Counseling Clients with Disabilities

Counseling Clients with Disabilities

Faaizah Sweatte

Liberty University Online

Introduction

Individuals with disabilities are amongst the categories of the oppressed. They are often underrepresented, especially when it comes to obtaining adequate support with regard to all aspects of life. Despite the laws enacted, and the fact that this class of individuals requires an additional level of understanding and sensitivity with regard to every day incidences in life, they are often overlooked and not tended to in the way they require and deserve. The disabled are often ostracized and isolated intentionally and unintentionally in society based on their disability both physical and intellectual. Although a necessity to their daily lives, accommodations and simple aspects to aid the disabled are often omitted and overlooked, resulting in a more difficult and isolated place in society. Over the last few years, scholars and researchers have begun to focus more on disability as a category within the theory of multiculturalism. While still in its infancy stage, and with limited resources and models, the concept of multicultural counseling with regard to counseling the disabled has developed.  This new theory is step in the right direction to aid in effective assistance in counseling in one area of their lives. 

Abstract

Over the last few decades several concepts, theories, tactics and models have been studied and established with regard to effective means of counseling clients. In this paper I will discuss and explore the various types of clients that psychologists and counselors are presented with in counseling, specifically those that may feel separate and isolated from society based on race, ethnicity, culture, education, social class, gender and disability.  These classes of individuals require an additional layer of training and sensitivity as a result of these identities. The paper will specifically focus on counseling clients with disabilities. I will discuss disabilities both physical and intellectual and the additional difficulties these clients are faced, with regard to society and obtaining effective counseling.  As a result of the additional difficulties these clients are faced with, theorists have established the Multicultural Theory of counseling to assist in more effective methods of counseling for these clients. I will define and explain multiculturalism and the multicultural model, in addition to discussing studies that have been conducted and the results obtained under this theory. Additionally, I will discuss applying multicultural counseling to client’s disabilities and how this model offers a more sensitive effective means of counseling for clients. 

Disabilities

Disabilities have several meanings. The legislature and scholars have several definitions for the term. According to section 504 of the Rehabilitation Act of 1973, individuals with disabilities are defined as “persons with a physical or mental impairment, which substantially limits one or more major life activities.” Similarly, Banks and McGhee define disability as “physical or mental characteristics of an individual that prevent or limit a person from performing their specific tasks”. (Anastasiou, p. 5, 2016; Banks and McGhee, p. 353, 2013).

Whereas, the Individuals with Disabilities Education Act of 2004 states that a disability is “having a mental retardation, a hearing impairment, a speech or language impairment, a visual impairment, a serious emotional disturbance, an orthopedic impairment, autism, traumatic brain injury, a specific learning disability, deaf-blindness or multiple disabilities. (Woo p.232, 2016)

The global burden of disease classifies disabilities as loss of health, where health is conceptualized in terms of functioning capacity in a set of health domains such as mobility, cognition, hearing and vision. (Ashok, p.2, 2015) It is estimated that 15% of the world’s population has some form of disability. (Ashok, p.2, 2015) According to the Global Burden of Disease 15.3% of the world’s population, approximately 978 million people had moderate to severe disabilities and 2.9% of the population; approximately 185 million people have severe disabilities. (Ashok, p.2, 2015). Approximately 1/3 of adults with disabilities have challenging behaviors (Brown et. al , p. 1,  2013).  There is evidence that people with disabilities are 3 times more likely to experience depressions (Noh et. al , p. 2, 2016)

Disabilities can be congenital, from birth, or acquired; visible, such as a physical disability, or hidden; such as an intellectual disability. Based on the variety of classifications, the complexity of the nature of disabilities can be seen.

The operational definition for physical disability is a person having loco motor disability, loss or absence or inactivity of whole or part of hand or leg or both due to amputation, paralysis, deformity or dysfunction of joints which affected their “normal ability to move self or objects”, those with physical deformities in the body other than limbs such as hunch back, deformed spine. For example, Dwarfs and persons with stiff neck of permanent nature who generally did not have difficulty in the normal movement of body and limbs were also treated as disabled. (Ashok et. al, p.2, 2015)

Conversely, developmental disabilities are cerebral palsy, muscle and bones diseases, neurological disorders, craniofacial deformities, metabolic disorders, endocrine disorders, seizure disorders, cleft palate, cleft lip, visual impairments and blindness, hearing impairment, deafness, mental retardation, attention deficit disorder, attention hyperactivity disorder, learning disabilities, autism, chromosome and genetic disorders, to name a few. (Richmond-Frank, p. 308, 2015).

The definitions of disability are informative, yet lack and are void of the socially constructed barriers such as to education, medical care and counseling services. People with disabilities suffer from and experience many factors that contribute to the likelihood of depression such as, abuse, loss of roles in society, stress related to poverty, social and economic barriers, insufficient access to healthcare. Individuals with a disability are a normal part of society, however, they do not experience life as others do and continuously encounter barriers in their day to day lives, such as insufficient ramps, elevators or cut outs in the curb for them to safely travel and navigate in the community. Disabilities represent a particular part of human diversity that is not adequately captured by the concept of cultural diversity.  Most people with disabilities have been excluded socially and face environmental and attitudinal barriers limiting their opportunities.  Easy things such as being able to commute in the neighborhood, that people who are not disabled take for granted and overlook are inconvenient, major tasks and obstacles for the disabled. They experience, barriers based on the restrictions they are subject to as a result of their disability; which go beyond social exclusion and social oppression and may not be resolved through social manipulation. (Anastasiou, p.5, 2016) The issues range from personally adjusting to their disability, developmental tasks, career goals and transitions, cultural identity, and quality of life. Disabilities have an influence on the overall capability of a person, some individuals require additional assistance to accomplish normal day to day activities, or they may be faced with economic challenges due to the inability to find or keep employment.

Disabilities should not be lumped into one disability practice or research. There are

varying disability identities within the group of individuals.  There is a major diversity in types

and degrees of disability, which makes generalizations inappropriate.  For example, people with mild forms of learning disabilities are not in the same situation as those with severe intellectual disabilities. Those with physical disabilities do not have the same challenges as an individual with autism or an intellectual disability. As stated by Shakespeare, disabilities constitute “a complex interaction of biological, psychological, cultural and sociopolitical factors” (Anastastiou, et al, p.6, 2016).

Disability legislations such as the Americans with Disabilities Act of 1990 and the Individuals with Disabilities Education Act of 2004 call for attention to the diverse mental health needs of individuals with disabilities that have been neglected and the relevant intervention services for them (Woo, p. 229, 2016).  Morally and ethically, it would be assumed and expected that given the amount of awareness there would be a more proactive effort ensuring that the vulnerable populations such as the disabled are not disproportionately harmed in the counseling process. A person is disabled 24 hours a day 7 days a week, 365 days a year; this is something counselors and therapists must constantly remember and take into consideration when counseling clients with disabilities. There are many ways a client can be exposed to potentially harmful treatment, such as exposure to negative role models, low empathy on the part of counselors, alienation, invalidation, or oppression of minority and disabled clients, exacerbating outside negative treatments faced in society.

Researchers have noted that many psychotherapeutic interventions have a western cultural foundation, (Wendt et. al, p.15, 2014). There have been negative experiences of ethno racial minority clients who have been treated through mainstream, European American interventions. (Wendt, et al., p. 4, 2014) According to the multicultural guidelines, European interventions and treatments may be ineffective and essentially go against the APA standard and actually “do harm” to culturally diverse individuals. (Wendt, et al, p. 6, 2014). Research indicates racist and discriminatory practices at an individual counseling level. (Wendt, et al, p. 6, 2014). 132 scholarly articles showed racism in American mental health care systems (Wendt, et al., p. 6, 2014). For example, white clinicians working with black clients used overly pathologized diagnoses, used less intensive and lower quality interventions. Additionally, it was frequently shown that misdiagnosis were given to black clients; due to imposing European American standards when assessing “normality” of individuals and assessing racial and ethnic differences as a deficit resulting in misdiagnosis.