Person-centred Planning - Background

Background

"Person Centred Planning discovers and acts on what is important to a person. It is a process for continual listening and learning, focussing on what are important to someone now and in the future, and acting on this in alliance with their family and their friends"

Person-centred planning was created in response to some specific problems with the way in which society responds to people with disabilities. Those who first described the processes were responding to the effects that 'services' can have on people's lives. In this context 'services' is a general term used to refer to the organisations which are set up to help people in relation to their disability (or at least in relation to how other people have responded to that disability). It would include health and social care services funded by government or local authorities, but also privately funded or voluntary sector projects of many kinds.

Person-centered planning has similarities to other processes and ideas, but was first named and described more definitely by a group of people in the US, including the Center on Human Policy's Rehabilitation Research and Training Center (RRTC) on Community Integration e.g., Julie Ann Racino, Zana Lutfiyya, Steve Taylor, John O'Brien (human services thinker), Beth Mount, Connie Lyle O'Brien, technical assistance "partners" of the RRTC (e.g., Michael Smull, Wade Hitzing, Karen Green-McGowen, Nick Arambarri) and person-centred planning in Canada by Jack Pearpoint, Judith Snow and Marsha Forest. Whilst it was developed because of the social and service response to disability, it was quickly recognised to be as useful for many other individuals and groups of people.

Disabled people in the UK and USA developed the Social model of disability, arguing for a shift in the balance of power between people and the services on which they rely. Person centred planning is based in the social model of disability because it places the emphasis on transforming the options available to the person, rather than on 'fixing' or changing the person. Specifically person-centred planning was based diversely on principles of community integration/inclusion/ normalisation/social role valorization. Prior to its inception, these principles were crystallised by John O'Brien and Connie Lyle O'Brien in the 'Framework for Accomplishment' which listed five key areas important in shaping people's quality of life, and asserting that services should be judged by the extent to which they enable people to:

• Share ordinary places
• Make choices
• Develop abilities
• Be treated with respect and have a valued social role
• Grow in relationships

The title 'person-centred' is used because those who developed it and used it initially shared a belief that services tend to work in a 'service-centred' way. This 'service-centred' behaviour appears in many forms, but an example is that a person who is isolated would be offered different groups to attend (each run by a service specifically for people sharing a specific label), rather than being helped to make friends in ordinary society.

The person-centered concept grew out of the critique of the "facility-based services" approach in the US (and worldwide)which was central to the development of "support approaches" in the US The nationwide technical assistance funded by the National Institute on Disability Research and Rehabilitation (NIDRR), which included the person-centered approaches, is reported in the "Journal of Vocational Rehabilitation"

A central idea behind person-centred planning, is that services which are set up to respond to problems of social exclusion, disempowerment, and devaluation, can unintentionally make the situation of individual people worse (i.e. further disempower, devalue and exclude people). Person-centred planning is designed specifically to 'empower' people, to directly support their social inclusion, and to directly challenge their devaluation. One of the benefits of person-centered planning is that it can address the perennial "service problems" of ethnicity, gender, culture and age by starting with planning by or with the "whole person".

Person-centred planning isn't one clearly defined process, but a range of processes sharing a general philosophical background, and aiming at similar outcomes. As it has become more well known further processes and procedures have also been given the title 'person-centred planning'. Some of these have little in common with person-centred planning as originally envisaged. Person-centered planning through the Rehabilitation Research and Training Center on Community Integration in the US was, in part, an agency and systems change process as opposed to only an "individual planning" process moving to an "individual budgeting process"

Person-centred planning involves the individual receiving the service, with family members, neighbors, employers, community members, and friends, and professionals (such as physician/ doctors, psychiatrists, nurses, support workers, care managers, therapists, and social workers) developing a plan on community participation and quality of life with the individual. In contrast, traditional models of planning have focussed on the person's deficits and negative behaviours, labelling the person and creating a disempowering mindset from the start.

Person-centred planning offers an alternative to traditional models, striving to place the individual at the centre of decision-making, treating family members as partners. The process focusses on discovering the person's gifts, skills and capacities, and on listening for what is really important to the person (e.g., Snow, O'Brien & Mount). It is based on the values of human rights, interdependence, choice and social inclusion, and can be designed to enable people to direct their own services and supports, in a personalised way.