Dr. Susan Stuntzner PhD, LPC, LMHP-CPC, CRC, NCCOregon Counseling Association 2013 Fall Conference

November 8, 2013

An Inside Look at the World of Disability: Enhancing

Counselors’ Skills in Addressing the Needs of

Individuals with Disabilities

1.Name2. Background/Employment3. Interest or Draw to this Session4. Something Interesting….

Getting Acquainted

1. Passionate about topic.2. Disability is an experience typically misunderstood.3. There is an increased demand for professionals to understand this population.4. Understanding is key to be an effective helper/professional.5. Provision of a starting place for further learning.

Rationale

1.Enhance counselors’ understanding of personal and societal barriers of persons with disabilities (PWDs)

2. Increase counselors’ ability to assist clients in uncovering and addressing their feelings following disability

3. Discover methods to empower and enhance counselor effectiveness when working with PWDs

Objectives

Other Areas of Interest ?

1. Getting Acquainted 2. Rationale/Objectives 3. Laying for Foundation of Disability4. Experiencing “What it might be like…….”5. Understanding Personal/Societal Barriers6. Issues of Concern to Persons with Disabilities7. Techniques to Address Personal Concerns8. Increasing Counselor Effectiveness

Overview/Agenda

As we move forward keep in mind the:

1. populations you work with or hope to counsel;2. challenges or concerns you face as a professional;3. ways you could apply this information;4. additional knowledge or skills you want to know.

Moving Forward…

Take a moment to ponder:

DISABILITYPay attention to your thoughts and feelings this word evokes…

What aspects of counseling persons with disabilities are ambiguous or challenging to

you?

How might your feelings and experiences affect the

counseling relationship?

Increasing Your Understanding of the Experience of

Disability:“VISUALIZATION”

1. PWDs hear messages about what they can’t do.2. PWODs have a history and tendency to separate themselves from PWDs. This creates more social isolation. (Siller et al., 1967; Smart, 2009)

3. PWDs receive conflicting messages from many directions.

Q: Who should they believe?4. PWDs don’t want be referred to as a “label” or a “condition”. Q: Where is the compassion or the humaneness?

5. PWDs’ personal boundaries are often not respected. 6. Poor attitudes about disability are not the sole responsibility of PWDs. (Stuntzner, 2012)

Some Thoughts to Consider

“Barriers reported by persons with disabilities may “sound” out-of-the-ordinary unless you have

had exposure to the many obstacles encountered and first-hand experience in seeing what

that might look like….”

Personal & Societal Barriers

How might the differences in

counselors’ and clients’ perceptions

affect the therapeutic relationship?

- Perceptions about client motivation- Trust or lack of trust between people - Level of involvement – client stops coming to counseling- Mismatched counseling approaches - Inadvertent promotion of negative attitudes toward PWDs - Quality of therapeutic relationship

Possible Outcomes…

Examples of Personal & Societal Barriers (See References)

Personal» Self-concept/self-esteem» Beliefs about abilities» Family (+/-)» Learned helplessness» Lack of self-advocacy

skills» Coping skills/Negative

emotions» Meaning & integration

of disability

Societal» Poor attitudes» Stigma attached to cause» Architectural barriers» “Second-class” citizenship» Reduced access & quality

of services» Employer attitudes /

assumptions» Religious beliefs &

disability (+/-)

Example: Ways Perceptions about

Disability Vary…

Enhancing Effectiveness Tip: Make note of discrepancies in perceptions between you and your clients. Consider

all the information……

Clinical Issues of Interest to PWDs

Adjustment & AdaptationFamily Roles & ChangesCaregivingAccess to ResourcesInsurance Options & Health CareRelationships /S. SupportIntimacy / SexualityGrief & LossSelf-advocacyCoping (i.e. Depression)Motherhood/WWDsInaccurate Myths

Societal & Environmental BarriersSubstance AbuseChanges Following DisabilityIndependent LivingBody-image/ AttractivenessSpirituality / ForgivenessResiliencyCareer Decision-makingSocial Security

Enhancing Effectiveness Tip:Consider your beliefs,

comfort level, and skills in exploring the issues of

importance to persons with disabilities….

Counseling Techniques: Getting

to the Source

Given what we know thus far, how does a counselor determine

his or her starting place?

Some professionals may naturally consider a person’s:(a) coping skills (+/-)(b) thoughts/emotions (+/-)(c) level of denial(d) ability to practice acceptance(e) family, personal/social support(f) self-identity or self-esteemWhile all these are good ideas, there is the whole “realm of life” that differs and is altered because of disability……

A Counselor’s Natural Tendency……

1. Listen to the person’s concerns.2. Sort out priorities and which ones relate to disability.3. Assess how these areas affect a person’s overall level of functioning, independence, adjustment, happiness, emotional well-being.4. Choose a direction, techniques, and approaches.

Uncovering the Source of Hurt….

Very similar to models of grief & loss, there are ways to conceptualize and understand adjustment to disability.

Best practice is to understand a few of these:

-Stage Models (Livneh & Antonak, 1997)-Ecological Models (Scofield et al., 1980)-Psychosocial Adaptation (Wright, 1983)

Understand Disability Through the Process of Adjustment

Negative emotions are commonly a part of the process.

-What function are they serving?-Are they serving to sustain a person until s/he can get to a better place?-Are they impeding healthier functioning?-What if these feelings are justified?

Negative Emotions Following Disability are Normal

1. Learning to deal with negative emotions2. Coping with life changes following disability 3. Finding one’s own voice4. Educating self about disability 5. Teaching others how to respect and “treat” you6. Developing resiliency skills7. Learning how to forgive self, others, and God8. Knowing how to infuse self-compassion into one’s own life9. Being a well-skilled self-advocate

Counseling Techniques & Approaches

* Be willing to educate yourself about disabilities and peoples’ needs.* Do not generalize or “group” PWDs together (Smart, 2009)* Recognize your limitations. Own your beliefs & expectations.* Treat PWDs as a person, not their disability.* Be willing to “hear” their concerns. * Match your approach to their adjustment needs and reported issues of concern (i.e., multiple layers).* Teach people to help themselves. Do not caudle.* Look for strengths and solutions.* Know that disability affects more than the person (Reichman et al., 2008).* Seek supervision….. (Stuntzner, 2012; Stuntzner, in press)

Being an Effective & Approachable Counselor

Application Exercise: Case of

Anne