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Ability Therapy Specialists ~ Armidale New England NSW Australia

Independent Consulting with Individuals, Couples, Families, Children ~ NDIS Registered Provider of Behaviour Support, Counselling Therapies with Creative Arts, Rehabilitation, Employment, Paediatric Early Childhood Intervention

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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Restrictive Practices and NDIS

Behaviour support in Australia has evolved in significant ways over the past five years. The NDIS has created a new social, political, and legal environment. One of the areas of most significant change is around restrictive practices.

On one hand, the disbanding of state based systems in some states like NSW has left some with the illusion of deregulation and less oversight of complex cases and restrictive practices. Orgs that used to engage state resources to cover governance of restrictive practice panels and annual review no longer have this support.

On the other hand, many factors are converging to encourage higher standards for disability support and around restrictive practices. These factors include greater legal recognition, the emergence of a national scheme, international standards, professionalisation of the disability sector, and changing community and social expectations.

Insidious Travel Distance, NDIS Behaviour Support, and Regional Australia

Access, choice, and control in regional Australia and across northern NSW relies on stronger travel policies that take large distances into account.

For example, in the New England North West of NSW it is extremely common to rely on services by travelling from one regional centre to another – especially to see a specialist service.

Case in point, it is common for Inverell people to shop in Armidale, 1.5 hrs away, and to go to Tamworth, 2.5 hrs drive, for other essential services not available in Inverell. Armidale people go to Inverell as well. In fact people rely on neighboring regional centres such that they form part of local identities much like residents of large bush estates rely on neighbours who may live far away. But then again distance is rated differently in the bush.

Many services are sought across regional centres but health and allied health services commonly require a great deal of travel.

It is also more common for professionals and specialists to travel in regional Australia. Of course we think of the flying doctors. Nurses also travel extensively. But this is very true for mental health and disability specialist therapists. The latter is all the more relevant for people with disabilities because therapists often prefer to see these clients in their own environment where there is greater chance to observe natural functioning without the added stress for the client that comes from travel to a foreign or clinical setting.

Over the past many years behaviour specialists have travelled across northern NSW under state government funded initiatives because that policy acknowledged the incidious nature of regional travel as a vital life line for regional Australian’s access to specialist disability supports. The policy also followed best practice in evidence based outcomes. Visiting people with disabilities in their own homes or community generally attaches better outcomes.

Many feel the NDIS has not yet generated an adequate funding policy for regional Australia, which does not fall into the remote policy definitions.

What exists so far may not reflect the reasonable and necessary needs of regional Australians. Naturally for the new Scheme existing policy arises from an urban centered model, and applies notions from the urban-based health sector, without acknowledging the critical and historical differences the disability and regional sectors present that either make service provision viable or fall flat on its face.

To reduce if not eliminate this layer of travel and service quality support to regional Australia is to effectively reduce access to specialist behaviour support and other therapies.

Such services may not ever exist in smaller regional centres. Travel will always be an issue.

It is simply not viable to set up a clinical service in most areas of northern NSW. This is unlikely to change in the near future.

This means travel across region to access specialists or for practitioners to visit clients will likely remain the norm.

In the same light, certain NDIS services will not likely expand with the market due to certain geographic, regional, and economic reasons, and will require policy initiatives to support regional access. Other methods will need to be employed to maintain the limited number of viable independent specialist services the region can sustain as a market niche.

Add to this discussion the fact that the former state model saw three tiered services with local practitioners, specialist behaviour support supplied regionally, and an added statewide senior specialist backup system, networked across levels. The current reality in NSW is by no means matching pre Scheme measures.

People who need a service are often encouraged to go back to their Support Coordinator, NDIS Planner or Local Area Coordinator and put up a change of circumstances review.

Sad as this is for a family in need, it is the only way the Scheme will register these needs, and eventually come up with better ways to measure allocations for behaviour support or other therapies.

Having said all of this, in our opinion the NDIS is an impressive vision and historic accomplishment. We are only on the cusp of NSW formal transfer this July, and yet so much progress is evidenced already.

As vital as this remains for so many, progress so far has a way to go before the sector can actually sustain services for regional Australians and for high needs complex cases. Even for those others who require periodic specialist supports the current system is falling short.

But we live in hope.

From Behaviour Support to Trauma Counselling

ATS are NDIS Registered Providers, and we do private work with a wide range of clients.

The NDIS allows participants of the Scheme to access our services under the guidelines of funding. We have developed a number of tailored solutions for people with disabilities and mental health concerns. As specialists in this area our work adapts counselling, psychotherapy, psychology, education, and other methods to individual needs and capacity.

Assessment and offering suggestions for treatment and support planning have become central to our work, and helps to inform many client’s NDIS planning. Addressing complex needs is often part of this work.

We have taken on many psychometric and educational tools for assessment like the ABAS 3. These may assist with diagnostic observations and in some cases may inform funding programs that request assessments.

Clients across these areas from Scheme to private interests access counselling, psychotherapy, trauma therapy, grief and loss counselling, couple counselling, and other specialist methods like clinical hypnotherapy.

Contact us via our contact page form with questions.

Australian Counselling and Psychotherapy

People from around the world ask me whether there is a distinct form of Australian counselling and psychotherapy. My response is immediately, yes!

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Over the past three decades my work has brought me to many conferences. Over time presenting and doing keynotes has given me a unique perspective. Teaching counselling training at universities, and maintaining interest in the field long after leaving full time academic work, has given me many strengths in understanding Australian approaches to psychotherapy and counselling.

For one, Australian Aboriginal culture is unique around the world. Nothing exists like Aboriginal ways arising from the Dreamtime, deeply connected with Country as Sacred Place, and the many quite profound ways this translates into familial values, community identity, and as time goes on influences within mainstream Australian culture that are often overlooked by people who grow up in this country.

Secondly, Australia is completely unique in its very landmass, and how this holds a great deal of influence, meaning, and inspiration for Australian music, art, science, and culture. Australians have an existential basis in this place we call home, our country, our land and sea. Australians unconsciously and often in full awareness gravitate and hover around the Centre, the desert as heartland, the place of unconscious, that tends to dominate our consciousness. This forms a rich compost layer within the Australian psyche. A hinterland for dreams, vision, and mysticism. A source of enormous power in creativity and problem solving.

Thirdly, Australian counselling and psychotherapy has its own unique professional traditions within the fields of education, public health, and ironically as an offspring of the psychology professional body’s decision to become highly exclusive and begin shutting down their grandfather clause during the late 1990s. Besides, the profession of counselling in Australia grew very quickly to be extremely diverse due in large part to a great deal of healthy competition between factions. This resulted in hundreds of smaller professional and specialist bodies being formed – something that is still sorting itself out as the next couple of generations of therapists cope with the confusion and mess handed down to them by their senior founders.

Finally, Australian counselling and psychotherapy are often places of advanced innovative research and advancements in our understanding of qualitative issues. We can think of a dozen studies that match this criteria, across the areas of child sexual abuse, abuse recovery, trauma and healing, Aboriginal cultural methods in therapy, sexuality and identity, sexual health counselling, ageing and community practice, couple and relationship issues, depression and anxiety, just to name a few. Perhaps in contrast, as a professional body psychology tends toward advancements in quantitative research outcomes.

Unlike psychology perhaps worldwide, counselling in Australia is unique because as a profession counsellors and psychotherapists are not as interested in “rats and stats” as the focus is on human relationships, understanding the dynamics of healing and change outcomes, and actual practice based outcomes that advance our knowledge of evidenced based therapeutic strategies.

These are just a few of the ways that Australian counselling and psychotherapy are unique around the world. There is much to be thankful for in Australia. And most Australians are not aware of the incredible resources we have in our communities and across our nation in the form of counsellors, whose work is often hidden and unassuming, but whose efforts form part of the social fabric of our community.

Who Comes from Where?

Our service is based in beautiful Armidale. But we find that our clients come from all over the New England and now from Coffs Harbour and Mid North Coast. We have had several from Tenterfield in the North. To the West we see people from as far as Moree. The South brings people from beyond Tamworth, and of course Tamworth itself.

We are now doing a fortnightly clinic in Inverell due to the excellent efforts of Individual Ability Supports (IAS Inverell). They asked our service to come over and they provide clients with supports to attend the clinic.

We are interested in helping via a clinic in Tamworth or Coffs Harbour, should providers in those areas seek to engage with independent senior therapist expertise. The model of independent professional practice and the wide range of services available to NDIS participants are actually not that well known or understood by NDIS providers and participants. People have little awareness of what is actually possible, and what best practice actually looks like.

At the cutting edge of the therapeutic fields of counselling, psychotherapy, and behaviour support there are many options for people. We suggest you explore this site for ideas. And get in touch if you have an NDIS Plan, or are looking for private therapy. If we can help or suggest another option, and if we cannot assist ourselves, we are happy to refer to other providers across the region.

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Inverell Community Clinic

Ability Therapy Specialists begins this Monday providing a fortnightly clinic in Inverell focused on participants of the National Disability Insurance Scheme. We are hosted by Inverell’s own Individual Ability Supports (IAS). We also have participants coming via other organisations like Brighter Access.

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If you know of people interested in attending the clinic, the way to connect is via our Contact Page on this website, or via staff at IAS Inverell.

The clinic provides counselling therapies, behaviour support, and some informal group and community social time depending on who is around and whether people have time to share a cuppa. In some cases, individuals decide the clinic is not for them. They may decide to visit us at our Armidale studio.

By providing a regional clinic, IAS Inverell and our therapy service are working to address the sad lack of adequate NDIS funding for travel and therefore the lower rates of access to senior therapist assistance in the New England North West. By hosting this clinic, we are able to drastically reduce travel costs per participant.

Importance of Independent Behaviour Support

So many people rely on professional supports. We all need doctors, nurses, therapists of many disciplines, and specialists.

Yet in disability support many still accept in house practitioners for behaviour support and counselling. Even though these fields are highly specialist – or should be… the complexity of therapy in disability and mental health really requires at least masters qualified and experienced practitioners. But most orgs are lucky to have a bachelor qualified person on staff with little experience.

At Ability Therapy Specialists we have two doctoral qualified specialists on staff. We are independent. So we no longer need to be influenced by the policies and cultures of organizations and the politics this invariably brings. Having worked many years in different settings we have a heart of compassion for ways to deal with institutional cultures – but our focus is on advocacy for the NDIS participant and their family.

Contact us via our Contact page. We look forward to hearing from you.

Year End Reflections for 2017

Looking at 2017, many changes and developments followed just as many challenges and accomplishments. Ability Therapy Specialists (ATS) had its first year in full time practice. We have growth to include two practitioners, one full time, the other engaged part time. Our clients come from privately paid requests, government paid services under the NDIS, corporate and training clients, and educational and tutoring needs.

During 2017, the majority of clients came via the National Disability Insurance Scheme (NDIS). These people asked for help with Behaviour Support, Counselling Therapies, and associated Clinical Assessments and Reports. We found by end of year that we were providing a wide range of clinical assessments, with new requests to engage the Adaptive Behaviour Assessment System 3 (ABAS 3) as well as other psychometric and educationalist assessments.

Clients used their assessments for a wide range of purposes. Some needed reports to share with Psychiatrists or Clinical Psychologists to assist with case reviews and planning, others needed reports for helping to evaluate what funding was more necessary and relevant to their needs under the NDIS Plan Review process, and other clients were seeking evaluations to share with primary care providers like Paediatricians for the purposes of diagnosis and/or to help with school/educational programs.

Our work during 2017 focused on Armidale and regional New England. Being based in Armidale we are slowly becoming known by families in the area, and word of mouth is always the best. We work with people of all ages, including children, individuals, parents, couples, families, schools, agencies, and NGOs. Much of our work with disability agencies and schools actually goes back many years within our specialist educational, therapeutic, and disability work – and we are excited to re-engage under this new and independent service.

We fairly quickly expanded beyond Armidale by offering a fortnightly day clinic in Inverell, hosted at Individual Ability Supports (IAS) across from the Inverell High School. The clinic had great success and many clients will be returning during 2018 to continue their awesome projects. The clinics run on the Monday beginning 22 January, but are by appointment only. No drop-ins please. Clients book in a month before usually, and each client tends to have at least an hour to engage in therapy activities. A sense of community is growing and participants do tend to visit with each other in a common room and have a cuppa at some point during the day. Contact for the clinic is via Dr Bowers (see this site’s Contact page), or IAS Inverell (see phone directory).

We were also excited to offer tailor made education and training for NGO staff during 2017, having designed modules in disability behaviour support and in trauma informed disability practice. Major shifts away from block funding create challenges for NGOs to find funding to pay for staff training and development. On behalf of clients we are grateful for those exceptional managers and team leaders who have taken the additional time necessary to find options during this transition.

The year also saw us using Skype for client meetings via distance. This had great success for certain client’s needs, and was useful for staff at regional NGOs. Using video/audio technology allowed these individuals to feel important, to gain better use of therapy and consultation services, and to save heaps of money that would otherwise go to travel time and costs. We hope to see greater interest by New England residents in 2018, as this form of working really does make a lot of sense for people who can communicate via this method.

Our geographic footprint seems to be in-flux given the only two year roll out of the NDIS in New England, and only first year roll out in Coffs Harbour and surrounding locations up to Dorrigo in the mountains, and along the coast north and south of Coffs. This being said, during 2017 we have calls from Coffs in the East to Moree in the West, and from Tenterfield in the North, and from Quirindi in the South and Gunnnedah in the South West.

Travel is an issue cost-wise given already inadequate funding packages under the specific line items that we can use, with inflexible terms for participant use of core funding allocations. But we have found a few work arounds for these issues. For one, we created a regional clinic out of Inverell which may assist people from Moree up to Tenterfield if they are able to travel to Inverell. We have also tended to provide significant discounts for travel costs where participant needs warrant and we were able to assist.

All up 2017 was an eventful and memorable year, with many amazing gifted people crossing our paths. We are inspired and encouraged. We wish everyone a peace-filled and healing 2018 for personal growth, and for family and friends.

Dr Joseph Bowers and Dr Dwayne Kennedy

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