Counseling Skills in Working with Families with Disabilities

Question 1

Why would a client benefit much more when families are included?

Answer 1

because of the family systems theory–families are interdependent

Question 2

What did Owens, Farinella, & Metz say about how much time our clients spend with us vs. with their family?

Answer 2

A patient might spend 2 hours a week with an SLP but 110 awake hours with family

Question 3

For people with disabilities, unemployment is an issue… what are the 2013 Department of Labor statistics?

Answer 3

May 2013 Department of labor: people 16 years and older without disabilities=6.9% unemployment rate but 16 years and older with disabilities have a 13% unemployment rate

Question 4

What kind of contract is marriage?

Answer 4

a verbal and nonverbal contract

verbal: marriage vows
nonverbal: our expectations

Question 5

When something happens to their spouse, how may the other spouse feel?

Answer 5

feelings of anger and being cheated—loss of a dream

People feel frightened, anxious, lonely

Question 6

What are factors in preserving a marriage after an injury/disability?

Answer 6

Disability is mild

Lots of Resources

Tolerable substitutions made for lost activities

If well spouse is prone to nurturance (easily slips into a caregiver role)

Question 7

When working with spouses, what should we do?

Answer 7

Pay lots of attention to well spouse—educate and support him/her

Include spouse in assessment and treatment

Let spouse ventilate

Provide a support group

Question 8

What do Chabon & Cohn say about spouses who have a spouse with a degenerative disease like Alzheimers, what does the well spouse have to do?

Answer 8

simultaneously take on extra burdens and promote the sick spouse’s independence as much as possible

Question 9

What are the 2 most important variables in a child’s improvement?

Answer 9

parents personal qualities (communication, patience, proactively seek tx, teamwork, adaptability, & humility)

strength of parents’ marital relationship

Question 10

When a child is born with a disability, what is most destructive to a marriage?

Answer 10

anger

Question 11

When parents are experiencing displacement and can’t blame each other for the child’s disability what do they fight over?

Answer 11

parent fight over little, unrelated things

Question 12

With guilt comes the…

Answer 12

super dedicated parent

Question 13

What are men considered to be? and how do they feel when they can’t do their job?

Answer 13

“family protector”

feel helpless and deny reality; may turn to affairs or extra work

Question 14

When a child has a disability, what can happen in the family?

Answer 14

Lots of changes in family structure when children are born with a disability

Many women postpone or lose their careers

Question 15

When working with parents, it’s important to give permission to them to do what in order for them to be happier?

Answer 15

give parents permission to take care of themselves first

if parents are happy as individuals and a couple, children are much better off

Question 16

What has research found about families with higher SES?

Answer 16

they have more choices for coping and more varied support

Question 17

What has research also found about why parents feel Greater stress when they have to take care of their disabled child but also have other responsibilities ?

Answer 17

parents who felt that their caretaking responsibilities for disabled children took time away from their spouse, other children, and self

Question 18

What has research found about parents who care for their children with disabilities in regards to children’s behavior?

Answer 18

Children’s behavior problems caused parents far more stress than child’s cognitive delays

Question 19

What does Naseef say about what men wanted when he interviewed couples who had a disabled child?

Answer 19

women to understand that they were doing their best and were frustrated when they couldn’t make things better

More time alone with their wives as a couple

Women to be more rational and less emotional so solutions could be discussed

More responsibility for special needs children; women need to “get out of the way” and let men help

Women to tell them what they are doing right

Question 20

What does Naseef say about what women wanted when he interviewed couples who had a disabled child?

Answer 20

Men involved in child’s education; tired of going to meetings alone

Time by themselves to relax without children

To talk about their feelings without men getting defensive

Men to develop a better understanding of their children’s special needs and not leave everything to women.

Question 21

What does Tiegerman-Farber et.al say about how mothers often feel when they have a disabled child?

Answer 21

I feel totally overwhelmed with my children

No time to spend with husband or other children

No time for myself—stressed out!

My husband feels: along with cooking, housecleaning, and disciplining, our special needs child is MY problem and responsibility

I am concerned that my husband is afraid of our children (fear of failure)

Question 22

How can we build positive relationships with parents?

Answer 22

Focus on the child’s strengths as well as weaknesses

Focus on parent’s strengths and expertise

Put yourself in parents’ shoes

Conscientious parents will get multiple opinions

Don’t make instant diagnoses

Always emphasize child’s happiness, success, best interests

Show interest in parents as people

Find a point of agreement and build from there

Use “foot in door” technique, getting parents to say “yes” and agree with you at the very beginning of the meeting

Watch where you sit. When you sit across from somebody, that indicates a possible adversarial/authoritative position. If you sit next to someone, there is a greater feeling of camaraderie.

Maintain good eye contact, and use the parents’ names throughout the meeting

Validate parents’ feelings, acknowledge their struggles

Schools—remind parents—IEPs can be re-written: feel less boxed in

During meetings, write things down on a whiteboard or flipchart; use parents’ exact words

During a meeting, if a parent loses control, get person alone; remove audience

If parent continues to be abusive despite requests not to be, terminate meeting—indicate meeting will re-convene when everyone has calmed down

When meetings are held, best if both parents can be there, especially since so many fathers deny problems

Remember—mothers especially experience isolation and depression.

Question 23

What does Robinson, say about how we should behave as professionals with the parents?

Answer 23

Sit Next to parents

Professionals never disagree in front of parents

If parents are resistant to labeling, explain that student is old enough to be involved and there will be more buy-in if s/he understands

Question 24

How may grandparents be affected by grandchildren with disabilities?

Answer 24

Isolated by our prosperity—single family dwellings

Grandparents longer in denial than parents (grandparents wear rose-colored glasses)

Adult parents want to bring their parents joy—this may be gone

Isolation—everyone acts like everything is OK

Many grandparents—primary caretakers

Poverty—major issue

Grandparents ideally can take over and help parents with non-disabled siblings

Question 25

How may siblings be affected if they have a sibling with disabilities?

Answer 25

When children are born with a disability, oldest daughter is most affected

Siblings who are caretakers have more responsibility, fewer social activities

Siblings can be very helpful in assessment and treatment

Question 26

KNOW PAGE 263 IN THE BOOK!!!

Question 27

How may poverty influence families who have children with disabilities?

Answer 27

One issue is that the parents need as much support as their children do—we can use a team approach to try and provide this support

Parents are barely surviving; speech and language issues are often very low priority

There can be value conflicts: Middle SES families: proactive, make good choices now and planning ahead–Low-SES families: survive in present; future not a priority

Question 28

How may children of disabled adults be affected?

Answer 28

Adolescence is a luxury of affluent societies. In most countries, adolescents begin working right away to support families

Adolescent children of disabled adults usually either: Become REALLY RESPONSIBLE or Get into trouble (delinquency)

Very hard for adult children to institutionalize their parents

Can be extremely costly (up to $7000/month)

Adult children try to care for aging parents at home themselves or adult children institutionalize parents and give up own home to pay bills

Question 29

What has research found in regards to caring for disabled children can do to aging of mothers?

Answer 29

Caring for a chronically sick/disabled child accelerated aging in mothers

Question 30

What has research found in regards to which gender causes more stress in parents when raising disabled children?

Answer 30

Parents of disabled boys experienced more stress than parents of disabled girls

Question 31

What has research found that helps relieve some stress of parents who raise disabled children?

Answer 31

Respite care–very helpful in decreasing stress

Question 32

What does Tiegerman-Farber et.al say about how fathers often feel when they have a disabled child?

Answer 32

I work—my primary responsibility. My wife takes care of the kids.

I try to help my wife, but she is much more effective in managing our son.

My son listens much more to my wife than me.

After working all day, I don’t want to be bothered with the noisy havoc in the house

I need to go to work in the morning. I can’t stand the confusion, screaming, and mess at home.