July 27, 2015
This essay presents a problem in the DVE protocols and
offers a solution designed to encourage Vocational Rehabilitation Evaluators to
employ a client-centered approach to evaluation and counseling as opposed to
the prevalent program-centered approach.
I. The Problem
A) The “Mean Push”
Hypothesis
The “mean push” hypothesis [see Addendum 1] describes the unspoken protocol
used by VR workers that focuses on the mean of capability/functioning as the
ideal goal, that in effect uses its programs to “push” clients towards the
mean. The push is in fact beneficial for below-the-mean scoring clients,
supporting of expands vistas, empowering clients to achieve maximal functionality
at a level that is as close to the mean as is practicable. Yet for
“above-the-mean” capability clients, the effect of the “mean push” is
detrimental.
The higher above the mean the client’s capabilities are, the
more detrimental it is. This is because DVE protocols seek to accurately
measure capabilities of those clients whose level is at, or below, the mean. Any
client with capabilities above-the-mean, whether small, great or extraordinary
will – as a result of a protocol of non-measurement – be placed in a vague,
non-articulated “catch-all” category or class: “functional or better,” “average
or better.”
B) Above-the-Mean
Capabilities, Non-Measurement and its Consequences
The correlation of capability on the one hand and
psychological suitability of a vocational goal for a VR client is on the other
hand ignored by the “catch all” treatment and the impossibility of pinpointing
capabilities with any semblance of accuracy. It should come as no surprise that Evaluators will often fail to encourage or support the proper goal that would
best allow the client to be integrated socially in the work environment, to
achieve suitable earnings, and to engage in activities that are not straining
to the client due to their banality, repetitiveness, meaninglessness, with the
result that the client is disengaged socially and emotionally from both work
and social environment.
The “do no harm” principle is violated in that this
improper protocol, a), alienates the client, perhaps exacerbating the clients’
diagnosed disability condition, and, b) interferes with achieving the true goal
of the exercise, “suitable employment,” and, c) contributes to continued
poverty and marginalization.
The higher the client’s proficiency the more extreme the of
the created by the “mean push” is on the VR evaluation (the DVE).
The inappropriate attitude of Diagnostic Vocational
Evaluators that is expressed by obfuscatory behavior (failing to accurately
inform the client about the DVE process) and expressed by obfuscatory evaluation
of results (exhibited by “capping” the reports, by misrepresenting, or failing
to represent, actual measurable demonstrated capabilities, abilities and skills
that can be derived from the tests conducted during the DVE) undermines the
fulfillment of the VR standards that expressly delineated by law.
It should not be surprising that the client’s awareness that
an Evaluator is untrustworthy, un-thorough and unconcerned with the veracity of
the DVE process will produce an attitude on the part of the client that will
exhibit a lack of confidence in, and a lack of respect for the professionalism
of the Evaluator, and a lack of confidence in the resulting report’s veracity,
accuracy and conformity with federal law requirements.
C) Violations of
ADA Statute & Policy Directives
The biased treatment of above the mean capability clients
violate – either directly or indirectly – the delineated obligations and
requirements of law. Following is an itemized list of violations of
requirements of federal law governing ADA mandated State Vocational Rehabilitation programs.
1) “Informed choice”
(law term) – Clients are not informed in advance of the testing that their
capabilities that fall above the mean will not be measure and recorded in the
official DVE report. Thus when the client is made aware in what is in many
cases the first test administered, the reading comprehension test, that the
maximum score is “college admission level or above” the client often feels
blind-sighted and quite justifiably thinks of the DVE procedure as unethical and
improper, or at best, unproductive and irrelevant. “The employment goal also must reflect the individual’s
interests and informed choice to the extent that those factors are consistent
with the individual’s strengths, resources, priorities, concerns, abilities,
and capabilities.” (RSA-PD-97-04)
2) “Individualized”
(law term) – The tests meet the individualization standard for clients who are
at the mean or below in capabilities, yet discriminated against clients whose
demonstrable capabilities are “censored” from the DVE process and report, thus
violating the individualized standard. “The State VR Services program is designed to assist
individuals to obtain employment that is consistent with their strengths,
resources, priorities, concerns, abilities, and capabilities (also referred to
in this document as the “individual’s primary employment factors”). Designated
State Units (DSUs) conduct an individualized assessment of the VR needs of each
eligible individual to assist the individual in establishing in the IWRP an
appropriate vocational goal that is consistent with this standard (7(22); 102(b)(1)(A)
and (b)(1)(B)(ii)).” (RSA-PD-97-04)
3) “Unique strengths, resources, priorities, concerns, abilities, and capabilities” (law term) – The 1997 Policy Directive uses the unequivocal word “must” when stating that the VR employment goal that is to be authorized by State VR agencies are to services be “consistent with the individual’s strengths, resources, priorities, concerns, abilities, and capabilities.” (RSA-PD-97-04)
4) “Maximize their employability” (law term) – “Consistent with the increased statutory obligations placed on state VR agencies, on August 19, 1997, the federal Rehabilitation Services Administration (RSA) issued a Policy Directive, RSA-PD-97-04. This directive requires state VR agencies to approve vocational goals and the services to meet these goals to enable persons with disabilities to maximize their employment potential. It represents a dramatic shift in RSA policy.” (S. Rep. No. 388, 99th Cong., 2d Sess. 5 (1986), as quoted in Polkabla v. Commission for the Blind, 183 A.D.2d 575, 576, 583 N.Y.S.2d 464, 465 (N.Y. App. Div.1st Dept. 1992)
5) “Maximize …
economic self-sufficiency” (law term) – “Congress has stated that VR services are to empower
individuals to maximize employability, economic self-sufficiency, independence
and integration into the work place and the community through “comprehensive
and coordinated state-of-the-art programs.” (29 U. S. C. § 701(b)
6) “Comprehensive and
coordinated” (law term) – “Comprehensive and coordinated state-of-the-art
programs of vocational rehabilitation.” (29 U. S. C. § 701 (b)(1)(A))
7) “Maximize …
integration into the work place and the community” (law term) – “Congress has stated that VR services
are to empower individuals to maximize employability, economic
self-sufficiency, independence and integration into the work place and the
community through “comprehensive and coordinated state-of-the-art programs.”
(29 U. S. C. § 701(b)
8) “Highest level of
achievement or a goal” (law term) – “The court noted that the intent of
Congress, in adding the maximization language, was: [T]o establish a program
which would provide services to assist clients in achieving their highest level
of achievement or a goal which is consistent with their maximum capacities and
abilities. Id. at 365.” [Hager report; reference to Buchanan v. Ives,
793 F.Supp. 361 (D. Me. 1991)]
9) “Establish employment goals that are beyond entry level
positions” (law term) – “RSA has stated that VR agencies must establish employment goals
that are beyond entry level positions for those capable of more challenging
work.” [Ronald M. Hager, Esq., “Work, Assistive Technology and State Vocational
Rehabilitation Agencies The Vocational Rehabilitation Agency’s Obligation to
Fund AT to Support Employment Preparation,” National Assistive Technology
Advocacy Project, Neighborhood Legal Services, Inc., Second edition, Feb. 2013,
p. i]
D) Client Experience in Dealing with the Process-Oriented Evaluator
The intent of the client who has high capabilities (and IQ in the higher ranges: “gifted” and above, or 130+) and who seeks to find an outcome that marches his cognitive skill and style with a proper employment outcome will, when taking texts and in fulfilling a written assignment, seek to demonstrate his highest level of ability.
D) Client Experience in Dealing with the Process-Oriented Evaluator
The intent of the client who has high capabilities (and IQ in the higher ranges: “gifted” and above, or 130+) and who seeks to find an outcome that marches his cognitive skill and style with a proper employment outcome will, when taking texts and in fulfilling a written assignment, seek to demonstrate his highest level of ability.
Yet, in the program-centered environment of so many VR
programs, including the DVE portion, the client will be shocked to discover his
or her production and effort that was directed towards establishing a correct
measure of his capabilities, is not only to go unmeasured and unreported, but
also that the Evaluator will demonstrate an apathetic, indifferent attitude,
sometimes a supercilious one, towards what seems (with true justification) to
the client to be a matter of the utmost importance.
Evaluators who do not account for the of the disability diagnosis provided by knowledgeable expert sources will fail to meet the individualized standard in conducting the evaluation and in making recommendations. An example would be a client who is diagnosed with ADD (but who has a gifted IQ and is known to have high capabilities) will be treated in an authoritarian and demeaning fashion, will not be given information about the expectations he or she is expected to meet, will not have the option of informed choices to be considered, and will be pushed into tasks which exacerbate the ADD condition.
The ironic upshot of the process may end up being a damning recommendation that strips the client of all employment goal options except for those which his or her ADD (combined with high capabilities and extensive professional experience) would render impossible to endure, one that places him in an authoritarian environment, expected to perform petty tasks which induce extreme boredom, which give the client no hope of success or fulfillment of his potential in any important area: emotional, financial, intellectual, professional or social.
Evaluators who do not account for the of the disability diagnosis provided by knowledgeable expert sources will fail to meet the individualized standard in conducting the evaluation and in making recommendations. An example would be a client who is diagnosed with ADD (but who has a gifted IQ and is known to have high capabilities) will be treated in an authoritarian and demeaning fashion, will not be given information about the expectations he or she is expected to meet, will not have the option of informed choices to be considered, and will be pushed into tasks which exacerbate the ADD condition.
The ironic upshot of the process may end up being a damning recommendation that strips the client of all employment goal options except for those which his or her ADD (combined with high capabilities and extensive professional experience) would render impossible to endure, one that places him in an authoritarian environment, expected to perform petty tasks which induce extreme boredom, which give the client no hope of success or fulfillment of his potential in any important area: emotional, financial, intellectual, professional or social.
Vocational Rehabilitation practitioners are social workers. Despite this fact,
those among them who adopt a program-centered approach to the DVE process and Vocational Counseling
demonstrate, in situations like this, involving a client who seeks (and, in
actuality, needs) to reach a vocational goal that is consistent with his capability
level, what the handbook Direct Social
Work Practice by Dean Hepworth et al., calls “inept
behavior” in “dealing with a problem beyond their scope of practice.” The rigid
program-centered Evaluator will often match the following description:
“Despite educational preparation, some practitioners
demonstrate behavior that lacks the basic tenets of a helping relationship, for
example, a lack of empathy or being in tune with those seeking their help; a
lack of genuine and authentic concern; a lack of appreciation of different
beliefs, lifestyles, and values.Their inept behavior may be attributed to
anxiety, a lack of skill or experience, dealing with a problem beyond their
scope of practice, or an inability to build collaborative relationships with
clients.”
[Dean Hepworth, Ronald Rooney, Glenda
Dewberry Rooney, Kim Strom-Gottfried, Direct Social Work Practice: Theory and Skills, 9th Edition (Brooks/Cole Empowerment Series), Brooks/Cole, 2013, pp.
556-7]
The DVE process and report are far to important to the life of the client to be allowed to be undermined by the unprofessionalism and mental limitations of an inadequate, unconcerned, and improperly prepared Evaluator.
***
II. Initiating the Solution
A. Eliminating the
measurement/reporting “cap”
DVE must measure, as accurately and precisely as possible
and report precisely as possible:
1) “academic achievement in reading, mathematics, and
language” (language taken from a DVE report).
A “12.9+ grade equivalent level” is the maximum level posted
on official DEV reports, yet the usage is misleading in that the DVE report states
this level as “academic achievement,” implying it is an accurate measurement
rather than the representation of the upper limit which will be noted in all
DVE reports.
Addendum 2 below gives a 5-rank scale in which level 3 is
roughly equivalent to “12.9+.” This scale offers two distinct ranks that are
above the “cap” currently used in DVE reports.
2) “verbal and abstract reasoning.”
Results of tests implemented during the DVE must be scored
and represented in the report accurately rather than being given the vague
“capped” designation of “above average range.”
3) “writing skills”
This skill is tested in the DVE process through a “research
and creative writing assignment.” Rather than reporting the misleading “capped”
skill-level of “functional expression.” “Functional,” it should be noted, is a
term that describes a level of minimal competency above the level that would require
remediation.
Standard designations, used in testing these skills are more
properly expressed in ranked terms, such as those in the “ACTFL Writing
Proficiency Test Rating Scale” which included : “Superior,” “Advanced (“High;”
“Mid;” “Low”), “Intermediate” (“High;” “Mid;” “Low”), “Novice (“High;” “Mid;”
“Low”). (Note: This particular scale is designed to represent foreign language
skills, thus it is not the proper scale for DVE purposes, but is given here as
an example of a useful, properly ranked scale.)
B. Effect of
eliminating the “cap”
The accurate reporting of skills will influence the
judgment, opinions and aims of all parties in the VR process.
• The client will get a clear picture of capabilities,
information that will influence his or her plans and choices.
• The Evaluator will be given the data necessary to
formulate a report, give guidance and make recommendations that will; be
consistent with a client-centered approach and with the requirements of law.
• The State Vocational Counselor will receive a report that
is far more accurate, one that meets with the legally required “individualized”
standard so that the Counselor may be better prepared to guide the client in a
manner consistent with the directive’s requirement for services that assist the
client in maximizing employability through making use of his or her “Unique
strengths, resources, priorities, concerns, abilities, and capabilities.” (29
U. S. C. § 701 (b)(1)(A))
This will help to insure that the 1997 Directive is honored,
at least at the DVE stage of the VR process.
This reform is a step in the direction of assisting clients
possessing above average up to superlative skills, capabilities and capacities
to gain necessary access appropriate social environments that include cognitive
peers as well as to make use of their talents and problem-solving capabilities
and inclinations to engage in work involving complex processes and creative
problem-solving work activities. Clients whose disability and recent history (including
temporary debilitating physical or emotional conditions which the client’s
rehabilitative process is geared to overcome or even eliminate) has allowed him
or her to become alienated from job market and community, due to the
inappropriateness of available jobs that involve hostile environments that may
exacerbate disabilities – such as a cognitive gap (or mismatch) of the client
with tasks and with colleagues who are cognitively and culturally radically
different – require appropriate employment contexts. Jobs that inculcate within
the VR client of the very "highly capable" category, feelings of
extreme boredom, which involve routine and rudimentary tasks, and which place
the client in associations with work colleagues who are hostile to high achievement,
a strong work ethic and unappreciative of the use of fluid intelligence in the
workplace, which are so poorly paid the client becomes trapped on poverty and
consequently becomes socially restricted and isolated (from peers and from
family).
This reform will, it goes without saying, have no positive
effect, however, if the other VR professionals involved in the client’s case
fail to make appropriate is of the data on the client’s “unique strengths, resources, priorities, concerns, abilities, and
capabilities.”
The DVE protocols in their present form work against the
reforms of the 1997 RSA Policy Directive which require recalcitrant state VR
program designers and VR social workers to eliminate the practice of pushing
clients to lower rather than higher levels of achievement (and thus to lower
levels of financial independence, self-actualization and social integration).
As disability rights lawyer Ronald M. Hager, noted in his revised (2013) report
on the rights of VR clients, “the law requires VR agencies to establish VR
goals that are based on the individual’s interests and capabilities.
Additionally, RSA has stated that VR agencies must establish employment goals
that are beyond entry level positions for those capable of more challenging
work.”
Only a client-centered approach that takes into serious
consideration the “whole person” can fulfill the ethical and legal mandates
that pertain – in particular to clients with superior abilities. Thus this
first step in reform must be followed by an attitude, a protocol on the part of
those professions engaged in providing such a client with VR services, that
embodies a full scale reform that combats the counter-productive effects of
protocols that are exhibited when service providers hold a program-centered, bureaucracy-centered,
routine, rigid and regimented approach. Such an approach may, in actuality, not
always harm all clients, yet when dealing with high capability clients, it will
be the case that program-centered approach, characterized by lack of engagement
on the part of the VR service provider, lack of familiarity with (and respect
for) the client’s capabilities and needs (emotional, intellectual, financial
and social) will, in most cases, grossly violate the “do no harm” axiom.
Another important consideration when VR agencies deal with
high capability clients is the recognition of the fact that all VR providers
involved in the case must be well-matched with service providing individuals
who are properly qualified and able to comprehend and work with the
information conveyed to them by clients regarding his or her requirements
(especially with regard to cognitive/IQ-appropriateness in vocational goals).
Respect for the client’s rights and goals is of paramount
importance. In cases where the service provider has difficulty comprehending
the clients communication of matters pertaining to business, marketplace
economics, finance, “opportunity cost” to client resulting from avoidable
delays in services being provided, employment goals involving high-level
problem-solving and entrepreneurial attitude, it is necessary that the service
provider elicit the assistance of a properly qualified professional (such as a
senior supervisor).
The reforms discussed in this essay, despite having been delineated in the 1997 Policy Directive, and despite not having not been instituted by some States as of yet, is nevertheless establishes legally mandatory practices that must be followed by agencies, regardless of any given State’s failure to direct VR Service providers to follow the federal law.
The reforms discussed in this essay, despite having been delineated in the 1997 Policy Directive, and despite not having not been instituted by some States as of yet, is nevertheless establishes legally mandatory practices that must be followed by agencies, regardless of any given State’s failure to direct VR Service providers to follow the federal law.
It is to be hoped that this effort to clarify important
failings of the DVE process will inspire service providers to alter their
practices – out of their own professional integrity in an effort to properly
serve the needs and requirements of all their clients including those who
represent an exceptional class of client (whose “whole person” needs are just
as great as those of the ordinary clients), rather than to remain focused on
below-average-capabilities clients.
***
ADDENDUM 1:
The “Mean Push” Hypothesis
1) Hypothesis: Dragging down one group and lifting up another.
Could there be a latent desire (perhaps fueled by a misapplication of notions of “equality” employed perversely to denote sameness in behavior and aptitude, rather than properly to denote equality of opportunity) on the part of VR professionals, expressed in their models, methods, programs, and evaluation techniques to drag down VR clients (a tiny minority of the total population of VR clients) populating the right-hand side of the IQ bell curve, while at the same time exhibiting a sincere effort to lift up those populating the left hand?
ADDENDUM 1:
The “Mean Push” Hypothesis
1) Hypothesis: Dragging down one group and lifting up another.
Could there be a latent desire (perhaps fueled by a misapplication of notions of “equality” employed perversely to denote sameness in behavior and aptitude, rather than properly to denote equality of opportunity) on the part of VR professionals, expressed in their models, methods, programs, and evaluation techniques to drag down VR clients (a tiny minority of the total population of VR clients) populating the right-hand side of the IQ bell curve, while at the same time exhibiting a sincere effort to lift up those populating the left hand?
Are Vocational Rehabilitation professionals inadvertently,
or in some cases, deliberately, taking a VR client who has “gifted” or “very
superior IQ,” persons who are capable of complex “fluid” thinking, and then
implementing a series of actions (services), or inaction (denial of services)
that would, in effect, attempt to make the client more disabled after
implementation of VR treatments, than the client was before exposure to the VR
system?
We might consider these questions in light of this
observation: “… a sustained pattern of repeated errors, insensitive behaviors
can cause psychological damage to clients.” [Dean Hepworth, Ronald Rooney,
Glenda Dewberry Rooney, Kim Strom-Gottfried, Direct Social Work Practice:
Theory and Skills, 9th Edition (Brooks/Cole Empowerment Series),
Brooks/Cole, 2013, pp. 556-7]
My hypothesis that there might exist a unwritten policy, or
a tendency at least, to unjustifiably and inappropriately “push” High IQ VR
consumers towards the mean – a practice that clearly is harmful to the consumer
in terms of both process and outcome – should be named the VR “mean push”
hypothesis.
2) Expanding vistas vs. Constricting vistas
The VR “mean push” is predicated
on an ideal goal of promoting averageness or sameness, rather than in seeking individualized
suitability in the true, legally required, sense (“whole person” sense). It
does not essentially fail or harm clients who can be seen as “below the mean”
in cognitive ability (as well as skills) on the bell curve to be pushed towards
functionality resembling the mean. This is an approach that seeks to expand
vistas. Yet the “mean push” when applied to “above the mean” in cognitive
ability, the approach is harmful in that it seeks to constrict vistas rather
than expand them. The “mean push” while seeming to be predicated upon a concept
of aggregate (society-wide) “equality” it in fact is seeking coerced sameness,
and in fact treats individual members of different classes inequally.
3) Parallel to Above average IQ clients: The DV “Mean
Push” Hypothesis
With regard to the non-measurement of above-average
abilities and aptitudes and the production of a generic “average or above”
ranking of skills and abilities, replacing an accurate measure that the client
reasonably would have expected to underscore the client’s hope for success,
achievement, social integration and financial independence, we see a parallel
akin what is described above as the VR “mean push” hypothesis. The area
of the client’s positive self-perception which the client may see as the
“shining light” of hope for self-improvement and escape from an unhappy status
and way of life, is dashed to the ground – in favor of a bias towards
“averageness,” a prejudice against talent, a stereotypical discounting of the
“gifted” or High IQ client as “privileged” and undeserving of, and not in need
of, the assistance that has been solicited.
ADDENDUM 2:
U.S. Department of
Education, Institute of Education Sciences, National Center for Education
Statistics, PIAAC Proficiency Levels for Literacy.
Description of PIAAC
literacy discrete achievement levels
• • •
Achievement level and
score range - Task descriptions
Below Level 1: 0 – 175
The tasks at this level require the respondent to read brief
texts on familiar topics to locate a single piece of specific information.
There is seldom any competing information in the text and the requested
information is identical in form to information in the question or directive.
The respondent may be required to locate information in short continuous texts.
However, in this case, the information can be located as if the text were
non-continuous in format. Only basic vocabulary knowledge is required, and the
reader is not required to understand the structure of sentences or paragraphs
or make use of other text features. Tasks below Level 1 do not make use of any
features specific to digital texts.
Level 1: 176 – 225
Most of the tasks at this level require the respondent to
read relatively short digital or print continuous, non-continuous, or mixed
texts to locate a single piece of information that is identical to or
synonymous with the information given in the question or directive. Some tasks,
such as those involving non-continuous texts, may require the respondent to
enter personal information onto a document. Little, if any, competing
information is present. Some tasks may require simple cycling through more than
one piece of information. Knowledge and skill in recognizing basic vocabulary
determining the meaning of sentences, and reading paragraphs of text is
expected.
Level 2: 226 - 275
At this level, the medium of texts may be digital or
printed, and texts may comprise continuous, non-continuous, or mixed types.
Tasks at this level require respondents to make matches between the text and
information, and may require paraphrasing or low-level inferences. Some
competing pieces of information may be present. Some tasks require the
respondent to
- cycle through or integrate two or more pieces of information based on criteria;
- compare and contrast or reason about information requested in the question; or
navigate within digital texts to access and identify
information from various parts of a document.
Level 3: 276 – 325
Texts at this level are often dense or lengthy, and include
continuous, non-continuous, mixed, or multiple pages of text. Understanding
text and rhetorical structures become more central to successfully completing
tasks, especially navigating complex digital texts. Tasks require the
respondent to identify, interpret, or evaluate one or more pieces of
information, and often require varying levels of inference. Many tasks require
the respondent to construct meaning across larger chunks of text or perform
multi-step operations in order to identify and formulate responses. Often tasks
also demand that the respondent disregard irrelevant or inappropriate content
to answer accurately. Competing information is often present, but it is not
more prominent than the correct information.
Level 4: 326 - 375
Tasks at this level often require respondents to perform
multiple-step operations to integrate, interpret, or synthesize information
from complex or lengthy continuous, non-continuous, mixed, or multiple type
texts. Complex inferences and application of background knowledge may be needed
to perform the task successfully. Many tasks require identifying and
understanding one or more specific, non-central idea(s) in the text in order to
interpret or evaluate subtle evidence-claim or persuasive discourse
relationships. Conditional information is frequently present in tasks at this
level and must be taken into consideration by the respondent. Competing
information is present and sometimes seemingly as prominent as correct
information.
Level 5: 376 – 500
At this level, tasks may require the respondent to search
for and integrate information across multiple, dense texts; construct syntheses
of similar and contrasting ideas or points of view; or evaluate evidence based
arguments. Application and evaluation of logical and conceptual models of ideas
may be required to accomplish tasks. Evaluating reliability of evidentiary
sources and selecting key information is frequently a requirement. Tasks often
require respondents to be aware of subtle, rhetorical cues and to make
high-level inferences or use specialized background knowledge.
***
ADDENDUM 3:
Problems of the Program-Centered Approach (as opposed to Client-Centered or Person-Centered Approaches)
“Despite educational preparation, some practitioners demonstrate behavior that lacks the basic tenets of a helping relationship, for example, a lack of empathy or being in tune with those seeking their help; a lack of genuine and authentic concern; a lack of appreciation of different beliefs, lifestyles, and values. Their inept behavior may be attributed to anxiety, a lack of skill or experience, dealing with a problem beyond their scope of practice, or an inability to build collaborative relationships with clients. Ineptness and ethical practices on the part of social workers, such as abrasive, egotistical, controlling, judgmental, demeaning, patronizing, or rigid behavior can cause an appropriate negative reaction from clients. In these interactions, clients’ reactions can become a cycle of escalating conflict. For instance, a practitioner demeans an individual, an individual reacts, and so forth. It is not unusual for the professional to attempt to control by exerting his or her power and authority, which of course tends to cause another reaction from the client. Being habitually late or unprepared for appointments, appearing to be detached or disinterested, and under-involved are further indicators of troubling behavior. Most people will react to behavior that they view as disrespectful or unprofessional. In many cases, a practitioner would not tolerate similar behavior in a client.
ADDENDUM 3:
Problems of the Program-Centered Approach (as opposed to Client-Centered or Person-Centered Approaches)
“Despite educational preparation, some practitioners demonstrate behavior that lacks the basic tenets of a helping relationship, for example, a lack of empathy or being in tune with those seeking their help; a lack of genuine and authentic concern; a lack of appreciation of different beliefs, lifestyles, and values. Their inept behavior may be attributed to anxiety, a lack of skill or experience, dealing with a problem beyond their scope of practice, or an inability to build collaborative relationships with clients. Ineptness and ethical practices on the part of social workers, such as abrasive, egotistical, controlling, judgmental, demeaning, patronizing, or rigid behavior can cause an appropriate negative reaction from clients. In these interactions, clients’ reactions can become a cycle of escalating conflict. For instance, a practitioner demeans an individual, an individual reacts, and so forth. It is not unusual for the professional to attempt to control by exerting his or her power and authority, which of course tends to cause another reaction from the client. Being habitually late or unprepared for appointments, appearing to be detached or disinterested, and under-involved are further indicators of troubling behavior. Most people will react to behavior that they view as disrespectful or unprofessional. In many cases, a practitioner would not tolerate similar behavior in a client.
“Ineptness is a serious concern which calls for corrective
behavior on the part of the practitioner, through supervision, skill
development, or self-reflection. Pathological behavior on the part of the
social worker in which there is a sustained pattern of repeated errors,
insensitive behaviors can cause psychological damage to clients.”
[Dean Hepworth, Ronald Rooney, Glenda
Dewberry Rooney, Kim Strom-Gottfried, Direct Social Work Practice: Theory and Skills, 9th Edition (Brooks/Cole Empowerment Series), Brooks/Cole, 2013, pp.
556-7] (emphasis added)
***
ADDENDUM 4:
Person-Centered
Reforms in the USA & UK
A) 2001 (USA)
“The person at the focus of planning, and those who love the
person, are the primary authorities on the person’s life direction.”
“The purpose of Person-Centered Planning is learning through
shared action. People who engage in Person-Centered Planning may produce documentation
of their meetings, proposals, contract specifications, or budgets. These are
only footprints: the path is made by people walking together.”
[Amado, A. N. and McBride, M. (2001), Increasing
Person-Centered Thinking: Improving the Quality of Person-Centered Planning: A
Manual for Person-Centered Planning Facilitators. Minneapolis, Minnesota:
University of Minnesota, Institute on Community Integration, p. 3]
B) 2001 (UK)
“Good management of learning disability services requires:
strong partnership working: while learning disability has been at the forefront
of making use of the flexibilities under the Health Act 1999, many areas have
yet to achieve real partnership between health and social care. Joint
commissioning has been slow to take off. Few areas have partnerships involving
service users, their families and the wider range of agencies.
good planning to ensure that services are responsive:
“Few places attempt to have the individual’s aspirations,
needs and views as the driving force for providing services.”
[“Valuing People: A New Strategy for Learning Disability for
the 21st Century, A White Paper,” March 2001, Presented to Parliament by the
Secretary of State for Health by Command of Her Majesty, UK, p. 21]
C) 2008 (UK)
Regarding the transformation of social care: “To do this
will require a common assessment of individual social care needs, emphasising
the importance of self-assessment. The role of social workers will be focused
on advocacy and brokerage, rather than assessment and gate keeping. This move
is from the model of care, where an individual receives the care determined by
a professional, to one that has person centred planning at its heart, with the
individual firmly at the centre in identifying what is personally important to
deliver his or her outcomes. With self-directed support, people are able to
design the support or care arrangements that best suit their specific needs. It
puts people in the centre of the planning process, and recognises that they are
best placed to understand their own needs and how to meet them.
“They will be able to control or direct the flexible use of
resources (where they wish to), building on the support of technology (eg
telecare), family, friends and the wider community to enable them to enjoy their
position as citizens within their communities.”
[“Transforming Social Care,” Department of Health (UK), 17
January 2008 (Gateway Reference: 9337), p. 17]
http://webarchive.nationalarchives.gov.uk/20130107105354/http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/documents/digitalasset/dh_082139.pdf
D) “Person-centred planning”
http://webarchive.nationalarchives.gov.uk/20130107105354/http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/documents/digitalasset/dh_082139.pdf
D) “Person-centred planning”
“A central idea behind person-centred planning, is that
services which are set up to respond to problems of social exclusion,
disempowerment, and devaluation, can unintentionally make the situation of
individual people worse (i.e. further disempower, devalue and exclude people).
Person-centred planning is designed specifically to ‘empower’ people, to
directly support their social inclusion, and to directly challenge their
devaluation. One of the benefits of person-centered planning is that it can
address the perennial “service problems” of ethnicity, gender, culture and age
by starting with planning by or with the “whole person”. [From: “Person-centred planning,” Wikipedia, Jul.
28, 2015]
“Person-centred planning involves the individual receiving
the service, with family members, neighbors, employers, community members, and
friends, and professionals (such as physician/ doctors, psychiatrists, nurses,
support workers, care managers, therapists, and social workers) developing a
plan on community participation and quality of life with the individual. In
contrast, traditional models of planning have focussed on the person’s deficits
and negative behaviours, labelling the person and creating a disempowering
mindset from the start.” [From: “Person-centred
planning,” Wikipedia, Jul. 28, 2015]
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