Oppression within the counselling room

This paper suggests that the oppression experienced by disabled people in society is sometimes replayed in the counselling room by counsellors who are unaware of their own disablist attitudes and prejudices. Whilst the provision of Disability Equality Training (DET) within counselling courses would ameliorate the problem, I believe that disabled people would be most empowered by a counselling approach which recognises the potential for oppression within the counsellor‐client relationship. One solution may be the creation of a new counselling approach (disability counselling) which includes the social model of disability as one of the foundations. An alternative solution may be found within the emerging counselling approaches that treat counselling as a social and political process and place emphasis on developing comprehensive anti‐discriminatory practice.     

Counselling,autism and the problem of empathy

The experiences of disabled people suggest that ableism insidiously and invasively impacts upon the practice of counselling and related therapies. This article critiques a particular account of psychotherapy with a child with the label of autism to illustrate how ableism can disrupt the process of empathy and negate the therapeutic experience. In so doing the article highlights the inherent difficulties in traversing different epistemic positions to make sufficiently informed readings of counternormative expressions of being. General principles of counselling practice are then proposed to support practitioners with providing effective therapy for all clients.     

The Visual Foucauldian: Institutional Coercion and Surveillance in Frederick Wiseman's Multi-handicapped Documentary Series

During the mid 1980s, the renowned American documentary filmmaker Fred Wiseman produced a four-part series of films that sought to record the operations of institutions in Talladega, Alabama, devoted to the care and training of people with disabilities. These films—designated as the Multi-handicapped Series—have received much less attention than Wiseman's earlier work, as if films about disability mark a drastic departure from his previous award-winning productions, such as Titicut Follies (1965) and Hospital (1970). The Multi-handicapped Series takes up general categories of disabled populations as discrete documentary topics, Deaf (1986), Blind (1986), Multi-handicapped (1986) and Adjustment & Work (1986) as opposed to a specific location as in his earlier films. As a result, the latter series of films identify social and interpersonal structures developed in the name of specific conditions. Like Foucault's research on disciplinary tactics, Wiseman's films seek out many of the segregated social spaces typically occupied by persons classified as deviant: prisons, hospitals, charity networks, sheltered workshops, resident facilities, and vocational training structures. The Multi-handicapped Series focuses on the activities of professions and practitioners in education, administration, and therapy, as well as the institutional roles designed for bodies marked as disabled. Unlike its 19th century predecessor classification, feebleminded, the latter twentieth century U.S. policy answer has been waged as a matter of dividing disabilities into a binary structure of orthopedic or cognitive categories. Such a development has left many crossover bodies in a diagnostic no-body's-land. To analyze the history of these developments, this essay recognizes the formation of today's disability category as an effect of new regimes of power; a form of domination based upon the application of particularized diagnostic pathologies that provide the basis for cordoning off bodies which fail to fit neatly within the cognitive/orthopedic binary. As documents of the social spaces that are occupied by disabled people, Wiseman's films offer a rare contemplation of institutional practices and their application to populations viewed as nonnormative.     

Towards a social model approach to counselling disabled clients

The social model of disability has emerged over the past 30 years in Britain to challenge the dominant individual, particularly medical and tragedy, models. This social model is borne from the experiences of disabled people and essentially defines disability as the discrimination faced by people with impairments. This paper explores the possible conflicts between some counselling approaches that can individualise and personalise problems and disability as a political issue. Drawing on research with counsellors and disabled clients, we illustrate the social construction of disability as an individualised problem within the counselling process. Considering the implications for counselling practice, we argue for an approach to counselling which recognises the social model of disability as the basis for social change.     

Reconsidering the Social Location of the Medical Model: An Examination of Disability in Parenting Literature

This paper challenges the view that there is one medical model of disability monolithically and oppressively imposed on disabled people. Because the presence of disability may be ambiguous in any given case, multiple actors, lay and professional, may invoke particular medical models of disability and advance competing claims about an individual's disabilities and related needs. The literature for parents of disabled children is seen as a resource on which parents can draw in making claims about their children's disabilities and disability-related needs. Particular attention is given to the assumptions that this literature makes about the identity, resources and dispositions of the audience. Ultimately, these assumptions favor disability claims made by white, highly educated, upper-income parents.     

Disability and Life Satisfaction in Italy

During the last decades, the socio-economic policy agenda has devoted an increasing attention to the inclusion of disabled people into society. It follows that understanding the drivers of life outcomes and conditions of disabled people is essential to analyze the sources of disadvantaged positions.This paper brings evidence on the predictors of life satisfaction of disabled people in Italy, focusing on four specific dimensions (relations with relatives and friends, economic conditions, and leisure time) and analyzing information on people with functional limitations and health problems, as provided by the 2011 ISTAT survey.Estimation results show that household structure, health and disability status affect life satisfaction more significantly than personal and income variables. Education attainments significantly affect satisfaction with the economic conditions. In addition, support in daily activities may increase satisfaction with economic conditions and leisure time, suggesting that providing non-monetary support would be effective in increasing life satisfaction, especially in those domains requiring freedom of movement. Finally, we find that older disabled people are, on average, more satisfied than younger disabled people, while gender is relevant when interacted with the household type.     

Toward science‐informed supervision of clinical case formulation: A training model and supervision method

Case formulation is a core competency in the practice of clinical psychology and although many component skills can be taught in lectures, supervised clinical practice is a key step in moving from knowledge about case formulation to knowledge of formulation. The present paper outlines a model of science‐informed clinical practice and the ways in which clinical supervision may play a role. In addition, a methodology for assessing and benchmarking skills in case formulation is described to assist clinical psychology training programs to provide supervisees with normative feedback about their skills in case formulation. In so doing, the supervision of case formulation can become more informed by science and responsive to evaluation.     

Couple and Family Therapy Within the Current Pan-Canadian Context

Canadians take numerous approaches to couple and family therapy due in part to Canada’s diversity of people and geography, as well as the influence of the health care context, a central facet of our national identity. Tracing back to Nathan Epstein, the founder of family therapy in Canada, there continues to be a strong tradition of couple and family therapy within Canada which has international reach. Formal training in family therapy, as well as couple/marital therapy occurs largely outside of the scope of degree granting programs and university settings. The American Association for Marriage and Family Therapy has a strong presence in Canada, with six divisions across the country. Popular models of practice for Canada’s couple and family therapists include cognitive-behavioral therapy, solution-focused therapy, narrative therapy, emotionally-focused therapy, and Bowenian/intergenerational therapy. A growing number of training opportunities are becoming available across Canada, and the practice of couple and family therapy is becoming institutionalized as one of the core competencies for professions such as psychiatry. In this article, we examine the context of family therapy in Canada by examining its history, the unique accreditation standards, qualifications and organizations associated with family therapy, the relationship between couple and family therapy, and future directions for this field of practice.     

Disability and participation: It's about us but still without us!

Participation is often espoused as a strategy to promote inclusion, social justice and equality. Exactly how to facilitate participation in practice is often not explicated, nor are the challenges or issues highlighted. By drawing on interview data, the first aim of this paper is to identify the key barriers to participation in an organizational planning activity as experienced by 12 disabled and non‐disabled staff and board members in a small community‐based disability advocacy organization. The second aim is to draw upon Jim Ife's principles of participation to further analyse the factors that hinder and enable participation in organizations. Reported barriers to participation were categorized at individual, interpersonal and organizational levels of analysis, and included a lack of skills and competence, interpersonal conflicts, poor resourcing and ad hoc processes. The importance of understanding the dynamic interplay of individual and structural factors, valuing different forms of participation and having participatory structures and processes embedded in organizational settings are all highlighted. This study illustrates that, even in an organization that is specifically attuned to meeting the needs of disabled people, there is still considerable exclusion and institutional discrimination. Strategies to promote participation within an organizational context may include providing sufficient time for reflection and support, and opportunities for board members to learn how to take part in constructive planning activities and to develop their strengths. Copyright © 2010 John Wiley & Sons, Ltd.     

Professionalism: A Competency Cluster Whose Time Has Come

Despite the burgeoning literature on professionalism in other health professions, psychology lags behind in the level of attention given to this core competency. In this article, we review definitions from other health professions and how they address professionalism. Next, we review how this competency evolved within health service psychology (HSP), and we propose a definition. We offer an approach for assessing professionalism within HSP. Consideration is given to strategies and methods for providing effective education and training in this multifaceted competency. Finally, recommendations are made for creating a culture of professionalism within HSP and honoring psychology’s social contract with multiple publics.     

Disability and countertransference in group psychotherapy: connecting social oppression with the clinical frame

Psychoanalysis has paid limited attention to disability, and at times the approach has lacked political awareness. Over recent decades the international disability rights movement has argued that disabled people constitute an oppressed, systemically disadvantaged minority. Lately, a critical psychoanalytic view has connected disablist discrimination to universal unconscious conflicts evoked by impairment. Corresponding evocations emerge in the therapeutic frame, producing countertransference responses to the impaired body. Drawing on psychoanalytically oriented group psychotherapy with severely physically impaired adults, countertransference phenomena were studied in developing discussion on disability-related clinical work. The complex, uncertain role of psychoanalytic practice in combating oppression was also examined. Key issues include challenges to the traditional frame, the crossing of psychic boundaries, anxieties relating to not knowing, and the role of unconscious factors in marginalizing disabled experience.     

Toward a feminist theory of disability

We need a feminist theory of disability, both because 16 percent of women are disabled, and because the oppression of disabled people is closely linked to the cultural oppression of the body. Disability is not a biological given; like gender, it is socially constructed from biological reality. Our culture idealizes the body and demands that we control it. Thus, although most people will be disabled at some time in their lives, the disabled are made "the other," who symbolize failure of control and the threat of pain, limitation, dependency, and death. If disabled people and their knowledge were fully integrated into society, everyone's relation to her/his real body would be liberated.     

Representing disability in charity promotions

Social psychological research in relation to charity advertising in the area of disability has attempted to distinguish between ‘positive’ and ‘negative’ images and the way in which these are related to their fundraising potential. In the light of the critique of charity advertising offered by a number of disability theorists, it is suggested that this perspective would be enhanced by consideration of the attitudes of disabled people to charity advertisements. A study is reported that compares the attitudes of disabled and non‐disabled people to two charity advertisements. Differences between these two groups are reported and in the light of the nature of these it is suggested that what are considered to constitute ‘positive images’ is unlikely to be consensual. Copyright © 1999 John Wiley & Sons, Ltd.     

'Limits to therapy and counselling': Deconstructing a professional ideology

The rapidity with which therapy, as discourse and as clinical—professional practice, has become established in contemporary culture is subjected to a searching deconstructive critique. Specifically, it is argued that therapy's pretensions to being a legitimate professional, clinical practice are not only highly questionable, but actually constitute a self-serving and ethically questionable ideology. The 'scientific' status of therapy as a modernist enterprise is argued to be fundamentally undermined by new-paradigm epistemologies. It is further argued that, in its professionalised, commodified form, therapy can become routinely and intrinsically abusive to the extent that it self—fulfillingly constructs a framework which then serves to guarantee its own legitimacy within a discursive 'regime of truth'. Parker's important work on discourse and power is drawn upon to illustrate these radical arguments, and to make the case for an approach to therapy which is ongoingly and processually deconstructive of its 'professional' ideologies and clinical practices, if the kinds of dangers outlined are to be avoided. Such deconstruction would also include an ongoing and explicit interrogation of 'therapy' as an historically specific, evolving and, it is submitted, transitory cultural practice. Deep and honest ethical reflection is needed on the nature of therapy, and on the possibility of developing more healthily appropriate socio-cultural forms for helping people with their 'difficulties of living'.     

Self-assessment in clinical health psychology: a model for ethical expansion of practice

Society expects autonomous professions to ensure the competency of it practitioners, and professions should facilitate the continuing education and training of its members. Given the shift from psychology as a mental health profession to that of a health profession, the authors propose a self-assessment model for the individual practitioner to gauge his or her readiness to provide professional service in expanded areas of practice. This model could also be useful to the American Psychological Association, state psychological associations, and other purveyors of continuing education programs in systematically developing postgraduate experiences. A template for self-assessment that reflects well-accepted core domains of knowledge and skills is presented.     

Cognitive-behavior therapy and physical disability

This article attempts to assist the cognitive understanding of children and adults with significant physical disability. A discrimination is offered between disability and handicap. Common cognitive schemes and irrational beliefs of people with physical disabilities are explored. The development of belief systems from a social learning perspective and several cognitive assumptions of parents and families of children who have physical disabilities are presented. Finally, certain self evaluative beliefs specifically related to physical disability are examined in terms of how they relate to self image and, concomitantly, behavior. The article offers information arrived upon from the author's clinical practice as well as the author's personal experience as a person with a physical disability.Dr. John D. Sweetland, received his Ph.D. in Clinical and School Psychology from Hofstra University in 1979. His doctoral dissertation involved the application of a Rational Emotive Education program specifically for severely physically disabled children. He is a licensed psychologist in New York State, a school psychologist with the Port Washington Public Schools and in private practice with offices in Merrick and Massapequa, Long Island. Dr. Sweetland had polio and is semiambulatory. He was also a gymnast and a nationally ranked competitive acrobat.     

Neoliberal ideology in work and organizational psychology

This paper explores the role of neoliberal ideology in workplace practices and in work and organizational psychology (WOP) research. It analyses how neoliberal ideology manifests in these two domains by using a prominent framework from the field of political theory to understand ideology through three different logics: political, social and fantasmatic logics. We explore the main neoliberal assumptions underlying existing practices in the workplace as well as in WOP research, how individuals are gripped by such practices, and how the status quo is maintained. The paper analyses how individuals in the contemporary workplace are henceforth influenced by neoliberalism, and how this is reflected in the practices and dominant paradigms within WOP. In particular, we focus on three ways neoliberalism affects workplaces and individual experiences of the workplace: through instrumentality, individualism and competition. The paper finishes with practical recommendations for researchers and practitioners alike on how to devote more attention to the, often implicit, role of neoliberal ideology in their work and research. The discussion elaborates on how alternative paradigms in the workplace can be developed which address the downsides of neoliberalism.     

The Widening Gulf: Group Therapy Training and Traditional Training Models

The decline of training programs using traditional methods in group psychotherapy training may correspond to a static growth in membership and certifications in the two recognized national group associations. In addition, the increasing distance of group therapy from family therapy, two modalities that utilize group principles, may further illustrate the isolation of group training from the reality of today's practice. New ideas are needed for training programs to combine the varieties of group practice and settings, and the various practitioners, with standards of competency. A three-tiered training model may serve as an example of a training model that moves in a much needed, new direction.     

Anger - the hidden destroyer A psychodynamic approach with the physically disabled

Abstract

A basic challenge in the psychodynamic counselling of the physically disabled is the engagement of anger in relation to the patient's disability. Regardless of a patient's age at the onset of disability, they will exhibit anger, resentment and frustration for losses they may have, or perceive themselves to have, endured. Healthy physical and psychological adaptation requires the disabled patient to ‘cope’ with their anger. Feelings of anger may impede, obstruct or even derail the impetus towards healthy psychological and behavioural functioning. The manner in which we learn to negotiate the vicissitudes of daily life is linked to our selfobject development. This development does not end when we become adolescents or young adults, but continues throughout our life span. The normative, healthy psychological maturation required for adaptive behaviour is vulnerable to a wide range of impediments acquired at any point along the individual's developmental continuum. As clinicians we need to keep in mind that the self-regulation of internalized emotional states is transacted through a complex set of characterological and personality traits that may be impaired, or wanting, eventually leading to maladjusted psychopathological states. The therapeutic function of the clinician is to redress those ego deficits that stand in the way of a fully creative and productive life. The intended aim of this paper is to illustrate the manner in which I engage with those physically disabled persons presenting anger. I shall consider the use of counter-transference responses as behavioural in modifying various forms of anger formation manifested by disabled clients. It is my position that a positive shift in a disabled person's ego ideal through empathic transference will help to alleviate their underlying hostility and other forms of anger. The paper commences with a brief review of the experience of the disabled in Western society. I shall then turn to an examination of the psychotherapeutic approach underpinning my work with disabled clients. The third section will describe and illustrate, through case material, the clinician's use of self in the dyadic transaction with disabled clients.

The power of a positive therapeutic outcome lies in the clinician's ability to engage with the client despite emotional content, clinical aptitude or specific approach. Empathic attunement brings into operation those mechanisms underpinning the dynamic process integral to the approach used in the above cases. Countertransference issues sometimes intervene in the unconstrained flow of therapy. Regardless, those issues that are salient to the client and are incorrectly handled by the clinician will appear recurrently until satisfactorily addressed. Further, even when errors are made in sessions, outcomes may be positive.

Whatever the initial purpose that brings a physically disabled person to therapy there will eventually be a need to address issues around their condition. It is not enough to ignore or accept a client's earliest statement that their disability Ms not a problem'. They may initially not have come into therapy for problems concerning their disability; however, the particular disability will ultimately play an important role as to how and what the person feels, thinks and believes about him or herself. In general, psychodynamic counselling with the physically disabled requires knowledge of disability issues as well as of counselling procedures. Those working with the disabled need to understand their own personal issues through analytic work and continued supervision. Working with the physically disabled can be overwhelming, frustrating and exhausting, but in the end is most rewarding.     

Multicultural competency in research: examining the relationships among multicultural competencies, research training and self-efficacy, and the multicultural environment

Research on multicultural competencies has mainly focused on the practice dimension of psychology training and practice. Little theoretical or empirical research has examined multicultural research training and self-efficacy. In this study, 119 psychology graduate students filled out a Web survey focusing on the research training environment, research self-efficacy, multicultural competency, the multicultural environment, and social desirability. Results showed that multicultural competency, research training, and the multicultural environment were related to multicultural research self-efficacy. Hierarchical regressions showed that multicultural competency predicted students' research anxiety; social desirability predicted multicultural research utility, multicultural competency, and the research training environment; and multicultural competency predicted students' confidence in research and perceptions that their graduate training programs were multicultural. Implications are discussed.