WHAT MAKES PERSON-CENTRED PLANNING WITH MAPS AND PATH SO VERY DIFFERENT FROM OUR TRADITIONAL WAYS OF WORKING WITH YOUNG PEOPLE AND THEIR FAMILIES?

“Person-centred planning is an event, not a document”

Pete Ritchie (2002)

The term ‘person-centred planning’ was coined to distinguish this approach to planning from approaches that are framed by what services are typically available – so-called ‘service centred’ approaches. People’s lives are seen to be managed by the service system within service-centred planning, whereas within person-centred planning the individual is given as much choice and control as possible and this includes who comes to the planning meeting, where and when it is held and, crucially, that the young person whose meeting it is – is always present. The questions asked and the conversations that lie at the heart of MAPS and PATH go well beyond the mandate of any support service, school or statutory agency. So MAPS and PATH are not a substitute for an IEP, a Health Plan an ISP or any other type of service plan. What MAPS and PATH do is provide an overall direction for a person’s life, thus enabling particular services to see their role in supporting this. At the centre of PATH and MAPS is a vivid focus on the young person’s dream for the futureand what it would take to be travelling towards this. Bringing this dream into view on the graphic is the first step in in the PATH process. It is followed by a step that works backwards from the dream by asking the group to imagine what positive and possible milestones towards the dream could have been achieved within one year.   The remainder of the steps within PATH are about the actions and the people that will be needed to make the desired changes. MAPS also puts the dream centre stage but has a variety of other steps and stages that lead to actions.

  • Person centred working is driven by ‘capacity thinking’ not deficit thinking. Its aim is not to ‘fix’ anyone or uncover the past causes of their isolation, difficulties or despair – the focus is on imagining a desirable future and what it will take to make this happen. Person-centred planning does not begin by asking what is wrong with someone, his or her diagnosis. As such it is not just a new set of tools and procedures to be done to someone; person-centred planning is a radically different way of working with an individual and their supporters. The underlying goal of person centred planning is inclusion and the tools themselves are framed in ways that serve this goal.
  • The focus of person-centred planning is first and foremost on ordinary needs and not solely on special needs. Ordinary needs (sometimes called ‘valued experiences’) have been described in various ways, the listing used here is based on that developed by Beth Mount and Connie Lyle O’Brien (2002) and is as follows:

* Being somebody

* Making a contribution by sharing gifts and capacities

* Knowing people and having relationships –

* Having choice and control particularly over the funding that is used to support you

* Sharing ordinary places – being present in local spaces and having a valued role there

Sometimes this is described as a focus on the whole person and not solely on their impairments or their diagnosis. This means that a person-centred meeting looks much more widely than a traditional assessment of difficulties and the support needed to address these. This doesn’t mean that the person doesn’t need help or that it wouldn’t be good for them to learn new things or have new experiences. Person-centred working recognises that ordinary needs can soon take second place to special needs and that, in the process, the young person themselves, their social networks and the wider community are ignored. Another way of saying this is that person-centred planning is not about answering the question: What do you need (or qualify for) from our Service? It is about asking: What sort of life do you want to make and who can help you?

  • Along with this focus on ordinary needs comes an emphasis on the big picture of the person’s life and on the long view – if we could run the clock forward 10 or 20 years – what would a good life look like for this young person? Can we imagine a world that works for them, whatever their labels and challenges? This is in sharp contrast to our more usual planning and review processes which typically look one year (or less) into the future and might also look back to what has happened since the last planning meeting. However person centred planning also recognises that the future arrives one day, one month and one year at a time and the final action planning steps within MAPS and PATH explicitly spell out who will be doing what and by when.
  • Person centred planning, when done well, is about a team, not about an individual alone. Whilst the planning session may be described as Joe’s MAP or PATH, the purpose of the event is to bring together a group of people who have an investment in Joe’s future and this will include both paid support workers and the wider network of unpaid natural supports within a young person’s life. This may mean – extended family, friends, neighbours, peers from school, people who were important to that young person in the past, people the young person knows because of a shared interest or people with whom they share a strong identity (a recent PATH session had in attendance the president of the local bowls club. She was someone the young person had come to know well and who had a keen interest in being part of the planning; another was attended by the fiancée of the young person’s stepsister – this was a young man who had a productive relationship with young person in question and who was able to offer the young person the chance to have an in-depth conversation about his future during the course of an extended car drive on the following Sunday afternoon – a clear illustration of the fact that natural supports – if they are invited to the planning and their contributions valued and listened to – can reach into places that no Service ever could. So the list of invitees needs to be much wider than would typically attend a case conference or other review meeting. The people that can make things happen in a young person’s life need to be there.
  • Person centred working, when it is most effective, brings together natural and paid supports. Because person-centred working mobilises the natural supports in a young person’s life, it opens up opportunities for the kind of supports that could never be provided by a Service however well staffed or effective it was. Sometimes natural supports will be people who didn’t know they were needed.
  • The facilitators are not there as experts in disability or difference, diagnosticians, advice givers, problem-solvers, assessors or counsellors – in fact, they do not actually need to know anyone at all in the assembled team for the facilitation to be effective. As a rule, facilitation is easier when the facilitators have no personal stake in what happens next. Trying to facilitate a MAP or a PATH for someone you are also providing a service to is one too many hats to wear. You will run the risk that your own fears or defensiveness about how things got to be the way they are leads you to struggle with listening well and staying open-minded about what might be possible. It is also important to understand that the facilitation skills needed for MAPS and PATH can be learned and carried out irrespective of the facilitators’ professional backgrounds or initial training. This is not a ‘reserved profession’, but you do need to have had training and opportunities for ‘safe practice’ (ideally including having your own MAP or PATH done) before working directly with young people and their supporters. Because of this, person-centred planning holds the promise of creating the type of forum where genuine inter-professional working is more likely to develop. Standing as we do (May 2013) on the threshold of new SEN and Disability legislation in England (The Children and Families Bill) that will introduce new joint planning expectations on Education Health and Social Care Departments (EHC Plans) – it seems obvious that the methodology of person-centred planning holds the promise of a fresh way forward towards joint working across departmental boundaries.
  • MAPS and PATH both involve the use of graphic facilitation and the invited team assemble around a large sheet of paper taped to a wall and on which the upcoming steps of the process are already apparent. The graphic belongs to the person whose MAP or PATH it is and is given to them at the end of the session. Each graphic is unique and like no other. It is the only document produced and often a digital image of the finished graphic is taken and sent on to all who were part of the MAP or PATH. One of the most important functions of the graphic is in providing a visible acknowledgement that individual contributions were heard and individuals know this because they can see their words and images recorded on the poster.
  • The methodology of person-centred planning, particularly its use of the imagery and colour implicit in graphics, recognises that not all that we know can be expressed in words or propositions; that qualitative judgements are needed about ‘what feels right’ and that not everything can be reduced to a formula, a rule or a box to be ticked. It is for these kinds of reasons that person-centred planning is often referred to as an ‘art’.
  • Person-centred planning does not come with its own specialised vocabulary or unique jargon terms attached; its various frames, steps and processes are captured in everyday words: “MAP”, “PATH”, “The Dream”, “The Story So Far”, “The Nightmare”, “Staying Strong” “Actions” and so on.

To my mind the it is the conceptual shift that underlies person centred working that needs most thought and effort to achieve.

The risk that services will simply use person centred plans to underwrite ‘business as usual’ is always present and we need to be vigilant that actual changes in people’s lives are apparent because we have adopted this way of working.

 

Derek Wilson

Inclusive Solutions

Nottingham

July 2013

 

SOURCES

Mount, Beth and O’Brien, Connie Lyle. Building New Worlds – A Sourcebook for Students with Disabilities in Transition from High School to Adult Life. Amenia NY: Capacity Works, 2002

Ritchie, Pete et al, People Plans and Practicalities – Achieving Change Through Person-Centred Planning. Edinburgh SHS Trust, 2003

Ritchie, Pete. A Turn for the Better In O’Brien, J. and O’Brien, Connie Lyle (Eds.) Implementing Person Centred Planning. Toronto: Inclusion Press, 2002. Pp 11-24.

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