A Challenge for Professionals
The development of services and supports around outcomes for people stretches the role of the organization's employees, especially those professionals performing assessments and evaluations. In fact, the purpose of assessment and evaluation changes.
In the past, the development of goals followed the process of professional assessment and the interdisciplinary team meeting. The purpose of professional assessment and evaluation was to design a service plan. The use of person-centered outcomes reverses the relationship between assessment and planning. Person-centered outcomes require that professionals play two distinct roles -- that of learner and that of facilitator.
The first role is that of learner.
Person-centered outcomes require learning before acting. The professional must first understand the person's prioritized outcomes. This understanding requires that professionals listen, observe, ask, discover, question, and redirect. The professional learns what the person expects from the services and supports rendered. This learning precedes any decisions about what role the professional might play in the provision of supports and services.
The learning process is conceptually simple, but subtle in practice. The outcome questions in CQL’s Personal Outcome Measures® provide guidance and suggestions for talking with people, but we learn much more when we allow the person to guide the conversation. In this manner, the questions are used as follow-up probes when we need more information. Learning is enriched when we can identify the larger context for people's preferences.
We further our learning when we ask "why."
For example, taking the statement that work is a priority and asking the question "why" can reveal that work is important for financial security, as an opportunity for making friends, or for participating in the life of the community. Asking the question "why" moves us from means to outcomes. Once we discover the person's outcomes (friendships, money, or job performance) then there may be multiple means that can facilitate the outcome.
For some individuals, this process of identifying outcomes rests upon the discovery of preferences. For some people with significant cognitive or communication difficulties, we must offer people a range of experiences and support and then, over time, discover preferences. Family, close friends, and regular service and support staff can most often identify people's preferences.
The identification of a person's priority outcomes enables the professional to ask the question, "What skills, abilities, and knowledge can I use to facilitate this outcome?” Very often, assessment may identify particular methods that the professional can use in facilitating the outcome. Assessment provides information about processes and methods for accomplishing outcomes. Assessment, by itself, cannot yield information about a person's outcomes. People define their own outcomes; assessment provides information about how the professional may facilitate that outcome for the individual.
This evolving role will require that professionals act as patient listeners, observers, and learners before they render services and supports. People identify their priority outcomes and professionals use assessment and clinical and educational skills to assist people in reaching those outcomes.