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Ability Therapy Specialists Pty Ltd

Individuals, Couples, Families, Children ~ NDIS Registered Provider of Behaviour Support, Counselling Therapies with Creative Arts, Early Childhood Intervention ~ Serving Armidale, New England, NSW, Australia and Online

Whole-istic Health and Behaviour Support

Many people ask, what is behaviour support? At the most basic levels, therapeutic behaviour support provides assessment and practical options for assisting with behaviours of concern. Naturally, we ask, what are concerning behaviours? In common sense terms, these are anything that people do that causes high levels of concern – such as self harming, other harming, high risk, and socially concerning or difficult behaviours.

All behaviour support includes a functional behaviour assessment. This comes in various forms, and depending on the practitioner’s experience and expertise can involve a wide range of observations, interviews, file review, data collection, and assessment tools.

Beyond the basics within behaviour support itself, there are other practical areas that are worth our attention. For example, social relationships, daily activities, level of physical activity, sleep patterns, medications review, healthy eating, diet, and nutrition.

In this day and age of rising expectations around measures for quality of life and its natural and obvious sidekick, holistic (or whole-istic) health, why should behaviour support and therapy among people with behaviours of concern be any exception? Holistic health considerations are part and parcel – or should be – for most practical reviews. If we actually apply the United Nations standards for people with disabilities, we clearly ought to include holistic and allied health principles and practices that are now commonly part of most people’s lives.

This comes up often these days in many of our reviews. Particularly with the new NDIS Commission behaviour support standards, along with the new NSW behaviour support guidelines for review of medications. These emerging frameworks that came to light during 2018 ask everyone to step up to the challenges of human rights standards in terms of access, quality measures, and providing as comprehensive and holistic a service-perspective as possible.

We welcome these necessary applications of the UN human rights frameworks and are excited to be a part of this movement within Australia. For our part, as behaviour support specialist counsellors and psychotherapists, we can apply holistic human ecological and cultural principles and practices across a wide range of therapy methods. These specialist approaches enhance and provide depth, scope, and quality to traditional behaviour support practices.

It is also a great delight and honour, on behalf of our clients, to collaborate with health, medical, psychiatric, and allied health practitioners towards integrative models of care. In many ways, the NDIS environment has created these quality-based opportunities for experienced practitioners to advance our methods of service that ultimately give greater choice and control to NDIS participants.

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Youth Mental Health – 2018 in Review

As a member of the Global Coalition on Youth Mental Health, ATS Pty Ltd was proud to assist with the shout outs on the G7 Summit happening overseas. The collective efforts of membership helped to influence inclusion of Youth Mental Health on the global agenda. Fascinating and insightful, from our view, that the Summit’s leadership demonstrated an inclusive vision centred around woman’s and youth health and well-being.

The official CHARLEVOIX G7 SUMMIT COMMUNIQUE, no. 6, reads:

“To support growth and equal participation that benefits everyone, and ensure our citizens lead healthy and productive lives, we commit to supporting strong, sustainable health systems that promote access to quality and affordable healthcare and to bringing greater attention to mental health. We support efforts to promote and protect women’s and adolescents’ health and well-being through evidence-based healthcare and health information…”

We also joined global efforts with the following initiatives:

Letter Writing Campaign to World Leaders

 

In the beginning of 2018 the global Coalition joined together for our first global project. In order to reach our global leaders on a mass scale, ATS Pty Ltd and 59 Coalition members from 12 countries signed onto a joint letter to 27 leaders, urging them to prioritize youth mental health and include it on the G7 Summit agenda, hosted by Charlevoix, Canada. In response to our letter, the Coalition received positive affirmation from Dr. Theresa Tam, Canada’s Chief Public Health Officer, proving the power of a motivated, unified Coalition and inspiring us to continue towards our goal.

We Got Social!

 

United by a common hashtag—#195forMentalHealth— ATS Pty Ltd and Coalition members raised our collective voices for youth mental health, regularly sharing campaigns and best practices. In a unified voice, members retweeted, liked, and posted about their fellow organizations’ initiatives as well as made sure G7 and world leadership heard our calls for greater attention to youth mental health.

 

Coalition Members Take Leadership at the 1st Ministerial Mental Health Summit

We are happy to report that further advances were made by our membership around the world, and that youth leadership is a cornerstone of global advancement and sustainable outcomes.

Following the G7 Summit, health ministers from Canada, the UK, and Australia collaborated to create the first Global Ministerial Mental Health Summit, bringing together the world’s political leaders, innovators, experts, policy makers and civil society to share the most effective and innovative approaches to mental health. Several Coalition members took up the mantle to spread the word on youth mental health to leaders around the world during this meeting and the world responded with some admirable commitments:

–        Lancet Commission

–        Global Declaration on Achieving Equality for Mental Health

–        Recommendations to Ministers:

–   the right of young people’s access to mental health care,

–   the involvement of young people and families in mental health decision- and policy-making,

–   the support and funding of ‘physical and mental health integration’, and

–   the promotion of mentally healthy environments from birth to early adulthood.

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This post follows the Press Release from the Global Coalition on Youth Mental Health dated 5-2-19.

New Free 2019 Ability-Diversity Multicultural Calendar by ATS Pty Ltd

We are happy to provide you with free download of our new 2019 Ability-Diversity Multicultural Calendar.Screen Shot 2019-01-06 at 4.01.13 pm.png

The 2019 Ability-Diversity Multicultural Calendar is a project of Ability Therapy Specialists Pty Ltd and Earth Rattle Publishing. You can print this calendar in A4 Paper Size, or other paper size adjustments on your computer or printer.

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Many of our clients, friends, colleagues, and people near and far will enjoy this calendar very much.

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The project includes a very wide range of national, international, and global events, cultures, and traditions.

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The project reflects a unique Aussie and southern hemisphere perspective. Traditions not normally highlighted are included as the goals were to provide greater inclusion and diversity reflecting a multicultural universe.

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We have produced an informal pilot calendar for several years that has gotten kind reviews and encouraging comments from many. This year we decided to take the project one step further and to offer this online for free.

While we cannot promise future editions as this project takes a great deal of time and the technical issues are many, we welcome your comments and feedback. If you enjoy this calendar or have suggestions let us know. You need to fix the email by taking out the space: admin@ abilitytherapyspecialists.com.au

Thank you so much, and Happy New Year 2019!!!

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Clink this link below to download the 2019 ATS Pty Ltd Ability-Diversity Multicultural Calendar.

2019 ATS Pty Ltd Calendar PDF 2.5MB

 

Restrictive Practices Update in Light of NDIA Commission Developments

The NDIS Commission launched 1 July 2018 with new standards for behaviour support. In NSW we have entered into a joint agreement that fits our standards within the umbrella determined by the Commission. This means a few changes to NSW Policy and Practice. To read more and learn about the changes, click on the links.

These vital and important developments are not without their growth pains. However we need to keep a view to the big picture – that emerging requirements will aim towards eventually strengthening the review of restrictive practices. This is important for individual’s rights to adequate treatment under legal, ethical, and professional standards. The hope is that legal, ethical, and professional standards will be upheld among some of Australia’s most vulnerable population.

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Australian standards for Restrictive Practices is vital towards protection of the human rights of people with disabilities.

On the ground people who come forward for behaviour support reviews are somewhat surprised by the administrative burdens of 1. setting up a service generally under the NDIS and 2. processing issues around cases with restrictive practices.

After 1 July 2018 in many cases existing funding allocations may not be adequate to address the complexities of NDIS Commission requirements. This means that participants may face NDIS Plan reviews that can often take a great deal of time, leading to delays in situations where risks tend to be high.

Lengthy NDIS template forms for behaviour support and equally extensive NSW authorisation processes go in tandem with behaviour support reviews by practitioners. It appears that NDIS requirements may easily double if not triple the time it once took to provide clinical reviews, in large part due to compliance measures for data collection by the Commission.

While the new requirements may lead towards greater compliance and standardisation of services across the sector, there are always inherent risks when a government department takes oversight of clinical and professional roles. Whether discussing the historical track record in the UK or in other countries, in relation to Australian core disability service standards we are next in line for major adjustments and growth pains across the disability sector.

Implementing providers such as those managing day programs or home based supports are required to undertake NSW state level restrictive practice authorisation reviews. This process requests a great deal of information and forms, and in some cases appears to double up what is required by the Commission. The time it takes to process information appears so far to be without funding allocated for these complex mandatory requirements. It is unclear how vulnerable people with disabilities will fair in the midst of these contradictory set of circumstances. But like all things NDIS, there are positives and negatives as the Scheme rolls out across the country.

In the bigger picture, the NDIS Commission is charged with a large and important undertaking, and as things roll along the goals of monitoring and safeguarding will invariably be shared with the states. The proposed role of NSW for example is quite vital for the purposes of reviewing restrictive practices, how they are managed, and in what ways they can be reduced or eliminated over time. External senior clinical review appears to part of the NSW proposed authorisation model, which makes absolute sense. The state is taking on the burden of cost for maintaining a list of qualified external reviewers who will sit on review panels alongside the organisations presenting the restrictive practices review request.

Even though the NDIS has been trundling along for a few years already, and the safety net that once existed for people with disabilities has vastly expanded to include many more people within funded supports, the NDIS Commission role for people with more profound disabilities and behaviours of concern who require restrictive practices review is extremely necessary and entirely reasonable. How they go about this vital task is another matter, which Australians may not entirely comprehend for some time to come.

At the end of the day, it is important to see one thing clearly. The NDIS Commission and the NSW Restrictive Practices Authorisation under Family and Community Services are undertaking one of the most core and vital responsibilities of the disability services sector. In many ways this should have been the first undertaking of the NDIS. But we welcome the leadership of the Commission and the NSW FACS and we look forward to the ways that disability standards in Australia will grow and evolve from this point onwards.

 

Specialist Behaviour Support

NDIA Commission Lauch 1 July 2018

The new financial year brings new government oversight of behaviour support. In NSW where we are based, the state system has now fully transitioned (more or less) to the new national system.

This means that disability service providers will face new regulations and standards for behaviour support practice. The NDIA Commission’s new website just launched provides the detailed legislative instruments that will guide and direct upcoming changes and management of behaviour support as well as other functions of governance across the sector.

Disability service providers until now have been managing within a transitional environment. For the past five or so years, this context includes the disbanding of state based agencies like the Department of Ageing Disability and Homecare. In the absence of state based leadership, disability non-gov organisations have been responsible to govern behaviour support policy and practice still under the state established guidelines. Effectively, many organisations have struggled in the wake of NDIS transitions where due to funding shortages they may have let go of staff, not had resources to hire behaviour support practitioners for review of cases, and not been able to maintain independent oversight of clinical services through restrictive practices analysis, authorisation, and review.

In all likelihood, most multi-service option organisations will be doing the catch up, with many people waiting on clinical reviews, and many more individuals carrying old and outdated behaviour support plans. These plans, and the ideally holistic and generative clinical oversight that they represent, are the foundation of positive person centred behaviour support practice.

Alongside, NSW has a history of major investments in capacity building across the disability sector. For example, for over a decade past, Stronger Together reforms established behaviour support practices across the state and offered skills training to NGOs across the sector. Also parallel, the current reality on the ground appears to suggest that the disability NGO sector cannot sustain behaviour support practices without significant independent input by clinicians and specialists. Such expertise tends to be rare, particularly in rural Australia.

The reforms ahead will be interesting to say the least. NDIA Commission led reforms will need to provide vital sector wide leadership as well as provide a conduit for seasoned clinical advice. In saying this, we acknowledge that behaviour support policy and practice are a backbone to the disability services sector – and have held an historical and key society wide leadership role in the spread of positive behaviour support practices and standards.

Where individuals have behaviours of concern, these often touch on every other aspect of life, lifestyle, health, relationships, and community participation. As a field that represents fundamental human rights to dignity and fair treatment, positive behaviour support standards represent key international and national guidelines. The NDIS and now its Commission has a key role in Australia to forward these standards for the wellbeing of Australians.

Finding Your Path in Life

One of the amazing parts of counselling psychotherapy is when a person is seeking where they belong. We feel lost, afraid, alone, stressed out, and even desperate. But only one sleep can change all that. We honestly never know what is around the corner. Life is actually a massive adventure, and we have no idea where we might end up.

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For some of us, not knowing is stressful. Do you think the bee knows exactly where her next bunch of flowers might be found? Surely I can imagine, a bee flying around not sure where the flowers might be growing and blooming. Even whatever sensors they have probably leave them with not knowing, maybe a sense of intuitive instinct. Why should human beings be all that different?

When I was a young man, several really close friendships fell apart leaving me pretty much all alone in the world for the first time in my life. The crisis lasted for a few years because there was no clue inside me of how to cope. Towards the end of this searching someone flatly told me to “go see Redge Craig.” He was a senior counsellor in our region of Canada.

After sitting down with Redge, and sharing the ending of those friendships that still made me feel lower than low, he leaned forward and said something that I cannot easily forget. He said, “How deeply you really cared for each of your friends, and that love you have for them is just as strong now, inside of you.” For some reason, his saying this was like light bulbs going off inside my body. For the first time, it dawned on me that instead of feeling defeated by loss, I could actually feel good about my capacity to care for others. This was a huge turn around that led me toward a new path in life.

Counselling can be like this for many people. It never ceases to mystify me how people come to therapy on the cusp of healing, change, and new pathwork.

Mental Health 101

So many people talk about “mental health” nowadays… but the simple truth is that dealing with the illness side of mental health can be extremely challenging.

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Therapists and clinicians, doctors and nurses, psychologists and counsellors, also deal with mental health and illness in their personal lives. I remember as a young Counsellor in training one of the first times a senior Minister visited my practice. It surprised me to realise how everyone carries challenges, sometimes hidden, other times not as well concealed.

Ministers, priests, doctors, psychologists, disability support workers, managers, and all sorts of helpers over the years have sat down with me. They have shared stories of deeply personal battles through depression, anxiety, suicidal thoughts, relationship break ups, workplace stress, and conflicts that deeply impacted their lives.

Interesting enough, the vast majority of helpers we’ve seen over the years have carried what I have come to recognise as a deep seated fatigue, something kin to existential depression, often appearing like a pragmatic and even realistic loss of hope and wonder in the mystery of life. This strikes me as quite powerful, and endemic to our era that is so focused on logic, critical theory, analysis, and science. While focusing on evidence and measuring everything in life, even our emotions, we have lost a sense of childlike innocence in just exploring, and staying curious about life.

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Within the journey of psychotherapy and counselling, helpers are seriously among the hardest people to help. We helpers throw up every self-defence mechanism known to humanity. Being well trained in communication, we can spin circles around any sentence and interpret about a dozen different meanings in half a minute flat. As the words cascade from a helper’s lips, they are often immediately internally sabotaging their heart and body by avoiding, superimposing, dissociating, and confusing meanings.

Yet working with helpers has been one of the most rewarding aspects of my career. For over two decades my focus was training therapists, and mentoring counsellors. The most valuable lessons included the fact that we are all so very human.

We cannot go it alone. In fact, everyone needs someone else to help them sort the harder parts of life. And as older and wider as you get, this fact never changes.

Psychometric and Educational Assessments

ATS offers a range of psychometric and educational assessments upon request. This post is dated and will not be revised in future. To see a more up to date list visit the page on this topic found via a link on the site menu.

The following tests and assessments we may be able to provide. This list may change without notice, and may depend on third party availability of testing materials. This being said, please contact us to discuss your needs. If an assessment tool is not listed here, send us a note via the Contact page to inquire whether we can provide the test you are seeking.

  1. Adaptive Behaviour Assessment System Edition 3 (ABAS 3). The Adaptive Behavior Assessment System Third Edition (ABAS-3) is used to assist assessment, diagnosis, intervention planning, and progress monitoring with Autism Spectrum Disorder, Intellectual Disability, Developmental Delays, Learning Disabilities, Neuropsychological Disorders, and Sensory or Physical Impairments.
  2. Brief Infant Toddler Social and Emotional Assessment Screening for Issues (BITSEA), 12 to 36 months.
  3. Autism Spectrum Rating Scales (ASRS).
  4. Independent Living Scales (ILS).
  5. School Functional Assessment.
  6. Vineland 3 – Adaptive Behaviour Scales. To assist toward diagnosis of Intellectual Disabilities and Developmental Disabilities.
  7. Adolescent and Adult Sensory Profile.
  8. Quality of Life Inventory (QLI).
  9. Quality of Life Questionnaire (QLQ).
  10. Behavioural Assessment of Dysexecutive Syndrome (Adults).
  11. Brief Cognitive States Exam.

Restrictive Practices and NDIS Part 2

Essentially, when the states hand over certain controls of the disability sector to the #NDIS, existing standards for safety, dignity, and human rights once covered by state policies will translate to national standards. For example, the NSW Behaviour Support Policy and Practice Guide.

The assumption is that existing standards will actually remain if not become subject to increasing quality assurance measures. Over time standards may also raise and in ways this is already happening. No one would suggest standards may fall or become less.

If anything the NDIS vision indicates a rather comprehensive overhaul of disability service standards quite unlike anything Australia has seen in past.

This development may be combined with other changes across the sector, and influenced by external forces like legal and community expectations, leading to higher standards of care and professionalism among disability service organizations.

The role of the Disability Support Worker is due for reappraisal. We often consider the DSW role as defined so far by common sense as quite inadequate to the tasks and demands of the job. We see a new role emerging in practice where staff gain greater skills across a range of areas particularly within mental health support. Something we have called a Disability Support Clinician.

In similar ways we are seeing the disability sector slowly shifting away from one stop shops, orgs offering everything under one umbrella, toward a greater emphasis on multi-professional input and collaboration. Naturally no one org can do nor specialise in everything and often by trying to do too much orgs become top heavy and inflexible. In these settings behaviour support and access to counselling and other therapeutic services often become overlooked if not avoided for the simple fact that therapeutic work often involves question of the status quo.

Not at all beside the point, we are well into this discussion and we have not even defined key terms like #restrictivepractices and behaviour support. The reason I have not looked at the practical details yet is that our current situation in Australia demands seeing the big picture within the transition to full NDIS jurisdiction. Dispelling a few key myths. And setting the stage for clearly looking at standards for behaviour support.

As you might guess this article is turned into a mini series… a bit of a drama really… but a discussion that actually often involves extremely important values. For example?

Health. Safety. Individual and staff rights. Human rights more broadly but often in cases where maintenance and oversight of these rights becomes critically important. Dignity and duty. Freedom and responsibility. Ethics and standards of care… and these are only a few of the values applied in #behavioursupport and the closely related field of #mentalhealth.

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