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Specialized Approaches to Counselling Persons With Disabilities

Effective counsellors adapt their approaches to the needs of each client.

This article discusses specialized counselling approaches that you may find helpful when working with clients who have disabilities.

A comprehensive approach

The Achieving Career Balance model addresses recommendations from recent literature and focuses on building strengths. You may want to use this model to help clients move toward greater independence and self-satisfaction. Clients take control of their own career path while you support them in learning the skills to do so.

The model includes 3 components that provide a foundation for career work with persons with disabilities.

1. The career-building process

Decisions about one’s career or life path are not separate events, but part of a process that continues throughout life.

In career counselling your clients, use a process that traces both the planned and unplanned steps they take. Assessing where people are in their life at given times allows them to begin moving toward future or enduring goals. As clients learn and have new experiences over time, specific needs or goals will emerge. These contextual or immediate goals will lead to new experiences and learning, which in turn will require reassessing and possibly readjusting their future or enduring goals.

2. The personal profile

A personal profile helps to clearly and comprehensively assess the needs and situations of clients with disabilities. Work with clients to complete a personal profile through structured 1-on-1 interviews. The profile should include:

  • Needs and goals, both immediate and enduring
  • Interests and values
  • Skills and experiences
  • Background, training, and education
  • Work and lifestyle preferences
  • Challenges that might impede growth and development

Seeing the whole person

“Use good, solid communication and counselling skills and recognize the person as a whole person. In terms of strengths, the first thing is to find out what they like to do. Build confidence, work 1-on-1, consider peer support groups, share testimonials, and identify resources. Exchange materials that will be helpful to all parties involved and collaboratively seek solutions to problems. Give credit for their potential—the answers lie within them.”

—Gary Davis, Career and Employment Consultant, Government of Alberta

3. Areas of competence

After the personal profile has been compiled, focus on developing competence in these 5 areas:

  1. Systemic supports, including work-site analysis and job analysis
  2. Personal supports
  3. Experience and learning
  4. Work search
  5. Lifestyle balance and job maintenance

The following section breaks down each of these 5 competencies into capabilities that are essential for a satisfying career path. In counselling clients, help them look at how the capabilities figure in their lives. Support them in making informed decisions based on needs that they express at that time. Not all clients need or want to work on all competencies at once.

Systemic support competency

Employers’ willingness to hire persons with disabilities often depends on the information, assistance, and incentives provided through:

  • Equity programs
  • Legislation on the duty to accommodate and undue hardship
  • Education initiatives or partnerships
  • Formal mentorships
  • Persistent efforts by qualified individuals

Such programs and strategies increase career opportunities for clients and encourage employers to see them in a more favourable light. To maximize client success, it’s important to analyze the systemic supports in both the work site and the job that the client will be entering.

Work-site analysis evaluates the work environment and helps clients determine their needs. The assessment could include:

  • Physical accessibility
  • The work roles that interest clients
  • Employer and employee education
  • Possibilities for movement within the organization

Job analysis seeks answers to the question “What will the employee do in the course of an average day?” Job analysis allows clients to:

  • Identify the requirements of the position
  • Determine how their strengths and abilities fit with the position
  • Determine the adaptations or accommodations that might be necessary

Sample questions include:

  • What happens if the task is performed incorrectly?
  • How is success measured?
  • What knowledge is necessary?
  • What skills are necessary?
  • What are the environmental conditions?
  • How much problem solving, decision making, and attention to detail does the job require?
  • How much emotional exertion, such as stress and pressure, does the job involve?

Demonstrating competencies

“It is particularly important for people… to learn how to do their own job analysis and problem solving. Then the issue is not about the disability but about their knowledge and skill. If clients can show employers that they’ve thought these issues through, then that indicates that they will be more able to manage their work and life.”

—Audrey Stechynsky, Human Resources and Skills Development Canada

After job analysis, you’ll work with clients and, in some cases, the employer to help clients creatively meet the challenges of the work role. You can provide the employer with information about reasonable job accommodations, such as adjustments to a task or workplace.

Personal support competency

A strong system of personal support can provide clients with:

  • Increased self-esteem and self-confidence
  • Emotional balance
  • Wider participation in the community
  • A sense of empowerment

Support systems might include family, professionals, informal mentors, allies, peers, and community resources. Understanding how to develop and maintain a support system is vital to staying on a satisfactory career path.

A way to help clients build their support system is through mentoring or peer support programs. Role models can ease the initial transition into the workforce as well as assist with professional development and personal satisfaction once the client is working.

Your client needs to be aware of how to build a support system on the job as well. Co-workers need information about persons with disabilities and should have the opportunity to share perceptions and fears. And a new employee with a disability, like any new employee, needs a thorough orientation that includes information about social and unwritten rules. Open and effective communication is the key to helping people feeling accepted and valued on the job.

Experience and learning competency

Building connections to the world of work

“The transition from a post-secondary institution into the workplace can be difficult for anyone. It takes confidence in your abilities, initiative, and persistence. Students with disabilities can ease that transition by pursuing relevant volunteer experience, job shadow opportunities, and internships while they are still attending school... If they are able to build practical connections with the world of work while they are in post-secondary, it is much more likely that they will find and retain meaningful employment after graduation.”

—Joanne Yardley, University of Alberta

Part of your role is to help clients integrate what they are learning or have learned about themselves and relate their experiences and learning to their career path options.

Experience and learning includes formal academic coursework, school, and research, as well as less formal opportunities to develop skills and to explore ideas. Relevant activities include:

  • Volunteering
  • Job shadowing
  • Information interviews with people working in a field
  • Work experience, such as on-the-job training, internships, and co-op educational experiences
  • Personal research

Work experience opportunities can be particularly valuable for clients with disabilities. You can help clients obtain this experience by:

  • Helping them identify suitable and interested employers
  • Profiling the targeted positions and comparing these to clients’ personal profiles to identify gaps
  • Using the gaps to help employers and clients devise an individualized training program
  • Negotiating a time frame and strategy to gain work experience

Lifestyle balance and job maintenance competency

Lifestyle balance is a major factor in predicting career satisfaction for persons with disabilities who are successfully employed. This competency includes:

  • Knowledge of self
  • Involvement in community
  • Exploration of interests
  • Lifestyle options
  • Self-management skills (for example, communication, time management, self-esteem, goal setting)
  • Accommodation
  • Skills that support successful job maintenance

The choose-get-keep approach

The choose-get-keep approach to career counselling has been used widely for several decades and applied to employment services for persons with disabilities. The approach follows the usual process in career counselling with adaptations for clients coping with disabilities.

1. The choose phase

The goal of the choose phase is for clients to select an employment goal that matches their values and qualifications.

Begin by making sure that the client wants to work by surveying the risks and benefits of taking a job.

The next step is employment goal setting, which includes:

  • Assessing interests, values, education, training, and skills
  • Taking extreme care to objectify personal values so that they are observable and provide criteria for making an informed career choice
  • Using personal criteria and qualifications to identify the type of work, the work environment, and the number of hours

Example of a goal: Within 2 months, I want to work as a library assistant in a small art or music library for 20 hours a week.

In the decision-making step, when the client has chosen a goal and is deciding which jobs to apply for, significant others (family, professionals, friends) may be involved to support the client’s goal.

Making a choice is not always a comfortable activity for clients, so this first phase may take longer than expected. Persons with disabilities may feel discouraged. Engage the client by building a close, trusting relationship. Allot time to teach decision-making skills so clients can improve their ability to make decisions with less professional support in the future.

Allow clients to repeat this phase if necessary, even after reaching the get and keep phases. Efforts to educate employers and co-workers will contribute to client success.

2. The get phase

The get phase begins with job search and closes with accepting a job offer. You will teach job search skills to engage clients and to prepare them to apply for other positions or promotions when ready. You will also undertake placement planning.

This phase includes these steps:

  1. Job analysis—matching the client’s social, mental, and physical qualifications with the requirements of the job
  2. Identifying tasks needed to secure the job
  3. Identifying accommodations that might be required

Direct placement may be part of this approach. This involves presenting the client to a potential employer, particularly if the client has good work potential but may not present well in an interview. You will need to know and apply a variety of strategies to overcome employers’ potential perception of clients’ liabilities.

Placement support involves helping clients gain the skills and resources they need to get the job independently. This would include using strategies to address any liability that the employer might perceive.

3. The keep phase

In the keep phase, the focus is on helping clients successfully do the job and function in the workplace. Depending on the nature of the disability, this may mean reinforcing and building on interpersonal and intrapersonal skills demanded in the workplace.

Activities in the keep phase include:

  • Helping clients do functional and resource assessments of the skills and supports they need to be successful and satisfied in the job
  • Planning the interventions needed to address any skill and resource deficits
  • Planning skill development
  • Co-ordinating services and training
  • Modifying the work environment and arranging job accommodation if needed

Strength-based approach

How do you focus on strengths?

“Assume that people are bright and have capabilities. Ask them, ‘How have you gotten to where you’re at? What do you think your strengths are?’ Often people have lots of strengths and it’s best to find out their competencies 1-on-1.”

—Patricia Sears, Specialized Support and Disability Services, University of Alberta

Your challenge as a counsellor is to help clients understand their strengths and their disabilities in relationship to the employment options they may be considering. This involves helping them assess their strengths and limitations and then identify and explore employment options.

Strength-based interview strategies:

  • Establish a client-focused, collaborative process with clients
  • Empower clients by facilitating self-identification of strengths
  • Reinforce client autonomy

The following types of interview questions help clients identify their strengths:

  • Survival questions—Given what you have gone through in your life, how have you managed to survive so far?
  • Support questions—What people have given you special understanding, support, or guidance?
  • Possibility questions—What are your hopes, visions, and aspirations?
  • Esteem questions—When people say good things about you, what are they likely to say?
  • Exception questions—When things were going well in your life, what was different?

Many persons with disabilities have developed their own adaptations and accommodations that they may not be fully aware of. Use questions such as these to identify what accommodations clients have developed on their own:

  • What has worked for you before?
  • What’s happening right now?
  • What have you been thinking about as far as work goes?
  • How do you manage your work or daily life?
  • If you could take pictures of your future, what would you like to see in those pictures?

Strength-based strategies are most effective when they are woven through all interactions with clients. They are not stand-alone strategies, but they are part of the larger whole of the career-building process.

Consider the following ways to build upon clients’ strengths:

  • Interact with clients as individuals and see their abilities rather than their disabilities.
  • Encourage clients’ autonomy while providing, or helping them access, the supports they need.
  • Help clients identify and acquire personal and professional skills transferable to real work situations.
  • Help clients determine how to apply their strengths to a variety of work situations.
  • Involve as many partners as possible, including employers and other community agencies.

Person-centred planning approach

The Institute on Employment and Disability at Cornell University advises that “person-centred planning is a process-oriented approach to empowering people with disability labels. It focuses on the people and their needs by putting them in charge of defining the direction for their lives, not on the systems that may or may not be available to serve them. This ultimately leads to greater inclusion as valued members of both community and society.”

6 key factors influence the effective implementation of person-centred processes:

  1. Clearly defined roles
  2. A personal relationship with the focus person
  3. Desire for change
  4. Creation of a personal vision
  5. Commitment to planning and followup
  6. Flexibility of resources

Helping to change lives

“Good plans reflect the perceptions of the focus person and those who know and care about him or her. Learning how people want to live is just the beginning, the foundation. Helping people have their own lives requires changing how we think, how we are organized, and how we act.”

—Michael Smull, Essential Lifestyle Planning

When using person-centred planning:

  • Look past where people are today and explore the potential for what they might become.
  • Take the time to get to know the client, including their abilities, dreams, and needs.
  • Develop plans that clients find meaningful to them and that reflect their language and goals.
  • It’s a “vision-quest” experience. Get to know people and their vocational aspirations. Don’t discount their dreams. Find ways of helping them become involved in those areas.
  • Avoid placing personal limits on what people can do. Find out what attracts people to the area they are choosing and look for ways to help them become involved.

Person-centred planning for persons with developmental disabilities

Person-centred planning gives clients more autonomy in making choices. This benefit is particularly significant for clients with developmental disabilities, as they have not always been offered this right.

Essential lifestyle planning approach

The essential lifestyle planning approach is a guided process for exploring how someone wants to live and then building a plan to help the person get there. This approach builds on person-centred planning, introducing additional terms and concepts, including:

  • Personal futures planning
  • PATH (Pre-vocational Assessment, Treatment, and Habilitation)
  • Individual service design
  • 24-hour planning and whole life planning

Developmental approach

Traditional employment counselling focuses on assessment, followed by helping the client prepare to conduct a job search alone. For persons with disabilities, an incremental developmental approach helps in building toward employment goals.

To help with a client’s career development, begin with these questions:

  • How does the client learn best?
  • Who are the members of the client’s support system in the community? These may include doctors, hospital workers, family members, friends, therapists, and staff of other community agencies. See yourself as part of that team.
  • What can the people in the client’s support system tell you about the client that applies to the client’s goals?
  • What is the impact of the client’s disability on work and life aspirations? What are the client’s dreams?
  • What other community agencies, programs, and services might be of use to the client?
  • Where can you refer each client?

Behavioural approach

A behavioural approach may be successful with clients who have a mental health disability because the focus is on events (behaviours) that are easy to observe and are clearly defined. Accountability is built into this approach, since the outcome readily shows whether or not the desired change has occurred.

The first step in applying a behavioural technique is to define the problem:

  • What happens just before the behaviour occurs?
  • Where, how often, and for how long does the behaviour occur?
  • What’s the consequence of the behaviour?
  • How long does the behaviour continue?
  • What happens after the behaviour occurs? What is the consequence?

The second step is to construct a baseline or standard against which to measure change. This process involves observing the individual over a period of time and recording the frequency of the behaviour.

The third step is to choose a technique with which to change behaviour.

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