Understanding Disability and Ableism in Counseling

1. CHAPTER 8:Disability, Ableism, and Ageism Developing Multicultural Counseling Competence: A Systems Approach Second Edition Danica G. Hays and Bradley T. Erford

2. Disability Defined • Economic security - extent that family or society has resources available for support of individuals who are aged, young, ill, or disabled • Definition of disability varies greatly • Social Security Administration • Americans with Disabilities Act (ADA) and other federal nondiscrimination laws • Individuals with Disabilities Education and Empowerment Act (IDEIA) • State Vocational Rehabilitation (VR) Programs

3. Types of Disability • Blindness/vision impairment • Deafness/hearing impairment • Developmental delay in one or more areas of: • Physical development • Cognitive development • Communication / language development • Social / emotional development • Adaptive development • Traumatic brain injury that causes cognitive & learning/memory disability

4. Types of Disability Cont. • Severe medical conditions such as heart/cardiovascular disease, diabetes, sickle cell anemia, HIV/AIDS, gastrointestinal difficulties, respiratory/pulmonary disease • Mental retardation • Neurological impairments • Orthopedic/musculoskeletal impairments • Psychiatric/mental illness

5. Disability Statistics • The U.S. Census Bureau (2006) suggests that there are approximately 51.2 million people (18.1%) with disabilities • 32.5 million with a severe disability • Older people are more likely than younger to have a disability. • 19.5% of females and 16.7% of males have a disability

6. Models of Disability • Paradigm shift with models moving away from medical models to include social model • Smart & Smart (2006) proposed 4 broad models of disabilities • Medical model - disability/illness occurs as the result of a physical/mental condition • Social model - focus on societal barriers & biases against people with disabilities, not on the person, the disability or medical condition

7. Variations on the Social Model of Disability • Disability is more than the individual’s differences and include attributes outside of the individual • Disability is highly correlated with low education, poverty, community setting, environment, and low resources • Pathology  Impairments  Functional limitations  Disability • Helpful for counselors to gain a greater understanding of the disability process because it considers potential risk factors that influence the onset of pathology • The model also considers extraindividual intervention strategies

8. Counseling Individuals with Disabilities • Understand that different societies view disabilities differently • Understand intersecting roles: • Role of the individual - the role that a person with a disability is expected to have in the community influences the willingness of the community to integrate the person into the culture; possible tension & conflict of views • Role of the family - conflicting views of individuals from Western cultures & other cultures about basic rights of individuals with disabilities & cultural beliefs • Role of the community - individuals with disabilities in the workforce either viewed as rehabilitative or abuse/neglect by family

9. Counseling Individuals with Disabilities • A subgroup of clients with a disability who are seeking counseling are combat soldiers / veterans with war wounds (either physical or psychological) • Have higher rates of polytrauma – two or more permanent injuries to the body which result in physical, cognitive, psychological, or psychosocial impairment and functional disability • Consider the following when counseling veterans: • May need to change from “we” mentality of military to “I” mentality in order to plan and achieve goals • Cultural background is an important factor • Service member’s strengths and limitations are important to note in order to overcome barriers

10. Ableism • Ableism - social attitudes, policies, rehabilitation & counseling practices that favor individuals who have full physical and mental abilities • Focus on the role of the larger society: cultural attitudes, beliefs, & perceptions • Individuals with disabilities are excluded from social power & full access to resources • Some cultures assign a value or meaning to one’s condition

11. Disability, Ableism, & the Counseling Process • Understand the complexity, sensitivity, & variability of how these concepts are portrayed in our culture • Awareness: • Become more aware of ableism & its effects on individuals with disabilities • Advocate for individuals with disabilities • Have an understanding of & appreciation for clients’ needs, across cultures

12. Disability, Ableism, & the Counseling Process Continued • Knowledge: • Have knowledge about past historical events & U.S. disability legislation • Understand the rehabilitation service delivery system and laws that govern the system are not “culture free” • U.S. Department of Veteran Affairs • Social Security Act • Soldier Rehabilitation Act • State based worker compensation laws • Civilian Rehabilitation Act • Elementary & Secondary Education Act of 1965 • Education for All Handicapped Children Act of 1975 • Individuals with Disabilities Education Improvement Act of 2004 • Americans with Disabilities Act (ADA)

13. Disability, Ableism, & the Counseling Process • Skills • Assess the client’s feelings about experiences of having a disability, one’s own understanding of these experiences, & how it interplays with one’s identity • Recognize that most clients with a disability may view their disability as a basic & valued part of their identity • Collaborate with the client in identifying & promoting full participation & integration into society based on identities & roles • Avoid imposing own values on the client with a disability • Be knowledgeable about various topics related to disability issues • Establish professional relationships with agencies that serve people with disabilities • Create effective change within local, regional, state, & national policies/systems • Contribute to research efforts

14. Age Demographics • Estimated that by 2030, 20% of the population will be comprised of older adults • 35 million Americans are 65 years of age • The number of people over 65 is expected to double and the number of people over 85 is expected to triple • Baby boomers - individuals who were born between the years 1946-1964 • The advancing age of the baby boomers, the increased life expectancy of older adults, & increased racial & ethnic diversity of older adults will put more emphasis on social policies that directly benefit older adults

15. Ageism • Ageism - the assumption that chronological age is the main determinant of human characteristics & that one’s age is better than another • Form of discrimination against those age groups with higher vulnerability & less access to resources & power • Adultism - discrimination against young people & children • belief that young people are ignorant, untrustworthy, unpredictable, & have nothing to contribute to their well-being or society

16. Ageism & Older Americans • Distinct psychological & physical issues associated with aging may result in experiences with ageism • changes in skin, hair, voice, height, & mobility • age-related medical/health conditions may impact the therapeutic relationship • reduction of independence & ability to take care of themselves • dementia & loss of spouses, family members, & aging friends • socioeconomic & employment issues. • U.S. Age Discrimination Act of 1996 • Older Americans Act Amendment of 2006

17. Age, Ageism, & the Counseling Process • Counselors should facilitate guiding older clients in making informed decisions & showing respect for the client’s years of life experiences, knowledge, & expectations that form the client’s individual decisions • Gerontological counselors-provides counseling services to elderly clients & their families when faced with changing lifestyles as they grow older. • Gerontological Competencies for Counselors & Human Development Specialists adopted by the ACA.

18. Age, Ageism, & the Counseling Process Continued • Awareness • Be aware of own attitudes toward individuals of various age groups • Knowledge • ACA Gerontological Competencies • Standards of the Council for Accreditation of Counseling and Related Educational Programs (CACREP) • Skills • Facilitate clients’ ability to build upon the positive aspects of aging • Foster successful aging