Counseling interventions are considered a resource to support full functioning and participation of people with disabilities in their communities or specified environments of choice. The World Health Organization’s (WHO) International Classification of Functioning, Disability and Health (ICF) considers disability to result from a person with a health condition’s interaction with his or her environment where a person is restricted in his or her ability to engage in activities typical of others in the same or a similar environment. The functions of an individual with a disability are impaired by any disease, disorder, or health condition, and the severity of impairment contributes to the extent of disability or activity restrictions. The environment can enable or hamper participation. For example, an enabling environment for a person with mobility limitations would include access to mobility aids while, by contrast, environmental barriers would include inaccessible buildings. Additional limiting factors such as negative attitudes, stigma, and power relations arise from social environments, and these factors often influence the organization of and delivery of support services. Persons with disabilities are restricted from activities typically open to others by environmental restrictions more than by the objective qualities of their specific disability. This raises the question whether persons with disabilities need counseling, and if they do, (a) what the rationale is for providing counseling services, and (b) what would the counseling address.
历史考虑
残疾人是并且从历史上一直被剥夺了社会文化压迫的少数群体的认可,这是由于对通常发展他人的活动的限制和普通的生活方式。例如,由于对他们负面的社会偏见,残疾人与通常发展其他人相比,无法使用基本社会便利。由于与残疾相关的差异(例如,无能,贫穷,苦难),它们也倾向于在社会文化上处于不利地位和归因于负面特征。
Sociocultural Deprivation
从历史上看,出于(a)化妆品原因被认为是一种不愉快的视线,应保护无残障人士的原因,(b)政治原因是因为他们被剥夺了基本的人类和公民身份,以及政治原因(c)从某种意义上说,文化原因是他们的生活经历和需求被认为与普通人的生活和需求太大,无法保证社会关注。种族灭绝行为还针对残疾人,因为他们可以在未经同意的情况下被cast割,并剥夺了结婚或繁殖的权利。慈善组织也将残疾人视为商品,其中一些人通过营销残疾人的未满足需求为其创始人和董事带来了财富。对于这个人群,咨询很少是对他们在社区中的作用和功能有很大矛盾的选择。
Influence of Disability Rights Movements
With the internationalization of civil rights for cultural minorities, persons with disabilities were perceived by the civic community, state, and federal governments to benefit from counseling that would enable their participation to the extent possible in typical activities and environments for others. Disability rights movements resulted in several national laws and international conventions to enable people with disabilities in their entitlement to equal and fair access to resources and a preferred life style. It may seem paradoxical that people with disabilities are regarded as in need of counseling when the evidence suggests that they are victims of societal oppression.
Goals
Counseling may enhance a sense of personal and environmental control in people with disabilities by helping them (a) identify the particular goals they seek to achieve and the methods of achieving them, (b) access the resources in the environment that they may need in order to achieve their self-selected goals, and (c) learn more effective self-management skills. Counseling approaches for people with disabilities need to consider that disability is not an intrinsic feature of the individual, but the result of interactions with his or her environment. There are no universal counseling needs or processes that will address the counseling needs of people with disabilities in their diversity. However, the WHO ICF provided guidelines on functioning with disability, including types of domains of activity restriction and participation in nine areas of health and well-being.
Guidelines
WHO ICF指南可以考虑到社会和身体环境因素,从而确定与残疾相关类型的活动或参与限制类型。一些咨询专业人员认为,WHO ICF指南为残疾人的咨询需求提供了一个实用框架。例如,抑郁症的心理障碍可以通过自我隔离来限制与他人互动的机会。其他人可能会否定地感知自我隔离,从而增加了在社会环境中避免或拒绝社会孤立的人的机会。社会隔离和社会拒绝的循环可能会陷入更严重的抑郁,焦虑,学习的无助和咨询是一种资源的消极性。
Influences
残疾人的咨询需求也可能取决于特定的残疾类型。与稳定的残疾相比,诸如肾衰竭之类的慢性疾病(例如肾衰竭)的残疾提出了独特的咨询需求。与慢性肾衰竭相关的透析治疗的需求通常会导致对常规或典型生活方式和选择的严重破坏。常规通过增强对环境的控制感增加了生活的可预测性。一些残疾与慢性健康状况有关,并表达不可预测的症状,这将对个人管理生活的方式构成重大挑战。例如,精神疾病患者可能会出现严重症状和/或精神疾病持续症状的急性阶段,这些症状往往会破坏其生活中的大多数方面。许多人面临着使社会表现出的态度污名化的额外挑战。相比之下,诸如治愈截肢之类的稳定残疾可能会带来不同的挑战。因此,残疾人的咨询需求取决于个人,环境和与残疾相关的特征之间相互作用的影响或产物;(b)环境,残疾和个人因素的相对严重程度。
Future Directions
残疾人的咨询需求是那些能够使他们能够对自己的生活更加控制的人。个人的特定咨询需求受到个人,残疾类型和环境特征的影响,并且这些特征的影响通常是相互关联的。在个人,环境和残疾类型因素背景下考虑残疾的WHO ICF框架与了解残疾人的咨询需求特别相关。
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