Miner, C. & Bates, P.,

1997,

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

Methodology

In this study, a person centred planning approach was implemented for a group of adolescents with learning disabilities as part of a preliminary activity to the Individualised Education Program (IEP)/ transition meeting. IEP/ transition meetings were observed for students whose families participated in the PCP activities and a comparable group whose families did not.

Participants were 22 students in special education services in the US and their families. They were divided into 11 pairs matched on variables of program placement, IQ, year of school leaving, and communication skills. One of each pair was randomly assigned to the PCP activities group and one to the control group. The IEP/Transition meeting of all participants were observed to assess both process and outcome variables. Post-meeting satisfaction surveys were also completed by all participants. Parents in the PCP group also completed a satisfaction questionnaire regarding the PCP activities. Finally, a follow-up questionnaire was completed by all families to assess their attitudes and behaviours in relation to previous years.

The PCP activities were usually conducted in the family home and used procedures adapted from Personal Futures Planning. This involved developing a personal profile of the student and their family by: developing a circle of support; constructing a community presence map; listing student preferences; and listing the student's gifts and capacities. It was suggested that primary members of the circle of support be included in future planning sessions. Students were then asked to describe a desirable future in relation to living situation, community participation, employment and leisure. Participants were then asked to identify activities that should be undertaken to move towards this desired lifestyle. The facilitator encouraged participants to continue meeting periodically to review these activities. The facilitator met with them again prior to the IEP/transition meeting to review materials developed during the PCP activities. The control group were provided with information and assistance regarding PCP following the IEP/Transition meeting.

At the end of each IEP/Transition meeting participants a survey was used to assess satisfaction with preparation, input, goals and likelihood for achievement. Families were given a questionnaire to assess satisfaction with this year's meeting compare to previous meetings. Families in the PCP group also completed a questionnaire about: the value of PCP activities; the effectiveness of the facilitator; most beneficial aspects and least beneficial aspect of PCP activities; and likely future actions as a result of the activities. All 22 IEP/Transition meetings were observed. Observers used predefined categories to record: who attended the meeting; meeting length; topics discussed; and who was participating in discussions. Content of discussions and who was participating in discussions was noted during meetings at 15 second intervals.

Critical appraisal

Whilst the PCP group took part in PCP activities prior to the IEP/Transition meeting, the authors' discussion indicates that the meetings themselves took a traditional format which would not have been conducive to a PCP approach. For example, it is noted that all meetings were 30 minutes in length and at the end of 30 minutes the participants for the next scheduled meeting would enter the room. There were also two meetings going on at the same time in the same room with some participants joining a meeting to give their input before moving off to another meeting. Further, procedural requirements of the meeting discouraged discussion of issues beyond annual goals and short term objectives. In these circumstances, it is perhaps surprising that any difference was found between the treatment and control groups.

Some of the methodology is imprecise. It is noted that PCP participants were encouraged to continue to meet after the initial activities but there is no indication of whether or not any participants actually did so. It is not clear whether the positive effects of the PCP activities were due to their person centred nature per se or just a function of family members becoming more comfortable in talking during meetings as a result of their involvement with professionals during the PCP activities.

Key findings

Interobserver reliability was 90.3% for participation and 71.6% for content of discussion. A statistically significant difference was evidenced in the percentage of intervals in which parents spoke in meetings between the treatment and control group. Those who received PCP activities participated more than those who did not. There was no difference in the percentage of intervals during which post-school issues were discussed. Families in the PCP and control groups expressed similar levels of satisfaction with their preparation for the meeting, input into the meeting, goals selected, and likelihood of goals being achieved. Those in the PCP group considered this year's meeting to be more favourable in terms of process and outcomes that in previous years than those in the control group. In the PCP group, 9 out of the 11 families rated the planning activity to be extremely valuable (6) or valuable (3). Beneficial aspects of the planning activity were reported by all families.

Social work practice/ policy implications

This study shows that preliminary work with families and students may help to increase their active participation in planning meetings. However, such preliminary work cannot be a substitute for a meeting which does not adhere to person centred principles. The person centred planning process demands a move away from traditional formats for planning meetings and the meetings described in this study are perhaps good examples of how it should not be done.