Supporting Psychological Health Neighborhood Bridges Supporting Psychological Health

Neighborhood Bridges A Human Rights community committed to creating activist environments that end oppression and establish meaningful citizenship for people with intellectual disabilities A community built on the notion that disability is a distinct culture, and still affected by various forms of oppression.

Our Community: Who are the People in the Neighborhood? People with Intellectual Disabilities Families Human Rights Workers Supportive Roommates and Neighbors Community Partners

Areas of Focus Supported parenting for parents with Intellectual disabilities People with dual diagnosis, trauma histories and multi system involvement including: penal and justice system, addictions, sex work, registered sex offenders

The Behavioral Paradigm Why ‘Behavior First’ interventions don’t work Why our own Experiential Bias interferes with democratic and useful supports Why WHY is the most important aspect of exploring what people do EXAMPLE: Perseveration around food post institutionalization. Control of meds vs

The ‘Behavior First’ Myth Discredits the notion of functionality – ALL behaviors are serving a function BUT not the one you think That surface interventions net zero long term outcomes Is dehumanizing

Experiential Bias People with intellectual disabilities have a different set of experiences with which to respond to the world, and it is not expressed in the same way as people who have not experienced oppression Therefore assigning motives that would mirror your own is counterproductive Because causality and emotion dictates behavior (and we cant read people’s minds)

Why is WHY so Important Because you cannot KNOW someone else’s motivation Because by being curious we get better context and often, disclosures allowing us to develop better therapeutic interventions Because not asking results in negative emotions, labels and responses – and then no healing or learning can happen

Assessment Along the Continuum Diagnosis - Acute and Chronic Trauma Self Identity and Self Concept Family of Origin - Where oppression starts Personal History Internal drivers – Unmet wants and needs

Personal Agency, Evaluation and Recovery: Why we follow a continuum of knowledge to ensure we are useful

Oral History and Asset Framework The Oral History allows us to tell the story of who a person truly is, it seeks to explore more valuable information such as family history, personal history, current self concept and the clues, behavioral and otherwise of who a person is seeking to be. Asset Framework The asset framework provides a work plan for Human Rights Workers to be useful in supporting each persons progress towards relationships, contributions and citizenship. Needed assets are identified on each of 5 domains.

The 5 Domains Service – appropriate resources incl: Housing, medical (generic), childcare, employment counselling Financial – access to adequate funds to pay bills, access to credit, savings, support for success Social – trusting relationships with supports, reciprocal relationships with family/friends, understanding of what authentic relationships look like

5 Domains Continued Personal – sense of self outside of labels imposed by others, ability to stand up for personal rights, a life without fear Human – Access to knowledge, skills in making decisions, comfort in using available resources (people/tech/learning)

How to be Useful(s): Keeping well day to day These tools keep the community: Attached to the details that make life more meaningful Sensitive to emotional/psychological triggers Aware of our own behavior

Keeping the Vision Alive ALL. THE. TIME.

The Log Note Requires the staff to address a goal area in each of the 5 asset area frameworks Need to be revised and evaluated regularly Need staff to be trained to be good observers, curious and interested at all times

The Team Meeting Framework Looks for each of the team members to examine not just what has happened but why Requires a skilled mediator to be successful Demands each member contribute and challenge each other Requires weekly/bi-weekly evaluation of all support documents Allows for changing gears ‘on the fly’

What About When People are not well? Supporting psychological health

The Support Matrix Seeks to improve on the functional assessment/behavior program paradigm Seeks to have a deeper understanding of a person’s core identities Seeks to understand the internal and external wants and needs of a person Recognizes the emotions and experiences that drive a person to do things Recognizes that ALL behaviors are, in fact, FUNCTIONAL

Restrictive Procedures Suck All aspects of our supports must have a learning component All aspects of our supports must address the underlying emotional issues All interventions need to be trauma sensitive All interventions need to be anti oppressive in practice All interventions need to be sensitive to vicarious trauma

CRISIS PREVENTION PLAN Modeled on the CPI model of 4 domains Does not generally include restrictions Primary focus is on safety , Recovering the relationship which is WHY there is RARELY physical restraint and currently only on an emergency basis

OUTCOMES USING THIS METHODOLOGY NB WORKS FOR 19 PEOPLE WTH SEVERE TRAUMA HISTORIES WE HAVE 1 ENVIRONMENTAL CONTROL , AND 1 RESTRICTIVE PROCEDURE

Continual Evaluation Read, Research, Review, Revise

How We Work to Keep on Vision Requesting and evaluating feedback from all community members Engaging in academic research Seeking the input of other social movements Engaging in community development