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CRDITED Rehabilitation Center - University Institute
  • 3255 rue Foucher G8Z 1M6 Trois-Rivières, Québec Canada
  • +1 888 379-7732​
  • crditedmcqiu@nullssss.gouv.qc.ca
  • Guy Sabourin
  • bureau@nullguysabourinphd.com


Hope for people with serious disorders of behavior, Trois Rivières, Quebec

  • Health : Autism
  • North America : Canada
  • Experience Index Card

From Guy Sabourin the Oct 01, 2015

With the help of intervention model developed below by Mr. Guy Sabourin Phd, psychologist and consultant to the SQETGC (former Director of this program) Associated to the Universitary integrated center for health and social services of Mauricie-et-du-centre-du-quebec, it could be performed a large number of individualised plans of multimodal interventions with success for people with various types of deficits and serious behavioural problems.

Some 15 years ago I was offered to lead an experimental program of support and intervention for people with various cognitive and behavioral deficits severe including people with intellectual disabilities, disorders in the autism spectrum or a craniocerebral trauma. To access our services in the Montreal area, they should be already supported by a network of health and social services institution and presented a serious disorder of behavior (SDB).

However, at this time, it was difficult to determine precisely which presented or not a SDB, because we had no consensus on the definition of the clinical concept. Following various research and consultation work, we were able to establish gradually a definition and estimates of the prevalence of this phenomenon. For the moment, we consider it at 5 to 7% of the clientele of people supported in the network of rehabilitation of the DI and the TSA in Quebec. This four-year programme was set up after pressure from parent groups to improve the quality of services these people given the large number of complaints from them concerning the excessive use of in such physical constraints of physical restraints or isolation measures.

In our work, we were able to achieve  clinical consultations with international experts for a number of these people. Then, we asked them to give lectures on their approaches and their understanding of these complex phenomena, in particular to our team of multidisciplinary consultants, but also to all stakeholders in the region. In parallel, we conducted a study on the  clinical and organizational impact of our consultation services, training and development of expertise. In General, our efforts have led us to see that the main problem of these people stood at the level of perception of the causes of their problems that tend to reduce to a few main causes or even a single cause without consideration of the multiple presence causes and especially their interaction. In fact, too often, it lacked a holistic vision of the problems of the person and especially of its needs.

It is in this framework that we have developed and released in Quebec a model theoretical and clinical called analysis and integrator of Intervention MultiModales (AIMM), which facilitates the identification of causal and global assumptions and choice of various well intervention strategies targeted and coordinated to be an intensive follow-up results to verify the optimal achievement of clinical objectives and quality of life for the person and his entourage (Sabourin and Lapointe , 2014). Using this model of intervention, we were able to achieve a large number of individualised plans of multimodal interventions with success for people with various types of deficits and serious behavioural problems. Then, little by little, complete teams of professionals and stakeholders have been trained and supervised, in the most intensive way possible, in the use of this model with associated methodologies (grid of MIOS, multimodal action plan, mode of intensive follow-up, etc.). This allowed to produce positive results in the vast majority of cases that could be monitored and evaluated by an academic researcher independent (N over 30 users). It found an average improvement over 40% of the behavioural indicators over a period of 18 months, as well as significant improvements in most of the other indicators used, even at the level of their mental health (pre-post).

Our initial work has been made exclusively in the Montreal region in the years 2000 to 2006. And then, gradually, the funding of other institutions across Quebec is added to Montreal. Now, this program is funded directly by the Department of health and social services of Quebec. Our services are centered now more on the supervision and support of the intervention teams of all Quebec institutions that rely on our services, but also on the development of expertise as such (animation of communities of practice, conferences, trainings, supervision on measuring participation in pilot projects, etc.).

All of the results of this program are relatively positive, although many paths to all the manifesting of TGC receive the type of services they really need. Because it is always difficult to question our vision personal and professional to another person whose deficits are often multiple and which have required most of the time, a lot of energy and aroused enormous negative consequences on the environment. In fact, the biggest challenge yet found is create again of hope and start again on a new basis with various interventions... or almost. Another challenge that is sometimes as large is the collaboration of all parties concerned by this person, as an adequate collaborative approach, it is often difficult to install significant changes in a person's life, often very dependent on his entourage.

Reference

Sabourin, g. & Lapointe, a. (2014). Analysis and intervention multimodal in serious disorders - grid and lexicon. Montreal, Canada: FQCRDITED | SQETGC.

Canonical language : French
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