Traditional versus Person Directed Approach:

  • An important aspect is that person centered planning often requires that community agencies be fully engaged with their community and local services in order to ensure that the person is fully integrated into their community of choice in a way that is meaningful to them.
  • As such, the process differs considerably from traditional service planning approaches where each agency typically provides only those services within its mandate and does not concern itself with service deficits outside its own mandate.
  • Some of the distinctions between traditional service planning and person centered planning are detailed in the table entitled: Traditional versus Person Directed Approach, below:
Traditional ApproachPerson Directed Approach
Self-determination comes after individuals have successfully used treatment and achieved clinical stabilitySelf-determination and community inclusion are fundamental human rights of all people
Compliance is valuedActive participation and empowerment is vital
Only professionals have access to information (e.g., plans, assessments, records, etc.)All parties have full access to the same information – often referred to as “transparency”
Disabilities and deficits drive treatment; Focus is on illnessAbilities/choices define supports; Wellness/health focus
Low expectationsHigh expectations
Clinical stability or managing illnessQuality of life and promotion of recovery
Linear progress and movement through an established continuum of servicesPerson’s chooses from a flexible array of supports and/or creates new support options with team
Professional services onlyDiverse supports (professional services, non-traditional services, and natural supports)
Facility-based settings and professional supportersIntegrated settings and natural supporters are also valued
Avoidance of risk; protection of person and communityResponsible risk-taking and growth
Traditional versus Person Directed Approach
Tondora, 2011

Cultural factors, including religion, beliefs about mental illness, its etiology, and its acceptability, views regarding a person’s right to make choices as opposed to having those choices made for oneself, to name just a few, can substantially impact on the planning process, services received, and recovery process. In addition, the impact of past traumatic events relating to race or gender for example including stigmatization as a result of mental illness or previous unsuccessful service experiences can contribute negatively to trust building and engagement. Language barriers can also have a profound effect on ability to communicate the many important facets of a person’s life and background. All these factors impact on the planning process.

Listen carefully to what the person is saying and perhaps not saying!

  • Past difficult or negative encounters with health care professionals and systems can impact people’s willingness to engage with services. For example Indigenous peoples may mistrust and avoid seeking health care services due to both historical and current negative experiences leading to poor health outcomes. Other examples of negative encounters could be going into hospital and not being provided care in a way that the person finds helpful or relevant to their life circumstances.
  • Recovery services are provided within a trauma informed lens as it is expected that many people including people receiving services have been traumatized. Trauma not only impacts physical and mental health but can impair functioning, reduce opportunities to participate in activities  and damage trust leaving it difficult to form relationships and seek help.  Some individuals may have experienced significant trauma and may need additional support from specialized services to help them continue to access services and or be successful in their recovery journey. see: https://trauma-recovery.ca; https://cewh.ca/wp-content/uploads/2012/05/2013_TIP-Guide.pdf
  • LGBTQ+ individuals may also have experienced discrimination due to insensitivity lack of cultural humility, and stigma (to name a few factors) and exclusion from services and therefore may have significant unmet needs
  • There are many cultures in which young people or women do not ordinarily make decisions or choices for themselves but defer to the wishes of their elders. Sensitivity to individuals from backgrounds that differ from what might be considered the mainstream is essential if steps toward person centered planning and services are to be taken. 
  • In such cases, greater attention to family beliefs and preferences should be considered primary while attempting to involve the individual to the greatest extent possible and facilitate planning, service delivery, and ultimately recovery on the person’s and family’s terms. In all cases, the person’s wishes about culturally-influenced choices must be respected.

To learn more about cultural safety and humility, please visit https://www.fnha.ca/what-we-do/cultural-safety-and-humility 

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