Developing the Care Plan and Getting the “Buy In”

Shawn Herz, MSG, MFT Director of Family Services Los Angeles Caregiver Resource Center Developing the Care Planand Getting the “Buy In”

Our client, the caregiver • View clients as healthy, competent, resourceful, and have theability to construct solutions and alternative stories to enhance their lives. • Help clients recognize their competencies and build on their potential, strengths, and resources.

Three Kinds of Relationships between Family Consultants and Clients • Customer-type relationship: client and FC jointly identify a problem and a solution to work toward. • Complainer relationship: a client who describes a problem, but is not able or willing to take an active role in constructing a solution. Expect other person to change. • “Court ordered”: clients who call for help because someone else thinks they have a problem. Disagree they have a problem.

Conceptual Questions Used in Developing the Care Plan • Magic wand question: If a miracle happened and the problem you have was solved overnight, what would be different in your life? • Scaling questions: On a scale of zero to 10, where zero is the worst you have been and 10 represents the problem being solved, how would you rate your problem right now? • Asking questions: can lead to separating “person” from “problem”, identifying preferred directions, and creating alternative stories to support these directions.

Key Concepts of Constructing the Care Plan • Downplay “past”, while highlighting “present and future” • View clients as healthy, competent, and resourceful, and have the ability to construct solutions to enhance their lives • Focus on what is working • The care plan process is focused on creating solutions rather than talking about the problems • People can create their own solutions • Small changes lead to large changes

Key Care Plan Concepts Con’t • The best care plan involves a collaborative partnership and mutual respect • A family consultant’s having the answer gives the client an opportunity to construct a solution • Goals are most powerful when they align with your values. • Setting goals is achieved through the process of discovery (Clients often don’t know what they want or need. They may need to discover or create it AND then change their mind along the way).

Care Plan Goals: • Focus on small, realistic, and achievable changes • Small change leads to big change • Remain goal-directed and future-oriented • E.g., what has changed since last reassessment? • Prioritize goals which may mean having only one step on the care plan towards achieving the goal

Family Consultant’s Role • View clients as experts about their own lives • Create a collaborative relationship • Create a climate of mutual respect in which clients are free to create and explore solutions • Listen to clients with an open mind • Encourage clients to share their stories • Listen to a problem-saturated story of a client without getting stuck

Family Consultant’s Role • FC’s demonstrate respectful curiosity and persistence • Help clients to explore what they would like to see different, how to make a difference, and to recognize signs that indicate that changes are happening. • FC provides feedback to clients: compliment what clients have done toward effective solutions and encourage more action steps • Help clients to use their strengths and resources to construct solutions

Building Trust between Client & Family Consultant • The relationship is an important factor for change to occur • Client-as-expert, clients are the primary interpreters of their own experiences • FC’s seek to understand client's lived experience and avoid predicting and interpreting • The person is not the problem, but the problem is the problem

From a Multicultural Perspective • Contributions • Fit with diverse worldview • Clients provide their own interpretations of life events • Limitations • Diverse clients may expect FC as a expert instead of “client-as-expert”

Summary and Evaluation • Client-as-expert (not knowing position) • View clients as competent and able to create solutions and alternative stories • The attitude of the FC is critical to the success of outcomes • Establishing and maintaining rapport is a process that is learned through continual practice • Without the ability to establish and build rapport with your clients, your success in assisting the client meet their goals will be very limited

Developing the Care Plan and Getting the “Buy In”