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So how do I get a family of someone with a traumatic injury to buy into
rehabilitation if there are cultural barriers? Well I start by buying into the family. I
look at it the other way around where you're collaboratively,
and so that's why I start with their priorities and their goals, and then look
at how I can facilitate their goals, and then perhaps
add on ones that I thought of that didn't occur to them, or that they didn't notice
yet. But I buy into them, that's the way I look at working
on that. That's on a personal working with people level.
But that's a much bigger issue in terms of society as a whole.
We have a lot of disparities in rehabilitation, that is to say that within the United States
people of various minority status generally receive fewer rehabilitation services than
the majority culture people. And the barriers
to that, probably the most important is healthcare funding, is that we have such a
crazy quilt of healthcare funding that does not
reach everybody by any means, forty six million people without coverage, and so on, and
that's certainly a very important factor. Other factors are institutional barriers,
lack of awareness in the community of the services
that may be available, lack of faith in those services, lack of appropriate outreach and
language accessibility and so on. Fortunately there's a government agency that has
addressed all of those issues and has some very good guidelines. It's cultural and linguist
access to services I believe it's called CLASS, and in the slides that accompany this
interview I'll list out some of those things, of ways that institutions can look at making
themselves more accessible to the ethnic minority communities that are in their catchman
area in their neighborhoods. So there are a lot of things that keep people
from ever arriving at the office, or the clinic, or the rehabilitation facility, or whatever
it is. But once they've arrived, then other things
having to do with those barriers are buying into them, working with their goals, finding
out about their background, and those kinds of
things. As I said before, not just tolerance, but
valuing and respecting that. Most of the things that I talk about, most of the things that
I teach come from the people that I've worked
with. They don't come so much from what I learned in graduate school or what I learned
from the scientific literature.