Consent, choice, and control: what person-centred NDIS support really looks like

Carl Rogers, the psychologist who developed the person-centred approach, described a way of supporting people built around genuine curiosity, respect and understanding. [1]

At ENGEN, that's not a slogan.

It's a starting point.

Person-centred support goes wrong when a provider assumes they know someone after one interview, one induction or one intake form.

You can't centre support around someone you don't actually know yet.

Real person-centred support means continuing to ask questions, listen and learn who someone is.

Because people change.

What someone wants today might not be what they want six months from now.

What does that look like in practice?

Sometimes it's something as small as a cup of tea.

Imagine being told you can't have another — not because it's dangerous, but because someone decided it wasn't good for you.

It would feel controlling.

Now imagine a support worker making that decision about someone's third energy drink of the day.

It might not be the healthiest choice.

But taking it away entirely sends another message:

Someone else gets to decide what's good for you, in your own life.

That's where dignity of risk matters.

Not as some big, dramatic concept, but in the small decisions people make every day.

Good support doesn't remove every risk.

It helps someone understand the choice, consider the consequences and make their own decision wherever possible. [2,3]

That doesn't mean ignoring genuine risks.

It means asking:

What is the risk?
How can we make it safer?
What does the person want?
What support do they need to make an informed choice?

This is particularly important when someone needs assistance with decision-making. Supported decision-making focuses on helping people understand their options and communicate their preferences, rather than automatically making decisions on their behalf. [3,4]

The goal isn't to eliminate every risk.

It's to make room for choice while providing the right support around it.

Choice is more than being asked

Sometimes we say someone has a choice because we gave them two options.

But real choice goes further.

It means having opportunities to express preferences, change your mind and influence what happens in your own life.

It means being listened to even when the answer isn't what someone else expected.

And sometimes, it means accepting that a person may make a decision we wouldn't make ourselves.

That's part of respecting autonomy.

For people receiving disability support, having control over everyday decisions can contribute to greater autonomy and quality of life. [5]

At ENGEN, we don't think good support means making every decision perfectly.

It means making sure the person is part of the decision.

Because support should never quietly become control.

It should create the space for someone to have a voice, make choices, take reasonable risks and build a life that actually feels like their own.

Support should make choice safer — not make choice disappear.

References

[1] Rogers CR. The necessary and sufficient conditions of therapeutic personality change. Journal of Consulting Psychology. 1957;21(2):95–103.

[2] Chicoine B, Kirschner KL. Considering dignity of risk in the care of people with intellectual disabilities: A clinical perspective. Perspectives in Biology and Medicine. 2022;65(2):189–198.

[3] Bigby C, Douglas J, Smith E, Carney T, Then SN, Wiesel I. Parental strategies that support adults with intellectual disabilities to explore decision preferences, constraints and consequences. Journal of Intellectual & Developmental Disability. 2022;47(2):165–176.

[4] Browning M, Bigby C, Douglas J. A process of decision-making support: Exploring supported decision-making practice in Canada. Journal of Intellectual & Developmental Disability. 2021;46(2):138–149.

[5] Wehmeyer ML. Self-determination in adolescents and adults with intellectual and developmental disabilities. Current Opinion in Psychiatry. 2020;33(2):81–85.