Structure

Especially in care for people with an intellectual disability and people with autism, the main focus often is on structuring the daily routines and environment of the person. The structure may have different aspects.

 

A predictable structure of the daily routine

There is a strict and recognizable structure of the day and sometimes also of the week. Regular activities at regular moments. Often this structure of the day is supported by visual signs as pictograms indicating the activities.  

This kind of predictability is important for many people with a special vulnerability, especially people with autism. The less a person can trust his inner strength or the support of others, the more he needs support of predictability.

 

Predictability in regard to rules

In many groups there are a lot of rules a person has to stick to. When the person doesn’t act according the rules, usually this has negative consequences, like getting reprimands, not getting something he wants, or even punishment. 
The rules can be set with different motivations.

  • to make a person behave socially acceptable
  • to make a person respect social values and standards
  • to secure the amenity in the group
  • to have clear working conditions for the caregivers

 

Predictability in the posture of the caregiver

It’s important for every person to know what he can expect from others. The more you are depending on others for your daily quality of life, the more important this is. Therefore the caregivers should be consistent in their contacts with the people they serve.
In daily life this is often explained that all caregivers in a team should act the same way, and that when a caregiver once has taken a position, this will not change: ‘yes is yes and no is no’ and every colleague in the team should support this. Even when they know the position isn’t fully justified.

 

Compared with gentle teaching

Also in gentle teaching we know that every person needs some kind of structure and predictability. The need for structure is one of the eight basic values of Quality of Life.

 

From the perspective of gentle teaching, a structure in the form of a predictable daily routine  can be important and supporting for the person. But it should never replace, or be more important than, feeling safe and loved by others, and it should always be possible to change the program when you see the person wants something else. If you would always stick to the program, the structure is not supporting but suppressing. It will cause resistance and violence. If you need to force the person into the daily routine, it’s clear that it’s not the routine he needs, but probably the caregivers or the organization need it.

 

A structure that tells the person what he is supposed to do or not, is squeezing and disciplining, and is not in line with gentle teaching. Most rules are not because the special person needs them, but because the caregivers need them in order to have control over their work. Or the rules are an expression of social values and standards, or regulations of the agency, which have no meaning for the special person. This is not the kind of structure we want in gentle teaching.

 

Every rule, which has no meaning for the person, or that is difficult for the person to obey, is a potential point of conflict and can obstruct the development of a safe and loving relationship.

 

Of course in every community we need some rules to make sure everybody can feel safe. In gentle teaching we strongly plead to reduce the rules to a minimum. And when it’s difficult for a person to respect these basic rules, it is our responsibility as caregivers, to lead him in a safe and loving way through a difficult moment. In order to be able to do this, we first need to focus on establishing companionship with the person.

 

In regard to being consistent as a caregiver, this mainly has to do with being emotionally  clear and consistent. It is not important that yes is always yes and no is always no. When you are wrong and doing injustice to the person, it’s always better to admit it and to correct it. This is the only way the person will ever learn that he can trust you.

Also it isn’t necessary that all caregivers in a team act the same way. They are all individual persons and so they should be recognizable as individual. Most important is that each caregiver is emotionally consistent and clear towards the person: ‘I will never be angry with you and I will always feel loving towards you’. This is the kind of predictability a person needs most. In our actions we show this predictability by:

  • we never argue of fight with the person
  • our loving and supporting attitude is unconditional, so regardless what the person is doing
  • when the person needs our help, we always help him

 

Of course we can’t guarantee that we will always be able to be like this. We are humans and we may still be in the process of learning. Especially in the beginning we still may get angry or disappointed once and a while. For the special person it would be nice if we wouldn’t, but it is the reality of life. There is no need to blame ourselves for being like this, as long as it’s our intention to learn from these moments.

 

In whatever approach based on giving structure, it’s impossible to be emotionally consistent and neutral, because we focus on the structure instead of our emotional engagement with a person. As long as a caregiver has emotions, the person will feel them. So we better train ourselves in transforming negative emotions into positive, instead of trying to suppress our emotions and try to become robots.

 

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