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Supported Decision-Making in the NDIS: A Practical Guide for External Support Providers and Families:

Updated: Mar 12

Supported Decision-Making, a guide for external support providers and families - resource within NDIS - My Right 2 Voice - Specialist Disability Services
Supported Decision-Making in the NDIS - A Practical Guide for External Support Providers and Families

What is Supported Decision-Making? 

Supported decision-making (SDM) is about recognising and respecting that people with disabilities have the right to make their own decisions, with the proper support, not control. 


Instead of others making choices for someone (known as substitute decision-making), SDM is about making sure the person has what they need—like information, time, trusted relationships, and the right tools—to make their own choices in their own way. 

It’s not about stepping back or leaving someone to do it alone. It’s about stepping up alongside them—walking with them, not ahead of them. 


This approach is grounded in Article 12 of the United Nations Convention on the Rights of Persons with Disabilities (CRPD) and backed by the NDIS Act 2013, both of which support the values of choice, control, dignity, and inclusion. 

 

Why Is Supported Decision-Making Important? 

Respects autonomy and dignity:

  • Every person has the right to direct their own life. 

Promotes better outcomes:

  • Participants who are empowered to decide are more engaged and satisfied. 

Reduces risk of abuse and neglect:

  • Empowered individuals are more protected. 

Aligns with legal obligations:

  • Upholds human rights and principles under the CRPD and the NDIS Act. 

 

 

Why It Matters for Providers 

NDIS providers and professionals play a vital role in upholding the rights, dignity, and autonomy of people with disabilities. Supported decision-making is not only best practice—it is also a human rights obligation. As frontline workers, managers, coordinators, and practitioners, providers are often in the position to influence how decisions are made and whether people with disabilities are genuinely included in choices that affect their lives. 


A core responsibility is actively respecting and promoting each person’s right to choice and control. This means going beyond simply offering options—it requires providers to create environments and supports that empower individuals to make their own informed decisions. Whether it's deciding on daily routines, support staff, or major life transitions, people with disability must be the central decision-makers in their own lives. 


It is also essential for providers to avoid substitute decision-making, unless there is a clear and lawful authority—such as guardianship or an order under state or territory law. Even in those circumstances, the individual’s will and preference should be the starting point of all support and planning conversations. Over-reliance on substitute decision-making can undermine a person's rights, independence, and confidence. 


Providers must also ensure that all information is communicated in accessible, person-centred ways. This might include using plain language, visual aids, Easy Read documents, interpreters, communication devices, or giving someone extra time to process and respond. Accessibility is not a one-size-fits-all solution—it must be tailored to the individual’s communication style and cognitive processing needs. 


Lastly, collaborating with supporters—such as family, friends, advocates, or formal decision-making supporters—should always be done respectfully and transparently. The role of the supporter is to assist the person in making their own decisions, not to make choices for them. Providers should facilitate conversations that centre the person’s voice and preference, and be careful not to override or dismiss the person's will, especially when their decision-making style or communication needs differ from conventional norms. 


By embedding these practices into everyday service delivery, providers can significantly improve the quality, inclusiveness, and ethical standard of support—ensuring people with disability are not only heard, but genuinely in charge of their own lives. 


Key Legal and Ethical Frameworks 

  • NDIS Act 2013, s4(8): Emphasises participant choice and control. 

  • UNCRPD, Article 12: Right to equal recognition before the law. 

  • National Disability Strategy 2021–2031: Recognises SDM as essential to participation. 

  • Disability Discrimination Act 1992 

  • NDIS Practice Standards 

  • Ethical Principles 


How to Practice SDM: Practical Strategies 

1.       Presume capacity 

  • Always start by assuming the person can make decisions with the right support. 

2.      Use accessible tools 

  • Easy-read documents, visual supports, AAC devices, supported conversations. 

3.      Involve trusted supporters 

  • Family, friends, or advocates chosen by the participant. 

4.     Provide time and space 

  • Don’t rush decisions. Allow for reflection and clarification. 

5.      Support skill-building 

  • Encourage small decisions daily; use role-play and guided reflection. 

6.      Document preferences 

  • Record how the participant was supported to decide and their stated preferences. 

 

Training staff on respecting choice is essential for creating ethical, person-centred, and rights-based disability support. Here's a practical, step-by-step approach you can use to train staff effectively across all levels—from direct support workers to coordinators and leaders: 


1. Start with the "Why": Build Understanding of Human Rights and Autonomy 

  • Introduce key frameworks: UNCRPD (Article 12), Disability Discrimination Act 1992, NDIS Practice Standards. 

  • Explain why choice and control are legal rights, not just good practice. 

  • Use real-life examples and stories to illustrate what it looks like when choice is respected vs overridden. 

  • Connect it to staff roles: “How do your daily actions affect someone’s autonomy?” 


2. Teach Active Listening and Communication Strategies 

  • Train staff in active listening: allowing space, not rushing decisions, asking open-ended questions. 

  • Include training on supported communication: plain language, visuals, assistive technology, and body language cues. 

  • Role-play common scenarios where someone may need more time or a different method to express choice. 


 3. Clarify the Role of Support vs Control 

  • Reinforce that the support role is to enable decision-making, not to decide for the person. 

  • Unpack terms like dignity of risk, duty of care, and substitute decision-making, showing how to balance them. 

  • Include case studies where "best interest" decisions caused harm or reduced independence. 

 

4. Use Practical Tools and Visual Aids 

  • Provide tools such as: 

    • Decision-making profiles 

    • Will and preference planning templates 

    • Decision-making flowcharts 

    • Communication access checklists 

  • Show how to record evidence of respecting choice in daily notes and NDIS documentation. 


 5. Incorporate Scenario-Based Learning and Reflection 

  • Use real or fictional case studies to explore: 

    • Grey areas (e.g. safety vs choice) 

    • Conflict with family or guardians 

    • What to do when someone makes a decision you disagree with 

  • Encourage reflective discussions: “What assumptions am I making?”, “How could I do this differently?” 

 6. Embed it into Everyday Practice and Supervision 

  • Set expectations that respecting choice is a performance standard, not an optional value. 

  • Use supervision sessions to debrief tricky decisions or ethical concerns. 

  • Encourage peer support and learning: “What’s one thing you did this week to support someone’s choice?” 

 7. Offer Ongoing Training and Refreshers 

  • Make this part of induction and annual PD plans. 

  • Use short refresher sessions, eLearning, team huddles, and guest speakers with lived experience. 

  • Review changes in legislation, policy, or NDIS standards that relate to choice and control. 

Bonus Tips: 

  • Include people with disability in co-designing or co-delivering training. 

  • Encourage a "choice-first" culture at every level—language matters (e.g. “supporting what they want” vs “what’s best for them”). 

  • Celebrate examples where staff went above and beyond to support choice. 


Examples of SDM in Practice 

1. Housing and Living: 

  • David wants to move from his SIL home. His coordinator helps him explore options using visuals and trial visits. He chooses a quieter environment near a park. 

2. Health and Therapy: 

  • Aisha, with an intellectual disability, doesn't feel speech therapy is working. With visuals and family support, she chooses an alternative provider. 

3. Community Participation: 

  • Nguyen uses a visual schedule to try new programs. He gives feedback with thumbs-up/down cards and reshapes his week. 

4. Financial Decisions: 

  • Lena wants a pet cat. Her support team helps her write a letter to her trustee explaining the benefits. Her voice leads the request. 

5. Communication Support: 

  • Matiu, non-verbal, meets two support workers. He consistently chooses one, using his AAC device, and the choice is respected. 

6. Risk and Choice: 

  • Jordan wants to go camping alone. His team helps him create a risk plan with safety supports, enabling him to go safely. 

 

 

Barriers to Support Decision-Making:

Barrier

Impact

Presumption of incapacity 

 Decisions are made for the person. 

Legal/guardianship constraints 

Rights overridden without inclusion. 

Lack of tools/support 

Can’t express preferences clearly. 

Time/resource pressure 

Rushed, provider-led decisions. 

Family overprotection 

Participants’ growth is limited. 

Misunderstood disability 

Fluctuating capacity not recognised. 

Staff training gaps 

Lack of SDM confidence. 

System rigidity 

Choices constrained by policy. 

 

Educating Families on Supported Decision-Making

1. Values-first framing: Link SDM to dignity, love, and autonomy.  

2. Easy-read tools: Use plain English, visuals, and real stories.  

3. Family workshops: Co-designed learning with people with disability.  

4. Clarify roles: Families support, not substitute.  

5. Reframe risk: Embrace "dignity of risk".  

6. Practice at home: Start with daily choices.  

7. Peer networks: Link families to others with experience. 

 

 

Reducing System Rigidity: Organisational Interventions 

1. Policy Integration 

  • Embed SDM into intake forms, planning, reviews, and documentation. 

2. Flexible Service Design 

  • Enable participant-led scheduling and support selection. 

3. Reform Planning Processes 

  • Train planners and auditors to ask how decisions were supported. 

4. Practical Tools 

  • Use decision trees, visual aids, and SDM reflection checklists. 

5. Workforce Training 

  • Mandate SDM and dignity of risk training with lived experience input. 

6. Co-design Governance 

  • Include participants in service design, hiring, and evaluation. 

7. Reflect in Reporting 

  • Capture and celebrate SDM in audit and quality systems. 


 Resources and Tools 


More Questions Regarding Supported Decision Making?

If you have any questions about Supported Decision Making, need guidance on how to implement it in your life, or would like to speak with our Specialist Support Coordinators about accessing support, please don't hesitate to reach out.


Our specialist support team is here to guide on your journey, every step of the way.


 

Click below to download our free resource on End-of-Plan Reporting Made Easy: A Guide for Professionals, Participants & Plan Nominees



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