any item, piece of equipment, or product system, whether acquired commercially off the shelf, modified, or customized that is used to increase, maintain, or improve functional capabilities of individuals with disabilities
Augmentative and Alternate Communication
A process in which the counselor identifies devices and techniques that the client can use to improve their communication
Durable Medical Equipment
Medicare term for reusable physical supplies such as wheelchairs and hospital beds that are ordered by the provider for use in the home; reported with HPCPS Level II codes.
Philosophical Principles that Define the Client's Role
a) the client must be involved
b) the client must recognize their own beliefs and feelings and how they affect their ability to function
c) the client must be willing to accept help
What is the purpose of anti psychotics?
Used to treat psychiatric conditions by altering the chemistry of the brain
What are the five levels of exertion?
1) Sedentary: less then 6lbs regularly and no more than 10lbs at a time
2) Light: less than 11lbs regularly and no more than 20lbs at a time
3) Medium: 26lbs regularly and no more than 50lbs
4) Heavy: less than 50lbs regularly and no more than 100lbs
5) Very Heavy: 50lbs regularly and more than 100lbs
7 Characteristic of "Universal Design"
1) equitable use
4) low physical exertion
5) perceptible information
6) size & space
7) tolerance for error
design of products and environments to be usable by all people, to the greatest extent possible, without the need for adaptations or specialized design.
Principle Universal Design; services or products are made to provide information in a way that anyone can access despite abilities or limitations.
Size & Space
Principle Universal Design; a service or product is designed so anyone can use it, interact with it despite limitations such as grip strength, moving, reaching, etc.
Tolerance for Error
Principle Universal Design; product or service is designed do that user mistakes are hard to make
5 Principles of Ethical Behavior
actin in a fair an impartial way towards all clients not letting "favorites" or biases influence the service provided
faithfulness to one's promises or obligations; not making insincere statements or impossible promises
Treatment Protocol for Alzheimer's
No cure but exercise, nutrition, physical therapy can help. Need visual monitoring to stay safe and need frequent reminders and queues to reduce anxiety
A genetic disorder that surfaces around age 30 causing anxiety and physical weakness as well as psychiatric and cognitive issues
Used to treat clinical depression; typically work on the neurotransmitters serotonin, nor-epinephrine, and/or dopamine
4 Etiologies of Medical Disorders
1) Congenital Defects
2) Degenerative Disorders
3) Acquired Disorders
4) Unknown Origin
4 Categories of Rheumatoid Disease
1) Rheumatoid Arthritis
an autoimmune disease that leads to inflammation of the joints and surrounding tissues
linked to genetics and affects more males than females; causes inflammation of joints between the spinal bones, and joints between spine and pelvis, eventually causes the affected spinal bones to join together.
When assessing functional capacity the two major components are...
a) Behavior: the client's past and present actions
b) Level of skill: the difficulty of activities that the client can complete successfully
Principle of Universal Design: a service or product is made to work in any reasonable way
Principle of Universal Design; a product or service is made to be used with little or no training
Low Physical Exertion
Principle of Universal Design: a product or service can be used comfortably, easily and safely
Restore, maintain, or teach skills of daily living and work; Focus on motor skills and mental acuity
Restore, maintain and promote overall fitness;
Focus on strength, endurance, and range of motion
Improve and maintain overall well-being: physical, mental and emotional; Focus on using leisure/recreational activities to increase/maintain abilities
A special program designed to help those with a physical or mental impairment to obtain, prepare for, engage in, or retain a job. Services are provided through the division of vocational rehabilitation. This program is supported by federal and state funds.
Principles of Treatment Planning
a) Tailor treatment to the specific needs of client
b) Treat ALL factors that affect the overall well-being of the client
c) Ensure that treatment lasts as long as the client needs it
d) Give the client the information needed to create and implement the treatment plan
the ability to perform necessary tasks; what a person is actually capable of doing
Functional Assessment Evaluation
(FCE): the assessing of client skills and the performance of certain tasks
any technique, strategy, or service that is intended to treat/diminish a specific problem
Philosophical principles that define the counselor's role
a) recognition of and focus on client's strengths
b) recognition and development of client potential
c) working with others to provide necessary services
d) recognition that the client is part of a system (family/community) and that the system may affect the rehabilitation process
e) ensure that the client continues to make progress towards goals
Steps of Strategic Planning
1) identification of goals
2) assessment of counselor ability to meet these goals
3) outlining of specific techniques that can be used to achieve
4) carry out the chosen intervention
5) evaluate progress on a continuous basis
The family member whose symptoms or behaviors are stated by the family as the reason for coming to therapy.
Payments for healthcare services made by an insurance company or health agency on behalf of the insured
Current Procedural Terminology - a systematic medical listing and coding of procedures and services.
Skills needed to coordinate services
1) communication- ability to transfer information
2) concatenation- ability to ensure the client has access to needed professionals
3) continuity- ability to ensure that all involved are working as a team
3 Types of Accommodation
1) Physical Accommodation- environmental
2) Resource Accommodation- a personal assistant
3) Equipment Accommodation- special tools
Solving Teamwork Problems
a) using conflict resolution techniques as problems arrive
b) re-evaluation and defining of individual team member roles
c) re-evaluation and redesigning of team goals
Piaget learning concept that is acquired between the ages of 7-11 where a child understands that volume, weight, and mass of an object stays the same even when the shape changes
The Piagetian stage for when children between the ages of 7-11 understand conservation of matter
Kohlberg's first phase: two parts- a child doing what is right to avoid punishment; an older child doing what is right as way to avoid consequences and because it is in the interest of the other
Maslow's Hierarchy of Needs
Pyramid of priority of needs
base to top: physiological needs, safety needs, social needs, esteem needs, self actualization
Pavlovian Methods in the Military
The use of transmarginal inhibition (TMI) techniques are used to re-program solider responses to discomfort of pain, fear
Steps of Work-Hardening
1) assessment of client's functional ability
2) Job analysis to discern the needed skills for employment
3) Identify options for employment
4) identification of specific accommodations, modifications &/or changes that will need to be made
Stages of Human Growth & Development: 8 stages that refer to how a person interacts with their environment. Each stage is a "crisis" which needs to be resolved before a person can successfully move to the next stage.
Myers-Briggs Type Indicator: psychological test based in Junian theory; four categories
1) Extroversion - Introversion: Where do you prefer to focus your attention?: Where do you get your energy?
2) Sensing - Intuition: How do you prefer to take in information?
3) Thinking - Feeling: How do you make decisions?
4) Judging - Perceiving: How do you deal with the outer world?
Purpose of Rehabilitation Services Administration
Division of the U.S. Department of Education's Office of Special Education and Rehabilitation Services; meant to ensure that people with disabilities have access to services needed to function and work and in daily life
Purpose of Office of Special Education Programs
Ensures that children with disabilities have access to an education that is tailored for the specific needs
An organization agrees to cover the costs of the item insured in trade for dues and fees
Purpose of State Workers' Compensation
An insurance program available to employers to cover costs when a worker is hurt on the job
Skills for Job Retention
a) ability to prioritize
b) ability to function under pressure
c) effective communication
d) ability to make decisions
e) ability to problem solve
f) ability to be part of a team
1918 Smith Sears Act
Authorized Federal Board for Vocational Education to organize and offer programs of vocational rehabilitation for veterans with disabilities. Employment as a result of vocational rehabilitation training had to be a feasible possibility.
1920 Smith Fess Act
The civilian vocational rehabilitation [act] program. Counseling, training, prosthetic appliance and job placement to physically disable from industrial injuries. Provided federal funds to states on a 50-50 matching basis.
1935 Social Security Act
established three types of federal provisions public assistance, social insurance and health/welfare services; also established voc-rehab as a permanent program
1936 Randolph Sheppard Act
joblessness among the blind must be reduced through a robust program to assist blind people in the establishment and operation of cafeteria, concessions, and vending businesses on federal, state, municipal and potentially private property
1943 Barden-Lafolette Act
made substantial changes in the federal/state program of rehabilitation; broadened the program's financial provisions, offered a comprehensive definition of vocational rehabilitation, expanded services to include physical restoration, and each state had to submit a written plan for approval by the federal agency as to how federal/state dollars would be used; expansion of services included on a limited basis person who were mentally handicapped and mentally ill; fostered separate agencies for general rehabilitation and rehabilitation of person who were blind.
1954 Amendments-what did they do?
reshaped the roles of the federal and state government in the rehabilitation program; established the basis for a working relationship between public and private rehabilitation and expanded the role of the state agency; established funding sources for (1) college and university training of rehabilitation professionals; (2) improvement and remodeling of rehabilitation facilities; and (3) research and demonstration grants; increased federal funding to states (3 federal dollars for each 2 dollars from the state); increased services to persons with mental retardation and mental illness through items (2) and (3) above, along with agency expansion and improvement grants.
Rehabilitation Act of 1973
Prohibits discrimination of hiring persons with disabilities by federal agencies and federal contractors.
RA of 1973 Section 502
created the Architectural and Transportation Barriers Compliance Board (ATBCB) to enforce standards set under the Architectural Barriers Act of 1968
RA of 1973 Section 503
prohibited discrimination in employment on the basis of physical or mental handicap on the part of businesses with federal contract or their subcontractors
RA of 1973 Section 504
prohibited discrimination on the basis of physical and mental handicaps in programs receiving federal funds; also established the Client Assistance Demonstration Projects (CAPS) to provide assistance in informing and advising clients and applicants of all available benefits under the Rehabilitation Act; emphasized priority of services for persons with the most severe handicap and the development of the Individual Written Rehabilitation Plan (IWRP); established by statute the Rehabilitation Services Administration.
1990 Americans with Disabilities Act
requires employers and public facilities to make "reasonable accommodations" for people with disabilities and prohibits discrimination against these individuals in employment.
1992 ADA Amendment
stressed respect for ind dignity, personal responsibility, self determination, and pursuit of meaningful careers based on informed choice
1998 ADA Amendment
purpose is to empower ind w/ disabilities to maximize employment, economic self-sufficiency, independence and inclusion and integration into society
2009 ADAAA Amendments
reiterate who is covered by the ADA civil rights protections. It revises the definition of "disability" to more broadly encompass impairments that substantially limit a major life activity. It also states that mitigating measures, including assisstive devices, auxiliary aids, accommodations, medical therapies and supplies (other than eyeglasses and contact lenses) have no bearing in determining whether a disability qualifies under the law. Changes also clarify coverage of impairments that episodic or in remission when active, such as epilepsy or post traumatic stress disorder, that can substantially limit a major life activity. These amendments took effect January 1, 2009.
Family Medical Leave Act
1993; Requires employers with 50 or more workers to grant up to 12 weeks of unpaid leave a year to allow workers to take time off to help care for a new baby or an ill family member without fear of losing their jobs.
Uniformed Services Employment and Reemployment Rights Act
1994. It protects military members for weekend duty, 2-week training periods, short term assignments and war theater assignments
Workforce Investment Act
the federal government's effort to adapt workforce training system to current economic conditions--- provides states with block grant programs that target adult education, disadvantaged youth, and family literacy
The Ticket to Work & Workforce Incentives Improvement Act (TWWIIA)
1999--- increase individual choice in obtaining vocational and employment services; provide increased health care coverage for workers with a disability; and eliminate some of the disincentives to work. The law also created the Medicaid Buy-In program which enables certain individuals to receive Medicaid coverage by paying a premium.
A form of insurance paid by the employer providing cash benefits to workers injured or disabled in the course of employment.
Health Insurance Portability and Accountability Act (HIPAA) 1996
federal law that requires all health care settings to ensure privacy and security of patient information. Also requires health insurance to be accessible for working Americans and available when changing employment.
Genetic Information Nondiscrimination Act (GINA)
A 2008 Federal law that prohibits employers from discriminating against applicants or employees on the basis of genetic information gleaned from the individual or family members.
1917 Smith Hughes Act
established the Federal-State Program in vocational education; created a Federal Board of Vocational Education with the authority and responsibility for vocational rehabilitation of disabled veterans.
4 areas of concern in client-counselor relationship
1) Team approach to treatment planning
2) Monitoring to determine progress of plan
3) Development of realistic, attainable goals
4) Consideration of client resources: $$, transportation, and social support
Duty to Warn
The ethical responsibility to take appropriate action when there is knowledge of impending danger.
Mandatory Ethical Guidelines
Rules that must be followed to avoid personal, legal, or criminal troubles- sex w/ client, conflicts of interest, fees
Aspirational Ethical Guidelines
Moral compulsions to behave in a way that is perceived as moral and proper
Feelings of intrinsic motivation, in which people perceive their abilities to have impact and meaning and perceive themselves to be competent and capable of self-determination.
Statement of Disclosure
A written document that lets the client know about the procedures and practices of the services they are to receive. Includes: billing, office hours, counselor credentials, and confidentiality procedures
Is it ethical for a counselor to talk about a client with another professional?
Only if the reason for talking to another professional is in the best interest of the client
4 Types of Advocacy Groups
Strategic Therapy: developing of a specific strategy to treat a specific problem; use of directives;the therapist takes responsibility for directly influencing clients
Paradoxical intervention: characterizing a negative behavior in an even more negative way
Helping a family with a child in the hospital
1) re-evaluate current needs of the family; refer them to additional services if needed
2) ensure the family understands the medical information and treatment protocol
3 goals of Behavioral Group Approach
1) develop social skills
2) teach the skills necessary to function in society
3) help teach the skills necessary to adapt to whatever the situation is
Structural Family Therapy: uses joining, enactment, boundary making, and mimesis techniques
Structural Family Therapy intervention: therapists attempt at greeting and bonding with family members
Structural Family Therapy intervention: family members are asked to act out the problem situation to bring insight into the family dynamic
Structural Family Therapy intervention: the therapist mimics the positive and negative behavior patterns of individual family members
Advantages of Group Counseling
1) extension of client social support system
2) improved ability to communicate
Positive Group Actions
a) attend to the person speaking
b) no interrupting or distracting behavior
c) encourage each member to voice their thoughts
d) take steps outside group to meet goals
Autocratic (authoritarian) Leadership
leader forces themselves into group dialog often and is always right
1) upper class
2) upper middle class
3) lower middle class
4) working class
5) working poor
A range of mild to more severely debilitating behaviors for which treatment may be necessary
Importance of job analysis for psychiatric disabilities
Identifies the skills a person will need to fulfill a specific position. How much stress a position has is especially important w/ this population
developed by Glasser; focus is on the present and felt that people could control life by taking action; stressed the importance of perception
when an individual is diagnosed with both a psychiatric disorder and a substance use disorder
Psychedelic "mind manifesting" drugs that distort perceptions and evoke sensory images in the absence of sensory input; alters moods, thoughts, and sense perceptions, including vision, hearing, smell, and touch
opium and its derivatives, such as morphine and heroin; they depress neural activity, temporarily lessening pain and anxiety.
Info in a Treatment Plan
a) client diagnosis & codes
b) major goals for treatment
c) timeline for goal achievement
e) signatures of client and counselor
Stress Management Techniques
b) relaxation- deep breathing, music
Competitive Employment Setting
a work environment in which a person with a disability does the same work and receives the same benefits as a non-disabled peer
Integrated Employment Setting
a person with a disability works alongside people without disabilities
Marketing Rehab Services to an Employer
1) Gather as much info as possible- labor analysis
2) Decide what skills/services to market
3) Develop a plan
3) Develop a strategy- to target appropriate employers
Steps of Job Matching
1) Assess client strengths, skills, and limitations
2) Use available tools to find appropriate occupations
3) Use resources to find employers who are hiring
4) Identify relevant job openings
What is the purpose of employer development?
To create a job for a specific client with an employer which isn't actually available.
Structured Development Model
Designed by Delworth & Maki in 1995 expands on the Integrated Development Model by the 8 domains into 2 subgroups a) primary domain group & b) process domain group
The process of describing, setting up, and defining a valid research experiment
Ethical principles of research
1) protecting the rights of participants
2) research is consistent with organization's rules, standards of practice, and all laws
3) the counselor is responsible for actions taken by those under their supervision
4) respect of the culture of participants
5) minimize the harm done to participants
Integrated Developmental Model
Designed by Delworth & Stoltenberg states that counselor skills can be developed in 8 domains: client assessment, ethics, interpersonal assessment, conceptualization, intervention, serving people w/ different needs, understanding and applying theory, & treatment planning/goal setting
Hypothesis is a theory based on observations but are of no use unless they are tested. All hypothesis are subject to rigorous experimentation to determine truthfulness.
4 methods of sampling
1) Random Sampling
2) Cluster Sampling
3) Stratified Sampling
4) Horizontal Sampling
Participants are taken from the general population w/o regard to characteristics then randomly assigned to a control or experimental group.
3 characteristics of an effective qualitative research strategy
1) credibility of sources
2) dependability of sources
3) transferability of results to a larger population
A process in which an organization provides monitoring and evaluation of the performance of its counselors.
The independent variable (intervention) is manipulated and the results are monitored
The skewing of results that may happen if the intervention is administered only once; change in the dependent variable due to the temporary nature of extreme values; threat to internal validity
5 Main Qualitative Research Strategies
1) Grounded Theory
5) Case Studies
Information is gathered about a specific population group through the stories told about them
5 actions a counselor can take to be an effective advocate
1) encourage people to act in the interest of those with disabilities
2) encourage clients to represent their interests
3) work with people to remove environmental barriers
4) ensure access to services
5) promotion of designs and models that accommodate functional limitations
The variable that cannot be changed by the experiment; the effect of the intervention method being tested
Statistical Conclusion Validity
when the information obtained can be used to prove or disprove a particular theory
Why is cultural background important?
influences values and beliefs which may then influence the techniques used, methods used, or how the counselor interacts with the client.
Steps of Mediation
1) the people involved in the dispute select a mediator
2) mediator establishes a format
3) mediator will host a joint meeting between all parties to discuss issue/s
4) mediator will facilitate a discussion of solutions
Requirements of Participation in Work Conditioning Program
Person must have a physical impairment, must not have a behavior or pain issue, there must be a reason for a Dr to think they will be able to return to work and they must consent to participation
Time Management Techniques
2) Allows for as many tasks to be done as possible
3) use of technology that may make job easier
Showed that we have a need for comfort, touch, or cuddling and w/o it physical problems and dysfunctional behaviors develop
Perls-a way in which a person perceives a chain of events and what they see as important or unimportant; he believed these relationships are constantly changing.
Skinner- found that adding (positive) reinforcement or taking away (negative) reinforcement incentives would increase a desired behavior
Circular or Reciprocal Causality
The dynamic interactions that have more than one effect; from family systems approach
(psychoanalysis) the process whereby emotions are passed on or displaced from one person to another noun- during psychoanalysis the displacement of feelings toward others (usually the parents) is onto the analyst
is composed of members who voluntary commit to the group with the intention of improving them self
Goals of Family Therapy
a) to achieve & maintain homeostasis with in the family unit
b) achieve adaptability so that the family unit can adjust to new circumstances
Behavior Modification Term: the process of getting a behavior to disappear with little or no reinforcement
An extinction technique where the individual is removed from the situation and put into a low stimulus environment
A learned response which teaches the user to recognize and change unhealthy thoughts
the manner in which a parent reacts to the discovery that their child has a disability
the set of customs, traditions, physical characteristics, and other cultural influences that are inherited from past generations
Experiential Symbolic Family Therapy
Developed by Whitaker, a hands-on approach where role play and mimicking are used in sessions to bring about change
Help a person fall asleep and stay asleep; often the same meds used to treat anxiety bu ion higher doses
an illness or injury or other disorder that developed suddenly or that is expected to last only a short time
an illness, injury, or other condition that is expected to last for a long time or which has developed slowly over a period of time
an illness, injury, or other condition that is not expected to last as long as a chronic condition but longer than an acute condition
Core Values of RC according to CRCC
1) services must be provided based on client-counselor cooperation
2) counselors must recognize the worth and dignity ot each person
3) must concentrate on client's strengths
4) must ensure that clients have the opportunity to work and interact within society
5) must advocate for equal opportunities & rights
6) must recognize that the inability to function is often the result of a combination of factors
Two types of functional capacity evaluations (FCE)
1) general function: assess the skills required in a variety of occupations; before an occupation has been chosen
2) job-specific: assess the skills for a particular occupation: after an occupation has been chosen
The study of workplace equipment design or how to arrange and design devices, machines, or workspace so that people and things interact safely and most efficiently.
Human Factors Engineering
field focusing on designing objects so that they are compatible with the human body and human cognition
4 Types of Orthotic Devices
1) lower extremity devices
2) spinal devices
3) upper devices
4) simple/special assistive devices
a process in which the counselor gathers info =from/about client to determine strengths, weaknesses, and needs
a rank is assigned to client skills or aptitudes based on interview and assessment results
results are compared with a large body of test takers who have established a normal range of scores
Interpreting Test Results
1) review results looking for trends and patterns
2) organize information in a way that makes sense
3) check the validity and reliability of tests and focus on client strengths/abilities
Factors to consider when choosing software
1) reliability and validity
2) reputation of developer
Factors to termini client career/employment needs
1) overall ability
2) physical restrictions
3) psychological limitations/impediments
4) basic interests
5) social skills
3 tests designed to measure predictive validity
1) GRE: used to predict the success of a person entering grad school
2) SAT/ACT: predict success in undergrad education
3) Polling: predicts outcome of elections; often deemed inaccurate predictors
Advantages of computerized evaluation
1) allows a large amount of info to be collected quickly
2) determine results more accurately as well as quickly
3) keeps testing conditions more consistent
4) more convenient to store results
Two types of norms used ti interpret psychometric assessments
1) General norms: typical score because a large number of others have achieved the same score
2) Special norms: a large number of people who share a common characteristic have achieved the same score
What is the difference between a speed test and a power test?
Speed tests measure how long it takes a person to complete and is not concerned with difficulty while a has no time limit and is designed to measure the breadth of knowledge of the taker
When giving feedback to client the counselor should:
1) reiterate the purpose and format of the assessment
2) share the results and exactly what they mean
3) ask for and answer all questions
the extent to which a test yields consistent results, as assessed by the consistency of scores on two halves of the test, on alternate forms of the test, or on retesting
standard of comparison for test results developed by giving the test to large, well-defined groups of people
What is the difference between a spiral test and a cyclical test?
In a spiral test there is only one section and the questions get progressively more difficult throughout while in a cyclical test each section has progressively harder questions
4 goals of counselor during a feedback interview
1) deliver information as effectively as possible
2) engage client in a discussion
3) ensure the client understands the information
4) gather enough information to develop a plan to proceed
List 3 formulations of Bandura's Social Learning Theory
Rather than interests guiding carer choice social learning guides it. The relationship with own body; environmental/geographical influences; instrumental/conventional) learning and reinforcement
Extent to which scores suggest that a test is actually measuring an ABSTRACT theoretical idea (such as anxiety, personality, introversion, etc.).
the degree to which two separate tests that are said to measure the same thing, agree on results
Standard Error of Measure
The amount of error determined to exist using a specific instrument, calculated using the instrument's standard deviation and reliability.; uses a point system
What should a counselor avoid doing in a feedback session?
1) arguing with client
2) not focus on disability or weaknesses
3) avoid confusing the client
3 methods of measuring test reliability
2) Equivalent or alternate form
3) Split-half Method
a method for determining the reliability of a test by comparing a test taker's scores on the same test taken on separate occasions
Equivalent or Alternative Forms
Giving people two or more different tests that are designed to measure the same thing and comparing results
checking the reliability by comparing the odd answers of one group by the even answers of another group
Disadvantages of a Computerized Evaluation
1) mistakes might be made that would not be made on a paper test
2) Test may be blemished due to the program administering it
3) Some may provide too much information which can make it difficult for the counselor to sift through
Ginzberg's Developmental Approach
Based on developmental factors that relate to occupational choice
1) Fantasy, birth-11: children dream of future work
2) Tentative, 11-17: the teen begins to view career in terms of abilities, background, and education
3) Realistic, 12- early 20s: person compromises between abilities and aspirations
*Later expanded theory to say that career development is a lifelong process
Krumboltz: stressed the importance of modeling and vicarious learning in career choice
Human Capital Theory
people invest in training and education to get the highest return from career choice
Status Attainment Theroy
states that a person will achieve the same levels of emotional and financial success as parents.
Wechsler's Intelligence Tests
a) WPPISI: ages 3-7
b) WAIS-II: ages six and older
c) WISC III: age 6-16 & 11 months
as a toll allows the client the opportunity to provide more information and choose a direction
prompts from the counselor to narrow the topic of discussion or to bring the discussion back on track
What is the white vs. black IQ controversy?
a controversy of the 1960s/70s that white people were on average 11-15 points smarter than black people; in reality when given an IQ test that was more culturally sensitive to blacks they scored just as well
not putting something brought up by the client off until later but rather discussing it now
to have confidence in expertise and reliability of the counselor in the client's eyes is important; the counselor must not pretend to know things they don't
A projective assessments that follow a free-response formula. There are 30 of an ambiguous nature and the client is asked to tell as tory about them; attempts to determine underlying needs, attitudes, and responses to environmental conditions.
A projective assessments that follow a free-response formula. The Rorschach uses 10 ink blot cars and the client is asked what they see.
Relies on opinions rather than facts and leaves room for interpreter biases (ex: essay test)
Forced Choice Tests
requires the test taker to recognize the information being presented by answering all questions
divided career fields into 8 categories and 6 levels
Categories: arts/entertainment, general, technology, outdoor, science, business, organizations, and services industry
Levels- requiring most to least experience and knowledge: professional & managerial, semi-professional, skilled worker, semi-skilled worker, unskilled worker
3 prominent people in career guidance
1) Frank Parsons: wrote "Choosing a Vocation," known as the "Father of Voc Guidance," trait-factor
2) Edmund Williamson: advocated for use of Minnesota Occupational Rating Scale and trait-factor
3) Anne Roe: voc psychologist who suggested career choice theory based on personality traits, relied on Maslow; developed a system of job classification
Name 3 career counseling tests
1) Minnesota Occupational Rating Scale
2) Meyers-Briggs Type Indicator
3) Guilford-Zimmerman Temperament Survey
American Indian Voc Rehab Services Program
Offered by Rehab Services Administration; support services for American Indians w/ disabilities, grants for reservations to offer counseling, medical services, &/or other services that a person with a disability may need
Holland's 6 Personality Types
Freudian Term: when a boy in the phallic stage bonds with his mother and experiences a sexual attraction to her
Perl's Phony Layer
Gestalt Therapy: 1st layer- people live according to rules imposed from the outside and become frustrated when others do not understand who they really are
Perl's Phobic Layer
Gestalt Therapy: 2nd layer- a person presents a layer which others think they should be
Perl's Impasse Layer
Gestalt Therapy: 3rd layer- attitude of phony role playing hardens and becomes a barrier to growth
Perl's Implosive Layer
Gestalt Therapy: 4th layer- willings on the part of the person to expose true self
Perl's Explosive Layer
Gestalt Therapy: 5th layer- when a person gives up the unreal/false personality built by outside expectations
Skinner: used positive and negative reinforcement and punishment to change behaviors
a technique used in behavior therapy to treat phobias and other behavior problems involving anxiety
a behavior therapy procedure that conditions new responses to stimuli that trigger unwanted behaviors; based on classical conditioning. Includes exposure therapies and aversive conditioning.
5 levels of consumer initiative
Designed by Oncken & Wass to measure personal initiative.
a person will recommend an action and then take it if it is approved by the supervisor
a person will take action without approval but will report the action and the results to supervisor immediately
a person will take action without approval but will report at regular intervals to the supervisor
Demand-side Job Development
a counselor's attempt to encourage an employer to hire people with disabilities
established by Social Security Act of 1935- designed to provide benefits to people who have lost their job
What techniques should a counselor use to help a family with a child receiving in or out-patient care?
1) double check all info collected about family to insure accuracy
2) Evaluate home to ensure that child and family will be able to function
Helen Keller National Center
established by the RSA- offers rehabilitation and support to people who are deaf and blind
Independent Living Services for Older People Who are Blind
established by RSA to help states provide rehabilitation services to people who are blind and over the age of 55
The Randolph Sheppard Vending Facility Program
offered by RSA to help people who are blind find and obtain employment by federal, state, &/or private facilities
Managed Care Delivery System
also known as a managed care plan is a private insurance plan or a government program that helps customers manage their healthcare costs
Managed Care Organization
an agency that provides managed care services
Medicare Part A: must be 65 and eligible to receive social security or railroad retirement OR have been disabled for 24 months and is eligible for social security
duties, responsibilities, &/or working conditions associated with a particular position have been altered to be more suitable for a specific person
a mock employment setting that allows a person with a disability to practice parts of a particular job position
written document that details a person's knowledge, skills, abilities, and experiences
Employment Inventory (EI)
used to determine whether a person will be an effective employee and where they need to improve.
What questions should be asked when performing a Labor Market Survey?
a) competitiveness of market
b) How is the market changing?
c) What occupations are available and what is the needed skills set?
What are the two major categories that the U.S. Labor Market can be divided into?
a) Primary- white collar jobs
b) Secondary-blue collar jobs
What are three ways physical factors affect job selection?
a) lifting restrictions
b) Visual difficulties
c) Severe allergies
Assistive Technology State Grant Program
offered by RSA, to help states design their own assistive technology program
The Protection and Advocacy for Assistive Technology Program
offered by RSA to encourage states to create their own assistive technology advocacy agencies.
a field of medical design to create devices that help people with disabilities function
What is the Medicare Program?
established in an amendment to the Social Security Act in 1965 offers healthcare to the elderly and/or people with disabilities
What are some of the typological roles assumed by members of a therapy group?
always tries to implement rules and attempts to get others to contribute often forgetting to talk about their own issues
What steps should a counselor take when working with a group form a different cultural background?
1) gather information about the culture
2) Understand how groups in that culture communicate
3) Ask questions to clarify any confusion
What actions make someone an effective supervisor?
1) encourages the giving and receiving of feedback and encouragement
2) Cooperates with subordinates
3) Demonstrates the skills and attributes to be followed
4) Demonstrates a sense of enjoyment and satisfaction in their work
5) Discusses problems as soon as they arise
the result of high expectations, when the teacher explains that those in the front row because they did better than the rest of the students which results in the front row doing better than the other rows.
4 Types of Quantitative Research
2) ex post facto
4) True experimental
4) True experimental
people are randomly assigned to an experimental/control group and the results of the two groups are compared
Kirkpatrick's 4 Levels of Evaluation
1) reaction level- measures client's reaction to program
2) Learning level- evaluates program by testing clients' new knowledge
3) Behavior level- evaluates program by monitoring client behavior
4) Results level- evaluates program by analyzing progress made toward original goal/s
changing the responsibilities of a position to meet the specific needs of the person
confusion in the subject in regard to the stimuli, when a small bell triggers a response but then the person reacts to a different bell the same way
Extended Period of Eligibility
SSA incentive which provides supplemental support to a person who is working but is earning less than the SSA income limit
Trial Work Period
SSA incentive to provide a person with SSA money for up to five nine months in a five year periods when they have earned more than the SSA income limit
Integrity vs. Despair
Erickson Stages of development, starts at 60yrs when a person starts to reflect on life- did they live a meaningful life or one with regrets?
Post conventional Morality
Kohlberg's highest stage of morality- occurs late in life and is a personal morality, developed by the adult and which supersedes society's rules, laws. And restrictions
Trust vs. Mistrust
Erickson's Stages of Development- newborn will wither trust or not based on the reliability of having needs for food and comfort met.
Piage term to describe a child's understanding that a process can be done in reverse (ex: toys in backyard can also be picked up and put way)
What are some of the consulting services an RC may offer to an employer?
a) recruitment services
b) Disability information services
c) Productivity services
What are some of the employment strategies prohibited by the ADA?
discrimination against people with disabilities. It requires that any agency with 15+ workers have positions available that could be filled by a person with a disability. It also requires that the agency ensure that the person with a disability has access to the place of employment unless it causes significant harm to the business.
What actions should a counselor take to prepare for the employer development process?
a) gather as much info from client and employer as possible
b) The counselor should get the job application from the employer
c) Help the client prepare for interview by helping to prepare a resume and cover letter
Plan to Achieve Self Support (PASS)
offered by the Social Security Administration to help people save money for education, training, &/or any other activity that will help them further their career goals
The Employer Focused Model
the focus is on the needs of the employer rather than those of the client
Factors that affect successful position development
a) client's specific skills
b) Rarity of those skills
c) Employer's needs
Once employed what are some of the available support services?
b) Financial support
c) Job coaching
d) Retention services
e) Travel services
What requirements must a person meet to work in an extended support employment setting?
a) must have a severe disability that restricts function in at least 2 ways
b) The person must require support services from at least 2 different employment services
c) The person must be unable to work in a competitive environment
d) The person's disability must be classified as a "significant disability" by the support agencies
What is the purpose of employment support services?
they are designed to help people with disabilities to find or maintain employment
Supported Employment Setting
a work environment in which a person with a disability is required to perform only the tasks that they are capable of performing but may be able to eventually perform all the tasks and so need support only for a limited time
Extended Support Employment Setting
a work environment in which a person with a disability is required to perform only the tasks that they are capable of performing and may always need extra support because will not be able to ever take on all of the duties
Transferable Skills Analysis
the counselor helps to identify the skills a person has that could be used for a new occupation
What are the steps of the desensitization process?
1) relaxation training
2) Construction of an anxiety hierarchy
3) Desensitization in imagination
4) in vivo or "real" life desensitization
a system of beliefs and values that a particular group has established , as well as the way people with in that group act because of those values.
the similarities and the differences that can be distinguished between differing cultures
the attempt to understand and incorporate the beliefs and values of a particular group
Describe Group Theory
developed by Adler & Dreikurs based on the idea that people are strongly motivated to seek the acceptance of their peers. Through the feedback of peers a person's behavior can be modified
What are some of the behavioral differences between male and female children?
Females- use more feeling words at an earlier age, better understanding in non-verbal situations, more suicide attempts
Males- better visial-perspetive skills, more often successful in suicide, punished more
an idea of Perls that a person needs to complete unfinished scenarios in order to achieve self-actualization
Name 2 tests that measure inclination/aptitudes
1) Thematic Aptitude Test (TAT)
2) Minnesota Viewpoint Test
3) Myers-Briggs Type Indicator (MBTI)
What are the four categories in the MBTI?
1) extroversion vs. introversion
2) Sensing vs. intuition
3) Thinking vs. feeling
4) Judging vs. organizing
Piaget's first stage of motor development, birth- 2yrs when the child understands their environment only through the 5 senses.
Freudian term, the defense mechanism that helps the individual accomplish real world objectives like education or career
Freudian term, the psychic mechanism which governs the ego, inability to satisfy results in shame, guilt, and other internal conflicts
What are the characteristics of a good counselor?
sincere and genuine, empathetic, consistency and perseverance
What is the Heinz Story?
Kohlberg- a man cannot afford his wife's life saving medicine, he tries to convince the pharmacist to sell him the med at a discount but the pharmacist refuses so the man steals it.
- A person's response to this scenario indicates what stage of moral development they are in
Transmarginal Inhibition (TMI)
Pavlovian, the point at which a person shuts down due to an extreme stimulus,
Equivalent stage of pain response
stage in which a person's response to stimuli is equal to the amount of stimuli
Brinkerhoff's Six Stages of Evaluation
1) Evaluation of need assessment & goal setting
2) Program design
3) Program implementation
4) Evaluation of learning
5) Evaluation of usage and endurance of learning
6) Evaluation of payoff
form of behavioral therapy where client is bombarded with their issue or behavior until they reach exhaustion
form of behavior therapy which involves exposing client to source of phobias either with pictures or directly
What are the exceptions to privileged communication?
When there is a danger to self or others such as in child abuse, suicidal or homicidal behaviors or other harmful criminal intentions
Is it ethical for a counselor to use an unfamiliar assessment?
No, a counselor must be familiar with the tools they use and in how to interpret/use them.
The American Association of People with Disabilities (AAPD)
a multi-disability, multi-issue advocacy group. They address issues such as accessibility, career development, equal employment, civil rights as well as resources for people with disabilities
The American Disabled for Accessible Public Transit (ADAPT)
national grass-roots community that organizes disability rights activists to engage in nonviolent direct action, including civil disobedience, to assure the civil and human rights of people with disabilities to live in freedom.
a blood clot that forms in an area away from the brain but then travels through the blood stream to the brain and deprives it of oxygen
What are the career implications for Myasthenia Gravis?
commonly found in young women between the ages of 20-40, it is an immune deficiency that causes muscle weakness and can be exasperated by a stressful environment.
What are the career implications for Parkinson 's disease?
A degenerative disease that causes loss of muscle control symptoms includes shaking, fatigue, balance troubles, and eventually dementia. A cold working environment should be avoided as should working with chemicals or other lung irritants.
Figure Ground Relationship
Gestalt term, refers to how a person perceives an event, the drawing of the vase/faces the one that is perceived is the foreground and the other is the background
How can a counselor use the internet to aid a client?
helping the muse it as a communication tool and an information gathering tool
What is the process of a transferable skills analysis?
1) identify client's skills
2) Look at each skill to determine if it is transferrable
3) Use resources to identify compatible occupations
4) Use a job matching system to find specific jobs
What is the purpose of a one-stop career center?
They help people find, obtain, and retain employment. Their development was part of the Workforce Investment Act of 1998.
American Foundation of the Blind
a single-disability, multi issue advocacy group for people with visual impairments
The American Association of Intellectual & Developmental Disabilities
multi-disability, multi issue advocacy group that helps people with DD
The National Association of the Deaf
single-disability, multi issue advocacy group for people that are deaf or hard of hearing
Short-term disability insurance
provides a percentage of the income that a person formerly received each month when they are unable to work due to a temporary disability, generally available only for a specific time period
Long-term disability insurance
provides a percentage of the income that a person formerly received each month when they are unable to work due to an acquired disability, generally lasts for more than 2 years
Federal Employment Compensation Act
enacted in 1916 to help people who have been injured or disabled while serving in a federal position
Basic Vocational Rehabilitation State Grants
offered by RSA, to help each state design its own Voc. Rehab. Program.
The Client Assistance Program
offered by RSA, provides information about the legal rights and the service to which a person with a disability is entitled
The Projects with Industry
program offered by RSA, to help people with disabilities find, obtain, and retain competitive employment.
Rehabilitation Engineering Research Center
a research facility funded by the National Institution on Disability and Rehabilitation Research that works to develop new techniques and devices for people with disabilities.
Rehabilitation Research and Training Center
a facility established by NIDRR to study a specific disability, a group of disabilities or a specific topic related to the rehabilitation process.
Individual Practice Association Program
a managed care plan in which participants can seek care from a specific group of physicians for a set fee.
Point of Service Plan
a managed care plan that allows members to seek medical care from any physician or facility.
used to describe how a person transmits information, a person states outright what they are trying to convey w/ minimal non-verbal information
used to describe how a person transmits information, a person uses a variety of non-verbal signals to help convey what they are saying.
What are the 3 main factors that determine if a supervisor and a counselor can work together effectively?
1) ability to agree on goals
2) Ability to agree on methods
3) Ability to cooperate
substances or entities which are inert or inactive that are given to an experimental group, often people report an "effect" even though there is none
a person formulates a rule based on a specific observation or study, all the kids who ate sugar got hyper- therefore, sugar makes kids hyper
a person formulates a specific idea based on a general observation, all birds have feather-Big Bird is a bird- therefore, Big Bird has feathers
What is the purpose of a program evaluation?
a review of a treatment program to see if it as achieved or is moving towards its desired outcome
What is the purpose of the Job Openings and Labor Turnover Survey?
a labor market assessment preformed by the US Dept of Labor, it attempts to identify the number of jobs that are available in each occupation.
What are some the trends expected for the US labor market?
1) significant increase in number of service jobs
2) A significant decrease in the number of manufacturing jobs
3) An increased need for formal education
What are some advantages of a job-matching system?
1) an easier job matching process
2) Easier transferrable skills analysis
3) Provision of a relatively through list of potential job openings
Directory of Occupational Titles, book published by the Dept of Labor since 1939, it lists over 28,000 jobs and describes requirements, training, and number of people employed
Standard Occupational Classification, a manual that codes jobs in clusters that contain jobs that are similar enough that a person may have the skills to work in any of them
What are the ethics around client-counselor conflict of interest?
a relationship outside of the business association would be considered unethical
Is it ethical for a counselor to accept a client's property in exchange for services?
In most cases no
Client Right to Privacy
legally the client has the right to confidentiality unless harm to self or others is an eminent risk or ordered by the court.
a counselor is obliged to refer clients to another counselor if for any reason they must no longer provide services
when a counselor has a relationship with a client outside of the counseling environment
What are the ethics around establishing fees?
1) client's ability to pay must be evaluated, if they cannot afford services the counselor must refer them to another agency
2) Counselor's must inform clients of the Fee for Service
3) A counselor is prohibited from charging any non-agency fees
What are some ground rules for therapy groups?
1) no eating or drinking
3) Respect for self and others
What are some techniques that are useful for maintaining a group?
Computer Assisted Career Guidance
a computer program that allows clients to identify their skills and how they can be used, can only be used at one location
Internet-based Interactive Career Planning
a computer program that allows clients to identify their skills, it can be accessed at any location
Independent Living Paradigm
a rehabilitation model based on that idea that the goal of RC is to reduce the negative effect that environment has on an individual due to their functional limitations
prevents a person from performing required tasks as effectively as another person
What factors should be identified by a labor market survey?
a) size of current labor force
b) Unemployment rate for area
c) Total labor force available to employers
d) Occupation mix
Where can a person find information on occupations?
1) Publications- Business Almanac, Business Directory, OOH
2) Programs/Websites- O*NET, internet-based career planning, job-matching programs
Functional Job-matching Strategy
focuses on the functional limitations rather than the skills of the client
3 Main Types of Job Skills
1) Data/Informational skills
2) Interpersonal/Social Skills
3) Mechanical Skills
a pulmonary disease that causes breathing problems and attacks, attacks can be triggered by stress, pollen, chemicals, and odors
a pulmonary disease that causes deterioration of the lungs resulting in difficulty breathing, work environments with dust or other irritants, need to be avoided
uncontrollable movements, sudden reflex actions caused by nerve impulses to hands and fingers.
a blood disease that is transmitted genetically and causes excessive bleeding due to a low amount of clotting factor.
located at top of spinal column, it is the conduit between the brain and the rest of the body, controls reflex actions
the earliest part of the brain to form, it is the control center and regulates metabolism, sex drive, hormones, and other basic functions
the largest part of the brain where upper level functions occur such as emotions, intelligence, judgment, language
the second largest part of the brain it coordinates muscle movements like walking, running, and other motions
is an acute viral infection of the spinal cord, followed by residual paralysis of muscles. The person may use prosthetics or other mobility devices and heavy, manual labor may be difficult.
a birth defect of the spinal column, can now be partially corrected in utero, causes muscle weakness and/or paralysis, and impaired bowl/bladder function. May use mobility devise to improve functioning, may need long-term rehabilitation/therapy care, and often have hydrocephalus and learning disabilities
Central Nervous System
consists of the brain, spinal cord, and the nerves that run throughout the body. The CNS runs both voluntary and automatic functions and is the communication system of the body.
established as part of the Social Security Act of 1965 to offer health insurance to people who cannot afford it otherwise. It allows each state to claim matching grants from the federal government to support such programming.
Social Security Disability Insurance (SSDI)
work incentive program offered by the Social Security Administration to provide financial assistance to people with disabilities who are preparing to re-enter the workforce
Supplemental Security Income (SSI)
a work incentive program offered by the Social Security Administration to provide financial assistance to people with disabilities after they return to work.
a Haley family therapy strategy is a no-win situation where any of the solutions to an issue are equally insufficient
the use of procedures, techniques, and resources to make sure that all clients receive the necessary services and care.
the use of procedures, techniques, and resources to make sure that a specific client receives the necessary services and care.
Is it ethical for a counselor to refuse to work with a specific client?
Yes, and in some cases they are required to refuse to work with a specific client due to other ethical issues such as dual relationships
What is the difference between collectivism and personism?
they both relate to the role groups play in a person's culture. In collectivism the individual is not seen as independent to the group. In personism the individual is seen as independent from the group.
transient ischemic attack: a "minor" stroke that occurs when the blood flow to the brain is only temporarily interrupted.
Reflecting Treatment Team Therapy
a postmodern method first used by Tom Anderson, a technique that allows the family to listen to the discussions of a treatment team about the family's case
the person in the group who feels insecure whenever the group conversation gets close to their personnel issues. They are also good at pointing out the weaknesses of others.
the group member who tends to digress and rarely get to the point as well as frequently gets off topic.
How many people and how much time is appropriate for a counseling group?
Adult groups should meet to 1.5-2 hours and have about 8 groups. Groups with kids should meet for shorter amounts of time and have no more than 4 members.
What is the RESPECTFUL counseling model?
it is an approach where the counselor focuses on a person's background and the primary goal is to help the client obtain knowledge, skills, abilities, and the resources the person needs to function.
E- Economic Background
S- Sexual Identity
P- Psychological Maturity
E- Ethnic Background
C- Challenges Developmentally
F- Family History
U- Unique Characteristics
a postmodern theory developed in the 1970's/80's by White, White, & Epston. It believes that a client invents their own story and issues become characters in the story.
Gestalt Therapy Technique where the client acts out the dialogue between two selves- a self who attempts to grow & change and a self who undermines the process & stays stuck
Gestalt Therapy Technique where the client sits in one of two chairs and addresses the empty one in regards to the individual's issues
Gestalt Therapy Technique often used in group sessions the counselor confronts the person in the "Hot Seat" while other group member just listen, the members will then get an opportunity to relate their own experiences to that of the one in the "Hot Seat"
a stage of moral development described by Kohlberg, during this stage a young child begins to follow society rules through conditioning and disciplinary action
the opposite of stimulus generalization, usually requires conditioning beyond the original set of conditioners to teach the individual to differentiate between two similar stimuli
What is the ABC theory of personality?
presented by Albert Ellis, it is a method of refuting false beliefs. Clients are taught to link the A- activating event, with the B- beliefs, and the C- consequences. D & E can also be added D- dispute, E- effect
Why is a counselor's behavior and body language important when providing services?
it greatly effects the quality of communication and is interpreted through an individual's culture.
a theory by Adler, proposed that birth order had an effect on later experiences, it sees birth order as a source of conflict
Compare structured and unstructured therapy groups
according to Yalom structured groups are less effective than unstructured groups in resolving client issues although most prefer a structured group setting. He raises three criticisms of structured groups 1) group stages may be passed over
2) Structured exercise raise thoughts/feelings before the people are ready to confront them
3) Participants rely too heavily on group leadership and too little on their own insights
What are the 4 stages of group progression as outlined by Yalom?
the process through which the group leader forms the group, lays the ground rules, advises of risks, and discusses the goals of counseling
group members become hyper-aware of differences but a sense of group identity has not yet been formed
a time when group identity is confirmed and members begin to recognize and confirm each other's goals
the final phase where group goals have been achieved and group members have obtained a better understanding of themselves and the other members. There is also acknowledgment of the upcoming separation and time to process it.
What are the four areas of cultural competency a counselor is expected to have?
a) an understanding of beliefs and values of different cultures
b) An understanding of their own personal beliefs and values
c) The ability to recognize the similarities and the differences of different cultures
d) The ability to apply what they know about a particular culture
What are 3 reasons group work may not be appropriate?
1) counselors can lose control of the group
2) Group members can experience emotional harm
3) Not all clients are going to be able to trust enough to participate in group
Specific Vocational Preparation
the length of time it will take to teach a person the skills he or she will need to perform a particular job
the reason that a particular type of work is being done as well as the way it is being done
the specific characteristics that make a person well suited to a particular occupation
4 main functions a counselor typically performs for a client
List some client rights
a) counselor disclosure statement
b) Intent and purpose of rehab plan
c) The techniques and potential risks of services utilized
d) The cost of services
e) The types of assessments/evaluations that are going to be used
f) How the results of assessments are going to be used
g) Client has right to refuse services
Explain Tarasoff vs. Board of Regents of the University of CA?
a 1969 court case which set precedent for duty to warn. A counselor was informed by a client that the client planned to kill a woman. The counselor had the means to contact the woman directly but instead called the campus security who interviewed the client but took no further action. He then murdered the woman and her family sued and won because the counselor did not warn her of the impending threat of harm.
Individuals with Disabilities Education Act
(IDEA) originally passed in 1975desighned to give kids with disabilities an educational tailored to meet their needs. It requires schools which get federal funding to provide these accommodation services free of charge to students
Scope of Practice
is the area in which an individual has training; the services they provide must stay within that area
the idea of paradoxical intervention is when a counselor uses a technique that seems to contradict the goals of counseling
studied the behavior of young children and infants who had been in hospitals or institutions since birth and did not have parental contact, she found that these kids had problems sleeping and were more prone to illness which were in line with Harlow's earlier work
an illness described by Spitz describing the behaviors of excessive crying, sleep difficulties, and physical illness
a defense mechanism by which a person develops a behavioral or physical alternative to make up for a particular weakness
a defense mechanism by which a person refuses to acknowledge a fact or condition of their existence
a defense mechanism originally described by Freud by which a person stuffs down important issues and does not let them into their existence
United States Dept. of Veterans Affairs
(VA), a federal agency that helps people who have served in the Armed Forces, their programs provide education, training, financial support, insurance benefits, and rehabilitation services
3rd stage of Kohlberg's theory of moral development, teenager/adult gets more comfortable to conform than to oppose the rules of society, they begin to understand morality as a system of customs and rules which benefit all of society.
Name 3 Behaviorists
Pavlov, Watson, Skinner, they developed the premise that humans develops in response to their environment
a behavioral method that use a variety of overwhelming stimuli to bring about a behavior change such as in military boot camp
a defense mechanism which occurs in a variety of forms when a reaction to a situation is placed on something else. (ex: frustration with a poor test grade at school gets internalized and is then demonstrated through reckless driving)
a psychoanalytic technique for opening pathways to the subconscious. The therapist induces the client to say anything that comes to mind. Freud believes that people burry or repress feelings of guilt, shame, inferiority, and sexuality in the subconscious and that free association was a way to bring them into the conscious so that they could be dealt with
stressed the importance of co-therapy groups because they allow for a greater range of counseling exercises, developed the techniques of psychotherapy of the absurd
Psychotherapy of the Absurd
a technique developed by Carol Whitaker the absurd is the unreasonable exaggeration of an idea to the point of underscoring the underlying meaninglessness of much human reaction.
3 Adlerian Principles
1) the strongest motivation of a person is to find a place in society and its groups
2) Reality is a matter or perceptions that can be altered or improved through therapy
3) Assimilation is a strong source of motivation so it is natural for an individual to change his behavior to gain acceptance of a group
Ethics regarding record keeping
a) must record the information required as required by agency policy and governing laws
b) Counselor must not record session electronically
c) Records must be kept confidential and secure at all times
d) Information must not be released unless permission is given by the client
d) Counselor must let client have access to their file upon request
designed by Guy & Heidi Burgess, it is a mediation method designed to address complicated disputes in which all parties are unwilling to consider alternative solutions. It proposes that most disputes can be resolved if secondary issues are addressed before primary issues
How does a family aid the development, education, and function of its members?
Parents and grandparents pass their heritage down to children and thus teach them what is and is not acceptable. A family can also be a healthy support system for its members
According to Satir what are the 4 issues which impeded communication within a family?
4) Over reasonability
a negative therapeutic phenomenon which can occur during therapy when a client superimposes their issues onto the therapist
What are the three goals of a cognitive group approach?
1) help each group member improve their self-opinion
2) Help each member distinguish fantasy from reality
3) Help members find the information and resource they need
What are some different group leadership styles?
a) focus on process rather than content
b) Pay more attention to facial expressions and other non-verbal cues over what is actually said
c) Emphasis on content rather than process
What are some predictable behaviors during group development?
a) Initial/getting acquainted stage- distrust among members in regards to each other
b) Transitional stage- friction between members and protests of the leadership
c) Final stage- sense of accomplishment about what has been learned
d) Planning will take place in all stages
a stimulus is used each time the behavior occurs, most effective method to create new behavior
stimulus is used only at set times, most effective in maintaining new behavior
How did Kohlberg's work differ from Piaget's?
It expanded on Piaget's work by adding adolescent and adult moral development
How was Maslow different from his predecessors?
he added the concept of actualization, he also developed a hierarchy of needs
How might the conditioning response be used in sports?
An athlete is trained to react in specific ways to specific stimuli, these behaviors may be different than natural responses
How can denial be an advantage and a disadvantage?
denial can allow an individual to keep going in the face of adversity it can also keep them from seeking help to a problem they have
A holistic approach to care may require a team of professionals, who might be on the team?
PCP, PT, OT, Mental Health Professional, Vocational Counselor
Name two electronic-mechanical devices used to diagnose traumatic back injuries
X-rays and myelograms
What are some difficulties when working with people who have arthritis?
a) unpredictable w/ symptoms coming and going
b) Since debilitating symptoms vary it can be hard to form a treatment plan
c) The is a general disagreement on "best-practices" among doctors
What are the common symptoms of Alzheimer 's disease?
a) memory loss
c) Difficulties with orientation
d) Difficulties with judgment
a neurological disorder characterized by seizures which can last a few moments to minutes. It is thought to be caused by abnormal chemical reactions in the brain. Frequency of seizures can be partially controlled or eliminated by medications. Seizures can cause safety issues and can be induced by stress
What are the methods of electronic diagnosis for neurological disorders?
a) CAT scan (Computed Axial Tomography)
b) MRI (magnetic resonance Imaging)
c) EEG (electroencephalograph)
Give an example of a rehabilitation counseling plan for a stroke patient
a) familiarize with medical aspects
b) Discuss the case with the family/friend/community support
c) Counseling as needed
d) Liaison between treatment team and employer
The Rehabilitation Engineering and Assistive Technology Society of North America
a non-profit that ensures that people with disabilities have access to assistive technology
Contributions of Gestalt Psychologists
by Perls and first published 1925 emphasized the importance of insight
occurs when a stimulus similar to the one originally used to condition a behavior produces the desired behavior
Piaget's 4 stages of cognitive development
1) senorimotor- up to age 2yrs when the child develops the 5 senses and uses then to take in information
2) preoperational- 2-6yrs, a child is able to perceive outside objects and events as separate things
3) Concrete operations- 6-11yrs, the ability to logic develops and the child learns to by more systematic and can count w/o visual aids, understands conservation
4) Formal operations- the child is able to do whole scale human reasoning and can think hypothetically as well as understand abstract ideas
Why are resources like the Dictionary of Occupational Titles an Occupational Information Network important?
they provide a large amount of information on the skills required by a variety of specific occupations
suggests that a person has a functional limitation if the person has a medical condition that impairs ability to function
suggests that a person has a functional limitation if the person is unable to work effectively as other people
suggests that a person has a functional limitation of society recognizes that the person is unable to function as well as other people.
Functional Assessment Inventory
(FAI), designed by Crewe and Athelstan in 1984, tests functional limitations and their effects on occupational performance
What are the disadvantages of a job-matching system?
a) incapable of considering every relevant factor
b) does not have access to all the resources the counselor has
c) can only search the databases they are linked to
Prescribing the symptom
a paradoxical intervention strategy that prescribes the symptom to get an enlightened reaction from the client
a recasting of the negative behavior in a positive light in order to get an emotional response from the client
What is society's role in the rehabilitation process?
1) to ensure equal rights for a disabled person
2) ensure the people with disabilities have access to necessary services
3) ensure that people with disabilities has access to employment
more commonly known as anti-seizure drugs, help prevent seizures due to epilepsy or other disorders
What are some of the cultural concerns for people with a psychiatric disability who belong to the Hispanic or Native American cultures?
a) Hispanic: less likely to seek and accept help for psychiatric disabilities b) Native: more likely to seek and accept help than Caucasians
What are four types of employment a person with a psychiatric disability may be able to receive?
What program was established by the Social Security Act of 1935?
Old Age, Survivors, and Disability Insurance (OASDI) offers benefits to people with disabilities and retired people
What are some of the major cultural factors that can affect a person's ability to receive services?
3) level of trust
4) level of willingness
Describe the three main types of environmental barriers faced by people with disabilities
What conditions are treated with Risperidone?
the most common anti-psychotic drug prescribed in the U.S. in larger doses it is used to treat psychosis but in smaller doses has been used to treat bi-polar, depression, Tourette's syndrome. Side affects include, muscle stiffness and pain, tremors, weight gain, insomnia, changes in BP, and sexual dysfunction.
Describe a Genogram
a way to map out a person's family and give a "snap shot" of information. Standard symbols- males/squares, females/circles, line/family ties, dashed line/adopted, X/death
an eating disorder most common in adolescent females where they deny themselves food and usually exercise in excessive amounts to get to the "ideal" weight which is never achieved. Treatment is most successful when caught early
designed by Rogers, the "trinity" of the approach is made up of genuineness, empathy, and unconditional positive regard. The helper meets the client where they are at, helps them tell their story, and encourages them to become self-reliant
Why is it important for a counselor to keep track of the medications their clients are taking?
to help ensure that the client is on appropriate meds, to be aware of possible side effects, and over/under medication issues.
What are the results of a poorly written pre-employment test or a poorly designed interview question?
the possibility of a discrimination claim- the ADA prohibits asking questions that may directly or indirectly identify or assess the extent of a disability. A poorly written question could violate this protective legislation.
What is the process of filing a discrimination lawsuit?
first a person must file a discrimination claim with the Equal Employment Opportunity Commission (EEOC) then wait for further notification. If there is enough evidence for a claim the EEOC will attempt to reach a settlement with the employer if a settlement cannot be reached the EEOC will file a lawsuit on behalf of the person. If the EEOC determines there is not enough evidence the individual will be lettered and given 90 days to file a suit on their own after which point stature of limitations will expire.
What would a typical treatment plan for schizophrenia?
treatment measures are directed at symptom management and may include anti-psychotic medications, behavior therapies, and social skills
What are some barriers a person with a psychiatric disability might face?
1) occupational- functional limits such as anxiety or lack of motivation
2) social- inability to interact appropriately with others
3) societal- how others view the disorder
How should a counselor help an individual with a psychiatric disability who is from a different culture?
a) gathers as much info as possible about the culture
b) gain understanding of the client's views and beliefs
c) identify the cultural barrier that is keeping the client from functioning or accessing services
d) identify a series of techniques that can help resolve cultural issues
a common anti-psychotic used to treat schizophrenia, manic episodes, delirium, drug psychosis. Side effects include cramps, depression, dry mouth, fatigue, muscle stiffness, restlessness, tremors, and weight gain
Symptoms of bi-polar
alternating periods of hyperactivity and depression, severely interrupted sleep patterns, intense activity/agitation, and exhaustion
Treatment for anorexia or bulimia
individual and group therapy with cognitive-behavioral approaches to gain insights, medications to help with anxiety and depression
How does culture affect a person's decision to accept help?
beliefs and values in regards to disability are often determined by the cultural, individualistic vs. collectivist for example. These beliefs and values can be difficult to overcome.
generically known as fluoxetine is a psychoactive medication used to treat depression, bulimia, OCD. Side effects include- agitation, anxiety, restlessness, and insomnia
a dispute resolution method in which parties involved agree to allow an outside person hear all the facts and make a decision
a dispute resolution method an act in which two or more people agree to work together towards a common goal
a dispute resolution method in which parties involved agree to allow an outside person hear all the facts and then offer advice and suggestions
What workplace factors should be assessed during an ergonomic assessment?
setting, desk, computer height, seating, positioning, height of the person, keyboard
Case Management System
a computer program that helps a counselor organize information used to serve a specific client
Public Vocational Rehabilitation Program
(VR) is an online database that helps the counselor keep track of the information that they are required to report to the state.
What are the 5 functions typically associated with case management?
Is it appropriate for a counselor to discuss the abilities of other rehab professionals with a client?
No, as it is not professional conduct as described by the CRCC
What are the three main types of arbitrators?
1) ad hoc- a person who is chosen by the client, counselor or employer to handle a specific dispute
2) permanent- an individual who regularly works for a counselor or firm
3) arbitrator panel- a group of arbitrators that have been chosen by parties involved handling the dispute
Is it ethical for a counselor to discuss a client with another professional?
Yes, as long as it is to best serve the client.
What four actions should a counselor encourage group members to take?
1) actively listen to other members
2) refrain from interrupting/distracting
3) stay involved in group discussion
4) to take necessary steps outside of the group
Counselor-client relationship concerns
1) treatment plane developed with input from client
2) close monitoring to check for Tx plan effectiveness
3) Realistic and attainable goals
4) the economic, transportation, and social support of client are taken into account
Role of formal education in U.S.
employers have learned that those with college education typically perform work better therefore saves the company money through lower training expenses. The higher paying the job is the more likely it is to see college degrees as part of the job requirement.
the work done by social psychologists such as Kohlberg, Maslow, Erikson, and Freud is the study of human cell growth and development
What are some of the basic actions that a rehabilitation is expected to take according to the CRCC?
a) conduct assessments
b) counsel clients on potential occupations
c) design disability specific Tx plans
d) evaluate programs
e) manage cases
f) eliminate/reduce the effect of disability
g) consultation services
h) job seeking/retention skills
i) job placement
Give an example of "real world" conditioning
the work of industrial psychologists and interior decorators design environments are designed to change people's behavior- work harder and more efficiently, lighting, ergonomics, comfort
Job Seeking Skills
a) ability to network
b) ability to communicate effectively with prospective employers
c) ability to write a resume and cover letter
d) ability to fill out an application
What are some of the assessments an organization might use during selection process
b) realistic job previews
c) selection interviews
What factors would a counselor use to determine if a client was able to work in a competitive employment setting?
a) the ability of the person to fulfill the job responsibilities
b) the amount of support the client will need to return to workforce
c) the ability of the client to work in an integrated setting
What are the four types of agency employment services?
1) federal agencies
2) state agencies
an employer's attempt to help an employee further their career &/or advance in the company
an employer's attempt to make sure that an employee continues to perform as effectively as possible
What are the main situations in which a person may need a supported work environment?
1) if they have never been able to work in a competitive environment before
2) has troubles being in competitive employment since onset of disability
3) if the client is incapable of performing takes that typically part of the job
4) transitional employment due to a sever mental disability
What employment support services are available before the client is employed?
assessment services, financial support services, job preparation services
Is it necessary for a counselor to let their employer know of issues that may interfere with their ability to preform their job duties?
Yes, they must according to CRCC they must eliminate the issue if there is a legal and ethical way to do so
Process of case management
1) assess client's specific needs
2) decide whether or not the counselor is suited to fulfill those needs
3) if outside help is needed, acquire it
4) discuss needs and services with client
5) provide services and ensure service from outside agencies are received
6) ongoing monitoring of progress
a rehabilitation technique in which a person learns/preforms a series of strength building or safety exercises that will aid their ability to function in a work environment
a rehabilitation technique in which a person learns/preforms s series of pain management, strength-building, safety, and/or coping techniques that aid function in day-to-day life
are contrived by people who are unable to cope with problems, can be both beneficial and detrimental depending on the situation and the extremity of how they are used
Give an example of conventional morality
considered by Kohlberg to be the middle ground of morality where a person strives to conform to laws and rules of society breaking these regulations is source of discomfort; conforming to the same style of dress as the supervisor or the "popular" employee
a dispute resolution method in which the people involved hold discussions to reach a compromise
developed a theory the id controls human motivation and behavior and is the set of desires, which are stored in the unconscious. Even though individuals are not aware of these desires they influence behavior. He also outlined 5 stage of human development and dream theory.
Name three possible coping strategies used to deal with a disability
the person attempts to deny, avoid, or ignore the existence or extent of disability
the person continually strives to overcome the issues related to their disability thus they are more likely to accept their disability
What are the seven types of negative attitudes people with disabilities encounter from non-disabled people according to Siller?
1) authoritarian virtuousness
2) Distressed identification
3) Generalized rejection
4) Inferred emotional consequences
5) Imputed functional limitations
6) Interaction strain
7) Rejection of intimacy
a negative attitude proposed by Siller, the belief of a non-disabled that they are superior over a disabled person
a negative attitude proposed by Siller, feelings of being uncomfortable or nervous because of how they represent how a person can be disabled later in life
a negative attitude proposed by Siller, avoiding the person with a disability because of a negative view held about disability in general
Inferred Emotional Consequences
Maladjustment and ill temper, Self-consciousness, irritability, and hypersensitivity are attributed to a people with disabilities
Rejection of Intimacy
rejection of close, particularly familial, relationship,
An unwillingness to date, fall in love with, or marry a person with a disability
Imputed Functional Limitations
the assumption that a person with a disability is functionally limited, dependent upon others for assistance, and has difficulty providing financial support for himself and his family
involve uncertainty about how to deal with the disabled and conversation is inhibited and leads to tension
What factors influence where group members sit in relation to each other?
ethnicity, socioeconomic class, education, and age
What are three barriers to employment for people with psychiatric disabilities?
1) occupational- when disability prevents the individual from doing specific duties of position
2) social- when the disability keeps the individual from interacting with other appropriately
3) societal- when others view the disability in a negative way and so don't hire the individual
the understanding that a person has that they have needs for happiness and success and that they are responsible for their behaviors and the positive and negative consequences of them.
comes from a pattern of behavior that causes distress and personality disorder; for an example an addict who uses because it makes them more socialable
Behavioral Control of Perception, an idea advanced by Glasser which states that thoughts, feelings and actions are controlled by the individual's perceptions
The 3-R's of Reality Therapy
right, responsibility, and reality- according to Glasser these are the essential elements of successful therapy
Rational Emotive Therapy
(RET), founded by Albert Ellis it helps people understand their environment through neutral perceptions and taught people to override irrational thoughts with rational ones.
a behavior in which a person behaves in a manner opposite to the way they truly feel
the existential therapy term meaning the process of being and existing, sees life as a perpetual problem involving choices which a person can make with freewill
a form of existential therapy popularized by Frankl, stated that people cannot control their environment but they can control their reaction/response to it
an employer practice through which they encourage people to apply with and become employees of the company
an employer practice, which attempts to reduce the number of applicants for a position so the number of applications is more reasonable
brand name of Olanzapine which is an antipsychotic used to treat anxiety disorders, eating disorders, depression in bi-polar, PTSD, and schizophrenia. Side effects include- apathy, dizziness, dry mouth, aggressiveness, increased appetite low blood pressure, runny nose, weight gain
What is the importance of a job analysis in placing a client that has a psychiatric disability?
it allows the necessary skills to fill a particular position
What are some of the cultural characteristics a person with a psychiatric disability if they belong to the African or Asian American culture?
African Americans are less likely to seek or accept help for a for a psychiatric disability and Asian Americans are even less likely to ask for help
a method of analysis developed by Glasser to help clients focus on the present rather than past experiences
a psychiatric disorder, which is characterized by auditory and visual hallucinations as well as delusional/paranoid thoughts
What information should a treatment plan include?
client diagnosis, DSM diagnostic code, major goals of treatment, objectives for measuring progress, a timeline of target dates, description of planned intervention, signatures of both the counselor and the client
an employer practice to choose the best candidate for a position from a small group of potential candidates
an employer practice of teaching an employee to behave and perform the job tasks in a way that is appropriate to the organization
When developing a position for a client a counselor should:
1) identify and contact an employer who might be willing to create a position
2) contact another employer if the first is unable to create a position
3) When an employer agrees an interview with the client should be set up
believe that behavioral treatments over simplify human behavior to the point that it is counterproductive and emphasize client choice and self-realization/actualization
What are the three main programs used to treat substance abuse?
drug-free outpatient programs, methadone outpatient programs, and residential therapy programs
Computed Axial Tomography , the least evasive of all diagnostic imaging, uses both computer and x-ray to construct a graphic image
Magnetic Resonance Imaging, uses radio waves, computers, and magnetic fields to construct images, it is a non-evasive experience
Types of functional limitations
a) mobility- impaired ability to move
b) motility- spasticity, trembling
c) communication- language, hearing or sight are impaired
d) cognitive dysfunction- limits metal abilities
What are some common back treatments?
a) conservative- ointments, baths, cold/heat compresses, limited exercise, physical therapy
b) Nerve stimulation and acupuncture
c) surgery and epidural blocks
Describe the structure of the spinal cord
the largest nerve conduction track in the body, composed of 33 or 34 vertebra separated by pads called discs, the vertebra are divided into 5 sections- lumbar (bottom 5), Thoracic (middle 12), Cervical (Top 7)
How can attitudes toward disability be a major impediment to successful treatment?
the physical symptoms may be misunderstood, ignorance can cause fear, old stereotypes are still active, lack of patience and understanding
sees women as more evenly matched with males, also incorporates a less heterogeneous sexuality
Counseling an individual with an injured back
assistance coordinating medical care, if needed accommodations such as wheelchair accessibility, help with attendant care, and other disability specific issues
galvanic skin response, measures electrical conductivity of the skin through the amount of sweat, a high degree of conductivity indicates stress or tension
What are some early steps to be taken when setting up counseling groups for adults?
1) pre-screening interviews to determine a suitable fit
2) during the interview the purpose of the group should be described as well as why the client wants to join
What are some of the major ways a counselor can help a family who has a child with a disability?
a) career counseling
b) stress management training
c) disability education
d) referring the family to other support services
How can a counselor ensure that treatment objectives are valid and useful?
they can use the acronym SMART to develop them
stimulate the brain and speed up the metabolism, they can be used to treat ADD/HD and narcolepsy but can also cause mood change, high blood pressure, confusion, dizziness, euphoria, fatigue, paranoia and other similar issues
an illegal stimulant drug derived from the coca plant, it is extremely addictive and causes euphoria, hyperactivity, insomnia, psychosis, increased heart rate, and diminished appetite
4 main psychiatric disorders associated with dual diagnosis
3) personality disorders
What are the three traits necessary to cope with a disability?
According to the somatopsychological approach
1) the ability to identify activities that they can still participate in
2) the ability to acknowledge of quality of life in spite of disability
3) the ability to discover techniques for improving quality of life
4 major illness prevention strategies
3) stress management
What are the two main services a counselor should provide to the client during case management?
education and restoration services
What is the basic experience in a work conditioning program?
1) client will be assessed by a care provider and treatment plan will be developed
2) the person will then be taught exercises to help them develop more endurance, flexibility, mobility, and strength
3) Progress will be monitored for up to 6 or so weeks
Erikson's 8 stages of development
0-2 yrs. Trust vs. Mistrust
2-4 yrs. Autonomy vs. Shame & Doubt
4-5 yrs. Initiative vs. Guilt
5-12 yrs. Industry vs. Inferiority
13-19 yrs. Identity vs. Role Confusion
20-24 yrs. Intimacy vs. Isolation
25-64 yrs. Generatively vs. Stagnation
65- death Ego Integrity vs. Despair
a behaviorist who experienced with dogs and was able to condition their natural salivate response to food so that they would salivate to a bell
the emotional recognition of a traumatic event and the realization that it happened and has other effects
the process of adapting activities, beliefs, values, goals, and other elements to a specific situation
Counseling in dual diagnosis
used to help people find better ways than alcohol and drugs to cope with the stress of their psychiatric condition and other issues
Dual Diagnosis Treatment Center
a facility specifically designed for people with dual diagnosis which offer support services in addition to the services usually offered by a clinic or hospital.
If English is not a first language for a client what should the counselor do?
1) gather information about the other's culture
2) identify the cultural factors that may affect the person's ability to communicate
3) determine whether the client speak English well enough to communicate
4) identify and implement strategies to minimize the language barrier
a condition in which a person has become dependent on a particular substance and continues to take more of it and has withdrawals if they discontinue the use
a physical or psychological condition in which a person has taken so much od a substance that their body needs it to function normally
the set of symptoms a person experiences if they stop using the substance that they have become dependent on
how a person perceives his or her role in society because of their male r female characteristics
What three factors influence a person's attitude toward disability?
environment, culture, and personality
the belief that one should be the opposite gender from the gender that they were born as
Three strategies a counselor can use to change the ways society views people with disabilities
1) experiential strategies- exposure to people with disabilities
2) informational strategies- educating people eon disability
3) simulation strategies- an activity that allows the individual to "try-on" a disability
the set of sexual characteristics of a particular person, the person's perceived sexual characteristics, and the effects of sexual characteristics in other people
Intensive Case Management
a program in which a case manager contacts a person with a dual diagnosis to remind them to complete certain tasks such as appointments, medications, and other actions that need to be taken
Intensive Outpatient Case Management
designed to help a person with a dual diagnosis to continue to function after receiving treatment
a goal the counselor is attempting to achieve for a specific client during the rehabilitation process
the basic rehabilitation process in which a counselor establishes the client's objectives and identifies appropriate interventions
Strategies for identifying ways to change diet to improve health
Read the USDA guidelines to determine which include calorie intake and the Food Pyramid
What are the goals a person must achieve in order to adapt to a disability?
1) the person must recognize their skills and understand the opportunities that are available to them
2) must alter the personal beliefs they hold that get in their way
3) must recognize opportunities to overcome and circumvent physical limitations
4) must not let the disability control areas of their life which are not relevant
What is the typical treatment process for a dual diagnosis?
varies from person to person but typically is detoxification from their substance of choice, chemical dependency treatment, treatment for psychological diagnosis, and will continue these treatments until they can function
a depressant that decreases the amount of activity in the brain, with excuse use can cause agitation, aggressiveness, altered vision, anxiety, depression, euphoria, insomnia, irritability, and sensitivity to light
marijuana is a psychoactive drug derived from the cannabis sativa plant it creates an altered sense of time, mood changes, dry mouth, euphoria, impaired balance/coordination, increased appetite, increased relaxation; may also be used to treat the pain and decreased appetite in cancer and HIV/AIDS patients
What is the purpose of a treatment plan review?
to evaluate and assess the client's progress toward treatment goals through time
originally designed by Barker, Gonick, Meyerson, and Wright in 1953 to describe adjustment to disability. It is based on the idea that a person's reaction to an event is the result of their perceptions interacting with the environment (how a person thinks about disability affects how they respond to becoming disabled)
a technique where issues are brought out into the open by the counselor or group members so that the individual becomes aware of them
the process by which a counselor assumes the client's perspective and relates to them and their experiences
the process of encapsulating areas of discussion and comment at various points during a session
What are some major factors that can affect a person's ability to adapt to disability?
ability to perform daily tasks, medical treatments, functional limitations, effects of disability on family and friends, response of others, ability to pay for needed services