Bark’s Bytes #5 | From the Inside Out

The easy answer is to say “we need to know what a client can’t do” so we can fit the peg into the correct shaped hole.  The harder question is to ask “what can the client do” and then work on their behalf to develop a job that both meets their interests and is valued by the business.  Referred to as “customized employment”, this shift in practice is something that we are beginning to embrace at Merrick and in June 2010, 5 of our employees will begin participating in a 1-year customized employment (CE) training program through the U of M.

While many in the industry feel that CE only applies to clients hired directly by a business, I feel it is just as relevant to clients that choose to work on-site.  Admittedly, my view is unpopular with those that declare themselves as “champions” of CE and feel that on-site supports are just the latest version of institutional warehousing.  I can only defend my position based on the many personal victories I have witnessed here and suggest that our critics be brave enough to look from the inside out.

One of our Coordinators shared the following thought with me – “When clients are referred to us, they often come in with a documented history of significant behavioral challenges.  In a sense, they are labeled as ‘aggressive, abusive, self-injurious, behavioral…’  Based on the premise that it is normal to be abnormal, we have come to expect that each person comes to us with these special gifts.  However, we do not enter a relationship with them with the idea that we are going to change them.  We do not have a mold for which we try and fit people in.  Instead we try to figure out how to safely get them from one place to another, how not to allow anxieties to take control, and to understand their wants and needs when they communicate in unconventional ways.  We get rid of the pressure on them to change, and find the great gifts that make them who they are.  The work we put into understanding and helping them overcome challenges forces us to open our minds and look at things differently.  We find better ways to ambulate, communicate, initiate, and achieve our ‘best outcomes’ not only within our four walls but also to creatively serve people at home, at work, and in the community.”

So, while we will continue to sharpen our skills in CE, it is just as important to stay true to person-centered planning and support a client’s choice even if it does not match the philosophy of others.  We will certainly make mistakes as we shift from the “can’t not” to the “can” perspective; and we hope others will join us in recognizing that system reform only happens at the point of service delivery.  Regardless, we will persist because we become better people when we see the abilities in others and it is truly a gift when you see how they benefit from the support provided