1 Pam Treadway, M.Ed. Senior Clinical Consultant March 28, 2013THURSDAY TARGETED TRAINING: The Impact of Words, Interactions and Relationships on Participant Success Pam Treadway, M.Ed. Senior Clinical Consultant March 28, 2013

2 Agenda Stories to think about in the context of relationshipsPower of words Exploring Power Relationships Evaluating our Interaction Style

3 stories

4 Some stories to ponder…..Last night you fought with your significant other over financial issues. In the morning when you left for work your car wouldn’t start. Things snowball…. you are late to work, the boss yells at you for being late and asks you for a report that you didn’t even start yet. You sit at your desk overwhelmed and feeling like you are on a sinking ship. To add insult to injury, your co-worker places yet another demand on you and you snap…. slamming the folders in your hand on the desk, in an irritating and loud tone of voice , you state “would everyone just leave me alone” and storm out of your office slamming the door behind you. Your co-worker follows you…… How do you want your co-worker to respond?

5 Some stories to ponder…..Tyrone is a gentleman in his 30’s who lived independently in his own apartment until his SC and team decided it would be safer if he lived a group home. Tyrone is not happy about losing his independence and having staff looking over his shoulder all day long. He is worried about his foster grandmother who isn’t feeling well. Tyrone goes into the refrigerator and pulls out a jug of ice tea. Bob, a staff member in his group home, sees him from a distance and yells in a demeaning tone of voice, “What do you think you are doing? Get out of the refrigerator, you can’t have iced tea. You know you are pre-diabetic and overweight.” Tyrone defensively replies that there is nothing else to drink. Bob replies, “I am tired of you ignoring the house rules. I am writing you up. You are getting on my last nerve.” Do you think this interaction had a positive outcome?

6 Some stories to ponder…..Will is a young man who spent his childhood in and out of foster care homes. He lives in his own apartment. Will is always being encouraged to get a job by his support workers, but he refuses. One day his support worker, Jeff, was overheard talking with him about this issue and was speaking to him in a very demeaning tone, calling him lazy and a “drain on the system”. When confronted by the Supports Coordinator, Jeff stated, “but, I can speak to Will like that because we have that kind of relationship. It doesn’t bother Will.” When the SC asked Will how he felt, he replied that he is repeatedly hurt and insulted that he is spoken to that way, and does not have “that kind of relationship” with Jeff and does not like him for that reason. What do you think the impact is of this relationship?

7 Common thread The relationship, words, and interactions between the individuals in the stories made all the difference: In our bad day at work, our positive relationship with our co-worker and their supportive and empathetic response made all the difference. We calmed down after a conversation over a cup of coffee. Tyrone was not so fortunate…. he lacked a supportive relationship with his support staff and things did not turn out so positive for him. Tyrone became agitated over the staff’s response and they got in a confrontation which resulted in the police being called to the group home. Will gets angry and defensive when Jeff comes to support him. He doesn’t feel Jeff understands him and is judgmental. Their time together is strained and unproductive

8 Power of words

9 “Sticks and stones may break my bones but words will never hurt me”"Handle them carefully, for words have more power than atom bombs." Pearl Strachan Words have tremendous power - they give out energy and a message which creates a reaction in others Whatever you say to someone else will produce some kind of an effect in that person Words can positively impact others or wound others and ruin relationships Speak words that will build self-esteem, confidence, build relationships and possibilities

10 Nonviolent Communication (NVC)Exploration of this communication process within ODP Guy Legare has adapted this into a “person directed’ framework Tenets of NVC: All people have the capacity for compassion People may resort to violence or behavior that hurts others when they don’t recognize more effective strategies for meeting needs Habits for thinking and speaking that lead to violence are learned through culture Conflicts arise when the strategies for meeting these needs clash

11 Nonviolent Communication (NVC)Communication that interferes with compassion: Moralistic judgments: When we imply wrongness or badness on people who act inconsistent with our values (e.g., blame, insults, put-downs, labels, criticisms, comparisons) Demands: When we threaten others with blame or punishment if they don’t comply (explicitly or implicitly ) Denial of responsibility : When we use language that obscures awareness of personal responsibility (e.g., "I had to“, group pressure, regulations, policies) Making comparisons between people. A premise of deserving, that certain actions merit reward while others merit punishment.

12 Nonviolent Communication (NVC)Four steps to communication using a NVC framework: State the observations that are leading you to feel the need to say something State the feeling that the observation is triggering in you. Or, guess what the other person is feeling, and ask. State the need that is the cause of that feeling, or, guess the need that caused the feeling in the other person, and ask. Make a concrete request for action to meet the need just identified.

13 Power in human services

14 I’ve got the power….. There is great power within human servicesAs staff we have incredible power over those we support David Hingsburger explored the concept of power in human services his book Power Tools.

15 I’ve got the power….. “Myth-taken Assumptions” about power (Hingsburger): Staff have power and may not even be aware of the power they have. “I have responsibility in my job, but no power” (e.g., belief that power is in the organization structure above them, but not in the behavior plans or interventions that are used) We believe we “serve” the people in our programs, but do we really view them as our employers? We outgrow our temptation to misuse power. We think we have “learned”, but we need to constantly monitor our interactions.

16 What about power? We all say things one way but mean it another wayHingsburger did an exercise where he wrote down everything he said when his power or control was tested: Well it’s about time! (…. Stupid!) Because I said so! (I’m in control here.) I said “Right Now!!” (There is no room for debate) I don’t have time for your nonsense! (there is no room for you here)

17 Rethinking Power Hingsburger makes the following suggestions for change: Three steps, Two skills Step 1: Recognize that it is not your job to craft the person into your image. Let the person discover their own way in the world Step 2: Give the person time to think/process things through for themselves Step 3: Take to time to look at yourself and how you are affecting other people

18 Rethinking Power Skill 1: Developing the ability to recognize or at least consider if behavior is the result of oppression. Skill 2: Teach self-advocacy skills.

19 relationships

20 Thinking about relationships…Relationships are important to us and impact how we behave Would you engage in activity that you don’t really care for just because you want to be with the person who invited you? Historically we have neglected the role relationships play in our line of work – why would impact of relationships be any different for individuals with disabilities? People with challenging behavior are often alienated and rejected by peers, friends, family, and community in general For some, the only relationships they have are paid relationships

21 Paid versus Unpaid/Natural SupportsTendency to focus primarily on natural supports We need to be careful not to minimize the importance of staff relationships, even if these are temporary Research studies are finding that the quality of relationship between individuals and their support staff was one of the most important factors in contributing to positive outcomes for the individual

22 Research Studies on Staff RelationshipsMcLaughlin and Carr (2006) Research studies have shown that the quality of staff-participant relationship is a important variable influencing the likelihood of problem behavior Rapport can function as a setting event Good rapport decreased the “aversiveness” of task demands (participated in more daily activities) Poor rapport increased the “aversiveness” “Why will he do that for you and not for me?”

23 Research Studies on Staff RelationshipsRobbedo & Donnellan (2008) study looked at properties of supportive relationships identified by individuals with autism Six properties were identified: 1. Trust 2. Intimate Connection 3. Shared vision of independence 4. Presumption of competence 5. Understanding 6. Communication Effective support was dependent on quality of relationship

24 Characteristics of Good RelationshipsUnconditional regard or acceptance Understanding the participant’s perspective or walking in someone’s shoes Being in-tune: Ability to predict and interpret subtle cues or behavior Genuine caring (Bambara presentation on Relationships and PBS)

25 Evaluating our interactive POSTURES

26 Interactive Posture SurveySelf-assessment Means to evaluate our interaction styles Based on the work of John McGee (Gentle Teaching) What is your interactive posture?

27 Interaction Posture Survey: Four PosturesSolidarity Values participant’s perspective Provides growth-directed experiences Participant success is important Works together for positive outcomes Authoritarian Caregiver is in charge Only one way to do something – caregiver’s way

28 Interaction Posture Survey: Four PosturesOverprotective Values taking care of and protecting participant Fosters dependency in safe, predictable routines Cold-mechanistic Values task/activity completion Caregiver is robot-like Knows little about the participant

29 Wrapping it up

30 Some Concluding Thoughts…Many of the participants we support do not have supportive relationships Even though we may be temporary and paid, we can be the catalysts to the development of future relationships Our words and actions will make or break the development of supportive relationships with those we support Our words, interactions, and relationships can contribute to the occurrence of problem behaviors Consider hiring staff based on mutual interests and liking Consider staff orientation and training on relationships and communication

31 References Hedeen, D.L., Ayres, B.J., Meyer, L.H., & Waite, J. (1996). Quality inclusive schooling for students with severe behavioral challenges. In D.H. Lehr & F Brown (Eds.), People with Disabilities Who Challenge the System (pp ). Baltimore: Brookes Publishing Hingsburger, D. (2000). Power Tools: Thoughts about power and control in service to people with developmental disabilities. Quebec: Diverse City Press. McLaughlin, D.M. and Carr, E.G. (2005). Quality of rapport as setting event for problem behaviors: Assessment and Intervention. Journal of Positive Behavior interventions, 7(2), Robledo, R. and Donnellan, A. (2008). Properties of supportive relationships from the perspective of academically successful individuals with autism. Intellectual and Developmental Disabilities, 46(4),