Complete working with clients section

Person-centred practice

Client in wheelchair laughing A person-centred process involves listening, thinking together, coaching, sharing ideas, and seeking feedback.  This process is ongoing to make sure each person is supported towards their personal goals, even as they evolve and change. 

The ultimate aim is to understand what each individual person wants and needs to live their own, personally defined, life.

While the concept of person-centred practice is not new, it is an issue that is coming to the fore particularly with the advent of the National Disability Insurance Scheme (NDIS).

In the past, the most common service approaches to working with people with a disability were ‘service-centred’ – where support was related to what the service provider could offer – or ‘problem-centred’ – where a therapist or support worker made decisions about a person’s life based on their own skills and experience.

A person-centred approach focuses on making sure a person with a disability is at the centre of all decisions and actions that relate to their life and their support.

What is self-direction?

Self-direction, or self-directed funding, lets the person with a disability and their family decide how to use their funding to best meet their needs. It provides choice and control over the supports and services used.

The NDIS has been designed based on self-direction. In Queensland, you can self-direct your support through Your Life Your Choice.

Queensland disability services

In Queensland, Department of Communities, Child Safety and Disability Services (Disability Services) initiated a self-directed funding model in 2012. Prior to this, Disability Services provided funding to services, and people with a disability were referred to these services.

By taking on a person-centred framework, the government acknowledged that the person with the disability and their family were often the best placed to know what is needed to meet their needs.

In some cases, Disability Services holds the person’s funding and they make payments directly to the person’s bank account. This is referred to as ‘direct payments’.

Alternatively, funding may be held by a host provider who assists the person and their family to manage their money. In both cases, the person gets to direct where, when, how and on what their funding is spent. 

Implementing person-centred approaches

lady in wheelchair arms stretchedPerson-centred approaches require that resources be used flexibly to achieve what is important to the individual.

For a person with a disability, good planning is essential so that everyone in the person’s life is aligned with them about what they want to achieve in their life and how they want to achieve it. It is also a requirement to ensure that the person is able to use their funding to build the life they want to live.

For services organisations, and the people who work there, it is important to listen to clients and work with them and their families to help them achieve what is important to the person, rather than trying to slot them into predefined service offerings.

Real person centeredness comes from:

  • Listening and being willing to hear and act. It calls for all parts of an organisation to listen to what’s important to the person now and into their future.
  • Giving up power over the person and being willing to work with the person’s capacities and choices and assisting them to find ways to overcome barriers.
  • A willingness to work with the person’s family, network and community to enable what is important to them to become a reality. 

The client/ worker relationship

When meeting a client for the first time, you will need to work towards engaging them in conversation and discussion of their needs, expectations, goals and aspirations. They may have difficulty engaging due to low self-esteem or feelings of being overwhelmed.

When you work with clients in a community and disability service organisation, it is vitally important to realise that the clients are much more than their presenting problems/issues and much more than the personality standing or sitting in front of you.

This section looks at two elements in which community and disability workers need to develop competency as service providers. They are as follows:

  1. Establishing interpersonal relationships with clients that will enable all issues to be dealt with.
  2. Evaluating the clients' range of issues and the delivery of appropriate services.

To establish an interpersonal relationship with clients that will enable all issues to be dealt with, you need to:

  • have facilitative communication skills to assist clients to identify areas of concern, to prioritise areas for immediate and long-term action and to determine options for action and workable strategies to address their priority areas
  • be able to define boundaries and use communication skills that will establish trusting and respectful relationships
  • assist clients to develop their own action plans to address their circumstances
  • share relevant information with clients about services available, options, and health and wellbeing issues to assist them in determining a course of action
  • work with clients to set personal goals and explore personal strategies and to identify a hierarchy of strategies; including contingency plans
  • work with clients to identify and plan for potential consequences of their decisions
  • implement procedures to ensure all services and responses to clients comply with duty of care and accepted standards of ethical behaviour

Holistic service provision

For a worker to respond holistically to a client’s issues, they need to:

  • appreciate the complexity of the person’s situation/issues and the environment in which that situation/issue occurs
  • understand how this issue/situation affects the client in all aspects of their functioning – physical, emotional, spiritual, and mental
  • establish an effective and trusting relationship with the client to explore their options with them so they can resolve their issues
  • liaise with other significant people or organisations in the client’s life to facilitate the client’s goals and action plans.
To find out more about this approach complete the eTraining course 'Respond holistically to client issues'.