Approaches to Service Delivery

Person-centred practice is the underpinning philosophy of all community services in Australia. From aged care to disability services and childcare, the application of person-centred practice ensures there are quality outcomes for allclients.

The essence of person-centre practice holds the client at the centre of all decision-making, and involves them in all stages of assessment, planning and review processes. It takes into account the lived experience of the client andrespects their rights. The ability of a practitioner and service provider to be flexible in their services to support a client’s needs and wishes is an important aspect of person-centred practice. The practice is inclusive of the client’s support networks, families and carers, which is a part of a strengths-based approach.

The successful implementation of a person-centre practice requires a commitment from an entire organisation.

Organisations that are person-centred have:

• policies and procedures that are based on the principles of person-centred practice
• a commitment from leadership to actively implement person-centred principles, policies and procedures
• continuous improvement, training and development for staff
• commitment to partnering with clients and their families or support network
• staff and volunteers who work with clients on an individual level, and who value and demonstrate respect for each client and their abilities and values
• commitment to positive and inclusive language, symbolism and behaviours that promote a person-centred culture.

Watch this YouTube video from Open Future Learning that explains how person-centred work differs from system-centred work.

Now, ¬watch this YouTube video of Larry’s story from the Office for People with Developmental Disabilities, which describes person-centred planning. Then answer the questions below.

Principles of Person-Centred Practice

We’ve already put the person at the centre of the practice,so what other principles are there for us to follow in aperson-centred approach? Other principles are:

• seeking to understand the client in the context oftheir lived experience, age, gender, sexuality, incomestatus, education, family, culture, ethnicity, customsand beliefs
• demonstrating respect for their choices and goals
• being inclusive and accessible in all aspects ofservice delivery
• focusing on positive outcomes for clients, not deficitsor obstacles
• including other people who are important to theclient, according to the client’s wishes, in clientsupport processes
• fostering community connections through whichclients can learn to develop positive relationships and social skills, work or earn an income, and actively participate in community life
• assisting clients to develop their priorities andstrengths
• providing clients with access to services that allowthem to enhance their abilities, focus on their own interests, dreams and aspirations.

Person-First and Non-Judgemental Language

Person-first language is language that recognisesthe person and avoids defining them by their signs, symptoms or circumstances. For example, you would describe a client as ‘a person who has survived trauma’rather than as ‘a trauma victim’. Similarly, you would say ‘a person with mental health issues’ rather than ‘a mentally-ill patient’.

1. Recognise
   Your clients have various strenghts. They can continously learn, grow and change
2. Focus
   Focus on the strenghts and aspirations of your clients
3. Environment 
   Your clients social environments and communities are full of resources.
4. Collaborate
   With your clients rather than directing- key to success.
5. Self-Determination
   Basis of interventions.
6. Empowerment
   Commit to environment of your client.
7. Problems are not deficits of individuals
   Result of interactions between individuals within organisations or structures.

Strengths-based practice is a mindset based on a philosophy in which practitioners and service providers view clients as resourceful and resilient. When practitioners in community services use this philosophy, they empower clients to seek and build on their inner strengths so that they can develop skills and strategies to manage their own lives.

Strengths-based practice works on the premise that individuals can be their own agents of change. It focuses on building a framework within the bounds of service provision that clients can use to control and direct the processes of change.

Strengths-based practice recognises that the client is the expert in their own situation and lived experience. Practitioners in community services must recognise that their clients are almost always disempowered by theattitudes and actions of people and structures around them. When we begin to acknowledge a client’s expertise, their resilience, and the strengths they have already shown in seeking help, we begin a journey with the client towards healing and recovery.

Applying a strengths-based approach to client relationships is:

In a strengths-based approach, practitioners collaborate with their clients. Practitioners identify with the client what the client’s resources and capabilities are, including the client’s personal strengths, and the social and community networks the client can draw on.

Supporting the client to recognise their strengths and resilience, and to understand how these can be used in a positive way towards recovery is important in empowering people. Often people accessing help and support cannot see how resilient they have been in the past. They might not recognise that the coping strategies which they have put in place – even if they are negative behaviours – are signs of strength and autonomy.

Identifying and highlighting a person’s strengths in goal setting can inspire hope for the future, encourage positive targets, and encourage the recognition of existing support networks and community connections.

Identifying Client’s Strengths

Strategies for identifying strengths

• Identifying goals
• Looking at interests
• Looking at history and experience
• Looking at skills and personal strengths
• Exploring client’s support networks
• Exploring culture
• Listening to people’s stories
• Ensuring you hear from a range of voices (not only the loudest)
• Building strong, effective relationships.

As a practitioner, it is important to be non-judgemental when a client expresses aspirations and goals in the process of identifying strengths.

Keep in mind that a strengths-based approach does not mean that you ignore or minimise a person’s issues.It also does not require that problems are spun into strengths. Rather, issues and problems are looked at through the frame of progress already made and thevalue of those strengths in promoting hope.

Watch these two YouTube videos for more information about strengths based practice- Social worker Jasmine Ama:

Graeme Stuart from the Family Action Centre:

A rights-based approach ensures that in providing services and assistance to individuals and communities, an organisation does not violate the rights of the people that they are helping, through omission or through actions. This approach is based on the Universal Declaration of Human Rights from the United Nations.

A rights-based approach means that the rights of the individuals and communities should be respected and promoted through the provision of services. It considers not only what services are provided, but how they will be provided.

Decisions about what services are going to be provided are based on a consideration of the human rights of the clients and target communities, alongside their capacity; decisions about services also consider the organisation’s human rights obligations to clients and target communities.

Once your organisation establishes what services are going to be provided, you can contemplate how you will implement those services to promote human rights.

To ensure a rights-based approach is meaningfully embedded in an organisation’s operation, all priority setting, decisions, and actions should be approached in a way that critically analyses the human rights legitimacy of what is done and how it is done.

Implementing Rights-Based Approaches

The Australian Human Rights Commission identifies five principles for implementing rights-based approaches under the acronym PANEL, which stands for:

Participation

Every individual has the right to participate in decisions that impact on their human rights. Individuals must be allowed to participate in the decision-making freely,and in an active and meaningful way. This includes incorporating accessibility to improve participation, suchas providing information in languages and form that iseasily understood.

Accountability

Compliance with standards of human rights must be effectively monitored. The organisation must have effective remedies for human rights breaches; that is, policies and procedures that support individuals to report breaches and effective organisational mechanisms for remedy. If accountability is to be effective in securing the human rights of clients, there must be laws, policies, organisations, procedures and processes that enable redress.

Non-Discrimination and Equality

All forms of discrimination that stand in the way ofindividuals achieving and practising their rights mustbe prohibited, prevented and eliminated. Prioritising the needs of individuals who are marginalised or vulnerable is essential to a rights-based practice.

Empowerment

Community service providers and practitioners must ensure that their clients and client’s carers, as well as their support networks, are able to claim and exercise their rights and freedoms. These clients and their community must be able to understand their rights and be able to participate in the development of policies, procedures and practices that affect their lives.

Legality

For the rights-based approach to be truly effective, practitioners need to operate under laws that are consistent with human rights principles. In other words, laws that recognise human rights and freedoms, and enforce entitlements.

A needs-based approach to service delivery is based on the premise that the needs of the client are essential in determining what services and programs you provide. This is rather than looking at what services the client qualifies for.

The needs-based approach acknowledges that all clients are unique in their needs, and that their needs can and do change over time. This means that each client needs a flexible, individualised, and responsive support plan that meets their needs, so that the support enhances the progress of their individual strengths and abilities.

Applying a needs-based philosophy to service delivery includes the following:

• a needs assessment for determining and addressing the needs of the client that are not currently met
• a focus on the client’s needs, strengths and abilities
• an emphasis on the supports the client needs and removing barriers to their access to that support
• a promotion of the client’s personal empowerment and self-determination
• a focus on outcomes of services for the client
• a provision of flexible services tailored to the client’s¬needs
• a responsive holistic approach to meeting the client’s¬needs
• a promotion of inclusiveness, respect and diversity
• an integrated and multi-disciplinary approach.

A Trauma informed approaches guiding principle is that many people managing mental health issues have experienced significant trauma. Mental Trauma is caused by incidents that deeply emotionally distress individuals and can lead to chronic, long term mental health issues. Physical trauma results in degrees of injury. Trauma is caused by single events or may be a series of events. Child neglect and abuse, bullying, substance abuse, accident, grief, and War all create trauma for the individuals who experience these events.

To work with people who manage trauma, the principles of a Trauma informed approach ensures that clients feel:

• Honesty, clarity, and transparency in communicating demonstrates trust which will not be easily given
• by trauma survivors.
• Physical and emotional safety needs to be provided by the environment to clients and carers when interacting.
• Ensuring that client’s voices are heard.
• Working with trauma survivors, ensuring clients have input and are an active collaborator builds safety and trust.
• Interaction is built on shared experiences and exchange of thinking to alter the clinical relationship from the typical provider/client relationship.
• Client’s needs are met thrgouh a lens of understanding cultural and gender identity.

Trauma informed care in practice:

1. Realises that trauma affects clients and carers.
2. Recognises the signs of trauma.
3. Responds with a trauma informed approach.
4. Resists “re-vistimise” or blaming trauma survivors.

In conclusion, this topic has centered on the fundamental principles that guide interactions within the community services sector, placing the individual at its core.

You have explored key approaches, including the strengths-based approach, which focuses on empowering individuals; the rights-based model, ensuring the protection of individual rights in service delivery; the person-centred approach, emphasizing tailoring services to individual needs; the needs-based approach, addressing specific requirements; and the trauma-informed approach, recognizing and responding to the impact of trauma on individuals. This comprehensive exploration provides a foundation for fostering meaningful and effective engagement within the community services sector, aligning services with each individual's unique qualities and circumstances.