Yeah. All right. And then I think I need access to share. Now, a chance. Perfect. Thank you. All right, we got desktop to go full screen. Everyone a chance to settle back in. All right. Thank you. Give everyone, start at 105, give people some time to settle in, come back from lunch or your break. Did you guys get a quick meal in? Yeah, very quick. Good. Anyone sneak in a nap? No? None of those like 15 minutes. I'm not going to lie, I lied down for 15 minutes. Give me a few minutes. You've all been, have you been all since the morning in Zoom trainings or Zoom meetings, like 9 AM? OK, that's a lot. All right, I guess we have everyone, I think so. So we'll get started. Welcome back all, nice to see you and hope you got a break. Hopefully after this, are you guys done for the day or is there more? You're done for the day, all right. Okay, so let's make this one enjoyable and then you can all go rest or is there work to be done? No, rest, you guys are doing great at giving me cues and signals here. All right, so let's get started. So with the second half, as I mentioned before, we're gonna do a little bit more into digging on, digging into practicing cultural humility and self-reflecting. We talked about before in some of the items that prompt up of questions is kind of what can I do? What are the roles I can play? And so one big piece of it is better understanding ourselves, our identity, how our biases, what biases exist, how we interact with others, as well as how others' identity, intersecting identities may play into the services they seek, their behaviors, how we interact and vice versa. So we're gonna dig a little bit into that. And so we're gonna get into that. So basically self-reflection is a crucial part for anyone involved in cultural responsive work. So we're gonna take the time to reflect on our own biases, our experience, our assumptions. This does a little bit of introspection and allows us to approach our work with greater empathy, awareness, effectiveness, and it's encouraged to engage in regular self-reflection. Some of the activities we're gonna be doing are not a one-time thing. You can always do them over time. You'll see differences if you think about, if you even, when we're looking through them, if you even think about it, well, a few years back to now, how will my responses have changed? And we're gonna dive into that a little bit. So we're gonna jump into it again, a Mentimeter. So this is a new one. So I'll give you guys a few minutes to scan the code or type in the webpage and the access code. So I'll give you a few minutes for that. We're all good? Everyone? Thumbs up or sign in? Anyone need the code? All right. Thank you. All right. So our first activity we're going to jump into is the wheel. So let's get into that. All right. So starting off with cultural humility. So cultural humility is a lifelong process of self-reflection and self-critique, whereby we continuously assess and address our own cultural biases and perspectives. It involves recognizing power dynamics and imbalances that exist in cross-cultural interactions and strives to understand and respect the cultural experience and viewpoints of others. So again, as we were talking before, mentioning before it's understanding ourselves, our biases, understanding others, and how our cross-cultural experiences can intersect and impact our relationships. And when you were all talking before about relationship building with clients, this is a piece that we can strengthen and build on. And as you said, kind of what can I do? This is a starting point. So I'm sure you've all heard about cultural competency. So unlike cultural competency, which it implies more of a static level of knowledge. So I studied the book. I understand competency. I know what it is. I can check it off. I've done the process of being competent. Cultural humility is more about emphasizing as an ongoing commitment to learning. So it's not a one-time completion, one-time done. It's a lifelong process and commitment to learning, listening, and improving one's ability to engage respectfully, effectively with people from diverse backgrounds. So it's, we often say, you know, when we're doing this work, we're not experts. No one's an expert at this. We're constantly learning and growing over time. If anyone says they're an expert, probably run because we're not an expert at this. And so this is a key piece to remember. All right. So we're going to jump into the activity, the wheel. All right. Has anyone seen this wheel before? You can, I think you guys have the little, like, like, the little thumbs up. If you have, feel free to hit it. You've seen the wheel of power and privilege. Okay. Keep an eye on that. So the wheel of power and privilege is really a visual tool that highlights how various social identities, such as race, gender, social economic status, and more can grant advantages or disadvantages in society. When we talk about cultural humility, it involves recognizing where one self stands on this wheel and understanding how our positions impact our interactions with others. And when, so when we talk about cultural humility, it requires us to acknowledge the dynamics and to then approach each interaction with an open mind and a willingness to learn. By doing so, we can be more, we can be more effective in challenging the systemic inequities, inequalities, and build more inclusive, respectful relationships. So as you guys were saying before, you know, when you, how, you know, the system, it's a larger system. What can I do? A piece of changing the system and challenging the system is better understanding your conditionality, your intersecting, your powers, your privileges, and what can you do with them and understanding others and their privileges and their power. So privilege provides certain advantages in our society. However, it does not necessarily guarantee good outcomes. It's just within a societal context provides advantages. So take, for example, if your parents were not out working nights and weekends, it's likely that there was more time to focus on your health and wellbeing to ensure that your, your developmental milestones were being met, that your school was, you know, activities were being completed, et cetera. And so overall your needs were being taken care of. If take for another example, if you're able to walk down the street, holding your significant other's hand without fear of what someone will say, fear of violence, fear of, of hateful speech or someone saying negative to you, that is also an act of its privilege. And so many of these different pieces of privilege reinforce each other. So such as those related to socioeconomic status, race, ethnicity, et cetera. It is important to note that everyone experiences privileges and everyone experiences oppression. What is critical is to reflect on how these interact to create your experience. So you'll see, as you create, as you do this activity, that there will be places where you will have privilege and others where you may not, but it's important to see the full picture and understanding your positionality. So when we look at this image we'll quickly see the center is quote unquote power and privilege and around it are the, what society has deemed as normal and what we've identified as it providing, you know, privilege, et cetera. What is the norm within society? As we go further away from what is perceived as the norms, we get closer to systems of oppression. So take for example, if we look at this wheel and we see a white cisgender heterosexual male experiences and is more closer to the power piece of the wheel than a black cisgender bisexual female. So recognizing that internally and the closer to the quote unquote norms is power and those as we go out further marginalization and oppression occurs. So we're going to take some time to do a little exercise. I don't know if you guys have the sheets in front of you. If you do feel free to bring those out. If not, it's easy to just draw a circle. And so we're going to look at our own privilege and our impact on our day to day. So you're going to start at the top and you ask yourself whether you receive advantages based on your race. So if so you would be closer to the center and you will place an X there. You're closer to the, to the norms, quote unquote, the power. And then how, and then go down each section. And if you are further away from the power, you will place your, the X further away and closer to the more marginalized oppressed system. So face for example, a white male would place their X closer to the circle, the center circle versus a black female would start, would go out into the further pieces of the center circle. So I would recommend let's do an activity, place your X's go through, go through these pieces, place your X's. And when you're done connect your X's and you'll see kind of a physical representation of the inter intersection and of power and privilege and oppression for yourself. So we'll take 10 minutes to do this and we'll come back. So I'll be quiet. How's it going? Good, good. Keep working on them. I'm just gonna switch over to the next screen. So as you complete them, you can kind of respond to some of the prompts. So wanna dig a little bit different into what do you experience as privilege and how does this impact your life? So. All right. I see one response came in. I'll give you time to add any other responses, we can definitely unmute and have a conversation. I did have a question on the empty chart. It seems like there's some different slots that are different categories than the one that's filled in. Like, for example, with age, religious affiliation, and political affiliation, I didn't know if we're just supposed to use our best judgment to fill that in with regards to if we think that makes us privileged or not, and to what degree. I feel like age kind of seems like a little bit, for example. Yeah, I don't know. I feel like you could argue either way. No, I appreciate you. Thank you for bringing that up. So you're right. There are different adaptations of this wheel. And so in this one, it really encompasses a much more in-depth kind of the privileges and whatnot. With this one, it's actually, and thank you for pointing that out, the exercise wheel is actually is slightly different. And I do think that there are pieces of your understanding of your privilege. So with political affiliation, religious affiliation, et cetera. There are, though, what we would conceive as norms, right? And so let's say in America, the predominant religion is Christianity, Catholicism. And so how does your religion kind of fit in regards to that, in the expression of religion, et cetera? Think about schools. There's a lot of Catholic and Christian schools available if you don't want to go to public school. But are there other opportunities in other religions? So a piece to that. With age, interestingly enough, one of the other exercises we're going to do is actually going to dig into that one a little bit more. So that is a great point. But think again about kind of for yourself, thinking about in an age perspective, I do think that there is a little bit of, like you're saying, you can argue here or there. So with this circle, I do think that there are some pieces that are kind of a little bit kind of like, OK, we got to sit with that one. But that's kind of the point. We want to sit and have this conversation and see what you think. So what is your argument with age? What would you say? Come on. I mean, I guess ageism is a real thing. I guess I'll start with that. But then I guess you could make, and I mean, it exists both ways. That can tie into, yeah, the older population is often a forgotten one. So in that respect, society isn't built for older people in a lot of ways. But also, I guess with other things like voting, for example, I don't think younger people's input is always taken into account. So I think you could argue that you have privilege if you're younger or older. So an understanding of positionality, right? And so kind of what you're saying, and thank you for sharing. I mean, that's really true. There's ageism. I'm sure I've experienced it in the past where in professional settings, oh, I look younger than what I am. So no one wants to take me serious. So that's a piece of it. And like what you're saying, also in the health care system, older individuals may not do not receive maybe the same type of health care, et cetera, et cetera. So there is this kind of power struggle between privilege, what is privilege, what is not. I think it also speaks to our larger system in regards to some of these identities. But when we think about, and we're going to get into that exercise a bit, it really is that intersecting piece to it of how all of these come together to create more power or privilege in one way. And so like you're saying, there are these variables with age. But is an individual or yourself experiencing more of other variables that are skewed one way or the other, and therefore impacting your personal experience? Does that kind of make sense? OK. OK. As a cisgender or cis-rural person, I never have to worry about someone taking away my rights to marry, be who I am. Very true. Yes. That's a privilege. That's. And how do, well, I mean, and going back to the higher socioeconomic background, having more educational opportunities, ability to afford higher education, higher earning career, that's higher earning. So again, it's these privileges. Did anyone, well, we're talking about privileges here. I'm curious, well, any others, any other thoughts before I jump to the next? I'm like, it's that afternoon. I'm not, I'm drinking Sprite right now to get my sugar levels up. Nothing. How does it feel to talk about this or to even sit and think about this? And you can type it in. You don't have to say it out loud. I think something I've noticed when I have these discussions or think about this is trying to balance the competing idea that I am grateful to be in a position to have this privilege and power and also guilty for having it. Like I'm grateful I have so many things that give me advantages in life but it sucks because other people don't have that and by necessity some of these privileges that you have come at a cost to others. It's really powerful and I saw some like head nodding there so I think others others kind of connect to that and we're gonna go further into that but what you're really speaking to is yeah it's a reality that there is this uncomfortable feeling sometimes of well my privilege and and there may be guilt there but I also we want to talk about and we're gonna go into that of what can I do with my privilege? What is my role that that I have these privileges and what can I do to support and to make changes for those who do not? Again it's not an easy conversation to have and feel you know emotions come up and then thoughts come up and and also recognizing that and I know we're focusing on privilege but that we all like I said before experience privileges and oppressions but I appreciate you sharing that piece but we're gonna we're we'll talk about ways that we can utilize our privilege. Anything else? No? All right we'll keep going I got more questions. So how do you use your privilege? There we go. So how are you using it? So you know you have it. There's feelings there of others may do not so what do you do with it? There's no right or wrong. Please feel free to share. So you've gone into helping professions. Yeah. So you've entered professions that work with and address many of the social, the health disparities and other factors that we've talked about, and have utilized your privilege, as you all others noted of, you know, being able to get higher degrees, etc. What about your, how do you use your privilege when the language barriers come in in those telephone issues? Do you have privilege anywhere there? And do you think you can use some of it? Okay, advocating. Very good. Advocating, yeah, for more access to better interpretation systems. All right, we'll keep going until there's more questions, so. All right. So, how could this impact your work. So you we've already hit a little bit on going into your profession you chose etc. Can you think about maybe a recent experience where your privilege impacted your, your work experience or interaction, etc. Mm, filling a white savior role, being out of touch with the patient population. That's a big one. I mean, going into a health profession, wanting to make changes, knowing that changes are needed, you know, concept of white savior often does come into play. So it is taking a step back and recognizing, I, you know, what is my role? How can I help yet also recognize other people, et cetera. How about, and I know we talked about purge, but I'm curious, when you did your drawing and whatnot, you noticed your privileges. Were there any pieces where you noticed you were closer to the oppression, and have you ever sat with that and thought about those? Being able to make a better connection, I'm a Spanish speaking patient, so that's how it impacts, you're able to make better connections with English. So you may not think about all the issues. Someone more marginalized than you deal with, not prepared to provide well-rounded care, lack of resources ready for patient. Yeah. So it does provide, you know, kind of an exercise like this to recognize all the intersecting pieces and what an individual's identity may impact their experience. And again, as you're in a system, the healthcare system and whatnot, it does create challenges for you as a provider to be able to dig into this, but being able to take a moment and a step to kind of start some of these thoughts, start some of this understanding is a part of the change. It's not going to happen overnight. And that's important to recognize. All right, we'll jump into the second activity. This one doesn't get to dig a little bit deeper so we'll have more of a conversation here. So this is the addressing model so I'm going to kind of go through this with you. So this model was developed by Dr. Pamela Hayes, and it was developed to assist psychologists in recognizing 10 key factors of cultural differences relevant in the United States. So these factors included age and generational influence, developmental and acquired disabilities, religion, spiritual identity, ethnicity and racial identity, socioeconomic status, sexual orientation, indigenous heritage, national origin, and gender. While these categories do capture the most common points of cultural differences, it's not an all-encompassing and it's important to note that. And so this provides a framework, the address model provides a framework for understanding the different complexities and where better understanding, like we were talking about before of the whole individual and all the factors of their identity that come into play and influence. And this is not only in regards to a client, but also yourself and your beliefs and your biases. How does this kind of, where does this come from? So we're going to fill this out. So you're going to fill out the table by identifying your cultural identity in column one, and then reflecting on the implications of it in your work in column two. Consider the areas where you hold privilege and which group you might find easier or more challenging to work with. So there is on the first side is this example, what it is, and then the second image is an example of one that's been kind of partially filled out based on the individual's comfort level and sharing. And so you should see identities are written out and then how that may implicate the work that they do. So we'll take some time to fill that out and then we're going to dive into some questions about that. So we'll do like 10, 10 minutes, 10, 15 minutes. And if you have questions about it, feel free to chat them in, unmute yourself, ask me whatever you need. Sounds good. Okay. And if you, you should have the worksheet. If you do not, I can, I can pull up a better version. Do any of you need a copy of this? No, you're good. Okay. All right. How are you all doing? Need some more time? Any questions? No? All right. Ready to do some answer, to do some digging in? All right. And I want to apologize ahead of time. There's some, I don't know what they decided to be doing outside my apartment, but there's some wild banging happening and sounds like some construction work. So I apologize if you hear a loud noise, but hopefully it sounds like they went away. All right. So from your table, can you identify three areas where you hold privilege and three areas where you do not? And provide a bit of examples for each. So I know this can be a lot of typing, so if you just want to come off of mute and share, please feel free to do so. It's probably more likely easier that way. So open to sharing. So one area I hold privilege is my education, and an area where I don't hold privilege would be my race. Okay, thank you for sharing. Thank you. I thought I was gonna have to break there the therapeutic silence I was like am I gonna have to do it but thanks for helping out. Alright so what area is a recognizing your education, and another area where you recognize you do not hold privileges race or anyone else interested or willing to share. If not, move on. Okay, welcome. I'm white, which is a big privilege. Both of my parents have advanced degrees. Therefore, we're very knowledgeable about how to navigate the education system. And in terms of things that are not a privilege. I'm a woman. That's definitely something. But on the flip side, I'm also a cisgender woman, which has privilege, compared to say a transgender woman. Awesome. Thank you for sharing, appreciate your openness and willingness to share, and you highlighted some great points so family resources, having kind of that support, as well as, you know, gender, being. Yes, with a woman has its a disparity or it's a yes disparities to it but however as you're noting versus, you know, a trans woman gender woman so I appreciate you sharing. I'm not a, I'm not the type to like force people to answer so I'll keep going. So now this one though I would love to hear from you guys so take a minute really to sit with it and think about it. How might your cultural identities or personal factors influence your bias bias towards others with different cultural identities. So looking at your, your, the chart in front of you and you probably had some jotted down some notes on how it impacts your work, etc. But I love to hear kind of how is this, how is your identity, influencing your interactions your biases your beliefs about other cultures. So you can think about it from in your work setting, or you can also think about it in your day to day. Type it out, or unmute and share. One thing I have noticed in myself, a bias that I have is as a person who is like a career oriented woman who doesn't have children yet, I sometimes find myself judging women who have children younger, say women who have had children like in their early 20s or have like already been married in early 20s. I'm like a late 20s woman who did a career instead and how that is, you know, I have this internalized bias against that because it was not considered something in my growing up that would be highly valued as like, you know, it was the thing that was expected of you in the 50s but now is it sort of in the opposite direction where I'm judging people who choose to have a different type of path compared to me. And I appreciate you sharing that and that resonates with me so I thank you for sharing that. I'm curious, how do you see that bias? Like how do you see that bias in your interactions? Do you ever, are you able to pick it up and be like, oh, I, that's maybe why I said that or oh, that person or oh, maybe that's why I had the belief. Do you ever see it or is it just kind of implicit unconscious and more so when you sit with it like now it comes up for you? I think I've definitely been more conscious of it in general recently and have been trying to not allow that to, because it's like, you then make assumptions about that person based on these things like, you know, why didn't they keep getting degrees in school or why did they get married so young or something like that where I ascribe certain meanings to that that are not necessarily true based on my own bias against them. Mm-hmm, mm-hmm. Thank you. I appreciate you sharing. And yeah, you point out a great, you know, it sounds like you're becoming more aware and like knowledgeable about yourself and your reflections and maybe how you may, your perceptions of others based on this kind of bias of like, well, why would you do that? Or I don't, I'm not like that. Why would you do that? Kind of you're challenging that initial thought of like, why would you do that? Which is part of cultural humility and understanding others and where they're coming from as well as our own lens, but seeing things through their lens. Anyone else? Come on. Oh, here we go. Immigrant refugee parents make it easier to connect with, yes. Understand why they miss medical care and spend more time discussing problems they face related or not related to treatment. Yeah. Yeah. That's a big one. Thank you for sharing that. So it's part of your cultural identity is your family history. Your generational knowledge and trauma that you carry over from your family experience in immigrating and being refugees. And that kind of creates your understanding, your biases, your beliefs around the, you know, this experience. I think there's, like you're sharing it, there's a great piece to it because it helps to ground yourself in some understanding of an individual. I know, but also recognizing, and we do it, I do it myself, of sometimes because we understand it so well, we may put so much weight into these beliefs that we're not seeing the, not that we're not seeing full picture, but there's various factors. But thank you for, I appreciate you sharing that. This one also resonates with me. Both my parents are immigrant and my mother is a refugee as well. And so, yes, it really does kind of, you're connected to this. And sometimes you see yourself, some of your bias is also kind of the clients you gravitate towards and the support you provide them and the quality, not quality of care, but you see a shift. And so I think that's also a part of the work we have to do of person-centered care and where is my own personal stuff coming into play and where is my, where is the experience and what the person, the individual needs? One more, anyone? I think as an able-bodied person, sometimes when I see someone with like a visible disability tend to think, or just like my bias is like, oh, they need help. Perhaps they're weaker than I am. They need more assistance. And that could be true, but also we're just in a world that is not accessible for everybody. And I think if we were made more accessible, we can see that everyone is quite independent and can be independent. Yeah. Yeah, thank you for pointing that one out. And that's a unique one that we sometimes don't talk about, but able-bodiedness, our ability, our mobility, et cetera. And like you're noting oftentimes our bias or our understanding is to immediately almost place the individual in this helpless framework of, okay, I have to jump in, I have to do this, I have to do that, et cetera, for them. And we often forget that just because an individual has a visible disability does not necessarily mean that they're incapable. And like you're saying, though, again, when we talk about the system and how it plays into it. So also the system is a part of the change, but when we're talking about kind of bringing it inward and advocating in the system, but bringing it inward, like you're saying, being more mindful of, wait a minute, what is my reaction? My necessity to jump in, to wanna kind of intervene, et cetera, with this individual and assessing what are their needs? And are they based on my bias, my understanding of what the needs are, or is it the individual? Okay, wonderful. It's own biases become apparent, it can make it more challenging. Oh, okay. That's a really great one. So we're often talking about our own, right? But we're also experiencing and interacting with other humans. And we're not the only one who have bias. We are not the only ones who have belief systems. And so it's also where others are sitting, what lens are they coming through? What are their beliefs of what the healthcare system is? What is a, how does a doctor, what is a doctor supposed to do? What are gonna be the barriers and the challenges? And so it can impact more, impact the experience. So thank you for sharing that one. So yeah, it's important. I know a lot of it is in this work we're doing right now, and today is exploring our own, but I do think it is important to recognize that we're not just about us, we're in a system and others also have their own beliefs and their own biases. All right, let's... So we kind of did a little bit of this, but any other thoughts on how this could impact your work? How you could implement some of this into your way of thinking when you are working with an individual and kind of taking, addressing, or assessing all of the pieces of them as well as yourself? What are my thoughts, beliefs? Is there anything that pops up for you? Anything you wanna share? Just practicing noticing your emotional reactions to deal with the patient. Like sometimes patients can be very unpleasant, like have personality disorders or like other aspects of them that make you biased towards them and kind of practicing noticing those feelings and identifying. Yeah, thanks for sharing that one. And I think you make a great point, right? Like we were noting before some of, talking about an individual having a mental illness, a particular diagnosis, et cetera, et cetera. There's biases that come with it. Like I worked in a partial care hospital, so it's like a step down from inpatient. And I remember when clients are getting assigned and some of the diagnoses are read and it's like, oh, it's gonna be this way, it's gonna be that way. And that's our bias. So what are we walking in with? All right, they're gonna be difficult to manage or they're gonna be non-compliant, et cetera, et cetera. And so our emotions come up, our thoughts, our beliefs. And so it is a little bit of taking a step back and recognizing that. But I'm sure it's not that easy, correct? Nods, yes. Okay. How else? How about when you, how about for yourself, when you walk into the room or into the whatnot, like a patient's room or something in the healthcare setting, how do you respond when, do you experience biases? Do you see them? Do you identify them? Do you see them? And do you experience biases? Do you see them? Do you, how do you respond to them? What are you perceiving? Can you clarify what you mean? Yeah. So kind of, we're talking a lot about kind of our biases and how we, we see others, etc, etc. And our understanding of how we should respond. But what about your experience when you walk into a room and you feel, do you, are you aware that people may have biases against you? Do you, do you, how do you respond to that? You may have some, you know, you may be able to ground yourself in your own, okay, well, I'm feeling this way. This is my biases. But how do you respond when a patient has a biases towards you? I know it's not a easy one size fits all answer, but something to sit with and think about. We'll keep moving along and then we'll have we have some other opportunities for prompts and questions and I am mindful of time so. And okay, so now we're going to dig a little bit into kind of, you know, we've gone through these exercises and these frameworks like the addressing model and the wheel of privilege, and it highlights how our identities and social positions influence our practice, how we interact with others, our belief systems, our bias, etc. And one piece that is we can do something that we can in the moment, kind of the work we can start doing is going into more person centered care. And with person centered care, language is a first starting point. And I know we've talked about language being a barrier, particularly in the cultural translations, etc. But we're going to dive a little bit more into how our attitudes and beliefs and ultimately, the decisions we make, and the language we use around it can impact an individual. So this is a starting point of the changes that can be made. So here are a few racial microaggressions and subtle acts of exclusion that previous that colleagues have shared, when we built these model, these PowerPoint, they themself have experienced, I myself have experienced that people have said, when you see these, what are your, what are your initial reaction? What are your thoughts? Have you heard any of these? These are some kind of examples of microaggressions. So when we talk about microaggressions, we're often referring to subtle, often unintentional actions or comments made by white people towards people of color. These microaggressions can take many forms. So making assumptions about norms. So this happens when white individuals assume that their culture norms are universal, and therefore marginalizing the experience and practices of people of color. And so it's setting the norm and that privilege that we were talking about before into that power center, and that that is the norm, that is the structure we're working off of, that is kind of our beliefs. And so stemming from that, microaggressions can reinforce stereotypes. For example, the pervasive stereotype of the angry black woman, or privilege that some may imply that individuals, minorities, people of color have certain advantages, such as, oh, well, you were able to get into affirmative action and to a great school while failing to acknowledge, you know, their, the other, failing to acknowledge disparities and other pieces that come into it. Yeah. Any thoughts on this? I see people are getting tired, I see some yawning, it's okay. All right. So how do we address microaggressions? So understanding and addressing issues of race and privilege is continuous, a continuous lifelong process for everyone. It's important to acknowledge that discomfort comes with this journey. So again, today we're having this conversation, and there can be some discomfort talking around that you might be sitting wondering, you know, why are you talking about this? Do I have to talk about this? Or it's hard to talk about this, and so, and we want to acknowledge that, that it comes with part of this work. But it's also important to recognize that the BIPOC community individuals cannot disassociate from these issues. And so they're always remaining engaged in this type of work. And so it's important to recognize that. So we want to create a supportive culture of organizations should develop material that facilitates conversation about race and equitable staffing. And so providing kind of, you know, spaces to talk, education, et cetera, a lot of what you guys are doing today, even bringing this into your practice, part of your schooling, part of your information, that's a step towards something that can be done, and starting to dialogue, starting the conversation. So again, recognizing microaggressions, becoming aware of your own biases, we've talked about that, and challenging them. Creating a community or creating a, when we say call out, actually, we've been working on reframing that more towards calling people in. So we don't want to, you know, shame people or kind of create this dynamic, but more so of let's have a real conversation about it. Let's really understand what's going on. Let's challenge that language you may have used, et cetera. And then in an organizational standpoint, again, like we said, committing to education, creating a safe space, that is a really important one. And I know that there has been work and transitions in work environments to bring around more diversity, equity, and inclusion. I think that there continue to need work and to be built on. It's a starting point, and so hopeful there. And then enforcing, you know, strict policies, again, something that needs to be embedded more and built out more. So just quickly, we recognize that it's more than just a change in language to alter society's perceptions and attitudes on policies, but nonetheless, it is essential component to reducing stigma and enhancing obstacles and barriers to treatment that currently exist and is ways for everyone to contribute. So language is just part of the change. And so this is a great graphic. So actions speak louder than words. It's important to be mindful that communication is also much more than words. So 55% of kind of research has shown that communication is a body language. So I'm sure you've all, and like you've shared before, you can, you know, when you're working with a client, a patient, I'm sure you're reading their body language, you're understanding where they're coming from, their discomfort, what their needs are, et cetera. And so are they. And so being mindful of our nonverbals is really important. So person-centered language, we want to encourage language that, you know, we can immediately, these are immediate changes we can make. So we all talk about, we can all take part of culture humility and changing the language is one of them. So we want to kind of work on not reinforcing stereotypes. It's essential to use specific inclusive language, especially in sensitive discussions about sexuality and substance use. Using a first person approach, prioritizing the identity and individual. So using a person living with a substance use disorder versus tagging them as an addict or saying person with diabetes versus diabetic. We're not wanting to attach a tag to them. And we want to work on the language that says this is a part of something they're experiencing, but this is not them. Again, important to be open to learning. It's really key to not fear saying the wrong thing. And oftentimes I know many people oftentimes stray away from these types of conversations. I myself have earlier on in my career, not really wanted to dig into this type of work because I was concerned about saying the right thing, et cetera. But it's the conversations you're going to make mistakes. And the point of it is to make sure you, you know, if you catch yourself, then you can take a moment to say, Ooh, maybe that wasn't the right word of saying, and then change that, go back, have that conversation. I've had presentations where I may use kind of a term that wasn't the right fit. And then I take a break and I come back and I'm like, you know, actually, this is a perfect learning, you know, opportunity. I said, X, Y, and Z really, that wasn't the best terminology. It's more appropriate to identify a person as X, whatever it may be. And so taking opportunities like that is part of the learning process as well. So always asking how someone prefers to be identified and, and, and critically evaluating whether they mentioned any personal characteristics that they'd like to be, be respected, identified, spoken to, overall aiming for the language to be respectful, inclusive, and reflecting of diversity around us. So I think these are the key pieces of, of, of person centered language. So we'll dive a little bit more into it, but really we want to avoid stigmatizing words, be open to learning more, educating ourselves. A lot of it is, again, person centered, engaging with the individual and asking them about their, like what their identity, how would they like to be identified? What is their experience? And also when referring to person centered, I think it's also important as you're building that relationship to also, you can share pieces of yourself at an appropriate level. Again, in professional settings, we always have to remain, you know, at a certain level, but sharing your, you can introduce yourself and then share your pronouns. Pieces like that, that will open up the conversation, allow the person to feel connected, but also allow them the space to also feel comfortable to share identity pieces about themselves. And not all may want, may be interested or willing or, or ready to engage in such conversations. And that's also okay, but we want to just start creating an environment where we are creating dialogue that is geared and centered around what a person's needs are. So overall, just a quick overview, when we're looking at inclusive language, it's essential to promote equality, respect, sensitivity towards an individual, regardless of their background or characteristics. And just avoiding exclusive or marginalizing groups, like for example, easy kind of example is instead of using gender specific terms, like a fireman, we can use firefighter to be more inclusive for all genders. Similarly, rather than defining someone by their disability. So as I mentioned before, we use phrases like person with a disability to focus on the individual and not on the condition. And again, it's really about creating a more welcoming, inclusive environment and respectful environment and not kind of so geared towards more exclusive language. And with cultural humility, it applies across all our work. So individuals may have a disease and need reasonable combinations, but are not defined by their disease or ailment. People having an identity and needing reasonable combinations, but are not identified by this identity. Stigma, prejudice, discrimination are all rooted in the othering of people. So oftentimes, we may see that, right, in, oh, well, that's them. They deal with that. Well, they're just, it's always making it about others, them, them. And that impacts our beliefs on our work. So what do we do? We want to use culturally and racially aware language. It can help remove negative and stereotypical labels and improve patient-client encounters. And overall, we want to just help individuals achieve wellness and recognize that they have the capacity to lead healthy lives. And the greatest tool in prevention is reducing stigma and prejudice. So really, a piece is changing the narrative, changing the story around substance use, changing narrative around mental health and mental illness, changing narrative of what it means to experience or be or having or being inflicted by these diagnoses. It's really changing that language. And that's a piece that, when we talk about the system, there's a lot of changes you can do. It needs to happen. But something that we can start with within ourselves is helping to start to change that narrative, the language we use with our clients, with our patient, and also promoting and advocating around with others, your colleagues, your peers. You know, if you hear them say something, just be like, actually, you know, X, Y, and Z. If you're referring them to something, maybe give them a heads up and say, you know, this individual's preferred pronouns are he, she, he, him, or whatever it may be. I think that that's, those are pieces that you can start doing in work. So putting some of this into practice, what are examples of some certain person-centered terms and practices that we can all be using? So from your end, what are some person-centered terms you can think about? You've been using, you plan on using. I mean, instead of like homeless person, maybe a person without housing. Okay. Yeah. So that's a great one. Yes. So we've gone and you can actually, I believe SAMHSA and the CDC now have like some guidance on more person-centered language. But you're saying unhoused is now becoming a more utilized term instead of homeless individual that's an unhoused. So great point. We got alcoholic versus AUD. Yep. Person with schizophrenia versus schizophrenic. Yes. So we're not, person is not experiencing homelessness. Okay. So not placing these as identifying indicators of who this person is. It's not. It's not a trait of them, of theirs. Similarly for disabled people, persons with disabilities, persons with autism. Person with autism, person, yes. Person, yes, with a disability. Very good. Yeah. So again, making it. And I'm curious, as we're sharing, again, recognizing the system in the healthcare setting, etc. Are there, are there challenges at times to using this more set person centered language when in documentation, etc. And in the work you do, because I know oftentimes things have to be charted a specific way. And so do you, do you come across that experience? Do you, are you like, oh, I don't want to put, you know, X, Y, and Z. Do you ever come across that? I think just in terms of like, again, efficiency, it's faster to write, you know, schizophrenic than it is to write person with schizophrenia. I will also say in my experience on sort of on the flip side, I know some people who, especially people who are like disabled or people who have autism. Some of them actually have the sort of opposite preference where they want, would rather be called like autistic person or like disabled person because it's like they don't want people to associate those things with negative connotations. Like being autistic isn't like a bad thing. It's like not a bad thing to describe somebody as. So I know that there's like differences. So maybe like trying to figure out what the person, how the person refers to themselves is like a really big thing, you know, like what they're comfortable with and what speaks to their experience. That's kind of how I like to approach it. Yeah, no, you bring up a great point that again, we go back to recognizing that we're focusing on the individual and their identities, etc. And so these are best practices and team in person centered treatment, person centered care on adapting language, etc. But like you're saying there, there could be individuals where for them. This is, this is how they like to identify and we want to respect that. And over time if a relationship is built, again, recognizing that's not that easy in the settings you are all at, that maybe there's opportunities where you have dialogue and better understand, you know, their identity, their intersecting identities, etc, etc. But again, it really is coming down to that piece of understanding the person and what their, how they identify. That's the key piece there. So I appreciate you sharing that. I think, you know, I, I want to acknowledge, because I know I've, I've sat through presentations like this, etc, etc. And I do want to acknowledge that there are pieces that you can do that you can put into practice better understanding yourself, better understanding your identity, how does it impact what you bring into the room, how does it impact how you interact with others, like you've all been sharing before. What are my perceptions, what are my beliefs when I see a certain diagnosis or, you know, certain person or whatnot. But also, I want to acknowledge and respect the fact that I know you're also engaged and kind of in a battle with the system that is difficult, that you know, time purposes, the demand on your time, you know, the, the ability to, you know, the workload, etc. And I want to recognize that because I feel like a lot of times we sit in these and then it's like, but yeah, just do this, just do that. And it's not that easy and so I think part of it is also advocating. And that's not only on just one person or on you and one class and whatnot. I think it's a larger systems. There needs to be more federal funding and whatnot for hospital systems and medical systems to do better in regards to allowing for, you know, better, better overall structure of everything that, you know, you all have to do patient care, etc. So I do acknowledge that piece. We get that. Any other thoughts on some person centered terms. Um, I just, I find conversation or person sentiment terms, sometimes tough because it's, it feels like an academic liberal like conversation limited to like what would make people feel better like I read several articles talking about how people of like Latin background prefer Latinos overwhelmingly over Latinx. And like, and people experiencing homelessness, don't really care if you call them homeless people or people experiencing homelessness, they're homeless, they got bigger problems. Like, I think like these terms and our conversations around it are like can be useful to make us more mindful, then they like the respect you show in your interview in your dealings that, like, can be partially with a word to use, but mostly with your tone, your body language your demeanor, or like, much more indicative of the treatment that you give and how they perceive your reaction. Anyone else have have thoughts on that I mean I'm definitely, I hear you and I want to, I'm going to respond but I'm curious anyone else have any thoughts on that. I think about this too, in, in the context of like, you know, I think there's definitely a balance because there are more like appropriate ways to refer to people for sure like more respectful ways to refer to people. But at the same time, I think a lot about how if like the underlying stigma still exists for something just changing how you talk about it like it can't because words do like hold power and how we like think about things but oftentimes what happens is that that new term just absorbs all of the negative connotations, because you haven't addressed that either and then you have to find another term. It's, it's a, an element it's a tool but it's, I agree it's like not really necessarily like the biggest piece. Anyone else, I see some head noddings I see some thinking. So I, I appreciate this conversation appreciate you bringing it up and I, I agree and I understand what you're saying, in the sense of appreciate how you framed it, where, yes, there's been lots of information and lots of studies I've shown that actually like Latinx Latinx etc that's terminology primarily been created by, you know, white US American kind of structure system that was like we want a culturally competent terminology to use however majority of research has shown that most Hispanic, Latinos, Latinas actually more likely identify with their country of origin, and, and, or Latina Latino Hispanic like depending on the way like I grew up, and at the time that I grew up it was Hispanic. And then it transitioned into a Latino Latina and then it's Latinx and so yes, the, the, the, the wordings change and as you pointed out the wordings change but the underlying challenges the underlying structures, continue, and then it's just okay we're going to change into another word that as you're, and as you put really when we think about person centered care words do have power and so that's why we want to have these conversations to more so stardom and to be mindful and it's a starting point because, you know, not everyone is is at maybe the point that you all are at where you understand, you know, the, the, the terminologies and the appropriateness and the words that you can use, but like you're saying as you go deeper into person centered care it is about the, the tones that are used the body language like we said nonverbal has such an impact over the words we use. And so it's all of that piece that plays into the care of an individual and it being person centered and kind of back to that conversation about allowing the person the space to self identify and share how the terminology or the words that they, they, they have preference when, when able to, but really this is setting a foundation. is in these conversations and I understand for a starting point, because not everyone is at the, at the level, or at the at the place to start using some of this terminology and so it is starting that conversation and making people be like, Oh wait, let me think about that. All right, we're almost there. We're almost there, guys. We're almost there. So just overall, and everything we've discussed today, how can you apply some of this? Or even if you just want to focus on on certain pieces, how can you apply this? And how, what could you share with others? Just curious, just share a bit about kind of what, again, this is scratching the surface. This is just the start of the conversations and the deep diving that's needed. And we could do this. I mean, this could be a whole semester worth of teaching, if not more. So this is just a starting point. Practicing introspection during patient interactions. Yeah. Your biases. Yep. Awesome. Any, is there more, more patients with elderly patients? Yeah. Yeah. Yeah. We tend to, I won't say we, I'll speak for myself, but I know sometimes I tend to forget that some of the disadvantages or the closer they, as you age, you know, certain factors come into play and how that can impact a person's health and the care they receive. So, great. Yeah. That's actually kind of leading into the, one of the questions I was kind of kind of asked is a big part of also the work that can be done and is again, recognizing where your privilege stands. Not everyone in the room has the same privilege and those who are closer to that privilege of utilizing your period privilege for advocating and what is advocating. And so being able to speak up and utilize your voice, like you're saying in these meetings and encouraging others to acknowledge their own is really important. Any other thoughts? All right, last slide. What questions does this leave you with? Sure, again, we're just, just a foundation. Thank you. How to deal with older colleagues who are resistant to change. Yeah, that's, yeah, that's a course in itself, but yeah, that is a piece, right? There are different privileges that come there, their position, their status, their age, et cetera, the power that they have in regards to, you know, the Institute, et cetera. And so it is, there is a challenge there. Okay. Yeah. These are really helpful because I know that, and I, you know, we'll be sharing these, I'll be collecting these, and then these responses, you know, Courtney, Courtney and the team will have, and that there's a mock to do more of this, but there's definitely opportunities. But how to deal with, yeah, how to deal with older colleagues who are resistant to change. Any other questions? If nothing else, I will wrap up for us. So in wrapping up, we ask that you guys take a moment and please scan this code. It's a feedback survey. We ask that participants complete it. It helps us to continue to be able to get funded to do trainings like this and other work that we do. I realize that slide deck did not have the introduction slides in regards to the opioid response network, but it is a SAMHSA grant funded technical assistance program that provides access to technical assistance, support, trainings, guidance at no cost to organizations or individuals who submit a request. And they go through different, what we call TTSs, transfer technology specialists and centers such as Courtney. And so the more data we have, the more information we have, the more it helps us to continue to get our funding and be able to continue doing this work. So if you could take a minute, scan and complete. And we'll also coordinate with Courtney any follow-up material and we can send the link as well. I just placed the link in the chat. I was trying to get to it fast enough. I had to log in. You're welcome to take it there. I can coordinate with Michelle Smith, who I believe is sort of administratively in charge of you all. And if you guys have questions, you're welcome to reach out to me directly. I'll put my email in the chat so you guys have it. And if you guys have additional questions, we're always here to sort of help provide tailored resources or guidelines if you may need it. Great. Thanks, Courtney. So yeah, there's in the chat, we got the links. You'll have Courtney's email address. And if you have any questions for me, I believe my email was in the slide and you can always email Courtney and she can connect us. I'm happy to provide any additional insider information. Yeah. So if no further questions, I'd love to give you guys some time back. I'm sure you'd be happy to break. It's been a long day. So I appreciate you taking the time to be a part of this, for participating, for having some discussion. And yeah, there's nothing else. Thank you. Have a good one. Thank you so much. Thank you. Thank you so much, Adriana.

cultural humility

self-reflective

diverse backgrounds

person-centered language

equality

respect

sensitivity

healthcare settings

advocating for change

privilege

inclusive environments

recognizing biases

elderly patients

feedback survey