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

2. Hays & Erford, Developing Multicultural Counseling Competence: A Systems Approach (2 nd Edition) © 2013, 2009 by Pearson Education, Inc. All Rights Reserved 8-2 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. Hays & Erford, Developing Multicultural Counseling Competence: A Systems Approach (2 nd Edition) © 2013, 2009 by Pearson Education, Inc. All Rights Reserved 8-3 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. Hays & Erford, Developing Multicultural Counseling Competence: A Systems Approach (2 nd Edition) © 2013, 2009 by Pearson Education, Inc. All Rights Reserved 8-4 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. Hays & Erford, Developing Multicultural Counseling Competence: A Systems Approach (2 nd Edition) © 2013, 2009 by Pearson Education, Inc. All Rights Reserved 8-5 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. Hays & Erford, Developing Multicultural Counseling Competence: A Systems Approach (2 nd Edition) © 2013, 2009 by Pearson Education, Inc. All Rights Reserved 8-6 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. Hays & Erford, Developing Multicultural Counseling Competence: A Systems Approach (2 nd Edition) © 2013, 2009 by Pearson Education, Inc. All Rights Reserved 8-7 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. Hays & Erford, Developing Multicultural Counseling Competence: A Systems Approach (2 nd Edition) © 2013, 2009 by Pearson Education, Inc. All Rights Reserved 8-8 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. Hays & Erford, Developing Multicultural Counseling Competence: A Systems Approach (2 nd Edition) © 2013, 2009 by Pearson Education, Inc. All Rights Reserved 8-9 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. Hays & Erford, Developing Multicultural Counseling Competence: A Systems Approach (2 nd Edition) © 2013, 2009 by Pearson Education, Inc. All Rights Reserved 8-10 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. Hays & Erford, Developing Multicultural Counseling Competence: A Systems Approach (2 nd Edition) © 2013, 2009 by Pearson Education, Inc. All Rights Reserved 8-11 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. Hays & Erford, Developing Multicultural Counseling Competence: A Systems Approach (2 nd Edition) © 2013, 2009 by Pearson Education, Inc. All Rights Reserved 8-12 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. Hays & Erford, Developing Multicultural Counseling Competence: A Systems Approach (2 nd Edition) © 2013, 2009 by Pearson Education, Inc. All Rights Reserved 8-13 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. Hays & Erford, Developing Multicultural Counseling Competence: A Systems Approach (2 nd Edition) © 2013, 2009 by Pearson Education, Inc. All Rights Reserved 8-14 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. Hays & Erford, Developing Multicultural Counseling Competence: A Systems Approach (2 nd Edition) © 2013, 2009 by Pearson Education, Inc. All Rights Reserved 8-15 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. Hays & Erford, Developing Multicultural Counseling Competence: A Systems Approach (2 nd Edition) © 2013, 2009 by Pearson Education, Inc. All Rights Reserved 8-16 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. Hays & Erford, Developing Multicultural Counseling Competence: A Systems Approach (2 nd Edition) © 2013, 2009 by Pearson Education, Inc. All Rights Reserved 8-17 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. Hays & Erford, Developing Multicultural Counseling Competence: A Systems Approach (2 nd Edition) © 2013, 2009 by Pearson Education, Inc. All Rights Reserved 8-18 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