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Effective Practices for Counselling Persons With Disabilities

As a counsellor, you play an important role in your clients’ career-building process. Helping them to take control, tap into their own creativity to overcome challenges, and access available supports are critical elements.

You also have a responsibility to keep current with the latest developments in your field. Career development practices are dynamic, influenced by ever-changing labour market trends and requirements. Advances in technology and support services, changing public perceptions of the capabilities of workers with disabilities, and a wider range of program alternatives all affect the career potential of disabled persons.

Qualities of effective counsellors

Counsellors’ personal beliefs

Keeping hope alive

“You can’t lose hope yourself. If you do, the client knows it in a heartbeat. It is important to be a beacon of light for people who can’t find that in themselves at that time. You have to create hope and you have to be empathetic.”

—Sandra Taylor, Alberta Health Services

Basic beliefs about persons with disabilities influence how counsellors relate to clients. Reflect on your own values, beliefs, and assumptions about disability as an aspect of social identity. Think, too, about the myths and stigma that your clients may face in their lives.

As a counsellor, you can help address stereotypes about disability in a number of ways:

  • Re-examine your own views about disabilities and confront any stereotypes you may harbour.
  • Build relationships with hospital staff and community-based programs, as appropriate. Work together to improve services to clients and to raise public awareness about this issue.
  • Be proactive in sharing positive attitudes about clients who have a disability with colleagues and employers.

When career counselling for persons with disabilities, the following ideas are key:

  • Each person with a disability deserves to be treated as unique.
  • Labels should be avoided whenever possible.
  • Persons with disabilities, no matter the extent, have limitless potential for becoming what it is within them to become.
  • There are many ways to accomplish the same task. Be open to the possibilities and exercise creativity.
  • Everyone has some form of disability. Career development can be a vehicle for growth for persons with disabilities.
  • It is important to emphasize abilities, not disabilities, and to examine how society defines success.
  • People change or modify their jobs to focus on abilities and to avoid shortcomings.
  • Accommodations are seldom costly, and these modifications can benefit other employees as well.

Lifelong learning

Taking time to learn

“Remember to make time for yourself to keep learning. Sometimes professionals spend all their time with clients and forget about their own professional development. Take time to do that because that’s how you’ll figure out what works and see how other professionals are helping their clients.”

—Sikin Samanani, Treaty 7 Nations Health Services

Developing skills to counsel persons with disabilities takes time. Consider using some of these strategies:

  • Examine your coping mechanisms.
  • Explore all the skills involved in practising unconditional positive regard.
  • Build your awareness of your own style and approach.
  • Read journal articles on different types of disabilities.
  • Find out who is engaging in new developments and touch base with them.
  • Use the internet to explore new information in areas of disability research.
  • Attend symposia, seminars, workshops, and conferences on issues related to persons with disabilities.

Advocacy skills

Many persons with disabilities would benefit from developing or enhancing their self-advocacy skills. These skills can be invaluable when discussing job or learning accommodations with employers or instructors. There may also be situations where clients could benefit by having an advocate who speaks on their behalf, especially if they are unable to speak or negotiate themselves. You can help clients determine:

  • How and when to use an advocate
  • What needs an advocate can meet on another’s behalf
  • How to find an advocate

Communicating with clients

The TALK principle

When communicating with clients who have disabilities, remember the TALK principle:

  • Take the time to get to know their preferences.
  • Ask, don’t assume. Never assist unless asked.
  • Listen attentively and speak directly to the person.
  • Know your client’s needs and the accommodations and special services available.

Disabilities can impair a client’s communication skills. Therefore, it is important to communicate as clearly as possible. The communication needs of persons with disabilities can vary greatly. Based on clients’ individual needs, consider these suggestions for adapting your communication strategies:

  • Ask clients how they would prefer to receive information from you—in writing, in person, over the phone, or in all these ways. Consider recording meetings so clients can review them at home.
  • Use as many modalities as possible when meeting with clients. Show and tell. If possible, let clients practise what you are telling them.
  • Provide a structure for your meeting and for each step in the counselling process, particularly in cases where a client struggles with knowing where to begin.
  • Use a step-by-step approach. Be patient and describe the details.
  • Keep background noise to a minimum. Meet in a room with a door, if possible.
  • Speak clearly, at a normal volume and in a normal tone of voice. Normal conversation is very important when you are building rapport with clients.
  • Be direct and specific. Divide what you have to say into small sections and pause between sections.
  • Use plain language, both written and verbal, when communicating.
  • Say the same thing using simpler or clearer words if clients have trouble understanding.
  • Check often with clients for understanding. Have them repeat information back to you to confirm that they understand.
  • Show appreciation and be genuine.
  • Make requests and suggestions positively, directly, and honestly.
  • Refrain from expressing negative feelings. If you must express displeasure, be clear that you are talking about a particular behaviour or action, not about the person.
  • Convey belief in clients. Let them know that you understand the impact of their disability and, at the same time, believe they can succeed.

De-escalation of volatile situations

In case the need to defuse a volatile situation arises, be prepared to use these strategies:

  • Slow the situation down. What’s causing the volatility? Remove the person or object that’s the focus of frustration. Let the client talk.
  • Be aware of the client’s personal space. If you are within it, the client might feel attacked. Give the client more space than normal. Keep listening.
  • Ask the client “What would you like to do?” or “What would help you?” Ask if intervention is needed.
  • Don’t appeal to logic. Don’t try to talk the client out of anything or argue.
  • Don’t bring up emotionally charged topics or concerns.
  • When you do speak, talk slowly and in a non-confrontational manner. Agree with the client when appropriate. Say something positive.
  • Use body language that conveys calmness. Don’t move suddenly or speak in an authoritarian tone.
  • As soon as possible, encourage the client to make some choices. This strategy helps the client to regain some control over the situation and decreases the danger of the volatility continuing.
  • Be aware that the situation might worsen and that it is important to get help.

Helping clients with life skills

Moving forward

“Motivation is always a big issue—and the willingness to invest the energy hoping that the outcome will be favourable. It’s hard for some people to move beyond the fear. I always ask about their daily routine and sometimes it is sleep, go to medical appointments, go home and sleep some more.”

—Sikin Samanani, Treaty 7 Nations Health Services

Persons with disabilities often report difficulties with daily living activities. Many say that a physical or mental condition or other health problem reduces their participation in society.

Take the time to ask about how your clients are coping with their disabilities in daily life. Doing so will help you build trust and learn how they deal with practical challenges.

In helping a client with life skills:

  • Listen to the client’s whole story about a problem or concern. Take notes. Summarize the story and check it with the client.
  • Ask what the client would like you to do. If the client requests that you not take action, respect this request.
  • Don’t do more than the client asks you to do. Your task is to support the client and provide reliable information. If the client decides that you can help with a particular issue, keep the client informed of each step you take. Stop when and if you are asked to do so.
  • Don’t offer advice in areas beyond your expertise.
  • Recognize your limitations. Don’t say you’ll do something you can’t deliver on.
  • Be sure the client takes an active role in clarifying the problem, finding an advocate, and seeking information.
  • Meet with third parties that you contact on behalf of the client with the client present. Support the client, but don’t take over.
  • Remember that a client’s frustration may stem from an inability to communicate acceptably. Help the client rebuild communication skills.
  • A client may be concerned about taking an issue to a higher authority. Let the client know that people in senior positions may be able to act on the client’s concern. Help the client prepare to present the problem effectively.
  • Keep your supervisor informed about your activities and let your client know that you are doing so.
  • Encourage your client to share the problem with others in similar situations. Mutual support and common action can often overcome feelings of isolation.

It may be helpful to gather information about clients by:

  • Interviewing clients and their family members or group home workers
  • Observing clients in different environments
  • Reviewing records and evaluations of previous experiences
  • Visiting clients repeatedly and communicating with clients and their families in familiar surroundings
  • Offering short-term assessment and trial work experiences
  • Arranging onsite visits to different businesses in the community

Helping clients set goals

Looking to the future

“Just the process of seeing an individual getting excited about goal setting and making changes is satisfying for me. Also, thinking outside the box rather than just trying to fit the client into what’s out there. Reframe your approach to fit their goals. It’s a partnership, and along the way you have to evaluate and monitor and make sure you’re in sync with what they want. If it’s not working, then do something else.”

—Sikin Samanani, Treaty 7 Nations Health Services

To address many of the challenges your clients face, it is important not to separate personal and work-related issues from each other. Instead, focus on the issue that is important to the client. If a client’s top 5 goals don’t involve work at this time, then choose a goal that might build knowledge or skills transferable to work and other situations.

For example, if a client wants to learn how to use email to communicate with relatives in another part of the world, you can help the client achieve that goal. In doing so, the client will gain transferable computer-based communication skills.

To help clients set realistic goals:

  • Listen to their ideas about their goals.
  • Find out how they have been using their skills.
  • Explore what is meaningful to them.
  • Provide honest, non-judgmental feedback.
  • Help clients examine alternatives, options, and different ways of doing work.
  • Help them recognize the demands and requirements of specific career goals.
  • Teach goal-setting and action-planning skills.

Making a better life

“Don’t forget to ask your clients what they want to accomplish. Goal setting is crucial. Accountability is part of the everyday process... People come in with very different ideas about what they need assistance with to make their lives better. We need to work with this.”

—Sandra Taylor, Alberta Health Services

When supporting clients with disabilities, adapt the popular SMART acronym for goal setting by adding another “S” at the end. Encourage clients to set goals that are:

  • Specific
  • Measurable
  • Achievable
  • Realistic
  • Time-limited
  • Supported

Goals that meet these SMARTS criteria will have a better chance of success.

Canadian Occupational Performance Measure

Certified occupational therapists may choose to use the Canadian Occupational Performance Measure (COPM) with clients to facilitate goal setting in areas of self-care, leisure, and productivity. The COPM is an individualized outcome measure designed to detect change in a client’s self-perception of occupational performance. Persons with disabilities report that they like it because it allows them to assess their own progress as opposed to having health professionals make that judgment. The Canadian Association of Occupational Therapists provides additional research into the uses of the COPM.

Post-secondary training

Wade: Psychology (2:58)

Many post-secondary institutions in Alberta, including all publicly funded schools, have a Disability Services Office that can provide students with information, accommodations, services, and supports in accessing funding. Available solutions may include:

  • Volunteers to make audio recordings of written work or books
  • Volunteers to edit written work
  • Access to appropriate technical aids
  • Information about assessments
  • Accommodations for completing exams

The National Educational Association of Disabled Students provides further information about services and programs available to students with disabilities at Canadian post-secondary institutions.

Carly: Arts (2:50)

Career planning approaches

The process of career counselling persons with disabilities is no different than career counselling persons without disabilities. However, the issues for those with disabilities may be wider in scope. Each disability has literature related to personal, employment, and career counselling.

Some clients’ presentations may be dominated by concerns about their symptoms, medication, stress levels, daily habits, access to specific services, or other factors not directly related to the career planning process. As a result, a person’s talents, abilities, strengths, and interests can be forgotten or relegated to the background by the concerned individuals helping them.

Your task as a counsellor is to help clients with disabilities increase their chances for gaining and maintaining satisfying work by helping them to:

  • Identify their strengths and special skills
  • Identify their preferred future, including preferred work choices
  • Recognize their disabilities if they do not already
  • Understand their disabilities and how they might affect work situations
  • Identify any coping strategies they have developed to address challenges they face at work
  • Identify appropriate assistive devices and additional strategies to address work challenges
  • Make attainable work choices that relate to their preferred future

As you work with clients who have different disabilities and are at different points in their career journeys, you will likely need to draw from a variety of career planning approaches. The next section describes approaches that have proven successful for clients with disabilities.

General career counselling approaches

Being a change agent

“You have an opportunity to be a change agent, not only out there in the world challenging stereotypes, but also in helping your clients see themselves as whole, as contributors. Use all the tools we have available to us to help clients see their strengths to be able to work, whether it is 4 hours a day or working from home.”

—Dr. Patricia Pardo, Mount Royal University

Consider the following models for working with clients with disabilities:

  • Use a 3-way partnership between employers, counselling professionals, and clients.
  • Use a systematic approach that exposes the client to a variety of experiences early on, develops decision-making skills, uses supportive counselling, and helps with accessing other services.
  • Help clients get to know themselves well and develop positive attitudes. Clients benefit from taking control of the career development process.
  • Adapt existing services to assist persons with disabilities and stress the importance of clearly defined goals.
  • Contact community organizations that serve persons with disabilities in your local area. Meet informally with service providers. Ask them about the issues faced by people they serve.
  • Learn from your clients. Follow up regularly to find out about their progress. If needed, hold case conferences with the agencies involved with clients. Too often people fall between the cracks. By staying current, you can better assess what your clients need and select timely and useful referrals.

Some models specifically emphasize the needs of persons with disabilities. They consider:

  • How persons with disabilities approach decision making and lifestyle options
  • How life experiences and self-concept influence their career choices
  • How environmental factors influence persons with disabilities
  • How counsellors who work with persons with disabilities can shift the focus from job search to career development

A client’s belief system is also a critical factor in determining the success of an employment action plan. According to the theory of learned helplessness, clients may come to feel that they are powerless to change outcomes through their actions. In contrast, competent clients acknowledge the challenges their disability presents and the barriers they face in gaining employment and achieving promotions. They attribute their successes and failures to the effort they invest.

Reframing to see one’s disability in a more positive way is a critical skill. The process of reframing includes:

  • Recognizing the disability
  • Understanding one’s own strengths and weaknesses
  • Accepting these abilities and limitations
  • Setting a plan of action toward reaching goals

Here are additional suggestions you can implement when counselling clients with disabilities:

  • Generate discussion on their interests, hopes, and dreams.
  • Never make assumptions about clients.
  • Explore their presenting limitations and solutions to problems.
  • Talk with them about general employment information, such as jobs available and training required.
  • Focus on their skills and interests to direct them to job possibilities.
  • Arrange job trials for clients.
  • Explore reworking or trading job duties to accommodate clients and co-workers.
  • Explore win-win scenarios for clients.

You might also consider exploring some of these more specialized approaches when counselling clients with disabilities:

  • The comprehensive Achieving Career Balance model
  • The choose-get-keep approach
  • The strength-based approach
  • The person-centred and essential lifestyle planning approaches
  • The developmental approach
  • The behavioural approach
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