A Story
Imagine going to your physician, only to be
told that you have been assigned to see another doctor that day. During your appointment, the doctor quickly
reviews your record and asks very personal questions that have nothing to do
with the reason you have come to see her.
You are told that you have an incurable illness and that you must take
medication for the rest of your life.
When faced with this type of situation most people would seek another
doctor.
However, for individuals with behavioral
health and substance use issues, this is a common scenario. The doctor or therapist “knows” what is wrong
and decides what will keep you “stable”.
You are given a label of “mentally ill” or “addict”, prescriptions for
medication and a return appointment.
In the words of
individuals who have received treatment:
“My problems were also compounded by the
attitude of those people in the mental health system. No one tried to
understand me as an individual. They assumed that most people in the system …
had no potential.”
(excerpt from Psychiatric
Survivor Oral Histories: Implications for Contemporary Mental Health Policy,
Oryx Cohen, 2001)
“You keep talking about getting me in
the “driver’s seat” of my treatment and my life … when half the time I’m not
even in the car!”
(from “Person Centered
Planning: From Policy to Practice”,
Janis Tondora, Psy.D, 2005)
What is Person-centered Assessment and Discovery?
Person-centered Assessment and Discovery
begins with a philosophy that emphasizes the uniqueness of each person and
his/her right to self-determination. The
process is based on principles of wellness, recovery and hope and seeks to
discover the strengths that each person possesses that will help them in their
journey.
Providers view the relationship with the
individual as a partnership that supports the person’s hopes, dreams and
goals. The process is dynamic and
changes based on the person’s wishes and needs, not on some predetermined
outcome such as medication compliance, abstinence or “stability”.
Person-centered Assessment and
treatment is widely recognized as a transformative tool in the broader human
services arena; however, there are cultural and treatment misconceptions widely
seen in both the behavioral health and substance abuse fields. Challenges include:
- perceptions based on a medical model of treatment that is driven by
regulatory and funding entities and that does not support people and their
dreams for recovery.
- beliefs that having a plan that is signed by the person constitutes
being “Person-centered”.
In order for a meaningful partnership that is
truly driven by the needs and wishes of the person, organizations, and funding
sources will need to undergo a significant philosophical shift. Persons with behavioral health and or
substance use challenges must be included as equal partners with respect to
governmental policy, regulatory changes as well as on a personal level as “the
driver” in charge of their person-centered plan.
In the words of Shery Mead, one of the
leaders in the Peer Support movement:
“All people grow
through taking positive risks. We need to support people in making life and
treatment choices for themselves, no matter how different they look than
traditional treatment, building their own crisis and treatment plans, having
the ability to obtain all their records, accessing information around
medication side effects, refusing any treatment, (particularly those treatments
that are potentially hazardous), choosing their own relationships and spiritual
practices, being treated with dignity, respect and compassion, and creating the
life of their choice.”
(What Recovery
Means to Us, Shery Mead, MSW and Mary Ellen Copeland, MS, Plenum Publishers, New York, NY, 2000).
Resources
Resources that
provide more in-depth information on Person-centered Assessment and Discovery
as well as the Recovery Movement include:
CQL | The Council on Quality and
Leadership Resources (www.thecouncil.org/)
Mary Ellen Copeland (www.mentalhealthrecovery.com/)
Merinda Epstein, Australian Consumer
Activist (www.takver.com/epstein/index.htm/)
Person Centered Planning Education
site (www.ilr.cornell.edu/edi/pcp/)
Substance Abuse and Mental Health
Services Administration (www.samhsa.gov/)
Partial list of resources for person-centered planning: (www.carecoordination.org/recoveryplanning/pdfs/Resource_List_for_PCP.pdf)