broadcast is now starting all attendees
are in listen-only mode alright hello
everyone welcome to today's webinar on
raising awareness and developing
disability cultural competence in the
supervisory relationship my name is
Kristen Dempsey and I'm the assistant
director of professional psychology
programs in the education Directorate
here at APA
thanks so much all for joining in today
before we begin let me mention a few
housekeeping details today's webinar
will be one hour for anyone who would
like to follow along during the
presentation you can find a copy of
today's transcript under the handouts
pane of the control panel you'll receive
an email with a link to view a recording
of today's webinar on YouTube later this
month
you'll have the opportunity to submit
text questions to today's presenters by
typing your questions into the questions
pane of the control panel you may send
in your questions at any time during the
webinar and we'll address them during
the Q&A session at the end of the
presentation so without any further delay
please join me in welcoming our
three presenters dr.
Rebecca Wilber is a
licensed clinical psychologist on staff
at legacy good samaritan Medical Center
in Portland with specialized training in
neuropsychology and rehabilitation
psychology dr.
Angela Kimmel is an early
career rehabilitation psychologist in
spinal cord injuries and disorders and
the assistant director of psychology
training and education at the Louis
Stokes Cleveland VA Medical Center dr.
Eric Samuels is a licensed clinical
psychologist with a private
psychotherapy practice in downtown
Oakland in the Castro and an adjunct
professor at the American School of
Professional Psychology at Argosy
University in San Francisco with that
I'll turn it over to you dr. Wilbur
thank you we're very happy to give this
lecture we appreciate a APA's public
interest and the APA education
Directorate in their support of cultural
competence and including disability as
an important and valuable aspect of
diversity dr. Kimmel and I started this
work at the Louis Stokes Cleveland VA
and quickly found a real need for
further education and support in this
area we did a research project to learn
more about the current state of
psychology supervisors and their
knowledge and awareness of disability
and disability related issues such as
the Americans with Disabilities Act also
known as the ADA a
as well as reasonable accommodations
since we began presenting our findings
we've received great reception from the
training and supervision community and
recognition for the need for more
opportunities to grow awareness in
supervising trainees with disabilities
we feel is important to review our
learning objectives and provide some
context for a presentation our
overarching goal is to reduce bias and
harmful practices in education and
reduce health care access disparities
for students with disabilities our
objectives will increase supervisors and
educators awareness of disability
discuss the basic terminology on
disability issues understand the unique
challenges and socio-political concerns
that trainees with disabilities face
list applicable information about the
American Disabilities Act identify
common misperceptions that lead to
harmful practices in training and
associated inequities and disparities in
education and healthcare access identify
steps to establish accommodations and
how that applies in the supervisory
relationship and finally describe ways
to reduce bias in supervisory practices
essentially this project offers a model
to help supervisors avoid biased
practices that are harmful against
trainees with disabilities and provides
guidance in supporting supervisors
efforts to cultivate trainees
development and produce valuable new
professionals in their respective fields
first dr.
Eric Samuels will start with
some definitions and statistics about
disability in the United States and in
the field of psychology the 2010 u.s.
census found that 19 percent of the u.s.
population identifies as having a
disability however the number of
psychologists who identify as having a
disability is considerably lower
APA's 2015 workforce survey of psychology
health service providers found that only
5.8 percent of psychologists identify as
people with disabilities and though the
Americans with Disabilities Act
provides protections to individuals with
disabilities how a disability is defined
matters according to the ADA a person
with a disability is a person who has an
impairment that substantially limits a
major life activity and either has a
record of such impairment or is known to
have such an impairment in 1990 major
life activities included seeing hearing
walking caring for oneself learning
breathing and working and effective in
2009 the ADA broadened these interpretations
and added examples of major
life activities which included but was
not limited to performing manual tasks
eating sleeping standing lifting bending
speaking reading concentrating thinking
and communicating as well as the
operation of several specified major
bodily function in regards to what a
record of an impairment is an example
could be a history of depression even if
it's not currently limiting a major
life activity and regarded as having an
impairment for example could be a facial
figuration that doesn't limit a major
life activity but is otherwise regarded
as impairing the individual could be
qualified as an individual with
disability under the ADA there are two
important disability definitions to know
the first is visible disability which is
any observable indication of a
functional limitation that impacts daily
life and may include physical changes to
the body or the use of assistive devices
some examples are spinal cord injury or
multiple sclerosis
then there's invisible disability which
is any condition including physical or
mental that may not be immediately
discernible but that impacts functioning
or leads to limitations in daily life
examples are chronic pain rheumatoid
arthritis traumatic brain injury but
also serious mental illness like
schizophrenia in order to understand how
disability may affect the supervisory
relationship is first important to
understand the unique challenges and
socio-political concerns that trainees
with disabilities face disability is a
culture the most difficult challenges
for persons with disability involves the
social stigma and discrimination not the
physical or mental challenges associated
with the person's condition essentially
the biggest challenges of having a
disability are the physical and
attitudinal barriers that exist in
society not managing the disability
itself people with disabilities are
often viewed as pitiable particularly if
they use visible assistive devices such
as a wheelchair or as abusing the system
such as if someone receives
accommodations like extra flexible time
and assignments or work shifts due to
chronic illness such as if the person
had a ADA/ADHD or diabetes the cumulative
effect of such negative attitudes
referred to as microaggressions by
Keller and Galgay leads to the
oppression of persons with disability
psychologists themselves are not immune
to bias and prejudice towards people
with disability so for example how many
of us have flown on an airplane
I'm guessing that's many of us on this
call today how many of us who have flown
in an airplane had your legs broken by
the air carrier I'm guessing not a lot
of us but most people who use power
wheelchairs have even though we have the
air carrier Access Act almost everyone
who uses a power wheelchair has had
their chair broken or mangled by the air
carrier which led to delays or even
being stranded that's what I'm talking
about when I talk about the
discrimination that people with
disabilities experience it's about
having basic rights and enjoyments taken
away because of inaccessible
environments and attitudes I'm starting
with the premise that disability
is an aspect of diversity to have a
disability places one in a minority
group not by numbers because this
includes about 20% of the u.s.
population but by social stigma social
stigma and inaccessibility both physical
environment and attitudinal barriers are
the biggest challenges to persons with
disability this perspective is part of
the minority model or social model of
disability and is the basic values on
which this research and this
presentation is based so we add this mix
of stigma to supervision so disability
awareness is equal to diversity
awareness so the most important thing
for everyone to take away from this
lecture is that disability competence is
about awareness disability awareness is
as to diversity awareness we can give
you some good information and a place to
start but really I want to clarify the
real message and purpose of this webinar
this is essentially a type of diversity
lecture according to dr.
Derald Wing Sue
the first steps to raising ones cultural
awareness is to develop knowledge
awareness and skills the only way to
really do that is to really wrestle with
these issues so knowledge awareness
skills now wrestle with that this
webinar can give you a starting point
but you won't get everything from this
60 minute lecture to illustrate a
real-life example of what discrimination
may look like in psychology training we
provide several vignettes.
dr. Kimmel will introduce our first
vignette as I read the following
vignette think about the attitudes and
beliefs that caused the following
harmful supervision experience to occur
a practicum student with quadriplegia was
training at an outpatient mental health
center intakes at the center involve
cognitive and psychological testing emma
has completed
all necessary coursework for
intelligence testing and diagnosis and
treatment planning
however due to Emma's reduced hand
functioning and fine motor deficits her
supervisor is concerned that Emma will
not be able to confidently administer
the cognitive testing she will not
release Emma to do any testing until she
has had time to sit down and watch Emma
administer a complete battery doctoral
interns provide umbrella supervision at
this site and the supervisor has
instructed them to train the other
practicum students in the tests but not
Emma.
Emma's supervisor's biases about
disability led her to make assumptions
about Emma's abilities fortunately for
Emma
the interns at the site
believed their supervisor was
discriminating against her on a basis of
disability and went to their training
director to report this and determine a
better resolution now think about what you do if
you were in the room as I go through this vignette
students with invisible or less visible
disabilities might also experience
harmful practices during their graduate
training and education here's an example
ben is a clinical psychology doctoral
student with multiple sclerosis applying
for internships.
due to fear that sites
might judge him negatively for having MS
Ben decides not to disclose this
condition in any of his internship
application materials.
John is on the
internship review panel at one of the
sites were Ben applied.
during a review
of internship applicants with a review
panel John raises questions about one of
Ben's recommendations letters
in that letter
the recommender discussed how
well ben manages his responsibilities
while dealing with having multiple
sclerosis John asked the others on the
internship panel if the site can
realistically offer accommodations for
Ben's condition and starts guessing
what he thinks Ben would need like
working half days with half of the
typical workload and no
integrated assessment reports
the other committee members point out
their site could not take on an intern
who needed these types of accommodation
the director of training at the site
reminds the panel that a candidate's
disability cannot be used to judge an
applicant but also states that it is
concerning the student withheld this
information from his application what
else is he hiding because of these
concerns Ben's raking with an internship
review panel dropped
we've now seen two scenarios of how
trainees with visible and invisible
disability may experience disability
bias and harm in the training
environment as we know supervision is
central to training and there is much
research to show that negative
supervisory relationships have severe
detrimental effects on trainees.
the
factors that lead to difficult
supervisor relationships include
insensitivity, bias, and lack of awareness.
early research on supervision of
students with disabilities found that
clinical supervision is the worst part
of training in psychology for students
with disabilities due to prejudicial and
discriminatory behavior from the
supervisors, of which you now know two
real-life examples.
they found that the
supervisors thought that supervisees
must prove they can handle their
disability in a clinically appropriate
manner should they get questions about
it from clients or prospective clients.
Olkin advocates that supervisors should
give supervisees with disabilities the
same opportunity to be good, lousy, or
mediocre, just like any other trainee, and
not treat supervisees with disabilities
differently.
a very common concern that
comes up often in the supervisory
relationship is asking trainees to
disclose their disability to clients
before their first session or during
their first session.
but why would a
supervisor ask a trainee to do that? it's
evidence of the common perception that
working with a therapist with a
disability is going to inherently be bad
for the client, however the research does
not substantiate this.
in 2011,
Daniel Taube and Rhoda Olkin studied
whether a supervisor should require that
their supervisee with a disability
should disclose their disability to new
clients before the first meeting so that
the client is able to decide whether
they want to work with the supervisee.
they studied legal standards, ethical
guidelines, and clinical, professional, and
social justice issues.
similar to the
research of working with a
therapist of a different race Taube and
Olkin found that is not inherently bad
for a client to work with a therapist
with a disability, but this practice is
another example of the barriers that
arise in a supervisory relationship for
trainees with disabilities.
literature on
trainees with disabilities shows that
trainees are reporting concerning
experiences of disability bias in their
training and in their supervisory
relationships.
over 80% of trainees
experienced disability related barriers
including inaccessible training
environments, an inappropriate pressure
to disclose one's disability to clients
or prospective clients.
a third reported
mixed or negative reactions upon
disclosing their disability to faculty.
these negative or mixed reactions
included biased or uncomfortable remarks
or assumptions from supervisors and
colleagues.
discrimination may occur at
every step in the graduate school
process.
graduate school applications,
practicum training, graduate school
coursework and requirements, internship
application, or postdoctoral training, and
it may take the form of vague forms, lack
of accommodations, or outright
discrimination, such as barring a trainee
from a training experience based on his
or her disability status.
so who are
these trainees with disability anyway?
well according to APPIC data from 2010
2011 and 2012 match cycles, the most
common types of disabilities reported by
trainees were chronic health conditions,
learning disabilities, and mental illness.
so what do all of these have in common?
all of them are invisible disabilities.
so having awareness about disability, and
that the disability may be visible or
invisible, is crucial for all supervisors
because any trainee could be affected or
become part of this culture,
which we hope we have pointed out by
this point can impact the supervisory
relationship.
so students need to disclose to
get accommodations and everything will
be fine right?
so why is this even a
problem?
well disclosure and asking for
accommodations and the right
accommodations is actually a very tricky
process.
to illustrate this I would like
to read you a short passage by dr.
Rhoda
Olkin's 2011 article "when is differential
treatment discriminatory legal ethical
and professional considerations for
psychology trainees with disabilities".
in
the article dr.
Olkin provides a scenario
of a trainee with disability in
supervision, and then writes, "navigating
the clinical and supervisory issues
related to her disability requires
exceptional maturity on sarah's part.
she
is required not only to learn clinical
skills as our other trainees, but also to
be well versed in her disability and the
reasonable accommodations that benefit
her.
additionally she has to be capable
of discussing her disability openly, and
in a non defensive way, even in light of
others' prejudice.
then she has to
consider the potential responses of
clients, and handle those in a clinically
appropriate and professional manner.
she is unlikely to have any role models
in her training related to these tasks.
it is not only maturity that is required
of Sarah, but more clinical acumen that a
trainee is likely to possess at this
point.
this makes her vulnerable to
suggestions or mandates by her
supervisor, even if those suggestions are
prejudicial, discriminatory, and deeply
distressing." this leads us to a
discussion about disclosure and
reasonable accommodations.
it's not so
simple.
the recommendations are that
students must self-identify with
disability, ask for accommodations or
indicate a need. for those with invisible
disability, they must also provide
documentation at the student's expense
to establish the existence of the
disability, and all parties must
demonstrate the need for accommodation.
however in the recent article by Lund, Andrews, and Holt, described above,
one third of those who disclose their
disability reported mixed or negative
reactions upon disclosing their
disability to faculty.
so the only way to
get accommodations that a trainee needs
is to set oneself up for possible harm,
or bias, or at least mixed or negative
reactions from supervisors or those in
authority over them.
supervisors may
harbor disability biases that vary
across disabilities.
just because you
aren't biased towards one disability
doesn't mean you won't be biased towards
another.
countertransference issues and
supervisory relationships with students
with disabilities, like clients,
supervisors may become overly concerned
about a trainees welfare or feel a sense
of having to care for them.
results from
a research study recently submitted
for publication by dr. Wilbur and myself,
show that supervisors rated themselves
as feeling not competent to supervise
students with disabilities.
they felt
overwhelmed and they were concerned
about trainees meeting expectations.
also if a trainee teaches a supervisor
about their disability, the natural power
dynamic is shifted.
supervisors may feel
discomfort and begin to react defensively to
the trainee, and disability biases emerge.
unfortunately supervisors often
tell their supervisees to disclose their
disability to potential clients before
the first session.
my own experience is
represented in this vignette. as I go
through this vignette consider the
following question,
recognizing that supervisors have power
over their supervisees, how should the
supervisor handle the situation in the
future in order to create a more
collaborative relationship.
Eric is a
clinical psychology doctoral student in
his second year who has Tourette
syndrome that manifests itself in facial
tics, grimacing, and movement of his head
and neck.
Eric starts his second-year
clinical practicum at
a community mental health agency after having not
disclosed his Tourette's during the
competitive application and interview
process.
in his first meeting with his
supervisor, eric discloses having Tourette's
to his supervisor.
his
supervisor responds that he would like Eric to
disclose having Tourette's syndrome to every
single client that Eric is assigned to
work with during the first session of
therapy.
his supervisor expresses the concern that
Eric's potential clients might be
bothered by his tics and have a right to
make an informed decision as to whether
they'd want to continue working with
Eric as early in the therapeutic process
as is possible.
as this is all occurring
during Eric's first meeting with his new
supervisor, and due to the fact that he's
only a second-year student in his
program, eric is not sure how to respond,
and he obviously worries about how his supervisor
might respond to him
if Eric were to push back on this
request, or file a complaint with the
training co-directors.
in order for any
of the accommodations to work, trainees
must first identify with having a
disability, which in itself may not
always be easy, especially in the case of
individuals with invisible or
less visible disabilities.
some
disabilities may be more culturally
accessible, like depression, than others,
like substance abuse.
disabilities as
well may fluctuate as is the case with
chronic pain.
ultimately, different
factors impact a person's disability
identity.
these factors can be personal
and cultural, as well as a person's
actual disability. for people who have
invisible or less visible disabilities,
their ability to pass as able bodied
might afford them protection from bias
and discrimination from society.
however,
these people might have more difficulty
accessing accommodations and will have
to constantly disclose their disability to
others in relation to people with
visible disabilities.
the decision as to
whether or not to disclose is a constant
struggle that people with disabilities
have to face and how much a supervisee
identifies with their disability can
have a varying amount of impact upon
their training experience.
ultimately, students with disabilities
need to make decisions about whether
they want to disclose the disability
to supervisors and clients and whether
they want to request accommodations. when
they think about whether or not they
want to do this they will consider how
they believe that their request for
accommodations will be received, and
whether this disability can be
accommodated at all.
the ways in which
they identify as having disability might
also impact their ability to develop a
necessary support network as they'll
need to get through the challenging
demands of a doctoral program.
their
disability might also impact their
professional views of
themselves, as well as their thoughts
about professional opportunities that
will be available to them.
they'll wonder
about how the disability might impact
their work with clients.
identity is
different from adjustment.
for example, a
trainee may completely identify with
having a disability and feel completely
integrated with that identity, but
experience bias or are denied reasonable
accommodations, who are stressed from
experiencing discrimination or prejudice.
this is not an adjustment problem or an
identity problem.
the supervisors role is
to understand the factors that influence
the trainees with Disabilities identity
development.
what happens when
supervisors use clinical concepts to
understand their supervisees
disability?
well this is a cause for
multiple relationships boundary
disturbance to form or even a conflict
of interest and the impact on the
training with disabilities is belittling
let's talk about reasonable
accommodations and the cultural
challenges attached to them I'll start
with a quote that serves as an example
of a common type of of Tobias about
reasonable accommodations this came from
an article about social barriers for
university students in this case a
student with a learning disability
received extra time for testing a very
common type of reasonable accommodation
for this type of disability and the
reaction from the teacher was you get
extra time on a hard exam Oh aren't you
lucky suggesting that the student with
disability is getting special privileges
or some kind of unfair advantage but as
dr. Rowe Tolkien
pointed out in her 2010 article the 3
R's of supervising graduate psychology
students with disabilities reading
writing and reasonable accommodations
altering how standards are met does not
lower the standards themselves as long
as trainees are able to demonstrate that
they can meet the standard how they do
it including with reasonable
accommodations does not lower the
standard or give sink trainees some type
of pass this is not about producing
unfit clinicians this is about diversity
and leveling the playing field
here's another Mary is a post doctoral
fellow whose rheumatoid arthritis
effects typing for long periods she
discloses this to a primary supervisor
and asks for a reasonable accommodation
access to dictation software and a
private space in which to dictate for
confidentiality her supervisor follows
up with the office manager to obtain the
necessary software the office manager
refers the supervisor to the
institution's Equal Employment
Opportunity officer the EEO officer then
asks the supervisor to obtain permission
from the department head which the
department had grants the request for
space is denied and the software does
not arrive meanwhile the fellow feels
forced to use their own equipment which
goes against the institution's policy in
order to complete clinical documentation
after five or six months past the EEO
officer tells the supervisor that
additional paperwork must be submitted
by mary's medical provider because the
disability is not visible the fellow
submits the documentation from your
medical provider but the accommodations
are still not yet subsided six months
during this time period
Mary follows up with her supervisor on a
weekly basis about the issue
the supervisor realizes that he does not
know the accommodation process at the
institution he consistently responds to
Mary's questions that he has asked about
the accommodations and is still awaiting
a response however he's uncertain about
how to advocate for Mary's needs more
cessful II now that his supervisors have
said no or have not responded to his
requests he is uncertain about the best
course of action to establish reasonable
accommodations and move forward the
above vignette provides an example of
how challenging it may be for
supervisors to obtain reasonable
accommodations for their trainees at
their institution many psychologists
think that the trainee is the person who
is responsible for getting the
accommodations in place but as shown in
the vignette above it may be that the
trainee does not have the power to do
that and it falls to the supervisor and
then it is the supervisor who needs to
know how to navigate the system in their
institution which may not always be as
straightforward as one would hope many
psychologists and supervisors also
expect trainees to know exactly what
accommodations they need but different
training levels may lead to different
accommodation needs for example during
graduate school students may be able to
arrange their schedules to take breaks
and use pacing but there may be a more
rigid structured schedule at internship
the reaction from supervisors and
gatekeepers may be well but that is how
they must prove that they can cope in a
real job however not all jobs in
psychology are the same and having
different hours schedules accommodations
in and of itself does not make one a
danger to the public again altering how
a standard is met does not lower the
standard trainees may not have sought
reasonable accommodations in the past
and just over compensated without
accommodations but may begin to struggle
as the intensity of educational
requirements increase your four trainees
may not know what accommodations they
need until they're there the idea that a
trainee must disclose up front right
away assumes that accommodations will be
the same at all times and in all
situations and we know that that is not
true because circumstances
ments demands and disability changes
disability itself is not static it
changes whether due to chronic pain
assistive equipment breaks down new
medication side effects or other
elements of disability finally students
may experience consequences when
accommodations are delayed or not in
place research indicates that often
students with disabilities commonly
underutilized resources and
accommodations especially in
professional settings they may hurt
themselves or their clinical work may
suffer the contributing factors to this
are thought to be that students under
utilize resources out of a desire to be
equal and to be seen as comparable to
their non-disabled peers and to refute
bias and bias about those who use
reasonable accommodations so in talking
about reasonable accommodations it's
also important to consider the
institution and the culture of that
institution another barrier to obtaining
reasonable accommodations may be related
to the institutional cultural bias so
for example an institution may advertise
a 40-hour work week but the
institutional culture expects a 70 or 80
hour work week in this case a trainee
may think that with accommodations they
can meet the needs of the institution
not knowing the institutional culture
ahead of time and may set the trainee up
for possible failure also painting
reasonable accommodations may be very
different between institutions for
example persons with invisible
disabilities may be required to prove
their worthiness in obtaining reasonable
accommodations by submitting additional
paperwork from a medical provider which
is not necessarily required of their
visible disability peers trainees who
have just moved for internship or a post
doctoral fellowship who are required to
obtain this type of medical
documentation
to receive an accommodation maybe in a
really tight spot because it may take
months before they're able to see a
provider or specialist who can provide
the requested documentation and again
the attitudes of people including
psychology who work within an
institution may be colored by the
culture of that institution this cause
is a type of disability bias
trickle-down effect some of the most
common biases that may include some of
the following comments such as is your
disability that bad are you sure you
can't just use what's there well how did
you get this far well haven't you always
been providing your own accommodations
really all these comments just send a
message of devaluing the student not
only are these questions a type of
microaggression but the attitude may
lead to delays in establishing
accommodations which in and of itself
leads to serious self doubt lack of
growth and detriment to qualified
students so one of the things that that
we hope you do as a result of this
lecture is work to develop a disability
of firming environment so how do you do
that by increasing disability awareness
that's knowledge awareness and skills
can do that through self exploration of
your biases continuing education
consultation we strongly advocate that
training directors and psychology
leaders seek opportunities to raise
awareness about working with trainees
with disabilities among the clinical
supervisors on their staff know the
accommodations process at your
institution if supervisors want students
to disclose they must provide a safe
place for them to do so and one way to
do it is ask everybody about
accommodations so what do supervise
do if students don't disclose often
disability only comes up if a trainee
starts to struggle this should be one of
the first conversations after the
trainee has been accepted to the program
or site don't ask everyone if they have
a disability that question is
technically illegal it is important that
early in the beginning to identify your
role as a supervisor and facilitator in
navigating the new environment all
trainees will have questions are things
they don't know at the very beginning of
any new supervisory relationship
acknowledge and state that this includes
helping trainees seek and establish
accommodations if needed you can freeze
it however it feels most comfortable for
you but include I am the also the person
who would help you establish reasonable
accommodations if you needed them if you
ever need reasonable accommodations
please let me know
and finally supervisors must be
advocates for students with disabilities
so whose responsibility is it to help
the supervisor examine his or her
attitudes about disability well it's the
supervisors and supervisors should
engage in self-reflection to be aware of
their own biases Okin establishes that
educators bear a responsibility for
serious introspection and offers
questions to guide them can also seek
consultation with your colleagues we
found that there are benefits too when
students disclose disability including
to the supervisory relationship students
whose supervisors whose students
disclose report it's beneficial to the
supervisory relationship there's also
benefits in terms of APA accreditation
for training sites if students don't
disclose programs can't highlight
disability as part of diversity finally
the aspect of positive experiences
supervisors whose supervised supervisors
who supervise students with disabilities
report positive experiences working with
them including increased consultation
networking and professionals oh so when
is it appropriate for supervisors to ask
the supervisee to talk about their
disability we encourage you to consider
the social minority viewpoint at the
ruler Paulo sir you can insert another
diversity variable when considering the
importance of requiring trainees with
disabilities to disclose their
disability the law stipulates that
disability information is shared only on
the need-to-know basis and only if it
furthers supervision however even a
disability affirming environment does
not guarantee that a student will
disclose or respond to questions about
their disability the following vignette
is another real-life example to
highlight the importance of asking about
disability accommodations in the
beginning rather than waiting until a
trainee is struggling a supervisor is
very frustrated with an intern whose
reports and psychotherapy notes are very
slow to come and then repeatedly full of
spelling errors she has asked recently
asked the student do you need disability
accommodations
twice and the student has declined she
brings her concern to the training
committee and the committee recommends
that she give the student negative
ratings on her upcoming evaluation he
was not sure what more she can do the
truth is this is exactly what will not
lead to disability disclosure when you
have a frustrated supervisor and a
defensive student I subscribed above
while a supervisor cannot make a trainee
identify with having a disability or
accept reasonable accommodations it is
recommended that they have a
conversation about the issues that are
arising in the students work disability
could be listed as one potential
contributing factor or merely point out
that if reasonable accommodations were
ever needed that the supervisor feet
would be the person to coordinate this
if disability is something that the
trainee does identify with
encourage the trainee to get support to
trainees we say find your people there
are virtually no specific resources
available however there is sig the
special interest group psychologists
with disabilities students may also
start their own support group for
persons with chronic illness and
disability or build a support network
one Avenue may be to get in touch with
sea dip the American Psychological
associations Committee on disability
issues in psychology as a supervisor if
you work with a trainee who is
struggling and you suspect that
disability may be a part of the picture
ask to the trainee if reasonable
accommodations may be needed and
encourage the trainee to be part of
creating a solution and developing the
reasonable accommodation talk about
self-advocate and ways to approach
challenges to obtaining reasonable
accommodations remember accommodations
not a guarantee of success but are there
to level the playing field and so we
give you more information about the
special interest group in APA Division
22 a psychologist with disability that
is led by dr.
Erin Andrews and we give
you dr. answers email address division
22 also has a mentorship committee which
we provide their website and the contest
for that is Mary dr.
Mary Browns Berger
as well as the website for the American
Psychological associations committee on
disability issues in psychology
so how can a supervisor communicate
openness and recommend accommodations to
a supervisor with a disability who has
not requested them or does not want them
recognize that disability identity and
acceptance may play a role normalize
accommodations understand that trainees
want to be seen as comparable to their
non-disabled peers and remind them that
altering how a standard is met doesn't
alter the standard reframe
accommodations a supervisor could
reframe accommodations as routine ways
of maximizing chances of success take a
strengths-based stand and finally
encourage trainees to look to future
sites on how they will self-advocate
when they are independent practitioners
if they're having difficulty now it's
possible it will follow them that it is
in their benefit to explore all their
options now on the whole we encourage
supervisors to treat disability as any
other diversity factor and supervision
we encourage every supervisor to ask if
the trainee may need accommodations
early in the supervisory relationship
and continue to check in as noted above
one way we encourage this is for every
supervisor to open the door about
disability at the beginning of the
supervisory relationship this could be
as simple as also I let all my trainees
know that if you should ever need
reasonable accommodations of any kind
please let me know I'm aware of how to
establish accommodations at this
institution and would be the primary
person to do that
be aware that disability needs may
change over the course of training and
that accommodations may need to
correspondingly change be aware that
trainees may not know what
accommodations they need until they're
in the situation and it will be the
supervisors responsibility to help
coordinate and establish accommodations
our final point is a call to action for
supervisors
We strongly advocate the training
directors and psychology leaders seek
opportunities to raise awareness about
working with trainees with disabilities
among the clinical supervisors on their
staff supervisors you could be an
instrumental factor in making these
changes and creating a disability
affirming training environments we also
strongly encourage supervisors to become
more aware of trainees concerns are on
disclosure and work towards developing a
disability affirming environment
remember altering how standards are met
does not lower the standards themselves
we wanted to leave you with a final
quote by dr.
Samuels we chose this quote
to end this lecture to provide a window
into what we have tried to convey here
today and our hope for what disability
and training can be for the future so I
originally wrote this in a blog post for
the APA newsletter about my experiences
and challenges in psychology training as
a person with a disability going through
internship interviews in clinical
supervision is sometimes felt the focus
was primarily on my Tourette's focus on
my strengths and capabilities rather
than my disability would make me feel
more welcome in the profession we would
like to think of room for attending and
we will now take questions all right
thank you dr.
Samuels Thank You Elliot
to the presenters we're now going to
begin answering the questions submitted
during today's presentation as a
reminder you can still submit questions
through the questions pane in your
attendee control panel
so looks like our first question is what
other suggestions do you have for
training director that wants to create a
disability affirming environment dr.
Wilbur do you want to start um you know
I think that one of the important things
are what we mentioned here Lee um
including disability as part of training
perhaps in lecture series that are given
to both trainees as well as to
supervisors in some institutions there
is a supervisor kind of ongoing you know
supervisory issues group that they have
and I would encourage training directors
to include disability as part of that as
something to consider as part of the
disability environment and to in this
in a supervisory relationship and maybe
Angela will offer some insight since she
is also the assistant training director
at the Cleveland VA sure so I was I was
just gonna suggest we've got a great
reference list and we quoted some great
articles throughout the presentation
today use those for journal clubs with
supervisors send those out for readings
and echo dot what dr. Wilbur said about
making sure you know your supervisors
get to see a presentation like this yeah
I totally agree with what dr. Wilbur and
dr.
Camilla are saying I was gonna say
what dr. jablow was just saying just now
in regards to just you know seek out
opportunities to enhance your knowledge
and awareness about these issues we've
we've name-dropped dr. Rowe token
several times as well as people like
Emily lund and Andrews so forth you know
these are preeminent people in our field
we've written a lot about the issues
within psychology and within training
communities and you know so reading any
of their materials will take you a far
way
in Reverse enhancing your knowledge and
awareness of these issues which would
then hopefully make you a more
disability and affirming training
environment all right thank you
we have another question I just want to
answer really quickly someone asks are
the complete reference is going to be
available yes we're going to upload this
presentation to YouTube and you're going
to have a list at the end of this
PowerPoint of the full set of references
so thanks for asking great question we
have another question that says can you
say more about how a standard is met and
it doesn't affect the standard well for
example in some cases there may be a
disability where extra time is needed so
you know a great example that dr.
Okun
gives in one of her articles was for
example some of the spinal cord injury
may have to do bowel program in the
morning and maybe it doesn't go as
planned
and so the trainee may not necessarily
get to
a site on time in the morning and that
in and of itself does not necessarily
make one a danger to the public but
having maybe flexible hours that we'll
be able to fit you know of tell well
into you know what the trainee can do
but also being mindful of accommodations
so you know some of it like you know a
lot of the examples for reasonable
accommodations include things like you
know extra time on tasks for someone
with ADHD or some kind of learning
disability as part of their disability
and you know the student still has the
opportunity to demonstrate the knowledge
and the skill the the purpose is to
still be able to demonstrate that they
have the capability they still have to
meet the standard but having extra time
you know because of attentional
difficulties doesn't necessarily mean
that the person can't meet the standard
it's just meaning in a slightly
different way yes that's a that's a
really comprehensive answer I don't I
don't have anything to add
okay we have
one more question
doctors Kimmel and Wilbur would you be
able to share a little bit about your
research sure um that would be great um
so well I was at the Cleveland VA I'm
doing my post doctoral fellowship I
worked with dr. Kimmel on my super on my
research project there and we were
curious about the knowledge and
awareness of supervisors in psychology
across the country in terms of how well
they were familiar with disability
issues and reasonable accommodations and
so we developed a anonymous online
questionnaire for supervisors to answer
and it came in three parts the first
part was just a demographics
questionnaire to kind of understand the
pocky
that responded in terms of things like
where they were located what populations
they served institutions that they were
a part of and also what division they
were a part of because we were curious
if people for example from the
rehabilitation psychology division or
health psychology might have more
awareness around disability issues and
maybe someone from a research field or
something like that and then the second
section really looked at just basic yes
or no kind of questions about awareness
about disability you know what is a
reasonable accommodation and you know
knowledge about the Americans
Disabilities Act and then the last
section was one of two possible
vignettes both vignettes were exactly
the same they both described a trainee
who had previously been doing well at
their site and now we're exhibiting some
difficulties in one of the vignettes it
mentions that the student is a lifetime
wheelchair user and the other one
doesn't mention anything and the purpose
of that was to see if the responses in
terms of how the supervisors would
respond to the issue related to whether
or not they had any awareness around
this being related disability so the one
that doesn't mention anything about
disability was an invisible disability
vignette and that's obviously the one
that mentions that the trainee was a
wheelchair user was the visible
disability vignette and we found some
amazing differences in terms of how
supervisors would handle the situation
just by the simple fact that one of them
mentioned that one was a wheelchair user
so we knew that there was some
misunderstanding among our supervisors
and we felt it was really important to
try to understand that where are the
places where we have some holes in our
training for our supervisors and how can
we best support them alright great yeah
the only the only thing I want to add
real quick is you know dr. Wilbur talked
about the biases and the supervisors
treating visible and invisible
disability better the
they were also incredibly confused about
a disability accommodations yes that was
also very clear from our research so
we're hoping that you know this webinar
and and future research and publications
will be able to offer supervisors just
more resources more education and
hopefully to be able to kind of change
some of the the culture in psychology in
general around disability issues all
right perfect
well thank you so much to our presenters
thank you for everyone for attending
today's webinar you're going to receive
a follow-up email with a link to view
the recording of today's webinar
sometime this month as well as a survey
on the presentation and a way to contact
the presenters if your questions have
not been answered today we'd greatly
appreciate if you would complete that
and provide your feedback on behalf of
APA and our presenters thank you so much
for joining us today and have a great
rest of your day
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