Ensuring Client Dignity

By Jeridith Lord, LCPC, BCBA

Dignity can be described as being worthy of honor and respect. By simply existing, we are all worthy of being treated with dignity. Yet, how do we ensure that we are treating others (especially our learners) with dignity?

1. The BACB code of ethics (2020) can help guide clinicians (and parents!) as they prioritize ensuring dignity, offering several themes that may be useful in day-to-day interactions. First, there should be an emphasis on respecting autonomy and choice. This may look like providing multiple options for snacks, meals, playtime, books, and more! There may be times that choice is not possible (such as when safety is concerned), but choice should be prioritized whenever possible. Learners should also be respected if they decide that they do not want these choices.

2. Dignity is humanizing. Professionals should be cognizant of the language that they use to describe their learner’s behaviors. Person-first language stresses the importance of seeing the person before their diagnosis. There is no such thing as a bad kid. Instead, we should view these learners as people who sometimes engage in challenging behaviors and those behaviors should be the focus instead of associating it with their morality (Friman, 2021).

3. All interventions should emphasize the least restrictive option before moving to the most restrictive option. An example may look like encouraging a learner to wash their hands with a verbal prompt before escalating to physical guidance. There are some exceptions to this rule, especially when safety is concerned. However, in a safe environment, least restrictive interventions promote autonomy, thereby promoting dignity.

4. Clinicians should strive to be culturally sensitive and humble. Incorporating the learner’s background encourages their participation and collaboration. It also ensures that the families’ values align with treatment goals. These values will be different depending on the family, so it is important to include them when considering the impact of culture. This may be difficult for clinicians who work with families who come from different cultural backgrounds, so additional supervision and education is encouraged. We can never learn too much!

5. Ensuring dignity means fostering a supportive and caring environment. A supportive and caring environment begins with emphasizing positive reinforcement and celebrating successes. Building confidence in the learner contributes to the development of independence which is essential for the cultivation of dignity. This also looks like acknowledging the learner’s individual needs, emotions, and methods of self-expression. Our uniqueness is what makes us, us and our learners are no different.

Prioritizing these strategies can help guide clinicians (and parents!) in their pursuit of promoting and ensuring dignity. While it is our job to protect, guide, and instruct our learners, it is equally as important to build them up to become their own person. As their own person, they are entitled to dignity as much as everyone else and we should strive to support that in every interaction we have.

References

Behavior Analyst Certification Board: (2020). Ethics code for behavior analysts. Littleton, CO: Author.

Friman, P. C. (2021). There is no such thing as a bad boy: The circumstances view of problem behavior. Journal of Applied Behavior Analysis, 54(2), 636–653. https://doi.org/10.1002/jaba.816

About the Author

Jeridith Lord is a practicing clinical counselor and a Board Certified Behavior Analyst. Her passions include research in trauma-informed care and compassionate care. She has been fortunate enough to present internationally on topics such as compassionate care in first responders, behavioral training for first responders, adherence to ethical guidelines, traumatic impact and mental health collaboration, and advocacy for domestic violence and sexual assault survivors. Jeridith is a third-year PhD student and an adjunct professor at Endicott College and Southern New Hampshire University.