Tag Archives: Rehabilitation & Disability

Rehabilitation & Disability

Celebrating the role of rehabilitation counseling

By Sonia Peterson February 6, 2020

June 2 will mark the 100-year anniversary of what many of us in the field of rehabilitation counseling consider the inception of our specialty counseling area. On June 2, 1920, President Woodrow Wilson signed the Smith-Fess Act (also known as the Civilian Vocational Rehabilitation Act), which established the first vocational rehabilitation program for Americans with disabilities. It was modeled on an earlier law that provided for the rehabilitation of World War I veterans with disabilities.

Rehabilitation counseling is a unique specialty area of counseling focused primarily on disability advocacy and vocational rehabilitation counseling for individuals with disabilities. The field continues to grow, with new and expanding educational programs, opportunities for state licensure, and rewarding career paths. Certification is available through the Commission on Rehabilitation Counselor Certification (crccertification.com), and opportunities for counselor licensure are available in all 50 states. Recent developments in our field have further strengthened our relationship with the counseling profession at large and fostered opportunities for increased collaboration and education regarding disability inclusion in our profession as a whole.

Our history and specialty counselor education focus

The American Rehabilitation Counseling Association (ARCA) was established in 1957 and is a division of the American Counseling Association. ARCA’s mission is “to enhance the development of people with disabilities throughout their life span and to promote excellence in the rehabilitation counseling profession.” In 2019, the ACA Governing Council approved ARCA’s recommended Disability-Related Counseling Competencies (available on the ACA website at counseling.org/knowledge-center/competencies). ARCA invites all those in the counseling profession to review these competencies, to strive toward greater disability inclusion in the practice of counseling, and to consider ARCA their disability advocacy resource within our ACA fellowship.

Over the past several years, the rehabilitation counseling field has experienced a major shift in the accreditation of its education programs. As a result of the merger of the Council on Rehabilitation Education (CORE) with the Council for Accreditation of Counseling and Related Educational Programs (CACREP) in 2017, rehabilitation counseling is the newest counseling specialty included in the current 2016 CACREP Standards.

Rehabilitation counseling as a counseling specialty has existed in some form for more than 100 years. The history of rehabilitation counseling can be traced back to federal legislation in 1918 that initiated a program to vocationally rehabilitate veterans disabled during World War I. By 1920, additional legislation established the first broad-based federal program to provide vocational assistance to people whose disabilities were not the result of war. In the past 100 years, this state-federal vocational rehabilitation system has expanded its services and populations served to become the primary public service delivery system for all working-age youth and adults with disabilities in the United States. Each state has a designated vocational rehabilitation agency, and some states have an additional agency that serves individuals who are blind. The Council of State Administrators of Vocational Rehabilitation maintains a directory of all state VR agencies at csavr.org/stateagencydirectory.

State vocational rehabilitation agencies all receive federal funding from the U.S. Department of Education’s Office of Special Education and Rehabilitative Services under the Rehabilitation Services Administration (RSA) to provide services to individuals with disabilities. RSA’s mission is to “provide leadership and resources to assist state and other agencies in providing vocational rehabilitation (VR) and other services to individuals with disabilities to maximize their employment, independence and integration into the community and the competitive labor market.” All vocational rehabilitation services are individualized and generally include some combination of the following:

  • Vocational counseling and guidance
  • Job placement assistance
  • College or vocational training
  • Supported employment services
  • Skills training
  • Job coaching or tutoring
  • Transportation
  • Interpreter services for individuals who are deaf or hard of hearing
  • Services to assist students with disabilities in their transition from school to work
  • Reader services for individuals who are blind
  • Assistive and rehabilitation technology services
  • Referral services
  • Support, advocacy and follow-up services for at least 90 days following job placement

Currently, CACREP accredits more than 100 master’s-level rehabilitation counseling programs nationwide. Several of these institutions also offer doctoral degrees specifically in rehabilitation counseling education. The RSA regularly offers training grants to these institutions to support students who are pursuing graduate degrees in this counseling specialty area. Rehabilitation counseling students receive specialized training regarding the medical aspects of disability, legislation that affects individuals with disabilities, job placement strategies, and career guidance focused on workplace inclusion for multicultural individuals with disabilities. Over the years, the RSA’s definition of employment has expanded to support the efforts of people with disabilities to gain access to their communities, live independently, and direct the course of their own lives.

The emphasis on disability inclusion in rehabilitation counseling education programs provides students with specialized knowledge and skills related to the history of discrimination of individuals with disabilities in our society, the impacts of ableism in our society, medical aspects of disabilities, workplace accommodations, advocacy, and counseling ethics specifically related to disability inclusion. These skills are useful in a variety of settings, including state vocational rehabilitation agencies, the U.S. Department of Veterans Affairs system, county behavioral health systems, nonprofit agencies, return-to-work programs, human resources, legal settings, private rehabilitation hospitals, academia, and many other settings in our communities. Graduates of rehabilitation counseling programs find employment as vocational counselors, case managers, vocational evaluators, technology experts, forensic vocational experts, teachers, researchers, and private practice counselors in a wide range of work environments.

Social justice advocacy

Merriam-Webster’s online dictionary defines ableism as “discrimination or prejudice against individuals with disabilities.” Combating discrimination and the segregation of people with disabilities has been a long-standing principle and goal of rehabilitation counseling. Rehabilitation counseling scholars and educators have an established record of educating the public about the social construct of disability, the history of disability rights advocacy, and the existence of ableism in our society, and of combating negative attitudes toward individuals with disabilities.

The biggest barriers that individuals with significant disabilities encounter in our society are social isolation and poverty. According to the Bureau of Labor Statistics, 19.1% of individuals with a disability were employed in 2018. By contrast, the employment-population ratio for people without a disability was 65.9%. The depiction of individuals with disabilities in mainstream media is largely negative, and this has a huge impact on our attitudes toward disability as a society. Our institutions often seek to label individuals with disabilities as defective, different or “special,” with focus given to treating the person to fix their undesirable characteristic. Absent education and awareness, our society views disability as something being “wrong” with the individual rather than focusing on the attitudinal and environmental barriers that someone with a significant physical or mental impairment experiences as they navigate their way in the world. These negative and discriminatory attitudes are prominent barriers to financial independence and social inclusion for individuals with significant disabilities.

Mainstream media plays a major role in our societal attitudes toward individuals with disabilities. In film, on television and in the press, these individuals are often stereotypically depicted as being tragic, evil, heroic, objects of pity or objects of inspiration. They are rarely portrayed as people whose identities include the full range of human experiences and development, such as having intimate relationships, being family members, being students, working, traveling, enjoying hobbies, and engaging in other experiences that are normal parts of our lives and communities. Furthermore, characters with disabilities in films and TV shows are rarely portrayed by individuals with disabilities themselves. This is an additional form of discrimination experienced by actors with disabilities. Beth Haller, a prominent scholar who advocates for the positive portrayal of individuals with disabilities in mainstream media, makes a wide range of resources available at bethhaller.wordpress.com to those who are interested in exploring this topic further.

Our schools, public services and government institutions often perpetuate social isolation and poverty for individuals with significant disabilities through the various processes, regulations and financial restrictions that exist within programs designed to “help” individuals with disabilities. A main focus of rehabilitation counseling is advocating for people with disabilities and counseling our clients to reduce the environmental barriers that affect employment. Employment creates financial independence, provides a sense of purpose, and connects us in our communities. Rehabilitation counseling education programs focus on career development techniques, the Americans with Disabilities Act, and the impact of state-specific legislation on the employment of individuals with disabilities. Rehabilitation counselors help individuals navigate the complex public benefits system to avoid being penalized for earning income as they transition to work from dependence on public assistance programs.

Disability and cultural identities

Most individuals with disabilities have intersectional identities. More than half of those with disabilities are female, while individuals who identify as members of various ethnic groups or who identify as LGBTQ+ are also well-represented among those with disabilities. Individuals with disabilities live all over the world, and disability culture in itself is an aspect of multiculturalism. However, the disability experience is often overlooked or not included as an
aspect of multiculturalism in educational programs and staff development curricula.

The concepts of disability pride and disability culture have been emerging since the disability rights movement in the 1970s. Starting in the 1990s, a more formal construct of disability culture started to materialize in academic literature. Michelle Putnam, a professor of social work at Simmons University in Boston, explains that disability pride is an aspect of disability identity. It consists of claiming disability, acknowledging disability as a natural part of the human condition, advocating for the fact that disability is not inherently negative, and experiencing disability as creating the consciousness of a unique cultural minority group. Among examples of the disability pride experience are the Paralympic games, Deaf culture, and the recovery movement.

Disability pride: It is a common misperception that the para in Paralympics means the events are for “paralyzed” athletes. In fact, it means that it is an athletic competition that “parallels” the Olympics. The Paralympics include athletes with many different disabilities, including athletes who use wheelchairs. According to the International Paralympic Committee (paralympic.org), Paralympic athletes celebrate diversity and show that difference is a strength. Paralympic athletes, who are pioneers for inclusion, challenge stereotypes, transform attitudes, and break down social barriers and discrimination toward persons with disabilities.

The magazine New Mobility was launched in 1989 to bring quality journalism to wheelchair users who wanted more information on how to lead active, healthy lives. Editors, writers and college interns with disabilities produce this unique resource that shatters stereotypes and tells real stories of living life on wheels. Paralympic athletes and the producers of New Mobility magazine are examples of individuals and groups who choose to build community, celebrate diversity, and advocate for disability pride.

Deaf culture: According to sociolinguist Barbara Kannapel, American Deaf culture includes the values, traditions and language unique to individuals who are Deaf. Deaf culture centers on the use of American Sign Language (ASL) and identification and unity with other Deaf people. ASL is a complete and grammatically complex visual/gestural language with no vocal component. It differs significantly from written and verbal communication in English. ASL is not a universal language; there are signed languages in other countries. ASL reflects the unique and beautiful culture of Deaf people in our country. Gallaudet University’s National Deaf Education Center (www3.gallaudet.edu/clerc-center/info-to-go/deaf-culture/american-deaf-culture.html) is a good resource for additional information.

The recovery movement: Self-help groups available through the National Alliance on Mental Illness (NAMI), 12-step, and other recovery-related organizations have created an ever-expanding, cohesive and diverse community of individuals living in recovery who provide hope, solutions and strategies for others struggling with mental illness and addiction.

The recovery movement can be traced back to the founding of Alcoholics Anonymous in 1935 by Bill Wilson and Dr. Bob Smith. The 12 steps of Alcoholics Anonymous have been adapted by numerous other 12-step programs, including Al-Anon, Adult Children of Alcoholics and Dysfunctional Families, Co-Dependents Anonymous, Sex and Love Addicts Anonymous, Narcotics Anonymous, Crystal Meth Anonymous, Gamblers Anonymous, and Overeaters Anonymous. This peer-led, self-identifying, self-help approach to treatment has generated many other recovery-related groups in our communities, including SMART Recovery, Women for Sobriety, Secular Organizations for Sobriety (SOS), Refuge Recovery, and the Buddhist Recovery Network. An estimated 23 million Americans are currently living in long-term recovery from addiction to alcohol and other drugs.

NAMI is the country’s largest grassroots mental health organization dedicated to building better lives for the millions of Americans affected by mental illness. NAMI, which started as a small group of families gathered around a kitchen table in 1979, has expanded to include more than 500 local chapters throughout the country. The organization provides awareness, support and education on mental illness in our communities.

Although individuals with histories of mental illness and addiction continue to be affected by significant social stigma and discrimination, millions experience hope, healing, courage, support and pride as members of the recovery community. For more information on recovery, visit NAMI’s website (nami.org) or view the documentary The Anonymous People.

Solutions and recommendations for disability advocacy

Rehabilitation counseling is the social justice, multicultural and disability advocacy specialty. As rehabilitation counseling professionals, we advocate for outreach, education and awareness. The various ACA-endorsed counseling competencies (available at counseling.org/knowledge-center/competencies) and CACREP core curriculum standards emphasize multicultural awareness, education and advocacy. What follows are some solutions and recommendations for disability advocacy in our counseling profession at large.

  • Include the disability experience in all counselor education curriculum as a unique aspect of our diverse multicultural society.
  • Partner with ARCA and other ACA specialty divisions that promote social justice.
  • Advocate for disability inclusion. Don’t separate and segregate individuals with significant disabilities in our institutions, in our systems, and in our work as counseling professionals.
  • Help CACREP to integrate more disability-specific language into the core curriculum areas in its 2023 standards revisions. Connect with the Standards Revision Committee (cacrep.org) to express your ideas for the revisions.
  • Include works by multicultural disability scholars in counselor education curriculum.
  • Read autobiographies of individuals with disabilities.
  • Follow individuals with disabilities on Twitter.
  • Support the work of individuals with disabilities in the media.
  • Include scholarly articles written by individuals with disabilities in counselor education curriculum.
  • Create an information sheet with disability- and recovery-related resources to give to your clients
  • Increase your counseling competency by reading the Disability-Related Counseling Competencies on the ACA website (counseling.org/knowledge-center/competencies).

Resources

Many resources are available for those interested in learning more about the rehabilitation counseling specialty and connecting with rehabilitation counseling educators and clinicians.

One of the most current, comprehensive resources for an overview of rehabilitation counseling is The Professional Practice of Rehabilitation Counseling, second edition, compiled by editors Vilia M. Tarvydas and Michael T. Hartley (2017).

The National Council on Rehabilitation Education maintains a directory of all the rehabilitation counseling programs in the country at tinyurl.com/NCRERCPrograms.

Also visit the ARCA website (arcaweb.org) for a variety of resources. We invite all readers to stop by the ARCA booth at the upcoming ACA Conference & Expo in San Diego in April. In addition, attend our presentations at the ACA Conference that have a rehabilitation counseling and disability focus. We look forward to connecting with you.

 

****

Sonia Peterson is a licensed professional clinical counselor, a certified rehabilitation counselor, and an assistant professor in the Department of Administration, Rehabilitation, and Postsecondary Education at San Diego State University, where she serves as program director for the clinical concentration and certificate in psychiatric rehabilitation. In addition, she serves as the American Rehabilitation Counseling Association (ARCA) board chair of public policy, professional preparation and standards. Contact her at slpeterson@sdsu.edu or through the ARCA website at arcaweb.org.

 

Letters to the editor: ct@counseling.org

Counseling Today reviews unsolicited articles written by American Counseling Association members. To access writing guidelines and tips for having an article accepted for publication, go to ct.counseling.org/feedback.

 

****

Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.

Reconciling disability studies with mental health counseling

By Emily Cutler January 21, 2020

Growing up Jewish and queer in a conservative part of Birmingham, Alabama, I faced some pretty severe bullying as a child and teenager. It was a common occurrence for me to be called anti-Semitic slurs and mocked for looking and acting different. I was excluded by almost all of my classmates and had very little social support.

As a result, I struggled a great deal with my mental health. I felt depressed and anxious almost every day, and there were times when I felt sheer panic and terror about the prospect of attending school. Because I never seemed to fit in, I was convinced that I was fundamentally unlikeable and that the only positive quality I possessed was my near-perfect academic track record. So, on top of the anxiety and depression I felt as a result of being bullied, I also put enormous pressure on myself to score perfect grades. Any score less than 100 would send me into a spiral of shame and self-hate.

I cried a lot, and this worried many of the adults around me. I was sent to a number of therapists throughout my childhood. Most of them focused on figuring out ways to get me to stop crying so much. I was prescribed medication, exercise and an array of breathing techniques. Some of the therapists worked on encouraging me to act more “normal” — perhaps if I didn’t talk about my academic interests so much, or if I stopped trying to be the teacher’s pet, or if I were just less sensitive, then more of my classmates would like me.

Although some of the advice was useful, there were many times I walked out of therapy continuing to feel like something was wrong with me — that it was my fault that I was being bullied because I was just too weird and different to understand how to act like everyone else. More than anything else, I was frustrated with myself for not being able to stop crying or feeling depressed.

 

An empowering approach

My experiences with and perspective on therapy changed drastically when I went away to college. After struggling considerably with the transition to a new city and new environment, I reluctantly sought counseling from my university’s mental health center. I can still remember my first session. After answering some questions about my childhood during the intake, I said, “I know I must seem really messed up. Everyone hated me in high school, and now I just started college and I still don’t fit in. There’s something wrong with me. I know it. I just can’t fit in anywhere.” I could feel myself starting to tear up, so I immediately apologized for crying. “And on top of that, I am so overly emotional! I must be your worst client.”

My new counselor raised his eyebrows and looked up from his notes. “I was actually about to say that the way you’re reacting seems normal to me. It sounds like you had a pretty difficult time in school, and that was hard for you — it would be for anyone. And the transition from high school to college is hard too, which is also normal. I don’t know if I’ve met anyone who didn’t struggle to make friends in the first few months of college. I think it shows that you have a lot of resilience to get through all of that and to reach out for help.”

I was shocked. Here was a counselor who was not saying that anything was wrong with me or that I needed to change myself to fit in better. In his opinion, I was having a natural reaction to the circumstances I had been through. I’d never heard anything like it before.

Over the next several months, I went from viewing myself as an unlikeable weirdo to a person who is different (and perhaps weird in a good way!) but still deserving of acceptance and belonging. I started to see my uniqueness as a strength. Instead of encouraging me to change myself to fit in, my counselor empowered me to seek out on-campus groups and spaces where I would be accepted. As a result, I joined my campus Hillel as well as Active Minds, a student mental health organization. My counselor also encouraged me to stand up for myself in instances of bullying. Above all, he never pathologized my emotions or told me it was wrong to feel sad or depressed. I finally felt that I was being given the space to process and react to some of my experiences as a child.

 

Finding my path

Later on, I began to get involved with initiatives and organizations that focus on combatting prejudice and social injustice. I interned at the Anti-Defamation League of Philadelphia during my senior year of college, and I completed an honors thesis on weight-based bullying (bullying due to a child’s weight or size). Eventually, through my coursework and through my involvement in different advocacy communities, I found my way to disability studies, a discipline that centers the voices of people with disabilities and explores philosophical, cultural and sociological perspectives on the experience of disability.

Generally, the field of disability studies challenges the idea that disability is solely or primarily an individual defect in need of medical treatment. Instead, it posits that disability is the result of a multitude of factors, including societal exclusion and inaccessibility. The perspectives encompassed by disability studies greatly resonated with me as someone who cares deeply about challenging social injustices and exclusion rather than primarily changing individuals. Over the past several years, I have become intricately involved with disability studies research and advocacy.

One of my most pivotal moments has been coming to view myself and accept my identity as a person with a psychiatric disability. Embracing that identity has allowed me not only to accept myself and reduce my shame around having experienced mental health struggles, but also to become connected to a community of people with similar experiences and perspectives. I started working with the National Empowerment Center, an organization led by and for mental health consumers. With the center, I develop advocacy initiatives, educational programming and workshops that center the voices of people with lived experiences of mental health challenges and advocate for increased self-determination and acceptance of people with psychiatric disabilities.

The most meaningful and fulfilling part of my work has been spending time with people who have psychiatric disabilities, sitting with them through difficult times and empowering them to advocate for their rights and self-determination. My work has often included responding to people in crisis and providing space for them to experience strong emotions and extreme states.

 

A ‘fit’ for counseling?

My passion for that kind of intensely interpersonal, relational work sparked my interest in becoming a mental health counselor. As I began to explore the possibility of pursuing a graduate degree in counseling, I became increasingly certain that it was the right choice for me. There is little I care about more than supporting people with psychiatric disabilities to gain agency over their lives and experience community, connection and meaning. However, I also wondered how my disability studies background and perspective would fit with my role as a counselor. Whereas the disability studies field seeks increased acceptance and accommodation of disability in society, the counseling field often seeks to treat or prevent psychiatric disability. Would it be possible for me to reconcile both of these goals and perspectives?

I am only in my third semester of graduate school, so I do not yet fully know how I will integrate my disability studies background with my role as a mental health counselor. However, I believe it will be quite possible to do so.

In my own experience with counseling at my university’s mental health center, I felt that my counselor focused much more on encouraging me to accept myself and to find spaces where I would be accepted than on changing me or “fixing” me. I hope to take this same general approach with my clients. I believe that person-centered therapy and other humanistic approaches to counseling provide an excellent framework to accomplish this. These approaches require therapists to work with clients from a position of unconditional positive regard and to support clients in discovering their strengths rather than operating from a deficit-based model.

I also believe it is important to learn from counseling approaches developed by and for other marginalized communities. For example, while homosexuality used to be pathologized as a mental illness in the Diagnostic and Statistical Manual of Mental Disorders, many counselors now practice LGBTQ-affirming therapy. This approach supports LGBTQ clients in accepting themselves and decreasing any feelings of shame they may have related to their identities. Similarly, feminist therapy focuses on empowering women and people from other marginalized groups to advocate for themselves and to challenge injustice in their daily lives. Similar approaches could be applied to counseling clients with disabilities, including those with psychiatric disabilities.

I do not mean to suggest that psychiatric disabilities should never be treated or prevented. Many people with psychiatric disabilities want treatment such as cognitive behavior therapy, dialectal behavior therapy, and medication. Neither should exercise and breathing techniques be discounted because they are very useful for many people. However, there is no reason why the social and systemic factors affecting a person should not also be explored. In fact, professional counselors have an ethical and moral obligation to encourage people with disabilities to advocate for themselves. If clients are facing prejudice or discrimination on account of their psychiatric or other disability (or other difference), it may be helpful to explore ways of addressing that with them. Counselors can also encourage clients to request disability accommodations and link them to organizations such as peer-run wellness centers and peer support groups through which they might find acceptance and social support.

The 20/20: A Vision for the Future of Counseling initiative, sponsored by the American Counseling Association and the American Association of State Counseling Boards, reached a consensus definition of counseling as “a professional relationship that empowers diverse individuals, families and groups to accomplish mental health, wellness, education and career goals.” I believe that the disability studies field complements and enhances this goal rather than taking away from it. As a future counselor with a disability, I look forward to empowering my clients to accomplish their goals and to stand up to any injustice that stands in their way.

 

****

Emily Cutler is a graduate student in clinical mental health counseling at Troy University in Tampa, Florida. In addition to pursuing her studies, she provides training and consultancy on the topics of disability rights, trauma-informed care, suicide prevention, peer-run mental health services, and the Health at Every Size paradigm. Contact her through her website at emilyscutler.com.

****

 

Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.

Fostering resiliency in families and caregivers of individuals with disabilities

By Mariagrazia Buttitta September 26, 2019

It was like the world had collapsed on me, or worse. The words pronounced by my eye specialist felt like a sudden punch to my stomach, leaving me bruised and gasping for air. My life seemed over, or so I thought when I received an eye diagnosis of cone dystrophy at age 14. To this very day, it is emotional to recall the impact that diagnosis had on me and the confused look on my parents’ faces as they heard, for the first time, phrases such as “legally blind” and “disability.”

We all stood there in complete shock. Our faces must have looked ghostly white, perhaps hoping this was a nightmare from which we would soon awake. Instead, we left the office feeling defeated and frightened of what my future would look like, literally. The following day, I gathered all the energy I had left and Googled “cone dystrophy,” learning that it affects roughly 1 out of every 30,000 individuals (according to the National Organization for Rare Disorders). That number did nothing to lift our spirits or morale. My family still feared for my future and, the truth is, so did I.

According to the World Health Organization, nearly 1.3 billion people have a form of vision impairment. Furthermore, the Centers for Disease Control and Prevention reports that 1 in 4 people in the United States lives with a form of disability. So, why did my parents and I feel alone at the time of my diagnosis?

 

Media portrayals of disabilities

Today, it is clear to me that both my cultural background and the way that the media portrays individuals with disabilities might have influenced how my family and I coped with this news.

Growing up in Sicily, I experienced firsthand how my culture viewed disabilities as a weakness. Generally, individuals with physical or mental disabilities were looked down on and were not provided with the same opportunities as other people were. For example, it was assumed that I — someone affected by an eye condition — had less to offer; therefore, I was discouraged from pursuing education. Being the first person in my family with a visible disability did not help us know how to move forward either.

In addition, the media seems to send mixed messages regarding individuals with disabilities. Most of us have compared ourselves with models on magazine covers or wished to be the next Jennifer Lopez or George Clooney. But rarely does our society associate beauty with a physical disability. How many times have you watched TV and noticed someone with a visible disability? GLAAD’s annual report on inclusion notes that less than 2% of the main characters on American TV shows have a disability. A 2015 “Sandy’s View” column for The Chicago Lighthouse website discussed both the positive and negative stereotypes used when representing disabilities in the media. Both stereotypes seem to be extreme — one representing these individuals as victims, and the other representing them as “exceptional” individuals with unrealistic powers.

It is no wonder that my family and I were uncertain about my future. We lacked the proper resources and role models that could have helped us combat some of the negative stereotypes. Despite this, we overcame tremendous obstacles. Having a physical disability did not limit my life, and the realities of my disability only made my parents stronger and more resilient. In addition, it made them more educated about disabilities and cognizant of what other families and caregivers might experience.

 

Accepting and moving forward

Admittedly, my diagnosis of cone dystrophy was life-changing, both for me and my parents. The families of individuals with disabilities may have a difficult time adjusting and can develop their own mental health problems as a result. A study by Juan J. Sola-Carmona and colleagues that looked at 61 parents of blind children found that anxiety is higher and well-being is lower among these parents compared with the general population (published in Frontiers in Psychology, 2016). In general, families with individuals who have a disability are at greater risk of developing psychological problems. However, if these families learn how to cope well, it can increase the strength of the family. Here are the top five things that helped my family and me at the time of my diagnosis:

1) Reaching acceptance: Learning to accept the diagnosis was one of the hardest things for all of us, and I can assure you that it didn’t happen overnight. Acceptance developed with time. Once we traveled to various specialists and knew there was nothing that could be done to cure my vision, we needed to figure out how to live with the diagnosis effectively. After reaching that point of acceptance, we were able to figure out how we would cope and move forward as a family.

2) Seeking professional help: I was a teenager at the time of my diagnosis. The diagnosis was devastating, and it took a negative toll on me. As I got older, I had no faith in my ability to be successful, and that led me to feel helpless and useless.

Counseling proved extremely beneficial to me, but that came later in my life, when I was in my 20s. Talking to someone was therapeutic. My parents were extremely supportive of me, but they were also emotionally impacted by witnessing my struggles. Therefore, it was nice to find a therapist with whom I could talk and share all my emotions without feeling the guilt of hurting anyone else.

Once I gained confidence in myself, it automatically made the process much easier on my parents. I was a happier person to be around. Seeking professional help can be equally effective for family members and caregivers, providing them the time and space to focus on themselves and their own experience.

3) Educating ourselves: We spent hours educating ourselves as a family about my eye condition. We looked at hundreds of websites, articles, journals and magazines. After gaining that understanding and knowledge, we could start educating others about my level of blindness, why I walk with a white cane, and why I have to wear sunglasses all the time.

4) Learning about resources: Neither my family nor I had any idea about the resources available to me. Through research, however, we came across various resources, including the Commission for the Blind. After joining, we learned about still other resources, such as the various tools and technologies that would help me navigate the world with confidence. The resources reassured my parents that I, too, could go to college, get a job, and live a life like people without disabilities.

5) Having role models: Despite the number of individuals with a disability, we can often feel alone or misunderstood. Over time, my family and I met other individuals who, despite being blind or having other forms of disability, managed to live a successful life. As a result, my family and I started to view disabilities differently. No longer did we view my disability as a barrier. More importantly, we learned that we were not alone. My dream of going to college would become a reality.

 

A counselor’s perspective on disabilities

Throughout my graduate studies in a clinical mental health counseling program, I took note of a significant gap in how professionals are trained to work with those impacted by a visible disability. So, from there, I was on a mission: I rolled up my sleeves and got to work.

First, I interviewed Judy Schwartzhoff, a licensed clinical social worker with more than 30 years of experience in the mental health field, to ask her point of view on this subject. I posed several questions to her, including “How competent do you feel working with individuals, families, and caregivers of those affected by a visible disability?” and “Do you feel there are enough trainings provided to help deal with these clients?”

Her response didn’t surprise me one bit: “As mental health practitioners, we are often trained to treat the  emotional side of things, but I agree that we could use more knowledge and training in this area. However, if we do come across the issue, we tend to overlook the disability and stick with the emotional problem because that’s what we are trained in. We continue to separate mental health issues from physical disabilities, but sometimes, the two go hand-in-hand. As professionals, we need to expose ourselves to a diverse population and become more inclusive and know how to deal with different abilities as well as be able to assist their families and caregivers.”

I walked out of the office feeling determined and ready to put my thoughts on paper. Having witnessed, firsthand, the impact this issue had on my parents, I had to bring light to this issue. I immediately asked myself, a soon-to-be mental health professional, a question: What can I do to ease some of the worries and anxieties surrounding individuals affected by a different ability and their families and caregivers?

 

What mental health practitioners need to know

The chances of working with clients who have a visible disability, or their families or caregivers, are high. The truth is, we all will experience a form of loss in physical functioning at one point or another. This could be as simple as experiencing hearing or vision loss as we age. Even so, mental health professionals may feel incompetent if they’re lacking the proper resources and knowledge regarding these clients’ needs.

The day of my diagnosis, I recall a sense of fear and worry hovering over me. My parents had similar feelings, but they also experienced other emotions such as disbelief, sadness and confusion. An article by Josephine Defini in VisionAware described how blindness really affects the entire family as a whole — and I believe this truth can easily be applied to any form of disability.

As mental health professionals, we must be cognizant that each member of the family (or caregiver) might be experiencing a different state of mind and level of acceptance. Therefore, each person may require additional time to process and cope with the diagnosis. As practitioners, we want to be cautious not to assume that all family members are dealing with the news in the same manner or that they are even ready to deal with it at all. As a recent graduate counseling intern, I’ll acknowledge that I catch myself wanting to fix clients’ problems right away. I need to remind myself that everyone has his or her own timeline for healing and processing.

What follows are my top five recommendations for mental health professionals:

1) Use a psychosocial assessment: A psychosocial assessment can be helpful to gather information about the level of acceptance, skills needed to cope, resources, and any other observations noted for the individuals and their families or caregivers (Defini). By gaining this insight, mental health professionals will have a better understanding of what services are needed. For example, when working with an individual who uses alcohol as a way of coping with their issues, co-occurring treatment can be offered. Understanding the client’s individual experience of a disability can reduce bias or assumptions.

2) Use person-first language: In a 2014 article for the American Counseling Association’s VISTAS, Susan Stuntzner and Michael T. Hartley suggested that counselors use person-first language and avoid using negative phrases that could make clients feel less empowered. This would include saying “person with a disability” rather than “disabled person,” for example. In addition, don’t jump to conclusions about how clients feel about their disability. For example, don’t assume that they feel any weaker or have lower quality of life because of the disability. Speaking from my own experience, I think that being open and asking your client to educate you is also important. Everyone deals with a disability in a different way. Ask your clients what they prefer, and do not assume anything.

3) Know your resources: As mental health professionals, it is fundamental to know the resources that can be most helpful to clients. For example, as Defini suggests, if someone is experiencing vision loss, be sure to know the proper state services or local community programs that are available, such as rehabilitation, vocational rehabilitation, or low vision services. As mental health professionals, it might be impossible to know all of the resources out there, but we can be knowledgeable about who might have that information. Listed at the bottom of this article are some resources that may be helpful to you and your clients. Don’t be afraid to seek out information about resources that are more specific to each client’s needs and location.

4) Understand the adjustment process: It is important for mental health professionals to understand their clients’ adjustment process, including awareness of when they found out about their disability and how they coped. If individuals or their families or caregivers are not yet ready to process anything, they might not be able to utilize available resources to the best of their ability. Depending on how well adjusted they feel, the treatment will vary. Specifically, if they just found out about the disability, counseling might need to focus on the grieving process rather than on finding services and moving forward. Additionally, understand the individual’s barriers and that of their caregivers or family members (Stuntzner and Hartley).

5) Know the proper techniques: Be competent and knowledgable about what techniques can assist your clients. Many techniques used center around self-compassion, forgiveness and resiliency (Stuntzner and Hartley). Family counseling may also be helpful to clients and their family members because it gives each individual the opportunity to be open about their needs with each other and the counselor. One intervention may be to have families engage in activities together (e.g., take a meditation class, go to dinner, see a movie, visit a museum) to keep the disability from overtaking their lives.

Mental health professionals shouldn’t be afraid to use their own judgment to see what their clients and clients’ family members or caregivers may need. Every person copes with a disability differently, and everyone is going to need different strategies, so get to know the needs of your clients and their families or caregivers.

 

Conclusion

I wish that I could go back in time and wipe clean the past — especially the day I received my diagnosis — to remove the fear and anxiety my parents felt. Sadly, I can’t. But as a recent graduate counseling student, career counselor intern, author, motivational speaker, and mental health and disability advocate, I aim to help decrease the pain and fear that others may experience. I plan to do this by educating individuals who have disabilities, as well as their families and caregivers, and by setting as example, because a disability does not have to define or determine our future or the future of our loved ones. As figure skater Scott Hamilton once said, “The only disability in life is a bad attitude.”

 

Resources

https://www.familyresourcenetwork.org/

https://nfb.org/

https://sites.ed.gov/idea/parents-families/

https://www.psychologytoday.com/us/groups

https://www.cdc.gov/ncbddd/developmentaldisabilities/links.html

rarediseases.org page on cone dystrophy

 

****

 

Mariagrazia Buttitta is an author, motivational speaker, and mental health and disability advocate. She holds a master’s degree in counseling education from the College of New Jersey and is national certified counselor candidate. Contact her at buttitm1@tcnj.edu and through her website at embracingyourdifferences.com.

 

****

 

Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.

Counseling Connoisseur: Revisiting the Spoon Theory

By Cheryl Fisher July 1, 2019

“If opening your eyes, or getting out of bed, or holding a spoon, or combing your hair is the daunting Mount Everest you climb today, that is okay.” – Carmen Ambrosio

 

Tara, 36, wakes up and rolls out of bed. Her pain factor is a five out of 10. She feels well rested after spending the past two days in bed–the result of working an 8-hour day and going to dinner with friends. Today she will try to finish her laundry and run errands. The lupus flare-up appears to have subsided–for now.

Kevin, 28, a graduate student, is not as fortunate. He struggles to keep up with the demands of a full-time job and graduate school. Kevin has weeks when he is able to manage both. However, today, he has become physically and emotionally paralyzed by his autoimmune disorder and struggles to bring even his thoughts together. He is contemplating taking an academic leave of absence until his health improves.

Carmen, 57, has been living with multiple sclerosis (MS) for over 20 years. Each day she wakes up and takes inventory of her physical and emotional well-being. Some days are better than others. However, the uncertainty of her health has prompted her to seize the moment and engage fully in her craft as an author.

For Tara, Kevin, Carmen, and thousands of others, the challenge of managing their chronic conditions while also meeting the demands of daily life can be daunting. To those around them, they look perfectly healthy. Smart and ambitious, they excel when they are feeling well. However, without warning they can be thrust into the throes of physical, emotional and cognitive dysfunction, rendering them unable to get out of bed, let alone handle professional, academic or personal responsibilities and obligations.

The Spoon Theory Revisited

In an attempt to help her dear friend understand what living with lupus feels like, writer and activist Christine Miserandino crafted The Spoon Theory to explain how energy is limited by chronic illness. Miserandino uses spoons as a metaphor for energy. According to the theory, a person has a certain number of spoons representing energy each day, and each activity depletes a portion of those spoons. In this way, individuals are encouraged to ration and pace their spoon/energy usage in order to accomplish their daily activities. This theory has become widely accepted, and some individuals have even coined the name “Spoonies” for those with conditions that restrict energy. However, the Spoon Theory relies on myths about chronic illness and energy.

Myth 1: There is a set number of spoons each day.

The amount of energy (spoons) needed to function is not prescribed in a daily dose. Clients may wake up and feel that they are armed with a picnic basket filled with spoons. Then a few hours later, they crash and burn and are entirely depleted of whatever resources they thought they had. It is as if the bottom fell out of the basket without warning.

As Jennie, a blogger for The Mighty, an online support community for people facing health challenges, describes in her post, “Why the spoon theory doesn’t fit my life,” what seems like a high energy day can suddenly turn into total depletion:

“Often I wake in a morning and think, ‘Yes! Today is a good day!’ Then, within hours, or even minutes, the tides have turned. Maybe my spoons are ninjas? Maybe the borrowers have been rifling through my stash? Whatever it is, I can go from having just enough energy to less than zero quicker than a scrambling fighter jet. Sometimes it’s due to a weather change; sometimes it’s stress. Often I have no clue whatsoever what happened.”

Myth 2: Spoons can be banked for another day

The Spoon Theory suggests that rest will help bank energy for the next day. This sounds like it makes sense, right? However, chronic illness doesn’t play fair. Resting for a day or two may result in feeling even more fatigued the following day. This makes it difficult to plan activities for the day, week or month. For example, my own daughter, who was recently diagnosed with lupus, confided that some days she wakes up feeling energized only to crash within hours and be wholly depleted the remainder of the day or even the next few days. It is frustrating to both the person who has the illness and those around them who may want to make plans. At times, life is only manageable in chunks of minutes versus days.

Myth 3: Activities require a specific number of spoons

One of the challenges of the Spoon Theory is that it is impossible to quantify (in spoons) the amount of energy it takes to accomplish any given activity. The amount of energy expended is influenced by other variables, including pain threshold. For example, getting dressed for the day may be as easy as slipping into an outfit one day, but feel like donning a suit of armor the next. So, although the activity for both days is identical, the depletion of energy is vastly different. Therefore, preparing for energy expenditure can feel like a futile effort.

 

How counselors can help

Living with the day-to-day uncertainties of a chronic illness can be isolating, alienating and frustrating. Making plans with friends and family must be spontaneous and depends on the illness effects du jour. Counselors can assist clients and families who are impacted by chronic illness by validating their experiences, providing psychoeducation, and stepping up to advocate on local, regional and national levels.

Validate

By nature, counselors are exceptional listeners who are able to hear and identify the concerns of the client. Additionally, we can validate the challenges experienced by the client. Clients may feel anger and resentment at how their condition may restrict activities. They may feel isolated and alone. Friends and family who were present at the initial diagnosis may have returned to their busy lives. This often may leave the client feeling abandoned and alienated. Validating the difficulties of navigating chronic illness allows the client to feel heard and understood.

Educate

While we are able to sit with the client and the emotional, cognitive and physical pain of chronic illness, we can also provide psychoeducation that may promote strategies for better self-care. For example, helping clients grieve the old lifestyle and create a new normal that is shame-free and includes strength-based coping skills that allow them to deploy greater flexibility in the face of those “not-so-great days.”

Counselors can also help clients locate resources in the community, such as support groups or career assistance. They can provide education to family and friends about the uncertainty of living with chronic conditions that tax energy. For example, helping significant others understand that staying in bed all day is not indicative of a character flaw or laziness but a real depletion of energy (those spoons again!).

Advocate

Counselors can contribute to efforts for institutional changes that will benefit clients by participating in legislation and signing petitions. We can attend hearings and provide testimony to the needs of our clients. Finally, counselors can use their voice and power to advocate for clients by participating in any number of activities to increase awareness or fund research.

Conclusion

The Spoon Theory attempts to explain the energy consumed by chronic illness. In reality, it oversimplifies the complexity of day-to-day functioning. Perhaps one of the gifts of counseling is to provide a relationship without conditions where the client is valued beyond the constraints of the illness and a place that welcomes vulnerability and recognizes the courage of showing up each day in spite of the challenges. Perhaps the act of counseling is — as Brené Brown suggests — joining the client in the “arena” and experiencing their pain and disappointment. Perhaps even in the complexity and uncertainty of living with chronic pain and illness, the counselor can help clients recognize that showing up each day if worth the challenges.

Finally, perhaps in the midst of the discomfort of the seeming betrayal of the body and mind, the best gift counselors offer to their clients is as author Hannah Brencher says in her book,  If You Find This Letter: My Journey to Find Purpose Through Hundreds of Letters to Strangers, “… the permission to feel safe in their own skin. To feel worthy. To feel like they are enough.”

 

****

 

Related reading, from the Counseling Today archives:

The tangible effects of invisible illness

Assessing depression in those who are chronically ill

 

****

 

Cheryl Fisher

Cheryl Fisher is a licensed clinical professional counselor in private practice in Annapolis, Maryland. She is director and assistant professor for Alliant International University California School of Professional Psychology’s online MA in Clinical Counseling.  Her research interests include examining sexuality and spirituality in young women with advanced breast cancer; nature-informed therapy; and geek therapy. She may be contacted at cyfisherphd@gmail.com.

 

*****

 

Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.

 

Leading an anti-bullying intervention for students with disabilities

By Katherine A. Feather and Tiffany M. Bordonada January 10, 2019

For more than 40 years, bullying in schools has remained relatively stable and today is recognized as a serious social problem. In 2014, the Centers for Disease Control and Prevention (CDC) and the Department of Education released the first federal standardized definition of bullying, which includes unwanted aggressive behavior, observed or perceived power imbalance, and repetition of behaviors or high likelihood of repetition. In addition, the CDC and Department of Education acknowledged direct and indirect modes of bullying and four types of bullying that school-age children can experience: physical, verbal, relational and damage to property.

According to the National Center for Education Statistics (2015), approximately 1 in 4 students in the United States reported having been bullied at school. However, evidence suggests that school-age children with disabilities are two to three times more likely to be bullied than are their peers without disabilities (for more, see the three-volume set Disabilities: Insights From Across Fields and Around the World). It is absolutely critical for professional counselors to assist those who are targeted and support proactive interventions that decrease bullying for students with disabilities.

Intervention strategies that are grounded in social learning theory and established on client-centered, community-based and experiential methods have been shown to be successful with children who have disabilities. Such interventions have a positive effect on children’s self-efficacy, self-determination and social skills. Furthermore, counselors can adapt experiential-based activities to provide these students with opportunities to learn new skills, make decisions, experience successes and take calculated risks. Finally, counselors need to recognize the strengths of students with disabilities, teach them to feel comfortable with who they are and empower them to implement bullying prevention skills.

This article will outline proactive prevention in terms of experiential group activities that focus on self-efficacy, self-determination and social skills training when working with school-age children with disabilities. The experiential group activity we will be describing was originally developed by Able SC, an empowerment and advocacy organization in Columbia, South Carolina, for people with disabilities. We collaborated with Able SC and tailored the activity to meet the needs of middle school and high school students with disabilities.

Aims

The experiential activity includes four primary objectives that positively affect self-efficacy, self-determination and social skills. The objectives are to help students:

1) Identify and understand various bullying behaviors

2) Recognize the warning signs when a person is being bullied

3) Learn strategies to manage bullying

4) Learn steps to take in the here and now to address bullying

Preconditions

Prior to engaging group members in the experiential activity, several preconditions should be met. First, counselors must have a strong therapeutic alliance with the participants before engaging them in the group activity. Second, counselors should provide proper accommodations to address the unique needs of the group members. Third, counselors must be willing to be creative and flexible to adapt the experiential activity to the individual strengths of the group members. Fostering a strengths-based approach is imperative when helping school-age children with disabilities to explore their self-efficacy. Finally, counselors must display competence with multicultural social justice counseling before working with children with disabilities.

The process

The first part of the group facilitation process involves assisting group members with understanding the various types of bullying (i.e., physical, verbal, relational and damage to property). The role of the group leader is to facilitate a discussion about these various bullying types, which may prompt group members to recognize specific examples. Additionally, the group facilitator should discuss the importance of recognizing real or perceived power imbalance and determining how often the power differential occurs. In other words, was this a one-time incident, or was it done repeatedly to hurt the individual? The group facilitator must guide students in understanding these two concepts that help to define bullying: observed or perceived power imbalance and repetition of behaviors. The group facilitator should also assist students in understanding the confusing distinction between when someone is joking versus when someone is actually engaging in bullying behavior.

To foster another mode of understanding, the group facilitator can also engage group members in a role-play demonstration to act out the different types of bullying. If the participants find it difficult to participate in the role-play, group facilitators can provide examples of the types of bullying to ensure support for students during the demonstration. In addition, it is important to identify the individuals involved with the bullying episode (i.e., bully, target and bystander) to provide clarity during the role-play. For instance, the group facilitator should discuss with group members how the bystander can be the most influential person in the situation either by acting as a solution to the problem or by instigating the bullying. Finally, the group leader encourages group members to identify characteristics of being a bully.

This will help students to recognize these traits so they can avoid engaging with those who display such behaviors.

The second part of the experiential group activity consists of identifying warning signs that an individual might be being bullied. These signs include:

  • Physical signs (e.g., cuts, bruises, scratches, headaches or stomachaches, damaged possessions, missing possessions)
  • Emotional signs (e.g., withdrawal or shyness, anxiety, depression, aggression, suicidal ideation)
  • Behavioral signs (e.g., changes in eating or sleeping habits, nightmares, no longer wanting to participate in school or activities that he or she once enjoyed, bullying siblings)
  • Academic signs (e.g., changing the manner in which he or she gets to school, being driven to school instead of riding the bus, having a noticeable drop in grades)

After determining the group’s understanding of the warning signs, the group facilitator can propose an experiential group activity in which the group members identify strategies to manage bullying. The group facilitator can engage the students in a role-play scenario in which the target initially fights back. The facilitator should then prompt a dialogue on the positive and negative consequences of engaging in this approach. Next, the group facilitator encourages the group to identify nonviolent strategies that the target can use in the same scenario. This will prompt group members to recognize how implementing a nonviolent approach to bullying can be an effective option.

Next, the group facilitator needs to co-construct with the group members prevention strategies to manage bullying behavior. A few general prevention tactics include:

  • Telling an adult
  • Walking away
  • Ignoring the bully
  • Avoiding the bully by interacting with friends or avoiding places the bully is known to be

Group members should be taught to understand the differences between the roles of bully, target and bystander and recognize appropriate prevention strategies that they can use if they find themselves in any of these categories. For example, the group facilitator could encourage the group members to identify effective prevention strategies specifically for the bystander role. These strategies include telling the bully to stop, helping the target to walk away, recruiting friends to intervene and getting an adult.

To reiterate, it is important to provide group members with specific scenarios to ensure that they understand the differences between the three roles and know which prevention strategies are appropriate for each scenario. Furthermore, have group members share times when they have fallen into the specific category of bully, bystander or target to guarantee that they are addressing their personal experiences with bullying.

Additionally, the group facilitator can engage the group in a role-play exercise to review the three categories and to collaboratively identify:

1) The bullying behavior

2) How the target reacted to the bullying

3) How the bystander(s) reacted

4) How the bully responded to the situation

5) Whether the bullying was managed in an effective way

6) How the bullying scenario could have been handled differently

7) How the group members would feel as the target in the scenario

This role-play provides group members with a greater sense of self-awareness as it relates to self-determination, self-efficacy and social skills. In addition, the role-play increases empathy toward others because group members vicariously experience the thoughts, feelings and behaviors of the target.

Finally, the group facilitator can engage the group members in personal action plans to reinforce what was previously reviewed and to address steps to manage bullying (for a detailed figure outlining the personal action plan, see Katherine A. Feather’s 2016 article “Antibullying interventions to enhance self-efficacy in children with disabilities,” published in the Journal of Creativity in Mental Health). The facilitator asks the group members to independently acknowledge personal situations in which they have been bullied; their thoughts, feelings and reactions to the experience; how they handled it; and what they could have done differently. Once they have completed the chart, group members are prompted to share their stories if they feel comfortable. The personal action plan is an important part of the experiential activity because it gives group members something tangible they can take with them to remind them of what they have learned and that they can reference in the future.

Finally, at the discretion of the group facilitator, group members are encouraged to discuss assertive communication and the various communication styles, such as the difference between “I” and “You” statements. This particular discussion can transition into recognizing the importance of self-advocacy and one’s ability to make informed choices. The group facilitator can end the session by reinforcing individual empowerment and emphasizing the group members’ potential to manage bullying. The tools used to combat bullying speak to the group members’ self-efficacy, showing them that they have the ability to exert control over their own behavior, motivation and social environment (as explained by Albert Bandura in his 1977 article “Self-efficacy: Toward a unifying theory of behavioral change”).

Modifications to the process

Counselors who use this experiential activity may wish to adapt the group in the following ways:

1) Assess whether a particular student would be a better candidate for individual counseling and modify the activity for individual, rather than group, counseling.

2) When implementing the experiential training, augment the activity to meet the needs of the group participants. For example, for the personal action plan, participants can use numerous mediums to complete the activity (e.g., act out the steps, cut out pictures from a magazine, draw, write, use note cards with words, use assistive technology, discuss steps verbally).

3) Delivery of the experiential group activity must be based on students’ presenting characteristics to ensure full understanding of the material. For example, counselors need to address a comprehensive range of needs among students with disabilities. Therefore, counselors can provide additional scenarios of the components for the activity. This will encourage repetition and opportunities for practice. Counselors are also encouraged to collaborate with school personnel to ensure that they are meeting the needs of the student and integrating all necessary interventions to promote student success.

4) This experiential group activity may not be applicable for all students with disabilities. We suggest that counselors consult and collaborate with school staff to gauge the appropriateness of the intervention for individual students.   

Considerations

Counselors must intervene in a timely manner by recognizing, assessing and engaging students in activities that will combat bullying and provide them with the skills to be successful in the school environment. However, counselors must be sensitive to group membership. Therefore, counselors may want to consider making the group available to peers without disabilities. Inclusive practices may buffer against bullying by providing peer models to students with disabilities, as well as by promoting social competence among all students. Isolating students with disabilities does not provide them with the practice and validation they need to develop appropriate social skills. Thus, combining students with disabilities and their peers without disabilities fosters an inclusive approach and ultimately enhances a community of knowledge and understanding.

Finally, prior to implementing this experiential activity, we encourage counselors to become familiar with the social model of disability and the capabilities framework versus the medical model of disability. The social model of disability is a different way of viewing the world and challenges the typical attitudes toward disability. Fostering a capabilities approach validates the ideologies of inclusion that stress equality, acceptance and valued participation. The capabilities approach is a holistic social justice initiative that assesses disability on the basis of one’s abilities and functioning within society. Counselors need to recognize the impact that society has on the individual and the barriers that students with disabilities face on a daily basis.

 

****

 

Helpful resources for counselors

  1. PACER’s National Bullying Prevention Center (pacer.org/bullying/resources/students-with-disabilities)
  2. StopBullying.gov page on bullying and youth with disabilities and special health needs (stopbullying.gov/at-risk/groups/special-needs)
  3. “Bullying and Disability: An Overview of the Research Literature” (tinyurl.com/BullyingAndDisability)

 

****

 

Knowledge Share articles are developed from sessions presented at American Counseling Association conferences.

Katherine A. Feather is a licensed professional counselor in Arizona and an assistant clinical professor in the Department of Educational Psychology at Northern Arizona University. Contact her at Katherine.Feather@nau.edu.

Tiffany M. Bordonada is an assistant professor in the Department of Counseling and Human Services at the University of Scranton. Contact her at Tiffany.Bordonada@scranton.edu.

 

Letters to the editor: ct@counseling.org

 

****

 

Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.