PERSON-CENTRED ACTIVE SUPPORT

Reviewed by Patricia Flynn, Senior Occupational Therapist, St Michael’s House, Adare Green, Coolock, Dublin 17

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Person-Centred Active Support is a comprehensive training resource aimed at enabling staff to promote participation, inclusion and choice for people with learning disabilities. The training pack is made up of six modules and employs a range of tools to assist presentation and learning, including ready-to-use overhead projector layouts; worksheets; questionnaires; case-studies; timetables; and video-clips (on CD-ROM)—all excellently integrated into the main body of supporting text. The pack is designed so that it can be used by a trainer to present to a group, or by an individual to learn independently.

The training material builds on work originally carried out in one of the first staffed houses for people with severe and profound learning disabilities in the United Kingdom (Mansell et al., 1983). It was more recently influenced by increased emphasis on person-centredness and the call for improved quality of support as opposed to paper plans, in such services. The resultant approach is built around the principle that ‘person-centred support is about enabling people to engage in meaningful activity and relationships, minute by minute, day by day and not about paperwork and plans’ (p.1).

Modules one and two concentrate mainly on challenging the learner to evaluate their own attitudes to the needs and rights of people with disabilities, and how a service can be designed to effectively address and promote these. This is achieved by directing the learner to relate their own needs to those of people with disabilities, and by emphasising engagement as the key to a high quality of life.

The related worksheets at this stage guide the user, through writing an individualised ‘active support’ activity plan aimed at illustrating that everyone can contribute to the world around them with appropriate support. It is through this meaningful contribution that new opportunities and experiences present themselves, which in turn lead to the person gaining more control to make informed and appropriate choices.

The emphasis is shifted in Modules three and four, from the change that needs to take place at an individual level, to what needs to happen at managerial and organisational level. The authors strongly advise intensive and on-going on-the-job coaching and evaluation of staff competencies, by first-line managers, and the consequent shifting of administration duties to senior managers. In Module Four, particular focus is put on the need for senior management to model and support good practice, provide appropriate and necessary training, and maintain high staff motivation levels. Managers are also challenged to identify and acknowledge current weaknesses in their service through distributing questionnaires to allow staff to candidly rate their organisation’s performance.

Modules Five and Six offer the trainer or independent learner additional background reading and supporting research to supplement the previous four modules. In these sections it might have been valuable to recommend reading around specific skill areas, such as task analysis and communication. However, this may have been a deliberate omission by the authors in order to support their purpose of moving staff away from teaching service-users skills, to promoting engagement for engagement’s own value.

The Person-Centred Active Support resource pack is exhaustive in promoting the value of engagement and of the person-centred model of practice. In this respect, the training programme would be a valuable framework for an induction course for staff new to the area of learning disabilities. However, additional supplementary training may be necessary to develop staff competencies to enable confident practice within this model, especially in the areas such as assessment of individual abilities and preferences; communicating with people learning disabilities; advocacy and working with service users’ families. There is a real risk that the introduction of formal evaluation of staff skills, as advised, without providing extensive training, may be a meaningless exercise that could have a negative effect on morale. This is especially relevant given the emphasis the authors place on the motivational levels of frontline staff as a highly significant factor in achieving truly person-centred practice.

Overall the Person-Centred Active Support training resource is an ambitious project calling for a strong, hands-on commitment to person-centred practice. Its structured framework offers a practical strategy for any service newly embracing person-centred principles. While the material would be very valuable in implementing positive attitude change, it would need to be supplemented by additional training in specific skill areas in order to inspire full confidence in staff new to the area of person-centred practice

PERSON-CENTRED ACTIVE SUPPORT by J. Mansell, J. Beadle-Brown, B. Ashman and J. Ockenden (2004). Pavillion Publishing, Brighton. ISBN 1 84196 131 0-

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