Professional Communication Practices:

Values, Ethics & Confidentiality

Delaware Division of Vocational Rehabilitation

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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

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THE FOUNDATION OF OUR WORK

Why is there a Public VR Program?

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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

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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.

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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.

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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.

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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?

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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.

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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.

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PUTTING OUR WORK INTO THE CONTEXT OF TODAY’S SOCIETY

Attitudes & Barriers11

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

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Why do Attitudinal Barriers Exist Today?

FEAR Many people fear they will say or do the wrong thing and, therefore, avoid people with disabilities.

BACKLASH People believe that individuals with disabilities are given unfair advantages.

DENIAL "Hidden" disabilities are not "real" disabilities that require accommodation.

SPREAD EFFECT "Hidden" disabilities are not "real" disabilities that require accommodation.

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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

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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.

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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

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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

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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

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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.

People First Language

Affirmative Phase Negative PhrasePerson with mental retardation retarded, mentally challenged

Person who is blind or has a visual disabilities

visually impaired, the blind the disabled, handicapped

Person with a disability Person who is deaf, person who is hard of hearing

suffers a hearing loss, the deaf

Person who has multiple sclerosis

afflicted by MS

Person with cerebral palsy CP victim

Person who uses a wheelchair confined or restricted to a wheelchair

Person with psychiatric disability

crazy, nuts

Words to Avoid Using

ChallengedHandicappedDisabledCrippledSuffers from…Is afflicted with…VictimPityConfined

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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.

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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.

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PROFESSIONAL COMMUNICATION PRACTICES

Values, Ethics & Confidentiality

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Values

VALUES are attitudes and beliefs about things we think are important in life.Define what we prize, regard highly or

preferAre indicated by frequent and consistent

actionsOur values provide the lens on how we

view the world, including our attitude and action towards people.

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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?

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Being Aware of Personal Values

What are some examples of personal values that might impact our professional work?

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Some examples….

Sexual identity issuesSubstance abuse Assisted suicideChild CustodyIllegal means of supportSpousal abuse

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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.

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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?

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ETHICS

Merriam-Webster's Collegiate Dictionary (1999):

The principles of conduct governing an individual or a group <professional ethics>

A guiding philosophy

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ETHICS

Ethics refers to our “code of conduct”.

Our personal values contribute to the strength of our ethics with positive behaviors and positive attitudes.

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ETHICS

ETHICS IS EASIER SAID THAN DONE.

(Josephson Institute 1991)

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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.

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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.

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Confidentiality

Factors which complicate the issue:Multiple partners Referral sourcesPhysical environmentSmall communitiesSpecial populations

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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?

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Response

YES. If it 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.

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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.

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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.

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When Is a Dual Relationship Harmful?

Intimate relationshipsPersonal benefit: monetary gain, goods

and servicesEmotional and dependency needs:

confusion between personal and professional lives

Altruistic gestures: performing favors; providing nonprofessional services, giving gifts and being extraordinarily available

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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?

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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  

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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?

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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?

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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?

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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?

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FIRST IMPRESSIONS ARE POWERFUL

Effective Communication Skills48

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

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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?

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First Impressions: Why is it Important?

Earlier we talked about the attitudinal barriers that people with disabilities experience in society.

If we treat consumers discourteously, they may believe our agency views disability in a negative way, which is not the case. By treating them with respect, we are reinforcing their value to society and the belief of the agency that people with disabilities CAN work!

If we treat them with disrespect, the success of their VR program may be hindered.

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Professional Image

You are one of the first professionals to have contact with potential VR customers, either over the telephone or in person. Having a professional image is essential. Your image is important when communication with customers over the telephone and in person.

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Professional Image: Learning Experience

Telephone Contact Scenario:You are making a phone call to your physician

to ask for a referral to a specialist because you have been having persistent back pain.

What are the communication skills of the professional answering the phone at your physician’s office that would be important to you as a consumer?

How might his/her skills impact you as a consumer in both a positive and negative way?

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Professional Image: Learning Experience

These are communication skills of the professional that will impact a consumer, where it is over the phone or in person:

ProfessionalismRespectfulnessPositive tone of voiceHelpful AttitudeAttentiveness/Active Listening Skills

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The Initial Contact with the Customer

How you open a conversation with the customer sets the stage for the entire information gathering session.

The goal is to help customers feel comfortable by communicating with a helpful and friendly attitude from the start.

This helps the customers feel comfortable with the process and will impact their experience with the agency in the future.

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Starting Off Successfully: Active Listening Skills

Good listening skills are very important to communicating in a positive way with customers. Listening validates the customer by showing that you are interested in what he/she is sharing.

Active listening involves the following four nonverbal activities:1) Assume an active listening posture.2) Maintain eye contact.3) Make nonverbal encouragements4) Make active listening facial expressions.5) Use a pleasant tone of voice.

Active listening also involves verbal encouragements.

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Refocusing the Conversation

Often times customers may provide many details and may go off topic.

How might you refocus their attention to the questions at hand?

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Refocusing Statements

Maintain your positive attitude, despite frustration you may be experiencing.

When the consumer takes a break (or a breath), interject by saying: I appreciate your situation… I understand your concern… Let’s stop for a minute… I’d like to get more information from you about your

“education” or whatever question you were on…

Completing the statements with and am sure your counselor will talk with you in greater

detail when you meet…

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Special Situations: Learning Experience

Communication techniques may vary depending on the customer’s disability. How would you handle situations with customers who: Have a cognitive disability with difficulty

reading and/or understanding information forms or instructions

Using a computer to enter data speaking clearly has a visual disability has a hearing disability?

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Telephone Hostility

Sometimes customers are frustrated and/or angry for a multitude of reasons: dealing with bureaucracy, adjustment to disability issues, associated with a mental health disability, etc.

Since you are not face to face, you do not face immediate threat – this may allow you to feel less intimidated.

Remember you have control over phone conversations, you are not expected to tolerate poor treatment or abuse from customers.

You should tell the customer that you would like him/her to talk with someone who may be able to help.

Place the person on hold and refer the call a supervisor or counselor.

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In Person Meetings: Safety First!

Ensure that the meeting room where you meet customers is safe: Always advise the

supervisor/counselor/receptionist that you are meeting with a customer.

He/she may want to check in with you, if it appears the meeting is running long.

Room set up: always have direct access to the door; do not have the customer between you and the exit.

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In Person Meetings: Safety First!

Consider safety as bottom line: always err on the side of safety

If the customer starts making advances, is angry or aggressive, excuse yourself immediately and seek assistance from a supervisor or counselor.

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Learning Experience: Role Playing

Let’s break into groups if three. You will each take a turn in three roles: Clerical professional gathering the information Customer Observer

Refer to the “Professional Communication Practices Summary” as a cheat sheet during all three roles.

The observer will record comments (positives as well as constructive criticism) on the topics listed on the summary.

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Learning Experience: Role Playing (cont’d)

Typically the clerical professional will not have any background information on the customer. So during this learning experience only the customer and observer will receive a description of the customer’s role.

Let’s review the observer sheet, where you will record whether or not effective communication skills were present.

We will take 5 to 10 minutes for each scenario. After each role play we will debrief as a group prior to moving to the next scenario.

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Professional Communication Practices:

Values, Ethics & Confidentiality

CONTACT INFORMATION:

JOAN KESTER, CRC

HRD SPECIALIST

MID-ATLANTIC REHABILITATION CONTINUING

EDUCATION PROGRAM

THE GEORGE WASHINGTON UNIVERSITY

202-489-7112

JKESTER@GWU.EDU

WEBSITE: WWW.GWU.EDU/~RRCEP

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This information is the intellectual property of the George Washington University and is to be used for training purpose only.