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Rehabilitation & Disability

Peer support, mad pride and disability justice

By Luke Romano February 9, 2022

Do the phrases peer support, mad pride or disability justice ring any bells? If your graduate education was anything like mine, probably not very many. In this article, I’d like to offer an introduction to these terms and the social movements with which they are associated. My goal is for every counselor to walk away from this article with increased curiosity regarding these terms’ significance and relevance to our work and equipped with some practical tools to enhance our professional skill sets.

Some of the perspectives presented in this article are critical of the mental health professions. As counselors, we know that integrating critical feedback from our clients allows us to repair ruptures and ultimately strengthen the therapeutic work. The point isn’t to agree or disagree with client feedback but rather to take it seriously. Similarly, my belief in the importance of these perspectives is related to how they enhance my counseling practice. Putting new ideas on the table doesn’t mean taking other ideas off.

My personal background might contextualize my familiarity with the content presented in this article. Prior to my career trajectory as a counselor and educator, I had devoted more than 10 years to participation in various social justice movements and organizations. In the course of my journey, I had encountered and involved myself in peer support, mad pride and disability justice ideas and social spaces.

I’m now an early career counselor working toward licensure in Pennsylvania. My primary occupation is as a child and youth outpatient counselor in a community mental health clinic in Philadelphia. I also work part time with adults at another practice and recently gained experience as a course instructor in a counseling graduate program. Many of the lessons and principles I learned from my experience as an activist underpin my clinical work. My hope is to bring these lessons and principles to a wider audience in the world of professional counseling.

What is peer support?

Peer support is a tool of the mad pride and disability justice movements, in addition to recovery communities such as Alcoholics Anonymous. Peer support generally refers to acts of care that exist outside of the mainstream health care system, provided by and for those with lived experience who are critical of the hierarchy between professionals and individuals. You may be familiar with the existence of publicly funded peer support specialist certifications and practitioners in states such as Pennsylvania, Tennessee and New York. However, prior to the professionalization of peer support services, peer support practice arose as a grassroots response to the systemic mistreatment of patients in mental hospitals. Peer support represented a pushing back against harmful and coercive functions and practices evident in the medical model of mental illness.

The medical model of mental illness is here defined as an understanding of mental distress wherein symptoms indicate an underlying pathology related to the structure and function of the brain. Although counselors more often cite a “biopsychosocial” model that incorporates biological, developmental and societal factors in conceptualizing mental distress, the “bio” component remains the most prominent foundation on which the mental health system functions. Regardless of our individual inclinations toward developmental conceptualizations of distress or trauma-informed care, most of our clients still require a diagnosis out of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) to receive treatment.

Robert Whitaker’s 2002 book Mad in America: Bad Science, Bad Medicine, and the Enduring Mistreatment of the Mentally Ill thoroughly reviews the history of systemic mistreatment of those with psychiatric labels. In Whitaker’s view, current psychiatric and mental health practices remain impacted by and situated within a historical legacy of discrimination and mistreatment. Forced hospitalization and inadequate informed consent related to medication use are two common examples of mistreatment cited by peer support, mad pride and disability justice activists. Peer support practice arose as an alternative to mainstream mental health while demonstrating that communities of mad or disabled individuals can care for themselves, sometimes with better results than when left in the hands of so-called experts.

The peer support movement simultaneously arose out of necessity. The onset of neoliberal domestic policy during the 1970s and 1980s in the United States involved closing down psychiatric hospitals and filling prisons with those who were mentally ill. It was under this context that communities of those with psychiatric labels learned how to care for themselves without the assistance of professionals. Texts to further investigate the successes and lessons from these movements include Outside Mental Health: Voices and Visions of Madness, edited by Will Hall, and We’ve Been Too Patient: Voices From Radical Mental Health, edited by L.D. Green and Kelechi Ubozoh.

Practical applications

It can help to have knowledge of peer support resources in your area. Peer support groups (whether institutionally sanctioned or autonomously organized) can serve as a useful supplement to traditional one-on-one counseling. They may serve as an alternative for some. Project LETS is a national resource offering a peer crisis line along with various programs, trainings and workshops. It has chapters on college campuses across the United States. Trans Lifeline is an excellent peer resource for our transgender and nonbinary clients. Whether our clients choose to use these resources as a supplement or an alternative to professional counseling, we can respect their self-determination in finding services that suit their self-identified goals and needs.

We can integrate lessons from the peer support movement by centering the self-reported lived experiences of our clients. This could mean using our DSM-5 diagnostic framework and following associated treatment protocols. This could also mean tempering or modifying that approach to better suit client preferences. For instance, the Hearing Voices Network in the United Kingdom is a peer support network that includes members who view psychosis as transformative or spiritually significant and reject medication and hospitalization as helpful forms of treatment. If we encounter such individuals in our practice, we can operate out of a place of respect for their choices while weighing other ethical and professional considerations.

As we aspire to combat racism in our profession, we should also be aware of non-Western cultures that celebrate or revere those with symptoms that we might label psychotic, further integrating these individuals into their communities rather than forcibly isolating them — often with better health outcomes. The 2016 documentary Crazywise explores this topic in depth, albeit from a predominantly Western lens. 

Standard E.5.b. of the 2014 ACA Code of Ethics asks us to “recognize that culture affects the manner in which clients’ problems are defined and experienced.” It is an ethical imperative to acknowledge the limitations of our profession and to allow outside resources and non-Western perspectives to shape how we conceptualize our work with each client.

What is mad pride?

In the 1960s and 1970s, organizations led by psychiatric survivors (individuals who identified as having survived harmful or abusive psychiatric interventions) began to emerge. Groups such as the Insane Liberation Front and the Network Against Psychiatric Assault organized demonstrations across the country, including demonstrations in San Francisco against the use of electroconvulsive therapy (ECT) that led to the city discontinuing use of ECT for 10 years. Psychiatric survivors began to organize under the banner of “mad pride” in the early 1990s, with the term uniting many social movements composed of current and former users of mental health services.

The psychiatric survivor and mad pride movement is not to be confused with the anti-psychiatry movement. The anti-psychiatry movement was pioneered by thinkers such as R.D. Laing and Thomas Szasz who were critical of psychiatry but who were not psychiatric survivors themselves. One difference between the anti-psychiatry movement and the modern mad pride movement is that mad pride activists are careful not to criticize or shame those who have benefited from conventional psychiatric interventions.

Judi Chamberlin’s 1977 book, On Our Own: Patient-Controlled Alternatives to the Mental Health System, was an important text in the psychiatric survivor movement. In it, she used personal experience to critique involuntary hospitalization and coercively administered medication as well as expose human rights abuses in psychiatric wards. However, the mad pride movement offers more than just a critique of the mental health system.

The mad pride movement views mental distress as situated within social, political and economic circumstances. Fireweed Collective is a prominent organization associated with mad pride. I have had personal involvement with an earlier iteration of this organization known as the Icarus Project. According to the Fireweed Collective website, the Icarus Project “conceived mental health struggles not as faulty brains, but in the context that we live in a world that is not healthy for us.” Oppressive structures — colonialism, white supremacy, patriarchy and more — are seen as implicated in, if not directly responsible for, individual experiences of mental distress.

Furthermore, healing from trauma is seen as a tool in the fight for a better world. The Fireweed Collective “seeks to disrupt the harm of systems of abuse and oppression, often reproduced by the mental health system.” This falls in line with the ethical imperative stated in Standard E.5.c. of the ACA Code of Ethics for counselors to “recognize historical and social prejudices in the misdiagnosis and pathologizing of certain individuals and groups and strive to become aware of and address such biases in themselves or others.”

Practical applications

We can integrate the values and lessons from the mad pride movement into our practice by affirming what kind of relationship the client has, or wants to have, to their diagnosis. Some people feel validated or empowered by receiving a diagnosis that they believe reflects their lived experience. Others feel boxed in or inappropriately pathologized by their diagnosis. Standard E.5.d. in the ACA Code of Ethics states that counselors “may refrain from making and/or reporting a diagnosis if they believe that it would cause harm to the client or others.”

Similarly, some people have a positive relationship to their medication, feeling they benefit from it. Others feel disinterested in psychiatric medication or harmed by their experience with it. We can advocate for our client by collaborating with their doctor or psychiatrist to center the treatment goals and preferences of our client. By centering the self-reported lived experience of our client, we avoid harm while encouraging a sense of self-determination in treatment and, by extension, life — a healthy developmental marker for which we should be aiming.

Mad pride activists are often opposed to the practice of involuntary hospitalization. A growing body of research finds higher suicide rates post-discharge among those involuntarily hospitalized compared with the general population, raising questions about the effectiveness of involuntary hospitalization. One study published by JAMA Psychiatry in 2016 revealed a suicide rate approximately 15 times the U.S. national suicide rate within three months post-discharge. 

Regardless of the meaning we make or don’t make of such findings, counselors should consider them alongside mad pride narratives when faced with the decision to hospitalize someone. We can include these considerations in our ethical decision-making processes alongside “consultation; consideration of relevant ethical standards, principles, and laws; generation of potential courses of action; [and] deliberation of risks and benefits” as outlined in Standard I.1.b. of the ACA Code of Ethics.

What is disability justice?

According to Leah Lakshmi Piepzna-Samarasinha, author of Care Work: Dreaming Disability Justice, disability justice “centers sick and disabled people of color, queer and trans disabled folks of color, and everyone who is marginalized in mainstream disability organizing.” Disability justice asserts that ableism — discrimination against and oppression of the disabled — is “locked up tight” with all systems of oppression. The idea that disabled people require “fixing” underpins ableism. The disability justice framework arose out of a critique of the disability rights movement for failing to examine the roles of oppression and identity in experiences of ableism. It advocates for leadership by those most affected.

The disability justice framework builds off of the social model of disability. This model defines disability as resulting from an impairment (including pain, paralysis, fatigue, etc., that would exist regardless of society) plus inaccessibility. Inaccessibility is understood as a society that accommodates the needs of nondisabled people (such as the construction of stairs in buildings) while failing to accommodate the needs of disabled people. As such, disability is a social construct that happens only when an impairment meets an inaccessible society.

Although many issues raised by disability justice writers and activists are of relevance to counselors, the concept of sanism — discrimination and oppression of those who have (or are judged to have) a particular mental trait or condition — is of particular significance in mental health settings. Sanism is understood as a form of ableism. Some disability justice advocates view involuntary hospitalization as an example of sanism, conceptualizing the practice as a violation of basic human rights enabled by cultural stigma toward those with a mental illness or disability. Furthermore, we can consider the ways in which this stigma may be compounded by racial and other biases with the inclusion of an intersectional feminist lens.

Practical applications

Center and adopt your client’s identity and use of language on a case-by-case basis. Many counselors are taught to use person-first language (e.g., Sam has autism). However, increasing amounts of disabled people are asking to be referred to using identity-first language (e.g., Sam is autistic). This is why I’ve chosen to use identity-first language in this article. 

The rationale for this shift is due to an increasing acceptance of disability as an identity or part of who someone is rather than an illness or something to be cured or extinguished — the latter notion having historical roots in the eugenics movement. The nuances of language vary from individual to individual and disability to disability. If you are unsure what type of language your client prefers, simply ask.

Adopting a curious stance that avoids assumptions will assist you in your work with disabled populations and any marginalized or oppressed population with which you might not be familiar. Use the motto of the disability rights movement — “Nothing about us without us” — as your guide. Where did you learn what you know about disability? If it wasn’t from a disabled person or source, you should revisit and examine your knowledge base and assumptions.

Consider the ways in which explicit and structural ableism show up in your practice or at your workplace with the following questions: Is your workplace wheelchair accessible? Do you frame disability as either tragic or inspirational? Do you conceptualize the needs of your disabled clients with the same amount of depth and complexity as you would with your nondisabled clients? Is your workplace scent free? Do you speak for your disabled clients in situations in which they are able to speak for themselves? Have you ever asked invasive questions about the medical history of your disabled client? Do you view disability as something to cure? Do you feel like you need to rescue your disabled clients from their disability? How does ableism intersect with other forms of oppression to create unique social and institutional barriers for each client?

Also take some time to examine your internalized ableism. Do you ever feel like you’re a burden when you have a need? Do you ever feel like you don’t belong because of a perceived deficit? Do you feel “lazy” when you are unproductive? Do you blame yourself when you are unable to accomplish something? How comfortable are you when you need to ask for an accommodation? Do you compare yourself to more “successful” people? How does your internalized ableism interact with other forms of internalized oppression such as racism or sexism? Consider how the answers to these questions might influence how you conceptualize and work with your disabled clients.

There is an entire world of discourse and activism related to disability justice, the surface of which has barely been scratched in this article. Prominent scholars and activists to look to include Patty Berne, Mia Mingus, Stacey Milbern, Leroy F. Moore Jr., Eli Clare and Sebastian Margaret.


The mad pride movement understands external circumstances (poverty, racism, transphobia, etc.) as implicated in individual experiences of mental health. Similarly, disability justice views our dominant culture as “disabling” rather than locating disability exclusively within the individual. Peer support is a method with which these communities care for themselves, whether due to necessity, rejection of professional services or both. 

Knowledge of these perspectives enrich the tools of our profession rather than detract from them. Turning toward critical feedback allows us to repair historical and individual ruptures, broaden the scope of our practice and advocate for our clients while connecting them to helpful resources.


Links to referenced organizations and resources:

A woman at a march in Amsterdam in March 2020 holds a sign that says “Nothing about us without us,” the motto of the disability rights movement, in Dutch. ElenaBaryshnikova/Shutterstock.com



Luke Romano is an early career mental health counselor, educator and psychoanalytic candidate in Philadelphia. With a background in mad pride and other political activism, Luke is interested in the intersections of decolonial and anti-capitalist values and practice, psychoanalysis and the counseling profession. Contact Luke at luke.j.romano@gmail.com.


Counseling Today reviews unsolicited articles written by American Counseling Association members. To access writing guidelines and tips for having an article accepted for publication, visit 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.

From the President: October is National Disability Employment Awareness Month

Sue Pressman October 1, 2020

“Just because a man lacks the use of his eyes doesn’t mean he lacks vision.”

— Stevie Wonder

Sue Pressman, ACA’s 69th president

As counselors, we are privileged to work with people from every respective background and with varying abilities. In that light, I want to share that this year we are celebrating both the 75th observance of National Disability Employment Awareness Month and the 30th anniversary of the Americans with Disabilities Act (ADA). The Office of Disability Employment Policy (ODEP) aptly chose the theme of “Increasing Access and Opportunity” for this commemorative year. The 2020 events initiated by ODEP explore disability inclusion through the lens of workplace policies and practices that support mental health.

What does this all mean? Let’s review the ADA — historic legislation that changed the blueprint of the American workplace. As defined by the ADA, disability is “a physical or mental impairment that substantially limits one or more major life activities, a person who has a history or record of such an impairment, or a person who is perceived by others as having such an impairment.”

The passage of the ADA in 1990 was a new beginning for the nation, giving hope to so many people living with disability. However, the ADA was not the first piece of legislation that brought positive changes to the employment arena. The Rehabilitation Act of 1973 prohibited discrimination on the basis of disability in programs conducted by federal agencies, in programs receiving federal financial assistance, in federal employment and in the employment practices of federal contractors. Seventeen years later, on July 26, 1990, these “equal access to employment” practices were extended to the private sector of business and industry when the ADA was signed into law.

As we celebrate these momentous events, let’s take a brief look at some of the significant legislative outcomes:

  • Wheelchair access to transportation systems, sidewalk/curb and building ramps, etc.
  • Communication access: American Sign Language interpreters and closed captioning in the workplace, universities, hospitals, theaters, etc.
  • Braille: Use on signage, crosswalks, elevators, for hotel room numbers, in publications, etc.
  • Accessible technology via assistive software, TVs with captioning, accommodations in the classroom and in the workplace related to seating, testing, expanded time requirements, emergency notifications, etc.

Even so, we’ve just scratched the surface. People who have a disability are twice as likely to be unemployed. We need to be mindful that people of color with disabilities are disproportionately represented in the workplace at all levels. Almost 40% of African Americans with disabilities live in poverty, compared with 24% of non-Hispanic Whites, 29% of Latinos/as and 19% of Asian Americans with disabilities. People of color with disabilities face double marginalization, discrimination and stigma that lead to poor socioeconomic outcomes. For more, visit nationaldisabilityinstitute.org.

How can we as counselors increase employment access, opportunity and wellness for those living with disabilities?

  • Learn what barriers our clients with disabilities are facing. In other words, listen.
  • Empower clients to set, achieve and own their goals.
  • Educate ourselves, our clients and employment decision-makers about available resources at the federal, state and local levels.
  • Help clients understand their rights under the law, and help them identify and practice articulating their reasonable accommodation needs.
  • Understand the role that social media can play in connecting those who have a disability with potential employment opportunities.
  • During COVID-19 and times of crisis, help clients develop coping strategies.

As we honor the disability rights movement, it has never been more important to ensure that we all have a voice and that our unique needs and abilities are recognized.    

“We all have ability. The difference is how we use it.” — Stevie Wonder

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).


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.



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.”








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.