October 2010

Validation Training Institute

Quality Manual

Requirements and Guidelines for:

Certification levels

Maintenance of Quality of certified individuals

Teaching Curriculums

Training Courses

Testing and certification

Authorized Validation Organizations

Caregiving Institutions

Written by:

Rita Altman

Andrea Fink

Marie-Claire Giard

Benno Meichtry

Francesco Mosetti

Guy Mullez

Kathia Munsch

Hedwig Neu

Ulli Praschl

Cinzia Siviero

Angelica Soula

Gunvor Sramek

Hannes Weber

Vicki de Klerk-Rubin, working group chair

Authorized by the Validation Training Institute as of October 1, 2010
VTI Quality Maintenance Manual

Validation

The Validation method is a theory and method for communicating with old-old, disoriented people, often diagnosed with late on-set Alzheimer’s disease. It was developed by Naomi Feil between 1963 and 1980. Validation has three aspects: a respectful, empathetic basic attitude; principles that describe this late life-stage and guide the Validation practitioner’s behavior; verbal and non-verbal techniques that can be used to improve communication, increase feelings of self-worth and regain dignity.

Definitions

Naomi Feil founded the Validation Training Institute (VTI) in 1981 as a non-profit corporation to support the development and spreading of Validation. A VTI priority is to ensure high quality standards in every aspect of Validation training and use, thereby ensuring the integrity of the method.

Authorized Validation Organizations (AVOs) are organizations that have a contractual relationship with Naomi Feil to offer Validation certification courses and spread information about Validation. There are, as of this writing, 19 AVOs in the United States, Europe and Japan. Each AVO has a responsibility to ensure the integrity of the method by following the quality standards set by VTI.

The Origin of this Manual

As use of and training in Validation has increased and professionalized since 1981, Validation teachers, Masters, managers and organizations have seen the need to create quality standards in all aspects of using, training and promoting the method. The Authorized Validation Organization Guidelines were written in the late 1990’s; various documents concerning quality standards in training have been written and authorized in the last 15 years. It was felt that there was a need to combine all the documents already written, up-date these materials, and create new quality standards in reaction to problem situations occurring throughout the Validation community.

This manual was created by an international team of Validation Teachers, Masters and managers of AVOs. Its development began at a European Validation Association Teacher Meeting in 2007 and was carried out over 3 years in German, English, Italian and French simultaneously, people adding their contributions in their mother-tongue. The working group chair wishes to express respect and thanks to everyone who contributed to this document.

Intended and Allowed Uses of the Quality Manual

In general: this manual shall be up-dated and improved on a continual basis. New materials will be posted to the VTI website for AVOs and Teachers/Masters, as well as distributed by email. This manual falls under the responsibility of VTI

All materials contained in this manual may be copied and distributed as needed.

This manual should be used by Validation Teachers and Masters as a reference for all issues related to certification levels, courses, testing procedures and curricula. Each Teacher/Master is required to follow the guidelines and quality standards. Forms are meant to be used as written. Evaluation forms for certification may not be changed or altered in any way without authorization from VTI’s Education Committee.

This manual should be used by AVOs as a reference for all issues related to the rights and responsibilities of being an AVO, including offering certification courses, testing procedures, protecting the integrity of Validation and the quality of teaching. The AVO Guidelines are considered to be extensions of the contracts between the AVO and VTI.


VTI Quality Manual

Contents Page

Level 1: Validation Worker 5

Requirements for certification 5

Maintaining Quality at this Level 6

Level 2: Group Validation Practitioner 7

Requirements for certification 7

Maintaining Quality at this Level 8

Level 3: Validation Presenter / Teacher 9

Requirements to begin this course 9

Authorizations 9

Guidelines for Experienced Teachers regarding Co-Training 11

Guidelines to Presenters and Experienced Teachers regarding Co-Teaching 12

Maintaining Quality at this Level 14

Level 4: Validation Master 15

Requirements for certification 15

Role of a Master 15

Maintaining Quality at this Level 16

Registration of Quality Maintenance – all certification levels 17

Curriculum Authorization 18

Criteria for a Level 1, Validation Worker curriculum 18

Criteria for a Level 2, Validation Group Leader Curriculum 22

Level 3, Validation Teacher Curriculum 24

Quality Issues relating to Validation Courses and other forms of training 26

For the AVO 26

For Validation Teachers 27

Quality Issues Relating to Testing 28

Testing procedures for Level 1 and 2 28

Written Test Procedures 28

Practical Demonstration Testing Procedures 29

Useful Forms and Criteria 31

History and Baseline Behavior form 32

Individual Validation Session Summary 33

Individual Weekly Validation Session Summary 34

Summary of a Validation Group meeting 36

Summary of a Validation Group Meeting 37

Evaluation of Progress – Validation Group 39

Evaluation of Progress – Validation Group 40

Validation Group meeting – session summary 42

Validation Training course check list for certification – Worker 43

Fieldwork and Test Completion Record – Worker Course 45

Record of Submitted Fieldwork Assignments – Worker Course 47

Summary of Practice – Validation Worker 48

Summary of attendance and testing – Validation Worker, Level 1 49

Written Documentation Requirements for certification 50

Validation Training course check list for certification – Group Leader 51

Record of Submitted Fieldwork Assignments – Group Practitioner 53

Fieldwork and Test Completion Record – Group Leader 54

Personal Development Plan: Validation Presenter Course, Level 3 55

Personal Development Plan: Validation Presenter Course, Level 3 (filled in example) 56

Video or Live Demonstration Evaluation – Worker Level 1 57

Evaluation of Validation Group tape 58

Feedback and Evaluation for Level 3, Presenter certification 60

Criteria for Final Evaluation of Co-Teaching, for Level 3, Validation Teacher certification 61

Student Evaluations 63

Evaluation of Level 1 Worker course or Level 2 Group Leader course 63

Presentation Evaluation 64

Intervision 65

Attendance List (sample) 66

Workshops and Presentations given by (Teacher’s Name) 67

Agreement between Course Participant and AVO – Validation Worker Course 68

Agreement between course participant and institution regarding video taping of Validation Practice 69

Agreement for Certification by an AVO of a Validation Worker Course (Level 1)
offered by a non-AVO 70

Quality for Institutions 76

Validation Quality Certification 76

Validation Quality Criteria for Institutions 77

Validation Quality Certification, Help for Evaluators 81

GUIDELINES FOR AUTHORIZED VALIDATION ORGANIZATIONS 94

1. What is an AVO? 94

2. What does an AVO do? 94

3. Requirements/Qualifications for becoming an AVO 95

4. Ways of accomplishing AVO responsibilities 95

5. Validation Training Courses 97

II. Training materials 101

III. Testing procedures for Level 1 and 2 101

IV. AVO responsibilities for training courses 103

V. Procedures for training/teaching in cooperation with non-AVO/VTI organizations 104

VI. Cooperation between AVO’s in offering training 104

VII. Offering courses in geographic areas not under an AVO contract 105

VIII. Offering courses in geographic areas under another AVO contract 105

6. Communications – with VTI and with other AVOs 106

7. Making an AVO Profitable 107

8. Strategies for Building an AVO 108

List of Authorized Validation Organizations 109

The Relationship between Validation organizations 113


Level 1: Validation Worker

Requirements for certification:

attend each day of the training course [1]

practice individual Validation for at least 26 weeks, some sessions with a client in each of the four phases of resolution [2]

show documentation of practical work [3]

pass written and practical examinations [4]

Authorizations:

can practice individual Validation

can give short presentations of Validation for small groups [5]

can give support to interested people

A Validation Worker is able to:

* empathize.

* listen exquisitely to another human being, to hear the underlying meaning.

* put his or her feelings in abeyance in order to be non-judgmental.

* observe a Maloriented or disoriented elderly person in an organized, careful manner.

* understand the symbols used by Maloriented and disoriented elderly.

* diagnose the stage of disorientation (according to Validation).

* build a warm, trusting relationship with a Maloriented and disoriented elderly person.

* demonstrate all the Validation techniques at a basic level.

* demonstrate that he or she knows which techniques to use with which stage of disorientation.

The Validation worker knows:

* Erikson's life stages and tasks, as well as Feil's "Resolution vs. Vegetation" stage, and is able to apply them to disoriented elderly.

* the basic human emotions and universal needs, plus can identify and match these needs when Validating the disoriented elderly.

* the goals of Validation both for the client and for the worker.

* the population for which Validation was developed.

* the differences between an early on-set Alzheimer patient and a disoriented old-old person.

* the physical, psychological and emotional characteristics of the four stages of disorientation.

* how Validation differs from and compares to Reality Orientation, Reminiscence, Remotivation and Sensory Stimulation methods.

* the principals of Validation.

Maintaining Quality at this Level

Without consistent input, feedback and opportunities to share experiences, it is easy to lose the ability to validate. In order to maintain validation skills, practice and input from others is necessary. Additionally, Validation Workers represent the Validation method to other people and their validation work should represent the method accurately using a standard for quality.

There are no requirements for maintaining certification. However, to maintain quality, the following recommendations are offered.

Validation Workers should:

Maintain consistent practice of Validation with Maloriented and disoriented elderly on a weekly basis

Attend a supervision, workshop or intervision session once a year. Only certified Validation Teachers may offer supervision sessions.

The word ‘supervision’ has different meanings or connotations in different countries. In this context, supervision is the process where a person demonstrates his or her work and a more experienced person watches, listens and feels, gives feedback/evaluation in a constructive, validating way. Additionally, the person has an opportunity to ask questions and pose problems. The more experienced person answers questions and helps solve problems.

Intervision sessions are when groups of Workers get together to help each other. They should follow the guidelines for intervision. (See ‘Forms and Criteria’.)

Meet with other Validation Workers regularly to exchange experiences and support each other. (See Intervision.)

The goals for supervision and intervision are to motivate the participants to continue validating and solve their problems. Exercises and videos of participants’ work are recommended learning methods.

Criteria for evaluation: each participant should get feedback from the teacher and also should give feedback to the teacher. An Evaluation form should be used when evaluating video or live demonstrations in supervision sessions. A copy of this form should be sent to the AVO and one given to the Worker. Participants of supervision sessions should offer feedback to the Teacher using an Evaluation form. (See “Forms and Criteria”)

Level 2: Group Validation Practitioner

Requirements for certification:

show Level 1 certification in order to begin this course

take part in a training course [6]

practice and document group Validation for at least 6 months [7]

pass written and practical examination [8]

Authorizations

can practice group Validation

can give support to people with Level 1 and interested people

can give short presentations of Validation for small groups [9]

A Group Validation Practitioner is able to:

* perform all the skills required of a Validation Worker.

* easily recognize the stages of disorientation even when there is blurring of the stages.

* form a trusting relationship with a disoriented elderly person and with each disoriented elderly member of the Validation group.

* form a Validation group, select group members, assign roles, plan agendas.

* work with a Validation team.

* share his or her knowledge with others

* give family members tips on how to improve communication with their Maloriented and disoriented relatives (simple Validation techniques);

* explain simple Validation concepts that will improve the family relationships and give both the disoriented person and the family member more joy;

* explain, demonstrate and give tips to colleagues.

* select Validation Team members;

* evaluate the progress of the client.

The Group Validation Practitioner knows:

* all the information required as a Validation Worker.

* basic group work theory.

* the goals of a Validation group.

* the role of a Validation group leader and that of the co-worker.

* how to involve other staff members within an institution.

* the elements of a Validation group

The Group Validation Practitioner can demonstrate:

* a successful and correct Validation group.

* that he or she has satisfied all of the above.

Maintaining Quality at this Level

Without consistent input, feedback and opportunities to share experiences, it is easy to lose the ability to validate. In order to maintain validation group skills, practice and input from others is necessary. Additionally, Validation Group Leaders represent the Validation method to other people and their Validation work should represent the method accurately using a standard for quality.

There are no requirements for maintaining certification. However, to maintain quality, the following recommendations are offered.

Validation Group Leaders should:

Maintain consistent practice of Validation with disoriented elderly on a weekly basis

Attend a supervision, workshop or continuing education session once a year

Meet with other Validation Workers and Group Leaders regularly to exchange experiences and support each other (Intervision).

Only certified Validation Teachers may offer supervision sessions.

The word ‘supervision’ has different meanings or connotations in different countries. In this context, supervision is the process where a person demonstrates his or her work and a more experienced person watches, listens and feels, gives feedback/evaluation in a constructive, validating way. Additionally, the person has an opportunity to ask questions and pose problems. The more experienced person answers questions and helps solve problems.

Intervision sessions are when groups of Group Leaders get together to help each other. They should follow the guidelines for intervision. (See ‘ Forms and Criteria)

The goals for supervision and intervision are to motivate the participants to continue validating and solve their problems. Exercises and videos of participants work are recommended learning methods.

Criteria for evaluation: each participant should get feedback from the teacher and also should give feedback to the teacher. An evaluation form should be used when evaluating video or live demonstrations in supervision sessions. A copy of this form should be sent to the AVO and one given to the Group Leader. Participants of supervision sessions should offer feedback to the Teacher using an Evaluation form. (See ‘Forms and Criteria’)

Level 3: Validation Presenter / Teacher

Requirements to begin this course

Show Level 2 certification

Demonstrate teaching knowledge[10]

Before beginning a Level 3 course, participants should