Staff Prompting (and Feedback)
After the initial training meeting, the clinician (and, again, the supervisor if the clinician is not the supervisor) should visit the staff with their participant group several times before the date of the follow-up training meeting. The primary purpose of these visits is to prompt staff efforts to change activities if necessary and to give feedback on any new activities observed. When new activities are observed that are in line with the guidelines for meaningful activities, staff should be commended for their efforts. If any new activities do not reflect improved meaningfulness, the clinician should discuss how the activities could be further changed, again using the guidelines as a template. Staff also should be queried about any additional plans for changing activities, with appropriate feedback provided about the focus of the planned activities.
The visits provide a number of opportunities to build on the training conducted during the initial meeting with staff. When the clinician visits directly with staff and their participant group, staff have the opportunity to ask questions specific to their group that they may have been reluctant to ask during the initial meeting with other staff present. Staff may also have questions that they had not thought about during the initial training meeting.
Another purpose of the visits is to demonstrate that changing to more meaningful activities will be a continued emphasis within the agency and the expectation is that the staff will be actively involved in the process. When staff know that the focus on providing more meaningful activities will persist, their efforts in complying with the expectation can be enhanced. Finally, and perhaps most importantly, the visits allow the clinician to reinforce staff efforts regarding desired activity changes they may see during the visits.
If the visits indicate that the staff are making progress in changing activities to more meaningful ones, then one or two visits between the initial and follow-up training meetings usually suffice. However, if staff are not making activity changes or the new activities are missing the mark, the clinician will need to become more involved in the change process. Specifically, more frequent visits to the group will be needed with specific directions provided to the staff about needed changes. When direct support staff are having difficulty following through on changes, a new activity or two may need to be demonstrated by the clinician (e.g., acting in the role of the direct support staff). In short, when desired activity changes are not observed during the time between the initial and follow-up training meetings, the participative aspect of the process diminishes to a degree and the clinician must take a more active role in directing the necessary changes.