Articles on Accessibility in Psychology Graduate Education and Practice

Articles on Accessibility in Psychology Grad Schools & Practice

Ken Pope, Ph.D., ABPP

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I gathered the following resources to help those who are interested in accessibility and disability issues in psychology training and practice:

  1. "Disability: A Primer for Therapists" by Rhoda Olkin. This chapter in the Oxford Handbook of Counseling Psychology edited by Elizabeth Altmaier & Jo-Ida, Hansen (Oxford University Press, 2012) covers such issues as models of disability, common disability experiences, legal issues relevant to persons with disabilities, sociocultural and familial factors for persons with disabilities, disability-affirmative therapy, and key questions to explore with clients. The chapter discusses various training and supervision issues from two perspectives: when the client has a disability and when the therapist has a disability.

  2. "ADA Accommodation of Therapists with Disabilities in Clinical Training" by Hendrika Kemp, Jennifer Chen, Gail Erickson, & Nancy Friesen. This article in Women & Therapy (vol. 26, pages 155-178) discusses "the need for reasonable accommodation at clinical practicum, clerkship, and internship sites." The authors note that "Despite the obvious need -- virtually all investigators agree that approximately 15% of Americans have a disabling condition -- disability is not a standard part of clinical training... We found that of the 618 internship sites recently listed on the APPIC web site, only 81 listed a disabilities rotation.... The picture is even bleaker when we examine how training sites accommodate clinicians with disabilities."

  3. "Increasing Accessibility in Couple and Family Therapy Training" by Aníbal Torres Bernal & David A Zera.This article in Contemporary Family Therapy: An International Journal (vol. #1, March, 2012, pages 112-123) notes that "in the last three decades the number of US graduate students with disabilities has increased exponentially" and discusses the Universal Design initiative and how it can "foster inclusivity and provide accessible educational experiences for all students, including those with disabilities," "diminish the need for individualized accommodations," and "increase the accessibility of courses and clinical training."

  4. "Psychology Graduate Student Training in Developmental Disability: A Canadian Survey" by Jonathan A. Weiss, Yona Lunsky, & Diane Morin. This article in Candanian Psychology (August, 2011, vol. 51, #3, pages 177-184) reports that "With the exception of being educated about the diagnosis of DD, at least half of respondents noted not receiving any education in specific DD topics. The level of coverage for respondents who did receive training was also often rated as inadequate." It also states: "Clearly, graduate students in Clinical and Counselling Psychology programs value training in DD, and most believe that this will contribute to their skills in providing psychological services to other client groups. This insight is shared by psychiatrists in training (Reinblatt, Rifkin, Castellanos, & Coffey, 2004) and medical students (Burge et al., 2008) and is based on the idea that being able to establish rapport, communicate, assess, and treat individuals with DD, who by definition have impairments in communication, problem solving or adaptive behaviour, requires a skill set that can assist any psychologist who provides clinical services. There is a need for greater training in DD for Canadian Psychology graduate students, especially given that the majority of individuals with DD in Canada live in the community across the life span, and many will use nonspecialized psychological services rather than professionals with specialised advanced training in DD."

  5. "Vulnerability and Protection Talk: Systemic therapy process with people with intellectual disability" by Helen Pote,Teresa Mazon, Jennifer Clegg, & Susan King. This videotape study in Journal of Intellectual and Developmental Disability (June, 2011, vol. 36, #2, pp. 105-117) identified "vulnerability and protection themes...within the content of therapeutic conversations, including protection from the disability and its consequences; protection from peers, siblings, and the world at large; and protection from emotionally sensitive topics. Protective strategies were also used by all system members through the process of therapy. Key strategies were topic switch and reversals." The authors write that "Protection is a key issue. Clinical practice could be enhanced if therapists reflect on the strategies they employ in addressing protection effectively."

  6. "Perspectives on ethical practice with people who have disabilities" by Jennifer Cornish, Kimberly Gorgens, Samantha Monson, Rhoda Olkin, Barbara Palombi, & Arnold Abels. This article in Professional Psychology: Research and Practice (October, 2008, vol. 39, #5, pp. 488-497) states that "Ethical practitioners have a basic knowledge of the Americans With Disabilities Act of 1990, as well as information on office and Web accessibility (Pope & Vasquez, 2005) and obstacles to care, including physical barriers and the cognitive and affective biases of practitioners themselves (Pope, 2005). Knowledge of disability models, such as moral, medical, grief, minority, wellness, and social (e.g., Olkin,1999; Prilleltensky & Prilleltensky, 2003; Wendell, 1997), is important. In addition, ethical practitioners seeking to work competently with individuals with disabilities are familiar with developmental issues, including dating, sex, pregnancy, and childbirth among people living with disabilities (e.g., Ashe & Fine, 1997) and, of course, with medical considerations of specific conditions. Further, it is crucial to develop an understanding of multiple minority statuses (e.g., Sue & Sue, 2003) as illustrated by a woman of color with a disability."

  7. "Disability and Psychotherapy Practice: Cultural Competence and Practical Tips" by Laura K. Artman & Jeffrey A. Daniels. This article in Professional Psychology: Research & Practice (October, 2010, vol. 41, #5, pages 442-448) notes that "Despite the popularity of multiculturalism in the field of psychology, most of the disability-related literature in psychology focuses on psychosocial adjustment to disability, rather than strategies for better serving this population." The article discusses "issues for psychologists to consider when working with clients with disabilities, including conceptual models, case conceptualization, cultural competence issues, and practice applications. Just as it is necessary for psychologists to obtain education, experience and supervision with various ethnic minority populations to attain competency, we have argued that the same is required of psychologists to obtain competence in working with PWDs. Such efforts will serve to increase the quality of psychological care that clients who present with disabilities will receive."

  8. "Can Psychology & Disability Studies Join Hands?" by Rhoda Olkin & Constance Pledger. This article in American Psychologist (April, 2003, pages 296-304) opens with the following passage: "Psychology has generally viewed disability in the domain of rehabilitation psychology and thus has conveyed that most psychologists do not need to be trained and skilled in working with people with disabilities and their families. Research on disabilities has reflected that perception by focusing on the clientele most likely to be seen in rehabilitation psychology. Although it is the case that some clients with disabilities, particularly those with recent onset of disability such as traumatic brain injury, spinal cord injury, or stroke, may be treated primarily by rehabilitation psychologists, most clients with disabilities who seek evaluation or psychotherapy are seen outside the sphere of rehabilitation psychology. This is increasingly true because more people with disabilities are living independently and are integrated in the community. Thus, all psychologists in the traditional (i.e., clinical, counseling, and school) and substantive specialty areas of psychology must be prepared to work with this population. If psychologists are to be culturally competent in working with clients with disabilities, they need appropriate training. This training should reflect the state of knowledge about disability; the field of disability studies is the discipline where such knowledge is synthesized and explicated."

  9. "Community Psychology and Disability Studies" by Peter Dowrick and Christopher Keys. This article in Journal of Prevention & Intervention in the Community (volume 21, issue #2, 2001, pages 1-14), part of a special issue of the journal, examines the development of the disability rights movement and of community psychology, looks at opportunities for collaboration, and suggests a model.

  10. "Disability and Accessibility in Psychology: Three Major Barriers" by Kenneth S. Pope. This article in Ethics & Behavior (vol. 15, #2, 2005, pages 103-106) discusses the physical barriers, internet barriers, and cognitive & affective barriers in psychology training and practice that block accessibility for people with disabilities.

  11. "Disability: Its Place in the Psychology Curriculum" by Adrienne Asch. This chapter in Phyllis Bronstein and Kat Quina's book Teaching a Psychology of People: Resources for Gender and Sociocultural Awareness (American Psychological Association, 1988, pages 156-167) provides a literature review and suggests approaches for including this material into a variety of psychology courses.

  12. "Discourse on Disability & Rehabilitation Issues: Opportunities for Psychology" by Constance Pledger. In this article introducing a special section in American Psychologist (volume 58, issue #4, 2003, pages 279-284), Pledger writes that the new "conceptual framework, similar to the Nagi (1976) and IOM model (Brandt & Pope, 1997; Pope & Tarlov, 1991) of disability, examines the relational nature of the disabling condition and the environment. The focus is on functionality within a socio-ecological context. A major thrust of this construct is that external factors (i.e., those beyond the body structures and functions) have the potential to contribute to and shape the disability experience. 'This disability paradigm maintains that disability is a product of the intersection of individual characteristics (e.g., conditions or impairments, functional status, or personal and socioeconomic qualities) and characteristics of the natural, built, cultural, and social environments' (U.S. Department of Education, Office of Special Education and Rehabilitative Services, NIDRR, 2000, p. 2)."

  13. "Ethical Reasoning and Mental Health Services with Deaf Clients" by Virginia Gutman. This article in Journal of Deaf Studies and Deaf Education (vol. 10, #2, 2005, pages 171-183) notes that "ethical problems encountered by mental health practitioners working with deaf clients are often complex and involve issues not fully addressed in professional codes of ethics. A principles-based ethical reasoning process can assist in resolving many of these ethical concerns." The article "discusses some applications of these principles in working with deaf individuals and proposes an ethical decision-making process that can provide a framework for ethical reasoning in thinking through complex problems."

  14. "Historical reflection on advocacy in the psychology of intellectual disability" by Donald K. Routh. This article in the Journal of Clinical Child and Adolescent Psychology (December, 2005, vol. 34, #4 (4), pages 606-611) notes that "In the area of intellectual disability, many relevant laws have been passed, court cases fought, and administrative decisions made. These policy decisions have, however, sometimes been based on a division of labor, with psychologists doing the research and lawyers and representatives of parents' groups carrying out most of the advocacy. It now appears that some of the earlier advocacy by psychologists in this area had unfortunate results. This is partly because some of it was based on flawed research and partly because our values have changed over time. Some more recent instances of advocacy, better grounded scientifically, had more favorable effects. Nevertheless, there is clearly not a simple linear relation between research findings and policy. Ample illustrations of these statements are provided in the careers of four psychologists who were influential as advocates in this domain during their lifetimes: Henry Goddard, Cyril Burt, Jack Tizard, and Donald M. Boer."

  15. "Impact of Professional Training on Case Conceptualization of Clients with a Disability" by Nancy Kemp & Brent Mallinckrodt. This article in Professional Psychology: Research & Practice (vol. 27, #4, 1996, pages 378-385) reviews the literature, including that which supports the conclusion that "inadequate training often results in ineffective interventions and therapists' avoidance of clients with disabilities." The study, using videotape analogues, found that "Therapists gave different priorities to treatment themes depending on whether the client had a disability and whether they, the therapists, had received any training in disability issues. Untrained therapists were more likely to focus on extraneous issues and less likely to focus on appropriate themes for a sexual abuse survivor with a disability." Among the findings were that "even a small amount of training on issues of disability may be associated with significantly less bias in case conceptualization and treatment planning."

  16. "Implications of the Americans with Disabilities Act for the Training of Psychologists" by Nancy Crewe. This article in Rehabilitation Education (volume 8, issue #1, 1994, pages 6-16) discusses the responsibilities of psychology graduate training programs under the Americans With Disabilities Act (ADA) and the kinds of information that needs to be integrated into the education of psychologists whose clients or work environment includes people with disabilities. The author states: "Instruction of the ADA and its implementation needs to be part of the predoctoral curriculum for all applied psychologists in the US, not just for rehabilitation psychologists." This work also appeared as a chapter in Susanne Bruyere and Janet O'Keefe's book Implications of the Americans with Disabilities Act for Psychology (American Psychological Association & Springer, 1994, pages 15-23).

  17. Implications of the American With Disabilities Act for Psychology edited by Susanne Bruyere and Janet O'Keefe. The chapters in this book (which was co-published by the American Psychological Association and Springer Publishing Company, although it is now only available from Springer, 1994) discuss such topics as disability and discrimination, staffing, assessment, consultation, etc.

  18. "Important Implications for Psychologists of the Americans with Disabilities Act: Case in Point, the Patient Who is Deaf" by Lawrence Raifman and McCay Vernon. This article in Professional Psychology: Research & Practice (August, 1996, pages 372-377) reviews 3 court cases and concludes "that these legal decisions represent a potentially troubling round of legal case law that defines a new standard of care for mental health professionals who serve persons with disabilities." The authors recommend that the American Psychological Association "take a proactive, well-developed position on the responsibilities of psychologists who work with patients with disabilities [rather] than . . . wait for the courts to make the decisions associated with appropriate standard of care under the ADA's provisions."

  19. "Integrating Disability Awareness into Psychology Courses: Applications in Abnormal Psychology and Perception" by Stephen Wurst and Karen Wolford. This article in Teaching of Psychology (December, 1994, pages 233-235) presents an approach to heightening university students' awareness of disability issues. The approach includes simulation activities, discussion, and speakers.

  20. "International Classification of Functioning, Disability and Health: An Introduction for Rehabilitation Psychologists" by David B. Peterson. This article in Rehabilitation Psychology ( May, 2005, vol. 50, #2, pages 105-112) notes that "The ICF is intended to be used with its companion classification, the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10; WHO, 1992). There is some overlap between the ICF and the ICD-10 in that they both classify impairments in various body systems. However, the ICD-10 provides an etiological classification of health conditions (e.g., diseases, disorders, injuries), whereas the ICF offers a framework for conceptualizing functioning and disability associated with health conditions. Disease may manifest itself differently in two individuals, and similar functioning does not necessarily imply similar health conditions. Thus, together the ICD-10 and the ICF yield a complementary, broad, and meaningful picture of the health of an individual or of entire populations. Health outcomes data gleaned from the ICF can be used in tandem with ICD-10 mortality data to monitor the health of international populations, allowing a much broader picture of public health to emerge than either alone could permit." The article "orients rehabilitation psychologists to the ICF so they can apply it to research and practice. The structure of the ICF is described, and important concepts are defined. Reviewed are related research, clinical applications, and ethical considerations associated with the use of the ICF in rehabilitation psychology and general clinical practice."

  21. "Internship Accessibility Issues for Deaf and Hard-of-Hearing Applicants: No Cause for Complacency" by Peter Hauser, Deborah Maxwell-McCaw, Irene Leigh, and Virginia Gutman. This article in Professional Psychology: Research & Practice (October, 2000, pages 569-574) discusses ways in which "Federal laws, accreditation guidelines of the American Psychological Association, and rules of the Association of Psychology Postdoctoral and Internship Centers require that internship training programs provide access for interns with disabilities." The authors note: "Those with disabilities who have completed their doctorates and those who are still in the process have had to deal with much more adversity than their nondisabled peers throughout the course of their training because of their 'difference.' To put it bluntly, this is a case of inequitable treatment."

  22. "Issues and Implications of Deaf Culture in Therapy" by Camilla Williams and Norman Abeles (in Professional Psychology: Research & Practice, December, 2004, pages 643-648) notes that "in the United States, it is estimated that between 200,000 and 500,000 individuals are culturally Deaf. Deaf culture provides unique challenges that can impact standard therapeutic techniques." The article discusses "the ability of hearing therapists to effectively work with Deaf clients" and provides "guidelines...to assist hearing therapists in bridging language barriers and cultural gaps with Deaf clients" The article also examines "concerns about the selection and inclusion of sign language interpreters."

  23. "Personal, Professional, & Political When Clients Have Disabilities" by Rhoda Olkin. This article in Women & Therapy (vol. 22, #2, pages 87-103) discusses disability-affirmative therapy and the clinician's responsibilities. Among the topics covered are "valuing disability culture; awareness of the distinction between disability and impairment; facility with discussions of values and disability dialectics; ability to integrate sociopolitical forces into treatment; facility with countertransference; ability to incorporate disability into the case formulation; staying within one's area of competence; working with disability within larger systems; understanding of disability in context; and valuing disability as part of diversity training, teaching, and research."

  24. "Professional Psychology and Deaf People: The Emergence of a Discipline" by Robert Pollard. This article in American Psychologist (April, 1996, pages 389-396) notes that from "graduate schools to local community mental health centers to the APA itself, new standards of equity and excellence are accelerating the evolution of psychology and its relation to persons who are deaf. . . . A small but vibrant educational continuum is teaching the foundation skills of psychology along with the specialized clinical, linguistic, sociocultural, and ethical knowledge needed to competently provide services and conduct research with the deaf and hard of hearing population. Professionals emerging from this discipline, including a long-overdue influx of deaf professionals, are being supported in their work by organizations like ADARA and, increasingly, by the APA itself. The growing community of deaf and hearing psychologists in this field are breaking new ground in scholarship and in professional and public advocacy for deaf consumers and students alike."

  25. "Psychology for Physically Disabled People" by Philip Jones. This article in Educational & Child Psychology (volume 9, issue #1, 1992, pages 6-16) discusses the view that the "development of psychological and therapeutic services related to physical disability has evolved dysfunctional models both theoretically and in relation to how services are often presented and implemented."

  26. Women With Visible and Invisible Disabilities: Multiple Intersections, Multiple Issues, Multiple Therapies edited by Martha E. Banks & Ellyn Kaschak (Haworth Press, 2003). This book address a broad range of issues as exemplified by this sampling of chapters: "ADA Accommodation of Therapists with Disabilities in Clinical Training"; "Women Living with Traumatic Brain Injury: Social Isolation, Emotional Functioning and Implications for Psychotherapy"; "The Influence of Silent Learning Disorders on the Lives of Women"; "Chronic Pain Syndromes and Violence Against Women"; & "African American Women Living with HIV/AIDS: Mental Health Issues."

  27. Alzheimer's from the Inside Out by psychologist Richard Taylor (Health Professions Press, 2006). Psychologist Richard Taylor was diagnosed at age 58 with Alzheimer's. He began lecturing and writing about the experience of being a psychologist with a progressive cognitive disability.

  28. "The Consumer–Survivor Movement, Recovery, and Consumer Professionals" by Frederick J. Frese & Wendy Walker Davis, in Professional Psychology: Research & Practice, vol. 28, #3, June, 1998, pages 243-245. One of the authors, a psychologist, wrote in this article: "After spending 1963 to 1965 in Japan as a young marine officer, I was sent to Florida, where my primary duty was to provide security for atomic weapons. I found the assignment quite stressful. I was diagnosed with paranoid schizophrenia and hospitalized for 5 months, primarily at the Bethesda Naval Hospital in suburban Washington, DC." The other author, also a psychologist, wrote in the article: "At age 30, following 10 years of experience working in human services, I developed symptoms of mental illness and experienced the mental health system as a patient. I have fully recovered from the illness, and I have gone on to complete a doctorate in clinical psychology. I have chosen to work in the public sector."

  29. "Survey of Psychological Services to Clients with Disabilities: The Need for Awareness" by Irene Leigh, Laurie Powers, Carolyn Vash, & Reginald Nettles. This survey, which appeared in Rehabilitation Psychology (vol. 49, #1, 2004, pages 48-54), surveyed members of the American Psychological Association "to identify barriers to, strategies for, and supports for psychological services for clients with disabilities." Amond the major barriers were "funding, accessibility, lack of provider knowledge, limited training in disability issues and services, and lack of sensitivity." The article provides vivid examples: "In the diagnostic category, descriptions of bias included statements such as the following: 'A deaf woman [was] diagnosed as having schizophrenia by a mental health agency because she flailed her arms around; she was signing.' Another respondent indicated that a child with hearing impairment had been misdiagnosed with mental retardation. With regard to test interpretation, a respondent reported that a provider administered a short version of the Minnesota Multiphasic Personality Inventory and did not take into consideration how disability might affect some responses such as 'I have difficulty standing or walking.' Other examples of bias described by respondents included providers not using an interpreter and provider refusal to treat persons with disabilities. Bias in nonclinical settings was also described. For example, one respondent reported, 'When I was in graduate school, the head of the department suggested to a paraplegic prospective student that he would be better off in rehab psychology rather than clinical.'"

  30. "Special Issues in Psychotherapy with Minority Deaf Women" by Carolyn Corbett. This article in Women & Therapy (vol. 26, #3-4, 2003, pages 311-329) notes that "It would be highly unlikely for a minority Deaf woman to have a therapist who matches her in racial background, hearing status, and communication mode" and that consequently "the therapy process will be completely cross-cultural." The article discusses relevant issues including "access to important information; communication, support and level of involvement with biological families; competing cultural demands; health concerns; and coping with chronic mental illness."

  31. "Transforming Psychological Practice & Society: Policies That Reflect the New Paradigm" by Carol Gill, Donald Kewman, & Ruth Brannon. The authors of this article in American Psychologist (vol. 58, #4, 2003, pages 305-312) write: "As people with disabilities mobilize to oppose discriminatory practices and social exclusion, they, too, challenge psychology to consider the sociopolitical foundations of their disadvantaged status. . . . [The new framework is a] shift from viewing disability as a medical problem located completely in the individual to viewing disability as a limitation produced by the complex interaction between individual difference and the social environment."

 

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