Feature Issue on Person-Centered Positive Supports and People with Intellectual and Developmental Disabilities

Caroline Chavez has over seven years of experience in a supported living agency, starting as a direct care provider, then becoming house manager, and lastly program manager. Now working for the New Mexico Developmental Disabilities Supports Division, she reflects back on her direct care experience and shares her thoughts about how her view of support, and of her job, changed over time.

I came into the field with no prior experience and didn’t really know what I was getting into. I began working overnight and had little contact with the guys living in the home. It was “just a job.” Then I switched to days and everything changed. I began to see the difference I could make in their lives and also began to recognize that I was changing, too. I wasn’t satisfied with the behavior programs that sought to shape the guys into compliance. What I saw was unnecessary punishment that made things worse, made their lives miserable and compelled me to do things I wouldn’t allow in my life. “Punishment,” “consequences,” and “solitude” are the terms I was taught. I remember many instances when our intervention actually escalated minor events into full blown crises, all to “teach the person a lesson.”

I gradually began changing the way I thought about the guys and how I believed we should design support. I asked for help from more experienced people in the field who were talking about this person-centered, positive approaches stuff that fit with how I was evolving. We attended to the contributing stressors in the person’s life and their underlying emotional upheaval rather than their behavior. As we adjusted our expectations and behavior toward giving the guys a life and control over their lives, remarkable change began to take place. Eventually, I was offered the opportunity to train and mentor staff toward these practices. Staff began to shift away from discipline, control, and management toward nurturing support.

I have found that most DSPs are able to make this necessary shift. We have been successful in helping some transition from working in prison and institutional settings to being compassionate DSPs in the community. I find that genuinely promoting the voice of DSPs in planning processes, formal and informal recognition of their efforts and outcomes, demonstrations of appreciation, and encouraging them to draw from their personal experiences all contribute to their fully adopting the practices I believe in.

To me direct care is now an investment, not a job. One of the guys never addressed staff by name, ever. He simply saw no value in forming an attachment. I had worked for a long time to remove the intrusive, shaming aspects of his plan, often by simply asking him how he would like to be treated. I let him define what support and assistance looks like for him. One day, out of the blue, he addressed me by name. My stunned co-workers asked why? “She treats me like a human being.” Seven words and my seven years are worth it. Seven words and I no longer have a job. I have my life’s work calling.