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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

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will be doing the catch up, with many people waiting on clinical reviews, and many more individuals carrying old and outdated behaviour support plans.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.

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.

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.

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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Interview with Dr Joseph Randolph Bowers

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Dr Joseph Randolph Bowers

This interview was recorded by a colleague who wanted to remain unnamed. They gathered this information to share in their organisation.

Dr Bowers, may I call you Joseph? Yes, no worries.

Joseph, why did you create Ability Therapy Specialists (ATS)? About three years ago now, the NSW government and the commonwealth moved forward with plans that would create the NDIS. NSW decided to pull out of direct services in aged care and disabilities, so would disband Ageing Disability and Home Care. Managers and mentors encouraged me to remain rural and regional – we all knew most senior practitioners would move away because the jobs would not be found here in the New England. The vision of ATS was born on white boards in corporate offices, dreaming up a model for community based independent practice.

What is ATS all about? People. ATS is about people in our community. And access to high quality counselling and psychotherapy services. ATS is about keeping senior expertise regional and rural. We are about education and capacity building – because we know that helping helpers goes a long way to building community-based skills.

How is Earth Rattle Publishing connected here? ERP was a project started a number of years ago to help new authors get published. It was part of the explosion of online publishing. Back in the late 90s my first exploring websites and virtual media as a doctoral student was thought by professors to be risky. I remember being told to be cautious. But in the years that followed I founded a new online open access research journal – the first of its kind in Counselling in Australia. ERP came about over the years of supporting Indigenous authors, and seeing the need for earth-based ecological resources for human ecology.

But you revived this project recently, you said? Yes. Health issues got in the way a few years back. But recently ERP is reawakened as a partnership with ATS. One provides the publishing expertise, the other a therapeutic edge. ERP is now publishing ebooks only because this is more ecologically sound, and become more popular and accessible. As a small niche publisher we focus on selling direct only – our customers pay for our product that is emailed to them in PDF format. The author actually keeps the vast majority of income, but our own books are all donated to ATS.

You have a community therapy fund, what is that? It is a fund for money from sale of books. We sell books via the Payhip set up. They take a small fee per sale. We keep the rest. For our own books, we give the proceeds to the fund. When the funds grow enough, we can offer clients sessions that are either subsidized or paid for in full.

How will you determine the need for people to use therapy? The number of needs out there are no problem at all. The issue is with how to allocate limited resources. We simply keep a word of mouth approach that over time develops a clear criteria for need and the practicality of offering a service to a person or family.

We see you have published heaps over the years. Tell us a bit about your own writings. That is like asking a truck driver to tell you about his new Mack truck. He looks at you like, are you ready for the long or short answer?!

LOL, OK… let me try again… What are you working on now? Ha ha ha ha, well… actually I am seeing clearly to publish a series on Counselling Sexology. I’ve just launched a book on retro texts in the Christian western mysticism tradition, and I am writing a book on Counselling Psychotherapy, a text book, based in the therapeutic methods that I have developed over about 25 or 30 years.

Wow, tell us about the Sexology project. This seems a bit out there, no? This is actually a growing area of interest for me since my graduate days of doing research on gay and bisexual men’s experiences. That work was back in the mid 1990s in Canada. Over here in Australia my PhD focused in part on LGBT people’s experiences. But even before my graduate research, my first masters degree courses were focused on couple and family life. My first group therapy work was with men remanded by court to deal with their violent behaviour, and the women who were their partners who were recovering from trauma. These different groups introduced me to the darker side of human sexuality – mostly heterosexual in fact. The GLBTI work I have done over the years has been quite inspiring and nothing like the heteronormative cultures that straight people inherit from their parent’s parents.

Are you saying that heterosexual people are more prone to violence? No, not at all. We all could do with less blanket assumptions like this. What I was saying is that we all actually inherit values, beliefs, and practices from our families. We grow up with these internal mindsets. If we do not have a radical reason to question our assumptions, we tend to keep on keeping on. This is human nature! We think, why fix what is working OK. But for most of us humans, what is working OK actually causes us grief. This is to say, our attitudes and beliefs about gender and sexuality are so twisted by past generations of values and beliefs from old and outdated perspectives, we have not yet faced these issues.

So why is this any different for gay people? Great question! Short answer: It’s not! Gay, lesbian, bisexual, transgender, intersex, and Two Spirit people get the same inheritance as the rest of us. But being different from the majority forces a change. That change is initially as simple as a different way of thinking. This reality makes minority people question assumptions and look at life differently. Nothing comes as easy, so everything is open for revision. What starts as a perceived weakness becomes a strength.

And for straight people, what is an assumed strength is actually a weakness? Perhaps so… Mostly likely an unconscious weakness for most. Things do not come up in awareness around these issues until couples find their marriage breaking down. Or they find they have a child or young adult child who is gay. In later years and in different forms of crisis, people find their value system challenged. Mostly these times do not lead to a real convergence of change and openness to evolution, because the human system demands preparation and training toward the more profound layers of growth.

What do you mean here, that spiritual growth relies on prior preparation? In some ways yes and in other ways no. Someone like Tina Turner carries a great deal of insight and very likely wisdom, based in her life experience. Nothing against her by the way, as she is pretty freaking awesome. But all due respect, Tina Turner is not the Dali Lama of Tibet. But if you got them in one room, sparks of spiritual enlightenment and many other sexy sparks would very likely fly. Two passionate and driven people in one room does that regardless of vows to the contrary. Now few of us are at the height of either of these people. But point be taken, Tina writes music and revolution. The Lama writes silence and awakening. Both are at the top of their game. That does not happen overnight. The Lama becomes a Buddha because he tips the scales on years of practice. The Turner becomes a pop icon and goddess of music because she tips the scales on years of practice. Both people take their game seriously, and both are pretty awesome.

So how does this relate to everyday people dealing with gender stereotypes and attitudes toward sex and sexuality? That is a very funny question, like, don’t you see that already?! What is the matter with you?! LOL Here you got the insight when you see the Lama and Turner in one room. She is all dolled up and sexy. He is in a robe all holy and saintly. But they both shine like stars. Gender and sexuality are here in the room with us too. American family values, at various levels. And Tibetan spiritual traditions, in various ways. When we meet, any of us in real life, we carry our heritage and traditions with us too. Couples who come for therapy because they are fighting and he wants to abuse her and she wants to displace her anger on her kids but holds back, they also carry a lot of baggage like the Lama and Turner do. The difference? Our stars are a bit older and maybe wiser. Those of us still at the coal face have to deal with our reality of lack of practice and lack of preparation. But we all have to start somewhere.

So your child is gay, what do you do? You grow the hell up and realise it is not your fault and that actually, being gay is a freaking awesome thing to be when you fall in love with someone and your life is going well because you got a decent job and your bills are paid. You might even think about having children with your gay partner. So you parents once you grow up and face your attitudes and beliefs are outdated and just plain impractical, you start to realise how bloody unjust the world might be for your child. You start to become an advocate for change. That is what real human evolution is all about.

You are very passionate about this stuff. Yes, and don’t invite me to your workplace unless you want to be enlightened by truth and confronted by passion.

We were thinking you might want to visit. Sure why not.

So therapy, writing, publishing, building a regional practice, NDIS, Earth Rattle Publishing, Ability Therapy Specialists, scholarship, research, you even have a Youtube channel for music you have written in past… what else do you like to do, in your spare time? (with a wicked grin). Well, I love to cook. And this espresso coffee machine is by best friend. I’ve tried my hand at painting using acrylics on canvas. We had a show a few years back in Canada, at Cape Breton University. It was a feature of Canadian Indian and Australian Aboriginal artists called Three Artists: Two Countries: One Heart. It was pretty awesome and very exciting to see our work on the huge gallery walls.

Who were the Australian artists that did that show with you? Dr Dwayne Kennedy and Grace Kennedy, from Guyra NSW. Their work was highly sought after and I had to fight people off to keep some of their paintings.

What are you doing in the next few weeks or months? Funny enough a bit more landscaping and I hope gardening… I’d love to visit family in Canada but that seems a distant vision at the moment…

No dull moments I am sure! How do people find you? We like to be hard to find actually, LOL. But if you insist we can be found via email and phone (0468863740). Email is best as we are actually in session most of the time. We want to stay close to people, so no admin answering service as yet. You get us directly. Surprise, surprise we get back to clients fairly quickly. People see us by appointment only.

Thanks for this talk, much enjoyable. And thank you, I am sure your CEO will raise an eyebrow and wonder why you bothered.

The bother is all mine, thanks again. LOL, no worries mate.

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