Appreciative Inquiry as a method to increase capabilities of professionals to support adolescents with autism spectrum disorder in developing the life they value.
Teunisse, Jan-Pieter; Jansen, Erik (2016). 'Appreciative Inquiry as a method to increase capabilities of professionals to support adolescents with autism spectrum disorder in developing the life they value.' Paper presented at the annual conference of the HDCA, Tokyo 2016.
abstract Introduction Treatment and care for people with Autism Spectrum Disorder (ASD) is often characterized by an interventionist approach focusing on the problems in daily functioning. Such an approach tends to overemphasize the ASD as a disability rather than a condition of human diversity. While in practice this may often be adequate to support people with ASD in dealing with concrete problems in their functioning, it also bears effects of (self-)stigmatization and imposes a perspective of deprivation rather than development and human flourishing. The present study aimed to develop a multi-organization network partnership in which the care perspective is shifted towards creating realistic opportunities and enabling individual agency for adolescents with ASD in the course of their life-span. This entailed changing the balance in each organization's approach from a specialized focus on functionings to more emphasis on the capabilities of clients from a shared integral perspective. Thus, the project consists of a substantive component but also an organizational change component. To pursue this double purpose, an action research approach (Appreciative Inquiry, AI) was deemed most appropriate. Method and process Two teams of an autism treatment center (Dr Leo Kannerhuis, Doorwerth) and one team of a supported living service (RIBW Arnhem & Veluwe Vallei, Oosterbeek) participated in the project. A researcher of HAN University facilitated the AI process, which consisted of 4 full-day meetings spread over a year (2015) in which the steps of the 4D model were followed: Discovery (what is the best of what is?), Dream (envisioning what could be), Design (what should be the ideal organization?) and Destiny (how to learn, empower, execute and improvise) (Ludema & Fry, 2008). As the positive core for the AI process, the following theme was defined: “self determination and collaboration as a basic assumption for the adolescent with ASD… and for ourselves”. In the first meeting, only the professionals were present, in the following meetings the adolescents with ASD also had an active role. At the start of the project, the organizations chose Person Driven Planning (PDP; O’Brien, 1987; Sax, 2002) as their shared methodological approach for decision making. Evaluation of the project was both on descriptions of the new trajectories in treatment and support (including duration and costs) and on focus group information of respectively the adolescents with ASD and the professionals of both organizations. Results and conclusion The AI process succeeded in creating a shared perspective on how network collaboration between the treatment center and the supported living service can contribute to the lives the adolescents with ASD value. Both professionals and adolescents with ASD were positive about PDP as this approach focused on the adolescents' capabilities and the beings and doings they realistically value rather than on their problematic functioning according to a normative standard defined by able persons. By taking capabilities as a starting point, the organizations changed perspective from individual-focused care and treatment to contributing collaboratively but substantially to the adolescents' support network alongside family, friends and formal community support. This resulted in the adolescents with ASD generally being more motivated to set and work on their personal goals with the professionals. Thus, the personal network support offered by the collaborating organizations effectively enhanced clients' agency by providing them with the opportunities to pursue the life they have reason to value. The AI participants selected instruments for monitoring the relationship with the adolescents and facilitating the communication of the support network. Based on the outcome of the action research the organizations decided to develop and extend the network approach to other teams in the organizations and to other partners that are involved in the support of the adolescents with ASD. On the basis of the findings we conclude that the participating organizations have successfully taken initial steps in developing a shared capability-focused approach in which adolescents with ASD are actually supported in pursuing the lives they have reason to value.