I found myself thinking about this article and wanted to address a “plot hole” of sorts. From another’s perspective– agree with the article or not– I can imagine reading this and having some concerns from an ethical standpoint. How do I– an active practitioner– deliver culturally humble services to conservative families?
It’s a valid question. I just called all right-wingers unethical, and it’s not exactly a secret that I find many beliefs attributed to conservative thinking to be abhorrent. Such beliefs inhibit one from delivering ethical services. I stand by that statement, but is the opposite true? By holding the opinion that certain beliefs are harmful and unethical, am I able to ethically serve those families?
Tl;dr: Yes. The difference is clients’ rights.
Biased statement ahead: The main difference between the right and the left from a social perspective is the right wants to restrict rights of others and the left wants to extend them. Yes, that’s a loaded statement, and most right-wingers aren’t going to agree with it because they think their ability to restrict others is their right, and any action to stop that as a violation thereof.
From a practitioner perspective though, affirming learners who are gender, sexual, and/or romantic minorities, accessing and providing community support for people with varying needs, socialized medicine and financial assistance like medicaid and food stamps: These are all things conservatives tend to oppose. The above linked article goes into all of those details.
How do I do it better?
So when I find myself working with a family with strong conservative views, what do I do?
The oversimplified version? I honestly try not to think about it.
That doesn’t mean I pretend those uncomfortable values aren’t there. It means I don’t break those caregivers down to just their beliefs. When working with a family, just like when working with a learner, you should be looking at the whole person, right? Practitioners (who are worth a shit) don’t break down learners to just the empty parts of an assessment and their “deficits of autism.” They look at the whole learner as a person who behaves according to the principles of behavior just like a person without a diagnosis. Their conservative families are the same way. They’re not just a Trump voter or a fundamentalist Christian. They’re a caregiver who loves a person with a disability and wants to do everything they can to help them. Their definition of helping and what’s right is bound to be different sometimes, but I’ve found it’s not as often as you might think.
What we don’t have in common rarely if ever comes up. What we do have in common is the desire to support their learner. Most of the time – at least in my experience – these families are far less concerned with your voting practices and far more concerned with your expertise. They expect you to be able to meet their goals of giving their loved ones whatever they need to succeed. Often, that comes with some level of receptiveness to feedback and ideas.
What does it look like?
If a family has their loved one enrolled in speech or occupational therapy, best practices would suggest that we would be collaborating in some way with those other practitioners. Same goes with learners who are attending school and receiving special education services. When we do collaborate, we are likely to be speaking different languages. If you’re effectively collaborating and not just waiting for your turn to tell them why they’re wrong, chances are you will find you are saying roughly the same thing and have the exact same outcome in mind, you’re just using different vocabulary to say it.
Now, what if a family wants to include a religious leader in supporting their learner? What if their learner is receiving some kind of service or support through a religious organization? Should our collaboration be any different? It’s more likely these services will have slightly different outcomes in mind than say, speech or education, but that doesn’t necessarily mean they are going to be less receptive to feedback. This is especially true if they’re viewing you as an expert on that child and/or that child’s disability, and in general, if they’re willing to collaborate with you, then they likely do hold that view of you to some extent.
Just like when working with other professional fields, the goal will be to help those providers understand how to appropriately support that learner and that learner’s rights. That might mean learning some new vocabulary or applying the science of behavior to a novel environment. It will definitely mean building rapport– which doesn’t usually involve arguing with someone about their beliefs, no matter how abhorrent you might find some of them. Usually rapport is built much faster when you either validate their feelings or beliefs or simply keep your damn mouth shut and focus on what’s relevant to the learner.
What about when it goes wrong?
Go to any ethics discussion or forum and you will find hundreds of questions asking about this. What do we do when a family’s values contradict the learner’s best interests?
The answers tend to be pretty similar: Build rapport, listen, educate. If that doesn’t work, you may need to refer out. Depending on the communities you work with, this will come up more or less often. Obviously, this is a little oversimplified as well. No one is going to want to refer out, especially because that will leave that learner in a potentially harmful situation, and these conversations often continue along those lines. How do we protect the learner from harmful viewpoints? It’s always going to be delicate. Behavior change is a long process, and with any “challenging” behavior, that long process can make us antsy.
So what do I do when a family says “spare the rod, spoil the child?” Well, just like with any functional assessment of a behavior, the first question is going to be “is what you’re doing working?” If they’re coming to you for help, they’re probably going to realize pretty quickly (if they haven’t already) that it is not. Boom. +1 Trust. There’s also tons of research across fields showing that corporal punishment is ineffective. There’s research on sensory differences in autistic brains that could shed some light on how corporal punishment may be particularly ineffective for that family’s child. There’s the education component. No need to argue with them on the concept of sparing the rod. They are talking to you because they have noticed their child is different and doesn’t respond in the ways their learning history would make them expect. Another +1 Trust.
Soft skills are easier for some than others. Personally, I find myself often flooded with empathy when I am talking to someone face-to-face who is worried about someone they love, even if they had previously expressed a view that upset me. If you are able to actively listen and think behaviorally and critically, it should be fairly easy to look past Quran quotes or Trumpism to see a caregiver who is vulnerable and coming to you for help. As I’ve discussed before, most caregivers are doing the best they can with the tools they have to help their loved one thrive. Just like with learners, we are getting their consent to treatment and shaping behaviors that will benefit their loved one.
Maybe over time, those interactions will affect their politics or their views as a whole to be less exclusive. That would invariably make the world a better place and that’s a hell of a potential perk to our job.
But that’s not our job. Our job as applied practitioners working with disabled individuals is to support those individuals to be successful by whatever definition that word carries for them. Inevitably, that is going to involve families and other caregivers who can also benefit from support. The way we accomplish all of that that is through recognizing and navigating our own biases, but that is going to be impossible if our biases restrict others’ rights.