(Excerpts from Amado, A. N. and Mc Bride, M. (2001), Increasing Person-Centered Thinking: Improving the Quality of Person-Centered Planning: A Manual for Person-Centered Planning Facilitators. Minneapolis, Minnesota: University of Minnesota, Institute on Community Integration).

In our quest to increase person-centered thinking, September’s spotlight contrasted images of traditional versus person centered planning, and October highlighted the “what” and “how” of the process of change. This month will feature qualities of effective teams. While person-centered planning is somewhat separate and distinct from traditional planning, several of the concepts apply to the work that we do.
Person-centered thinking sees teams as INTER-VISIONARY. The planning group is true to the principles of Person-Centered Planning and does not come together simply because of professional roles and requirements. A Person-Centered Planning group consists of people who want to contribute their time and talents because they care about the particular focus person and want to work for change.

​Ideally, a person-centered planning group consists of a variety of people and roles. First and foremost, “Family” members are critical to the team, since they provide a historical perspective, and a strong alliance with the focus person. The “Host” acts as the guardian of hospitality for the circle. They offer a warm welcome to all team members and ensure that everyone is comfortably situated. Next, the “Personal Assistant” is
responsible for day-to-day responsiveness to the person. They are a key part of the planning process, since in many cases, they are the people who are most intimately familiar with the focus person. Teams also need a “Warrior” who focuses on immediate and long-range actions to help implement the plan. “The Teacher” provides information and skills that can help the circle to implement the plan, and the “Community Builder” offers connections, bringing others into the circle and the person’s life, both to strengthen the circle and help in implementing the plan. Then there’s the “Administrative Ally,” who can see and advocate for administrative changes that might be needed both for the focus person and for long-term change. The “Mentor” provides information, guidance and insight and the “Benefactor” provides needed resources. The “Spiritual Advisor” renews the faith of the person and the group over time and finally, the “Facilitator” provides focus, keeps the process going, and keeps the group focused on and clear about the vision and actions needed to implement it.

Effective teams have mutually set team goals and there is an understanding and commitment to these goals. There are also clearly defined and non-overlapping member roles. Development and creativity is encouraged, but decisions are based on facts, not emotions or personalities. Meetings are efficient and task oriented (to the extent that the individual at the focus feels comfortable). Discussions involve all members, and meeting minutes are promptly distributed · Members listen to and show respect for one another. Actions are based on problem solving, not blaming, and frequent feedback is solicited on the process. Members are kept informed and take
pride in their membership. There is a free expression of ideas. Members cooperate and support one another and there is tolerance for conflict, with an emphasis on resolution. Finally, and perhaps most importantly, members enjoy spending time with one another!

Thought Exercise: Reflect on the teams that you are a part of. What are some of the ways you can shape them to be more effective and person-centered?

 (Excerpts from Amado, A. N. and Mc Bride, M. (2001), Increasing Person-Centered Thinking: Improving the Quality of Person-Centered Planning: A Manual for Person-Centered Planning Facilitators. Minneapolis, Minnesota: University of Minnesota, Institute on Community Integration).

Amado and McBride identify 5 different levels of commitment to person-centered thinking. There are those who embrace it, and weave it throughout their actions and interactions, in all of the work that they do. There are those who support it and actively work to implement initiatives wherever and whenever possible. Next, there are those who believe in it. They like the concept, but have a tendency to stand by and watch, rather than taking an active role in the process. At the fourth level, there are those who are neutral. They’ll “go along for the ride,” but have some doubts about whether the process is legitimate and whether the vision is attainable. Finally, there is the “Yes, But...” level of commitment. These are people who like the concept, but find reasons not to engage directly in the process. They have difficulties moving forward or
taking risks.

The authors also identify qualities of a good facilitator, referring to this as the “what” in the process of change. They note that a change agent believes in the Person-Centered Planning philosophy, and holds a true understanding of the assumptions of Person-Centered Planning. They are committed to and supportive of the process and implement the logistical techniques of Person-Centered Planning, including: Supporting the focus person, inviting appropriate group members, and fostering a welcoming environment that supports creativity. They also have good skills in graphic organizing and group facilitation. A change agent is able to foster commitment and support from all stakeholders, using good listening and humor, and remaining non-judgmental, self-confident, genuine, flexible, and hospitable.​

Finally, the authors offer several suggestions for procedures and processes, which they refer to as the “how” of change. They note that the change agent knows how to facilitate a person-centered plan and can use pacing to move the Person-Centered Planning process along at a rate that works for the focus person and the circle of support. Good listening skills and teamwork enhances the effectiveness of the Person-Centered Planning process. Conflicts must be resolved constructively, and the group must work towards consensus building. The process of change also involves fostering the self-determination of the focus person so the person-centered plan is created by and with them and not for them. An effort is made to build relationships with the members of the circle of support so they will participate in the work of the action plan
on an ongoing basis. Finally, the group celebrates its successes and accomplishments, while recognizing upsets and breakdowns, and re-committing to the process to find
solutions.

Thought Exercise: What is your level of commitment to person centered thinking?
Do you Embrace it? Support it? Believe it? Neutral? Or “Yes, But...?”

 Welcome Back to another school year! Our monthly newsletter will feature a “Spotlight
Article,” highlighting foundational best practices in our field. This year’s articles are drawn from Angela Novak Amado and Marijo Mc Bride's (2001) work from the
Institute on Community Integration at the University of Minnesota. The series will focus on “Increasing Person-Centered Thinking.” In a world where systems have become all the rage, PBS remains committed to reinforcing our roots, prioritizing quality of care, and ensuring meaningful, lasting change in the lives of the children and families we serve. Happy reading!

September Highlight: Contrasting Images of the Future (Excerpts from Amado, A. N. and Mc Bride, M. (2001), Increasing Person-Centered Thinking: Improving the Quality of Person-Centered Planning: A Manual for Person-Centered Planning Facilitators.
Minneapolis, Minnesota: University of Minnesota, Institute on Community Integration).

In her 1992 sourcebook “Person-Centered Planning: Finding Directions for Change Using Personal Futures Planning,” Beth Mount commented on the dichotomies
between system-centered and person-centered ways of thinking about an individual’s future. Person-centered change challenges us to discover and invent a personal dream for people, and to craft a pattern of living that increases people’s participation
and belonging in community life. Rather than planning a lifetime of programs, the goal is to craft a desirable lifestyle. Too often, we find ourselves offering a limited
number of (usually) segregated program options. Instead, as change agents, we need to design an unlimited number of desirable experiences. Instead of basing options on stereotypes about disabilities, we need to find new possibilities for each person. Instead of focusing on filling seats, spots, or placements, we need to focus on quality of life. As clinicians, we tend to overemphasize technologies and clinical strategies.
Instead, we need to emphasize dreams, desires, and meaningful experiences. Instead of organizing our efforts to please funders, regulators, policies, and rules,
we can organize to respond to people.

O’Brien and O’Brien’s “five valued experiences” (Framework for Accomplishment, 1989) lead to questions on which to focus in developing a more desirable future: COMMUNITY PRESENCE (“How can we increase the presence of a person in local community life?”), PROMOTING CHOICE (“How can we help people have more control and choice in life?”),
COMMUNITY PARTICIPATION (“How can we expand and deepen people’s friendships?”), SUPPORTING CONTRIBUTION (“How can we assist people to develop more competencies and contribute their unique gifts?”), and VALUED ROLES (“How can we
enhance the reputation people have and increase the number of valued ways people can contribute?”). 

Beth Mount also described the differences in images of the future in traditional program plans compared to futures that are worth working for.
● In traditional program plans, goals often focus on specific negative behaviors of the focus person to change or decrease, whereas plans might contain specific, concrete examples of positive activities, experiences, and life
situations to increase.
● Traditional program plans identify program categories and service options that are often segregated, whereas future ideas and possibilities might reflect specific community sites and settings and valued roles within those settings.
● In traditional program plans, many goals and objectives reflect potentially minor
accomplishments that can be attained within existing programs without making any changes. In future plans, some ideas may seem far out, unrealistic, and impractical, and may require major changes in existing patterns such as funding categories, service options, how and where people spend their time, and who is
involved in shared decision-making.
● In traditional programs, plans often look similar to the plans and ideas written for other people. Quality future plans reflect the unique interests, gifts, and qualities of the person, and the unique characteristics, settings, and life of the
local community.
● Traditional program plans will probably not even mention personal relationships or community life. Future ideas emphasize creative ways to focus on developing and deepening personal relationships and community life, ultimately resulting in a stronger circle of supportive stakeholders.

Thought Exercise: Take a moment to think about the work that you do. What are some of the ways that you can be more person-centered in your thinking and planning?

(Review of Jan, 2023 Training delivered to the Mental Health team by Dr. Christopher Smith)

This month’s mental health spotlight is on Learning Disabilities. Learning disabilities (LD) are differences in a person’s cognitive functioning that can affect how well they
read, write, speak, do math, and handle other similar tasks compared to people without LD. Learning disabilities are not related to intelligence; it just means that the individual with LD functions cognitively differently than others. Learning Disabilities involve differences that affect the way the brain processes information. They are usually discovered once a child is in school and has learning difficulties that do not improve over time. Learning disabilities can last for the person’s entire life, but can be
successful with the right educational support.

(Review of November, 2022 training delivered to PBS Mental Health team by Dr. Christopher Smith)

Specific phobias are marked fear or anxiety about a specific object or situation (e.g., flying, heights, animals, receiving an injection, seeing blood). The phobic object or situation almost always provokes immediate fear or anxiety, and is actively avoided or endured with intense fear or anxiety. The fear or anxiety is out of proportion to the actual danger posed by the specific object or situation and to the sociocultural context. The fear/anxiety/avoidance causes clinically significant distress or impairment in important areas of functioning, and lasts for 6 months or more. Some examples of phobias include: A fear of animals (e.g., spiders, insects, dogs), a fear of things in the natural environment (e.g., heights, storms, water), a fear of blood or injection injury (e.g., needles, invasive medical procedures), or situational fears (e.g., airplanes, elevators, enclosed places).

Excerpt from Magito McLaughlin, D. & Smith, C.E.(2017). Positive behavior support. In J. Matson (Ed.), Handbook of Treatments for Autism Spectrum Disorder (pp. 437-457) Switzerland: Springer.

February’s ethics presentation given by Dr. Magito McLaughlin, focused on the BACB’s Professional and Ethical Compliance Code for Behavior Analysts. The presentation reviewed upcoming changes in NYS’ Scope of Practice Law and discussed how these changes will impact the practice of Behavior Analysis going forward. As NYS LBA’s enter into a wider Behavioral Healthcare environment, they will need to consider how different disability paradigms could affect how services are provided. Behavior Analysts should prepare for ongoing
education, training, and supervision as they consider: 1) the direct effects of diagnosis and progression, 2) the effects of medications on cognitive, emotional, and physical presentation, 3) factors related to resilience, 4) management of personal biases, 5) working with a wider team of people, 6) understanding caregiver relationships, 7) identifying resources that facilitate community participation, 8) reducing access/performance barriers, 9) learning about different funding options, and 10) integrating behavioral services into a broader healthcare environment. Resources for continued education and training were shared, along with a case presentation and discussion.

 January’s CEU offering was presented by Kristin Harris. The training included a review of the literature in the areas of assessment and treatment with a focus on the most prolifically researched intervention: response interruption and redirection. In light of the neurodiversity movement, the ethics of intervention and considerations were highlighted, namely, the behavior analyst's obligations to maximize the benefits of therapy, supporting clients' rights, and the hippocratic oath of "do no harm" from the Behavior Analyst Certification Board's Professional and Ethical Compliance Code (2014). Anxious behavior was operationalized as a set of behaviors that increase or decrease when an aversive event is signaled and a recent study was cited for its utility to assess and treat behaviors hypothesized to be maintained by automatic negative reinforcement. Three types of assessment procedures were discussed along with considerations for use in applied settings. They were: the traditional functional analysis (Iwata, 1992/1984), the BRIEF functional analysis (Roscoe et al., 2008) and the Automatic Reinforcement Screen (Querim et al., 2013), respectively. A multitude of procedural variations in treatment packages involving response interruption and redirection investigated at differential reinforcement procedures, reprimands, response blocking and response cost as highly idiosyncratic components. Their inclusion in a treatment package must take into account the quality and nature of the reinforcement context for the individual along with practicality and social significance. Most importantly, behavior analysts should conduct an ecological assessment to determine if modifications to the environment can be made with relative ease. Environmental enrichment cannot be over-emphasized as a tool for behavior change in the reduction of automatically maintained challenging behavior.