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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- Go to chapter: Cultural Variables and the Process of Neuropsychological Assessment in the Neurorehabilitation Setting After Brain Injury
Cultural Variables and the Process of Neuropsychological Assessment in the Neurorehabilitation Setting After Brain Injury
Neuropsychological assessment involves the administration of a battery of tests that assess a variety of cognitive domains to obtain a clinical picture of brain behavior relationships. Within the inpatient rehabilitation setting, neuropsychologists often perform various functions, including neuropsychological assessment, psychotherapy, and assistance with adjustment issues for patients and their families. This chapter discusses some of the common cultural issues that impact neuropsychology in an inpatient rehabilitation setting. It focuses on potential sources of bias that can threaten the validity of neuropsychological tests. The chapter also examines the process of the neuropsychological evaluation within the inpatient setting when working with individuals from diverse cultural backgrounds. It deals with a complex composite of sociodemographic factors that include education, socioeconomic status (SES), race, ethnicity, language, and worldview, all of which interact with one another to influence brain-behavior relationships.
- Go to chapter: The Effects of Acculturation on Neuropsychological Rehabilitation of Ethnically Diverse Persons
This chapter explores the impact of acculturation on three diverse U.S. populations: Hispanics, represented by a specific focus on Mexican immigrants; African Americans; and Native Hawaiians. It reviews relevant acculturation theories developed to explain cultural and psychological changes occurring in racial and ethnic populations in the United States as a result of interactions with the majority racial/ethnic population. The chapter presents Berry’s model of acculturation in particular, as a helpful theoretical model for clinicians working in neuropsychological rehabilitation to use for understanding psychological issues related to acculturation pressures. It also highlights the unique historical context of acculturation for each ethnic group and its effect on their acculturation experience as well as mental and physical health outcomes. The chapter provides rehabilitation psychologists and counselors with culturally relevant assessment and intervention recommendations for working with ethnically diverse clients.
Rehabilitation providers who work with service members and veterans face significant cultural challenges that may impact the rehabilitation process. Part of this challenge is maintaining an awareness that any individual engaged in rehabilitation could have had prior military service that could impact rehabilitation care. This chapter provides an overview of military culture, including specific aspects of this culture that may affect the rehabilitation process, the various co-occurring disorders that are common in military/veteran populations, and resources and programs that are particularly useful when working with service members and veterans. Service members and veterans face unique challenges and stressors that are over and above some of the routine sources of stress that others face in the workplace. Stress can come from participating in combat, including exposure to traumatic events, risk of injury, and fears about deployment.
This chapter describes spirituality, religiousness, and indigenous/folk belief systems in a multicultural context. The majority of religion and health research to date has primarily focused on persons with life-threatening diseases and conditions, as persons facing death may use religion to help them accept their condition, come to terms with unresolved life issues, and prepare for death. In contrast, rehabilitation patients who suffer acute injuries or chronic progressive disorders may live for decades after the onset of their condition and use religious and spiritual resources to help them cope with their disability, give new meaning to their lives based on their newly acquired disabilities, and help them to establish new goals. The chapter then explains the different ways rehabilitation psychologists can address religious and spiritual beliefs with individuals from different faith traditions.
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.
Rehabilitation counseling (RC) recognized family impact on service outcomes decades ago (Power & Hershenson, 2003; Westin & Reiss, 1979), but failed to develop substantive research (Bryan, 2009), practice, or policy (Kneipp & Bender, 1981) on their behalf. The cursory overview of family counseling approaches presented in this chapter is informative as a gestalt of theories and as a collection of unique tools. From the Community-based Rehabilitation Counseling (CRC) perspective, the therapeutic tools of family counseling can be repurposed for inclusive community development outcomes through community processes in all of the nested and networked communities that populate our lives. Thinking about counseling in systems and inclusive community development provides the backdrop for a CRC consideration of the models and tools of family counseling. The chapter describes models that align with social justice and integrated author’s own thinking in the hypothetical discipline of the CRC.
- Go to chapter: Which Counseling Theories and Techniques Work Best With Different Disability Populations and Why
The identity of rehabilitation counseling is rooted in the constructs of counseling psychology and is expressed through current best practice. This chapter provides a brief description on which counseling theories and techniques work best with different disability populations and why. It traces the emerging threads of rehabilitation counseling through counseling theories and techniques. Next, it focuses on the relevance of theory and an accounting of successful applications of theory to practice. It then moves outward from the roots of counseling, from common factors to schools of thought, to describe how counseling fits into our community-based world. Career counseling is a signature venue for rehabilitation counseling. The chapter describes three of the most popular and useful approaches (Minnesota Theory of Work Adjustment, Holland’s Theory, and Super’s Life Span, Life- Space Theory) to providing a sense of the spectrum of service possibilities.
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.