Hagner, D., Helm, D., & Butterworth, J.,

1996,

Reviewed by Janet Robertson,
Institute for Health Research,
Lancaster University

Methodology

This study looks at the use of person centred planning in the transition from school to adult life for 6 individuals with learning disabilities in Massachusetts , U.S. Participants were selected from a state-wide transition project which involved a total of 108 participants. The 6 individuals were selected using a purposeful sampling process to select both men and women, from urban and rural communities, who could and could not communicate easily.

Personnel attended a two day training seminar on whole life planning which involved learning a five step planning process based on creative problem solving principles. The planning process was then implemented for 108 individuals. For the 6 participants, consent was obtained for a researcher to observe and take notes at planning meetings, collect copies of documentation, and to interview those involved in the meetings. The researcher joined whole life planning meetings that took place over an arbitrarily selected 6 month period. In-depth open ended interviews were conducted with key planning participants, the focus person, a family member, the facilitator, and in 4 out of 6 cases the individual's teacher. A total of 21 hours of meetings were observed and 11 hours of interviews recorded. Data were analysed independently by three researchers using an emergent themes approach where data are examined for general themes, models, or implications, with differences between researchers being reconciled by discussion.

Critical appraisal

The study brings to the fore some of the possible problems of implementing PCP. Some of the problems may have been minimised by providing potential facilitators with increased training and continued support. Training consisted of a one off two day session and there is no suggestion that facilitators received any support beyond this. This may partly explain why facilitators described the planning process as complex and unpredictable and why two felt 'exhausted' after meetings. Due to the small number of participants, the results should be generalised with caution. Further, as the authors note, a limit of 6 months was placed on data collection when PCP is a long-term process.

Key findings

• Each participant had one or two meetings during the 6 month period. Themes were discussed in relation to constraints on equal participation in meetings, maintaining a positive focus, control of the planning process, the facilitator role, and planning outcomes. There were some inequalities in participation, with friends comprising the smallest group of attendees. Siblings and similar-age friends did not participate actively in meetings, with meetings being 'adult-centred'. Negative comments about the focus person were sometimes made by both professionals and family with facilitators not enforcing the rule that negative comments should be avoided. Whilst focus people decided who to invite to meetings and invited them, their control of the actual meeting was limited. Some statements made by focus individuals were ignored or reinterpreted to fit better with planning topics such as residential planning. Facilitators were in control of what was written down during meetings, for example leaving out areas which might be controversial.
• In terms of outcomes, 5 participants enjoyed the planning process, but 6 months after the first planning meeting several felt that 'not much happened'. The results section describes outcomes for each individual. In some cases, indirect outcomes occurred as a result of closer social relationships and a greater willingness to take advantage of opportunities as they arose. Overall the results point to an indirect, tenuous relationship between planning and outcomes, with most participants continuing to have few peer friendships.

Social work practice/policy implications