Working With Minors_Special Populations.pptx

Working With Minors/Special Populations Special populations include: Individuals with disabilities Individuals from economically disadvantaged families, including low-income youth and adults Individuals preparing for nontraditional fields Single parents, including single pregnant women Out-of-workfo...

Working With Minors/Special Populations Special populations include: Individuals with disabilities Individuals from economically disadvantaged families, including low-income youth and adults Individuals preparing for nontraditional fields Single parents, including single pregnant women Out-of-workforce individuals Homeless individuals Youth who are in, or have aged out of, the foster care system Youth with a parent who is a member of the armed forces and is on active duty Individuals with other barriers to educational achievement, including individuals with limited English proficiency Guiding principles: Access and autonomy Your role is to enable equal access to service as opposed to doing things or making the process errorfree for the individual. Resist the urge to do everything for them because they have a disability. Accommodation makes sense and keeps the individual in an active role. For context, family members and friends can be overly helpful or helpful in an unhelpful way, so you want to lean towards autonomy and respect. Guiding principles: Respect They are a person with a disability, they are not wholly defined by it. Talk to your clients and examiners about what language they want used in reference to them and their disability. Use the terminology that makes them comfortable, not what makes you feel comfortable. You should also not assume that since someone has a physical disability then they also have a mental disability/IDD. For instance, you should not talk to someone like a 2-year old just because they are in a wheelchair. Guiding principles: Descriptiveness One way to help build the therapeutic alliance is to be more descriptive when describing the counseling environment, the process of psychotherapy, and how you envision it going. Be mindful of your language and terminology (i.e., avoiding psychojargon) to better accommodate IDD for instance. Guiding principles: Routineness and consistency Helpful to have needed materials (manipulatives, forms, telehealth equipment) be in the same place every time. Guiding principles: Patient advocacy Society at large as well as systems and social environments these clients exist in are not built for people with disabilities and can be invalidating—both overtly and covertly. From this, you may also find yourself in an advocacy role at times. Some technologies that can be utilized to provide accessible services to those with visual or hearing impairments are: Populations with disabilities Video remote interpreting: A form of sign language that allows a deaf or hard of hearing patient to communicate via videoconferencing instead of live, on-site interpreting. Videoconferencing equipment is used at both locations (provider and patient). Assistive technology: Devices or equipment that can improve a patient’s Activities of Daily Living (ADLs) and enhance their ability to communicate. Closed captioning: The use of subtitles displayed on a television, video screen, iPhone or other visual display to provide interpretive information. Three-way video conferencing: Provider, patient, interpreter Telecommunications relay service: Operators facilitate telephone calls between deaf and/or blind patients and providers (Wright, 2020). Finer points: Eye contact/ Voice Visually impaired- Be descriptive in terms of what environment they are in, that you are in, and how eye contact typically looks with clients. Audio cues and ensuring high quality audio can help. Hearing impaired- Ensure that the client can see the interpreter and you at the same time. This can usually be accomplished by turning off Speaker view (one speaker at a time) and having all video feeds shown at once. Remember that all communication in the session must be interpreted by the interpreter and relayed to the client. If the interpreter needs to talk directly, they will identify themselves first. Expect for these sessions to be longer, and it’s okay to go a bit slower in therapy if needed. Best practice regarding documentation is to include the interpreter as an identified participant in the session, the interpreter agency (if used), and the interpreter’s license number. For those hard of hearing, understand that lipreading may play a major role in how they understand and comprehend others. This has the potential to be diminished over telehealth, so it can help to talk slower and make sure your video quality is high. When adjusting your voice for hard of hearing clients, it’s helpful to ask what specific changes could help (i.e., higher volume, adjusting your rate, high versus low pitch, etc.). Physical disabilities- It is helpful to have a sit-stand desk at the station that allows for the height to be easily adjusted to accommodate different kinds of wheelchairs as well as allow for eye contact levels to be adjusted if needed. Finer points: Materials Consider velcroing any needed materials (e.g., TV remotes) to the desk to ensure consistency; this is more important in a videoconferencetype telehealth setting (e.g., VA setting) than using a desktop, which can utilize accessibility software. Be mindful that the telehealth equipment used is accessible regarding fine motor control and dexterity issues (e.g., wireless mouse receivers can be tricky to plug in, phones should be positioned within reach). Finer points: Clinical settings For telehealth services provided through hub and spoke or through agencies/organizations (as opposed to direct-to-consumer), there should be accessible paths, doors, and restrooms as well as handicap accessible public transportation options to the clinical setting. Many barriers/factors that impact underserved clients such as transportation issues, lower SES, underinsured, ruralresiding can be amplified for individuals who also have a disability. Finer points: Environment Helpful to take the perspective of the client. This is particularly important for clients with visual impairment. When directing the client, use orientation heuristics (e.g., clock position: the mouse is typically at your 3 o’clock, the monitor is dead center at 12, and with the webcam position, you are looking at about 1 o’clock). Helpful to, as best as you can control, have a consistent path to and from things. Be sure to reorient if furniture is rearranged or if using a different room/environment than they’re familiar with. Principle to keep in mind with visually impaired clients is pathing. The shortest or quickest way to something is not the best way if it is unfamiliar to them. Paths that involve a small number of turns or are more straightforward even if they are longer are preferred. Child cases The telepsychology needs of child cases may be different from adult cases, and practitioners should do their best to adjust their telehealth care in the context of the children they are providing services to (American Psychological Association, 2020). A few important considerations for child cases include but are not limited to: The development of an understanding of telepsychology in child patients. Thus, the telehealth setup and services should also be explained to the client in a developmentally appropriate manner Difficulties establishing the same rapport as providers may be able to through in-person sessions. Stories, toys, and technologies are all possible tools for establishing rapport with the child to foster that strong patient-provider relationship even over telecommunications Keeping children, especially young children, engaged in the telehealth session. This may be done through switching activities or the use of interactive technology Awareness of the potential for child abuse and neglect. While noticing these Child cases signs can be more difficult than normal over telehealth, practitioners should still develop an awareness of the possibility Children with disabilities, medical needs, language barriers, from low income homes, and more may require adaptations to treatment E.g. a child without reliable internet may not be able to use videoconferencing to receive services, but they may be able to continue therapy by phone A child with autism may benefit from recreating the routines of in-person care as closely as possible A child with disabilities may require special therapies or supports Usage of appropriate screening methods to determine telepsychology fit. Environmental factors such as the ability of the family to create and maintain an optimal testing and service environment should also be considered