Interdependence in Action: A New Focus for Old Programs

John F. Murphy Homes, Inc.

Supporting individuals with intellectual and developmental disabilities and Autism has been the mission of John F. Murphy Homes, Inc. (JFM) for more than 33 years.  Priding themselves in delivering progressive services, JFM has developed a niche for providing safety and security to those who struggle with significant behavioral challenges.  For a decade, its services focused on keeping people busy with leisure or lower level “work” activities and behavior modification interventions, for those who needed it.  Helping people connect with each other and the community was not the primary goal.

More recently, however, JFM’s services have begun to shift from providing stability, to helping people thrive. This was the first step for the organization in taking a long, hard look at its services.  How would it need to change the way it does things so that the people supported could make better and deeper connections?  What information and skills did staff need to obtain?  Were there ways JFM could modify the planning process to help create the outcomes they desired?  Learning how to support people to move beyond very real barriers toward authentic engagement with the community became its mission.

Taking from new developments in Positive Psychology and Neuroscience and older theories like Maslow’s Hierarchy of needs, JFM began to take a very holistic approach to social capital.  They realized that a great many of the people supported had had difficult and often traumatic experiences.  These have led not only to behavioral challenges, but difficulties with developing relationships as well.  JFM began to look at how it could help shore up peoples’ physical, emotional, social and spiritual foundations to increase their capacity for relationship building. 

JFM’s first step was to look at sleep, nutrition and exercise.  Is each person getting 6-8 hours of good sleep a night and, if not, what types of support might be needed to achieve that?  Are they eating a variety of brightly colored fruits and vegetables to improve their nutrition?  Does everyone get outside in the sunshine for at least 30 minutes of healthy activity each day?  These three areas provide an important foundation for good physical and mental health. 

The next step was to assess whether a person has the skills to self-soothe when a situation becomes stressful.  The traumatic experiences that many people with disabilities have experienced have sensitized them to stress, making them more likely to over-react or withdraw.  Daily exercises in relaxation and mindfulness help increase the ability to maintain emotional balance—a prerequisite for developing and maintaining positive relationships.  Gratitude journals help teach the skill of focusing on the positive and the things that are good and enjoyable, counteracting the brain’s propensity to focus on the negative.  Providing these types of trauma sensitive interventions teach positive coping skills and widen the door of relational opportunity.

JFM’s third step utilizes the VIA Character Strength assessment (www.authentichappiness.com) to determine a person’s top five character strengths.  This assessment is lengthy and not every person will have the attention span or the intellectual skills to  comprehend all of the questions in the assessment.  In these circumstances, the Person Centered Planning Team assists by reviewing the list of 24 strengths and determining together which strengths best describe the person.  Determining each person’s character strengths has had a profound effect on the planning process.  Often, services at JFM had been so focused on changing interfering behavior that we have failed to appreciate the strengths each person possesses.  It has helped the organization make shift the focus on to how capable people are rather than what they need to change.  Once character strengths are identified, they consider the person’s interests and passions.  Combining strengths and passions has provided new ideas and inspiration for where and in what capacity people might connect with the community. 

The ultimate goal has been not just to get people involved in the community, but to look for ways to help them gain a new role. JFM looked for opportunities for their people to serve or volunteer, not as an end in itself, but as a way to contribute to others.  When people serve, their value increases in the eyes of others, moving them from a burden to someone capable of contributing.  In addition, the person gains the opportunity to experience the joy of giving, something we have often robbed them of in our role as service providers.  For a very long time, people with disabilities have been recipients of services, but have not been given the opportunity to reach out and give of themselves to help others.  Engaging people and the community in this way has led to some surprisingly wonderful outcomes. 

Through reflection and honest dialogoue about their services, JFM has began to change the culture of its organization.  Here are a few stories of how this looks like on the individual level:

Tracy struggled most of her life to find her way in the world.  Difficult/traumatic experiences coupled with intellectual challenges made coping with life more than she could handle on her own.  However, finding supports that could keep her safe and provide stability proved nearly impossible for almost 40 years.  But all of that changed 10 years ago when JFM. began supporting her.  A very structured, behaviorally based program provided Tracy with what she needed to find stability.  Healing, however, was illusive. 

Tracy loves to cook and enjoys children.  In the past, her personal challenges got in the way of pursuing these passions, but focusing on her strengths rather than those challenges changed everything.  Tracy began meeting with a friend weekly to work on making blankets, which they then delivered to the Ronald McDonald House for the families who reside there while their children receive medical treatment.  The feelings she experienced helping children in this way were new and positive.  Then Tracy cooked a meal for the families and began bringing baked goods to daycare centers, nursing homes and a local mission.  Within 6 months of beginning these new activities, Tracy no longer needed a gait belt to keep her from falling or a helmet to protect her if she did fall.  And the number of days life overwhelmed her coping skills decreased by half.  Tracy still needs a high level of support, but the impact of giving to others and focusing on what is good in her life rather than what needed to change has enhanced her life far more than the previous 10 years of behavioral interventions.  Engaging with her community has not only increased her social capital, but she has experienced both the physical and emotional benefits from finding her purpose and giving to others. 

Steve is personable and loves to learn and has a passion for history.  He used to take walks through cemeteries and do rubbings of the headstones, but it didn’t help him make any new friends or give him a sense of purpose.  In the past, our focus on ameliorating his intractable mental health issues clouded our ability to appreciate his humor, creative problem solving and people skills.  Now, he is a member of the historical society in his town.  He attends meetings and helps put on fundraisers.  It has given him a sense of belonging and his meaningful contributions the society are valued by the other members. 

Changing the culture at JFM has not come quickly or easily.  It has and continues to be challenging to identify the best way to implement change.  Training the 450 professionals who provide support in the residential services program is a big job, especially with ongoing budget cuts.  And they continue to wrestle with how best to teach staff the practical skills needed to help people make meaningful connections in the community.  But the successes JFM has had the privilege to witness and the contributions that have begun happening keep them pressing on to create more relational, strength-based supports that help people connect more deeply with their community.