Empowering informed decision-making

CHD staff discuss inclusive, person-centered communication around COVID-19 vaccination

Peer Support Supervisor for CHD’s Adult Mental Health team in Holyoke Jeffrey Bass and CHD’s Director of Recovery Supports Andy Beresky were recently invited to attend a virtual listening session led by Massachusetts Association For Mental Health (MAMH) and Center For Public Representation (CPR) focused on decision-making and informed consent around the COVID-19 vaccine for people with disabilities.

As part of this effort, CPR convened listening sessions with a racially diverse group of disabled individuals, their allies, and other stakeholder groups to discuss a range of topics, including identifying gaps in information about the vaccine, the best ways to share information within communities and constituencies, and best practices in supporting and empowering people in the decision-making process.

The purpose of the session was to learn from people about their concerns or hesitancies both past and present, how they would like to receive messaging about COVID-19 and the vaccine, and who they felt like they could trust when receiving that messaging.

Ultimately, information gathered from the session helped inform a suite of educational materials produced by CPR, including the webinar ‘COVID-19 Vaccines & The Disability Community,’ to help ensure people with disabilities and people in services have comprehensive information about the vaccines to empower them to make a meaningful, informed choice about vaccination.

During the listening session, Bass shared many of his own insights and perspectives, and echoed those of people in the communities he’s part of. He shared how trust is an especially important factor when it comes to decisions surrounding COVID-19 vaccinations for all, especially in communities of color, and how for him, leading by example and having open communication was an important way to help establish that trust and connect with his colleagues and people in services whom he supports.

“In the Black community, a lot of times we’ll listen to and trust a leader in the community,” Bass explained. “For example, church is a big part of some of our upbringings, but even people who don’t go to church will listen to a pastor or a reverend or another leader in the community.”

Bass said that he’s found that the sharing of firsthand experiences and perspectives from those who have received the vaccine is an effective tool in relating to one another and discussing the subject.

To help share his own perspectives, he told his colleagues that he would get the vaccine once he became eligible, and he let those colleagues know when his own experience receiving both doses of the vaccine went well. Similarly, his own motivation to get vaccinated, he said, was inspired by seeing leaders he trusts do the same.

“What pushed me to want to get vaccinated was when I saw Vice President Kamala Harris do it. I watched her get it and I thought ‘I’m going to go for it,’” Bass said. “Another person I really trusted is Anthony Fauci. Personally, I just believe in the science.”

Bass said that another helpful way to discuss the vaccine and help people learn more or build confidence in their choice-making is through representation and sharing insights from a diverse array of individuals and cultures.

“Sometimes when we see somebody else who shares our experiences or our culture do something, it can be encouraging for us as well,” Bass said.

Beresky, who was present to observe the virtual listening session with MAMH and CPR, also shares insight on the importance of striving to establish both trust and understanding when discussing the COVID-19 vaccine with others, including staff, and also people in services, who may not always feel their voice is heard.

“It’s so important that we really hear people out, respect their voice and opinion, and help address their concerns, regardless of whether they align with our own beliefs,” Beresky said. “It’s really essential that we meet them where they are and let them know we hear them and can see their concerns in order to build that trust.”

Like Bass, Beresky was also one of the earlier members of the team to be vaccinated, which in addition to helping protect himself against the virus also helped him openly share and discuss his experience with his colleagues, thereby creating an open dialogue where staff could connect on the subject, voice concerns, or identify barriers they might face.

“I think from a leadership perspective I really try to get to know my team and relate to them,” he said. “It’s about understanding a little bit about what makes them tick or what’s important to them, and what communication styles they value—ultimately, getting to know somebody as a human being.”

In discussing the vaccine with others, Beresky shares that there is no one-size-fits-all approach. While some may have similar concerns, everyone has their own set of beliefs based on what they’ve experienced or what they’ve heard, so it’s important to build bridges to understand and relate to one another rather than applying pressure.

“It’s important to make sure the person knows it’s their choice, and we’re not going to judge or shame them if they choose a way that we didn’t choose,” he said. “Shaming someone doesn’t help. In fact it often just backs them into a corner and they become more closed off to the idea.

Beresky shared insights on some helpful methods of communication around the vaccine decision-making inspired by effective techniques used in peer support, such as using a person-centered approach to partner with the person through whichever challenge or concern they’re facing—to understand the barriers they’re encountering, hear them out, and create a space for open dialogue and connection.

Another effective way of navigating these discussions productively is utilizing a key principle used in Motivational Interviewing called ‘Rolling with Resistance,’ a strategy to view resistances or what might seem like difficult conversations not as an impassable barrier but as something to ‘roll around’ and approach from a new angle in order to help someone see beyond their current narrative.

In doing so, Beresky noted that it’s important to keep the conversation open-ended and involve the other person as much as possible in the process, utilizing open-ended questions such as:

-‘What is it that would make you feel more comfortable about getting the vaccine?’
-‘What information do you feel that you’re lacking?’
-‘What do you need clarity around?’
-‘Do you think it would be helpful to have somebody go with you that you trust?’

“Building trust with people is fundamental,” Beresky said. “We have to be truthful with people. We have to hear them. We have to let them have their voice. Ultimately, they have to feel confident that it’s their choice at the end of the day.”