Counseling Persons with Disabilities

Contributors:
James T. Herbert, The Pennsylvania State University

Approximately 57 million people (20% of the total population) in the United States report having one or more disabilities, and as people age, the prevalence of disabilities becomes higher. For example, only about 12% of children have a documented disability, but for persons 65 years and older, the incidence is 50% (U.S. Census Bureau, 2012). Depending on one’s professional preparation, various counseling disciplines address disability on a continuum of being a central part of graduate training (e.g., rehabilitation counseling) or a less centralized role that depends largely on specialized disability practice areas (e.g., long-term mental illness, substance abuse), professional function (e.g., family counselor, clinical mental health counselor) and/or work setting (e.g., schools, clinics). A diversity in formal training and clinical supervision has resulted in varying levels of preparation for counselors working with people with disabilities (e.g., Dipeolu, 2011; Madaus & Shaw, 2007). This practice brief is intended to help counselors who have limited training in disability aspects and may benefit from resource information to inform professional practice. For the purposes of this practice brief, disability refers to broad categories that impact cognitive (e.g. learning disability), physical (e.g. persons with spinal cord injuries), sensory (persons who are Deaf), and emotional functioning (persons with long-term, persistent mental illness).

Counselor Attitudes and Interactions

When interacting with persons with disabilities, the general public consistently reports anxiety, fear, and social interaction strain as common experiences (Strauser, O’Sullivan, & Wong, 2010; Vash & Crewe, 2004). These reactions vary as a function of the type of disability and the perceptions attributed to persons without disabilities. For example, those who have a disability and drug and alcohol addictions may be perceived more negatively than those who have a learning disability. In accounting for this difference, greater knowledge and quality or nature of contact with persons with disabilities often mediates one’s attitudes and level of acceptance (McManus, Feyes, & Saucier, 2011).

Smart and Smart (2006) outlined several theoretical views that have important implications for how professional counselors may perceive and interact with people with disabilities. Counselors who perceive persons with disabilities as individuals striving to achieve “normality” share a biomedical view where disability is defined within a comparative framework of what is lacking, and therefore what must be corrected on an individual level (e.g., correcting one’s faulty thinking and perceptions about the disability experience). In contrast to this traditional view, functional and environmental models view disability as an interaction between individual and environmental influences. Counselors must address both of these aspects in order to promote change. For instance, a person with a spinal cord injury may have a clear and realistic career goal, but if the person does not have access to reliable transportation, the counselor would be remiss not to address this environmental consideration. Finally, a more recent view of disability is the sociopolitical or minority model of disability which argues that the major barrier for persons with disabilities is not associated with physical barriers (e.g., wanting to eat at a restaurant that has no ramp for persons who use a wheelchair), but rather the pervasive and hidden barriers resulting from societal attitudes and their expression in interpersonal relationships. These attitudes are historically embedded in our culture and promote beauty, health, and wellness, so anything--or anyone--deviating from idealized views of normality are devalued. From this viewpoint, counseling interventions must help to empower clients to gain full access to the same rights and privileges that people without disabilities enjoy. These views provide a context for counselors to determine how client problems are defined and addressed in practice.

Resources and Interventions

Employment rate comparisons between persons with and without disabilities indicate a significant disparity. Recent data indicate that while 65% of persons without disabilities are employed, only 17.5% of people with disabilities are employed (Bureau of Labor Statistics, 2016). Given this disparity, counselors are likely to address career and employment issues as a focus of their individual practice. Using earlier conceptual models as to how one views disability, successful vocational outcomes are contingent upon the counselor understanding the complex relationship among individual, employer, and societal influences (Strauser, Wong, & O’Sullivan, 2012). These influences recognize that many persons with disabilities have limited awareness of career and employment opportunities (Ochs & Roessler, 2004), and applying traditional career development approaches to address this problem is of questionable value (Rojewski, 2002). Experientially-based assessments (e.g., interviews with employers, job shadowing, situational assessments) as opposed to relying on conventional paper-and-pencil career assessments are needed to better understand and develop effective interventions to address employment barriers (Herbert, Trusty, & Lorenz, 2010). In addition, facilitating career and employment outcomes may require professional counselors to advocate directly or use available community resources to advocate on the client’s behalf. In practice, it means that simply focusing on the individual client with a disability to promote career awareness and assisting in the employment process is insufficient without acknowledging and often working directly with employers as well. With this background introduction, professional counselors may find the following resources useful to their practice to improve quality of life for persons with disabilities.

CareerOneStop (COS)
COS centers provide online information that assist persons with career information (e.g., education and training needed, employment outlook, salary and benefits), job preparation requirements (e.g., job interview, resume), and current job listings. This resource may be particularly helpful for clients who are more self-directed and independent in their career development and job placement efforts. On-site visits to a local COS center provide job seekers with access to computerized and hard-copy information (Social Policy Research Associates, 2009). In addition, having COS staff with disability expertise to work with persons with special needs, many of whom have limited computer and English literacy skills, presents additional challenges and may require more direct involvement by other helping professionals. Additional information can be found by contacting 877-872-5627 or TTY at 877-889-5627 or through the COS website at http://www.careeronestop.org.

disABILITY Information and Resources
This website contains links to about 70 disability information categories, and within each category, there are many other links that provide information regarding disability-related products that enhance independence and quality of life, augmentative communication and other assistive technology devices, car/van modifications and lifts, wheelchair recycling, home accessibility and design, travel and recreational resources, pain management, health and wellness, legal and advocacy resources and job training, placement and employment, national and international disability organizations, caregiver resources, independent living, and senior living resources. The website is www.makoa.org.

Job Accommodation Network (JAN)
JAN provides free consultation services related to workplace accommodations and disability employment issues (JAN, 2014). Supported through the U.S. Department of Labor, JAN provides information on products, services, accessible technology, disability legislation, and entrepreneurship options for persons with disabilities with the aim of helping people with disabilities gain or sustain employment. JAN also has trained workplace accommodation experts who can assist counselors to identify ways to modify the workplace that is accessible to all persons. There are over 300 disability-specific publications as well as a Searchable Online Accommodation Resource (SOAR) site that provides assistance in determining possible accommodation options for persons with various disabilities that may be used in both educational and work settings. The website for JAN is https://askjan.org. The toll-free number is (800) 526-7234 or TTY (877) 781-9403.

National Rehabilitation Information Center (NRIC)
NARIC serves as the library for the National Institute on Disability, Independent Living and Rehabilitation Research (NIDILRR). The database contains over 70,000 documents (books, compendia, curricula, journal articles, reports of limited circulation, research projects) and over 80,000 abstracts of research literature available through REHABDATA. Persons wanting to obtain copies of these materials pay a fee of five cents per page, which includes shipping and handling. There is a minimum charge of $5.00 for each order. Contact information is available at (800) 346-2742/TTY at (301) 459-5984, orhttp://www.naric.com/.

National Disability Rights Network (NDRN)
NDRN is a non-profit association of two agencies affiliated with protection and advocacy and client assistance programs. NDRN is the “largest provider of legally based advocacy services to people with disabilities in the United States” (NDRN, 2014). The protection and advocacy agencies monitor, investigate, and address situations that interfere with persons with disabilities having full access to educational programs, employment, financial entitlements, healthcare, and housing. The client assistance programs provide assistance to persons who are seeking or receiving state vocational rehabilitation services and are considering pursuit of legal or other remedies. Further information about NDRN can be found by visiting: http://www.ndrn.org/en/about/paacap-network.html.

Professional Organizations
Several professional organizations offer training in disability, rehabilitation counseling, and case management practices, and these include: the American Rehabilitation Counseling (http://www.arcaweb.org), American Psychological Association – Division 22 (Rehabilitation Psychology) (http://apa.org/about/division/div22.aspx) Council on Rehabilitation Education (http://www.core-rehab.org), International Association of Rehabilitation Professionals (http://www.rehabpro.org), National Rehabilitation Counseling Association (http://nrca-net.org), and Rehabilitation Counselors and Educators Association (http://rehabcea.org). Information about professional conferences, newsletters, and professional journals can be found by visiting these websites. Those interested in pursuing a specialty as a rehabilitation counselor may want to review a YouTube video entitled “The Art of Rehabilitation Counseling by CRCC” which can be found at: https://www.youtube.com/watch?v=nCZVNg3dhrU.

State Vocational Rehabilitation Office (OVR)
Each state and U.S. territory has an office of vocational rehabilitation whose sole mission is to improve the quality of life for persons with disabilities and help them find meaningful employment and careers commensurate with their abilities, interests, skills and temperaments. Although some states (e.g., Arkansas, Delaware, Florida, Iowa, Pennsylvania) have separate offices for persons who are blind or have vision loss and another office that serves all other disability groups, most states have one general office that serve all clients. In order to obtain vocational rehabilitation services, the person must be determined eligible. Simply having a disability may not necessarily mean that one can receive services. Given that states do not have sufficient financial resources to serve the volume of persons with disabilities, an “order of selection” has been developed to determine which individuals receive services. This process means that states, as required by federal law, must prioritize services for persons who have the most significant disabilities and functional limitations. Once the person is found eligible, he or she may receive any number of employment-related services that include: assistive technology, counseling, diagnostic services, educational and/or vocational training, job placement assistance (e.g., job-seeking training, job development, vocational evaluation), restoration services (e.g., physical, occupational, or speech therapy) and/or support services (e.g., post-employment services). A complete list of state vocational rehabilitation agency contact information can be found at:http://www.fda.gov/downloads/AboutFDA/WorkingatFDA/UCM277757.pdf

Vocational Rehabilitation and Employment (VR&E)
The VR&E program assists veterans with service-connected disabilities to identify, prepare for, and obtain suitable employment and/or promote independence. Eligible service members who receive an honorable discharge with at least a disability rating of 10% that results in an employment handicap of 20% or higher and that was incurred or aggravated by their military service are entitled to career counseling and employment-related services (e.g., on-the-job training, non-paid work experiences; see Title 38, United States Code, Chapter 36). The VR&E Program stipulates that veterans are entitled to services for up to 48 months and can receive services within a 12-year period of eligibility from the date of the initial disability rating notification to use services. In some cases, particularly with veterans who have more significant disabilities such as those with spinal cord injury or traumatic brain injury, this time period is compromised because initial medical rehabilitation can take several years before a veteran may be ready to pursue employment and, for this reason, a recommendation to increase the time period has been made by disability advocates (Paralyzed Veterans of America, 2014). Additional information about the VR&E Program can be found at http://www.benefits.va.gov/vocrehab/.

Advocacy Networks and Blogs Focused on Specific Disabilities
One final and important information resource that counselors should explore involves the various advocacy networks and specific blogs that discuss living with a specific disability. These resources and discussion groups can provide counselors with a broader framework that is often absent in the professional literature. Examples of blogs are provided in the disABILITY information and resource citation noted earlier (i.e., http://www.makoa.org). There are hundreds of blogs available that communicate the full range of a disability experience. These communication networks are not only important resources for counseling professionals, but they also provide social connections to persons living with a disability.

REFERENCES

Bureau of Labor Statistics (2016). Economic news release persons with a disability: Labor force characteristics summary. Retrieved from http://www.bls.gov/news.release/disabl.nr0.htm.

 Dipeolu, A. O. (2011). College students with ADHD: Prescriptive concepts for best practices for career development. Journal of Career Development, 38, 408–427. doi: 10/1177/0894845310378749.

 Herbert, J. T., Trusty, J., & Lorenz, D. C. (2010). Career assessment practices for high school students with disabilities and perceived value as reported by transition personnel. Journal of Rehabilitation, 76, 18–26.

 Job Accommodation Network (JAN). (2014). Ask JAN. Retrieved from https://askjan.org.

Madaus, J. W., & Shaw, S. F. (2007). The role of school professionals in implementing Section 504 for students with disabilities. Educational Policy, 22, 363–378. doi:10.1177/08959004807307069.

McManus, J. L., Feyes, K. J., & Saucier, D. A. (2011). Contact and knowledge as predictors of attitudes toward individuals with intellectual disabilities. Journal of Social and Personal Relationships, 28, 579–590. doi: 10.1177/0265407510385494.

National Disability Rights Network (2014). Protection & advocacy for individuals with disabilities. Retrieved from http://www.ndrn.org/index.php.

Ochs, L. A., & Roessler, R. T. (2004). Predictors of career exploration intentions: A social cognitive career theory perspective. Rehabilitation Counseling Bulletin, 47, 224–233.

Paralyzed Veterans of America. (2014). Submission for the record of Paralyzed Veterans of America. Hearing on 02/27/2014: A review of the effectiveness of the VA’s vocational rehabilitation and employment program. Retrieved from https://veterans.house.gov/submission-for-the-record/paralyzed-veterans-of-america-37

Rojewski, J. W. (2002). Career assessment for adolescents with mild disabilities: Critical concerns for transition planning. Career Development for Exceptional Individuals, 25, 73–95. doi: 10.1177/088572880202500106.

Smart, J. F., & Smart, D. W. (2006). Models of disability: Implications for the counseling profession. Journal of Counseling & Development, 84, 29–40.

Social Policy Research Associates. (2009). Findings from a study of one-stop self-services: A case-study approach. Retrieved from http://wdr.doleta.gov/research/FullText_Documents/ETAOP_2011-16.pdf

Strauser, D. R., O’Sullivan, D., & Wong, A. W. K. (2010). The relationship between contextual work behaviors self-efficacy and work personality: An exploratory analysis. Disability and Rehabilitation, 32, 1999–2008.

Strauser, D. R., Wong, A. W. K., & O’Sullivan, D. (2012). Career development, vocational behavior, and work adjustment. In D. R. Maki, & V. M. Tarvydas (Eds.), The professional practice of rehabilitation counseling (pp. 311–335). New York, NY: Springer.

U. S. Census Bureau. (2012). Nearly 1 in 5 people have a disability in the U.S., Census Bureau reports. Retrieved from https://www.census.gov/newsroom/releases/archives/miscellaneous/cb12-134.html

Vash, C. L., & Crewe, N. M. (2004). Psychology of disability (2nd ed.). New York, NY: Springer Publishing.

Published: September 2016
Updated: September 2016