By Allison Bohlke, Licensed Marriage & Family Therapist, Mains’l Health and Wellness Senior Manager
A stack of partially read self-help books on leading change, being present, rising strong, and family therapy sit to the right of my computer as I work through my day. I occasionally pick one up and read a few pages to gain some insight or find a tip or tool on how to support someone, or myself, with wherever issue crops up throughout the day. The simple truth is this: the issues we all work through in our lives are ultimately about finding the balance. This balance consists of what is important to me (the person) and what is important for me (the person). Finding this balance is the core concept of person centered practices.
Person centered practices are not a new concept. These practices have been used in other states service systems for years. In 2015, Minnesota adopted person centered practices into our service system for people impacted by the reform 2020 initiatives. Over the past four years, I have been learning and exploring the concepts and practices of what it means to provide person centered supports. I also discovered that the concept of “important to and important for” has many service providers, families, and social workers concerned that the pendulum will swing too far to one side and allow for people who use support services to become unhealthy or possibly at risk.
I’ve come to understand that one of the mistaken assumptions about person centered practices is that it is about “choice.” The idea of all choice and no responsibility is what every person in a support role, paid or unpaid, is afraid of. These fears do not go without concern; we all have examples of where choice was used as an excuse. However, when we focus all of our attention on what is important for a person, we often end up limiting a person’s ability to have positive control over their life and risk dictating their lifestyle by placing unnecessary restrictions upon the person. So, if all choice is irresponsible and no choice is unacceptable, finding the balance is a key – this is what person centered skills and practices help us accomplish.
So how do we find the balance? Where do you start? A good place to start is with a conversation to identify what truly is important to the person. This may take several conversations, and could require years of discussion, including conversations with those closest to the person. As we have learned, an environment that doesn’t support what is important to people can cause imbalance.
For example, we all know that bathing is important for us, both personally and socially. What is important tous is the everyday routine we use when we bath: shower at night or bath in the morning; gel versus bar soap; shampoo and conditioner or shampoo/conditioner combined, etc. If our preferences aren’t honored, or perhaps we run out of our preferred shampoo, we find ourselves out of balance – some might say they are having a “bad hair day.” I know a story of a woman who liked to use more than one washcloth for her bathing routine. When this preference wasn’t communicated to her caregiver, and only one washcloth was used, she would show her “imbalance” by screaming. Unbeknownst to the caregiver, the assumption was made that this woman just didn’t like taking baths. In reality, the woman was raised to wash her face with one washcloth, and her body with another washcloth. Once the caregiver discovered this, her preference could be honored, and the balance was restored.
Another starting point could be to attend the Person Centered Thinking training. This training offers the skills and tools to have meaningful conversations with the people in your life, which is not always easy to do. As an agency, Mains’l partnered with several organizations — the Department of Human Services, the Institute on Community Integration and Support Development Associates — to learn as much as we could about offering person centered supports. They provided multiple resources, tools and guidance to help support a balance in the lives of our employees and the people who use our services. Today, we are continually learning and discovering new ways to have deeper conversations with people.
Good support means working to find the balance – everyone has a right to have their preferences honored and have what’s important to them present in their lives. This is a skill that all people can learn and continually work to improve in their lives.