Lessons from Direct Support Professionals: What Quality Direct Support Requires

As we continue to reflect on DSP Recognition Week (which should be every week), we were honored to interview four DSPs who were part of ANCOR’s DSP Ambassador Program. The program is designed to help DSPs build their advocacy skills and use their experiences to inform conversations about the direct support workforce.

“ANCOR started the DSP Ambassador Program out of recognition that the best people to advocate on behalf of direct support professionals are DSPs themselves,” said Sean Luechefeld, ANCOR’s Vice President for Membership & Communications. “To date, 79 Ambassadors have graduated from the program, and together, they’re making clear that if we are to make good on our national promise of community inclusion for people with disabilities, we must strengthen the workforce of professionals who make inclusion possible.”

In our conversations with Jordan, Sabrina, Rose, and Bethany, they shared what quality direct support looks like in practice. Across their responses, they described the importance of listening, building trust,supporting choice, developing skills, solving problems, and advocating alongside people, while recognizing that the person receiving support is the decisionmaker and the expert on their own life.

Their experiences and perspectives offer a first hand look at what quality direct support requires and why a strong, supported workforce matters.

Direct Support Is Skilled Work

Getting to know how each person communicates, including their body language, routines, and behaviors, is an important part of providing quality direct support. A change in behavior may be a way someone is communicating what they need or want, even when they do not use words.

Sabrina, who has worked in direct support for nearly 12 years, has learned that communication does not always require words. As she put it, “If somebody can’t verbalize what they want, they can still show you in other ways.”

This is skilled work. Effective support depends on knowing the person, not simply completing a list of tasks. The U.S. Department of Labor (DOL) describes DSPs as skilled professionals whose roles extend beyond traditional caregiving to include community participation, employment support, job coaching, transportation, assistance with daily living, advocacy, accommodations, and emotional support. DOL also identifies professionalizing the DSP workforce, developing career pathways and training, improving wages and benefits, and creating opportunities for people with disabilities to pursue DSP careers as important areas for strengthening the profession.

Rose has advocated for greater professional recognition and occupational classification of DSPs, including through ANCOR’s DSP Ambassador program.  Currently, DSP work is captured inconsistently across occupational classifications, making it harder to collect reliable data about the workforce and establish consistent wage benchmarks.

Recognizing direct support as skilled work means recognizing the expertise DSPs bring to their relationships with the people they support and creating the training, career pathways, professional recognition, data infrastructure, and workforce conditions needed to sustain that expertise.

Whose Life Is It?

“It’s their life, not mine,” Jordan says.

A DSP can offer support and connections to resources, but decisions belong to the person receiving support.

Rose puts that principle into practice with the college students she supports. “The role of a DSP is not just to keep people safe; it’s about teaching skills that carry into other parts of life.” She helps students build self-advocacy, budgeting, conflict resolution, social, and employment skills as they make decisions and prepare for life after college.

Bethany describes the same principle from another angle:

“I may go to work each day with a plan but then remember that my clients also got up that day with a plan of things they would like to do.”

For Bethany, flexibility is not a perk. It is part of the job. Person-centered support requires DSPs to center the person they support’s own priorities, plans, preferences, and goals.

Trust Doesn’t Come with a Job Title

Jordan understands that trust is earned through the relationship between a DSP and the person they support. “You can’t force somebody to trust you just because your job title says you’re their DSP.” Trust develops through consistency, patience, listening, and follow through.

That becomes difficult when staffing is unstable. “Staffing shortages affect much more thana schedule. They affect people’s lives,” says Jordan.

The scale of the workforce challenge is reflected in ANCOR’s 2025 survey of community-based providers of services for people with disabilities. Eighty-eight percent of providers reported moderate or severe staffing shortages, while 62% said they had turned away new referrals because of inadequate staffing. Sixty-two percent also reported difficulty meeting quality standards because of staffing challenges.

These findings illustrate why workforce stability cannot be separated from the quality and availability of services.

Supporting DSPs Is Essential  

Rose emphasized that supporting DSPs themselves is essential.

“My job is to be there for them, to offer support and stability, but to be able to do my job, I have to take care of myself…we are people too, and our wellbeing matters just as much as the people we serve.”

The conditions of DSP employment shape the conditions under which support is delivered. Compensation, benefits, training, supervision, career advancement, and opportunities for professional growth all influence whether providers can recruit and retain the workforce needed to build stable, trusting relationships.

From Recognition to Action

DSP Recognition Week is an opportunity to honor DSPs, value their insights and vital service and leadership in the healthcare ecosystem and ensure their experiences and expertise shape and inform the policies and solutions that shape direct support work. Sabrina, Jordan, Rose, and Bethany show that person-centered, quality direct support depends on skilled communication, respect for choice, flexibility, trust, and strong relationships. Those relationships depend, in turn, on a consistent and supported workforce.

The NAB recognizes and values all the DSPs across the country for their commitment to supporting people with disabilities. Quality direct support requires involving DSPs and integrating DSP expertise and perspectives into how we shape the future of the healthcare ecosystem, the workforce, and the policies that support it. “We were honored to support the DSP Ambassadors and appreciated the opportunity to talk with Sabrina, Jordan, Rose, and Bethany about their essential work. Grateful for the collective commitment to supporting DSPs,” said Merrill Friedman, Regional Vice President, Inclusive Policy & Advocacy, Elevance Health.