June 2 will mark the 100-year anniversary of what many of us in the field of rehabilitation counseling consider the inception of our specialty counseling area. On June 2, 1920, President Woodrow Wilson signed the Smith-Fess Act (also known as the Civilian Vocational Rehabilitation Act), which established the first vocational rehabilitation program for Americans with disabilities. It was modeled on an earlier law that provided for the rehabilitation of World War I veterans with disabilities.

Rehabilitation counseling is a unique specialty area of counseling focused primarily on disability advocacy and vocational rehabilitation counseling for individuals with disabilities. The field continues to grow, with new and expanding educational programs, opportunities for state licensure, and rewarding career paths. Certification is available through the Commission on Rehabilitation Counselor Certification (crccertification.com), and opportunities for counselor licensure are available in all 50 states. Recent developments in our field have further strengthened our relationship with the counseling profession at large and fostered opportunities for increased collaboration and education regarding disability inclusion in our profession as a whole.

Our history and specialty counselor education focus

The American Rehabilitation Counseling Association (ARCA) was established in 1957 and is a division of the American Counseling Association. ARCA’s mission is “to enhance the development of people with disabilities throughout their life span and to promote excellence in the rehabilitation counseling profession.” In 2019, the ACA Governing Council approved ARCA’s recommended Disability-Related Counseling Competencies (available on the ACA website at counseling.org/knowledge-center/competencies). ARCA invites all those in the counseling profession to review these competencies, to strive toward greater disability inclusion in the practice of counseling, and to consider ARCA their disability advocacy resource within our ACA fellowship.

Over the past several years, the rehabilitation counseling field has experienced a major shift in the accreditation of its education programs. As a result of the merger of the Council on Rehabilitation Education (CORE) with the Council for Accreditation of Counseling and Related Educational Programs (CACREP) in 2017, rehabilitation counseling is the newest counseling specialty included in the current 2016 CACREP Standards.

Rehabilitation counseling as a counseling specialty has existed in some form for more than 100 years. The history of rehabilitation counseling can be traced back to federal legislation in 1918 that initiated a program to vocationally rehabilitate veterans disabled during World War I. By 1920, additional legislation established the first broad-based federal program to provide vocational assistance to people whose disabilities were not the result of war. In the past 100 years, this state-federal vocational rehabilitation system has expanded its services and populations served to become the primary public service delivery system for all working-age youth and adults with disabilities in the United States. Each state has a designated vocational rehabilitation agency, and some states have an additional agency that serves individuals who are blind. The Council of State Administrators of Vocational Rehabilitation maintains a directory of all state VR agencies at csavr.org/stateagencydirectory.

State vocational rehabilitation agencies all receive federal funding from the U.S. Department of Education’s Office of Special Education and Rehabilitative Services under the Rehabilitation Services Administration (RSA) to provide services to individuals with disabilities. RSA’s mission is to “provide leadership and resources to assist state and other agencies in providing vocational rehabilitation (VR) and other services to individuals with disabilities to maximize their employment, independence and integration into the community and the competitive labor market.” All vocational rehabilitation services are individualized and generally include some combination of the following:

• Vocational counseling and guidance
• Job placement assistance
• College or vocational training
• Supported employment services
• Skills training
• Job coaching or tutoring
• Transportation
• Interpreter services for individuals who are deaf or hard of hearing
• Services to assist students with disabilities in their transition from school to work
• Reader services for individuals who are blind
• Assistive and rehabilitation technology services
• Referral services
• Support, advocacy and follow-up services for at least 90 days following job placement

Currently, CACREP accredits more than 100 master’s-level rehabilitation counseling programs nationwide. Several of these institutions also offer doctoral degrees specifically in rehabilitation counseling education. The RSA regularly offers training grants to these institutions to support students who are pursuing graduate degrees in this counseling specialty area. Rehabilitation counseling students receive specialized training regarding the medical aspects of disability, legislation that affects individuals with disabilities, job placement strategies, and career guidance focused on workplace inclusion for multicultural individuals with disabilities. Over the years, the RSA’s definition of employment has expanded to support the efforts of people with disabilities to gain access to their communities, live independently, and direct the course of their own lives.

The emphasis on disability inclusion in rehabilitation counseling education programs provides students with specialized knowledge and skills related to the history of discrimination of individuals with disabilities in our society, the impacts of ableism in our society, medical aspects of disabilities, workplace accommodations, advocacy, and counseling ethics specifically related to disability inclusion. These skills are useful in a variety of settings, including state vocational rehabilitation agencies, the U.S. Department of Veterans Affairs system, county behavioral health systems, nonprofit agencies, return-to-work programs, human resources, legal settings, private rehabilitation hospitals, academia, and many other settings in our communities. Graduates of rehabilitation counseling programs find employment as vocational counselors, case managers, vocational evaluators, technology experts, forensic vocational experts, teachers, researchers, and private practice counselors in a wide range of work environments.

Social justice advocacy

Merriam-Webster’s online dictionary defines ableism as “discrimination or prejudice against individuals with disabilities.” Combating discrimination and the segregation of people with disabilities has been a long-standing principle and goal of rehabilitation counseling. Rehabilitation counseling scholars and educators have an established record of educating the public about the social construct of disability, the history of disability rights advocacy, and the existence of ableism in our society, and of combating negative attitudes toward individuals with disabilities.

The biggest barriers that individuals with significant disabilities encounter in our society are social isolation and poverty. According to the Bureau of Labor Statistics, 19.1% of individuals with a disability were employed in 2018. By contrast, the employment-population ratio for people without a disability was 65.9%. The depiction of individuals with disabilities in mainstream media is largely negative, and this has a huge impact on our attitudes toward disability as a society. Our institutions often seek to label individuals with disabilities as defective, different or “special,” with focus given to treating the person to fix their undesirable characteristic. Absent education and awareness, our society views disability as something being “wrong” with the individual rather than focusing on the attitudinal and environmental barriers that someone with a significant physical or mental impairment experiences as they navigate their way in the world. These negative and discriminatory attitudes are prominent barriers to financial independence and social inclusion for individuals with significant disabilities.

Mainstream media plays a major role in our societal attitudes toward individuals with disabilities. In film, on television and in the press, these individuals are often stereotypically depicted as being tragic, evil, heroic, objects of pity or objects of inspiration. They are rarely portrayed as people whose identities include the full range of human experiences and development, such as having intimate relationships, being family members, being students, working, traveling, enjoying hobbies, and engaging in other experiences that are normal parts of our lives and communities. Furthermore, characters with disabilities in films and TV shows are rarely portrayed by individuals with disabilities themselves. This is an additional form of discrimination experienced by actors with disabilities. Beth Haller, a prominent scholar who advocates for the positive portrayal of individuals with disabilities in mainstream media, makes a wide range of resources available at bethhaller.wordpress.com to those who are interested in exploring this topic further.

Our schools, public services and government institutions often perpetuate social isolation and poverty for individuals with significant disabilities through the various processes, regulations and financial restrictions that exist within programs designed to “help” individuals with disabilities. A main focus of rehabilitation counseling is advocating for people with disabilities and counseling our clients to reduce the environmental barriers that affect employment. Employment creates financial independence, provides a sense of purpose, and connects us in our communities. Rehabilitation counseling education programs focus on career development techniques, the Americans with Disabilities Act, and the impact of state-specific legislation on the employment of individuals with disabilities. Rehabilitation counselors help individuals navigate the complex public benefits system to avoid being penalized for earning income as they transition to work from dependence on public assistance programs.

Disability and cultural identities

Most individuals with disabilities have intersectional identities. More than half of those with disabilities are female, while individuals who identify as members of various ethnic groups or who identify as LGBTQ+ are also well-represented among those with disabilities. Individuals with disabilities live all over the world, and disability culture in itself is an aspect of multiculturalism. However, the disability experience is often overlooked or not included as an
aspect of multiculturalism in educational programs and staff development curricula.

The concepts of disability pride and disability culture have been emerging since the disability rights movement in the 1970s. Starting in the 1990s, a more formal construct of disability culture started to materialize in academic literature. Michelle Putnam, a professor of social work at Simmons University in Boston, explains that disability pride is an aspect of disability identity. It consists of claiming disability, acknowledging disability as a natural part of the human condition, advocating for the fact that disability is not inherently negative, and experiencing disability as creating the consciousness of a unique cultural minority group. Among examples of the disability pride experience are the Paralympic games, Deaf culture, and the recovery movement.

Disability pride: It is a common misperception that the para in Paralympics means the events are for “paralyzed” athletes. In fact, it means that it is an athletic competition that “parallels” the Olympics. The Paralympics include athletes with many different disabilities, including athletes who use wheelchairs. According to the International Paralympic Committee (paralympic.org), Paralympic athletes celebrate diversity and show that difference is a strength. Paralympic athletes, who are pioneers for inclusion, challenge stereotypes, transform attitudes, and break down social barriers and discrimination toward persons with disabilities.

The magazine New Mobility was launched in 1989 to bring quality journalism to wheelchair users who wanted more information on how to lead active, healthy lives. Editors, writers and college interns with disabilities produce this unique resource that shatters stereotypes and tells real stories of living life on wheels. Paralympic athletes and the producers of New Mobility magazine are examples of individuals and groups who choose to build community, celebrate diversity, and advocate for disability pride.

Deaf culture: According to sociolinguist Barbara Kannapel, American Deaf culture includes the values, traditions and language unique to individuals who are Deaf. Deaf culture centers on the use of American Sign Language (ASL) and identification and unity with other Deaf people. ASL is a complete and grammatically complex visual/gestural language with no vocal component. It differs significantly from written and verbal communication in English. ASL is not a universal language; there are signed languages in other countries. ASL reflects the unique and beautiful culture of Deaf people in our country. Gallaudet University’s National Deaf Education Center (www3.gallaudet.edu/clerc-center/info-to-go/deaf-culture/american-deaf-culture.html) is a good resource for additional information.

The recovery movement: Self-help groups available through the National Alliance on Mental Illness (NAMI), 12-step, and other recovery-related organizations have created an ever-expanding, cohesive and diverse community of individuals living in recovery who provide hope, solutions and strategies for others struggling with mental illness and addiction.

The recovery movement can be traced back to the founding of Alcoholics Anonymous in 1935 by Bill Wilson and Dr. Bob Smith. The 12 steps of Alcoholics Anonymous have been adapted by numerous other 12-step programs, including Al-Anon, Adult Children of Alcoholics and Dysfunctional Families, Co-Dependents Anonymous, Sex and Love Addicts Anonymous, Narcotics Anonymous, Crystal Meth Anonymous, Gamblers Anonymous, and Overeaters Anonymous. This peer-led, self-identifying, self-help approach to treatment has generated many other recovery-related groups in our communities, including SMART Recovery, Women for Sobriety, Secular Organizations for Sobriety (SOS), Refuge Recovery, and the Buddhist Recovery Network. An estimated 23 million Americans are currently living in long-term recovery from addiction to alcohol and other drugs.

NAMI is the country’s largest grassroots mental health organization dedicated to building better lives for the millions of Americans affected by mental illness. NAMI, which started as a small group of families gathered around a kitchen table in 1979, has expanded to include more than 500 local chapters throughout the country. The organization provides awareness, support and education on mental illness in our communities.

Although individuals with histories of mental illness and addiction continue to be affected by significant social stigma and discrimination, millions experience hope, healing, courage, support and pride as members of the recovery community. For more information on recovery, visit NAMI’s website (nami.org) or view the documentary The Anonymous People.

Solutions and recommendations for disability advocacy

Rehabilitation counseling is the social justice, multicultural and disability advocacy specialty. As rehabilitation counseling professionals, we advocate for outreach, education and awareness. The various ACA-endorsed counseling competencies (available at counseling.org/knowledge-center/competencies) and CACREP core curriculum standards emphasize multicultural awareness, education and advocacy. What follows are some solutions and recommendations for disability advocacy in our counseling profession at large.

• Include the disability experience in all counselor education curriculum as a unique aspect of our diverse multicultural society.
• Partner with ARCA and other ACA specialty divisions that promote social justice.
• Advocate for disability inclusion. Don’t separate and segregate individuals with significant disabilities in our institutions, in our systems, and in our work as counseling professionals.
• Help CACREP to integrate more disability-specific language into the core curriculum areas in its 2023 standards revisions. Connect with the Standards Revision Committee (cacrep.org) to express your ideas for the revisions.
• Include works by multicultural disability scholars in counselor education curriculum.
• Read autobiographies of individuals with disabilities.
• Follow individuals with disabilities on Twitter.
• Support the work of individuals with disabilities in the media.
• Include scholarly articles written by individuals with disabilities in counselor education curriculum.
• Create an information sheet with disability- and recovery-related resources to give to your clients
• Increase your counseling competency by reading the Disability-Related Counseling Competencies on the ACA website (counseling.org/knowledge-center/competencies).

Resources

Many resources are available for those interested in learning more about the rehabilitation counseling specialty and connecting with rehabilitation counseling educators and clinicians.

One of the most current, comprehensive resources for an overview of rehabilitation counseling is The Professional Practice of Rehabilitation Counseling, second edition, compiled by editors Vilia M. Tarvydas and Michael T. Hartley (2017).

The National Council on Rehabilitation Education maintains a directory of all the rehabilitation counseling programs in the country at tinyurl.com/NCRERCPrograms.

Also visit the ARCA website (arcaweb.org) for a variety of resources. We invite all readers to stop by the ARCA booth at the upcoming ACA Conference & Expo in San Diego in April. In addition, attend our presentations at the ACA Conference that have a rehabilitation counseling and disability focus. We look forward to connecting with you.

 

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Sonia Peterson is a licensed professional clinical counselor, a certified rehabilitation counselor, and an assistant professor in the Department of Administration, Rehabilitation, and Postsecondary Education at San Diego State University, where she serves as program director for the clinical concentration and certificate in psychiatric rehabilitation. In addition, she serves as the American Rehabilitation Counseling Association (ARCA) board chair of public policy, professional preparation and standards. Contact her at slpeterson@sdsu.edu or through the ARCA website at arcaweb.org.

 

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