The institutionalization of disability myths: impact on vocational rehabilitation services.Disability myths are based upon prejudicial prej·u·di·cialadj. 1. Detrimental; injurious. 2. Causing or tending to preconceived judgment or convictions: attitudes and inaccurate beliefs about people with disabilities. Such myths arise from cultural and psychological "learning" that prescribes the way one reacts to persons who have disabilities. Rehabilitation rehabilitation: see physical therapy. counselors, by virtue of their training, experience, and understanding, are among those professionals who are expected to have more realistic attitudes and beliefs toward disability. However, because rehabilitation counselors are part of the culture in which they live, many possess mythical myth·i·cal also myth·ic adj. 1. Of or existing in myth: the mythical unicorn. 2. Imaginary; fictitious. 3. attitudes that can be damaging to the person with a disability who is working toward vocational rehabilitation Noun 1. vocational rehabilitation - providing training in a specific trade with the aim of gaining employment rehabilitation - the restoration of someone to a useful place in society . This article explores some of the ways in which disability myths, when held by the rehabilitation counselor, may become institutionalized in·sti·tu·tion·al·ize tr.v. in·sti·tu·tion·al·ized, in·sti·tu·tion·al·iz·ing, in·sti·tu·tion·al·iz·es 1. a. To make into, treat as, or give the character of an institution to. b. within the agency framework of vocational rehabilitation (VR) and how those myths may jeopardize jeop·ard·ize tr.v. jeop·ard·ized, jeop·ard·iz·ing, jeop·ard·izes To expose to loss or injury; imperil. See Synonyms at endanger. services and case outcomes. Disability myths operating within a VR agency are usually more subtle than those found in the general population because rehabilitation counselors and other service providers have been trained to think and act from other perspectives. However, myths and elements of myths may influence the human mind so subtly that counselors may be unaware of mythical thinking in themselves. The VR client, on the other hand, may experience the direct effect of the counselor's thinking as a major life stressor; he or she may feel the impact of myth that, although hidden from the counselor, seems interwoven in·ter·weave v. in·ter·wove , in·ter·wo·ven , inter·weav·ing, inter·weaves v.tr. 1. To weave together. 2. To blend together; intermix. v.intr. into the service delivery system. In time, the client may begin to doubt that the VR counselor and the VR system can be trusted with the client's aspirations aspirations npl → aspiraciones fpl (= ambition); ambición f aspirations npl (= hopes, ambition) → aspirations fpl for rehabilitation. The Counselor's Culture: From Myth to Stereotype stereotype (stĕr`ĕətīp'), plate from which printing is done, made by casting metal in a mold, usually of paper pulp. The process was patented in 1725 by the Scottish inventor William Ged. Rehabilitation counselors live in the same culture as the general population and are no more immune to disability myths than others (DeLoach and Greer, 1981). Because much of what culture teaches is unconscious, each person may perceive his or her own behavior as normal, and peculiar behavior in others as irresponsible or psychopathic psy·cho·path·ic adj. 1. Of, relating to, or characterized by psychopathy. 2. Relating to or affected with an antisocial personality disorder that is usually characterized by aggressive, perverted, criminal, or amoral behavior. (Hall, 1976). These concepts are significant for the VR delivery system because rehabilitation counselors work in a setting in which the welfare of the client must be weighed against agency policies and financial limitations. Unconscious attitudes can hamper the counselor's professional behavior and the agency's ability to achieve its mission. Many rehabilitation counselors carry such large case-loads that it is impossible for them to spend much time with each client. Regulatory case management documentation designed to ensure service quality may demand that counselors spend more time on paperwork than with the clients they serve. Because of such pressures, the rehabilitation counselor may look for shortcuts See Win Shortcuts. and may learn to rely on culturally acceptable disability myths as a way to handle clients quickly and to survive in the agency. A myth can be a shortcut (1) In Windows, a shortcut is an icon that points to a program or data file. Shortcuts can be placed on the desktop or stored in other folders, and double clicking a shortcut is the same as double clicking the original file. in several ways. First of all, it may take less time to use a myth as a basis for action than it does to learn something firsthand first·hand adj. Received from the original source: firsthand information. first from a client. Disability myths may allow the rehabilitation counselor to form a stereotypical view of the client in lieu of Instead of; in place of; in substitution of. It does not mean in addition to. interaction aimed at understanding the client's experiential ex·pe·ri·en·tial adj. Relating to or derived from experience. ex·pe ri·en situation. Stereotyping allows humans to infer characteristics at the cost of distorting and restricting awareness of people as individuals (Carr, 1979). Disability myths, then, typically hinge upon Verb 1. hinge upon - be contingent on; "The outcomes rides on the results of the election"; "Your grade will depends on your homework"depend on, depend upon, devolve on, hinge on, turn on, ride the inference that the stigma stigma: see pistil. Stigma mark of Cain God’s mark on Cain, a sign of his shame for fratricide. [O. T.: Genesis 4:15] scarlet letter of disability automatically implies incompetency The lack of ability, knowledge, legal qualification, or fitness to discharge a required duty or professional obligation. The term incompetency has several meanings in the law. . This process becomes prejudicial when the VR counselor encounters clients and has made conclusions that are based upon stereotypes instead of upon the needs and abilities of the actual clients. There is ample historical evidence that such thinking has had a negative impact on people with disabilities who have received services from professionals. Mentally retarded Noun 1. mentally retarded - people collectively who are mentally retarded; "he started a school for the retarded" developmentally challenged, retarded people, for example, have been taught to believe they are second class citizens (Rehabilitation Research and Training Center in Mental Retardation mental retardation, below average level of intellectual functioning, usually defined by an IQ of below 70 to 75, combined with limitations in the skills necessary for daily living. , 1980). Recent evidence suggests that female VR clients receive less pay following job placement (National Institute on Disability and Rehabilitation Research National Institute on Disability and Rehabilitation Research (NIDRR) is a United States governmental institution that provides leadership and support for a comprehensive program of research related to the rehabilitation of individuals with disabilities. , undated un·dat·ed adj. 1. Not marked with or showing a date: an undated letter; an undated portrait. 2. ), a situation suggesting that the VR system has cooperated with the cultural myth linking human worth and salaries to gender. Similarly, research shows that some forms of disability may provoke more negative reactions. Allen, Peterson, and Keating (1982) suggest that alcoholics may be viewed negatively by counselors. Likewise, obese o·bese adj. Extremely fat; very overweight. obese characterized by obesity. obese adjective Characterized by obesity, see there; excessively fat clients may be seen as less competent than other clients (Kaplan and Thomas, 1981). This stereotypical thinking seems to rest upon the implication that these clients have somehow brought disabling dis·a·ble tr.v. dis·a·bled, dis·a·bling, dis·a·bles 1. To deprive of capability or effectiveness, especially to impair the physical abilities of. 2. Law To render legally disqualified. or medical conditions See carpal tunnel syndrome, computer vision syndrome, dry eyes and deep vein thrombosis. upon themselves through lack of will power. Thus, the stereotype involves the issue of personal failure as a contributor to the condition. Colorez and Geist (1987) conducted a study that reflected little difference between general employers and rehabilitation employers when it came to attitudes about hiring workers with disabilities. These researchers speculate that the lack of difference may not be attributable to the positive attitudes of general employers as much as to the negative attitudes of rehabilitation employers. They also mention that rehabilitation employers are not immune to negative attitudes about such workers and may lack sensitivity to them. People with disabilities are often barred from work activities by such attitudes and may learn inferiority from initially false myths and stereotypes (Henderson and Bryan, 1984). Although "cause and effect" is difficult to measure in stereotypical thinking, the effect can be seen throughout the cultural sphere. For example, Mead mead (mēd), wine made of fermented honey and water, sometimes flavored with spices. It is highly intoxicating. Mead was known in classical Greece and Rome and was the favorite drink of the tribes of N and W Europe. (1988, p. 40) states that, "The view that the poor are passive victims of conditions is valid mainly for the elderly and disabled, whom society does not expect to work." With such a statement, Mead helps perpetuate per·pet·u·ate tr.v. per·pet·u·at·ed, per·pet·u·at·ing, per·pet·u·ates 1. To cause to continue indefinitely; make perpetual. 2. myths about who may or may not take part in competitive work. A recent counseling textbook helps to do much the same (Zunker, 1986, p. 317) with the claim that, "The severity of functional limitations and the individual's adjustment to his or her limitations are the most important factors to consider in career counseling Noun 1. career counseling - counseling on career opportunities counseling, counselling, guidance, counsel, direction - something that provides direction or advice as to a decision or course of action ." Here there is no emphasis on ability or skill to suggest that a client is more than the negative stereotype. Such stereotypes and myths about persons with disabilities originate and survive within different segments of society but often influence the entire cultural "mind set." For example, Christianity has produced several powerful, long-lasting myths about physical disability (Weinberg and Sebian, 1980), many of which imply divine punishment or justice. Similarly, folklore folklore, the body of customs, legends, beliefs, and superstitions passed on by oral tradition. It includes folk dances, folk songs, folk medicine (the use of magical charms and herbs), and folktales (myths, rhymes, and proverbs). breeds myths and stereotypes because each culture sets the rituals, taboos, and ethical standards for dealing with the fragility of life (Illich, 1978). From the perspective of function, myths and stereotypes may accomplish several things for the person who believes them. One may find cultural security in such values (Spradley and McCurdy, 1971) or one may use myth as a way to avoid those who are different (Vash, 1981). Or because so much of culture is unconscious (Hall), one may not think about or guard against such attitudes at all. Still yet, one may utilize a stereotype to rationalize ra·tion·al·ize v. 1. To make rational. 2. To devise self-satisfying but false or inconsistent reasons for one's behavior, especially as an unconscious defense mechanism through which irrational acts or feelings are made to appear prevailing prejudices or situational needs (Allport, 1954). These functions serve the same purposes throughout society, including social institutions like the vocational rehabilitation system. In this context, disability myths are diluted di·lute tr.v. di·lut·ed, di·lut·ing, di·lutes 1. To make thinner or less concentrated by adding a liquid such as water. 2. To lessen the force, strength, purity, or brilliance of, especially by admixture. by public laws, agency policies, and specialized training for those entrusted with client welfare. On the negative side, unfortunately, there are some peculiar characteristics of the VR setting which may allow or even encourage rehabilitation counselors to think and act from the perspective of myths and stereotypes in ways that such notions become a functional part of VR as a social institution. Myth at Work in the VR System To understand the ways in which myths and stereotypes of disability may become operational in the VR service system, it is first necessary to understand the "climate" within the VR organization. On one hand, VR systems tend to be large bureaucratic bu·reau·crat n. 1. An official of a bureaucracy. 2. An official who is rigidly devoted to the details of administrative procedure. bu organizations and, on the other hand, seek to maintain an atmosphere in which a client-counselor relationship can develop and survive. Often, these two roles may seem mutually exclusive Adj. 1. mutually exclusive - unable to be both true at the same time contradictory incompatible - not compatible; "incompatible personalities"; "incompatible colors" and may leave the rehabilitation counselor with the task of performing a "balancing act" between agency demands and client needs. It is within this context that disability myths and stereotypes may emerge to undermine the rehabilitation process. Large bureaucratic organizations do not traditionally emphasize the continual examination of their values Scott and Hart, 1979). Unstated, unexamined values often go unquestioned as assumptions. That is, large organizations may assume that their values are correct and shared by all members, without those values being discussed openly. Within VR organizations, for example, values may prevail that encourage counselors and others to distinguish between agency welfare and client welfare and to place a higher priority on agency needs when the two come into conflict. VR organizations can, through their size and official policies, create an atmosphere in which attitudinal barriers emerge. Overgeneralizations (Vash), for example, may encourage the counselor to look upon the client as a type of client, instead of as a unique individual with particular needs. Policy may be so well developed and generalizable gen·er·al·ize v. gen·er·al·ized, gen·er·al·iz·ing, gen·er·al·iz·es v.tr. 1. a. To reduce to a general form, class, or law. b. To render indefinite or unspecific. 2. that the VR counselor feels he or she does not need information directly from the client to determine how the agency can best "help" the client. Large organizations like VR agencies cannot function as bureaucracies without control over what occurs within their zones of influence (Rose, 1974). The VR counselor may have internal conflict because he or she is expected by the organization to control the client while professional ethics professional ethics, n the rules governing the conduct, transactions, and relationships within a profession and among its publics. professional ethics liability, n 1. demand that the counselor allow the client to control his or her own destiny. The organizational environment becomes more complex as heavy caseload case·load n. The number of cases handled in a given period, as by an attorney or by a clinic or social services agency. caseload Noun demands produce bureaucratic expectations. Such caseloads may coexist co·ex·ist intr.v. co·ex·ist·ed, co·ex·ist·ing, co·ex·ists 1. To exist together, at the same time, or in the same place. 2. with agency quotas for successful case closures. The counselor may wish to judge himself or herself by professional or ethical standards while the agency may judge only from a standard of "production." As a form of organizational alienation (Faunce, 1968), such a conflict can leave the counselor feeling trapped between agency and client. At the federal level, regulations and policies are designed for the purpose of ensuring that states provide VR services in such a way that monies are properly spent and that people with disabilities receive the services they need. Likewise, states provide services toward the same ends, but construct their own organizational hierarchies to accomplish them. Many policies and administrative controls Direction or exercise of authority over subordinate or other organizations in respect to administration and support, including organization of Service forces, control of resources and equipment, personnel management, unit logistics, individual and unit training, readiness, mobilization, that start out to ensure client welfare, filter down to the rehabilitation counselor in the form of time-consuming administrative tasks. Such demands become major stressors for counselors when they are also expected to serve so many clients. The combination of demands leaves the counselor with limited time to manage properly the difficult cases. As one VR counselor recently put it (G.E. Holmes, personal communication, August 2, 1988), "The system is so powerful that no matter how client-centered you are, you must respond to the system instead of to the client. The system is not supportive of the client or the counselor, so real counseling just is not possible." Faced with such a dilemma, some counselors look for ways to reduce the amount of time they actually spend with clients. Ironically, many good counselors may begin to think in terms of myths and stereotypes as a way of saving time that can be used with clients, only to learn later that it has eroded e·rode v. e·rod·ed, e·rod·ing, e·rodes v.tr. 1. To wear (something) away by or as if by abrasion: Waves eroded the shore. 2. To eat into; corrode. the counselor-client relationship. For example, the counselor who imagines that all people with orthopedic orthopedic /or·tho·pe·dic/ (-pe´dik) pertaining to the correction of deformities of the musculoskeletal system; pertaining to orthopedics. disabilities share the same characteristics and need the same services, can project such a preconceived pre·con·ceive tr.v. pre·con·ceived, pre·con·ceiv·ing, pre·con·ceives To form (an opinion, for example) before possessing full or adequate knowledge or experience. agenda onto the client that the client learns not to trust the counselor. Without trust the relationship cannot prosper. Or to save time, a counselor may assign "leg-work" tasks to the client who cannot accomplish them because of disability, and then label the client as "irresponsible" for not performing. Again, trust suffers. When a rehabilitation counselor thinks of clients as types instead of as individuals, disability myths and prejudice form the basis of the thinking. Such behavior by the counselor is a maladaptive Maladaptive Unsuitable or counterproductive; for example, maladaptive behavior is behavior that is inappropriate to a given situation. Mentioned in: Cognitive-Behavioral Therapy attempt to cope with the stressors and demands of the job. As a form of triage triage Division of patients for priority of care, usually into three categories: those who will not survive even with treatment; those who will survive without treatment; and those whose survival depends on treatment. , this behavior becomes a sort of out-patient custodialism in which the client must hand over control and the right to self-determination. A myth or stereotype is institutionalized when it becomes a technique of routine organizational control over the client. Commenting on the impact of so many VR clients being rehabilitated into low-level jobs, Werboff (1988), states that such statistics help perpetuate the myth that people with disabilities are only suitable for certain types of jobs. Placement of this sort may represent the outcome of stereotypical thinking by VR counselors who find it easier to place clients in low-paying jobs because such jobs are generally more plentiful and take less time to arrange. Although placing clients in such jobs is appropriate in some instances, the fact that these placements exist in such large numbers suggests that many clients are being sent to such jobs because they offer easy solutions. This employment trend may seem to be the logical outcome of rehabilitation but may, in fact, be based on a disability myth that says to clients, "This is what you deserve because you are, after all, handicapped." The Mechanics of Myth According to according to prep. 1. As stated or indicated by; on the authority of: according to historians. 2. In keeping with: according to instructions. 3. the research of DeLoach and Greer, it is common for some professionals to express low opinions of clients and to rob them of their humanness as a way of absolving the professionals' guilt about their own attitudes and behaviors. These same writers cite the following common behavioral patterns In software engineering, behavioral design patterns are design patterns that identify common communication patterns between objects and realize these patterns. By doing so, these patterns increase flexibility in carrying out this communication. of professionals with devaluating attitudes toward people with disabilities: * interpreting as abnormal behaviors considered normal in nondisabled persons; * over-emphasizing the effects of disability on adjustment; * treating the disabled in terms of their disabilities instead of their other characteristics; * consistently underestimating the potentials of those with whom they work. (pp. 46 & 47) These same patterns may indicate that professionals utilize disability myths as the basis for preconceived notions Noun 1. preconceived notion - an opinion formed beforehand without adequate evidence; "he did not even try to confirm his preconceptions" parti pris, preconceived idea, preconceived opinion, preconception, prepossession about clients. The underlying attitudes that devaluate people with disabilities can be routinely reinforced through proof' that the attitudes and related myths are valid, at least in the minds of those holding the attitudes. Clients may be expected to behave in particular ways, but when they do, it may be seen as evidence to validate the original attitudes or myths. DeLoach and Greer also point out that clients who try to maintain control of their own lives may be viewed by rehabilitation professionals as aggressive, while passive clients are viewed as cooperative. The myth involved here is based upon the phenomenon of "spread" in which a person with a disability is treated as if the disability has spread to other physical or psychological aspects of the person. A physical disability may be taken as evidence that the client is incapable of making decisions for himself or herself. Funk (1986) mentions that self-advocacy behavior may be in direct conflict with social expectations of a person with disabilities, and that self-advocacy is not generally considered a part of the emotional, intellectual, or physical makeup of a person with a disability. Counselors or other rehabilitation professionals who think and act in these ways may control clients or encourage passivity in other ways as well. As Vash mentions, VR counselors control the funds to pay for services; money may be allocated or withheld. Clients may also be forced into conformity through threats of case closure for noncooperation non·co·op·er·a·tion n. Failure or refusal to cooperate, especially nonviolent civil disobedience against a government or an occupying power. non or as too severe" for VR services. Or, as examples, a client who is deaf may be encouraged to take a factory job because he will not be bothered by the noise, and a client who has an opportunity for full-time employment may be asked to refuse the job so the rehabilitation process may be completed (G.E. Holmes, personal communication, June, 1988). It is only because disability myths and stereotypes operate mostly at the unconscious level that their presence is so difficult to detect in day-to-day VR operations. Counselors who have attempted to cope with job pressures with such thinking, may not be conscious of their own behavioral patterns. Nor is it easy to detect the existence of disability myths or stereotypes by examining case records. When a counselor makes a decision about the client's case solely to enforce conformity, the casefile may reflect nothing extraordinary. Counselors may unknowingly justify their stereotype-thinking and prejudicial behaviors in case records by using professional-sounding jargon. For example, a counselor might write, "The client has displayed her mental health deficits through her failure to participate actively in vocational exploration due in part to her inability to adjust properly to the psychosocial psychosocial /psy·cho·so·cial/ (si?ko-so´shul) pertaining to or involving both psychic and social aspects. psy·cho·so·cial adj. Involving aspects of both social and psychological behavior. impact of disability." Such jargon sounds clinical, but carries very little informational content. In such instances, the language of case narratives serves two main purposes; it helps pass off personal decisions as if they were clinical ones, and it provides a way for the counselor to rephrase re·phrase tr.v. re·phrased, re·phras·ing, re·phras·es To phrase again, especially to state in a new, clearer, or different way. disability myths to make them seem like client-specific behaviors, deficits, or failures. Policies and regulations may be distorted through prejudicial thinking and used as "factual" citations in the record to uphold the soundness of counselors' decisions. The net result of such narratives is that they document neither the client's life situation nor the agency's ability to provide needed services. Such narratives may be quasi-fictional reports that, lacking evidence to the contrary, may be accepted by the VR agency as valid descriptions of a client's personal and unique situation. Faulty impressions or conclusions by the counselor using myths as a basis for clinical decisions, are professionally dishonest and self-serving, but may protect the counselor's job by giving the outward appearance of professional performance. Case reporting may, however, reflect the counselor's mythical thinking in yet another way. Some VR counselors may rely excessively upon reports and clinical decisions from other professionals such as physicians and psychologists that tend to support the counselor's point of view. A casefile may therefore fail to show that the counselor has made any real decisions about the client's vocational rehabilitation, the one area in which the VR counselor has expertise that no other profession can claim. The VR counselor may fail to view vendor reports within the holistic context of the rehabilitation process and may thereby allow other professionals to make decisions that rightly should be made by the counselor. If the counselor is operating from the perspective of disability myths, vendor reports that emphasize client weaknesses over strengths may be accepted as a total picture of the client, particularly if the reports reinforce the counselor's own thinking about the limited capacities of clients. When myths about disability are institutionalized in the VR system and become part of the routine reaction to clients' needs, successful rehabilitation outcomes are jeopardized. Casefiles become misleading, case logic becomes self-referencing and circular, and the VR system suffers from ineffectiveness in its primary mission of providing meaningful rehabilitative re·ha·bil·i·tate tr.v. re·ha·bil·i·tat·ed, re·ha·bil·i·tat·ing, re·ha·bil·i·tates 1. To restore to good health or useful life, as through therapy and education. 2. services. The VR Client: Target of Disability Myth Like rehabilitation counselors, people with disabilities may come from the same cultural settings that produce disability myths. However, because they do have disabilities, they may be exposed to disability myths in the form of personal experience. The phenomenon of "spread" occurs within the social world in such a way that people with disabilities may be assumed to lack both social and personal competency COMPETENCY, evidence. The legal fitness or ability of a witness to be heard on the trial of a cause. This term is also applied to written or other evidence which may be legally given on such trial, as, depositions, letters, account-books, and the like. 2. . In this way, disability myths may become part of the person's own self-concept (Wright, 1960). For example, people with congenital congenital /con·gen·i·tal/ (kon-jen´i-t'l) existing at, and usually before, birth; referring to conditions that are present at birth, regardless of their causation. con·gen·i·tal adj. 1. orthopedic disabilities may be taught by society to expect isolation, deprivation, and social rejection (Koerink, 1988). So people with disabilities may face the joint stressors of having to deal with disability while struggling with the social impact of disability (Bailey and Gregg, 1986). This social stigma Social stigma is severe social disapproval of personal characteristics or beliefs that are against cultural norms. Social stigma often leads to marginalization. Examples of existing or historic social stigmas can be physical or mental disabilities and disorders, as well as may produce various symptoms of poor self-image in people with disabilities (Schweitzer, 1982). Disability myths that adversely affect the person with a disability within the social realm, may form a vicious circle A Vicious Circle (1996) is a novel by Amanda Craig which dissects and satirizes contemporary British society. In particular, it describes the world of publishing -- its aspiring young authors, busy agents and opportunist literary critics. " if that person becomes a VR client with a rehabilitation counselor who also harbors similar attitudes. The VR system may then reinforce the negative social learning and self-image so that the client, too, "buys into" the disability myth. Along these lines, DeLoach and Greer (p.44) state that, "If lack of knowledge or aversive aversive /aver·sive/ (ah-ver´siv) characterized by or giving rise to avoidance; noxious. a·ver·sive adj. reactions cause a professional to view severe disability as a catastrophic event which destroys one's chance for a happy, fulfilling life, it will be difficult for her clients/patients/students to ever grow beyond her definition of their situation." A client faced with such attitudes from the VR counselor may lose interest in vocational rehabilitation, personal motivation or willingness to participate, the sense of personal control and the right to self-determination, and may appear lackadaisical lack·a·dai·si·cal adj. Lacking spirit, liveliness, or interest; languid: "There'll be no time to correct lackadaisical driving techniques after trouble develops" William J. Hampton. to the VR counselor. In turn, the counselor may conclude that such reactions are actually "symptoms" of disability or are personality deficits of the client. So disability myths feed upon themselves and trap both counselor and client in a "no-win" situation. Such an environment is not conducive to counselor-client rapport The former name of device management software from Wyse Technology, San Jose, CA (www.wyse.com) that is designed to centrally control up to 100,000+ devices, including Wyse thin clients (see Winterm), Palm, PocketPC and other mobile devices. and does not offer the client much opportunity for personal growth. Although under the best of conditions the rehabilitation process may be stressful for the client (Goodwin, 1980), when he or she is the recipient of institutionalized disability myths, the stress will be even greater. The counselor's behavior and attitudes may hamper the client's ability to adjust and may encourage the client to feel overwhelmed o·ver·whelm tr.v. o·ver·whelmed, o·ver·whelm·ing, o·ver·whelms 1. To surge over and submerge; engulf: waves overwhelming the rocky shoreline. 2. a. by the stress. Various defense mechanisms may be triggered or exaggerated in the client who is viewed by the VR system as an example of a type of client to whom standardized standardized pertaining to data that have been submitted to standardization procedures. standardized morbidity rate see morbidity rate. standardized mortality rate see mortality rate. remedies can be applied. For example, the rehabilitation counselor who has preconceived notions about client needs that arise from the type of disability instead of the type of human being, may prescribe pre·scribe v. To give directions, either orally or in writing, for the preparation and administration of a remedy to be used in the treatment of a disease. psychotherapy psychotherapy, treatment of mental and emotional disorders using psychological methods. Psychotherapy, thus, does not include physiological interventions, such as drug therapy or electroconvulsive therapy, although it may be used in combination with such methods. for every client who uses a wheelchair, extensive vocational evaluation for every client regardless of transferable job skills, and remedial social skills training for every client who is blind. The rehabilitation counselor who acts from this perspective has such a narrow scope of vision that he or she may forget personal responsibilities and even the overall goal of vocational rehabilitation. The natural outcome of such a situation, or the point at which the impact is most easily discerned, usually involves problems with vocational placement. Because jobs in modem society may be primarily important as opportunities to develop and maintain interpersonal relationships This article or section may contain original research or unverified claims. Please help Wikipedia by adding references. See the for details. This article has been tagged since September 2007. (Florian and Har-Even, 1984), low-level job placements may prescribe the kind of relationships to be found or may even prevent them. Volunteer work or extremely low pay may be perceived negatively by nonhandicapped co-workers or may seem self-devaluing to the client (Wehman and Moon, 1987). A mythical idea that operates here is that entry level placements are the result only of client limitations and not of counselor intentions. Although the poorly educated are more likely to have disabilities (Murray, 1988), it is fallacious to assume that VR services can only help the poor prepare for entry level jobs. Here myth equates lack of education or training with lack of intelligence or ability to learn, factors which are not necessarily linked to socioeconomic so·ci·o·ec·o·nom·ic adj. Of or involving both social and economic factors. socioeconomic Adjective of or involving economic and social factors Adj. 1. standing. The myth-oriented counselor may routinely prepare economically poor clients for entry level jobs without regard for their ability to learn new, higher-level job skills and without regard for vocational interests. Ironically, such practices are in direct opposition to traditional values Traditional values refer to those beliefs, moral codes, and mores that are passed down from generation to generation within a culture, subculture or community. Since the late 1970s in the U.S. and goals of the vocational rehabilitation service delivery system. As mentioned earlier, counselors may believe that they need to control the client in order to fulfill their own obligations within the large service organization. The client, who directly experiences these behaviors, may be left feeling bewildered and uncertain. The client cannot know from moment to moment whether a counselor is playing the role of bureaucrat, administrator or counselor. Of the three, the counselor has the most clearly defined ethical responsibility to safeguard the client's welfare. The client, watching the counselor change roles, may conclude that the counselor cannot be trusted and may remain "closed" to the counselor. But again, because myths demand reinforcement or proof of validity, the counselor may interpret the client's reticence ret·i·cence n. 1. The state or quality of being reticent; reserve. 2. The state or quality of being reluctant; unwillingness. 3. An instance of being reticent. Noun 1. as noncooperation, as some serious psychological problem, as lack of intelligence, as lack of motivation, or as any other shortcoming short·com·ing n. A deficiency; a flaw. shortcoming Noun a fault or weakness Noun 1. that would lend credence to the idea that the client has personal deficits. On the experiential level, clients who encounter such thinking, behavior, and treatment from professionals are encouraged to remain as outsiders to the rehabilitation process. Using myths as standards, counselors may contribute to "us versus them" thinking in which clients are viewed as the weakest link in the rehabilitation process. Such messages are not wasted on the client; he or she may join with the counselor in believing the disability myths that allow the counselor to take shortcuts. The client's family, too, may be called upon to support the myth by learning to believe only in the client's limitations and by helping the counselor convince the client that all problems of rehabilitation are directly related to client deficits. The quality of service, the client's progress, and low-level job entry, may all carry the one message, "This is appropriate for you because you are disabled." In such a bureaucratic environment as VR, it will always be difficult for even good counselors to maintain rapport with clients. The large agency setting becomes counterproductive coun·ter·pro·duc·tive adj. Tending to hinder rather than serve one's purpose: "Violation of the court order would be counterproductive" Philip H. Lee. to rehabilitation when individual counselors stereotype clients kith disability myths. This precludes all authentic rapport, leaves the client with little recourse, and turns the rehabilitation counselor into an overpaid o·ver·pay v. o·ver·paid , o·ver·pay·ing, o·ver·pays v.tr. 1. To pay (a party) too much. 2. To pay an amount in excess of (a sum due). v.intr. To pay too much. clerk. People with disabilities suffer much grief and may find it difficult to ask for the help they need (Hughes, 1980). Unfortunately, once disability myths become institutionalized at the level of client service, there simply is no one the client can ask for help. As a rehabilitation manager recently stated (G.E. Holmes, personal communication, August 16, 1988), "It is possible for a client to move through such a system without ever receiving any substantial services that could lead to rehabilitation." Here the manager alluded to the fact that a casefile prepared to minimum federal standards may provide rehabilitation only in the administrative sense, but not as an experience accomplished by the client. This notion should be considered by rehabilitation administrators and educators alike because it implies that case recording methods may not produce accurate client histories. Transcending the Myths: Clinical Thinking for VR Counselors Rehabilitation counselors can protect themselves from the negative influence of disability myths in several ways and can thereby improve the overall quality of the VR service delivery system. They can learn to monitor their own attitudes and behaviors as a way of fulfilling their ethical and professional responsibilities. Self-monitoring begins with counselors acknowledging the fact that their attitudes stem not only from professional study and work experiences, but also from the culture in which they live. Counselors can be aware that their attitudes come from a variety of sources (Schnieder and Anderson, 1980), some good and some not so good. They can learn to protect themselves and their clients from situations in which myths could play a role in rehabilitation outcomes. As helpers, VR counselors should respect the human and legal rights of their clients. Such respect begins with the counselor accepting each client as an individual with unique needs and desires. The counselor becomes a proactive participant in the rehabilitation process when he or she uses creative problem-solving to help the client toward maximum rehabilitation. Proactivity is linked to counselor attitude in that client strengths are emphasized over weaknesses. This differs from thinking based on disability myths in that the client's tenure in the VR system is viewed as leading toward rehabilitation instead of toward additional proof of client incompetencies. When negative prejudices arise from disability myths, the stronger one's belief in them, the greater the chance that the client will be viewed only as a stereotypical example of the myth (Wesolowski and Deichmann, 1980). For this reason, it is important that rehabilitation counselors constantly monitor their own attitudes and competencies. If, however, this self-monitoring becomes too systematic, there is always the danger that the counselor will merely train himself or herself to react to clients in a stylistic mode instead of a client-centered mode (Harrison, 1979). So self-monitoring should be comprehensive, personal, and of immediate value to the counselor. In a recent study, Patterson and Witten 1987) identified the following disability myths as being commonly held: * disability is a constantly frustrating frus·trate tr.v. frus·trat·ed, frus·trat·ing, frus·trates 1. a. To prevent from accomplishing a purpose or fulfilling a desire; thwart: tragedy; * the more severe the disability, the greater the psychological impact; * persons with disabilities do not recognize their limitations or abilities; * persons with disabilities worry about more important things than their sexuality; * employment problems for such people are almost always caused by disability; * people with disabilities have special personalities or special abilities. Counselors can examine these common myths in light of their own attitudes and can, therefore, guard against them. Care must also be taken during the rehabilitation process to ensure that clients are not taught such myths and that the counselor does not reinforce them if clients already hold such beliefs. It is appropriate for the VR counselor to utilize casefile information in his or her attempts at self-monitoring. The casefile does, after all, contain a record of the counselor's professional efforts on behalf of the client. By scanning casefiles, the counselor can get an overall picture of how well the client has been served. As a client's case progresses, the counselor can see how his or her own attitudes have affected service quality and appropriateness. Casefile management as a routine activity gives the counselor the opportunity to self-monitor and self-manage a host of attitudes and behaviors that reflect his or her own professionalism and ability to help clients toward desired rehabilitation outcomes. Monitoring Decisions Counseling aimed at teaching a client self-management skills is, by its nature, concerned with teaching clients that they control the decision-making process (Kanfer and Gaelick, 1986). Rehabilitation counseling rehabilitation counseling, n counseling started in the United States in 1920 to assist individuals disabled by industrial accidents; originally included physical, psychologic, and occupational training; expanded over the next 70 years and laid the in the VR setting shares this aim. The counselor interested in self-monitoring as a way to guard against disability myths and stereotypes, can focus upon case decisions that reflect counselor attitudes and beliefs. The following questions about decisions can be used by the VR counselor to measure his or her own behavior for mythical content: 1. Who made the decision, the counselor or the client? 2. Who benefited from the decision, the counselor or the client? 3. How does the decision improve the client's quality of life or lead toward vocational rehabilitation? 4. Was there an attempt to make the decision a joint one? (i.e., Was the IWRP IWRP Individual Written Rehabilitation Plan IWRP Institute of Water Resources Planning IWRP Individual Waste Reduction Program developed jointly?) 5. Did the decision make the counselor's job easier without benefiting the client? 6. Did the VR counselor consider the decision to be valid in the clinical sense? 7. Did the client participate in the decision with self-advocacy in mind? 8. Was the decision made in accordance with written agency policy or was it based on "informal" policy? 9. Did the decision fit well with the philosophical ideals of the rehabilitation counseling profession ? 10. Did the counselor think the decision was an ethical one? 11. Was the client satisfied with the decision and with the process by which it was made? 12. Did the counselor approach decision-making with any preconceived notions about the client? 13. Was the decision made to force compliance in the client or to punish the client for past failures? These are but a few of the questions the counselor might ask following a decision that affects the client's life. The counselor can use the answers with other case information to analyze case trends that may develop through the counselor's attitudes and beliefs about the client. This will help the counselor transcend mythical thinking during the case. Research by Byrd and Rhoden (1981) suggests that attitudes about disability may be influenced by the proximity of a person with a disability. Counselors can evaluate case decisions to determine if they have been adversely affected by encounters with clients who have disabilities or even, perhaps, by those who have disabilities of a particular kind. Generally speaking, case decisions that cannot be justified clinically are those that most likely were made from the perspective of disability myths, prejudice, or stereotyping. The casefile may identify such decisions as those for which the most elaborate documentation exists, as the counselor may have described them in clinical jargon so as to convince himself or herself that the decision was, in fact, a valid one based on clinical need and not personal whim whim n. 1. A sudden or capricious idea; a fancy. 2. Arbitrary thought or impulse: governed by whim. 3. A vertical horse-powered drum used as a hoist in a mine. . Conclusions Although neither professionals nor clients can predict the outcome of the VR case (Cook, 1983), counselors can at least accept this fact and not attempt to predict outcomes based on type of client or type of disability. Such attempts invite belief in disability myths and reduce the counselor's professional abilities. If the counselor finds that he or she has adopted disability myths as a quick way to deal with clients and to survive within the VR system, he or she must find other ways to handle the stress so that the client does not suffer in the meantime Adv. 1. in the meantime - during the intervening time; "meanwhile I will not think about the problem"; "meantime he was attentive to his other interests"; "in the meantime the police were notified" meantime, meanwhile . The degree to which the counselor is receptive to self-advocacy and assertiveness assertiveness /as·ser·tive·ness/ (ah-ser´tiv-nes) the quality or state of bold or confident self-expression, neither aggressive nor submissive. in clients may indicate the degree to which disability myths or stereotyping enters into his or her thinking. Because assertiveness is a method by which a client can maintain control (Sedge sedge, common name for members of the Cyperaceae, a family of grasslike and rushlike herbs found in all parts of the world, especially in marshes of subarctic and temperate zones. , 1982) over his or her VR case and life, the counselor's reaction may point out the counselor's own need to control the client. As mentioned earlier, this need for control is often an initial step toward the adoption of disability myths. If the counselor can claim that control is necessary because he or she knows best or because he or she is the "expert", chances are good that the counselor harbors at least some disability myths and considers them to be valid. Although this discussion on disability myth has been rudimentary rudimentary /ru·di·men·ta·ry/ (roo?di-men´tah-re) 1. imperfectly developed. 2. vestigial. ru·di·men·ta·ry adj. 1. and far from exhaustive, the central idea remains that counselors must examine their own attitudes to guard against disability myths. If counselors fail to do so, such myths are very quickly and effectively institutionalized within the VR delivery system at the level of client encounters. Rehabilitation counselors can also resist myth-oriented thinking by remembering their own special training as professional helpers. This training is what sets rehabilitation counselors apart from the general population in terms of understanding disability myths as potential hazards to clear thinking. Training also gives the counselor the skills with which to make appropriate and objective decisions related to preparing others for competitive employment or independent living. Additional research is needed to determine the complex ways in which disability myths may become part of the service philosophy of counselors and agencies. Specifically, empirical investigation aimed at measuring impact on clients is needed before systematic solutions can be sought by administrators. If client impact indicators can be identified and quantified, the data could be put to use in designing new methods of quality control and counselor self-monitoring. To empower clients with the skills they need to achieve competitive employment remains the primary mission of the VR agency, a mission that requires sound planning and accurate information. VR counselors can improve the system by recognizing disability myths for what they are and by refusing to stereotype clients. Only then can the VR system and the VR counselor provide the best possible services to clients in need. References Allen, H.A., Peterson, J.S., and Keating, G. (1982). Attitudes of counselors toward the alcoholic. 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