The Meaning of Direct Support Professional

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The Meaning of Direct Support Professional

• NADSP Code of Ethics

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History of Disabilities

• Disability History Timeline
• In 355 B.C. laws required that no deformed child
  should live.
• Attitudes were slow to change. The growth of
  modern religions-particularly Christianity and
  Islam- gradually caused people with disabilities
  to be treated, if not equals, as worthy of some
  protection

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History- continued

• The Catholic Church, the most powerful and
  influential force in Europe by the 5th century,
  taught charity as a virtue. Basing its position
  on frequent depictions of Jesus as showing
  kindness and even healing the disabled.
• St. Paul called to comfort the feeble-minded,
  making the first steps toward establishing basic
  human rights for people with developmental
  disabilities.

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History- continued

• However,treatment of most people with
  disabilities improved little. People born with
  disabilities still faced mistreatment and abuse.
  They were often kept as jesters (fools) in the
  courts of the nobility- abused for the
  entertainment of the wealthy and powerful.
  Although it did move out of the manors of lords
  and into the streets.

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History- continued

• In town squares, idiot boxes steel cages where
  people with mental illness or mental retardation
  were confined to keep them out of trouble, were
  not uncommon. Theses were, more often than not,
  used more for the cruel entertainment of the
  townsfolk than for any more humanitarian purpose.
  (it is from this practice that the term village
  idiot is derived.

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History- continued

• From there we went to a movement to create
  hospitals to care for people with disabilities.
  The first such institution, founded in 787 A.D.
  Italy.
• Now lets fast forward to the United States..As
  in Europe, the establishment of the almshouse
  was created where

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History- continued

• the government placed people with developmental
  disabilities with the mentally ill, unemployable
  poor, drunkards, criminals and runaways- the
  conditions of the government houses were less
  than ideal.
• It should be understood that the almshouses, the
  correctional institutions, and the hospitals were
  primarily for the benefit of those who were
  without family supports.

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History- continued

• While scientific advancements at the end of the
  19th century offered hope for new medical
  treatments, they also brought about many negative
  changes for the treatment of people with
  disabilities.
• Eugenics the breeding of a superior race or the
  protection of the gene pool. Laws mandating
  sterilization of people with disabilities became
  prominent.

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History- continued

• Indiana became the first of 23 states (over half
  of the states in the U.S. at the time) to pass
  legislation requiring the involuntary
  sterilization of any confirmed criminal, idiot,
  rapist, or imbecile in a state institution. Seven
  additional states passed similar legislation.

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History- continued

• Since, at this point, the vast majority of people
  with DD were confined to state institutions, it
  was nearly a foregone conclusion that if a person
  had a DD, that person was going to be subjected
  to an involuntary sterilization procedure.
• It is not insignificant that Virginias eugenics
  law became the model for Nazi eugenics
  legislation, and was a key piece of defense in
  the Nuremburg trails.

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History- continued

• In 1915, Good Housekeeping magazine advised its
  readers that people with mental retardation are
  born of and will breed nothing but defective
  stock and, without citing any source, asserted
  that seven-eights of our criminals are
  recruited from this population. Take care of
  the morons, the magazine said, and crime will
  take care of itself.

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History- continued

• It was not until 1950s (although there was some
  activity in the 1930s) that society as a whole
  began to question the wisdom of involuntary
  institutionalization for people with
  disabilities. With the formation of the ARC and
  following the Brown v. Board of Education case in
  1954, was ARC able to assert the rights of people
  with disabilities to receive and education.

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History - continued

• Although Brown v. Board of Education was
  primarily seen as an anti-segregation case, Brown
  was far broader in implication, affirming the
  right of all citizens to not face discrimination
  in the educational system.
• By 1960 Senator Robert Kennedy and other
  political figures began to raise the alarm about
  the conditions in public institutions.

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History - continued

• Public sentiment did not begin to change
  dramatically, until the media took up the cause.
• Burton Blatt and Fred Kaplan(photojournalists)
  documented the conditions in state institutions
  over Christmas. The photo and accompanying text,
  entitled Christmas in Purgatory, shocked the
  public.

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History - continued

• As a result of such exposure, states began
  passing laws recognizing the rights of people
  with disabilities. This process, known as
  deinstitutionalization, continues today.

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New Models

• As people were moved out of institutions and into
  the community, the focus of services to these
  individuals began to shift from caretaking to
  support.
• This was a significant difference in that
  embodied a new attitude toward people with DD
  instead of being people who needed attending,
  they were people who had goals and dreams of
  their own and simply needed assistance in
  achieving them.

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Models- continued

• We moved to group homes, active treatment,
  freedom of choice, inclusion,
  person-centered, American Disabilities Act
  Olmstead decision and so on.
• Views of people with DD have progressed from
  subhuman in ancient times through patient and
  client to finally citizen. As such, the
  decisions about their lives are being made less
  frequently by doctors and other professionals,
  Instead, they are made by the individual himself
  in concert with his/her circle of support.

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Today

• Today the focus is on self-determination.
  Self-determination is based on four basic
  principles
• Freedom to exercise of the same rights as all
  citizens. People with disabilities (with
  assistance, when necessary) will establish where
  they want to live, with whom they want to live
  and how their time will be occupied. They do not
  have to trade their inalienable rights guaranteed
  under the Constitution for supports or services.

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Self-Determination - continued

• Authority and control of whatever sums of money
  are needed for ones own support. This control
  includes the re- prioritizing of these dollars
  when necessary. This is accomplished through the
  development of an individual budget that moves
  with the person.

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Self-Determination - continued

• Support through the organization of thee
  resources as determined by the person with a
  disability. This means that individuals do not
  receive supervision and staffing. Rather,
  folks with disabilities may seek companionship
  for support and contract for any number of
  discrete tasks for which they need assistance.

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Self-Determination- continued

• Responsible and wise use of public dollars.
  Dollars are now being used as an investment in a
  persons life and not handled as resources to
  purchase services or slots. Responsibility
  includes the ordinary obligations of American
  citizens and allows individuals to contribute to
  their communities in meaningful ways.

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People First Movement

• These principles are part of the People First
  movement, an effort to promote the idea that,
  first and foremost, people with disabilities are
  people.
• Values and services continue to evolve as needs,
  understanding, and attitudes change. As our
  history demonstrates, this is inevitable.

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The Direct Support Professional

• Today

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Direct Support Professional

• The primary purpose of the DSP today is to
  assist people who need support to lead
  self-directed lives and to participate fully in
  our communities and nation.
• This emphasis on empowerment and participation is
  critical because of the prejudices of society
  form powerful barriers that prevent many people
  with mental or physical disabilities enjoying a
  high quality of life.

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Direct Support Professional

• Therefore, it must be the mission of the DSP to
  follow the individual path suggested by the
  unique gifts, preferences, and needs of each
  person they support, and to walk in partnership
  with the person, and those who love him or her,
  toward a life of opportunity, well-being,
  freedom, and contribution.

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Credo of SupportBy Norman Kunc and Emma Van der
Klift

• Do Not see my disability as the problem
• Do Not see my disability as a deficit
• Do Not try to fix me because I am not broken

• Recognize that my disability is an attribute
• It is you who see me as deviant and helpless
• Support me. I can make my contribution to the
  community in my own way

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Credo of Support cont

• Do Not see me as your client. I am your fellow
  citizen.
• Do Not try to modify my behavior

• See me as your neighbor. Remember, none of us can
  be self-sufficient
• Be still and listen.
• What you define as inappropriate may be my
  attempt to communicate with you in the only way I
  can

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Credo of Support- cont

• Do Not try to change me, you have no right.
• Do Not hide your uncertainty behind professional
  distance.

• Help me learn what I want to know.
• Be a person who listens and does not take my
  struggle away from me by trying to make it all
  better.

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Credo of Support- cont

• Do Not use theories and strategies on me.
• Do Not teach me to be obedient, submissive, and
  polite.

• Be with me. And when we struggle with one
  another, let that give rise to self-reflection.
• I need to feel entitled to No if I am to protect
  myself.

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Credo of Support - cont

• Do Not be charitable towards me. The last thing
  this world needs is another Jerry Lewis.
• Do Not try to be my friend. I deserve more than
  that.

• Be my ally against those who would exploit me for
  their own gratification.
• Get to know me. We may become friends.

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Credo of Support- cont

• Do Not help me, even if it does make you feel
  good.
• Do Not admire me. A desire to lead a full life
  does not warrant adoration.

• Ask me if I need your help. Let me show you how
  you can best assist me.
• Respect me, for respect presumes equity.

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Credo of Support- cont

• Do Not tell, correct, and lead.
• Do Not work on me

• Listen, support and follow.
• Work with me.

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National Alliance of Direct Support
Professionals (NADSP)

• Unfortunately, until recently there have been no
  set criteria to guide these journeys as there are
  for other professional groups (such as nurses,
  social workers, service coordinators and doctors)
  who have intimate knowledge of and responsibility
  for another persons emotional,financial or
  physical being.

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NADSP - continued

• andthere is no other position today in which
  ethical practice and standards are more important
  than direct support.

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NADSP

• Who is the NADSP?
• The NADSP is a coalition of organizations and
  individuals committed to strengthening the
  quality of human service support by strengthening
  the direct support workforce. The group has
  representatives from the fields of mental health,
  developmental disabilities, child welfare,
  education, and many others in the human services
  community.

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NADSP- continued

• The Alliance has developed a national agenda to
  address conditions chronicled for 25 years that
  are harmful to people who rely on human services.
  These conditions include high staff turnover, low
  social status, insufficient training, limited
  educational and career opportunities, and poor
  wages.

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NADSP - continued

• The NADSP believes that service participants and
  direct support professionals are partners in the
  move towards a self-determined life, and in
  complimenting and facilitating growth of natural
  supports. NADSP recognize that people needing
  support are more likely to fulfill their life
  dreams if they have well-trained, experienced,
  and motivated people at their side in long-term,
  stable, compatible support relationships.

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NADSP- continued

• These undermine the commitment of the Direct
  Support Professionals, and have made it very
  difficult to recruit and train qualified and
  committed individuals in direct support roles in
  every area of human services.

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Code of Ethics

• In 2000, The National Alliance for Direct support
  Professionals (NADSP) convened a national panel
  of DSPs, advocates, families, professionals, and
  researchers who constructed the Code of Ethics.
  Focus groups and surveys regarding the draft
  language were conducted throughout the country
  and were integrated to create the final code.

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NADSP Code of Ethics

• The Code of Ethics is intended to serve as a
  straightforward and relevant ethical guide,
  shedding some light on the shared path to a
  self-directed life. It is intended to guide DSPs
  in resolving ethical dilemmas they face every day
  and to encourage DSPs to achieve the highest
  ideals of the profession.

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Person-Centered Supports

• As a DSP, my first allegiance is to the person I
  support all other activities and functions I
  perform flow from this allegiance.
• As a DSP, I will
• Recognize that each person must direct his or her
  own life and support and that the unique social
  network, circumstances, personality, preferences,
  needs and gifts of each person I support must be
  the primary guide for the selection, structure,
  and use of supports for that individual.

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Person Centered Supports- cont

• Commit to person-centered supports as best
  practice
• Provide advocacy when the needs of the system
  override those of the individual(s) I support, or
  when individual preferences, needs or gifts are
  neglected for other reasons.
• Honor the personality, preferences, culture and
  gifts of people who cannot speak by seeking other
  ways of understanding them.

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Person Centered Supports cont

• Focus first on the person, and understand that my
  role in direct supports will require flexibility,
  creativity and commitment.

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Promoting Physical and Emotional Well-Being

• As a DSP, I am responsible for supporting the
  emotional, physical, and personal well-being of
  the individuals receiving support. I will
  encourage growth and recognize the autonomy of
  the individuals receiving support while being
  attentive and energetic in reducing their risk of
  harm.

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Promoting Physical and Emotional Well-Being - cont

• As a DSP, I will
• Develop a relationship with the people I support
  that is respectful, based on mutual trust, and
  that maintains professional boundaries.
• Assist the individuals I support to understand
  their options and the possible consequences of
  these options as they relate to their physical
  health and emotional well-being.

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Promoting Physical and Emotional Well-Being cont

• Promote and protect the health, safety, and
  emotional well-being of an individual by
  assisting the person in preventing illness and
  avoiding unsafe activity. I will work with the
  individual

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Promoting Physical and Emotional Well-Being - cont

• and his or her support network to identify area
  of risk and to create safeguards specific to thee
  concerns.
• Know and respect the values of the people I
  support and facilitate their expression of
  choices related to those values.
• Challenge others, including support team members
  (e.g. doctors, nurses, therapists, co-workers,
  family members) to recognize

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Promoting Physical and Emotional Well-Being - cont

• and support the rights of individuals to make
  informed decisions even when these decisions
  involve personal risk.
• Be vigilant in identifying, discussing with
  others, and reporting any situation in which the
  individuals I support are at risk of abuse,
  neglect, exploitation or harm.
• Consistently address challenging behaviors
  proactively, respectfully, and by avoiding the
  use of aversive or deprivation

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Promoting Physical and Emotional Well-Being - cont

• intervention techniques. If these techniques are
  included in an approved support plan I will work
  diligently to find alternatives and will advocate
  for the eventual elimination of these techniques
  from the persons plan.

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Integrity and Responsibility

• As a DSP, I will support the mission and vitality
  of my profession to assist people in leading
  self-directed lives and to foster a spirit of
  partnership with the people I support, other
  professionals, and the community.

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Integrity and Responsibility - continued

• As a DSP, I will
• Be conscious of my own values and how they
  influence my professional decisions.
• Maintain competency in my profession through
  learning and ongoing communication with others
• Assume responsibility and accountability for my
  decisions and actions.

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Integrity and Responsibility continued

• Actively seek advice and guidance on ethical
  issues from others as needed when making
  decisions.
• Recognize the importance of modeling valued
  behaviors to co-workers, persons receiving
  support, and the community at large.

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Integrity and Responsibility- continued

• Practice responsible work habits.

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Confidentiality

• As a DSP, I will safeguard and respect the
  confidentiality and privacy of the people I
  support.
• As a DSP, I will
• Seek information directly from those I support
  regarding their wishes in how, when and with whom
  privileged information should be shared.

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Confidentiality - continued

• Seek out a qualified individual who can help me
  clarify situations where the correct course of
  action is not clear.
• Recognize that confidentiality agreements with
  individuals are subject to state and agency
  regulations.
• Recognize that confidentiality agreements with
  individuals should be broken if their is imminent
  harm to others or to the person I support.

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Justice, Fairness and Equity

• As a DSP, I will promote and practice justice,
  fairness, and equity for the people I support and
  the community as a whole. I will affirm the human
  rights, civil rights and responsibilities of the
  people I support.

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Justice, Fairness and Equity continued

• As a DSP, I will
• Help the people I support use the opportunities
  and the resources of the community available to
  everyone.
• Help the individuals I support understand and
  express their rights and responsibilities.
• Understand the guardianship or other legal
  representation of individuals I support, and work
  in partnership with legal representatives to
  assure that the individuals preferences and
  interests are honored.

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Respect

• As a DSP, I will respect the human dignity and
  uniqueness of the people I support. I will
  recognize each person I support as valuable and
  help others understand their value.
• As a DSP, I will
• Seek to understand the individuals I support
  today in the context of their personal history,

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Respect- continued

• Their social and family networks, and their hopes
  and dreams for the future.
• Honor the choices and preferences of the people I
  support.
• Protect the privacy of the people I support.
• Uphold the human rights of the people I support.
• Interact with the people I support in a
  respectful manner.

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Respect - continued

• Recognize and respect the cultural context (e.g.
  religion, sexual orientation, ethnicity,
  social-economic class) of the person supported
  and his/her social network.
• Provide opportunities and supports that help the
  individuals I support be viewed with respect and
  as integral members of their communities.

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Relationships

• As a DSP, I will assist the people I support to
  develop and maintain relationships.
• As a DSP, I will
• Advocated for the people I support when they do
  not have access to opportunities and education to
  facilitate building and maintaining relationships.

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Relationships - continued

• Assure that people have the opportunity to make
  informed choices in safely expressing their
  sexuality.
• Recognize the importance of relationships and
  proactively facilitate relationships between the
  people I support, their family and friends.
• Separate my own personal beliefs and expectations
  regarding relationships (including sexual
  relationships)

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Relationships - continued

• From those desired by the people I support based
  on their personal preferences. If I am unable to
  separate my own beliefs/preferences in a given
  situation I will actively remove myself from the
  situation.
• Refrain from expressing negative views, harsh
  judgments, and stereotyping of people close to
  the individuals I support.

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Self- Determination

• As a DSP, I will assist the people I support to
  direct the course of their own lives.
• As a DSP, I will
• Work in partnership with others to support
  individuals leading self-directed lives.
• Honor the individuals right to assume risk in an
  informed manner.
• Recognize that each individual has potential for
  lifelong learning and growth.

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Advocacy

• As a DSP, I will advocate with the people I
  support for justice, inclusion, and full
  community participation .
• As a DSP, I will
• Support individuals to speak for themselves in
  all matters where my assistance is needed.
• Represent the best interests of people who cannot
  speak for themselves by finding alternative ways
  of understanding their needs,

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Advocacy - continued

• Including gathering information from others who
  represent their best interests.
• Advocate for laws, policies, and supports that
  promote justice and inclusion for people with
  disabilities and other groups who have been
  disempowered.
• Promote human, legal, and civil rights of all
  people and assist others to understand these
  rights.

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Advocacy - continued

• Recognize that those who victimize people with
  disabilities either criminally or civilly must be
  held accountable for their actions.
• Find additional advocacy services when those that
  I provide are not sufficient.
• Consult with people I trust when I am unsure of
  the appropriate course of action in my advocacy
  efforts.

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Do As I Say

• DSP Perspective

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Evaluation

• Thank you!