The Arc of Livingston-Wyoming: Ethical Decision-Making During Crisis
Submitted By: Jeff Kantrowski, The Arc of Livingston-Wyoming
When locations are struggling to provide supports to specific individuals The Arc of Livingston-Wyoming offers the chance to directly air concerns/roadblocks to the people “behind the scenes.” DSPs have sometimes expressed that there is a preference to directly communicate with who is perceived to be the policy makers, rather than have their message “translated” through a supervisor. Our clinical and compliance teams will work in tandem to respond to these situations.
Allowing DSPs to come directly to the clinical and compliance team(s) has been a successful way to bridge that gap. Additionally, conversations always strive to let DSPs know that there may not be perfect guidance but if they follow ethical decision-making processes the agency will stand behind them.
Impact Of The Program
Anecdotally, this has led to better outcomes for the people supported as the DSPs appear to have less hesitancy supporting with the anxiety of their specific scenarios addressed.
Essentially, if a DSP is worried about [specific bad thing] occurring, it can become overwhelming to the point where they withdraw from that person. By directly addressing that anxiety we can provide the DSP with a more precise toolkit and decrease that hesitancy. This has been mostly used in locations where specific situations are leading to morale issues and constant staff frustration. We’ve anecdotally noted improvements in staff confidence and decreased frustration/anxiety.
Additionally, we’ve increased willingness for staff that attended one of these meetings to reach out to compliance department for guidance, improving the direct connection to the program.
Steps To Implement A Similar DSP Program
- Clinic and Compliance give general guidance to agency (business as usual)
- DSPs and location staff express that aspects of guidance don’t seem to work
- More specific guidance is given to assist DSPs, often via a written method
- There can be a bit of a cycle to this, but ultimately DSPs voice that they feel unsafe/unprepared handling a situation
- Clinic or compliance staff schedule meeting time to reach maximum number of location staff
- Meetings often begin by allowing DSPs to voice concerns and challenges
- DSPs asked to provide specific scenarios they feel uncomfortable handling
- Clinical/Compliance team discuss possible responses, allowing DSPs to raise additional concerns with the new suggestions
- Clinical/Compliance team stress that ultimately there may not be a perfect solution. DSPs must choose the best one in the moment
- Clinical/Compliance team reinforce that agency will support DSP as long as all decisions are made with key ethics in mind
How could other organizations replicate your efforts?
In our agency, we have tried to incorporate some of these philosophies in courses such as Strategies for Crisis Intervention and Prevention, Incident Reporting, Trauma Informed Care and others. Ultimately this is a philosophy that allows for a flexible structure. All you need is compliance and clinical staff willing to reach out and offer their time to teams that might be struggling.
What challenges may organizations face in implementation?
The biggest barriers are culture and customer service skills. Our compliance and clinical teams embrace the open door culture our agency strives to achieve. Agencies with a rigid “chain of command” approach would need to be open to a little change. Additionally, once this process engaged meetings often are lengthy and emotionally charged (you’re trying to help DSPs who are frustrated and not sure what to do). Making sure your response team is comfortable positively addressing challenges in that environment is a priority, but can be challenging.
About The Arc Livingston-Wyoming
Parents founded The Arc of Livingston-Wyoming, an agency that is celebrating 60 years supporting the community. Their goal was to provide services for our community’s most at-risk children. As their first project, they established the area’s first preschool class for children with developmental disabilities.
Today, The Arc serves around 800 individuals of all ages, and parents continue to be the agency’s guiding force. According to the bylaws of The Arc of Livingston-Wyoming, at least half of the Board of Directors must be blood-related to persons with intellectual/developmental disabilities.
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