Supported Decision-Making Service

Supported Decision-Making Service for Persons with Disabilities | Service Model

The Human Rights Center for People with Disabilitis

4. Dilemmas that arose during the pilot

Supporters came across many dilemmas during the pilot. We believe these dilemmas are

educational for future support schemes. There are no textbook answers to these dilemmas,

and there is usually a range of solutions that need to be explored according to the particular

circumstances of each case. Therefore, there is value in raising supporter awareness of these

dilemmas and discussing them during the training:

a. Dilemmas concerning the relationship between the supporter and the supported person:

• Issues with establishing contact: the person forgets meetings with the supporter, the

person is habitually late for meetings, does not answer the supporter.

• Supporter/person relationship crises or trust building failure.

• Difficulties on the part of the supporter to communicate with or understand the person.

• Establishing boundaries within the support process (whether to provide cell phone

number, whether to accept an invitation to see a performance together etc.).

b. Dilemmas concerning the support itself:

• What level of support should the supporter give? Should the supporter take a proactive

approach to support? Is it legitimate for a supporter to try to speed up processes?

• How to deal with a process that remains stuck without progress.

• To what extent should the supporter represent the person to external actors?

• To what extent should the supporter state their personal opinion during the support

process?

c. Dilemmas concerning the person receiving support:

• Health conditions affecting the process, such as psychiatric hospitalization.

• What happens when the major change required concerns an internal change within the

person (motivation, anxiety, etc.) and veers toward therapy?

d. Dilemmas concerning the people in the supported person’s circles:

• Tension between the person and the people in their circle (objection to a decision, over-

involvement, lack of trust).

• Tension between the supporter and the people in the supported person’s circles.

e. Dilemmas concerning the supporter

• Frustration and attrition over the course of the process.

• Lack of faith in the person receiving support and in the process.