When applying the START model, presenting problems are conceptualized within the context of the environment in which the person lives, works, and interacts with those around them. Systemic consultation and intervention can occur at all levels of service delivery and draws upon already existing resources within the person and the system to promote sustained stability and change.
Systems Change
START uses a model of “systems change” pioneered by Dr. Salvador Minuchin, who developed structural-systemic family therapy in the 1970s. Unlike traditional therapy where there is an “identified patient,” he found that shifting relationships and interaction in a system was the key to success. Based on the family systems work of Dr. Minuchin, START Coordinators are trained in systemic consultation interventions to enhance service outcomes by training and influencing the way systems work together to support people with IDD.
Minuchin, S., Rosman, B. L., & Baker, L. (1978). Psychosomatic families: Anorexia nervosa in context. Harvard U Press.
Structural Systemic Model of Intervention
The structural systemic model of intervention emphasizes structural change as the main goal. This model provides a framework for a consistent way of operating and thinking about people within the context of their system of support rather than a prescribed list of strategies and interventions. The primary goal of intervention is to restructure the system and its transactional rules, which makes interactions more flexible and enables the system to improve its ability to cope with stress and conflict.
Haley, J. (1987). The Jossey-Bass social and behavioral science series. Problem-solving therapy (2nd ed.). Jossey-Bass.
Outreach and Linkages
Outreach is a systemic intervention provided to all people receiving START services and their support teams. It is a strategy used to improve the person-centered service outcomes for those served within the program. Outreach means “to reach out” or “reach further than.” START outreach is the act of connecting with the individual, family, and/or other team members for the purpose of cross-systems crisis prevention and intervention. Outreach is performed through a variety of activities including, but not limited to, listening to and joining with a person or their caregiver, training/coaching, information sharing, modeling interventions for families, meeting with outpatient providers, or reviewing START assessments.