[nabs-l] Handwritten pages, accessibility, and confidentiality

[Antonio Guimaraes]

Hi Kaiti,

I would personally ask a member of the treatment team, or administrator to type up the material, and email it to you. this way you reach out to someone in the organization who is already exposed
 to client information, and bound by the same confidentiality rules you are supposed to follow.

I would not be too concerned with doing the entirety of your job with zero, or close to no accommodations at all. Some times we do need help to get at things, and hand-written materials are definitely a special case.

Reaching out to a member of your team not only builds team work, but also helps educate the team about your technology, how you do things, and how you might need help.

Your independence is of tremendous value, but I think some times we must not turn away needed help on the basis of principle.

Just my thoughts.

Antonio










> On Oct 9, 2015, at 6:57 PM, Kaiti Shelton via nabs-l <nabs-l at nfbnet.org> wrote:
> 
> Hi all,
> 
> I previously posted about this issue on the human services list but
> have not gotten any suggestions for how to handle this challenge that
> suit my needs.  I got similar answers from a group of blind music
> therapists, but as both groups tend to be comprised of older folks I'm
> hoping I might get some more satisfactory answers here from people who
> know more about technology or why I might not want a reader other than
> just being a stubborn whippersnapper.
> 
> I am a music therapy student and for my practicum this semester I am
> working one-on-one with a young man who has Down Syndrome.  We have
> developed a great therapeutic relationship over the past few weeks,
> and the theoretical models I've used have worked wonderfully.
> Reciprocity is one of the core values of the format, which is great
> because it allows for him and I to help each other, and for him to
> take some of the responsibility and gain self-affirmation and success
> from that.  (Music-centered, client-centered, and resource-oriented
> music therapy are the principles I'm using in case anyone is
> interested).
> 
> In one of our sessions this week the client brought in a spiral
> notebook with some handwritten song lyrics that he had composed
> himself.  It was clear that he was seeking musical support and wanted
> me to work with him to shape the songs into musical works.  My role in
> this case would be to help him by forming the melodic material and the
> chord progressions for the harmonic structure, but that was extremely
> difficult for me to do without access to his lyrics.  I think he did
> feel like he got something out of it because he did a bit of
> directing, but it would be nice to really shape the song into
> something unique (he identified that he wanted a pop sound and chose
> to sing it along to the harmonic structure of "Fight Song," with my
> supervisor and I playing in addition to the recording of Fight Song to
> back him up).
> 
> In the following session the client agreed to let my supervisor make
> coppies of the notebook pages, and she took pictures of them using a
> scanner app on her phone and sent them to me as image PDFs.  OCR won't
> work on these since they're handwritten, so I'm still somewhat stuck
> in accessibility.  The real catch comes in how to make them accessible
> since I am not quite sure what the terms of the informed consent are
> (the degree coordinators handle that as this is still fairly early in
> my practicum sequence) and I also don't know what I can do on my end
> to be ethical.  I don't know if going through disability services or
> robo braille is an option because I can't guarantee that the files are
> destroyed once I get my coppies of them.  My professor suggested that
> we wave the usual requirements of not sharing more than superficial
> information between clinical teams and have a classmate read the
> lyrics to me so I can write them down, since I need to get them
> somehow.  However, I think this is something I need to figure out how
> to handle on my own because I may very well have this situation crop
> up in the professional world and may not be able to run to classmates
> or colleagues busy with their own work to do that.  Additionally, call
> me stubborn, but I'm the type of person that avoids readers at all
> costs because I want to be independent and not bother other people
> with my workload, especially peers.
> 
> That aside, when I emailed this to the human services list I received
> one response in which the clinician lectured me on how I should have
> the client read his lyrics to me so I can write them down in an
> accessible format, and I can use it as a way to educate him on how I
> adapt, how self-disclosure can be beneficial for the therapeutic
> relationship, etc.  I am well aware of these facts and have strived to
> self-disclose my blindness in ways that are beneficial to my client.
> We talked about it in the first session I had with him and he receives
> reminders of why he needs to tell me what he's pointing to or say what
> he wants as needed.  He has even read lyrics of songs I've printed out
> for us to work on for me a few times so I can find where he is looking
> on the page and guide him to the right spot.  He has heard voiceover
> and understands what it does for my phone on a basic level, as well as
> seen my cane and notetaker before.  I think considering his level of
> cognitive functioning that he understands it as well as he can and
> with reminders that I've been giving him will understand it possibly a
> little more as we continue working together.  On another note, I'm not
> willing to sacrifice valuable session time which could be used to
> address our goals for him to read to me.  This is because although
> give and take is very important in our relationship, I think that
> would be overdoing it.  It takes him longer to process and read things
> out loud, and sometimes I have to clarify what he says because his
> speech isn't always clear.  I think we'd at least sacrifice the
> majority of a session if not more with just getting the information
> into my computer and checking that it is correct, and that is not
> something I'm willing to do-to sacrifice a client's treatment for my
> own accommodations.  That's a principle I think I would stick to in
> the professional world, so I'm really looking for something that will
> allow me to independently and effectively get accessible versions of
> his song lyrics while maintaining professional and ethical standards
> of practice regarding confidentiality.
> 
> Any suggestions or methods any of you have used for navigating these
> issues would be appreciated.  With fall break my next session isn't
> until Wednesday, but I'd like to have time to look over the lyrics to
> see how I can best be of support.
> -- 
> Kaiti Shelton
> University of Dayton-Music Therapy
> President, Ohio Association of Blind Students 2013-Present
> Secretary, The National Federation of the Blind Performing Arts
> Division 2015-2016
> 
> "You can live the life you want; blindness is not what holds you back!"
> 
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