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Ability Therapy Specialists Pty Ltd

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

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NDIS

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.

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.

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.

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.

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.

Ask A Therapist Series Episode 2 What is Intellectual Ability?

“Episode 2 What is Intellectual Ability?” covers the cognitive intellectual and adaptive social skills and capacities that people have. This is huge!

Essentials of Behaviour Support – From NDIS Provider Ability Therapy Specialists in Armidale New England NSW

Behaviour Support begins with your goals, strengths, and skills.

Goals come from two places.

  1. The first is personal feelings. This is how you feel about your life and what you want to do.
  2. The second is social feelings. This is how others feel about your life and what others want for you and with you. Others are your family, friends, carers, staff, and community.

The balance of your feelings and other people’s feelings make for a stronger behaviour support plan.

After all what is a behaviour support plan?

Any good plan is made by you, your behaviour support specialist, and other people.

A good plan is to help you to feel safe and able to live your goals, strengths, and skills.

Strengths come from two places.

  1. The first is your feelings on your own strengths. What do you like best? What do you like least? What do you like to do most? What do you not want to do? What things do you really dislike?
  2. The second is other people’s experience of your strengths. What do they see about your likes, dislikes, and capacity to do different things?

The balance of your feelings and other people’s feelings on your strengths provides a good beginning to a strong behaviour support plan.

A good behaviour support plan is to help you practice your strengths.

Practicing strengths is best done with the help of friends, family, staff, carers, and community.

Skills come from two places.

  1. The first is your feelings on what you can do best, and what you can do least of all. All the things in between are also important. You may feel OK about house keeping skills. But you might feel yuk about eating ice cream in winter. Well, maybe not…! LOL
  2. The second is other people’s feelings on what you do best and least, and everything in between.

A good behaviour support plan will build on your skills.

Building skills means you can feel good about what you do good and not so good.

We are all learning and growing.

 

To finish Things Up

So we got goals, strengths, and skills.

Three things make a map or plan of how you are going. The behaviour part is social and relationships. How you can go, and how others can help you go.

Your plan can help to celebrate your goals, strengths, and skills.

Your plan can help to build up new strengths in things you would like to learn and do in future.

By making a plan your family, friends, staff, carers, and community members can better support you too.

Other people can use the plan to understand your goals, strengths, and skills.

This is how we make a good behaviour support plan.

 

Contact

Call Ability Therapy Specialists on 046 886 3740. Or email by going to the Contact Page. There is a form at bottom. Fill this in and say hello!

Sorry we cannot put the email on this page – there is too much junk mail that comes from putting the email here. But the form is good.

We do want to get your email. And we are excited to hear from you. Have a great day!

 

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