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Disability, Accessibility, and Ethics in Psychology:
3 Major Barriers
A profession's values -- including its ethical values -- are reflected in the degree to which its structures are accessible to people with disabilities. The profession expresses its values through the decisions of the people who are members of the profession to addresses effectively barriers to access or to maintain those barriers through action or inaction. What barriers can block access to the field for psychologists and psychology students with disabilities? What barriers can block access for people with disabilities to the services that psychologists provide? This brief editorial notes three major kinds of such barriers.
Physical Barriers
When I asked psychologists and psychology students with disabilities corresponding on various electronic mail lists what factors constitute the most pervasive or harmful barriers in psychology training and practice for people with disabilities, I was told some genuine horror stories.
For example, one respondent described how other candidates for admission to a psychology graduate program toured the building and met with each professor in the professor's office, but the respondent, a candidate who used a wheelchair, had to spend the whole day in one room on the first floor while others came to her.
Another respondent told of a library on the second floor, accessible only by stairs (but not for her -- she used a wheelchair). She had to ask one of the administrators to go up to the library and check out books for her.
In How To Survive & Thrive As a Therapist (Pope & Vasquez 2005) Melba Vasquez and I discuss the importance of paying careful attention to accessibility issues for those who use mobility appliances, who are blind, or who are deaf. For example, requiring an audio call in system to gain admission to an office in a secured building will create a significant roadblock for a deaf client.
We also included in our list of fallacies some therapists rely on an exaggerated error in reasoning along those lines:
Denying the Antecedent
This fallacy takes the form of:
If x, then y.
Not x.
therefore: not y.
Example: "If clients or colleagues using wheelchairs came to this office, there would be a reason to make my office accessible. But no one using a wheelchair comes into my office. So there's no reason too make it wheelchair-accessible." To paraphrase a well known media slogan, “If you do not build it, they will not come.”
Internet Barriers
Especially those who live in remote geographic locations, but also people who have mobility problems may rely heavily on the Internet for research, resources, and other services.
Sadly, many web sites do not provide accessibility for people with disabilities.
Such sites are no more usable by some people with disabilities than a library, lecture hall, or restroom at the top of a flight of stairs would be for a person who uses a wheelchair.
Each of my web sites includes a page about how the site approaches accessibility issues. Here's the page about accessibility features for the psychology site: <http://kspope.com/using/index.php>.
The disability and accessibility web site (http://kpope.com) has articles on web site accessibility, links to programs that will assess any site's accessibility, an article on "7 Easy Steps Toward Web Site Accessibility" (<http://kpope.com/seven/index.php>), etc.
Other internet barriers, in addition to web sites that, however unintentionally, block access to people with disabilities, include the use of HTML rather than plain text on internet lists.
Internet mailing lists constitute important resources for many psychologists and psychology students, who depend on such lists for information about professional topics, consultation, mentoring, networking, job notices, support, and so on.
Internet lists on which all messages are sent in plain text (also known as "ascii," for American Standard Code for Information interchange) promote accessibility.
To ensure that messages are accessible, an important step is to avoid using html fixed-size or fixed-color fonts, text that contains italics or bold formatting, html background colors, graphics, and other decorative changes from plain text that can block access for many people with disabilities.
In some cases these decorations can override the settings that people with visual impairments use to make email accessible.
As one person responded to my informal survey: "when you send email in html format, you're often forcing colour schemes and/or fonts that make it impossible for me to *see* the email (and often is so bright as to be physically painful) as a result of overriding the settings I've got in order that I can function in the online environment. . ."
In other cases these decorations can prevent various kinds of assistive technology from adequately processing email (e.g., the program will try to read the HTML coding for italics, bold, different sizes of text, etc., as if it were the content of the email).
Cognitive and Affective Barriers
In addition to the physical and Internet barriers, there are what might be described as the cognitive and affective barriers -- how we think about, feel about, teach about, respond to, etc., disability and accessibility.
I have provided citations and summaries of (and where possible, links to) articles on this topic at <http://kpope.com/accesspsych/index.php>, and other relevant articles (chapters, books, etc.) are mentioned on other pages of that site <http://kpope.com>) and on another site (<http://kspope.com>). On the level of individual psychological services, the section on "Disability Factors" in our APA book What Therapists Don't Talk About and Why: Understanding Taboos That Hurt Us and Our Clients cited Carol Gill's highlighting of how socio-cultural "misconceptions and prejudicial responses to the client's disability" can affect client, therapist, and therapy, and these factors continue to constitute barriers in many instances.
These barriers can serve as the focus of questions that have ethical
implications for each of us as individuals and for us as a profession:
Why do we maintain
these barriers, what are their consequences, and what, if anything, are
we going to do about them?