Module 7: Supporting people to make their own decisions

So before we begin, we would like to acknowledge the traditional owners of the land in which we are meeting on today.

So I am joining you from the lands of the Quandamooka people. On the lands of the Ngunnawal and Ngambri peoples. So we would like to acknowledge their ongoing connection to land, sea, and community, and pay our respects to elders past, present, and emerging. So just a quick, reminder to please look after yourself as we talk through the training today.

We will be referencing experiences of violence. So we ask that everyone prioritizes their wellbeing. Please step away or stop the training if you need to. And really importantly, please reach out for support if anything in the training brings up anything for you. 1800RESPECT is a nationwide service that can provide confidential counseling and opportunities to debrief.

The number is 1800-737-732. So as always, we will have our training workbooks today. So these have been designed to be used throughout the training to apply some of the knowledge learnt. We will let you know when it’s time to turn to your workbook, and we ask that you pause the training and complete your responses before continuing on with the training.

So what are we here to talk about in module seven? So we are here to talk about supported decision-making. So before we get to that, we’ll be looking at the key principles of capacity. We’ll be talking through some tips around supported decision-making, and sharing some things too for you to consider when you’re supporting someone to make a decision.

And as always, we’ll be putting it all together at the end with our key takeaways slides. As always, we are using a combination of person-first and identity-first language. please feel free to use what feels best for you, and ensure that you are using the terminology that your client prefers too. So supporting people to make their own decisions.

So I’ll just read out the quote here. So this quote, was from a disability sector stakeholder who participated in our co-development workshops And they’ve said, “We confuse intellectual and physical impairment with a lack of capacity and capability to make decisions. They can make decisions. We might not understand them, and we might think it’s the wrong decision, but it’s their decision.”

So we decided to use that quote because I think it’s a really important reminder that not only can people make their own decisions, they have a right to make their own decisions. And although we may not understand or the decision, it is theirs to make, and it is our role as supporters to ensure that the person making the decision feels supported and has all the right information to make the best decision for themselves.

Okay, so let’s have a look at the key principles of capacity, which has, come from Legal Aid ACT. and first off, as Jane was just saying, always presume a person has capacity. Always presume the person can do the thing, and that, that is with decision-making, but also in all aspects. we always pre- presume capacity and are happy to be shown otherwise, but we don’t want to be starting from a place of, “Oh, this is gonna be too hard for them.

I’ll just do it.” capacity is decision specific. So like way back in our earlier modules when we were talking about consent, you’re consenting to one thing. You’re not consenting to all the things in the world. capacity is related to, an individual decision or situation. assessing that capacity in each context and being aware that capacity is fluid.

There might be- You know, capacity one day and not the next day. There might be- a capacity for thing A but not thing B. So tuning into all of those things. really important that we’re not making assumptions about capacity based on a person’s appearance or disability. and as you can imagine, people who have, communication differences, for example, they can be a group of people who quite often, outsiders can assume, oh, they don’t understand, or they can’t tell me what they want.

Meeting each person where they are and working from their strengths, basically. This one is important. You are assessing the person’s ability to make a decision. You’re not assessing the decision itself, as in, and this comes back to the, if you disagree with the decision. So that’s not what we’re concerned with.

We’re concerned with whether the person has the capacity to actually decide what they would like to do next, for example. and someone making a decision for another person is absolutely our last resort, okay? And s- and again, this can be tricky when, these kinds of situations where you think, “Oh, gosh, this is such a bad situation.

I’ve gotta help them. I’ve gotta get them out of this. This is what they need to do, quick, We are- Yeah, never, wanting to make a decision for a person unless we just have no other option. So there’s lots of things we can be looking at first before we get- to the point of someone making a decision on behalf of another person.

Yeah, and as you were talking, Tessa, it just reminded me of a woman that I worked with, a few years ago who, was actually in a podcast we created for support workers. We also have a podcast for support workers, if you’re interested in looking at that on the website. but this person, talked about her experience of many years ago requiring decision-making support around money.

so having somebody in place to support her with her money, manage her money, make decisions about her money. So she talked about this being due to, poor capacity to do this at the time due to trauma, disability, and this person was also quite unwell as well at this time. However, this was something that was organized, it was formal, and went on for quite some time.

However, there was a time when this person did not require this level of support anymore, and when we were talking to her for the podcast, actually manages her own money, does not require that level of support. So I think just a really solid example around how capacity is fluid and can change. So just because someone requires a, a public guardian or a, public trustee at the time, does not mean that they will always require that level of support.

And I’ve also had people that I’ve supported over the years who have had a public guardian to support with accommodation, decision-making, health, and have since, applied to, it’s QCAT in Queensland, but ACAT, the equivalent would be ACAT in the ACT, and have applied to have that person, removed, and that has, they’ve achieved that and now make their own decisions.

just a reminder there that people absolutely can make their own decision when the time is right, when they have the right support, when the environment is right, and it might be our role as, supporters to advocate for that if that’s something that we, feel that we can do within our role. Okay.

So we’ve got a quote here from a lived experience stakeholder talking about decision-making, and they say, “In terms of supporting people to make their own decisions-” I guess understanding that yes, we absolutely want people making their own decisions, but when you’re in that sort of heightened, dysregulated, traumatized state, choice can actually feel really overwhelming.

and it can cause our, brain to shut down. It’s just too much to cope with. So in those situations, controlled choice can sometimes be helpful So for example, instead of just saying, “What do you wanna do next?” I don’t know, there could be a thousand things. You might say, “Who do you want to contact?

We could talk to these people or these people first.” And that’s about making choice accessible. so yeah, so again, you’re just monitoring how the person is coping as you move through the conversation because, they could just, it could just get too much at any point. It’s exhausting, it’s overwhelming, and that’s where you can be doing things like this.

still giving them the choice, still making sure that they are the ones in control of this situation, but just narrowing it down a bit so that it feels a bit more doable. I only have to choose between A or B, not decide the whole next step and how we go about it. So supported decision-making, what do we mean when we’re talking about supported decision-making?

So for the next few slides, we’ll look at what it means and provide some tips that hopefully will be useful for you in your practice. So step one always is ensuring that you have a strong relationship with the person that yous are supporting. So we talk about building rapport with someone when we first meet them during intake or, when we first go and support them.

But, building a strong relationship involves, ensuring that you’re putting time and effort into this relationship, no matter how long you’ve been supporting someone. It doesn’t stop just because you’ve been working with them for a really long time. So this is important because a strong relationship will allow the person to let you know if what you’re saying, the decision that you’re introducing, if they don’t understand that, as Tess talked about, if it’s just too big, there’s too many decisions to be made, it’s not the right time, they will hopefully feel comfortable because of your strong relationship to let you know.

but also because you know that person, you will be able to hopefully read their body language, will read perhaps what they’re not telling you. so if they’re saying, if you’re asking that person if they understand something, and if they’re saying, and you’re going, I think their body language is telling me otherwise,” and that’s because I know that person really well.

So there might be another way that you can check in around whether that person understands something. So building a strong relationship is important always, but particularly when we’re looking at supporting people to make their own decisions So clearly explain the decision and the reason it needs to be made.

So be really clear about this. So we have to make together, I’d like to help you make a decision about what you wanna do about this. So what you wanna do about accommodation or what you would like to do about, working with a domestic and family violence service, and then why that decision needs to be made.

So being really clear, and throughout this process- It might be impor- important to check in with the person around how they are going and if they are understanding the, suggestions that you’re presenting to them. Clearly explain any forms and difficult language. we know that if, at times, if there’s a decision being made that requires, support to fill out a form, often, and I’m thinking about, people who have an intellectual disability, may have difficulty with jargon, with really abstract language, with complicated language, so might need support to either look for easy read res- resources.

However, we know that in an ideal world, everything would be in easy read, so people could understand it and make these, decisions. But it, they may need support to understand exactly what they’re signing, exactly what they are agreeing to. And, it’s important, if you are also unsure and you’re in a role of providing support, because some of these, forms and things can be quite complicated, to reach out for some support for yourself so you can support that person, to make their decision.

So really important to explain what will happen if they make or don’t make a, certain decision, so discussing consequences. “So if we do this might happen. However, if you decide not to, this might happen.” So the person having an awareness of what might happen with each decision helps with an understanding of what they would like to do and why.

So really, people can’t make decisions unless they have an understanding of what the consequences might be of each different decision. And I’ve just done the- Throughout the process, Mary Jane … next slide. Yeah, You’re on a roll there. No. I just think this one is a really important point, that not making a decision or not taking action is al- always a course of action.

that is- Yes … one of the, options. Yeah … it can, for, if, we’re supporting someone, it can feel like, no, we have to do something.” Yes … but choosing not to do anything in that moment, is a valid decision as well, as long as the person understands, the, consequences, as you say.

But not doing anything is always one of the options. Might not have great outcomes, but it could be a valid choice for people, so that’s important as well. Yeah, absolutely. I think a really good point. I think as support workers or as social workers, a lot of our role is about the doing, is about the, that solution-focused style of work.

However, our role within this situation might be more around the listening and supporting and respecting the person’s choice in that moment to not do X, Y, Z, if they can clearly explain to you why that is the case, and have an understanding of the different, consequences of not, the consequence of not doing anything or making that decision.

So throughout the process, check for understanding. So this needs to be a really active process, so not b- assuming that the person understands, reading the person’s body language. so ways to do that, because, we’ve talked a lot about using, open questioning and not just saying yes or no.

So something that we really talk about a lot at WWILD is asking the person to explain back to us what we’ve just talked about, or explain back to me what I’ve, just said. And from there, I can really gauge really easily whether the person has understood or not, and then that’s a wonderful, opportunity for me to say, “Okay, I, I’ve…

I,” again, take that responsibility if you were the one explaining, “I need to try again. I, didn’t do a very good job of explaining that,” and have another go. So we know that for some people, saying yes and going along with things may be, something that they do quite regularly, so that might be to not appear stupid or to just, have this discussion hurry up.

So we need to be checking, particularly about decision-making, that the per- you and this person are on the same page where safe and appropriate, engage other support people in the conversation to ensure understanding. this might not be appropriate or needed for everyone, so not everyone is going to require mom or, another trusted worker or, somebody else to help this process, but some people will.

So I guess what we mean when we’re talking about whether it’s safe or not is, of course, to consider the relationship and whether there is any violence in f- going on in this relationship, whether that be disclosed violence or, something that, you are, have a feeling about. Because of course, inviting unsafe people into discussions around decision-making can either escalate the violence for the person once we leave and we’ve finished our discussion, or it can mean that the person feels really pressured to go along with what the other person is saying, rather than making a decision for themselves.

And I think be, really monitoring that. If you do invite somebody into the discussion to support, is that person safe? Are they a supportive person? And are they actually supporting that person to make it their own decision, or are they making a decision for the person? And the person may not feel, be comfortable or feel safe enough in that space to say, “Hey, actually, that’s not what I want.”

so it’s our role in those situations to be really monitoring that, and perhaps jumping in or ha- trying to have a discussion away from the other person just to check that what has been agreed on is actually what the person wants

Okay, so we’ve got some things to consider here, and you can think of it almost as a little bit of a checklist or, something that you can really refer to, as you’re preparing to have the conversation, as well as during and afterwards. So Thinking about how you’ve provided the information and whether you’ve considered the person’s accessibility needs.

did they need the communication boards from Speak Up and Be Safe from Abuse? Do they need Easy Read? Do they need some other method of communication? And access needs can also be about the when and where of having the conversation too. did you check that the person does understand each option that has been presented to them, including the consequences of any particular option?

Are there other people who need to be involved in this supported decision-making process? Does the person seem overwhelmed by this discussion? Do we need to pause here for today? Do we need to go and sit in the sun for 10 minutes and just have a chat about nothing in particular? What, do we need to do in this moment if they’re overwhelmed?

And do you need to change the way you’re providing the information? so again, that monitoring during the conversation. You might have prepared and going, I’ve brought in these things to help me explain what we could do.” As you’re monitoring the conversation as it goes forward, you can just see, oh, this is not getting through.

I need to change, what I’m doing here. so yeah, just staying attuned to what’s happening as you are having this conversation. Okay, so we’ve got a couple of questions to answer in the workbook. So two questions. Question one is: What are the things you would need to consider when supporting someone to decide whether they would like to be referred to a domestic and family violence service?

That’s question one. And question two: Why do you think it’s important for people who have a disability to make their own decisions after an experience of violence? So have a little think. Pause your video here. Complete your answers, and we’ll see you back here shortly. Welcome back. We have a quote here from another lived experience stakeholder, and it’s very short and to the point, “But don’t tell me what to do.

Don’t fix it. Just listen.” And this was something they felt quite strongly about, and they were saying, I’ve, got the answers in here. I can work my way forward through this situation. I don’t need you to do it for me. Just listen to what I’m saying, and we can go from there.” So really good advice as always So some of the key takeaways from our module today.

people have the right to make their own decisions, however they may require support to do this. So just because they require the support doesn’t mean that they can’t do it. so it’s about what type of support they need, adjusting that depending on the person that you’re working with, and being really open to, making changes, of course, when needed as well.

And if you’ve followed us throughout our module journey, you would know that it’s really important to ensure that we are giving, we are allowing people to have as much control as they would like to and as, as they deserve after an ev- experience of violence. And we know that this is actually a really key step to recovery.

So people who have experienced domestic, sex- domestic, family, and sexual violence have had a decision taken away from them. They’ve been in a space where they haven’t been able to be in control, and we don’t want to be replicating this in our support. We want to ensure that the person is able to make those decisions for themselves if they are able to in the moment.

And of course, if we think again about, module two, I think it was, when we were looking at why, violence happens to people with disability at such high rates, we, if we think about the ableism drivers, we would know that actually believing that people can’t make their own decisions is a key driver of violence against people who have a disability.

So respecting people’s right to make their own decisions and supporting them to do so is actually a key factor in helping prevent violence against people who have a disability. So we would like to thank you for joining us for module seven, and we hope to see you in module eight, where we’ll start, sharing some tips from the lived experience stakeholders around what it means to be a good support worker and a good organization.

We hope to see you there. Bye.