Supported Decision-Making Service

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Supported Decision-Making Service for Persons with Disabilities | Service Model
The Human Rights Center for People with Disabilitis
Stages of support 2
The decision-making process consists of six stages: establishing wishes; gathering the relevant
information for making choices and decisions; understanding the different options available
including their advantages and disadvantages; making a choice; implementing the choice; and
evaluating the choice made and the additional choices currently on the agenda. The support
outline is affected by what stage of the decision-making process the person in question is in. We
describe the support in each one of the stages:
A. Wishes
The support process is predicated on a person's wishes and preferences, and therefore
it begins with exploring these wishes. At this stage, the person expresses a range of
desires, great and small. This stage is crucial for building trust and marks a significant
difference between a decision supporter and a care professional. The supporter may regard some
of the desires as unrealistic or problematic, but their role is not to judge or to express their opinion
about them, but rather to help the person realize their own desires, to present the difficulties and
challenges in the process, and to propose ways to overcome them. At the same time, it is important
to help the person clarify their wishes more thoroughly: is there another way of realizing the
objective which should be identified (for instance, a desire to learn to read in order to successfully
pass a test which may also be taken orally)? Is the desire their own or someone else’s (for instance,
a parent’s desire for their child to attend an afternoon class)? This exploration is part of the
decision-making learning process. One of the major challenges of support is that sometimes a
person finds it difficult to identify their desires. The supporter's role is to help them identify their
desires and become acquainted with the diverse options available to them.
Practical tools:
• Introductory and trust building meetings: many people cannot embark on the support
process and identify a person's real desires without becoming better acquainted with
them and their support environment, and without building trust with them. During
the pilot, several desirable features were identified for meetings with the supporters:
• Meet the person in a location that is meaningful for them (workplace, childhood home).
• Develop clear and open communication based on respect, honesty and no judgment,
both in verbal communications and in gestures and body language.
• Use the person's social circle of confidants or meeting individuals who play a
significant role in the person's life.
• Build relationships through shared activities.
• Mutuality – the supporter should be ready to learn from the person and welcome
mutual exposure.