How we do it

Positive thoughts make things happen
Artwork by Kim Plaut

Borrowing from the experience of pilot projects around the world, the academic and practical experience of our Hunter/CUNY faculty associates, and in consultation with the New York Alliance for Inclusion and Innovation (formerly NYSACRA), SDMNY has developed a three-phase facilitation model by which persons with developmental disabilities (who we call Decision-Makers) can choose trusted persons in their lives—often family members, neighbors, or friends—to support them in making decisions in a variety of areas.

In the SDMNY process, a trained facilitator, supervised by an experienced mentor, works with the Decision-Maker and their chosen Supporters to negotiate and formalize an agreement, the Supported Decision-Making Agreement (SDMA), that sets out the responsibilities and obligations of the parties. Facilitation meetings are generally an hour long and can take place monthly or more frequently, as the parties agree. On average, the facilitation process requires between 6 and 12 meetings. Since the COVID-19 pandemic, almost all meetings have been held remotely, with protocols developed by SDMNY.

The facilitation process allows the Decision-Maker to explore how decisions are made, the different areas in which they may want support (health care, education, living arrangements, finances, etc.), and the kinds of support they may want/need in making decisions in each of those areas (gathering information; understanding the information; identifying alternatives; considering consequences; weighing the alternatives; communicating the decision to third parties; implementing the decision). Decision-Makers identify persons they want as their Supporter and the kinds of support, in a particular area, they want from each Supporter.

For example, a Decision-Maker might choose their mother to give support in gathering and understanding information about health care decisions, their dad to support them in developing alternatives and considering consequences about financial decisions, and a sibling and a friend to provide support in gathering information and weighing alternatives in choices about intimacy and relationships.

Decision-Makers may choose one or more Supporters for each area in which they want support, and may request different kinds of support from each Supporter. In the SDMNY project so far, the number of Supporters chosen by a Decision-Maker has varied from 2 to 11, and it is not uncommon for Supporters to be located outside New York (participating in meetings and providing support remotely) and even outside the United States.

As with everything else in the facilitation process, it’s the Decision-Maker’s choice!