Person-centred plans: empowering or controlling?

<p><strong>This research project used a case study design to explore the use of person-centred planning (PCP) with disabled people in a community day programme. The study was located in a New Zealand context as part of a music therapy student placement with data collected over six months at the facility. This case study involved reflection on music therapy work with three people as a part of the student’s regular practice, exploring methods, techniques and strategies using PCP when working with disabled adults. This interpretivist study used secondary analysis of data (including my clinical notes, reflective journals, and notes from discussions with the staff) as the methodology. A thematic analysis identified six themes that were of interest in the relationship between PCP and music therapy practice with disabled adults: building person-centred relationships; person-centred support; person-centred empowerment; collaborative reflexivity; holding community in mind; and providing an affirming space. The findings suggested that PCP is helpful as an inclusive practice for music therapy working with disabled adults in Aotearoa New Zealand. There were some challenges to implement PCP in the practice, such as the full involvement of disabled people and their families, as well as limited resources. Contemporary critical disabilities research also challenges traditional perspectives of disability rights, advocating for more inclusivity, accessibility, and equity. Although PCP and less ableist approaches focus on different aspects, they share some common values, such as respect for collaboration, inclusivity, and equity. Looking at the values of PCP and contemporary critical approaches might provide a new way of thinking and working for music therapists in future practice. The process of my research deepened my knowledge of PCP and improved my practice working with disabled adults. It also provided opportunities for me to engage critically and reflexively in thinking about different approaches in music therapy and the disabilities field.</strong></p>

BackgroundGoal setting for persons within health and social care environments can be a challenging task; although health and social care settings aim to address a person’s care needs, the literature tends to focus on health. Person-centred care should encompass the goals/needs/wants of the person, whether these goals focus on career, relationship, and/or health domains. To understand how a person-centred participatory goal setting process is carried out in a care environment, we used an integrated knowledge translation approach.MethodsWe conducted 11 semi-structured interviews with community-care staff to understand a person-centred planning process, including key components and impacts.ResultsThe interviews provide a thorough understanding of an implemented approach to person-centred plans, including its creation, implementation, and benefits (for the person-supported, family, friends, and staff). Person-centred plans provide a map with which to plan activities based on a persons’ goals, interests, and capacities, and have positive impacts for the person-supported, family, friends, and staff.ConclusionsOur study highlights how a community-care organization can facilitate person-centred services through person-centred plans and has implications for wider uptake of person-centred plans in community-care organizations.

Over the past two decades person-centred planning has been used to support people with learning disabilities to fulfil their personal aspirations. This has been backed up by national policies that have adopted the principles of person-centredness. However, widespread barriers to the implementation of person-centred planning for people with learning disabilities have been reported and the literature suggests that implementing person-centred planning is particularly challenging for people with more complex needs.This article discusses the findings of a literature review that explored the barriers and facilitators to the implementation of person-centred planning for people with learning disabilities and complex needs and their carers. The article identifies barriers such as limited funding and resources, challenges in accessing services and communication difficulties. It also describes initiatives that appear to have successfully engaged service users and their carers in person-centred planning. Further research is needed into the long-term effects of person-centred planning for people with learning disabilities and complex needs, notably to measure its effectiveness in enhancing their quality of life, while strategies to enable them to engage in person-centred planning need to be developed.

Person-centred planning has played a key role in the transformation of intellectual disabilities services for more than a decade. The literature has identified clear advantages for service users when service delivery is planned around the individual rather than the user is made to fit into service structures. Researchers however have pointed out that there is a lack of evidence that person-centred planning positively influences outcomes for users. Our study examined the application of person-centred planning during transition for young people with intellectual disabilities. We investigated the nature and content of 44 person-centred reviews of transition planning for this population in a local authority in the UK. We carried out a documentary analysis of all person-centred plans and conducted telephone interviews with all families participating in the programme. We focused on the issue of attendance at review meetings and what was discussed during the meetings. Analysis of the data shows an increase in the participation of young people and carers at review meetings and a significant shift in topics discussed during the transition planning process compared with previous programmes. However, some of these effects may dissipate once young people are actually leaving school as planning well is not synonymous with having an improved range of placement options. The findings suggest that person-centred planning can impact positively on some aspects of transition planning, while it may be too optimistic to expect radical improvement in other area. Key to further improvements is to complement person-centred planning with consistent involvement of all relevant stakeholders in planning for individuals.

Background: Effective person-oriented goal setting in care environments is challenging owing to the complexity of the environment, and the requirement of supportive person-centred care. Health and social care settings, such as the community-care sector, aim to holistically address persons’ care needs, however, much of the guidance in the literature focuses explicitly on health. Effective person-centred care should consider all goals of the person, whether these goals focus on career, relationship, and/or health domains. Person-centred care responds to a person’s wants/needs, with a consideration for how these revolve around their goals. However, little is known about how community-care organizations use tools such as person-centred planning (PCP) to meet the needs and goals of persons-supported. Aim and Methods: To understand how a person-centred participatory goal setting process is carried out in a care environment, we used an integrated knowledge translation approach to collaborate with community care leaders. Our co-designed qualitative descriptive research project explored a community-care’s approach to person-centred goal setting in Ontario, Canada. We conducted 11 semi-structured interviews with community-care staff to understand their perspective of the PCP process, including key components, facilitators, barriers, and impacts. Results: The interviews with staff provide a thorough understanding of the PCP process used by the community-care organization from beginning to end, including the creation and implementation of PCPs. Five themes were strongly exemplified in our study: organizational culture, flexibility, accountability, utilizing staff characteristics to their maximum potential, and the positive impacts of PCPs. The PCPs displayed benefits not only for the persons-supported, but for the people who support and surround them, including family, friends, staff, and the wider community. Moreover, our study demonstrates how a community-care organization has been able to balance the needs of the organization and the persons they serve within a government-mandated planning process. Implications: Our study highlights how a community-care organization can facilitate person-centred services through PCPs and has implications for a wider uptake of PCPs amongst individuals with intellectual and developmental disabilities. The outcomes of this project will inform the spread of PCPs in community-care organizations and encourage other professionals to explore the use of PCPs in their own settings. Additionally, PCPs have the potential to be effectively implemented for other vulnerable populations. Next Steps: Future research should explore the use of a flexible framework to guide the use of PCPs in organizations. Moreover, governments should support organizations in evaluating their programs to support the spread of effective programs and to ensure that future implementation can be successful.

Person-centered planning (PCP) is a recommended practice in developing and implementing individualized futures plans of and by youth and adults with disabilities. Yet, little is known about the cultural responsiveness of PCP, a salient issue because values and beliefs about transition differ across and within groups. Community connectors, facilitators of futures planning in two culturally distinct areas (a Spanish-speaking, socioeconomically depressed urban area and a suburb of English-speaking people from middle- and uppersocioeconomic backgrounds), were interviewed regarding their implementation of Planning Alternative Tomorrows with Hope and their responses to the preferences, strengths, and needs of families. Person-centered planning was effective in addressing transition-related concerns and obstacles to collaboration identified by community connectors, who adapted this model to address perceived community needs.

Person-centred planning (PCP) puts individuals with an intellectual disability atthe centre of service and support planning, identifying how individuals wish tolive their lives and what is needed to make that possible. PCP has beenidentified as having the potential to facilitate improved social inclusion andcommunity participation. A mixed-methods approach combined quantitative analyseswith qualitative case studies of individuals with severe-profound intellectualdisability to assess the impact of PCP on community participation for adultswith an intellectual disability at a disability service in Dublin. We concludethat PCP may provide a good basis to plan community participation and, with theright supports in place, may provide opportunities for people with complex needsto improve their community participation. Supports including familiar staff andfamily are critical to the success of PCP for people with complex needs, andtheir absence may undermine the best intentions of PCP for this population.

This study, by E mma C orrigan of the P lymouth Excellence Cluster and Community Psychology Service, explores the use of person centred planning ( PCP ) in supporting young people who have experienced school exclusion, in their transition and re‐integration to mainstream settings. Young people of different ages participated in the PCP process and multiple stakeholder perspectives provided insight into the implementation and outcomes of PCP over time. Reported findings indicate a positive impact upon young people's social‐emotional well‐being, attendance in school, and educational achievement, and highlight a range of ‘supports’ and ‘barriers’ that can facilitate and/or obstruct the use of PCP in practice. This research contributes towards practice‐based evidence at a time when legislative reform advocates a broader use of PCP to support special educational needs in the UK . Potential gains, pitfalls and further actions are considered to support a wider application of PCP within the new statutory framework and to inform implications for future practice and further research.

ABSTRACTDynamic Assessment (DA) is an interactive form of cognitive assessment used by some educational psychologists (EPs) to assess the learning potential of children and young people, through a focus on cognitive and affective aspects of learning. In terms of UK EP practice, this approach has the potential to complement the focus on ‘person-centred planning’ set out in the Special Educational Needs and Disability Code of Practice. However, there is little guidance or consensus on what constitutes good DA practice. This research employed a Delphi methodology to identify competencies required to carry out quality DA. A panel of five international experts in DA and 17 EPs, using DA in practice, participated in three rounds of a Delphi study that identified 13 knowledge and 12 skills competencies considered essential for quality DA practice. The resulting framework could inform training and professional development programmes for EPs wishing to develop their skills and competence in practice.

Opportunities for children to be involved in the decisions made about them are part of current statutory educational legislation. Person-centred planning (PCP) has been proposed as an appropriate method of meeting statutory requirements to gather pupil views. However, young people within alternative provisions (APs) may lack opportunities to be heard. This paper reports on an action research project with staff from an AP for children at risk of exclusion. Participants opted to trial the use of the PCP approach ‘Making Action Plans’ (‘MAPs’; carried out virtually due to Covid-19 restrictions) and evaluated the project through two focus groups. Findings indicate that (virtual) use of MAPs requires staff to carefully consider their setting’s structure, needs, capacity and capabilities. Pre-meeting preparation and adapting the MAP process with technology improved engagement, access and alternative ways of working. The MAP process provided a range of positive outcomes as a by-product of its implementation.

Person-centered planning emerged in the 1990s as an innovative practice to assist persons with intellectual and developmental disabilities. The foundational purpose of person-centered planning is to assist the individual in developing service planning that reflects the needs and desires of the focal person with the disability. Despite its popularity with disability practitioners, advocates, and policy stakeholders, debate emerged at the beginning of the 21st century as to the viability of person-centered planning as an evidence-based practice. This article examines the historical development and evidence base, as well as the current challenges and potential of person-centered planning for adults with intellectual disabilities.

Person-Centered Planning and Disability: barriers and opportunities for improvement in Catalonia

While research identifies spirituality and inclusion in a community of faith as key factors contributing to quality of life for many individuals in our society, people with disabilities are often not able to access this aspect of everyday life if they wish. To change this, four groups must come together: (1) individuals with disabilities; (2) faith communities; (3) families of people with disabilities; and (4) support service providers. Current research describes the efforts of faith communities and people with disabilities and their families relative to spiritual inclusion; however, little is known about how support service systems are addressing this topic. This study surveyed direct support professionals to examine their beliefs, perceptions, and practices regarding spirituality and its role in the person-centered planning process for people with disabilities. Results indicate professionals have a high level of support for including spirituality in person-centered planning; however, this attitude does not consistently transfer to their practices. Overcoming identified barriers and meeting the needs of professionals are discussed in the context of better inclusion of this quality of life aspect for people with disabilities.

Date Presented 04/06/19 Employment rates among people with intellectual and developmental disabilities (IDD) are historically low (26%) when compared to people without disabilities (76%). Understanding a person’s strengths, hopes and dreams for the future assists them in setting and achieving vocational goals. As person-centered planning (PCP) is embraced by many state agencies serving people with IDD across the US, occupational therapists have unique skill sets to play a vital role in the PCP process. Primary Author and Speaker: Meghan Blaskowitz Additional Authors and Speakers: Lindsay Layer, Sarah Scalero, Abigail Gore, Amy Castagnino, Katrina McNally

Policy appears to regard person‐centred planning (PCP) as underpinning strategic planning. While accepting the logic of its role in planning for individuals, this commentary argues that PCP cannot fulfil a strategic planning role because the development of PCP on a wide enough scale to be useful for this purpose is itself a strategic development, which will take considerable time and resources to achieve. There is still a place for population‐based norms or targets based on available epidemiological data to indicate the needed scale of provision and associated resource requirement. Three illustrations are described. In conclusion, it is noted that the current lack of indicative provision targets is a weakness of recently issued policy, an absence which does nothing to safeguard the interests of those who depend on service support.