My Professional Portfolio 14

Running Head: MY PROFESSIONAL PORTFOLIO 1

My Professional Portfolio: The Development of a Professional Philosophy and the Possible

Application of that Philosophy to the Rehabilitative Counseling of Persons with Autism

Khadija Andrews

University at Buffalo

CEP 649: Rehabilitation Foundations

15th December, 2009 MY PROFESSIONAL PORTFOLIO 2

A Professional Philosophy and its Application to Rehabilitative Counseling of Persons with

Autism

My Professional Philosophy

As I consider what my professional philosophy is; I think of a quote that sums up my philosophy both simply and beautifully: “He that gives good advice, builds with one hand; he that gives good counsel and example, builds with both; but he that gives good admonition and bad example, builds with one hand and pulls down with the other” –Sir Francis Bacon (1561-1626).

My philosophy encompasses the tenants that I believe are the true qualities of an efficient rehabilitation counselor. The most important of these qualities are:

 Placing great emphasis on the right to independence and dignity of all consumers, while

making them feel like they matter to others.

 Embracing and understanding multicultural counseling.

 Using the most efficient and thorough assessment measures and rehabilitative planning

tools.

 Giving every consumer the right to be a part of their rehabilitative process.

 Being an advocate for those with disabilities and for furthering of rehabilitative services.

 Knowing and understanding legislation, public policy and ethical standards.

Each of these qualities in themselves delves into the realm of many supplementary characteristics of effective counseling. As such I will discuss each of the previously mentioned MY PROFESSIONAL PORTFOLIO 3 aspects in further detail. Furthermore I will attempt to explain and demonstrate the ways in which these qualities can be most effective and best put to use.

Qualities of an Effective Counselor

Mattering to Others. The Commission on Rehabilitation Counselor Certification

(CRCC) (2007) mentions that one of the underlying values for rehabilitation counseling is

“facilitation of independence, integration and inclusion of people with disabilities in employment and the community (p. 1). As such one of my main goals as a counselor is to ensure that consumers feel that there is a possibility of independence and that there well being matters to not only them but to me as well.

As such I am drawn to counseling approaches that are both client-centered and relationship-centered. I believe that counseling must have a great emphasis on the relationship between the consumer and the counselor. As well, the feelings and attitudes of the consumer must be of the utmost importance throughout the counseling process. Kelly Jr. (1997) states:

A fundamental philosophical premise of the relationship-centered perspective is that the

distinctively human, in-depth qualities of self-determination, subjectivity, intrinsic worth,

personal uniqueness, creativity, purposefulness, meaningful directionality, self-

actualization potentialities, and a capacity of for transcendence are the primary elements

that inform and guide the conceptualization and practice of counseling. (p. 337)

If these qualities do guide the framework of counseling practice then the relationship between a client and counselor must be one that is full of trust and mutual respect. MY PROFESSIONAL PORTFOLIO 4

Apart from this another fundamental basis in counseling is ensuring that the consumer feels like they matter to others, particularly to the counselor (me). “Elliot et al suggested that the thought of not mattering to others in our lives is likely one of the most freighting perceptions we could ever have” (Rayle, 2006, p.483). Often times persons with disabilities express feeling unimportant or ignored. This perception of not mattering can have detrimental effects to their progress in counseling. Thus as a counselor there is an onus on me, the counselor, to ensure that these feelings are discussed and possibly dissipated over time.

Embracing Multicultural Counseling. “Desirable rehabilitation outcomes are harder to accomplish when rehabilitation counselors fail to assess their clients accurately in an appropriate cultural context” (Chen, Jo and Donnell, 2004, p.6). It is my belief that the only way that the field of Vocational Rehabilitation can become more efficient and more all encompassing is for counselors to become more all-rounded in their understanding of the cultural norms of differing groups. Understanding these norms will also help me (the counselor) to determine the best possible course of action for each client based on their ethnic background.

Research suggests that many students of rehabilitation counseling as well as many counselors seem to have inadequate training in regards to multicultural counseling. Furthermore as a result there is a disparity in the rehabilitative services received by those within ethnic minorities. These two factors quite possibly have much to do with each other i.e. if a counselor is not well versed in the cultural norms of an ethnic group then that group who feels misunderstood is unlikely to seek help.

Current mental health practices and delivery systems have not been designed to meet the

needs of ethno cultural minorities and poor understanding of the interplay of cultural, MY PROFESSIONAL PORTFOLIO 5

financial, organizational, and diagnostic factors contributes to inappropriate service

utilization, individual suffering and deep social and economic costs. (Rollock and

Gordon, 2000, p. 5)

This acceptance of a multicultural approach to counseling is also in keeping with the

Code of Professional Ethics of Rehabilitation Counselors (2009) (which will become effective in

January 2010). Specifically it aligns with the views expressed in Section D.2.a. which states:

“Rehabilitation counselors develop and adapt interventions and services to incorporate consideration of cultural perspective of clients and recognition of barriers external to clients that may interfere with achieving effective rehabilitation outcomes” (p.12).

Assessment and Planning. Again, the CRCC (2007) Scope of Practice states that two of the specific modalities to be used in rehabilitation counseling are assessment and appraisal along with diagnosis and treatment planning. This process includes many different types of testing as well as analysis of the information provided through this testing. After the assessment is done, its results can be used as a base from which to begin the counseling process. Also the evaluation can provide the foundation on which a rehabilitative vocational plan can be developed.

The evaluation process of the rehabilitation counseling process has two main functions.

The first of which is to give the counselor pertinent information about the consumer with regards to physical, educational-vocational, psychosocial and economic factors. Lastly this process is the point in which consumers can become better informed on their personal vocational range and interests, learn about the potential job opportunities that are compatible for them and find out more about the services and supports available to further their functioning and independence.

This evaluation includes aptitude testing, personality testing, intelligence testing and measures of vocational interests. Counselors should have knowledge and understanding of these MY PROFESSIONAL PORTFOLIO 6 testing measures and procedures. If the counselor is not familiar with these procedures then it is the responsibility of me, the counselor, to refer the consumers to someone who is qualified to administer such tests. The end result of this outcome must be that the consumer receives the best possible services to facilitate a thorough and accurate evaluation and assessment. Such an assessment would ensure that they receive the best possible treatment.

Allowing Clients to be an Active Part of Counseling. “In Canada, client-centered approaches adopted within occupational therapy involve consumers in collaborative partnerships with therapists to establish goals and achieve clinical outcomes” (Shaw, MacKinnon et al., 2004, p.181). As mentioned in the example above there has been a move in the vocational rehabilitation field towards clients having a larger and more active role in counseling. In my opinion this is step in the right direction. A consumer, who takes great pride in being a part of the process, seems more likely to succeed with the goals set out.

This bold and somewhat new initiative in the field of VR is definitely the way of the future. No longer are consumers passive receivers in the counseling process. This change can only be attributed to a change in the attitudes and feelings about persons with disabilities. Shaw,

MacKinnon et al. (2004) state: “The adoption of empowering ideologies in vocational rehabilitation reflects changes in the beliefs about a person’s rights, potential to make decisions and enact choices” (p. 182). No longer are persons with disabilities viewed and helpless, unable to make decision and unable to determine what is best for them.

Being an Advocate. Since I believe this topic is somewhat self-explanatory and also crosses into the following sub heading, I will only speak on it briefly. As a counselor the responsibility is not only to the consumer but also to all consumers. Advocacy in my opinion is very much part of what vocational counselors should do. This is especially true as today, even MY PROFESSIONAL PORTFOLIO 7 with the Americans with Disabilities Act, there seems to be a hesitance to allow these persons to live their lives freely. As well there is definitely still a stigma attached to persons with disabilities which causes them to not always have access to employment opportunities.

“About 10% of the world’s population, some six hundred million people, has a disability.

Disability persons nevertheless account for 20% of the world’s poorest individuals, a phenomenon that exists across developing and developed nations” (Stein and Stein, 2007, 1203).

This statistic is truly saddening and unacceptable and I believe it speaks to an underlying belief that persons with disabilities are unemployable or difficult to have employed. While as a vocational counselor I know that this is not the case, there are some persons of the general public who still seem to feel this way.

So regardless of the progress made in the area of disability rights, there is still more work to be done and rehabilitation counselors must bear part of that burden.

Knowing Legislation and the Ethics Code. As a counselor it is imperative to know the legislation that dictates how you clientele is to be treated as well as the history of the legislation with regards to persons with disabilities. This is also true as it regards to knowing and understanding the Code of Professional Ethics for Rehabilitation Counselors that governs all rehabilitation counselors. There are a few pieces of legislation that I believe are particularly imperative to know; they are (a) The Americans with Disabilities Act and; (b) The Rehabilitation

Act of 1973. So I will discuss the important point to note of each of these integral pieces of information.

Code of Professional Ethics for Rehabilitation Counselors. This document is the ethical guide by which rehabilitation counselors live. It informs on a number of topics concerning MY PROFESSIONAL PORTFOLIO 8 ethical issues a counselor can face as a result of counseling. These topics include information with regards to the following issues:

 The counseling relationship

 Confidentiality, privileged communication and privacy

 Advocacy and accessibility

 Professional responsibility

 Evaluation, assessment and interpretation

 Technology and distance counseling

 Business practices

 Resolving ethical issues

The Americans with Disabilities Act. This is arguably the most important legislation in today’s landscape with regards to persons with disabilities as well as their rights and the public’s responsibilities to them. The ADA firstly defines disability as: “ (a) a physical or mental impairment that substantially limits one or more or more major life activities of such an individual; (b) a record of such an impairment; or (c) being regarded as having such an impairment” (Rubin and Roessler, 2008, p. 96).

Apart from the definition the ADA outlines the laws that govern how persons with disabilities should be treated by both individual members of society and industries. Thus the

ADA ensures the:

 Prohibition of discrimination in employment practices

 Nondiscrimination on the basis of disability in state and local government services

 Nondiscrimination in public accommodations and commercial facilities MY PROFESSIONAL PORTFOLIO 9

 Increased access to telecommunication for persons with disabilities

The Rehabilitation Act of 1973. Another important piece of legislation that I believe rehabilitation counselors should be familiar with in the Rehabilitation Act of 1973. This legislation is possibly regarded as the precursor to the ADA. There were many amendments to the act but the “spirit of the times” is best expressed by the five main goals of the act. These are:

 Serve individuals with severe disabilities

 Promote consumer involvement

 Stress program evaluation

 Provide support for research

 Advance the civil rights of persons with disabilities

Upon comparison of the legislation one can see some very similar underlying threads. Both these laws attempt to deter discrimination, provide greater understanding and knowledge of the plight of persons with disabilities and facilitate further study and research in the field of vocational rehabilitation. In my opinion counselors must have a good grasp of the information and knowledge of this law as well, if they are to be completely understanding of the struggle of consumers.

Now I will discuss a disorder that is near and dear to my heart. As well I will cover how my professional philosophy may be applied to helping a consumer with this disorder.

Autism Spectrum Disorder

Etiology. “Autism spectrum disorder (ASD) is a range of complex neurodevelopment disorders, characterized by social impairments, communication difficulties, and restricted, repetitive, and stereotyped patterns of behavior” (National Institute of Neurological Disorders & MY PROFESSIONAL PORTFOLIO 10

Stroke, 2009). The etiology of this disorder or any of the disorders associated with it is not necessarily well known or comprehensive. However, as mentioned by the NINDS (2009), the belief is that:

ASD could result from the disruption of normal brain development early in fetal

development caused by defects in genes that control brain growth and that regulate how

brain cells communicate with each other, possibly due to the influence of environmental

factors on gene function.

Although there are indications that these may be factors that cause ASD, much more research must be done in this field. As it stands there are many other risk factors and causes that are being researched. Thus it seems that the exact etiology of ASD is still unknown and much research is being done to figure this out.

Functional Limitations. These disorders do cause functional limitations in consumers.

Autism has a particularly limiting effect on social interactions between consumers and others.

Persons with ASD thus present a specifically difficult challenge in vocational rehabilitation as a major aspect of gainful employment is communication with others; persons with this disorder have issues with such communication. These limitations include:

 Avoidance of eye contact and wanting to be alone

 Having trouble understanding other people's feelings or talking about their own feelings

 Having delayed speech and language skills

 Repeating words or phrases over and over (echolalia)

 Giving unrelated answers to questions

 Having obsessive interests MY PROFESSIONAL PORTFOLIO 11

Prognosis and Treatment. The prognosis for person with autism greatly depends on

how early the detection of the disorder takes place. If detected early in childhood, there is a

high possibility that the consumer can learn and develop to some extent. It is also likely that

the consumer, with treatment, can lessen disruptive behavior and gain some level of

independence.

As for treatment, traditionally it consists of multiple treatment options that are medical, psychological and even dietary. Treatment is best if introduced early and consistently. The main treatments include (Neurology Channel, 2009):

 Behavior Modification usually includes using token economies to reward behaviors that

the client should repeat and ignore the behaviors that are to be stopped or lessened.

 Communication Therapy is also quite common. This includes speech therapy and picture

exchange communications. These therapies allow the consumer with autism to better

express their feelings and concerns.

 Medication is sometimes given to help alleviate or temper the symptoms associated with

autism. These include depression, anxiety and obsessive compulsions. There is no known

medication to treat ASD itself.

My Professional Philosophy Applied to ASD

The most important aspect of vocational counseling in persons with autism is assessment and diagnosis. As the counselor I would ensure that the testing measures given are not only given properly but that testing measures are appropriate for the consumer. By this I mean that the assessments must take into consideration the consumer’s limitations unless the assessment being done is the initial intake evaluation. MY PROFESSIONAL PORTFOLIO 12

Autism presents many very difficult issues for the vocational counselor as a consumers progress is greatly determined by what end of the spectrum the consumer’s disorder falls under.

As such I think the most applicable aspect of my philosophy would be that of the client-centered and relationship-centered approach I value in counseling. This approach driven by the building of a relationship is very well suited as the relationship with a consumer with autism is key.

Particularly, because person with ASD often have a very difficult time connecting with persons who they are not especially close to.

This approach would allow me as a counselor to work with the consumer and really understand and utilize their strengths and interest. “Accommodating an individual’s interests and abilities in creative ways produces better outcomes than trying to fit the individual to certain jobs or environments” (Olney, 2000, p. 54). This is the only way I think rehabilitation counseling for this population can go forward initially, as persons with autism are usually very resistant to change and have very strong interests/strength.

Also in keeping with allowing consumers to be active participants in counseling, when possible the consumer should be allowed to be a part of the decision making process. Because persons with ASD take words and meanings literally and do not respond much indirect communication, I would say exactly what I mean. As Olney (2000) states the best way to communicate is to be “clear and specific avoiding euphemisms and figures of speech” (p. 55). In doing these things and making the consumer understand as much as possible, this would allow me to get their feedback or suggestions.

Lastly I would like to give particular attention to advocacy for this population particularly as it is a group that seems to be under represented in the vocational counseling field. Thus I would place a great deal of emphasis on research and better understanding on the needs of those MY PROFESSIONAL PORTFOLIO 13 with autism in terms of vocational counseling. As well I would lobby for a great deal more services for persons with autism as I believe there is a sort of gap with regards to services for these consumers. I think this gap stems from the possible belief that possibly persons with ASD are often times incapable of becoming gainfully employed. However there is so little research done that no one can be quite sure that this is true.

Conclusion

My professional portfolio and philosophy is guided by many factors, including the ones discussed previously in this paper. A counselor must take the time to continue to learn more with regards to legislation, social progression, ethics and policy, to ensure that they can and are providing the best possible service to their consumers. All of that being said, my professional philosophy is in a state of constant change. My philosophy is an evolutionary process. It is guided by the experiences I have had and all the information I will learn throughout my career. MY PROFESSIONAL PORTFOLIO 14

References

Chen, Roy K., Jo, Song-Jae, & Donnell, C.M. (2004). Enhancing the rehabilitation counseling

process: Understanding the obstacles to Asian Americans’ utilization of services. Journal

of Applied Rehabilitation Counseling, 35(1)

Commission on Rehabilitation Counselor Certification. (2009). Code of professional

ethics for rehabilitation counselors. Schaumburg, IL: Author.

Commision of Rehabilitation Counselor Certification. (2007). Scope of Practice for

Rehabilitation Counseling. Schaumburg, IL: Author

Kelly Jr., Eugene W. (1997). Relationship-centered counseling: A humanistic model of

integration. Journal of Counseling & Development, 75, 337-345.

Neurology Channel (2009). Autism: Autism treatment, autism prognosis. Retrieved from

http://www.neurologychannel.com/autism/treatment.shtml. Retrieved on December 15,

National Institute of Neurological Disorders & Stroke (2009). Autism fact sheet. Retrieved from

http://www.ninds.nih.gov/disorders/autism/detail_autism.htm#140163082. Retrieved on

December 15, 2009.

Olney, Marjorie F. (2000). Working with autism and other social-communication disorders.

Journal of Rehabilitation, 66(4), 51-56.

Rayle, Andrea Dixon. (2006). Mattering to others: Implication for the counseling relationship. MY PROFESSIONAL PORTFOLIO 15

Journal of Counseling & Development, 84, 483-487.

Rollock, David. & Gordon, Edmund W. (2000). Racism and mental health into the 21st century:

Perspectives and parameters. American Journal of Orthopsychiatry, 70(1), 5-13.

Rubin, Stanford E. & Roessler, Richard T. (2008). Foundations of vocational rehabilitation

process, Sixth Edition. Austin, TX: Pro.ed publishing

Shaw, Lynn., MacKinnon, Joyce., McWilliam, Carol., and Sumsion, Thelma. (2004). Consumer

participation in the employment rehabilitation process: Contextual factors and

implications for practice. Work: A Journal of Prevention, Assessment and Rehabilitation,

23(3), 181-192.

Stein, Michael Ashley. & Stein, Penelope J.S. (2006-2007). Beyond disability civil rights.

Hastings Law Journal, 58, 1203 MY PROFESSIONAL PORTFOLIO 16