Article

Frontline Initiative: Supporting Healthy Relationships

Advocating for the people you support in their relationships with their family

Author(s)

John Raffaele is the director of education services at the National Alliance of Direct Support Professionals (NADSP). John can be reached at jraffaele@nadsp.org

Families are so many things. They can be wonderful, challenging, engaged, disengaged. They can be great teachers, passionate, supportive, unsupportive, and so much more. Families are complicated and unique. More and more Direct Support Professionals (DSPs) are working closely with families. DSPs need to be equipped with knowledge, skills, and values to navigate family relationships with competence.

Code of Ethics

Many DSPs interact with family members of the people they support. When they do, they must always maintain their commitment to person-centered supports. The National Alliance for Direct Support Professionals has a Code of Ethics  which states, “As a DSP my first allegiance is to the people I support. All activities and functions I perform flow from this allegiance.” This can become difficult when a loved one has influence in a person’s life and they want something different for the person than the person wants for themselves. The DSP has an obligation to remain loyal and take direction from the person they support, not necessarily the family member(s). All activities that a DSP performs flow from this idea. This does not mean that the DSP is disrespectful of or ignores family; it means that the DSP must be sure the interests of that specific person they support are being met.

The DSP has an obligation to remain loyal and take direction from the person they support, not necessarily the family member(s). This does not mean that the DSP is disrespectful of or ignores family; it means that the DSP must be sure the interests of that specific person they support are being met.

Advocacy

There can be situations when a DSP needs to speak up or advocate with and for a person they support. Such times are when the person seems to be or is being pressured from a family member. This is tricky territory to navigate. One of the best ways that DSPs can address this concern is to look at the ethics and skills of advocacy. This NADSP Competency area states that the DSP, “should be knowledgeable about the diverse challenges facing participants/people supported (e.g., human rights, legal, administrative and financial) and should be able to identify and use effective advocacy strategies to overcome such challenges.” It is important for DSPs to be educated about when to engage. Some DSPs support people who do not speak with words by partnering with them and their support team. They gather information and may find alternative means of expression. DSPs advocate for laws, regulations, policies, and procedures that promote justice and inclusion for all. DSPs can help the people they support to understand their rights. DSPs can seek additional advocacy services when they need extra support and knowledge, and seek out qualified guidance when they are unsure of the appropriate course of action to take in relation to the family of someone they support.

Daniel and Tammy

Here is an example of how a DSP can provide person-centered support while navigating a family situation. Daniel is a 55-year-old man who lives in a supported apartment complex. Tammy is Daniel’s DSP. She visits him three days per week to assist with household management and community living skills and supports. Daniel’s brother visits frequently and wants him to attend religious services with him weekly. Daniel shared with Tammy that he is not interested in going to religious services with his brother. However, he feels pressured and is afraid to tell his brother. Tammy is now in a position to show her person-centered allegiance to Daniel. She reviews the role of advocacy in the NADSP competencies and the code of ethics. Tammy also reaches out to a supervisor for advice. She does not discuss anything with Daniel’s brother without direction from Daniel.

If guided by her ethics and competencies, Tammy can assist Daniel in speaking to his brother. She can help Daniel gather the words. She can strategize with him how to best share his feelings. The most person-centered outcome in this situation would be if Tammy successfully helps Daniel create an honest and open conversation with his brother about his lack of interest in going to religious services. Maybe Tammy could help Daniel share with his brother other types of opportunities for sharing time together.

There is complexity in working with a person in their family context. If DSPs are aware of and educated in the skills and ethics available, that increases the likelihood that person-centered outcomes will happen. DSPs must intentionally use this knowledge to balance allegiance to the person they support and their family members.