Disability Definitions, Diagnoses, and Practice Implications: An Introduction for Counselors

439 Pages·2019·2.238 MB·English

by  Julie Smart

DISABILITY DEFINITIONS, DIAGNOSES,
AND PRACTICE IMPLICATIONS
This introductory text defines and describes disability, while providing concrete
practice guidelines and recommendations for students in the fields of counseling,
social work, and other helping professions. Various specialty areas are explored
in detail, including marriage and family counseling, adolescent counseling,
addictions counseling, LGBTQ concerns, multicultural counseling, and career
counseling.
The first three chapters lay the foundation by discussing the demand for
counseling services by individuals with all types of disabilities; presenting
clinical, legal, medical/biological, and personal definitions of disability; and
describing physical, cognitive, and psychiatric disabilities. Next, author Julie
Smart examines core beliefs about disability using a range of first-person
accounts from individuals with disabilities (IWDs). The last seven chapters
focus on practice guidelines for various aspects of disability—including ethical
considerations, societal issues, social role demands, and individual responses—
and explore new possibilities for disability counseling professions.
With rich case studies woven throughout, as well as valuable information on
client needs, disability categorizations, and key Models of Disability, this essential
textbook will be useful not only to counseling students but also to professional
counselors, social workers, and psychologists.
Julie Smart, Ph.D. was Professor in the Department of Special Education and
Rehabilitation at Utah State University for twenty-four years. For ten years, she
was the Program Director of Graduate Programs in Rehabilitation Counseling.
She is also the author of Disability, Society, and the Individual.
“Dr. Smart, like all of her other scholarly contributions on disability, has once
again written an outstanding book for new and advanced social science stu-
dents and practicing counselors about working with people with disabilities.
This book ties together so many loose ends other similar books do not cover.
She explains what disability is for the many professionals who remain unsure
and explains various diagnoses using the ICF and DSM-V contemporary classifi-
cations. She blends current ethical, legal, and practice guidelines for counselors
that crosses practice disciplines in excellent fashion. Finally, she interweaves
personal account excerpts across various counseling disciplines, noting atti-
tudes, empathy, societal injustice issues and gender identity concerns, which
are exemplary and contemporary matters. This is a must read for undergradu-
ate and graduate students alike across disciplines.”
Irmo Marini, PhD, CRC, CLCP, FVE, certified rehabilitation counselor,
certified life care planner, Professor of Rehabilitation Counseling,
University of Texas Rio Grande Valley
“Dr. Smart is, indeed, a disability scholar. The strength of this book is the thor-
ough discussion of the impact that societal attitudes and perceptions have on
IWDs. This work integrates various models of research, technological, and med-
ical advances that positively transform the quality of life for IWDs. It compre-
hensibly defines and interprets complex laws, policies, movements, and disabil-
ity classification systems that govern programs, services, and systems for IWDs.
Dr. Smart’s passion for the multicultural nature of humanity drives this work.”
Mark A. Stebnicki, PhD, LPC, CRC, CCM, DCMHS, Professor,
Coordinator of Military and Trauma Counseling Program,
Department of Addictions & Rehabilitation,
East Carolina University
D I S A B I L I T Y D E F I N I T I O N S ,
D I A G N O S E S , A N D
P R A C T I C E I M P L I C AT I O N S
An Introduction for Counselors
Julie Smart
First published 2019
by Routledge
711 Third Avenue, New York, NY 10017
and by Routledge
2 Park Square, Milton Park, Abingdon, Oxon, OX14 4RN
Routledge is an imprint of the Taylor & Francis Group, an informa business
© 2019 Taylor & Francis
The right of Julie Smart to be identified as author of this work has been
asserted by her in accordance with sections 77 and 78 of the Copyright, Designs
and Patents Act 1988.
All rights reserved. No part of this book may be reprinted or reproduced or
utilised in any form or by any electronic, mechanical, or other means, now
known or hereafter invented, including photocopying and recording, or in any
information storage or retrieval system, without permission in writing from the
publishers.
Trademark notice: Product or corporate names may be trademarks or registered
trademarks, and are used only for identification and explanation without intent
to infringe.
Library of Congress Cataloging-in-Publication Data
Names: Smart, Julie, author.
Title: Disability definitions, diagnoses, and practice implications : an introduction
for counselors / Julie Smart.
Description: New York : Routledge, 2018. | Includes bibliographical references.
Identifiers: LCCN 2018014241 | ISBN 9781138244689 (hbk : alk. paper) |
ISBN 9781138244696 (pbk. : alk. paper) | ISBN 9781315276694 (ebk)
Subjects: | MESH: Counseling—standards | Disabled Persons | Counselors—standards |
Counseling—ethics | Disability Evaluation
Classification: LCC RC455.2.C65 | NLM WM 55 | DDC 362.2/04256—dc23
LC record available at https://lccn.loc.gov/2018014241
ISBN: 978-1-138-24468-9 (hbk)
ISBN: 978-1-138-24469-6 (pbk)
ISBN: 978-1-315-27669-4 (ebk)
Typeset in New Baskerville
by Apex CoVantage, LLC
CONTENTS
Preface vii
Introduction to the Chapters 1
1 A New Reality for Counselors 5
2 Defining, Diagnosing, and Measuring Disability 36
3 Models of Disability: Another Way to Describe Disability 76
4 Six Core Beliefs About Disability of Highly Empathetic Counselors 126
5 Ethical Considerations and General Practice Guidelines 163
6 Understanding the Experience of Disability: Counseling
Practice Guidelines 199
7 Integrating Counseling Practices with Societal Issues 240
8 Understanding the Individual’s Response to Disability:
Counseling Practice Guidelines 284
9 Understanding Social Role Demands of Individuals With
Disabilities: Counseling Practice Guidelines 332
10 Responding to Some Unique Demands of Disability:
Counseling Practice Guidelines 379
11 New Horizons for the Counseling Professions 402
Case Studies 406
Index 417

PREFACE
I wanted to write a book that provides basic counseling guidelines for working
with individuals with disabilities (IWDs). Throughout 24 years as a professor at
Utah State University, I searched for such a book to use in the courses I taught
and could not find one. Of course, there were many books on counseling, but
these books did not discuss clients with disabilities and there were also books
on disability, but these books did not mention counseling practice guidelines.
I promised myself that, when I had time, I would write this book. This is the
book. Counselors working with IWDs will find their professional and personal
lives enriched, strengthened, and expanded.
Counselors, social workers, and psychologists will be working more and more
with IWDs. However, ethical principles warn against professionals working out-
side their areas of competence. This book seeks to begin a reconciliation of
these two realities: 1) the need of IWDs for effective and empathic counseling
services and 2) the lack of disability training for most counselors, social work-
ers, and psychologists. It is my hope that this book will serve as a starting point
to learn about IWDs.
Some counseling professionals might think, “I’ve already been trained in
disability issues.” However, much of this disability training is based on unques-
tioned assumptions and does not reflect the daily lived experience of IWDs.
If the most important aspect of counseling is the relationship between profes-
sional and client, two concerns must be addressed: 1) counseling professionals
will be required to learn about the disability experience, and 2) it is essential for
counselors to examine their own feelings and reactions toward disability and
the individuals who experience them.
Like everyone else, counseling professionals live in a society that is perme-
ated with media that present unrealistic and demeaning portrayals of IWDs,
including the “brave inspiration” and the “pitiful, helpless cripple.” Neither is
realistic; but these portrayals are often incorporated into public attitudes toward
IWDs. Therefore, much of acquiring knowledge and experience of disability
viii preface
and the people who experience them will require a great deal of unlearning. It
may not be an exaggeration to say that counseling professionals possess little
knowledge, skill, and experience with IWDs and most of these are unrealistic
and demeaning to IWDs.
Most IWDs consider themselves to be normal people with the same typical
concerns and life tasks as anyone else. Their disabilities are a valued part of
their self-identity but not the most important aspect. Rather, most IWDs have
multiple roles and their self-identities are multifaceted. Counselors, social
workers, and psychologists might be inclined to refer clients with disabilities
to rehabilitation counselors and other allied health professionals. This may be
considered defining the individual by their disability. IWDs will seek out such
counseling, social work, and psychological services in the following areas: child
and adolescent, marriage and family, military and veterans, career counseling,
addictions, LGBT issues, academic, and many other types. Therefore, profes-
sionals with training, skill, and experience in these specialties will be required
to gain knowledge, skills, and experience in serving IWDs.
Should professionals be “disability blind,” ignoring the client’s disability? No,
but counselors should not define the client by their disability nor think that
the client obsesses about their disability 24/7. It will not be possible to build an
empathic relationship without understanding the client’s disability, including
their perceptions and reactions.
This book is intended as an introductory broad overview on disability. Using
the analogy of the elephant, I think it is important to gain a picture of the entire
elephant, learning how each of part of the elephant fits together. So, rather
than learning a great deal of detail about one specific part of the elephant’s
anatomy, such as the ears, a broad overview of the whole elephant is provided.
My hope is that presenting a broad picture of disability, sacrificing detail, will be
a helpful, logical start to learning about disability.
Two chapters are devoted to defining and describing disability, including
those characteristics that are not disabilities. The clinical, legal, cultural, and
personal definitions are discussed. Seven chapters describe practice guidelines.
I thought it important that readers gain some introduction to disability before
reading about professional guidelines. For example, it worries me when I read
articles about disability in the academic literature because I don’t think that
most readers know what disability is. Therefore, I wrote two chapters that define
disabilities. For specific types of disabilities, readers can access information
in the International Classification of Functioning (ICF) published by the World
Health Organization or the Diagnostic and Statistical Manual of Mental Disorders-5
(DSM-5) published by the American Psychiatric Association.
preface ix
Finally, I use many first-person accounts because these short excerpts illus-
trate concepts and, furthermore, it is important to understand the experience
of IWDs themselves. I am grateful to these authors for allowing me to use
their experiences. Occasionally, I have used the same excerpt in two or three
chapters because these particular accounts illustrate two or three important
points. I simply thought that re-writing the excerpt would be easier for read-
ers, rather than referring them back to previous chapters.
It is my hope that social workers, counselors, and psychologists will find my
book helpful.
Julie Smart
February 9, 2018
Salt Lake City, Utah