Some examples of what we might do are:
- change our therapy room to be downstairs to ensure accessibility for someone who has mobility issues or to ensure there is an accessible toilet for someone in a wheelchair
- provide regular breaks for someone whose concentration span or tolerance is limited
- be aware of sensory needs for adjusting levels of stimulation if needed such as turning down lighting, providing noise cancelling headphones or perhaps offering fidget toys
- allowing clients more control and choice to feel more valued/empowered.
We can also think more deeply about the adjustments we might be making (or not). One issue is who defines 'reasonable' and to what extent expectations are reasonable given the context ...
Then there are the different types of adjustments: i. 'anticipatory adjustments' such has moving to a more accessible room for a new client with mobility issues; ii. 'responsive, in-the-moment adjustments' we might make when we see a client might be struggling; iii. client's own 'self-service adjustments' where they are given and they take responsibility for attending to (or alerting us to) their needs.
I think self-service adjustments are important as its about respecting their choice and agency. It would be patronising to, say, turn down the lighting in advance of a client who is on the spectrum, simply because we assume they are going to need that. A more relational way forward would be to engage a dialogue about how you might collaboratively work together if there are special needs involved. On hearing someone is 'neurodiverse', for example, we could ask "How does that impact on us?" or "What do you need from me to support you there?"
If a client needs some extra accommodation, and we are unable to respond constructively, we might want to think about whether we are the best person to work with that client. A more interesting question concerns those moments when we feel reluctant to make a reasonable adjustment or we find ourselves resenting - or wanting to resist - clients when they are stating their requirements or asking for some accommodation. What is going on transferentially here? ...
