The multicultural movement in counseling and psychology has begun to provide scholars and practitioners with contextually relevant, systems-based ecological approaches to counseling as alternatives to the traditional theoretical models of human behavior and intervention that are based on Western dominant culture. This chapter provides awareness of the complexity of multicultural issues among individuals with disabilities and discusses culturally sensitive strategies to work with people with disabilities (PWDs). It reviews legislative mandates related to diversity and multiculturalism in rehabilitation and addresses the relationship between disability and culture in the scope of rehabilitation practice. The chapter introduces multiculturalism and multicultural counseling models as a therapeutic framework and provides guidelines to help psychologists increase their cultural sensitivity. It also provides strategies to work with individuals with disabilities from minority backgrounds.
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The concept of justice is deeply entrenched in America’s psyche. This book assumes that advocates for older people can increase their effectiveness by achieving a clearer understanding of Americans’ not-so- self-evident nor inalienable rights. It explores how social justice and human rights principles have applied to older adults in the past and are viewed today. It examines how the interests of older adults compare to and are intertwined with those of other groups. In essence, the book frames elder justice as the intersection between aging policy and policy that promotes human rights and justice. Chapters two through five describes historical antecedents and precedents for elder justice and suggests how human rights and social justice principles have been embedded in what has traditionally been referred to as “aging policy”. These chapters look at other policies that significantly affect older people but do not fall under that rubric. They further explore ageism and its role in policy. Taken together, they offer two models or approaches that can guide the development of elder justice: the public health model and proposals for an international convention on the rights of older people. Chapters six through ten considers how elder justice principles can be applied. As examples, they focus on how individual rights and social justice apply to elder abuse prevention, to the justice system, in the consumer context, at the end of life, and with respect to people with diminished mental capacity. They also look at equity across generations and among older people. Chapter eleven calls for a new paradigm of elder justice and offers a rationale for why one is needed. Chapter twelve builds on other chapters to demonstrate how elder justice might translate into practice, training, policy, public awareness and engagement, and research.
A dramatic shift has occurred in the field of long-term care in recent decades in how providers talk about those they serve. This chapter explains what consumer rights are and suggests how they might apply in long-term care. It considers obstacles that older consumers with physical and cognitive disabilities may face as well as barriers imposed by the markets themselves, such as the failure of healthcare to respond to market forces that are supposed to drive prices down and lead to new and improved products. It acknowledges the special rights of users of medical care, nursing homes, assisted living facilities, and health plans as articulated in patients' rights and residents' rights declarations and agreements. The chapter finally makes the case that consumers' rights should be a component of elder justice and that elder justice advocates and the public need to understand how to exercise and protect them.
Perhaps nowhere are the challenges to preserve individual rights and justice greatest than in the face of illness, disability, and death. This chapter calls attention to common violations of individual rights at the end of life such as the disregard of advance directives like “living wills” and “do not resuscitate” orders. It highlights the perils of these instruments, which were created to preserve autonomy but can be weaponized to exploit. The chapter then explores highly controversial rights of individuals to control their own deaths and enlist others to help them. It suggests how the “right to life” takes on new meaning in light of technological innovations that seek to extend life to previously unimaginable lengths and their implications for individual and collective rights. Finally the chapter also explores the implications of its corollary the “right to die”.
Elder justice has emerged from multiple fronts. It comes from researchers who are discovering that chronic illnesses, disability, and elder abuse are linked to poverty, discrimination, and social exclusion. This chapter calls for a new paradigm of elder justice that is based on the principles of human rights and social justice as they apply to older people. It builds on and reinforces past progress, revisits old assumptions and unfulfilled promises, and identifies new needs and challenges. The chapter then lays the groundwork for an elder justice agenda by suggesting the need for a new conceptual framework and elements to include. It builds upon principles of human rights and justice and employs public health methods to identify needs and suggest solutions. Finally the chapter connects the dots among existing policies and practices, building on those that have proven successful and rejecting those that have not.
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.
The authors of this chapter are tasked with reviewing the dos and don’ts of interacting with people with disabilities as human beings. A collection of suggested behaviors, a disability etiquette, has emerged from the collective experience of people with disabilities and is widely available in brochures and on the Internet. Although disability etiquette is an important read for anyone in the field, it is not a sufficient guide for the rehabilitation counselor. The authors are a value-driven profession. They share allegiance to the fundamental mission of full community inclusion for people with disabilities. They act with their clients and on their behalf to help individuals achieve standing in their communities and to advance a more inclusive world for all people with disabilities. Disability etiquette is only the superficial expression of professional values that have much deeper roots and higher aspirations.
- Go to chapter: Ethical Responsibilities in Working With People With Disabilities and Our Duty to Educate
The topic of ethics is vast and impossible to cover comprehensively in any single work. This chapter presents some of the relevant and controversial topics in this arena. It focuses on common ethical dilemmas, factors that influence counselor ethics, counselor competence, and current and debated ethical issues. Some ethical dilemmas seem inherent in the counseling process and are as likely to be encountered in the present day as they were in earlier generations. Others occur due to societal advancements and trends, new technologies, or catastrophic events or diseases that lead to increases in prejudice and discrimination. The chapter covers current and debated ethical issues related to AIDS/HIV and duty to warn self-injuring clients, biotechnology advances, wrongful birth and wrongful life actions, decisions related to choosing disability, ethics and private sector rehabilitation, online and Internet counseling, end-of-life counseling, and assisted suicide.
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.
Counseling people with disabilities has evolved in its constructs from medical models that focus on pathology within the individual, to functional models that focus on economic viability of the individual, to sociopolitical models that focus on the handicapping dynamics of the external environment. We have evolved science and practice sufficiently to understand that disability is a social construction. The meaning of disability emerges from the interaction between the person and the society; it varies across groups and changes over time. The sociopolitical lens highlights the issue of power, its use, and its abuse; the minority experience under a dominant culture; and the role of culture as a context for empowerment, research, and the development of more effective practice. This chapter considers the changeable nature of disability from this postmodern, multicultural perspective and explores its implications for serving diverse populations in diverse cultural settings.