Professional Communication Practices: Values, Ethics & Confidentiality

1. Professional Communication Practices: Values, Ethics & Confidentiality Delaware Division of Vocational Rehabilitation

2. Overview • Why is there a Public Vocational Rehabilitation Program? • The Foundation of our Work • Attitudes & Barriers Faced by People with Disabilities • Putting our Work in the Context of Today’s Society • Values, Ethics & Confidentiality • Professional Communication Practices • Effective Communication Practices • First Impressions are Powerful

3. Why is there a Public VR Program? The foundation of our work

4. Why is there a Public VR Program? • >54 million people with disabilities in the United States. • Historically, the condition of having a disability has been viewed as tragic. VSA Brief History of the Disability Movement, http://www.vsarts.org/x537.xml

5. Why is there a Public VR Program? • By the 19th century, institutionalization was the norm: clients who needed to be cured (medical model). • This practice had the effect of excluding people with disabilities from the larger society and implied that something was inherently and permanently wrong with them. It provided no room for integration, and perpetuated myths of inequality.

6. Why is there a Public VR Program? • As thousands of WWI soldiers returned home, the first VR acts were passed in the 1920s to provide services to WWI veterans with newly acquired disabilities. • But perhaps the biggest changes within the disability rights movement came with the civil rights movements of the 1960s.

7. Why is there a Public VR Program? • In the early 1970s, people with disabilities lobbied Congress to put civil rights language for people with disabilities into the 1972 Rehabilitation Act. • After a group of people with disabilities marched on Washington, a revised 1973 Rehabilitation Act was passed. • For the first time in history, the civil rights of people with disabilities were protected by law. This law is the foundation of the public VR program.

8. Why is there a Public VR Program? • People with disabilities did not achieve broad civil rights until the enactment of the Americans with Disabilities Act (ADA) in 1990. • ADA ensures equal access to employment opportunities and public accommodations for people with disabilities. Congress identified the full participation, inclusion and integration of people with disabilities into society as a national goal. • Why is understanding this history important in how we approach our jobs in the public VR program?

9. Rehabilitation Act Amendments of 1998 • Today, the public VR program is established in this federal law, which is to be reauthorized by Congress every five years. • The Rehab Act Amendments are part of the Workforce Investment Act (Title IV). • VR is funded by 78% federal dollars, and 22% state dollars.

10. Rehabilitation Act Amendments of 1998 • The purpose of the law is to empower individuals with disabilities to maximize employment, economic self-sufficiency, independence, and inclusion and integration into society.

11. Attitudes & Barriers Putting our work into the context of today’s society

12. Perception of Disability: Society at Large The greatest barriers individuals with disabilities have faced for decades and continue to face today are attitudinal barriers. Source: http://www.rcep6.org/il/conference/DRC%20version%20Disability_Sensitivity.ppt

13. Why do Attitudinal Barriers Exist Today?

14. Communicating With and About People with Disabilities • The Americans with Disabilities Act, other laws and the efforts of many disability organizations have made strides in improving accessibility in buildings, increasing access to education, opening employment opportunities and developing realistic portrayals of persons with disabilities in television programming and motion pictures. Where progress is still needed is in communication and interaction with people with disabilities. Source: Communicating With and About People with Disabilities, Dept. of Labor, Office of Disability Employment Policy

15. What is Disability Etiquette? • Etiquette considered appropriate when interacting with customers with disabilities is based primarily on respect and courtesy. • Listen and learn from what the customer tells you regarding his or her needs.

16. Handicap vs. Disability • Handicap or Handicapped • A legendary origin of the word “handicap” refers to a person with a disability begging with his “cap in his hand.” This is believed to come from our war veterans after World War II as a means to support themselves. Source: From Kathy Snow’s, “Disability is Natural” website. www.disabilityisnatural.com

17. Language in Powerful! • It reflects, reinforces, and shapes our perceptions of people. Words which reflect positive attitudes and awareness help develop positive communications. • Words about disability have been strongly influenced by legal, medical, and political terms. As a result, our daily language is filled with technical terms which often do not convey our intended social message. Source: People First: A Language Guide, The Institute on Disabilities at Temple University

18. Language Sets the Tone It’s not just a matter of semantics or being “politically correct”; the language we use reflects how we feel about disability. http://www.disabilitylearningservices.com/unit03.htm

19. Positive Language Empowers: People First Language • When writing or speaking about people with disabilities, it is important to put the person first. Group designations such as "the blind," "the deaf" or "the disabled" are inappropriate because they do not reflect the individuality, equality, or dignity of people with disabilities. Following are examples of positive and negative phrases. Note that the positive phrases put the person first.

20. People First Language

21. Words to Avoid Using • Challenged • Handicapped • Disabled • Crippled • Suffers from… • Is afflicted with… • Victim • Pity • Confined

22. Communicating with People with Disabilities • When introduced to a person with a disability, it is appropriate to offer to shake hands. People with limited hand use or who wear an artificial limb can usually shake hands. (Shaking hands with the left hand is an acceptable greeting.) • If you offer assistance, wait until the offer is accepted. Then listen to or ask for instructions. • Treat adults as adults. Address people who have disabilities by their first names only when extending the same familiarity to all others.

23. Communicating with People with Disabilities • Relax. Don't be embarrassed if you happen to use common expressions such as "See you later," or "Did you hear about that?" that seem to relate to a person's disability. • Don't be afraid to ask questions when you're unsure of what to do.

24. Values, Ethics & Confidentiality Professional communication practices

25. Values • VALUES are attitudes and beliefs about things we think are important in life. • Define what we prize, regard highly or prefer • Are indicated by frequent and consistent actions • Our values provide the lens on how we view the world, including our attitude and action towards people.

26. Learning Experience: Checklist for Personal Values • Using your Workbook, select the ten that are most important to you - as guides for how to behave, or as components of a valued way of life. • Now that you have identified ten, imagine that you are only permitted to have five values. Which five would you give up? Cross them off. • Now imagine that you are only permitted four. Which would you give up? Cross it off. • Now cross off another, to bring our list down to three. • And another, to bring our list down to two. • Finally cross off one of your two values. Which is the one item on the one that you care most about?

27. Being Aware of Personal Values • What are some examples of personal values that might impact our professional work?

28. Some examples…. • Sexual identity issues • Substance abuse • Assisted suicide • Child Custody • Illegal means of support • Spousal abuse

29. The Role of Your Values • Essential that you are aware of your values and how they influence what you think, say, and do when interacting with customers. • When you interact with customers, it is not a forum for you to impose your values on customers. • Customers have the task of clarifying their own values and goals, making informed choices, and assuming responsibility for what they do.

30. Learning Experience: Values • Darlene is obtaining referral information on John who is apply for VR services. John is a well-spoken individual who has recently lost his job because of epilepsy. During the course of collecting information, John discloses he is an atheist. Darlene is personally and religiously opposed to the lifestyle. • What should she do?

31. ETHICS Merriam-Webster's Collegiate Dictionary (1999): • The principles of conduct governing an individual or a group <professional ethics> • A guiding philosophy

32. ETHICS • Ethics refers to our “code of conduct”. • Our personal values contribute to the strength of our ethics with positive behaviors and positive attitudes.

33. ETHICS • ETHICS IS EASIER SAID THAN DONE. (Josephson Institute 1991)

34. Principles of Ethical Behavior • Autonomy: To honor the right to make individual decisions. • Beneficence: To do good to others. • Nonmaleficence: To do no harm to others. • Justice: To be fair and give equally to others. • Fidelity: To be loyal, honest, and keep promises.

35. Ethical Practices: Confidentiality Confidentiality has been defined by the International Organization for Standardization (ISO) as "ensuring that information is accessible only to those authorized to have access" and is one of the cornerstones of information security. A customer has the right to privacy and confidentiality.

36. Confidentiality Factors which complicate the issue: Multiple partners Referral sources Physical environment Small communities Special populations

37. Learning Experience: Chatty Cathy Cathy has had a rough day at the DVR office and goes to a local hair salon after work. She begins discussing recent interview of an VR customer with the hairdresser but is careful to disguise names and identifying information about specific customers. Has anything unethical occurred?

38. Response YES. Ifit is possible that someone can identify a customer by context, then confidentiality has been breached. If,for example, a relative or friend of a customer overheard such a conversation and could piece together the information, thereby identifying the customer, an unethical act has occurred. Even if the risk of identifying a customer is not significant, any practice of public discussion of cases is generally harmful of the trust of confidentiality. It risks decreasing the confidence of the lay public in the services provided by DE DVR.

39. Exceptions to Confidential • What should you do if: • A customer says they plan to do harm to him/herself, such as suicidal thoughts? • A customer say they are thinking of hurting another person, such as spouse or child abuse? • If at any time a customer discloses information that they may be of harm to him/herself or others, immediately refer the call/visit to a supervisor. Such situations warrant disclosure of confidential information.

40. Dual Relationships Contains both personal and nonprofessional components In addition to your role as a VR Clerical Professional referral information, you may have a relationship with the person in another “role” as a friend, teacher, community member or neighbor, church group, etc. Are dual relations always bad? Only if the relationship interferes with your ability to exercise your professional discretion, impairs your judgment, exploits customers, or does harm to customers.

41. When Is a Dual Relationship Harmful? • Intimate relationships • Personal benefit: monetary gain, goods and services • Emotional and dependency needs: confusion between personal and professional lives • Altruistic gestures: performing favors; providing nonprofessional services, giving gifts and being extraordinarily available

42. Learning Experience: Rena the Remote Rena is a the only support staff in a 2 person office. The office has received a referral on two family members of her best friend since high school. What are the ethical concerns and what should Rena and her Supervisor do to ensure there is no conflict due to the dual relationship?

43. Multicultural Awareness: Ethical Practices • Multicultural Awareness is a greater understanding, sensitivity, and appreciation of the history, values, experiences, and lifestyles of groups that include, but, are not limited to: • Race • Ethnicity • Gender • Sexual Orientation • Religious Affiliation • Socio-economic Status • Mental/Physical Abilities  

44. How do You View Others based upon Your Own Culture? • What is my cultural heritage? What was the culture of my parents and my grandparents? With what cultural group(s) do I identify? • What values, beliefs, opinions and attitudes do I hold that are consistent with the dominant culture? • What unique abilities, aspirations, expectations, and limitations do I have that might influence my relations with culturally diverse individuals?

45. How do You View Others based upon Your Culture? • Discuss the differences that may exist among various cultures: • Eye Contact • View of Gender • Family Influence • Others? • How might your cultural lens impact your reaction to others from diverse cultures?

46. Stereotyping • Cultural stereotyping occurs when we automatic and exaggerated mental pictures that we hold about all members of a particular group. When we stereotype people based on race, sexual preference, or ethnicity we don't take into account individual differences. • We may tend to ignore or discard any information that is not consistent with the stereotype that we have developed about the group. • How might stereotyping a customer impact your interaction when gathering base record information?

47. Gaining More Multicultural Awareness • As we gain more awareness and knowledge about multicultural diversity, our stereotypes will lessen. • If we learn about cultural diversity, we can appreciate our difference and improve our communication with our customers. • In doing this, we work to create a society in which all cultures are valued, appreciated, and embraced. • How might you expand your multicultural awareness?

48. Effective Communication Skills FIRST IMPRESSIONS ARE POWERFUL

49. First Impressions “First Impressions” handbook is being used, which is designed to help human service agency workers achieve a high level of positive communication. Source: http://www.rtcil.org/products/RTCIL%20publications/Service%20Provision/First%20Impressions.pdf

50. First Impressions • Most agency personnel do our very best to treat customers courteously, whether we are clerical professionals, counselors, social workers or administrators. We use empathy, sincerity, and humor to help build a solid foundation for providing courteous service. • Why do you believe this is important in our business?