
really bad day,
might only drink
one shake at best
?
What are we
Pleased about
 She is steadily
gaining weight
 Found at least two
options that work for
her
 She is committed
to eating when she
can
?
What are we
concerned about
Stress on
daughter to cook
and drive 5 hours
round trip every
weekend
Only eating once
a day
Will lose appetite
again if depression
comes back
+1: Keep doing protein shakes; find someone local to cook occasionally;
keep asking “what did you eat today, not just “did you eat today?”
© TLC-PCP 2012 www.learningcommunity.us
Everyday Learning SKILLS
• 4 + 1 questions
 Learning Log
• Working/Not Working (also called “What
makes sense/Doesn’t make sense)
© TLC-PCP 2012 www.learningcommunity.us
Learning Log
Using the learning log to replace progress notes
© TLC-PCP 2012
www.learningcommunity.us
TLC-PCP
2012 2012
www.learningcommunity.us
© TLC-PCP
www.learningcommunity.us
Recording learning for Charlie: What we have learned about what is:
What do we need to learn or figure out?
wrkbk pg 27
© TLC-PCP 2012 www.learningcommunity.us
PCT Trainer Candidate’s Learning Log
Using the learning log to replace typical progress notes
© TLC-PCP 2012 www.learningcommunity.us
Learning Log for Andrew (page 1)
Using the learning log to show a family’s learning over time
© TLC-PCP 2012
www.learningcommunity.us
Learning Log for Andrew (page 2)
Using the learning log to show a family’s learning over time
© TLC-PCP 2012 www.learningcommunity.us
Everyday Learning Skills
• 4 + 1 questions
• Learning Log
 Working/Not Working (also called “What
makes sense/Doesn’t make sense)
© TLC-PCP 2012 www.learningcommunity.us
Working/Not Working
Focus in on a specific issue or area of life
Helps you dig deeper
Negotiation Skill
• All must feel listened to – accurately reflect
perspectives
• Start with common ground
• Remain unconditionally constructive
• Done in partnership
Bridge to action planning
• What needs to be maintained/enhanced?
• What needs to change?
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Person’s
perspective
USE THIS
INFORMATION
TO BUILD THE
Staff’s
perspective
A
G
E
N
D
A
FOR THINGS
THAT ARE TO
STAY THE SAME
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USE THIS
INFORMATION
TO BUILD THE
A
G
E
N
D
A
FOR THINGS
THAT NEED TO
CHANGE
93
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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.
What doesn’t work/Doesn’t make sense
Perspective of new puppy’s owner
What works/makes sense
Wrkbk pg 32
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Use to organize perspectives about a specific
Issue or to get a snapshot description of
NOW
What’s Working
What’s Not Working/What
Could Improve
What does the person say is
working?
What does the person say is
not working or could be
better?
What does the family say is
working?
What does the family say is
not working or could be
better?
What does the staff
What do they say is not
person/teacher/therapist (etc) working or could be better?
say is working?
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Julie – Answer Slide
What is important to Julie? What is important for Julie?
Relationship with Teddy
Having some control –
• Over what happens with Teddy
• What she buys/wears
• Her things
Shopping a lot
Her sister &John Dandy in her life
Staying busy at the day service
Drinking as much as she wants
Keeping diabetes under control
• Monitoring blood sugar, giving insulin
• Weighing her food
• Controlling amount she drinks
• Helping her stay calm
Supporting her relationship with Teddy
Keeping her from falling
Planning in advance/
budgeting in advance for shopping
What else do you need to learn/know?
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?
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Staff’s perspective
Julie’s perspective
What works/makes sense
• Her relationship with
Teddy
• Feeding Teddy from her
plate (food = love)
• Feeding Teddy the same
food she is eating (people
food)
• Julie’s relationship with
Teddy
• Removing Teddy from the
dining room during meals;
monitoring Julie’s
food/drink intake
accurately
What doesn’t work/makes sense
• Staff removing Teddy during
meal times
• Teddy barking and being
upset at being locked in the
back room
• Feeding Teddy dog food in his
own bowl
• Julie feeding Teddy from her
plate
• Inaccurate monitoring of Julie’s
food/drink intake when she
feeds Teddy from her plate
• Teddy barking in the back room
and upsetting Julie and other
residents
• Teddy’s long-term health if he
eats too much “people food.”
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Wrkbk pg 35
Staff’s
perspective
Mother’s
perspective
Kathleen’s
perspective
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Staff’s
perspective
Mother’s
perspective
Kathleen’s
perspective
Family’s Perspective
Beth’s Perspective
After a Change in Seizure Medication…
• We think she’s dizzy and afraid
of falling
• She can’t walk as well as she
did before the new medicine
• She’s often angry
Nothing
• She doesn’t have seizures
• Generic medicine is less
expensive than brand name
med
• She is getting aggressive
• She’s not herself – no longer a
sweet person
• She’s afraid to walk, seems
fearful of falling
• Behaviors started after
changing seizure med from
brand name to generic – We
think the generic isn’t working
like the brand name did
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Supervisor’s
perspective
Your
perspective
Perspective of
Person
Supported
Looking at how you are doing in your work...
Wrkbk pg 36
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Logan’s Current Job
What makes sense, is working, the up side,
right now
• Pay check-How much I earn
Logan
Logan’s Mom
-Nancy
• Variety of stationary work & stocking
tasks
Supported
Living Coord.
-Jackson
• Getting off at 10 pm no energy to see live
music
• Paperwork required for processing inventory
• Co-worker’s support
• Working Saturdays
• Riding the bus to/from work
• Mom driving me home on Friday and
Saturday
• Logan developing new SKILLS
• Concerned he rides the bus late at night
• Logan has more confidence making
decisions, including making more friends
• Not spending as much time with family
• Giving Logan rides home Fri & Sat.
nights
Job Coach Brenda
What doesn’t make sense, is not working, the
downside, right now
• Complaining not able to see his friends as
much
• Logan may get hurt using the stocking lift
• Good job SKILLS & good attitude toward
work
• Recently asking co-workers to do his
paperwork
• His hours 3-10 pm. Logan is a “night owl”
• Not as productive lately, takes more breaks
• Work provides natural supports on the job
• Called in sick more this past month
• Has work friends
• Getting write-ups for not helping customers
• Starting at 3pm allows Logan to sleep in
• Logan complains no time to see live music
• Mondays off to assist with
activities/tasks at home
• Refusing support with medication prep and
shopping for meal at work
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Reflect
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As we close…
How did today go?
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Thank you!!!
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