Once the involvement of executive personnel and front-line supervisors is obtained by the clinician, the actual training and supervision process for changing a center’s activities from nonmeaningful to meaningful can begin. The process involves an initial training meeting with direct support staff, staff prompting, a follow-up staff training meeting, and ongoing provision of feedback.

Initial Training Meeting With Direct Support Staff

Just as in the meeting with front-line supervisors, the initial training meeting with direct support staff should begin with an explanation of the rationale for changing to more meaningful activities. The meeting should be conducted by the clinician and the staff supervisor (if the clinician is not the supervisor). Next, the difficulty that is often encountered when attempting to distinguish between meaningful and nonmeaningful activities should be acknowledged. The guidelines should then be presented as a way to assist staff in making the distinction. A written handout listing each of the guidelines along with multiple examples of both meaningful and nonmeaningful activities associated with respective guidelines should be provided to each trainee. This can be the same handout used during the clinician’s previous meeting with the front-line supervisors. Each guideline should be read aloud by the clinician along with the accompanying examples of meaningful and nonmeaningful activities.

Once the guidelines have been explained and examples have been discussed, staff should be asked to openly discuss the activities occurring with their respective participant groups and to decide which activities are nonmeaningful and should be changed. Ideas for more meaningful activities should be generated at that point, using the guidelines to help focus the ideas. If more than one staff member is responsible for the same group of individuals, they can work together to accomplish this part of the training.

It can also be helpful to provide staff with a worksheet to guide them through the task of identifying and replacing nonmeaningful activities. The worksheet should be structured to identify each (nonmeaningful) task to be changed and what new (meaningful) task will replace it. When trainees correctly identify an activity as either meaningful or nonmeaningful, their contribution should be praised or otherwise commended by the clinician. If a trainee’s example is a misapplication of a guideline, the clinician should reiterate the elements within the guideline that are relevant and give a correct example. At some point during the discussion, it should be noted that the guidelines should function only as a guide and there may be exceptions in their application with specific individuals (see previous discussion in chapter: An Evidence-Based Protocol for Improving the Meaningful Utility of Center-Based Activities).

The reason for promoting active involvement of direct support staff in generating ideas for activity changes is several-fold. Most notably, direct support staff are usually the most knowledgeable about the training needs and activity preferences of individuals in their respective groups. As a result, they are in the best position to know which new activities will likely be successful with their groups. Additionally, this type of a participative management approach usually enhances staff receptiveness to making the desired activity changes relative to an approach in which the clinician dictates what changes should be made (Reid, Parsons, & Green, 2012, Chapter 3).

Immediately prior to completing the initial training meeting, staff should be directed to begin planning changes in activities with their participant group. A date should then be set for a follow-up meeting, usually about 2 weeks after the initial training meeting. Staff should be informed that the purpose of the follow-up meeting will be to discuss their progress, any concerns they have, the need for additional materials, and to set a subsequent date regarding when the new activities will begin with their respective group.

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