Over-arching category 1 - Access to individualised funds enabled practical and psychological benefits to consumers
Review of 183 statements from the consumers’ action plans and speeches data, independent evaluators’ interview data, Guides’ reflection data, and financial data indicated that access to individualised funds provided practical and psychological benefits to consumers. Over-arching category 1 was established on two subcategories. These included the: 1) costs and types of recovery activities procured; and 2) the impact of having access to individualised funds.
Consumers’ action plans and financial data showed that a wide range of recovery resources (goods and/or services) were planned for procurement with the use of the individualised funds (Table
4). These activities spanned across consumers’ whole of life needs and were valued by them as being important for their recovery.
Table 4
Types of recovery resources that consumers identified for procurement on their action plans and/or procured
Developing skills and/or knowledge (e.g., getting a license or education and attending courses to learn to use computers, photography, massage, and painting) | 26% |
Purchasing equipment (e.g., computer, camera, gardening, kitchenware, TV antenna, and paint) | 26% |
Joining a group for social, health and fitness, and recreational purposes (e.g., dating sites, social groups, gymnasiums and health and fitness centres, model building clubs, and photography clubs) | 21% |
Developing aspects of ‘the self’ by doing courses (e.g., communication, confidence and assertiveness skills), securing counselling services for themselves and/or family members (e.g., individual or family counselling), and/or joining groups that could assist with discovering their heritage | 16% |
Taking time out (e.g., holiday, trip for fun and/or socialising, and enhancing connections with family who live overseas) with and/or without family | 7% |
Attaining certifications (e.g., first aid, working with children check and National Police Clearance) | 3% |
Other (e.g., securing a sitter to watch over dependents) | 1% |
The independent evaluator’s staff interview and nine consumers’ (denoted by C) speeches data showed that access to individualised funds was highly valued as it enabled consumers to procure resources important for their recovery that for many may not have been achievable without the funds. These consumers reported gaining practical benefits from having access to individualised funds, as highlighted in these statements:
“…started [study] in Aged Care…may achieve…academic ambitions sooner!” (C3)
“..thanks to individualised funding…doing an online course on computing…recapture and improve… skills…given me…opportunity…” (C4)
“…the funding…helped…[purchase] a bike…ride three times a week…” (C9)
These consumers also revealed that their motivation and feelings of self-worth and hope (for themselves or their children) were facilitated from having access to individualised funds, as stated:
“…being trusted with the money meant a lot…” (C1)
“…individual funding…confidence, self-discipline and self-esteem of…children…me… helped…” (C5)
“…the money to…return to the workforce…changed my outlook, wellbeing…helped me to take another look at life…join and participate in life…instead of hiding from it…” (C6)
The independent evaluator’s interviews and the Guides’ reflections data revealed that some consumers experienced initial challenges in managing their individualised funds. A few consumers did not keep receipts to effectively reconcile expenditure, purchased resources (e.g., incidentals) not identified on their action plans, and/or did not seek to gain value for money (e.g., choosing the most expensive). The Guides worked with these consumers to develop effective budgeting practices. Consumers were engaged to understand the value of keeping receipts and/or learn how to gain value for money when procuring recovery goods and/or services. They were also engaged to pay back money for expenditure that had occurred beyond action plan goals and/or learn how to manage limited money to procure expensive resources (e.g., using half of the individualised funds and half from other personal income). Some consumers from groups two and three had experienced disappointment at the beginning of service when they did not receive funding allocated amounts that they had expected. These consumers’ expectations had been formed from conversations that they had with consumers who had undertaken the SPS service before them. A few consumers also felt pressured to finalise their action plans within the specified time periods (e.g., before the end of the financial year) that had been established to assure the availability of funding. In these circumstances, the Guides worked with consumers to manage their disappointment and/or feelings of stress. Despite these initial challenges consumers seemed to encounter experiences that were beneficial to them, their families, and potentially their community, and these are discussed fully elsewhere [
28].
The Guides’ reflections and consumers’ financial data showed that the expenditure of the individualised funds, despite some initial challenges, was managed well by all consumers. At the time of the study, although total allocated individualised funds of all consumers amounted to $76,859, total expenditure across consumers remained modest with approximately $52,000 being spent. This modest spending seemed related to some consumers delaying the implementation of their action plans due to unpredictable events (e.g., ill-health, delay in accessing their money, and/or residential challenges) or most consumers learning and/or practicing effective budgeting as highlighted in these statements:
“…opened separate bank accounts…money…easier to keep track of…” (C1)
“…proud of my budgeting…only bought what’s on…action plan…kept…receipts” (C8)
Over-arching category 2 - Consistent contact in shared management and person-centred relationships enhanced the provision of timely and meaningful staff support to consumers
Overall, the support received by consumers, from working in shared management and person-centred relationships with the Guides, seemed essential to their recovery experiences that are fully discussed elsewhere [
28]. The independent evaluator’s consumer interview (denoted IE C INT) and ten consumers’ action plans, questionnaires and speeches data indicated that the Guides’ and others’ support was highly valued. This support seemed to facilitate consumers’ self-direction of services and/or management of life demands, despite some consumers feeling uncertainty prior to beginning the SPS service, as highlighted in these statements:
“…support received helped participants to clarify what they wanted to achieve not only in the project but in their life as a whole.” (IE C INT)
“…participants found strength to continue on due to the support they received.” (IE C INT)
“It takes a bit of getting used to all this freedom of choice… feel like I am listened to…supported with what I want to achieve…Guide support has been great…helped me plan my goals…kept me on track…when it got hard.. helped me think of ways around things” (C1)
“…thought this was just going to be the same as other [services]…was very different…huge support network…facilitators, the Guides, and support worker. Without this support I would not have got through it....” (C9)
Over-arching category 2 was developed from 516 statements that revealed 1,891 descriptors, which were shared across four subcategories (second tier). The four subcategories (second tier) were: 1) who provided support to consumers; 2) the nature of support interactions; 3) the type of support provided; and 4) engagement of other support activities. The nature of support interactions was underpinned by three subcategories (third tier) including: 1) consistency in contact; 2) direct contact; and 3) attuned and responsive support. The type of support provided was established on two subcategories (third tier) including: 1) practical support; and 2) emotional support. The engagement of other support activities was established on two subcategories (third tier) including: 1) facilitating connections between consumers and others; and 2) managing aspects of the service.
The Guides’ reflections and/or meeting minutes, the independent evaluator’s consumer interview data and data relating to hours of support provided indicated that a range of people supported consumers. The Guides provided the strongest support to all consumers. The consumers also had access to support from family, friends, support workers, PCP facilitators, and health care professionals and groups in the community; however this could not be fully explored due to the limits of the data.
The nature of the support provided to consumers by the Guides involved having consistent contact with them and being available to them during and outside business hours. In this, the Guides provided regular direct contact for a number of reasons. They met (mostly) or spoke over the phone (occasionally) to discuss and/or self-direct (e.g., take actions) service or recovery activities (e.g., budgeting, SPS service related questionnaires, preparing job or course registration applications, preparing speeches, etc.…), celebrate successes, and/or work through challenges. All consumers received the most consistent and direct contact from the Guides during their weekly visits where they worked together to develop and/or begin the implementation of their action plans. On average, the Guides provided 5.5 hours of direct contact to each consumer every week for the duration of the SPS service; but this varied across consumers dependent on their needs. In times of high stress (e.g., loss of a loved one, going through surgery, or recovering from an accident), throughout the entirety of the SPS service, the Guides increased their contact with consumers as needed. The Guides also provided one consumer regular and strong levels of support for the duration of the SPS service. The contact between the Guides and a few consumers from the first group continued after they had completed the SPS service.
The data also showed that the Guides (denoted G) provided attuned and responsive support to consumers’ needs. In this, the Guides, working in shared management and person-centred relationships with consumers, maintained awareness of consumers’ unique needs, openly discussed challenges, celebrated achievements, and facilitated and empowered consumers to make their own choices and decisions along their recovery journey. Throughout the SPS service, the Guides’ attuned and responsive support seemed to enable consumers to address and work through various challenges and develop solutions that met their unique needs.
The data also showed that the types of support given by the Guides included both practical and/or emotional, as highlighted in these statements:
“Reunion planning…reflecting on Consumer 3’s journey…help…put together…story.” (G)
“Support…encouragement to Consumer 3 to [manage]…issues with oldest son” (G)
“Attended counselling session with Consumer 6…” (G)
“Spoke to Consumer 15 about…being honest…in regards to [their] wellbeing.” (G)
Practical support involved the Guides working with consumers to access to recovery goods and/or services. This ranged from researching and sourcing recovery resources (e.g., equipment), attending appointments and developing documentation (e.g., job applications or speeches). This also involved navigating through Internet sites (e.g., employment or community service sites), and learning strategies to manage interpersonal conflicts, personal challenges, and/or budgeting responsibilities. The Guides also provided consumers with general and specific emotional support. General emotional support involved validating experiences and/or talking through challenges. Specific emotional support provided to consumers involved encouraging them to take action, praising them for their achievements, and/or reflecting with them on the impact of particular successes and/or challenges. Most consumers’ speeches data showed that this support was essential to their recovery journey, as stated:
“…guide support has been great, because [Guide] helped me plan my goals and kept me on track…encouraged me when it got hard and helped me think of ways around things.” (C1)
“When I haven’t known how to handle a situation with the boys, I air it with my [Guide] …they not only validate how I feel but also offer me different tactics to approach the situation.” (C3)
The data also showed that as consumers progressed through the SPS service, most became self-reliant and less reliant on the Guides’ support. Three consumers needed less support than others once they started implementing their action plans. Most consumers, as they became familiar and/or more confident in pursuing their recovery goals (e.g., sourcing and procuring recovery resources, attending appointments and/or budgeting), became more self-sufficient. As consumers’ capacity to self-direct services grew, the Guides provided less support (e.g., home visits, attending with consumers organised meetings such as PCP reunion meetings, events/appointments), gradually moving from weekly to fortnightly and then monthly contact. In doing this, they responsively and consciously worked towards developing consumers’ autonomy, as highlighted in these statements:
“Started withdrawing…hands on support [to Consumer 3]… [as they are] managing quite well” (G)
“Encouraged Consumers 8 to problem solve… [generate] options… did not jump in and fix…” (G)
“Got Consumer 13 to do her own research on prices” (G)
In reducing support to consumers, the Guides engaged in other support activities. This involved them communicating regularly with support workers, and others within (e.g., family) and outside the services (e.g., community professionals and/or organisations). This was done to enhance others’ awareness of consumers’ needs and facilitate connections between them and the consumers. The Guides also managed service aspects to support both the consumers’ and the service provider’s needs (e.g., facilitating the timely allocation of funds, reconciling expenditure, building strong inter-service network connections and relationships for consumers potential use). The other support activities, provided by the Guides, optimised consumers’ chances to achieve their recovery goals, as highlighted in these statements:
“Spoke to support worker …helped…identify… training needs.” (G)
“Got support worker to focus…on [developing] literacy skills with Consumer 1.” (G)
“…working with coordinator and family to have Consumer 4 reinstated into…” (G)
“Worthwhile…to ‘bulk buy’…better discounts…stretch…money further.”(G)
Over-arching category 3 - High quality shared management and person-centred relationships with staff and the opportunity to self-direct services enabled consumers’ change and growth
Over-arching category 3 is highly related to, but independent of, the previous over-arching category in that it emerged from the process of interaction, which occurred via the consistent and direct contact that took place between consumers and the Guides. The Guides’ reflections and the independent evaluator’s consumer interview and report data revealed a total of 1,304 descriptors, developed from 684 statements. This over-arching category was formed from two subcategories (second tier) that included the 1) consumers’ characteristics; and 2) the Guides’ characteristics. These two subcategories were developed from subcategories (third tier) that were initially coded as a range of person related characteristics (Table
5). The data suggested that the interaction of person characteristics between the consumers and Guides, while they engaged in shared management and person-centred relationships, seemed to enable high quality relationship encounters and enhance consumers’ self-direction and recovery experiences that are fully discussed elsewhere [
28].
Table 5
Consumers’ and the guides’ person characteristics that enabled high quality relationships
Courage and commitment | 16 | 160 | Awareness, knowledge, and ability to educate | 5 | 181 |
Awareness, flexibility, and initiative | 16 | 118 | Support and contribution | 8 | 170 |
Honesty and openness | 13 | 105 | Initiative and commitment | 3 | 156 |
Sense of humour | 6 | 13 | Honesty, courage, and openness | 3 | 150 |
Loyalty and compassion | 3 | 9 | Encouragement, guidance, and/or the ability to develop effective strategies | 6 | 121 |
Sensitivity | 6 | 71 |
Total descriptors
| 455* |
Total descriptors
| 849* |
Consumers’ characteristics were developed using the independent evaluator’s interview and report, the Guides’ reflections, and the consumers’ questionnaires and speeches data. The Guides’ characteristics were developed using the independent evaluators’ interview, the Guides’ reflections, and some consumers’ MIC questionnaires and speeches data.
All consumers’ showed some or many of the characteristics outlined in Table
5. These seemed present in their behaviour and ways of thinking while they were self-directing their services and recovery. These characteristics seemed to support them to achieve their recovery goals and develop their capacity to self-direct, as highlighted in these statements:
“…get myself into bad situations when I get…angry…really want to change…” (C1)
“…agreed to do the [SPS service]…was excited…anxious…uncertain…found out more about me…my world is opening up… (C3)
“…was a bit hesitant…thought…just…the same as other programs…realized…was very different…helped me…think about a positive new life for me and how to get there. (C9)
“…was scary… made me feel like I wasn’t alone…learnt…to make conversation…that it is okay to set goals and dreams.” (C10)
“…found it very strange…hard…finally clicked…made sense…could see others seeing me in a different light…slowly started to believe in myself…see myself as worthy......have a purpose, a journey to partake.” (C14)
More specifically, consumers’ openness to look at themselves and their flexibility and courage to attempt and engage (even when lacking confidence or certainty) new learning when having to self-direct services and resolve challenges supported them. They learned and/or experienced themselves and/or others in new or different ways. Their willingness to engage in new learning (e.g., ways of thinking and acting) provided them insight into their strengths, successes and limitations. These experiences alongside the support from the Guides enabled them to stay motivated to persevere (despite some initial negative feelings and/or struggling at times). The Guides’ characteristics (Table
5) seemed to enable them to become and/or stay mindful of consumers’ needs, and empowered them to provide effective shared management and person-centred relationships and timely, attuned, and responsive and meaningful support, as highlighted in these statements:
“Spoke to Consumer 1 [about]…loss of motivation at the moment due to ill health.” (G)
“Supported Consumer 2 through family crisis.” (G)
“Praised Consumer 6 [for their] efforts to address this” (G)
“…honest conversations, creating trust…reiterating Consumer 7 will not let us down.” (G)
“…not a one size fits all…some…needed extra support…other[s]…self-drive…minimal support” (G)
More specifically, the Guides’ provision of support to assist consumers to self-direct seemed enabled by their personal characteristics. The Guides’ initiative and commitment enabled them to provide timely encouragement and guidance that supported consumers. Their awareness and ability to educate consumers on strategies that might be helpful to them, and communicate with honesty, courage, and openness enabled them to provide meaningful support. This was balanced with the showing of sensitivity, respect and understanding towards consumers. This allowed for consumers’ lived experiences (e.g., challenges with services and/or life) to be discussed, and for them to experience effective support to achieve self-direction and progress their recovery journey at a pace and in a manner that met their unique needs.
In the shared management and person-centred relationships, the consumers’ and Guides’ person characteristics seemed to interact in an attuned manner and complement each other. This attuned interaction appeared to create a safe and trusted working space that enabled for high quality interpersonal relationship experiences. In these relationships, consumers encountered new or irregular experiences, including feeling respected, valued, understood, and trusted. This promoted, at varied levels, their feelings of happiness, confidence, worthiness, and self-pride and enhanced their self-direction and recovery experiences, fully discussed elsewhere [
28], as highlighted in these statements:
“…Guide…great…helped me plan…kept me on track…” (C1)
“… [staff]…guided…showed..[.us] we are valued…discovered things about me that I couldn’t see…” (C2)
“… [outcomes] come....from…respect, understanding…support… received from [staff]…” (C3)
“…proved…people…care about my future…willing to help…never happened…in my life…” (C8)
“…staff helped…encouraged…believed in me…all the way…provided… the tools… to get out of that hole…filled me with confidence…can’t thank them enough.” (C9)
These three over-arching categories (first tier), and related subcategories (second and third tiers) have been reported separately for the purpose of the study; but constant comparisons during coding and analysis revealed that these categories and subcategories were inter-related. These results showed that access to individualised funds and the chance to experience high quality shared-management and person-centred relationships and self-direction were essential for the progress of consumers’ self-direction and recovery. The individualised funds enabled consumers’ timely access to recovery resources. The experience of shared management and person-centred relationships, while self-directing their services, provided them with essential practical and emotional support. In this, consumers experienced positive and/or corrective emotional encounters that facilitated their learning, insight, change and growth, enabling them to gain hope for a happier future. Thus, the impact of the SPS service on the lived experiences of consumers seemed related to the combined effects of having access to the SPS service components and the quality of experience of these components.