The Bowlby Centre Disability Protocol
The Bowlby Centre Disability protocol aims to provide a framework for considering the organisational response to the needs of disabled people in all aspects of The Centre’s work. Specifically in relation to:
- The training and the needs of Students
- The varying needs of clients – at the point of entry into the assessment and referrals service and when they are referred on to psychotherapists in training and members in private practice
- Paid and voluntary staff – Teachers, Tutors, Administrators, Committee and Group members
- Post taught students and members
Consideration need to be given to:
- Implications for confidentiality and disclosure
- Logistical and practical implications
- Health and Safety implications
- Implications with regards to communication
- Ethical implications
- Educational adaptations
- Relational implications
As organisation, a therapeutic service provider and a charity and company limited by guarantee we are required to adhere to the principles laid out in the The Disability Discrimination Act 1995 (D.D.A.)
The D.D.A. was introduced to end unfair discrimination against disabled people in all areas of life. The D.D.A. aims to ensure that a disabled person is considered fairly and without prejudice and where appropriate accommodated in a manner that is respectful of their individual needs. Under the DDA, and in keeping with our values of attachment and inclusion The Bowlby Centre has a duty to make ‘reasonable adjustments’ for ANY disabled person coming into contact with the organisation. Failure or refusal to provide a service that is offered to other people to a disabled person is discrimination unless it can be justified.
What is the definition of a disabled person?
The definition of a disabled person is not clear-cut. The definition used by the D.D.A. is anyone under the Act with a ‘physical or mental impairment which has a substantial and long-term adverse effect upon his or her ability to carry out normal day-to day activities’.
Physical impairments include for instance, weakening of any part of the body caused through illness, accident or congenitally such as blindness, deafness, or paralysis of a leg or heart disease.
Mental impairments include well-recognised mental illnesses, including depression, and also what is commonly known as a learning disability – dyslexia and dyspraxia are included in this.
Substantial and long-term can be open to interpretation but substantial is generally regarded in legal terms as being more than minor, while long-term means permanent or else having lasted or expected to last longer than 12 months.
Normal day-to-day activities include: mobility; manual dexterity; physical co-ordination; continence; ability to lift, carry or otherwise move everyday objects; speech, hearing or eyesight; memory or ability to concentrate learn or understand; perception of risk of physical danger.
It is a requirement under the disability discrimination act that we make reasonable adjustments:
What does the term ‘reasonable adjustments’ mean? A large publicly funded organisation would be expected to make more significant (and costly) adjustments than a small organisation. However, there is no absolute requirement to change the way an organisation works to accommodate a disabled person but best practice and our values mean that we would look to doing whatever we can to support that individual in their involvement with The Bowlby Centre.
The critical word is ‘reasonable’. The sort of adjustments that an organisation might make could include:
- Making physical adjustments to premises (e.g. stair lifts)
- Altering working hours
- Allowing absences during working hours for rehabilitation, assessment or treatment
- Supplying additional training
- Acquiring special equipment or modifying existing equipment
- Modifying procedures for testing or assessment
- Providing a reader, a scribe, or interpreter
- Providing additional supervision
In keeping with The Bowlby Centre Values and commitment to anti-discriminatory practice it is vital that an individual with a disability is not marginalised or expected to carry the responsibility for best practice in relation to their disability. This is the responsibility of all members of The Bowlby Centre. It is important that the individual with a disability is seen in a holistic light; they must have the opportunity be supported in as much as is possible to have full and enjoyable participation in The Bowlby Centre community and its activities.
Some thinking needs to take place with the disabled person around:
The nature of their disability: Asking for a full and detailed description of disability and how this impacts upon their daily lives. Explaining the reasons for requiring this – so that we are able to respond appropriately in the area of the centre where they most need it; for example by offering additional learning support or to ensure appropriate referral as an organisation which refers to therapists working from a variety of settings.
1. Implications with regards to confidentiality and disclosure
Disclosure is a sensitive issue. Lack of understanding may have led to misconceptions of an individual’s ability. Mutual sensitivity and understanding are important for any individual with a disability to be encouraged to make disclosure. As an aspect of a therapeutic relationship or relationship between a student and The Bowlby Centre as a training organisation there may need to be space made to talk through the feelings about the implications of this both practical and emotional.
Because everyone is different there is no correct way to make a disclosure; the individual must rely on his or her own judgment. To make a disclosure, the individual who has a disability must feel safe and feel that the organisation is going to support them.
Why people may not decide to tell others they have a disability:
- They may feel vulnerable or exposed
- They may feel embarrassed
- Educational experience may have left a reluctance to acknowledge difficulty
- They may be afraid of loss or marginalisation, or being a nuisance
- They may feel they have overcome their difficulties
- They may feel it’s the line managers problem not theirs
- They may feel they will loose out on prospects
- They may feel it will prevent them from graduating/qualifying
1. The need for disclosure: Who needs to know?
The individual can disclose to whoever they feel safest with but over time but in the context of The Bowlby Centre as a service provider and as an organisation that holds legal responsibility for health and safety there may be implications for who will need to know that vary according to context: For example in relation to Students, their course Tutor, and The Clinical Training Committee, teachers and possibly colleagues may need to be made aware.
2. The logistical implications in relation to accessibility
Location of training/therapy/tutorials, does the person need a venue with no stairs, disabled toilet, or additional time to arrive at and leave sessions. Room setup, seating, adaptation to disability aids including hearing/guide dog. Can therapist make these adjustments? Client may have to wait for dial a ride on the street where there is no waiting room etc.
3. Health and Safety implications
For example where there are lifts and stairs – especially in relation to fire and emergency; for example a client who is a wheelchair user could not exit the building without the therapist’s assistance if their support worker did not arrive – this has both lifting implications for the therapist and obviously impacts in terms of the therapeutic relationship/transference. Their may also be implications with regards to liability insurance. Also working with a client with for example epilepsy where it would be necessary to establish a protocol for when they had a seizure. (Next of kin details disclosed/recovery position/999 etc)
4. Implications in terms of communication:
For example provision of a hearing loop, adaptation of any written material – perhaps directions or information about the organisation, location of practice, bill or invoice need to be supplied in a different format/Large scale type/well in advance
5. Ethical considerations:
Where adaptation requires an alteration to the therapeutic frame or the usual teaching protocol. For example when an additional person needs to be introduced into the therapeutic or educational environment – an interpreter, scribe etc – (for the therapist or client), or if seminars need to be recorded implications for confidentiality etc.
6. Educational adaptations:
The Bowlby Centre generally tries to foster a space for students to work effectively within their individual learning style. Teachers, tutors and year group members may be required to adapt their participation in and delivery of material in response to individual disability. For example in providing material in a different format for a hearing or visually impaired student.
7. Relational implications:
As a therapeutic organisation we are aware that real world issues impact upon relational possibilities. In this context we need to be able to open up the space for thinking about any factors that may influence our capacity to relate intimately with each other as we participate in organisational activities. The way in which disability is framed societally may mean that the space to think and feel becomes compressed by unspoken prejudice or lack of understanding. As with any process of marginalisation issues of fear, power and control may be present and need to be named. This may be particularly key in the relationship between therapist and client or between students, tutors and teachers where the organisation has a responsibility to ensure that the subtle currents of prejudice do not infiltrate and damage the learning/therapeutic environment.
Some General Thoughts:
- When someone makes a disclosure about his or her disability ask them what it means for them, and listen.
- People don’t need to “admit” to a disability; it is something they have not a “fault”
- People with ‘specific disabilities’ are individuals who share a common condition
- Be aware that the same disability may affect people differently; for some it may be a minor inconvenience for others it may have a major impact on their lives
- Disabilities are not always obvious
- Don’t assume someone does not have a disability just because you are not aware of it
- Disability is a natural part of human identity not something to be fixed
- It is important once someone has disclosed a disability they are not defined by it – not a ‘paraplegic’ or a ‘dyspraxic’ but a person with spinal injury or a person with dyspraxia
- You are not an expert on a specific disability because you know someone else who has it, only the individual is an expert on how a disability affects him or her
- Instead of using the terms “normal” or “disabled” consider how your use of language may be stigmatising and adapt it appropriately.
- When speaking to an adult treat them as an adult – use a normal speaking tone and style
- Do not ignore someone with a speech impediment because you are concerned you will not understand him or her
- People who are disabled in one area can become enabled through adjustment
- Don’t assume that a person with a disability who approaches a task differently will do it less well
- Sympathy is not as constructive as empathy and acceptance
- A disabled person does not have to be grateful for reasonable adjustment.
- Asking about disability at the point of entry into all our services.
- Needs and risk assessment: Individual departments will need to carry out an evaluation of a person’s’ specific requirements in relations to their disability, and decide with that person who will receive this information.
- Reasonable adjustments will need to be made to ensure that our services are as responsive as possible to an individual’s special needs.
- In consultation with line managers, we need to honestly and realistically name what is and what is not possible and recognise the implications for that person and the organisation.
- The organisation and its departments need to monitor and evaluate their responses to disability both generally in relation to individual needs on an ongoing basis.
- Open and ongoing communication with the disabled person as to how any adaptation may evolve as their relationship with The Bowlby centre progresses
- In keeping with our organisational values and commitment to equal opportunities and anti-discriminatory practice, all members of The Bowlby Centre community are responsible for, and need to be actively engaged in creating a safe and secure base for the full participation of individuals with mental ill health, physical and learning disabilities.
- All areas of The Bowlby Centre need to participate in creating a safe and secure base of disability and special needs (mental ill health, physical and learning disabilities). The emphasis being on collective responsibility for the creation of a fair environment within our centre.