This book deals with a number of issues and strategies for counseling people with disabilities. It allows counselors and other related health professionals to learn from the writings of 16 people with disabilities across North America. The book provides information on how other professional disciplines perceive and are trained to view disability. It discusses the medical and psychosocial aspects of caregiving in the country and highlights some of the most difficult decisions individuals and families may have to make in this process. The book is organized into four parts containing sixteen chapters. Part I explores disability from a sociological perspective. The topics covered are: the history of how people with disabilities have been viewed and treated in society; attitude formation, societal attitudes, and myths about disabilities; culturally different issues and attitudes toward disability; and attitudes toward disability by specific special interest and occupational groups. Part II focuses on the psychology of disability surrounding the individual and his or her family. The topics address: theories of adjustment to disability by the individual; family adaptation across cultures toward a loved one who is disabled; sexuality and disability; and the psychosocial world of the injured worker. Part III addresses pertinent topics concerning psychosocial issues of disability. The topics include: disability and quality of life over the life span; implications of social support and caregiving of loved ones with a disability; and thriving versus succumbing to disability: psychosocial factors and positive psychology. Part IV addresses counseling strategies and insights for working with persons with disabilities. The topics discuss: which counseling theories and techniques work best with different disability populations and why; social justice, oppression, and disability; counseling families in the community; ethical responsibilities in working with persons with disabilities and our duty to educate; and basic dos and don’ts in counseling persons with disabilities.
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The root causes of social injustice are in part centralized around wealth inequities, politicians and legislation favoring the wealthy, discrimination, and a Darwinian mentality (Greenwald, 2011; Marini, 2012b; Warren, 2014). This chapter explores the ramifications of social injustice in America focusing on those with disabilities. It discusses the ripple effect of poverty, oppression, and disability, and its subsequent deleterious impact for equitable treatment and opportunity. Beginning with prevalence statistics regarding poverty in general and disability specifically, the chapter segues into an exploration of the domino and vicious cycle effect of inequitable education, employment, health care, and health. The resulting psychosocial impact on minorities and those with disabilities is a reciprocal occurrence among these populations interfacing with an arguably apathetic societal and political populace. Finally, the chapter discusses a dialogue regarding the social justice counselor and strategies for counseling and advocating for this most ignored and disenfranchised population in America.
Persons with disabilities are sometimes ascribed angelical traits, despite the apparent paradox of attitudes that disability is a punishment for having sinned. This chapter explores the concept of attitudes, the sociological aspects of how attitudes toward persons with disabilities are formed, and what many of the myths and misconceptions are about disability. Finally, it discusses ways to enhance attitudes and the social consciousness toward disability. Despite the numerous suspected origins regarding negative attitudes toward persons with disabilities, nondisabled persons who are not blatantly prejudiced and unwilling to change their attitudes may only require greater exposure and accurate information regarding disability. With the 1990 Americans with Disabilities (ADA) representing the greatest civil rights legislation for persons with disabilities in U.S. history, persons with disabilities now enjoy greater access to employment, education, and social participation than ever before.
The history of treatment and attitude toward people with disabilities has often been marked by societal fears, intolerance, ambivalence, prejudice, and ignorance regarding disability. The independent living movement essentially evolved as people with disabilities learned from the social activist movements concerning minority civil rights, consumerism, and women’s rights. Ironically, because of medical advances, the life expectancy and quality of life for people living with disabilities in industrialized nations continue to improve from a medical perspective for those who can afford health care. To this end, the United States continues to arguably have a "survival of the economically fittest" mentality if universal health care is not soon realized. For the estimated 76 million baby boomers presently transitioning to retirement, the golden years may not be something to look forward to given the increasing health care costs.
The chronically injured worker is perhaps one of the most fascinating psychosocial topics relating to disability. For the chronically injured worker, negotiating the often confusing and sometimes dehumanizing gauntlet of receiving workers’ compensation benefits (WCB) for employees fortunate enough to have coverage may quickly turn into an injured worker’s nightmare (Binder, 1992; Dodier, 1985; Fallenbaum, 2003; Gribich, McGartland, & Polgar, 1998; Willis, 1986). This chapter explores a number of topics related to the world of work, the psychological impact of disability on the disabled worker, the impact of chronic pain, systemic problems in the WCB and Social Security Administration’s (SSA) programs, key players in the gauntlet, the impact on the family of an injured worker, and the discipline of disability management (DM). It briefly explores the anatomy, theory, and assessment of chronic pain.
This chapter explores perhaps the most profound and important empirical question researchers have regarding the psychological and sociological impact of the disability. The terms adjustment, adaptation, reaction, and response are used interchangeably despite the fact they may be different concepts but have overlapping definitions. The chapter first explores people born with a congenital disability, and questions whether such individuals experience any adjustment process as they have no preinjury, nondisabled experience with which to compare their situations. The remainder of the chapter explores the following seven theories of adjustment: stage models (Livneh, 1991), somatopsychology (Lewin, 1935; Trieschmann, 1988; Wright, 1983), the disability centrality model (Bishop, 2005), ecological models (Livneh & Antonak, 1997; Trieschmann, 1988; Vash & Crewe, 2004), recurrent or integrated model (Kendall & Buys, 1998), transactional model of coping (Lazarus & Folkman, 1984b), and chaos theory (Parker, Schaller, & Hansmann, 2003).
This chapter explores the impact that societal attitudes can have on persons with disabilities, both psychologically and socially. Affect, perceived self- esteem, and self- concept are largely influenced not only internally by our own thoughts and actions but also by input from our environment regarding how we perceive what others think of us and how we are treated by others. It focuses generally on empirical and conceptual studies pertaining to the views or perspectives of specific occupational and special interest groups. Stubbins (1991) advised the importance for rehabilitation psychologists and other counseling professionals to gain an understanding of or insight into the motivations, perspectives, or paradigms with which other groups view, treat, and interact with persons with disabilities. These insights provide rehabilitation professionals with relevant others’ perspectives as to how to better understand and work with these groups to facilitate better care for clients with disabilities.
- Go to chapter: Thriving Versus Succumbing to Disability: Psychosocial Factors and Positive Psychology
Perhaps the most crucial and significant question rehabilitation researchers have sought to answer over the past several decades is: How is it that some persons with disabilities appear to excel and succeed in life beyond all expectations, whereas others seemingly succumb or yield to the limits imposed by their disabilities and society? This chapter explores the multiple factors that contribute to this dichotomy. It focuses on disability from a salutogenic orientation (focusing on the traits of healthy and successful persons) as opposed to the traditional pathological approach (focusing on the reasons and treatment of those beleaguered with ongoing mental and physical health problems) (Antonovsky, 1987). The chapter briefly explores several of the more common disabling conditions in the United States, specifically substance use disorder (SUD), depression, anxiety, and suicide. It also explores the literature behind positive psychology and also the environmental and social barriers that obstruct wellness.
Caregiving in America is perhaps one of the most misperceived, underappreciated, sometimes stressful, and otherwise rewarding acts of unconditional love. Yet, depending on which study or author you are reading, caregiving is often described at one of the two contradictory ends of the spectrum; "a curse or opportunity". This chapter delves into caregiving for loved ones with a specific type of disability, including Alzheimer’s disease, neuromuscular disorders, traumatic brain injury, psychiatric disabilities, spinal cord injury, and congenital disabilities, such as muscular dystrophy (MD) and cerebral palsy (CP). Ellenbogen, Meade, Jackson, and Barrett (2006) indicate there are significant group differences in caregiving responsibilities and demands between disability types. The chapter explores the dynamics of caregiver abuse and the often painful decision to place a loved one in a long-term care facility and also explores the significance of having social support in caring for a loved one with a disability at home.
One of the historical pillars of rehabilitation counseling has been the use of assessment throughout the rehabilitation process. With this historical emphasis, it is not surprising that the focus on assessment and the methods and techniques used have changed and evolved. As a result, students, practitioners, and researchers are on a constant quest for updated and current information to guide and inform practice, policy, and research. This constant quest for updated and comprehensive information is directly relevant to the assessment of individuals typically served by rehabilitation and mental health practitioners and is the focus of this book. To date, there has not been a book that has been able to provide a comprehensive discussion of topics applicable to service delivery across both setting. This book attempts to fill this gap. One factor that guided the development of this book was the authors’ goal to provide both the foundational information necessary to understand and plan the assessment process and combine this material with information that is applicable to specific population and service delivery settings. To achieve this goal, each of the chapters is written by leaders in the field who have specialized knowledge regarding the chapter content. The chapters provide practical hands on information that allows for easy incorporation of the material to rehabilitation and mental health practice. To further strengthen practical application, case studies and templates have been incorporated where applicable to highlight specific key aspects to promote application to service delivery. Second, this is the first assessment book to be developed after the Council on Rehabilitation Counselor Education and Council on the Accreditation of Counseling and Related Programs merger. Finally, the authors hope that the readers of this book can apply this information to enhance the overall quality of life of the individuals they work with, especially individuals with disabilities.