Preparing Social Workers with Person-Centered and ...
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Preparing Social Workers with Person-Centered and Participant-Directed
Competencies
2014 CSWE APM Faculty Development Institute
hi
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FDI Teachers Nancy Hooyman, University of Washington
CSWE Gero-Ed Center Co-Principal Investigator Partnerships Project Coordinating Center Staff and Faculty
Participant
Doreen Higgins, University of Wisconsin–Green Bay Partnerships Project Faculty Participant
Anissa Rogers, University of Portland Partnerships Project Faculty Participant
Mark Sciegaj, Pennsylvania State University NRCPDS Senior Consultant for Training and Research Partnerships Project Coordinating Center Staff
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Partnerships Project Prepares BSW and MSW students with PC/PD
competencies
Targets Aging and Disability Resource Centers (ADRCs) and social work programs in Administration for Community Living’s eight Enhanced ADRC Options Counseling states and New York City
Connecticut, Maryland, Massachusetts, New Hampshire, Oregon, Vermont, Washington, Wisconsin
Builds upon GeroRich Program’s and Gero-Ed Center’s successful utilization of planned change model of curricular and organizational change
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What We Will Cover
Larger Context: Changing World of Practice
Person-Centered/Participant-Directed Approach
Engaging Faculty/Overcoming Resistance
Implementing Curricular Change
Tool Kit Overview
Next Steps with Your Curriculum
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Learning Objectives Understand the PC/PD philosophy, service delivery,
competencies, and role in community-based LTSS, such as the Aging and Disability Network, and implications for social work education and practice
Use the PC/PD Toolkit to select appropriate teaching resources for infusion into generalist social work courses
Apply relevant strategies to engage faculty, administrators, and students within your social work program in order to infuse PC/PD competencies, content, and measures of student competency attainment into your required generalist social work curriculum
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How Did You Get to the CSWE APM?
A. Car
B. Plane
C. Train
D. Other
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Which is NOT true about Tampa?
A. 50th Largest City in the USA
B. 3rd Largest City in Florida
C. Largest city in Hillsborough County
D. There used to be a loose Mystery Monkey in the city
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Which SW Degrees Does Your Institution Offer?
A. BSW
B. MSW
C. Both
D. Other
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What is Your Area of Emphasis?
A. Clinical/ Practice
B. Management/ Administration
C. Policy
D. Other
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What is Your Population of Focus?
A. Children and Families
B. Health/ Mental Health
C. Older Adults
D. People with Disabilities
E. Other
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What Do You Most Want to Gain from This Workshop?
A. New knowledge re: PC/PD competencies/ content
B. New teaching resources re: PC/PD practices
C. Ideas to overcome colleagues’ resistance to this content
D. Contacts with others teaching this content
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The Larger Context: The Changing World
of Practice
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The Changing World of Practice
Affordable Care Act
Section 2402a Facilitate PC/PD DHHS is to ensure that states develop service
systems that are person-centered and responsive to the needs and choices of beneficiaries including their desire for self-direction
Section 3506 Facilitate Shared Decision Making DHHS is required to establish a program that
develops, tests, and disseminates certificated patient decision aids
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Affordable Care Act
Section 2703 Medical (Health) Home Expansion Coordinated care to ensure access to a multi-
disciplinary array of services to treat the “whole” person” from a person-centered perspective
Section 2405 Aging and Disability Resource Center Expansion Single integrated entry point for both persons
with disabilities and older adults: PD programs to be in every community (Community Living Connections)
The Changing World of Practice
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Veteran-Directed Home and Community Based Services
Federal Long-term Care Commission 2013 Participant-directed LTSS (PD-LTSS) is an option
that would facilitate successful rebalancing efforts
Increasing numbers of people of all ages want options of choice and control
Autonomy central to sense of self
Growing diversity of American population
One size does not fit all
The Changing World of Practice
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Across All Types of Populations and Settings
• Self-Determination • Individual/Family-Directed • Centers for Independent Living
Developmental Disabilities
• Recovery Mental Health
• Informed Consent/Decision Making • Shared or Participatory Decision Making Medical
• Person-Centered • Consumer-Directed
Aging and Disability
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Person-Centered Care & Participant-Directed
Practices
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How Knowledgeable Are You About Person-Centered Practices?
A. Very Knowledgeable
B. Knowledgeable
C. Somewhat Knowledgeable
D. Little Knowledge
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Person-Centered Care
First implemented with adults with disabilities
Values of community inclusion, dignity, respect
Individual at center of planning process
Plan reflects on what is most important to the person, their capacities, strengths
Focuses on person’s life, not just services
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Person-Centered Planning
Service and
support plan
Participant preferences
Participant strengths
Participant capacities
Participant needs
Available supports
Participant desired
outcomes or goals
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How Knowledgeable Are You About Participant-Directed Practices?
A. Very Knowledgeable
B. Knowledgeable
C. Somewhat Knowledgeable
D. Little Knowledge
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Participant-Direction
Shift from traditional model in which decision-making and managing authority is vested in professional
Premise that person receiving services: is in best position to identify needs and
goals and direct and manage own care has decision-making authority, including to
hire, manage, and fire workers
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What is Participant Direction?
What
When Who
How
Participant Controls
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Traditional versus PD Services
Participant
Workers recruited
and report to agency
Program and
agency set tasks
Agency specifies salary and
benefits
Normal work hour
schedule
Worker training required
by agency
Case managers determine needs & services
Traditional Participant-Directed
Participant
Recruits and
manages workers
Sets tasks
Specifies salary and benefits
(optional)
Assigns flexible
work hour schedule
Trains/ arranges worker training
Makes decisions
about needs and services
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Shift in Responsibility for Risks Relationship is between the program and the provider Provider is accountable for health, welfare, and outcomes
Participant is responsible for decision-making, safety, and adequacy of services Participants have the opportunity to learn from their mistakes Effectiveness and quality are measured by the participant
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PC/PD Approach: A Paradigm Shift
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Exercises for Paradigm Shift
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The Paradigm Shift from “Expert” to Coach and Trainer
What is a Paradigm Shift? “one conceptual world view
is replaced by another” (Thomas Kuhn, 1962)
A change from one way of thinking to another
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From God to Guide
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Overcoming Resistance
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Asking for One More Thing! Really?
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Thinking About “Resistance”...
Resistance (Noun):
the act or power of resisting, opposing, or withstanding
the opposition offered by one thing, force, etc., to another
(Dictionary.com)
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Engaging Faculty and Relevant
Others in Curricular Change
What does resistance mean to you and how have you dealt with it in the classroom or field?
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Asking Faculty to do One More Thing! Really?
Maybe resistance is really just about…
Multiplicity of responsibilities Information overload
Multi-tasking
Heavy workloads
Limited budgets
Family, friends… having a life!
Our world today
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Curricular Analysis Strategies: Assessing Readiness for Change Review course syllabi
Obtain input from curriculum program committee, faculty, students, community partners
Despite best curricular analysis and input, resistance may occur
“Curriculum bucket is too full” Competency fatigue
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Implementation
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Experiences in Implementation
What experiences have you had in making curricular change?
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What is Infusion? The embedding of PC/PD knowledge, skills, and
values throughout the entire course, not just one class session
Course description, objectives, assignments, readings, and exercises, where appropriate
More than a list of competencies: links course content, readings, class exercises, media, & assignments to the targeted PC/PD & EPAS competencies
Competencies Teaching Resources (Matrix)
Guidelines for Infusion: Ideal to move toward
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Strategies for Success: Help Engage Faculty to Facilitate
Change and Implementation
Relationship-building
Logistics
Faculty Recognition
Maintaining enthusiasm and being realistic!
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Effective Implementation
Course Objectives – By the end of this course, students will be able to:
Articulate ways to advocate for consumer access to the services of social work (CSWE competency, language changed to reflect PC/PD philosophy)
Describe the philosophy and service model of person-centeredness in the context of social work as well as the roles and responsibilities of social workers, consumers, and agencies (PC/PD competency linked to CSWE competency)
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Effective Implementation Course Requirements – Theory Application Paper
(Linked to course objectives):
Pick an issue in which you’re interested. Based on what you know about the issue, apply a theoretical perspective to the issue that you think explains the dynamics of it. Include the following in your discussion: How does the theory “explain” the issue (e.g., what
“causes” the problem from a generalist perspective, how are people affected by it)? (25 points)
How would you intervene with a consumer who presented with problems related to the issue? What would the roles be of the social worker, consumer, and agency using the theory? How does that compare to person-centered, participant-directed approaches? (25 points)
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Effective Implementation
Theory Application Paper (continued):
Summarize whether or not the literature supports your ideas. What theoretical perspectives are presented in the literature related to this issue? What theories do others use to “explain” and to intervene with the issue? (25 points)
Briefly discuss the strengths/weaknesses to both your perspective and that presented by the literature. Include a discussion on how these perspectives align (or don’t) with strengths/person-centered, participants-directed philosophies. (25 points)
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Action Plans & Next Steps
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Take-Away Points Importance of engaging faculty and
community partners from inception
Emphasize ways to enrich courses rather than “taking away” other elements Be ready to assist colleagues with changes
Connect to what faculty are already doing Cross-cutting areas: Not just aging and
disabilities
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Take Away Points Infusion throughout the course, including
language
Use Competencies Teaching Resources matrix as starting point; tailor to fit your program Send us your additions to the matrix
Utilize existing resources from Tool Kit or www.Gero-EdCenter.org No need to “reinvent the wheel”
Curriculum change is often incremental and never proceeds in a linear fashion
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FDI Evaluation
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Evaluation
For each of the following statements,
indicate your response by selecting the
corresponding button on your clicker.
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Evaluation
I am satisfied with the quality of the didactic sessions presented in this FDI.
A. Strongly Agree B. Agree C. Neutral D. Disagree E. Strongly Disagree
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Evaluation
I am satisfied with the quality of this FDI’s discussions and small group activities.
A. Strongly Agree B. Agree C. Neutral D. Disagree E. Strongly Disagree
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Evaluation As a result of this FDI, I understand the PC/PD philosophy and role in community-based LTSS.
A. Strongly Agree B. Agree C. Neutral D. Disagree E. Strongly Disagree
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Evaluation
Due to this FDI, I understand the PC/PD competencies and their implications for social work education and practice.
A. Strongly Agree B. Agree C. Neutral D. Disagree E. Strongly Disagree
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Evaluation I feel more confident in my ability to infuse PC/PD competencies, content, and teaching resources into my syllabi than I did prior to this FDI.
A. Strongly Agree B. Agree C. Neutral D. Disagree E. Strongly Disagree
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Evaluation After attending this FDI, I have a better understanding of how to link PC/PD content, readings, and assignments to EPAS and PC/PD competencies.
A. Strongly Agree B. Agree C. Neutral D. Disagree E. Strongly Disagree
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Evaluation In this FDI, I learned about strategies to engage faculty, administrators, and students within my social work program in order to infuse PC/PD competencies.
A. Strongly Agree B. Agree C. Neutral D. Disagree E. Strongly Disagree
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Evaluation
Overall, this Faculty Development Institute met my expectations and needs.
A. Strongly Agree B. Agree C. Neutral D. Disagree E. Strongly Disagree