There are lots of ways to think about what happens when you start counseling for mental health or behavior supports. However, one thing to keep in mind is that what you and your therapist are focused on will most likely change over time. When we break this change down we can see 5 different stages of therapy.
The first stage is relationship building.
When you start therapy you are meeting someone brand new. A therapist is there to be a guide and to help you discover your own goals and abilities. However, in order to do this effectively your therapist will need to find out what is important to you, and you will need to find trust in your therapist.
Relationship building can happen very quickly or it may take some time.
While we often want change to happen quickly, remember that taking time to build a professional relationship will create a strong foundation for the other stages of therapy to build on.
The second stage is assessment.
Sometimes we start counseling because we have a specific question or concern we want to address. Sometimes we start counseling because we know we just don’t feel right or we feel overwhelmed.
Either way therapists may need to do some assessments in order to fully understand what challenges you would like to overcome. Just like relationship building, these assessments might happen quickly or they may take some time. Taking the time to do assessments allows therapists to learn more about you and clarify what concerns and supports might be the best fit for you.
The third stage is goal setting.
Once you and your therapist understand each other and know how best to work together it is time to put goals down on paper.
The fourth stage is intervention.
This stage is normally the longest and where the majority of the work is done. Every individual is going to have a different experience during this stage because every individual wants and needs slightly different things.
Sometimes people meet their goals in a few sessions. Other times meeting goals can take several months. Each experience is okay!
There is no one size fits all therapy. As long as you are feeling supported and doing hard but important work, you are on the right track.
The fifth and final stage is termination.
Just as no feeling lasts forever, no therapeutic relationship lasts forever either. Maybe you have met your goals, maybe your therapist is moving locations, or maybe you are moving to a new chapter in your life. Maybe it’s time to work with a new therapist who can support you in a different way. No matter the reason, therapy relationships do come to an end. And that can be a very good thing! Even if you have more goals and more work you would like to do — ending a therapeutic relationship with your counselor can be a milestone that shows you just how far you have come!
It is important to remember that while all these stages should happen in therapy, they can often be hard to distinguish between. You might have two or three stages happen in the same session. You might also move back and forth between stages. Maybe after a period of time you need to set new goals, or your therapist might want to learn more about your life through another assessment. The five stages of therapy are a good guideline to help you understand what might happen when you start therapy — but guidelines aren’t hard and fast rules. What is most important is working together to see changes that matter to you!
Before we jump in…what is behavior analysis?
Behavior analysis is a term dating back to the early 1900’s marked by the famous and foundational research of B.F Skinner, Ivan Pavolov, and John Watson. While the ideas that have come from these brilliant minds paved the way for the work a behavior analyst does, we have also come a long way from the days of the Skinner Box.
In today’s world, a behavior analyst works with individuals experiencing behavioral concerns to help them navigate the world in a productive way. While the old techniques often included the classic mouse receiving a reinforcement for good behavior, the techniques used today are much more than that.
This includes working with both the individual and their immediate circle of support to address behavioral issues that adversely affect their quality of life. While it is still important to understand the reinforcers to encourage positive behavior change, it is also crucial to understand the ways in which environmental pieces influence those individuals behaviors as well.
What does a behavioral analyst actually do?
One on one with an individual:
As behavioral analysts, we work to assess behaviors and their function as well as impact on someone's day to day life. For more on behaviors and what they can be, jump over to our blog post What is a behavior?.
When assessing behaviors, we start with reviewing if they are occurring in a way that is more or less preferred. Less preferred behaviors occurring in an inappropriate environment usually lead to individuals and families to seek support.
After we have assessed the behaviors, using evidence-based assessment tools like the FAST Assessment and Functional Analysis tools, we create a behavioral support plan including positive behavioral interventions to assist them in navigating healthier coping mechanisms.
Through this process we work with the individual themselves to help identify the areas of their life that cause them distress or trigger the maladaptive coping mechanisms to come out. By identifying those situations we are able to work with them one on one to face these challenges head on. Through our one on one work we are also able to be proactive in identifying potential triggers. We are then able to practice with the individual methods for how to react in those situations before they come up as well as coping strategies for when they arise.
Behavioral intervention work takes time and there is no immediate solution to decreasing challenging behaviors, however consistency in positive reinforcement is a tool we use as clinicians to support the individuals we serve in adapting their behavior in a way that helps them have a positive quality of life.
With those who support an individual:
Through this process we also work with parents, guardians, friends, family members, co-workers etc. to teach them how best to remind individuals of their positive coping mechanisms.
Behavior Analysts will also work with those individuals in their common environments, like school or the workplace, to integrate both individual interventions and environmental interventions. We collaborate for a whole-person approach as behaviors are rarely caused by one precipitating factor, but rather a full life history of interacting with the world around you.
Learn more about Behavior Services and where we can help.
Choosing a vocational and career path can be overwhelming. Making a vocational goal with your DVR Counselor and support staff can be challenging. Individuals living with disabilities can work in most environments and reach their employment goals, no matter how big or small! Sample Supports Employment team can help everyone identify their vocational or employment goals, to reach stable and meaningful employment for every individual.
Customized Planning Meetings
Sample Supports Job Developer’s start every job search process with a customized planning meeting. This meeting will occur during one of the first meetings together with the Developer and individual.
Our staff ensure customized planning is a person centered process surrounding each individual’s goals. Job Developers will work directly with individuals to identify their personal long and short term vocational and employment goals.
Job Development Planning includes identifying individualized:
I have a big goal. How do I get there?
We support every individual to break down their employment goals into obtainable steps. Sample Supports will engage with every individual, long term, to ensure they reach their long term employment goals. Job Developers will help identify barriers and create short term goals to overcome barriers.
Barriers may include:
The Supported Employment team will develop individualized plans to help individuals overcome barriers and increase their independence in employment settings.
Job Coach Fading
Individualized job coaching helps each individual on the job overcome barriers, increase job skills and increase their independence. The amount an individual may need job coaching at their plan of employment is individualized and agreed upon by individuals and their support teams. Job Coach Fading Plans are created for every individual.
Job coach fading plans include:
Stability, independence and reaching goals!
Sample Supports Supported Employment team uses this individualized approach to help all individuals identify and reach their employment goals. Our team will develop long and short term goals with identified plans to help individuals increase their job stability and independence.
Learn more about our Supported Employment Program here!
Agencies like Sample Supports partner with the Colorado Department of Vocational Rehabilitation (DVR) and your local Community Center Board (CCB) to help individuals living with intellectual and developmental disabilities prepare for, obtain, and maintain meaningful community integrated employment.
Let’s learn more about the process and how to secure a competitive and integrated employment position in the community.
How to Get Started
An individual's employment journey often starts with working with their local DVR to identify their employment goals and identify a local agency/vendor they would like to work for vocational support. Individuals and their support teams must complete an application with their local county DVR office.
You can find your local DVR location and information at https://dvr.colorado.gov/about-us/contact-us.
DVR counselors and staff will assist you in the following:
If you work with your local Community Center Board (CCB), your case manager can also connect with Supported Employment teams, like the one at Sample Supports, to get you started!
There is an individualized referral process that focuses on each person’s strengths and abilities. Agencies like Sample Supports then create customized employment plans to secure a meaningful job opportunity for each individual.
I selected an employment agency. Now what?
Once you start working with your Employment team, your local Job Development Coordinator will begin assisting you in finding employment and reaching your employment goals!
As part of the job development process your Job Developer will:
Following the pre-employment process, your job developer will assist you in applying, interviewing and starting an employment opportunity specific to your employment goal.
Our Job Developers have many community connections and partnerships to help assist you in finding individualized and meaningful employment! Your Job Development Coordinator will assist you in your job onboarding process. They will help gather all the uniforms and supplies you may need and assist in communication with your new employer as needed.
What if I need extra help to be successful at work?
Job coaching is available!
Every individual’s needs are unique when it comes to meaningful employment. Sample Supports can provide individualized job coaching to assist individuals in building their skills and increase their independence in their employment opportunities. Our Employment team will work with all individuals to develop Job Coach Fading Plans aimed at identifying strengths of each person and goals to increase independence and job skills, while fading job coaching.
A job coaches role is to help you learn and perform your job duties. They work 1:1 with you in your place of employment to ensure job stability. Job coaches help with skill development including:
Your team will work together to fade job coaching as appropriate for your individualized needs.
Establishing Job Stability
Employment Managers, Job Developers, and Job Coaches will continue to work long term with individuals and their employers to ensure job stability. Our team will check in with employers regularly and offer assistance as needed for any issues that may arise. We individualize support to ensure each individual is supported in their long term, meaningful employment. We will work together to find every individual meaningful and stable employment!
Learn more about our Supported Employment Program here!
Disability Services in Colorado
While it is not perfect, Colorado has a strong support system for individuals with intellectual and developmental disabilities (IDD). In reviewing other state’s regulations and billing rates, you can see that our state holds value in ensuring individuals with IDD have a high quality of life equal to anyone else living in the community.
Accessing those services, however, can be a large puzzle where families or individuals independently get stuck and turned in the wrong direction. We wanted to share easy to follow steps on how to get started to ensure that you or someone close to you is able to access the care they need.
Here is how it works:
Currently, one of the most important tools within Colorado’s IDD system is the Supports Intensity Scale (SIS) Assessment. We say this because the state is working to replace this system in the future. The SIS is an assessment that occurs before you begin services and is aimed to identify the level of support you need.
Accurate information is critical here.
As a family member or close connection to an individual seeking services, you have to step back and think ‘what would these various life skills look like if I were out of the picture?’
Your goal is to show the level of support the individual needs to be successful. The SIS assessment is then utilized to identify the reimbursement rates for providers AND the amount of services an individual qualified for. This is never an easy meeting and is extremely personal. It is important to discuss this with the individual receiving services beforehand to ensure they understand this may be uncomfortable but it is critical to be honest.
Sample Supports offers a step-by-step list of how to get enrolled in services — click here — or give us a call if you need support!
With the state of 2020, creating and adapting to new ways of supporting and providing services to individuals in our services, we are bringing together the social and political pieces through education, support, and psychosocial support.
The IDD population often is one that is underserved or under heard when it comes to the Right to Vote. Individuals with disabilities often need support or guidance with finding and reviewing resources for political understanding and personal growth around candidates’ agenda points.
We are providing neutral guidance and support ensuring every individual in our care has the ability to access relevant resources, candidates, and general outlining themes related to each candidate’s agenda.
As most of us Vote for the candidate we feel will better our society, social economic crisis, social/emotional supports, and overarching global trends, we also want to ensure our individuals have the opportunity to review the same information in a way that is consistent with their preferred communication and comprehension styles.
ALL of us have not only the right to Vote, but the right to know WHAT we are Voting for.
We have taken on the following model to support in implementing this in our Residential and Supported Living Services (SLS) programs, with that goal that 100% of individuals will be registered and engaged in voting for the November 3rd election.
Additional Resources to Vote in 2020
What is a behavior?
We hear the term behavior used all of the time in the disability community, but what does that truly mean? We break down the meaning of behavior and how that fits within the common therapeutic models, like Applied Behavioral Analysis, that you see often when you get started in learning about behavioral intervention.
A behavior is defined as an action or skill needed to interact with the environment. Think about any action or skill that you may need to communicate with the world around you — that is a behavior! The term behavior is often used with a negative connotation, but removing that association can be helpful as you are working through the process of defining what behavior means.
A few examples of behaviors are:
The list goes on! Any action we engage in can be defined as a behavior. All behaviors typically have an appropriate environment in which they are preferred to occur. For example, speaking at a high volume is totally okay at a sports arena, but less preferred in a classroom or group setting.
When assessing behaviors, we start with reviewing if they are occurring in a way that is more or less preferred. Less preferred behaviors occurring in an inappropriate environment usually lead to individuals and families to seek support in learning how to adapt and cope with those behaviors.
Are behaviors positive or negative?
There are not many truly negative behaviors, but simply less preferred behaviors occurring in an inappropriate environment.
When thinking of behaviors that typically interfere with an individual’s ability to function in their environment, we often think of physical aggression like hitting or destroying property or verbal aggression like yelling or making hurtful comments. When framing these behaviors in an inappropriate environment, individuals may be limited in their ability to access that environment successfully as it can cause a risk to themselves or others.
Through the basis of behavioral intervention, we break down the behaviors an individual is experiencing, if the behavior is occurring in an appropriate or inappropriate environment, and what the behavior is seeking to communicate or access.
For example, punching a pillow in your room when you are feeling frustrated is a less preferred behavior occurring in an appropriate environment. The risk of harm to yourself or others is low and you are working through an expression of an emotion that you may not be able to explain. If you were to take the behavior of punching and place it in an inappropriate environment, say in the classroom or group setting, you are now facing a behavior that is inappropriate for the setting as it can lead to harm to yourself or others.
Once we identify the behaviors, it is all about discovering what the behavior is trying to communicate as well as what the desired outcome of the behavior is so we can work on replacing it with appropriate behaviors for the given environment.
What causes and reinforces behaviors?
Behaviors are a form of communication in which an individual is typically attempting to gain some level of reinforcement. Reinforcement can be access to a preferred item and activity or social interaction and attention. Remember that there are rarely negative behaviors. Oftentimes the individuals we serve engage in a behavior as it is an effective way for them to meet their needs as they are unable to do otherwise.
Imagine being unable to verbally communicate if you were feeling sad, mad, or hurt. You would adapt your behavior to find a way to express yourself to get the help you needed and sometimes that leads to big expressions of emotion that may be commonly referred to as negative or challenging behaviors.
Our goal in behavioral intervention is to reestablish the reinforcements of behavior to support more preferred behaviors in the appropriate environment to occur more frequently.
How does this fit within the context of behavior intervention?
Behavioral intervention serves to develop a stopgap to challenging behaviors occurring in inappropriate environments by building the individual’s toolbox of coping skills and alternative behaviors to meet their needs instead of accessing the challenging behavior.
Increasing the use of coping skills and more preferred behaviors in place of less preferred behaviors typically allow for individuals to have more successful interactions with those around them and their communities.
This process takes time and there is no immediate solution to decreasing challenging behaviors, however consistency in positive reinforcement is a powerful tool that we harness as clinicians to support the individuals we serve in adapting their behavior in a way that serves them more successfully.
Learn more about Behavior Services and where we can help.
There are many reasons to choose to open your home to an adult with intellectual and developmental disabilities. Maybe you are an empty nester and feel a bit lost without someone to take care of? Perhaps you are ready to give up the isolation of a 9-5 job for something that provides more flexibility and a meaningful connection? Or, you might have just realized that your skill set and personality type are perfectly matched for a caregiver position. There are a wide range of reasons people choose to become host home providers.
Meet Deanne. She is one of our Host Home Providers here at Sample Supports. We were lucky enough to sit down with her and find out just how special being a Host Home Provider really is.
Meet Erica! We were very excited to sit down with her and learn more about her experience as a Host Home Provider.
Meet Brenton! He is one of our most experienced Host Home Providers, and we were excited to hear his thoughts and feelings about being an HHP.
3 Ways You Can Start Working with People with Disabilities
It can be difficult to narrow down your options when you decide you’d like to start working with individuals with cognitive or developmental disabilities. That’s probably because there are so many follow-up questions -- do I need special training? How do I even start? Will it be costly to do so?
We understand, and we’re here to help.
The most important aspect of working with an individual with a disability is being willing to, as Jana Thomas put it, “let your guard down, set aside your clinical perspective and really get to know another human being who happens to have a disability.”
If you’re ready to jump in, we have three options to help as you get started finding the perfect fit.