The aging population is at a state of development that is not as focused on employment, and thus has difficulty finding its place in a society that defines people by their careers. Research is needed on the issues of aging workers, such as training needs, career transition issues, and retirement planning. Research is also needed on which accommodations, workplace modifications, and changes to policies and practices positively impact the retention and continued productivity of an aging workforce. Counselor practitioners are in a unique position to contribute to needed research design conceptualization, metrics, and analyses to test the multiplicity of interventions we will be exploring in the coming years to keep our aging workforce healthy and intellectually engaged in the employment environment. Counselors are experientially qualified to provide the needed services to keep this population productive and more fully engaged in their communities and continuing employment.
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Assistive technology (AT) has a profound impact on the everyday lives and employment opportunities of individuals with disabilities by providing them with greater independence and enabling them to perform activities not possible in the past. Self-esteem, self-efficacy, and motivation are described as central elements in increasing a consumer’s confidence and belief in self. Good outcomes and efficacy expectations, as well as strong motivation, help lead to successful adaptation to AT. This chapter presents the human component of technology, the relationship between consumers and technological devices/equipment, and the acceptance and use by consumers. It offers recommendations to assist rehabilitation professionals in helping consumers with accepting, utilizing, and benefiting from technology. There needs to be a close and appropriate fit between the technological device and consumer. Therefore, the need for the counselor to actively listen and engage the consumer in the process is essential to the effectiveness and outcome of AT success.
Accepting the handicapped person as a full human being means accepting him or her as having the full range of human needs. The location of institutions and the houses in which handicapped people can live becomes important because their location within communities enables participation of the handicapped in community offerings. Architectural barriers become an issue because their elimination enables people with a wide range of physical abilities to have access to events within buildings at large. The lives of handicapped people are inextricably a part of a much wider socioeconomic political and ethical society affecting the lives of all people. It is therefore essential for all of us to remain vigilant to protect and extend the hard-won gains of recent decades and to be ready to counter undermining forces. Vigilance requires thoughtful action guided by continuing reevaluation of the effectiveness of present efforts and alertness to needs of changing conditions.
This chapter offers (a) a description of the empathy fatigue construct as it relates to other professional fatigue syndromes, (b) a recently developed tool (Global Assessment of Empathy Fatigue [GAEF]) that may be useful for screening and identifying professionals who may be experiencing empathy fatigue, and (c) resources for self-care of empathy fatigue and building resiliency. The chapter’s author hypothesizes that empathy fatigue may be different from other types of counselor impairment and fatigue syndromes. The experience of empathy fatigue is both similar and different from other types of counselor impairment or professional fatigue syndromes. Thus, it is hypothesized that the cumulative effects of multiple client sessions throughout the week may lead to a deterioration of the counselor’s resiliency or coping abilities. Developing a clearer understanding of the risk factors associated with empathy fatigue is pivotal in developing self-care strategies for the professional counselor.
- Go to chapter: Religion and Disability: Clinical, Research, and Training Considerations for Rehabilitation Professionals
Religion and Disability: Clinical, Research, and Training Considerations for Rehabilitation Professionals
It is clear that laypersons, health professionals, and researchers are interested in addressing the importance of religion in society and in health care. However, if we are to use religion effectively to improve the health of individuals, there is a need to better educate current rehabilitation professionals and students about religion, to critically evaluate the existing literature on disability and religion, and to develop practical suggestions for rehabilitation professionals to appropriately use religion to promote positive health outcomes. Rehabilitation professionals need to collaborate with faith-based organizations to improve the physical and mental health of persons with disabilities, as well as their ability to reintegrate back into their communities. Such collaborations are particularly important given the resources that are available in most community churches (e.g., church vans, counseling services) to assist persons with disabilities with transportation and provision of social support.
The first experiences of supportive and social units come, most often, from the family. This chapter discusses the impact of disability on family by examining the reactions of family members to disability, factors that influence adjustment to disability in the family, adjustment models, parenting reaction perspectives, effective family coping, the impact of disability based on the family role of the person with a disability, and cultural influence on family adaptation to disability. It is important to assess family needs and support services so that the family does not become overwhelmed or feel isolated in their endeavors to assist their loved one and to integrate into the larger community. This involves understanding numerous differences in family reactions and functioning based on the resilience of the family, who in the family has the disability, the extent of the disability, the resources available, and cultural beliefs and practices.
The root causes of social injustice are in part centralized around wealth inequities, politicians, and legislation favoring the wealthy, discrimination, and a Darwinian mentality. 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 between 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.
- Go to chapter: Giving Parents a Voice: A Qualitative Study of the Challenges Experienced by Parents of Children With Disabilities
Giving Parents a Voice: A Qualitative Study of the Challenges Experienced by Parents of Children With Disabilities
No other single individual or health care provider has more influence on the personal health and wellness of a child with a disability than the parent. To date, however, much research concerned with the well-being of parents of children with disabilities has not captured their experiences from the perspective of the parents themselves. Qualitative methods permit researchers to study selected issues in depth, and they produce a wealth of detailed information that increases understanding of the cases and situations studied. This chapter identifies specific sources of challenges related to raising a child with a disability as expressed by parents themselves. Specifically, it investigates the following research questions: (a) What are the principal stressors and challenges for parents of children with disabilities? and (b) What supports and services do parents identify as being needed to deal with the stress and challenges of their responsibilities?.
Rehabilitation counselors can begin to assist women with issues of abuse by acknowledging that advocacy and protection from abusive behavior are a priority for many women with disabilities. By routinely asking about abuse and addressing issues of safety and control during rehabilitation planning, counselors can provide valuable information, resources, and support that may help prevent abuse from occurring and assist women for whom abuse has occurred. To address abuse issues during rehabilitation, rehabilitation professionals have several responsibilities to (a) learn about violence by using available training related to abuse of people with disabilities; (b) employ universal screening as a routine client-intake procedure; (c) volunteer information, resources, and referrals to clients who are in danger or at risk of an abusive situation; (d) facilitate collaboration with domestic violence shelters to supply personal care services and replace medications and assistive devices left behind in an emergency situation.
- Go to chapter: Quality of Life and Coping With Chronic Illness and Disability: A Temporal Perspective
The concept of quality of life (QOL), as a psychosocial construct, process, measure, goal, and outcome, has gained much popularity in the rehabilitation literature during the past 35 years. As both a goal (i.e., assisting clients with chronic illnesses and disabilities (CIDs) to attain a better QOL) and a process-outcome indicator (i.e., assessing both subjective and objective levels of QOL during and following rehabilitation interventions), QOL has become one of the most prominent and central concepts in the field of rehabilitation. This chapter familiarizes the reader with the conceptual and temporal parallelism underlying the domains of community interventions and personal coping, of which rehabilitation services are an essential component, as part of their joint goal to improve QOL. It provides examples from the field of psychosocial rehabilitation, and more specific coping with CID, that address the temporal nature of QOL-improving coping strategies.
This chapter explores a range of topics related to obesity, including its prevalence, medical aspects, and associated complications. Other relevant areas include the psychosocial factors pertaining to societal attitudes and individual mental health issues, vocational implications concerning work/wage discrimination, Social Security regulations, and Americans with Disabilities Act (ADA) protections. The chapter also discusses the implications for rehabilitation counselors regarding vocational and mental health counseling. The implications of working with persons who are obese or overweight may be broken down into mental health counseling and/or vocational counseling. Obesity and related medical complications have soared to the forefront of medical conditions that lead to premature death, discrimination in employment, compromised quality of life, and negative psychosocial implications. Counselors who are aware of the medical, psychosocial, and vocational implications of obesity can assist clients in a variety of ways, keeping Olkin’s (1999) recommendations in mind regarding disability-affirmative therapy.
- Go to chapter: Working With Trauma-Related Mental Health Problems Among Combat Veterans of the Afghanistan and Iraq Conflicts
Working With Trauma-Related Mental Health Problems Among Combat Veterans of the Afghanistan and Iraq Conflicts
The impact of extraordinarily stressful and traumatic events on active-duty service members, veterans, and their family members is a critically relevant topic when providing services to those who have a combination of mental and physical disabilities. Recent conflicts in Iraq, Afghanistan, and other countries in the Middle East have spurred the expansion of programs and services for veterans, including those with disabilities. To inform the provision of mental health interventions for Operation Enduring Freedom (OEF)/Operation Iraqi Freedom (OIF)/Operation New Dawn (OND), veterans, a thorough understanding of the mental health problems in this population is a necessary first step. This chapter reviews research on the prevalence and types of mental health problems among OEF/OIF/OND veterans, associated risk factors, and other psychosocial issues and provides empirical evidence for treatment in this population. This material provides guidance to clinicians working with mental health and psychosocial problems of veterans of the OEF/OIF/OND conflicts.
In the past quarter of a century, several attempts have been made to categorize the different sources of negative attitudes toward individuals with disabling conditions. This chapter integrates the major approaches in the domain of attitudinal sources toward people with disabilities and offers a new classification system by which these attitudes can be better conceptualized and understood. Some of the major categories included are: (a) conditioning by sociocultural norms that emphasize certain qualities not met by the disabled population; (b) childhood influences in which early life experiences foster the formation of stereotypic adult beliefs and values; and (c) psychodynamic mechanisms that may play a role in creating unrealistic expectations and unresolved conflicts when interacting with disabled persons. Parental and significant others’ actions, words, tone of voice, gestures, and so forth, are transmitted to the child and tend to have a crucial impact on the formation of attitudes toward disability.
Women with disabilities constitute one of the largest and most disadvantaged populations in the United States. This chapter helps rehabilitation counselors understand the myriad factors that affect the psychological and social health of women with disabilities. After giving some background on the historical roots of the rehabilitation response to women and a description of the demographic and health characteristics of this population, the chapter presents a heuristic, holistic model for understanding the reality of our lives and strategies for helping us achieve optimal health. It first discusses the pivotal construct of self-esteem, followed by social connectedness, its polar opposite abuse and the consequences of disparities stress and depression. The chapter ends with recommendations on strategies that the rehabilitation researchers and practitioners can use to include gender in their examination of individual and program outcomes, and thereby advance the field.
Many disabled people who have internalized dominant, ableist, heteronormative notions of strength, beauty, sex, and sexuality continue to experience psychological insecurity and distress when confronted with their own sexuality. The institutionalization of disability studies and the proliferation of a vibrant and dynamic disability culture, both of which have their roots in disabled activism and the social model of disability, have given rise to a whole new subfield, disability sexuality studies. Transforming the future of (dis/abled) sexualities hinges on the notion that sex and disability are malleable, pliable, and quite often multifarious. Disabled people cannot, and must not, create a “dismodern” world on their own. They must continue to build coalitions, coalitions across disability, across various sexual and racial/ethnic minorities, and with their (often) privileged “nondisabled” allies. Researchers, activists, and artists need to work together to dispel powerful myths about the dominant arenas in which sexuality is performed.
The U.S. Citizenship and Immigration Services (USCIS; 2016c) under the U.S. Department of Homeland Security delineates the complex law and path to citizenship as it relates to immigrants, refugees, and asylum seekers. The etiology of the worldwide epidemic of immigrants, refugees, and asylum seekers is clear. It is war that is at the foundation of all human suffering as millions are forced to relocate geographically. This epidemic of person-made disaster points to the overall lack of respect and empathy for human life perpetrated by brutal governments, religious zealots, and other indigenous tribal warring groups. Disaster mental health responders who commit to work with specific indigenous populations of global cultures require a much different approach to provide culturally sensitive interventions and strategies. This chapter offers some guidelines to mental health professionals to begin working globally with the new culture of immigrants, refugees, and asylum seekers.
The chapter explores the history from the middle ages to the present day, noting the trials and tribulations of a population that continues to remain poorly understood and misperceived by the general public. Conditions for people with psychiatric disabilities did not fare much better in the American colonies. Similar to the circumstances during the Middle Ages, care for this population was the family’s responsibility if they had a family to care for them. Moral treatments began to decline in the second half of the 19th century in favor of somatic therapies and behavioral control techniques. Although psychiatrists initially scoffed at the notion that the quality of the care they provided in mental hospitals was subpar, research was conducted in the treatment of mental illness that brought about improvements. Physicians continued to develop and work toward improvement of somatic treatments for psychiatric disabilities in the early part of the 20th century.
This chapter provides the reader with an overview of (a) the dynamics (i.e., process) of psychosocial adaptation to chronic illness and disabilities (CID), (b) methods commonly used to assess psychosocial adaptation to CID, and (c) intervention strategies applied to people with CID. The chapter groups the psychosocial adaptation to CID under three headings: basic concepts such as stress, loss and grief, and quality of life, CID-triggered reactions, and CID-related coping strategies. The literature on CID-related coping strategies is vast. The chapter describes only a cursory overview of the most commonly reported strategies, directly related to coping with CID. It first briefly discusses the concept of coping and illustrates its relevance to CID. Over the past half century, a large number of measures of psychosocial adaptation to and coping with CID have been reported in the literature. The chapter reviews only those psychometrically sound measures most frequently reported in the literature.
In this chapter, the book’s editors, Marini and Stebnicki presents a compelling and provocative reflection on the counseling profession. They summarize salient aspects of dealing with culture and disability that reflect how services are provided in an evidence-based practice environment. Each editor offers opinions and considerations for counseling professionals in the 21st century. Together, they hypothesize an inconvenient and potentially frightening future for Americans, particularly those of lower socioeconomic status, many of whom are minorities with disabilities. The chapter explores the ramifications of social class and classism, whereby social injustice perpetuates and exacerbates classism. In particular, Marini and Stebnicki call on counselors and related helping professionals to take a more active role in advocating beyond their traditional narrowly focused job duties of working almost exclusively with the client to adapt and survive in an able-bodied world.
There is power in revisiting the underlying foundational principles of our past and looking at how they can inform our present and future functioning. This chapter looks back at the historic foundational principles of rehabilitation psychology (RP) and shows the links to current research on the psychology of well-being and explores implications for providing meaningful interventions that could improve the lives of persons with disability and chronic illness. It reviews how positive psychology (PP) approaches have been used for people with disabilities (PWD), presents an overview of the development and structure of well-being therapy (WBT), including a literature review, and then demonstrates how it could be applied to people with spinal cord injury (SCI). The chapter concludes with a discussion of the broader implications for utilizing these approaches more widely in RP as well as a cautionary note.
- Go to chapter: Risk and Resilience in Military Families Experiencing Deployment: The Role of the Family Attachment Network
Risk and Resilience in Military Families Experiencing Deployment: The Role of the Family Attachment Network
This chapter presents a family attachment network model to describe the adaptation of military families during the stress of deployment and their adjustment during the reintegration process. The family attachment network consists of multiple relationships existing at multiple system levels (e.g., individual, dyadic, subsystem, and system-wide interaction patterns), each of which has rules and attributes that are distinct and do not exist at other levels, yet are inextricably intertwined with other levels and the larger system. Similarly, within the family system, each attachment relationship is unique, such that a child’s attachment behaviors toward different caregivers can vary, siblings can demonstrate different attachment strategies with the same caregiver, and parent child attachment relationships often diverge from spousal attachment patterns. A central assumption of the proposed model is that attachment relationships and family systems are fundamental contexts for risk and resilience between military members and their families during the deployment cycle.
Identity arises out of the sum of our experiences. This chapter traces the developmental concept of identity through its manifestations at different levels of community, revealing a complex and systemic context for rehabilitation counseling. Each level of identity (personal, social, and collective) denotes a potential point of counseling exchange with the family. The authors of this chapter consider family identity in relation to disability and interaction with the community. They discuss personal identity versus family identity and social identity within a social movement. The McMaster model of family functioning and the three dominant tasks of family are explored as are the International Classification of Functioning, Disability and Health (ICF; World Health Organization, 2001) domains of health conditions, activities and participation, and functions affected. Finally, the chapter presents methods of family coping (both negative and positive strategies), family resiliency, and strategies that counselors can use to effectively assist families.
The conceptualization of disability as an attribute located solely within an individual is changing to a paradigm in which disability is thought to be an interaction among the individual, the disability, and the environment. This chapter draws both theoretical and practice implications, which may assist practitioners and educators in gaining a clearer understanding of counseling clients who have disabilities, from four broad models of disability. Intended as a broad overview of the major models and an introductory discussion of ways in which these models can affect the profession of counseling, the chapter presents several different ways of conceptualizing the experience of disability. The four broad models are: (a) the biomedical model, (b) the functional model, (c) the environmental model, and (d) the sociopolitical model. The functional model and the environmental model are presented together because both are interactive models; stated differently.
The International Classification of Functioning, Disability and Health (ICF; World Health Organization [WHO], 2001), and its predecessors the International Classification of Impairments, Disabilities and Handicaps (ICIDH and ICIDH - 2; WHO, 1980, 1999) have been influential in the conceptualization of the construct of disability in the United States and internationally for more than three decades. This chapter begins with a brief overview of the history of classification of health and illness, and the role that different conceptualizations of disability have played along the way. It then reviews the development of the ICF within the context of these conceptualizations and introduces its key concepts, conceptual framework, and a brief orientation to its use. It concludes with consideration of the current and future impact of the ICF on conceptualizing psychological and social aspects of illness and disability.
Substance abuse treatment programs and clinical counseling approaches are designed to treat a variety of substance use disorders (SUDs). Treatment approaches may include a combination of medical (e.g., pharmacotherapy) and psychosocial approaches. Counselors apply a variety of evidence-based treatments, counseling theories, and approaches to substance abuse problems. With continued care, successive treatments, and continual monitorng, individuals with SUDs can increase the interval between abusive episodes until the individual achieves either full abstinence or more responsible substance use, as well as a more stable life-fulfilling recovery. Successful long-term recovery requires the adoption of a healthy lifestyle and continued mindfulness that SUDs can rear their ugly heads if one becomes distressed or negligent in maintaining life-enhancing attitudes, beliefs, and behaviors. With patience, persistence, tolerance, empathy, and compassion, counselors can help individuals and their families successfully recover from this devastating and potentially life-threatening disorder.
This chapter reviews the history of treatment toward people with disabilities (PWDs) in the United States. Early immigration literature and the apparent attitudes and treatment toward PWDs, as well as certain other immigrant populations, were blatantly prejudiced and discriminatory. Antidisability sentiment became more evident with immigration restriction, which began as early as the development of the first North American settlements. The eugenics movement essentially died down after World War II, primarily because of Social Darwinism and the Nazi extermination of an estimated 250,000 German citizens and war veterans with disabilities. The survival-of-the-fittest concept and natural selection in the 21st century appear to have morphed into a survival of the financially fittest ideology. With the aging of America and millions of baby boomers moving into their golden years, the financial portfolios of these individuals dictate what the quality of their lives will be, like at no time before in American history.
This chapter explores one of the most profound and important empirical questions that researchers have regarding the psychological and sociological impact of disability: How do persons with disabilities react to their situation, and why do some actually excel, whereas others become indefinitely incapacitated both mentally and physically? The chapter explores seven common theories of adaptation to a traumatic physical disability. Some proposed theories have stronger evidence-based empirical support, whereas others rely on more qualitative and case study accounts, as well as clinical observation. The chapter first explores persons born with a congenital disability, and questions whether such individuals actually experience any type of adjustment process since they have no preinjury, nondisabled experience with which to compare their situation. It then explores the seven theories of adjustment: stage models, somatopsychology, the disability centrality model, ecological models, recurrent or integrated model, transactional model of coping, and chaos theory.
Family caregiving and support are perhaps the most essential elements in their disabled loved ones’ adjustment for response to disability. This chapter first explores the prevalence of caregiving in America, including demographic information about who the typical caregiver is and what the situational circumstances are for these individuals. It is followed by providing a definition of the types of caregiving support generally provided by loved ones, as well as the nuanced differences between unpaid family care versus paid formal care. This segues into a brief exploration into the significant family role caregiving entails and its impact on each member. The chapter then discusses caregiver abuse as well as the often painful decision to place a loved one in a long-term care facility. Finally, it explores strategies for counselors to be able to support family caregivers in caring for their loved one while maintaining their own mental and physical health needs.
The skills of working with the psychosocial aspects of grief, death, dying, and loss are essential, particularly in working with persons who have acquired chronic illness and disability. This chapter helps elucidate important psychosocial issues in death and dying as it relates to how individuals experience and express grief within the context of the person’s physical, psychological, cognitive, emotional, social, cultural, and spiritual well-being. Recognition in the new Diagnostic and Statistical Manual of Mental Disorders (DSM- 5) of the Persistent Complex Bereavement Disorder diagnostic category provides legitimacy for the individual’s sense of loss and mourning based on multiple events related to death and dying. It is essential that counselors address such psychosocial concerns clients because of the added therapeutic value and ethical obligation to guide the individual and his or her family in important decisions regarding death and dying.
The United States continues to grow in population, particularly among persons of minority. With the statistics in mind, it becomes all the more relevant for counselors to be knowledgeable and prepared to work with the growing populations in relation to their values, culture, family dynamics, and ultimately how they view and treat their disabled members. This chapter represents a synopsis of six different groups; Hispanic or Latino Americans, African Americans, Asian Americans, Middle Eastern Americans, European Americans, and Native Americans. It presents a synopsis of each specific group’s culture, cultural and family perspectives on disability, socioeconomic factors, and religion. Involving the entire family and not just the client can assist counselors to establish a relationship of trust that can be meaningful for the counselor-client relationship. Cultural competence has been known to be an important component in receiving school psychological services for Arab American youth and their families.