Lecture 10

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<A
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acquainted with your client</A> 
<H1 align=center>Racial, Ethnic, Cultural, and Linguistic Diversity</H1>
<H2>Introduction</H2>
This is a topic on which I can only advise you and share my experiences
working with people new to the United States. I come from very European lineage
- English, Irish, and Welsh. I have a very colleen face and the red hair of my
ancestors. The best thing I can tell you about working with people with
visual impairments who come from other countries is to not make assumptions.
Each culture has its own attitudes towards disability and blindness. As I said
in one of my early lectures in some cultures visual impairment does not have the
stigma it does here in America. In other countries people who are blind are
shunned. Some of this generates from religious views and some of it has to do
with how the society's culture is structured. In either Mexico or Spain
(I think it's Spain) people with visual impairments control the gambling
industry. This is a source of income, which maintains the blind citizens of the
country and is a very defined role for blind people. Other places expect blind
people to become massage therapists. Every culture has its own way of addressing
the disability of visual impairment. 
<H2>Assessing the Self-esteem of Clients from Other cultures</H2>
When assessing the self-esteem of a person from another culture you will have
to take his or her social relationships into consideration. It is o.k. If you
don't know anything about the culture, but if you don't know how the social
roles are established in a given cultural group you will be better off if you
spend some time learning what are the acceptable social roles in the culture of
your client. When visiting a client and his or her family for the first
time it is always a good idea to dress very conservatively. This is particularly
true for us women. Long sleeve blouses and dresses or skirts below our knees can
help a lot to show respect in the household of your client from another culture.
I don't want you to go against whom you really are, but covering your arms and
legs can help open communication a lot of the time.Most of the time families
from other countries and cultures don't expect that you know what is
appropriate. If you communicatethat you want to be respectful and honor the
family's societal norms you may be accepted more easily. 
<H2>Determine a rehabilitation plan</H2>
One of the biggest issues TVIs and O/M counselors face when working with
someone from another country (after the possible language differences) is
determining what an appropriate rehabilitation plan of action is. A man from a
culture where his sense of personal pride is tied to his sense of independence
may not be responsive to a woman teaching him personal life skills because of
the social roles women hold in his culture. A woman from a country where
females do not work outside the home will not necessarily do well mastering
employment skills and may resist mobility lessons, which would allow her to
leave her home. Some cultures expect blind people to remain at home out of sight
and suggesting that an individual learn how to cane travel may not be greeted
with enthusiasm. Rehabilitation professionals can get very frustrated
when they feel that their efforts toward rehabilitation are being resisted. This
is where you have to discern when a person is resisting learning something which
will help foster their adjustment to blindness or if what you are asking is
offensive to them culturally. Here are some general things for you to
consider when meeting with a client from another culture. How does your client
think about time? In some countries showing up for a 10:00 a.m. appointment
means that they may arrive at noon. They are not deliberately choosing to be
late to your meeting. It is just that in their culture time is not assessed the
same way it is here in the United States. Also in many cultures it is not
polite to discuss money. If you have to discuss money you may want to feel out
the family members and suggest that you meet privately with whichever family
member is responsible for the family's finances. Money is a touchy issue for
several reasons and it is important to be careful about talking about it. Also
some of your clients will have family members who are in the United States
illegally. This comes up a lot when the parents of a visually impaired child are
here illegally, but their child was born here and is entitled to receive your
services. Just know that the child is entitled to services and you can provide
them for the youngster in ways, which do not affect the parents. Even
family members who are here legally may not understand your role in your
client's rehabilitation. You may get some nervous questions about where the
information they give you will be sent. This has to do with a concern about
reporting the information you gather to government agencies such as the I.N.S or
the Social Security Administration. Illegal aliens receiving
rehabilitation services Another thing, which may be helpful for you to know, is
that someone from another culture who does not have a green card can receive
rehabilitation services from most state agencies. They are not eligible for
vocational counseling, but the rehab. Services are possible. A lot of people
don't know this when they haven't been living here very long. If your agency
employs language interpreters you can ask the person you are working with for
any pointers he or she may have about how to communicate with your client or
your client's family. If there is no interpreter often a family member is
recruited to do the translating. I have never had to work with a family
member, but what I have been told is that it is often difficult to work with a
family member because the person interpreting may be translating through his or
her own agenda. I don't know how true that really is, but the catch for you is
that if you don't speak the language of your client you can't assess how well
what you are discussing is being communicated. It also helps a lot to learn a
few phrases in the language of the people you are seeing. I usually learn how to
say hello, thank you, and my name in their language. I also learn to say that I
only speak English. I do this when I travel to other countries and it works
well. Physical touching is another area where you want to be conscious of
the social code. I notice this a lot when I shop in smaller stores, which are
owned by people from other countries. Since I request assistance in these stores
I often find that I want to be very sure I am touching a man or woman
respectfully when I am going sighted guide with them. I also alter how I hold
someone's arm depending on my instincts on how comfortable the person is with
me. . Most of the time someone in the shop is assigned to me and I try to get to
the store when I know the individual is working. A lot of the time the
men in the store speak better English than the women so a man often helps me. If
I am in a grocery store I usually suggest that I hold the back of a shopping
cart so that the man doesn't have to go sighted guide with me. If it is the kind
of store where I want to go sighted guide I explain what I want to the manager
and some kind of agreement is made to assist me. It may be that I stay in one
place and have the items brought to me instead of going around the
store. In some cultures men are not to touch women they are not related
to whether the woman is sighted or not. You will run into this in some form in
your work particularly if you are training to be an O/M instructor. 
<H2><A name=S1>Getting acquainted with your client</A></H2>
I think the easiest way to get acquainted with your client and his or her
family is by making the initial visits in teams. A male and female team is best
if you can find a colleague to go with you. Once you get to know the family
system you can go back by yourself more easily. The reason I keep
mentioning the family is because in many cultures an individual may not be in
charge of decision-making for him or herself. There may be a patriarch or
matriarch who makes the decisions for the younger members of the families. This
is a very different system than we use here, but it is how a lot of family units
operate. Also remember that there are many families born here in the U.S. who
operate in the same system, so don't assume that if the family is American that
your client will be making decisions. If there is a family decision-maker
you can get your points across by addressing your comments to both your client
and the family head. Another thing to be mindful of when you are meeting with
clients is that eating and gift giving may be part of the culture he or she is
from. Hospitality is very much a part of many cultures and no business is
conducted without eating first. If you are offered something that doesn't look
very appealing at least take a bite if you can. To outright refuse may be
insulting. Gift giving is a little harder for us to address since we usually do
not accept gifts. Some cultures regard gift giving to be both a sign of respect
and also may allow your client to accept your services more easily. They can
receive services because they have exchanged something with you. There
are also cultures were services are not provided unless some sort of bribe has
been offered. Please don't take this personally if you feel that is what is
going on. Just remember that your client comes from a very different culture
than you do and his or her survival depended on bribes where they come from. Use
your judgment when accepting the gift. Also if you feel thwarted in your
efforts to provide services it may be because the people you are dealing with
have an existing system for caring for their disabled members. In some cultures
it is not acceptable to turn the care of a family member over to an external
institution like vision services. Turning someone's care over to you may be
regarded as shameful because it would be seen as the family not living up to its
responsibility. In this kind of case what you can do is offer assistance to the
family in providing adaptive aids and other services. That may be as far as you
get in rehabilitating your client. If you are having a really hard time working
with your client and his or her family the last thing you can do is contact one
of the client's community leaders. This could be a religious leader or
the head of the local immigration agency. Most groups of immigrants settling in
New England form associations to support re-settlement. By contacting a
community leader you can get information on how to approach the client or the
family as well as possible assistance. At least you will get clear information
on whether or not to pursue your rehabilitation goals. The last thing I
want to alert you to is how the phrase, "vision rehabilitation" may be heard by
people from other countries. Vision Rehabilitation is a misnomer. It sounds like
people can get their sight back and sometimes they do, but we understand it more
to mean that someone will become adjusted to their remaining visual impairment.
I have had people from other countries say to me that they know a community
member will never be sighted again so they will not apply for services. This
kind of literal understanding of the phrase should always be kept in mind so
that you can be sure the people you are speaking with understand what vision
rehabilitation is. </BODY></HTML>

Copyright 2008, by the Contributing Authors. Cite/attribute Resource. tjain. (2007, October 19). Lecture 10. Retrieved November 22, 2009, from University of Massachusetts Boston Web site: http://ocw.umb.edu/speg/speg-623/lectures/Session10.htm. This work is licensed under a Creative Commons License.

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