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Disability Humility for
Employers:
A Framework for Training
I was
recently introduced to a concept that is gaining popularity
amongst people engaged in diversity issues in the health
care field. As an alternative to the traditional approach of
“Cultural Competence”, “Cultural Humility” is a new way of
thinking about how employees in the health care industry can
best relate to coworkers and customers who come from diverse
backgrounds. The more I thought about it, the more I came to
believe that, as a framework for training, it has important
insights for those of us who are engaged in educating
employers to effectively interact with job applicants and
coworkers with disabilities.
Cultural
Competence
Prior to the
introduction of the Cultural Humility perspective, the
predominant paradigm for addressing cultural differences in
health care systems was “cultural competence”. The Cultural
Competence paradigm posits that, in order to well-serve
people from different cultures, all health care workers need
to be extensively pre-trained and informed on the etiquette
issues, cultural nuances, terminologies, and sensitivities
of each diversity group that might be represented by any
particular client or coworker.
While this is
certainly a well-intentioned objective, this approach has
some major problems associated with it.
-
The sheer amount
of information that would have to be acquired and
assimilated by each worker is so extensive that it is
really impractical on a system-wide basis. (It has been
suggested that cultural competence presents “veritable
laundry lists of traditional beliefs and practices
ostensibly characteristic of particular ethnic groups.”)
-
While focusing on
the development of an information base for each health
care worker, this approach tends to overlook the
inherent cultural biases of the worker themselves.
-
This approach
also leaves little room for exploring the extent to
which any particular individual is influenced by, or
representative of, the generalized characteristics
attributed to the cultural group that they belong to.
The cultural competence model may, in fact, actually
reinforce cultural stereotyping.
Cultural Humility
As an alternative
approach, the concept of “Cultural Humility” has been
gaining widespread acceptance. Rather than promoting the
acquisition of an extensive informational inventory, it
advocates that health care workers learn both to reflect on
the biases of their own “cultures” and to engage in highly
individualized and respectful interactions with each client
- a mutually enlightening exchange, a resourceful
partnership that recognizes the unique experiences, traits
and perspectives that each patient brings to the clinical
encounter.
My partner, Denise
Bissonnette, recently wrote some brilliant articles on
Cultural Communication and her thoughts are very consistent
with the argument for the Cultural Humility approach:
“During the melting
pot era, however, what I witnessed in others and exemplified
myself, was that in our attempt to achieve “cultural
sensitivity” we instead practiced “cultural assumptiveness.”
For example, it was generally agreed upon that most of the
folks coming from Indochina would likely agree to anything
one asked of them in order to maintain harmony in the
situation, the Ethiopians were highly educated, assertive
and articulate who would bring a freshness to any job they
did, while the Romanians were a hard-working, industrious
and ambitious lot… and the cultural stereotyping went on and
on.
Through trial and
error, what I later came to understand is that learning
about a particular culture did not necessarily shed much
light on what I needed to learn about the individual. In
fact, most of the time it only got in the way! I hated to
think that anyone from outside the U.S. would presume to
understand me based on what they think they know about
Americans, and I realized that it was important to extend
the same courtesy to people from other cultures. This is
equally true of disability, ethnicity, nationality, and
every other dimension of diversity! Within each of these
categories there is such a fantastic range of experience and
individual distinction, such that anything we think we know
about that group should best be put aside.” (See True
Livelihood Newsletter, November 2006
http://www.diversityworld.com/
Denise_Bissonnette/TLN06/TLN0611.htm)
“Disability Competence”
There is a strong
parallel between “Cultural Competence” and much of the way
we have approached the education of employers on disability
issues. Well-meaning, but perhaps somewhat arrogantly, we
have too often asserted that employers should all be
well-versed in all the different types of disability,
varieties of accommodations and legal minutiae.
Overtly or subtly we
have suggested that, in order to successfully employ people
with disabilities, employers must be experts in disability
e.g. they must have high levels of “Disability Competence”.
Since most employers, particularly small business owners,
know that they will never have the time develop that
competence, they may consequently conclude that they can
never effectively employ people with disabilities. With a
focus on Disability Competence, we can discourage, rather
than encourage, employers to be more proactive about adding
people with disabilities to their workforces.
“Disability Humility”
As an alternative to
Disability Competence, a “Disability Humility” approach to
training employers would empower and support them to
interact with people with disabilities with inquisitiveness
and an open mind. An employer who is able to come to the
table humbly (willing to be open, inquisitive, creative and
respectful), is likely to be an effective employer of people
with disabilities – more so than one that only comes
well-armed with the “book learning” of disability types,
demographic studies, proper etiquette, and accommodation
strategies. With a clear understanding of their own biases
and confidence in their ability to engage in an open and
productive dialogue with people with disabilities, employers
can drop their pretences about being well-informed, their
fears about being politically incorrect, their feelings of
social awkwardness, and simply have honest conversations
with people with disabilities that are likely to engage and
enlighten both parties.
Many materials already
exist to help employers understand the misconceptions and
biases that are likely part of their disability perspective.
(The “Pick a Disability” module in the Windmills attitudinal
training program is a great tool.) Beyond that, employers
also need to be helped to overcome their reluctance and
discomfort in interacting with people with disabilities.
Certainly disability etiquette training can help, but I
would advocate opportunities more like the “Encounters”
program that I have run - which gives employers the occasion
to engage collaboratively with people with a variety of
disabilities.
Happily, many people who
conduct disability training sessions already underline their
training with; “Remember to treat everyone with a disability
as a unique person – not as part of a particular group.”
This need to focus on the specific individual is integral to
the Disability Humility approach. “We don’t come in teams”
as my friend Lance Dawson used to say. As someone who was
blind, Lance knew from personal experience how erroneous it
was to lump people with disabilities (even with the same
disabilities) together.
Personally, I have also
always favored training formats that maximize the
opportunities for employers to actually meet and interact
with people with disabilities. I believe it is the most
effective way to dismantle barriers and make way for
productive interpersonal dialogue between employers and
people with disabilities. (See the Power of Presence
http://www.diversityworld.com/Disability/DN06/DN0611.htm)
That is probably one of the main reasons why I am so
enamored with the concept of Disability Humility.
Remember, It Takes Two…
Disability Humility is
really a two-way street. It can’t work effectively unless
people with disabilities are just as ready to put aside
their stereotypes about employers, their expectations that
employers should be disability experts, and any “shoulder
chips” that they carry from past experiences. It demands an
honest attempt by the person with a disability to understand
and appreciate the position of the employer and the culture
that they operate within. There is a lot of work to be done
by education programs, disability organizations and
workforce development programs to prepare people with
disabilities to effectively engage in dialogues based on
Disability Humility.
As we seek to empower
employers to more readily hire and more effectively employ
people with disabilities, I believe that the concept of
Disability Humility holds a lot of promise. It represents a
conceptual framework within which we can better tune and
hone the informational content that we direct at employers
and the educational seminars that we engage them in. I hope
that it captures your imagination as much as it has mine…
~ Rob McInnes
© Rob McInnes, Diversity
World, August, 2008 (If not used for commercial purposes,
this article may be reproduced, all or in part, providing it
is credited to "Rob McInnes, Diversity World -
www.diversityworld.com". If included in a newsletter or
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Article: Beyond Cultural
Competence
Christopher
Harmon has multiple disabilities resulting from a little-known neurological
condition that was diagnosed when he was almost eight. Originally believed
to be terminal, the progressively degenerative disorder has rendered him
deaf, legally blind, quadriplegic and dependent on a respirator. Harmon is
the founder and owner of Legacy Pictures, Inc. in Burnsville, Minnesota. The
company is dedicated to the development and production of quality family
entertainment.
This
brochure from VSA Arts is a great informative source for basic disability
awareness. It was intended to be “a starting point for readers to increase
their basic knowledge, initiate discussion, and clarify myths and facts
about people with disabilities.” It includes overviews of predominant
disability types and suggestions for improving access and positive
interactions for each. Included are brief overviews of the ADA and the
“disability movement”. VSA Arts is an affiliate of the John F. Kennedy
Center for the Performing Arts and works to “create a society where all
people with disabilities learn through, participate in and enjoy the arts.”
America’s
Heroes at Work has the byline of “Supporting the Employment Success of
Returning Service Members with TBI & PTSD”. The site has a number of
valuable resources to support employers and workforce development
professionals in this effort: fact sheets, training outlines, success
stories and videos. 
According
to Statistics Canada, the employment rate for people with “activity
limitations” increased from 49.3% in 2001 to 53.5% in 2006. The increase was
even more dramatic for the sub group of people with severe activity
limitations – an increase from 31.8% to 38.3% in that same period.
“Recruiting
Young People with Disabilities: A Hiring Strategy with Bottom Line
Benefits” is a new fact sheet from the Office of Disability Employment
Policy that may be informative to employers and could be a useful tool for
transition specialists and job developers.
“Customized
Employment - Employers and Workers: Creating a Competitive Edge” is a new
report that draws on the “Best Practice” experiences of 26 projects
throughout the United States. 
EVENT:
USBLN Annual Conference and Career Fair
EVENT:
Canadian Council on Rehabilitation and Work (CCRW) Annual
Conference
EVENT:
EVENT:
Ever-Widening Circle
EVENT:
2008 Canadian Association for Supported Employment (CASE) Conference
EVENT:
2008 Conference
of the National Association of Disabled Students (NEADS)
EVENT:
Careers Conference 2009