Lifestyle Medicine and NDIS Funded Therapy and Behaviour Support

Dr Bowers and Dr Kennedy are members of the Australasian Society of Lifestyle Medicine.

Continuing to lead the professions of Counselling and applied Lifestyle and Integral Behaviour Support, Dr Bowers is on the path to becoming a Fellow of the Society.

According to their site, “The ASLM Fellowship is conceptually based on a Masters degree in structure and standard.” The “Fellowship is earned by demonstrating competency in the domains of Lifestyle Medicine from either a clinical, public health, education and/or research perspective.” As such, fellowship represents the highest level of expertise and peer recognition available to health professionals in the field of Lifestyle Medicine.

As Counselling Psychotherapists, we work in the NDIS Registered Provider categories of specialist behaviour support, counselling therapies, and early childhood intervention. As such, NDIS participants can use our expertise in a wide range of ways to help their NDIS Plan goals. One of these ways to use expertise is as specialists in lifestyle medicine and health.

We provide senior analysis of medications under NSW and national NDIS standards in behaviour support. Not only in disabilities, we have applied these methods with NDIS participants in support of their mental health concerns. Across a range of cases, and under the excellent standards for finding least restrictive options, i.e. other than being medicated for behavioural and mental health concerns, we are actively working with people to help them review their medications with their primary health practitioner, while helping individuals where possible to reduce medications while building personal resilience and support systems.

When you think of the implications here, the work under Lifestyle Medicine is very important. Over medication of people with disabilities (and mental health) is well documented. And is of great concern and is part of the historic reason for the NDIS Act 2013 being followed up by the Standards of 2018 that tabled Behaviour Support and Restrictive Practices standards. Unfortunately, we find that behaviour support practitioners that we have observed by reading their reports and hearing about their work from participants are not necessarily qualified and/or are not addressing these wider quality and health related concerns.

Under Lifestyle Medicine we also address lifestyle related chronic conditions and disease management, again from the perspective of counselling in allied health, and with a holistic integral mindset that provides for the question, “How can I better apply and find motivation to deal with my health concerns in daily life?” This central question at the heart of Lifestyle Medicine is incredibly important in a field where so many participants are dealing with chronic health issues, lack of exercise and activity, diet and nutritional deficiencies, weight gain and obesity, diabetes, and other chronic gut-brain dysfunction and a wide range of inflammatory conditions.

The often difficult but important question of motivation in light of human rights is central in disability and mental health treatment and support systems. For example, and while this sounds controversial, many NDIS participants have their health needs in daily practice largely overlooked. Yet this finding is not new to the literature, not at all.

For instance, The Australian Institute of Health and Welfare found that “adults with disability rate their health as poorer than adults without disability: adults with disability (42%) are 6 times as likely as those without disability (7.0%) to assess their health as fair or poor.”

Likewise, the Institute says that, “Mental health conditions can be both a cause and an effect of disability, and often involve activity limitations and participation restrictions beyond the ‘core’ areas of communication, mobility and self-care—for example, in personal relationships. Four in 10 (42%) people with severe or profound core activity limitation, and 33% of people with other forms of disability, self-reported anxiety-related problems in the 2017⁠–⁠18 NHS. This compares with 12% of people without disability (ABS 2019d). An estimated 36% of people with severe or profound disability self-reported that they had mood (affective) disorders such as depression, compared with 32% of people with other forms of disability, and 8.7% of people without disability (ABS 2019d).”

This huge gap is in part due to not carefully addressing the values of personal choice and agency in light of dietary choices that lead to the path of Type 2 Diabetes, Obesity, inflammatory conditions, gut-brain dysfunction, behavioural concerns, and a wide range of related chronic health conditions.

Traditionally, behaviour support in the disability sector has focused largely and narrowly on social behavioural risks and the reduction of immediate risks to health and safety. However, at the very core and heart and soul of clinical functional assessment of behaviour is the notion that we MUST take a holistic, integral, and lifestyle approach to correctly understand what drives behaviours of concern. More so, these ecological perspectives are necessary to find real and enduring solutions.

Featured image credits: Photo by MART PRODUCTION from Pexels