IM4Q: Independent Monitoring for Quality and the Pursuit of Happiness
This article was originally published in the Spring 2023 edition of the Chatham Recorder Alumni Magazine by Cara Gillotti. To view more digital Recorder stories, click here.
People with an intellectual disability (ID) often are mistreated, or don’t have access to the same sorts of opportunities or services that people without a disability have,” says Chatham psychology Professor Anthony Goreczny. Goreczny is the principal investigator of a program that is working to change that.
The program—which Goreczny has been running for 23 years—is called Independent Monitoring for Quality, or IM4Q, and it may be properly understood as an information-gathering method. Here’s how it works:
1. A pair of interviewers called monitors visit an individual with an intellectual or developmental disability at their home or a location of choice. Ideally, one of the monitors will have an ID or a family member with an ID.
2. The monitors ask questions about the individual’s happiness, quality of life, and satisfaction with the services that they receive.
3. The monitors develop “considerations” from the responses. Considerations are suggested interventions that address the individual’s concerns.
Considerations are entered into a statewide database, and the individual’s support coordinator gets notified as does the county in which he or she is receiving services. The support coordinator has 45 days to take action to implement changes.
IM4Q operates throughout the Commonwealth, and Chatham coordinates the program in Allegheny, Beaver, Greene, and Washington counties. Every year, Chatham’s IM4Q team completes anywhere between 500-700 interviews, and they have served thousands of individuals with ID since the program’s inception.
“The program is founded on the idea of self-determination,” explains Goreczny. “It’s saying, ‘I have a right as an individual to make certain choices—about the money I spend, who I spend time with, and the right to be treated with dignity and respect, and I have certain responsibilities that go along with it.’”
When health sciences students, including psychology students, enter the field, the literature suggests that there are at least three groups of people that they are disinclined to work with, notes Goreczny. Those groups include older adults, people with chronic mental illness, and people with intellectual or developmental disabilities. “But data shows that if we can expose students early on to diverse populations, it piques their interest and they say, ‘Wow, this is so much better than I thought.’ We begin to break down the barriers of stigma by mere exposure, and then some of them end up making a career out of that area. Which is awesome because we want the best and brightest to be available for some of the most marginalized populations.”
One of those students was Rachel Blick, Master of Arts in Psychology ’13. Blick joined IM4Q after hearing Goreczny talk about it in class. “It was a great experience to meet people where they lived, hear their stories, and see if we could improve the services they received,” she says. “I became very interested in improving public services from that experience, so I ended up going to Ohio State University and studied healthcare policy and administration. I briefly worked at Nationwide Children’s Hospital in Columbus, where I helped develop their autism services, and then I had an opportunity to work for state government where I could have more of an influence across thousands of providers and services.” Today Blick is the Strategy and Innovation Manager for the Ohio Department of Developmental Disabilities.
“We want the best and brightest to be available for some of the most marginalized populations.”
In addition to providing clinical experience to students, IM4Q also allows them to conduct data analysis and publish in journals, often as first author. In fact, the data analysis team recently submitted four proposals to present at a national convention of the American Association on Intellectual and Developmental Disabilities. All were accepted, and Goreczny and his students will be presenting at the national convention taking place in Pittsburgh this June.
“One of the questions we ask is ‘What would improve your quality of life’, and we get all kinds of answers—from ‘I want to see my family more often’ or ‘I want to attend church more often’ to ‘I want a new job’ or ‘I want to move’,” says Goreczny. “We had one young man who wanted to be a firefighter. Because of physical limitations, he didn’t meet the qualifications. So the support coordinator called the local volunteer fire department, and asked what they could do for him. They said, ‘Bring him down!’ They put him in firefighter gear, took a picture of him on the truck, and he was a firefighter for the day. To my understanding, he still has that picture on his nightstand. That was so meaningful to him. He can look at that picture and go ‘I am a firefighter.’”
“We also had somebody who said he wanted to marry Angelina Jolie,” he says. “Our staff is very well trained, so they explored that a little bit. And really at the heart of it, what this young man wanted was a life partner. Someone to go off and do fun activities with, like any of the rest of us do. And so we wrote that up as the person would benefit from having opportunities to meet someone who could be a life partner.”
“One of the key changes over the years—and I like to think IM4Q has been a part of this—is that before, we got a lot of people wanting to move or wanting additional services,” reflects Goreczny. “We still get those things, but these days we get people wanting to improve themselves in various ways, for example, to take college classes. People went from believing that there wasn’t a whole lot that they can do—and other people around them sharing that belief—to seeing the value that people with an ID have.
“It’s a changed mindset: Not just me existing and getting out of problems, it’s me creating a meaningful life for myself. And I think that’s awesome.”
“Back in the day it used to be believed that people with an ID had limitations beyond what they really had,” says Goreczny. “We’re now seeing that those limitations aren’t there. A perfect example: One of our monitors with an ID came to me one day and said ‘Dr G., I can’t work with you no more.’ I was like ‘What’s wrong, did we do something wrong?’ He was like ‘No, you guys were the first ones to believe that I could do anything of a meaningful nature. I went out and got myself a full-time job with benefits.’”